Journal of Perinatology最新文献

{"title":"Comparison of prenatal self-report of tobacco use to direct measurement of umbilical cord cotinine.","authors":"E Melinda Mahabee-Gittens, Nicole Mack, Carla M Bann, Jamie E Newman, Hongying D Dai, Junfang Zhao, Kenneth D R Setchell, Lara Stone, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Sara B DeMauro, Scott A Lorch, Deanne E Wilson-Costello, Brenda B Poindexter, Catherine Limperopoulos, Jonathan M Davis, Stephanie L Merhar","doi":"10.1038/s41372-026-02902-8","DOIUrl":"https://doi.org/10.1038/s41372-026-02902-8","url":null,"abstract":"<p><strong>Objective: </strong>This study compared maternal self-reports of prenatal tobacco product use with biochemically confirmed cotinine in umbilical cord tissue in newborns exposed to opioids in utero and unexposed controls.</p><p><strong>Study design: </strong>Secondary data analysis on 179 pregnant women and newborns. Chi-square and t-tests were used to compare sociodemographic factors of those who did and did not self-report tobacco use.</p><p><strong>Results: </strong>Mean (SD) maternal age was 29.5 years (5.0); 85.2% had public insurance, and 92 (51.4%) took opioids prenatally. Ninety-five (53.1%) mothers self-reported prenatal tobacco product and/or e-cigarette use, with cord cotinine detected in 98.9%. Of the 84 reporting no use, cotinine detection was 34.5%, resulting in moderate agreement (Gwet's AC1 = 0.68 (0.571, 0.788), p < 0.001). Of those reporting no use, 27 (32.9%) had cotinine detected (p = 0.038).</p><p><strong>Conclusions: </strong>Biochemically verified cotinine detection was much higher than maternal self-reports of prenatal tobacco use. Inquiring about household and community smoke exposure may help inform optimal care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127915","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":"Urinary neutrophil gelatinase-associated lipocalin concentration: a baseline study for establishing reference ranges in preterm neonates.","authors":"Nicole F Asdell, Jonathan L Slaughter, Shivam Joshi, Elizabeth M Bonachea, Tahagod Mohamed","doi":"10.1038/s41372-026-02848-x","DOIUrl":"https://doi.org/10.1038/s41372-026-02848-x","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) affects up to 48% of extremely preterm neonates and is associated with significant morbidity and mortality. However, AKI diagnosis remains challenging in this population due to limitations of traditional markers like serum creatinine (Cr) and urine output. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has emerged as a promising biomarker for early AKI detection, but its clinical utility is hindered by a lack of normative reference ranges in preterm infants.</p><p><strong>Objective: </strong>To characterize baseline uNGAL concentrations during the first postnatal week in preterm neonates without AKI and evaluate associations with gestational age (GA) at birth, birth weight (BW), and sex.</p><p><strong>Methods: </strong>We conducted a cohort study of 100 neonates <32 weeks' gestation without AKI, necrotizing enterocolitis, sepsis, or urinary tract infection. uNGAL and uNGAL/uCr ratios were measured and analyzed by GA, birth weight, and sex.</p><p><strong>Results: </strong>Baseline uNGAL concentrations vary significantly by gestational age at birth, birth weight, and sex in preterm neonates during the first postnatal week.</p><p><strong>Conclusions: </strong>Baseline uNGAL varies significantly with GA, BW, and sex in preterm neonates. These findings support the development of gestational age- and sex-specific normative reference ranges to improve the interpretation and diagnostic utility of uNGAL for neonatal AKI.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127917","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 role of prophylactic arginine supplementation for prevention of bronchopulmonary dysplasia in extremely preterm infants.","authors":"Stefani M Doucette, Sunil Kumar Jain, Harish Amin, Amina Benlamri, Muhammad Hussain, Selphee Tang, Vineet Bhandari, Abhay Lodha","doi":"10.1038/s41372-026-02922-4","DOIUrl":"https://doi.org/10.1038/s41372-026-02922-4","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate association between routine arginine supplementation for the first 28 days of life and incidence of bronchopulmonary dysplasia (BPD) and mortality for preterm infants <29 weeks gestational age (GA).