{"title":"Neurodevelopmental outcomes at age 3 years of preterm infants born at 22-31 weeks' gestation.","authors":"Yumi Kono, Satoshi Kusuda, Toshihiko Nishida, Rintaro Mori, Katsuaki Toyoshima, Hatoko Sasaki, Naohiro Yonemoto, Atsushi Uchiyama, Masanori Fujimura","doi":"10.1038/s41372-025-02268-3","DOIUrl":"https://doi.org/10.1038/s41372-025-02268-3","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate neurodevelopmental outcomes of very preterm infants by gestational age (GA) using high follow-up rate data.</p><p><strong>Study design: </strong>This secondary analysis included infants born before 32 weeks' gestation in 2012-2014 from the Improvement of NICU practices and Team Approach Cluster randomized controlled Trial (INTACT). The primary outcome was survival without moderate or severe neurodevelopmental impairment (NDI).</p><p><strong>Results: </strong>Among 2722 infants, NICU survival rate was 96.5%, ranging 72.1-99.6% at 22-31 weeks. At age three years, 2336 (89.5% of 2610 survivors) were completely assessed; 303 had moderate NDI and 183 had severe NDI. Of these, the proportions of infants surviving without NDI increased with GA; 45.2% at 22 weeks, 57.5% at 23 weeks, 88.1% at 31 weeks.</p><p><strong>Conclusion: </strong>Although survival without NDI varied by GA, more than half (55.0%, 83/151) of infants born at 22-23 weeks who survived to age three years were without neurodevelopmental sequelae.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The fifty billion dollar question: does formula cause necrotizing enterocolitis?","authors":"Mark A Underwood","doi":"10.1038/s41372-025-02277-2","DOIUrl":"10.1038/s41372-025-02277-2","url":null,"abstract":"<p><p>The question of whether preterm infant formulas cause necrotizing enterocolitis (NEC) is the subject of multiple lawsuits and has daily relevance in the care of preterm infants. Research supporting the hypothesis that toxic components in infant formula cause NEC is limited to preclinical data while data from human infants are lacking. Human milk should be the first choice for most preterm infants, however, preterm infant formula is at times a critical alternative. It is the absence of human milk that increases NEC risk rather than toxic components in preterm infant formula.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Erzinger, Mateus de Miranda Gauza, Silvia M Cardoso
{"title":"Response to the letter.","authors":"Gabriel Erzinger, Mateus de Miranda Gauza, Silvia M Cardoso","doi":"10.1038/s41372-025-02272-7","DOIUrl":"https://doi.org/10.1038/s41372-025-02272-7","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anup Katheria, Felix Ines, Judith Hough, Wade Rich, Ana Morales, Shashank Sanjay, Debra Poeltler, Neil Finer
{"title":"Changes in lung aeration with high-flow nasal cannula compared to nasal CPAP in preterm infants.","authors":"Anup Katheria, Felix Ines, Judith Hough, Wade Rich, Ana Morales, Shashank Sanjay, Debra Poeltler, Neil Finer","doi":"10.1038/s41372-025-02267-4","DOIUrl":"https://doi.org/10.1038/s41372-025-02267-4","url":null,"abstract":"<p><strong>Objective: </strong>To compare the degree of atelectasis in preterm infants on nasal continuous airway pressure (nCPAP) versus high-flow nasal cannula (HFNC) at 8 L/min.</p><p><strong>Study design: </strong>A cross-over study of infants <29 weeks gestational age (GA) receiving nCPAP and underwent 6-hours of HFNC at 8 L/min before returning to nCPAP. Electrical Impedance Tomography was used to measure lung aeration.</p><p><strong>Results: </strong>78 infants with median GA of 27 weeks [26, 28] were studied. HFNC was non-inferior to CPAP across the 4 periods (overall mean 2.1 ± 2.9, lower bound of confidence interval -0.9). Infants that failed HFNC had higher dependent silent spaces (DSS) measurements (1.6[0.48, 4.7] vs 0.30[0.0, 2.7], P = 0.046).</p><p><strong>Conclusion: </strong>This study of premature infants <29 weeks GA at birth demonstrated that HFNC was non-inferior to nCPAP as measured by DSS. Infants that failed HFNC had a higher percentage of DSS than those who tolerated HFNC for 6 hours suggesting decreased lung aeration.</p><p><strong>Clinicaltrials: </strong>gov ID: NCT03700606.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline G Borden, Veronika Shabanova, Sarah N Taylor, Catherine O Buck