</p><p><strong>Study design: </strong>This retrospective cohort study assessed preterm infants <29 weeks' GA before and after introduction of routine prophylactic arginine supplementation for the first 28 days of life. The primary outcome was bronchopulmonary dysplasia (BPD), defined as oxygen dependency at 36 weeks' postmenstrual age (PMA) and classified by severity using Jensen's criteria. Univariate and multivariable regression analyses were performed.</p><p><strong>Results: </strong>Overall, 676 preterm infants <29 weeks GA were included. The incidence of any BPD decreased from 85% to 73% following introduction of routine arginine supplementation. The adjusted odds ratios (aORs) for any BPD and severe BPD (Grade 2 and 3) were 0.50 (95% CI 0.27-0.90) and 0.94 (95% CI 0.41-2.14), respectively. The composite outcome of BPD or mortality was also reduced (aOR 0.51; 95% CI 0.28-0.91).</p><p><strong>Conclusion: </strong>In preterm infants born at <29 weeks' GA, prophylactic arginine supplementation during the first 28 days of life was associated with reduced odds of BPD and the composite outcome of BPD or death before 36 weeks' PMA, but not with severe BPD.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127932","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":"Vascular device practices in extremely preterm infants: an international cross-sectional survey.","authors":"U Mishra, S de Souza, J Buchmayer, R Maheshwari, D D'Çruz, K Walker, D Gözen, K Lowe, A Wright, J Marceau, M Culcer, A Priyadarshi, J Moore, V Shah, U Vaidya, A Khashana, S Godambe, F C Cheah, W Zhou, X Hu, M Satardien, J Oei, D Shah, D August, P R Jani","doi":"10.1038/s41372-026-02892-7","DOIUrl":"https://doi.org/10.1038/s41372-026-02892-7","url":null,"abstract":"<p><strong>Objective: </strong>To explore global practices in vascular device selection, securement, and monitoring for extremely preterm infants, and to assess regional variation.</p><p><strong>Study design: </strong>A web-based cross-sectional survey was completed by one respondent per neonatal unit.</p><p><strong>Result: </strong>We received 848 responses from 100 countries. Guideline availability varied: 85-98% for umbilical venous catheters (UVCs) and 29-97% for peripheral intravenous catheters. UVCs were the preferred initial vascular device at 23 to 26 weeks (70% and 63%, respectively). Transparent film dressings for peripheral catheters and Wharton's jelly stitch for UVCs were the commonest securement methods. Peripherally inserted central catheter sites were assessed at intervals of < 8 h in 56% (434/780) units, and 58% (490/848) units did not use an extravasation injury detection tool. Guideline availability was two-fold higher in units caring for 22-23 vs 24-25 weeks' gestation.</p><p><strong>Conclusion: </strong>Significant global variation exists, highlighting the need for standardized, evidence-based vascular care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127854","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":"Association of atropine use during neonatal intubation with cardiac arrest, severe bradycardia, and other adverse events: a report from NEAR4NEOS.","authors":"Taylor Sawyer, Michael Narvey, Michelle D Tyler, Ayman Abou Mehrem, Sabine Iben, Cassandra DeMartino, David Tingay, Kate Hodgson, Jae Kim, Heidi Herrick, Jennifer Unrau, Mihai Puia-Dumitrescu, Rebecca Shay, Stephen DeMeo, Michael-Andrew Assaad, Joyce O'Shea, Ivana Brajkovic, Bin Huey Quek, Kristen Glass, Michael Wagner, Katharina Bibl, Jennifer Rumpel, Devin McKissic, Nicole Pouppirt, Paul Wildenhain, Natalie Napolitano, Justine Shults, Joseph Reiter, Elizabeth E Foglia, Akira Nishisaki","doi":"10.1038/s41372-026-02916-2","DOIUrl":"https://doi.org/10.1038/s41372-026-02916-2","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the association between atropine use during neonatal tracheal intubation (TI) and procedural safety and success.</p><p><strong>Study design: </strong>Retrospective multicenter cohort study of neonatal TIs in the NEAR4NEOS registry (2014-2023). Multivariable logistic regression assessed associations between atropine use and cardiac arrest (primary outcome), along with safety and procedural outcomes, adjusting for confounders.