{"title":"Alterations in infant adipokine concentrations in the first postnatal week with exposure to diabetes in pregnancy.","authors":"Caroline G Borden, Veronika Shabanova, Sarah N Taylor, Catherine O Buck","doi":"10.1038/s41372-025-02269-2","DOIUrl":"10.1038/s41372-025-02269-2","url":null,"abstract":"<p><strong>Objective: </strong>Characterize changes in neonatal energy metabolism hormones in first postnatal week.</p><p><strong>Study design: </strong>Concentrations of leptin, adiponectin, insulin, resistin, and ghrelin were measured in cord and infant blood collected in the first postnatal week in a prospective cohort of term and preterm infants. Change over time in each hormone was modeled using linear mixed effects regression.</p><p><strong>Result: </strong>Among 106 infants, 65 (61%) were preterm and 44 (42%) were exposed to diabetes (DM) in pregnancy. DM group had higher leptin [between group difference β 2.5 (95%CI: 1.72-3.70)] and resistin [β 1.5 (95%CI:1.14, 1.92)] and lower ghrelin [β 0.49] [95%CI: (0.32-0.76)] versus non-DM group. Preterm infants had lower adiponectin [β 0.80 (95%CI: 0.67-0.96)] versus term group. Insulin varied by DM and prematurity (interaction-term p value < 0.05).</p><p><strong>Conclusion: </strong>In this cohort, hormone concentrations varied by DM and prematurity. Early alterations in energy metabolism hormones may reflect changes in developmental programming which persist in the early postnatal period.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heidi J Steflik, Matthew W Harer, David T Selewski, Michelle C Starr
{"title":"What's next in neonatal acute kidney injury? Discussion from the pediatric academic society neonatal nephrology focus group.","authors":"Heidi J Steflik, Matthew W Harer, David T Selewski, Michelle C Starr","doi":"10.1038/s41372-025-02263-8","DOIUrl":"https://doi.org/10.1038/s41372-025-02263-8","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazuki Nishizawa, Yoshinori Katayama, Yong-Kye Lee
{"title":"Unbound bilirubin and bilirubin-albumin binding levels of Japanese neonates.","authors":"Kazuki Nishizawa, Yoshinori Katayama, Yong-Kye Lee","doi":"10.1038/s41372-025-02266-5","DOIUrl":"https://doi.org/10.1038/s41372-025-02266-5","url":null,"abstract":"<p><strong>Objective: </strong>To determine postnatal changes in total serum bilirubin (TB), unbound bilirubin (UB), and bilirubin-binding affinity of albumin (Ka) among Japanese newborns.</p><p><strong>Study design: </strong>In a retrospective study, we evaluated for serum TB, UB, and albumin (Alb) levels, and their calculated UB/TB ratios, and Ka in 786 neonates born ≥36 weeks' gestation and analyzed to subcategories of three postnatal epochs: first, second, and ≥third weeks.</p><p><strong>Result: </strong>TB levels were significantly higher (p < 0.01) at age ≥three weeks, while UB levels were significantly higher (p < 0.01) in the first week. UB/TB ratios were significantly lower while calculated Ka values were significantly higher as age-in-weeks increased (p < 0.01).</p><p><strong>Conclusion: </strong>Hyperbilirubinemia in the first and second weeks of age in neonates born ≥36 weeks' gestation is associated with higher UB levels or UB/TB ratios with lower Ka and may potentially contribute to the risk of developing bilirubin neurotoxicity with aggravated variations in bilirubin, albumin and Ka.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew J Drago, Gabriella Raviv, Andrea Weintraub, Katherine Guttmann
{"title":"Maternal fetal medicine, obstetric, and neonatology perspectives on joint prenatal counseling at periviable gestational ages.","authors":"Matthew J Drago, Gabriella Raviv, Andrea Weintraub, Katherine Guttmann","doi":"10.1038/s41372-025-02260-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02260-x","url":null,"abstract":"<p><strong>Objective: </strong>To explore perspectives of maternal fetal medicine specialists (MFMs), obstetricians (OBs), and neonatologists (Neos) about antenatal counseling at periviable gestational ages and examine how those perceptions impact multidisciplinary counseling.</p><p><strong>Study design: </strong>Semi-structured interviews were conducted and thematic analysis performed until thematic saturation.