</p><p><strong>Results: </strong>Atropine was used in 8189 of 13,085 TIs (62.6%). It was not associated with reduced odds of cardiac arrest (aOR 0.52, 95% CI 0.25-1.09). Atropine use was associated with lower odds of severe bradycardia (aOR 0.33, 95% CI 0.26-0.41), but higher odds of oxygen desaturation (aOR 1.35, 95% CI 1.22-1.49) and lower first-attempt success (aOR 0.76, 95% CI 0.69-0.85).</p><p><strong>Conclusion: </strong>Atropine use during neonatal TI was not associated with reduced cardiac arrest. Although it reduced severe bradycardia, it was associated with increased desaturation and lower first-attempt success, warranting further study.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111206","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":"Artificial intelligence and digital technologies transforming neonatal respiratory assessment: a scoping review.","authors":"Simone Nascimento Santos Ribeiro, Maria Eduarda Ribeiro Rocha Vargas, Raquel de Carvalho Velame, Aline Elvina Rodrigues Fernandes, Marcos Aurélio Tavares Filho, Richardson Naves Leão, Helton Maia, Silvana Alves Pereira, Maria da Glória Rodrigues-Machado","doi":"10.1038/s41372-026-02894-5","DOIUrl":"https://doi.org/10.1038/s41372-026-02894-5","url":null,"abstract":"<p><p>Digital technologies and artificial intelligence (AI) have been increasingly incorporated into neonatal care, particularly in respiratory assessment. However, structured evidence regarding their clinical applications, performance, and limitations remains limited. This scoping review analyzed 35 studies published between 2019 and 2026 to map the use of digital technologies and AI in neonatal respiratory assessment. The findings showed that these approaches are mainly applied to predictive models, medical image analysis, and continuous physiological monitoring. Overall, the studies demonstrated potential for early diagnosis, prediction of respiratory outcomes, and clinical decision support. Nevertheless, the available evidence remains limited by methodological heterogeneity, lack of robust external validation, small sample sizes, and absence of protocol standardization. These findings suggest that, although promising, AI-based technologies are not yet ready for widespread clinical implementation, requiring prospective, multicenter, and standardized studies to validate their effectiveness and safety in neonatal care. IMPACT: This review synthesizes the use of digital technologies and artificial intelligence in neonatal respiratory assessment, highlighting their expanding role in neonatal respiratory research and clinical decision support. AI-based predictive models demonstrate potential for early identification of critical respiratory outcomes, including bronchopulmonary dysplasia and the need for mechanical ventilation. Imaging-based approaches, such as chest radiography and lung ultrasound combined with deep learning, may improve diagnostic accuracy and reduce interobserver variability. Digital monitoring technologies enable continuous, noninvasive, and real-time assessment of neonatal respiratory parameters. The lack of external validation, methodological standardization, and evidence of clinical impact limits their application, reinforcing the need for multicenter studies and structured integration of these technologies into clinical workflows.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111153","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":"Establishing reference intervals for fetal hemoglobin percentage from 23 to 40 weeks of gestation using refineR.","authors":"Bailey B Zeiler, Timothy M Bahr, Kelly Doyle, Rachel E Maxfield, Elizabeth F Stone, Joel L Addams, Robin K Ohls, Robert D Christensen","doi":"10.1038/s41372-026-02918-0","DOIUrl":"https://doi.org/10.1038/s41372-026-02918-0","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110548","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":"Hemolytic hyperbilirubinemia.","authors":"David L Schutzman","doi":"10.1038/s41372-026-02919-z","DOIUrl":"https://doi.org/10.1038/s41372-026-02919-z","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110639","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":"Development