</p><p><strong>Results: </strong>Interviews of 7 Neos and 8 OB/MFMs identified three themes: (1) roles in periviability counseling; (2) training and lifelong learning to develop/enhance communication skills; and (3) managing interdisciplinary dynamics. Participants agreed on consult content and the appropriate subspecialist to discuss specific topics but differed in their approaches. Subspecialty perspectives differed on resuscitation, survival, and developmental outcomes. Formal communication skills training was identified as a means to scaffold conversations into a uniform approach.</p><p><strong>Conclusion: </strong>Despite near universal agreement that joint perviability counseling would be beneficial, logistical barriers and lack of a shared framework may hinder its implementation. Formal communication skills training may support organized joint counseling.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Narendra Dereddy, Deborah Ruth, Jianbin Zhu, Julie Pepe, William Oh
{"title":"Insensible water loss in extremely preterm infants cared for in incubators with 70% and 90% relative humidity.","authors":"Narendra Dereddy, Deborah Ruth, Jianbin Zhu, Julie Pepe, William Oh","doi":"10.1038/s41372-025-02261-w","DOIUrl":"https://doi.org/10.1038/s41372-025-02261-w","url":null,"abstract":"<p><strong>Objective: </strong>To determine the insensible water losses (IWL) in preterm infants cared for in incubators with 70% or 90% relative humidity (RH).</p><p><strong>Study design: </strong>This was a single center retrospective study of extremely preterm infants between 22- and 28-weeks gestational ages nursed in 70% and 90% RH. IWL was calculated using a formula that utilized infants' fluid intake, urine output and body weight changes. IWL between the two groups were compared using independent t-test. Multivariate linear regression was used to assess the effects of humidity on IWL after adjusting for confounding variables.</p><p><strong>Results: </strong>IWL was higher in infants nursed in 70% RH when compared with those nursed in 90% RH (47.7 ± 30.3 vs. 28.8 ± 39.6, p = 002). Multivariate linear regression analysis showed that RH has an independent effect on the insensible water loss.</p><p><strong>Conclusion: </strong>Extremely preterm infants nursed in incubator with 70% RH have higher IWL than infants nursed in 90% RH.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mark F Weems, Molly K Ball, Isabella Zaniletti, Sharifa Habib, Shannon Hamrick, Theresa R Grover, Sarah Keene, Karna Murthy, Michael Padula, Ranjit Philip, Rakesh Rao, Shawn Sen, Philip T Levy, Sharada H Gowda
{"title":"Management of the patent ductus arteriosus among infants born at 23 to 32 weeks' gestation between 2011 to 2022: a report from in the Children's Hospitals Neonatal Consortium.","authors":"Mark F Weems, Molly K Ball, Isabella Zaniletti, Sharifa Habib, Shannon Hamrick, Theresa R Grover, Sarah Keene, Karna Murthy, Michael Padula, Ranjit Philip, Rakesh Rao, Shawn Sen, Philip T Levy, Sharada H Gowda","doi":"10.1038/s41372-025-02257-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02257-6","url":null,"abstract":"<p><strong>Objective: </strong>This study reports on patent ductus arteriosus (PDA) therapy trends across the Children's Hospital Neonatal Consortium.</p><p><strong>Study design: </strong>We performed a 12-year (2011-2022) retrospective study of premature infants (< 33 weeks) with a PDA. We utilized descriptive statistics to compare demographic, inpatient, and discharge characteristics in 3-year epochs.</p><p><strong>Result: </strong>From 54,813 infants, 19,843 (36%) had a diagnosis of PDA. Use of pharmacotherapy increased 44% (relative) over time, mostly with increased acetaminophen use. There was a 12.7-fold increase in exposure to multiple PDA medications over the study period. While the rate of definitive closure did not change, use of transcatheter PDA closure increased from 0 to 20.3% and surgical ligation decreased from 25.1% to 3.6%.</p><p><strong>Conclusion: </strong>There has been an increase in the use of multiple pharmacotherapies for PDA, especially among infants born <27 weeks' gestation. Transcatheter PDA closure has overtaken surgical ligation as the primary method of definitive PDA closure.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}