of consensus guidelines for classification of emergent neonatal transports using a Delphi process.","authors":"Luke Viehl, Elisabeth Anson, Vedanta Dariya, Daniel Dirnberger, Rebecca Martinez-Hannon, Tetyana Nesterenko, Shamik Trivedi, Samuel Wong, Kyong-Soon Lee","doi":"10.1038/s41372-026-02900-w","DOIUrl":"https://doi.org/10.1038/s41372-026-02900-w","url":null,"abstract":"<p><strong>Background: </strong>The transport of neonates to tertiary and quaternary neonatal intensive care units occurs frequently in North America, particularly for neonates requiring emergent intervention. The timely stabilization and transfer of a critically ill neonate requiring higher level of care is imperative for optimal clinical outcomes. There is no consensus on the definition of \"emergent\" related to dispatch of a transport team. However, some utilize a time frame of 30 minutes from referral center request based on illness severity and/or risk. Current definitions of illness severity and/or risk are institution-specific, lacking standardization. The development of consensus-driven guidelines for emergent neonatal transport criteria will provide a framework adaptable across diverse healthcare settings to standardize decision making, resulting in comparable data and outcome measures.</p><p><strong>Objective: </strong>The aim of this project is to develop expert consensus criteria for neonatal emergent interfacility transport.</p><p><strong>Design/methods: </strong>Following review of available literature and institution-specific guidelines and policies, a subset of neonatologists within the Children's Hospitals Neonatal Consortium (CHNC) Transport Focus Group compiled a proposed list of emergent neonatal criteria. These criteria were divided into three categories: (1) diagnosis, (2) clinical sign, or (3) specialized equipment and/or resources required. Using the Delphi process, CHNC transport leaders voted in two rounds for consensus.</p><p><strong>Results: </strong>Round 1 of surveys received responses from 31 of 49 (63%) CHNC sites and achieved 100% agreement on criteria, defined as >80% consensus of each criterion. Revisions and additions suggested by participants in Round 1 were incorporated into the Round 2 survey. Round 2 of surveys received responses from 40 of 49 (82%) CHNC sites and again received 100% agreement on criteria.</p><p><strong>Conclusion(s): </strong>All proposed conditions reached consensus for inclusion, falling into one of three major categories. Consensus-derived criteria for emergent neonatal transport will provide a standardized framework for triage, prioritization and resource utilization. Additionally, these guidelines should facilitate national and international benchmarking, improve efficiency and support neonatal outcome-based research across North America.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111142","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":"End tidal carbon monoxide and significant hemolysis.","authors":"David L Schutzman","doi":"10.1038/s41372-026-02921-5","DOIUrl":"https://doi.org/10.1038/s41372-026-02921-5","url":null,"abstract":"<p><p>The American Academy of Pediatrics identified significant hemolysis as a significant neurotoxic risk factor for newborns with jaundice in its 2022 guideline for managing hyperbilirubinemia. The guideline recommends starting phototherapy at a lower level than otherwise if significant hemolysis is present. Currently, the optimal way to measure hemolysis is by determining an infant's level of end-tidal carbon monoxide corrected for ambient carbon monoxide (ETCOc). However, it is unclear what the optimal ETCOc level is for determining significant hemolysis. Given the differences in ETCOc levels among infants of different backgrounds, the most reasonable conclusion would be for each unit to determine the mean ± standard deviation ETCOc level of an inclusive group of 200-500 infants in their unit. Each unit could then decide whether to use the 95th, 75th, or some other percentile value as their unit's indicator of significant hemolysis.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109815","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}