Journal of Perinatology最新文献_第2页

Urinary tract infection in the neonatal intensive care unit. 新生儿重症监护病房的尿路感染。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-29 DOI: 10.1038/s41372-026-02690-1

Jacqueline Magers, Alexandra Burton, Pavel Prusakov, Natalie O White, Randy R Miller, Richard Moraille, Anthony R Theile, Pablo J Sánchez

{"title":"Urinary tract infection in the neonatal intensive care unit.","authors":"Jacqueline Magers, Alexandra Burton, Pavel Prusakov, Natalie O White, Randy R Miller, Richard Moraille, Anthony R Theile, Pablo J Sánchez","doi":"10.1038/s41372-026-02690-1","DOIUrl":"https://doi.org/10.1038/s41372-026-02690-1","url":null,"abstract":"Objective: To determine adherence and safety of a diagnostic (culture, urinalysis) and therapeutic (5-day antibiotic course with a time-out) guideline for urinary tract infection (UTI) in the Neonatal Intensive Care Unit STUDY DESIGN: Prospective surveillance of non-bacteremic UTIs from 11/2020-12/2022. Safety outcomes were defined by re-initiation of antibiotics within 7 days for a subsequent UTI due to the same organism and overall and UTI-related mortality.Results: 77 infants received treatment for 93 UTIs with 77% (72/93) adherence to diagnostic criteria; 90% (82/91) of infants received ≤6 days of definitive treatment (median [IQR] antibiotic duration 5 [5-6] days). Antibiotics were restarted within 7 days for a recurrent (same organism) UTI in 1/91 (1%) UTIs. Mortality was 4% (4/93); none were due to UTI.Conclusion: Adherence to diagnostic UTI criteria was 77%. 90% of infants received short course treatment that was associated with a 1% failure rate. No safety concern was identified.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774514","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}

引用次数: 0

Tiny doses, big impact: Optimizing sedation weaning to reduce opioid use in a Level IV NICU. 小剂量，大影响：优化镇静脱机以减少IV级NICU中阿片类药物的使用。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-29 DOI: 10.1038/s41372-026-02630-z

Tara Glenn, Jeanne Carroll, Amy Kimball, Mark Speziale, Gale Romanowski, Nona Chamankhah, Halli Helgeson, Elaine Sim, Jennifer Kimmel, Jane Kang, Amie Wong, Peggy Grimm, Michael Van Gorder, Danielle Heath, Laurel Moyer

{"title":"Tiny doses, big impact: Optimizing sedation weaning to reduce opioid use in a Level IV NICU.","authors":"Tara Glenn, Jeanne Carroll, Amy Kimball, Mark Speziale, Gale Romanowski, Nona Chamankhah, Halli Helgeson, Elaine Sim, Jennifer Kimmel, Jane Kang, Amie Wong, Peggy Grimm, Michael Van Gorder, Danielle Heath, Laurel Moyer","doi":"10.1038/s41372-026-02630-z","DOIUrl":"https://doi.org/10.1038/s41372-026-02630-z","url":null,"abstract":"Objective: Infants in the NICU often require prolonged sedation, increasing risk for iatrogenic withdrawal. We aimed to reduce mean opioid exposure by 20% (26 to 21 days) by May 2023, with sustained improvement through May 2024.Study design: A multidisciplinary team used the Model for Improvement with iterative Plan-Do-Study-Act cycles and EHR tools to implement a standardized sedation-weaning guideline. Applicable outcome, process, and balancing measures were analyzed using statistical process control charts.Results: Among patients receiving >4 days of opioids, mean exposure decreased from 26 to 17 days, length of stay from 70 to 50 days; and overall dexmedetomidine exposure from 18 to 12 days. Adherence to individualized weaning plans improved and feedback indicated effective withdrawal management.Conclusions: Standardized weaning reduced opioid exposure, LOS, and sedative use, enhancing safety, care quality, and NICU capacity.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774500","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}

引用次数: 0

Incidence and factors associated with dysphagia in infants born very preterm or very low birth weight. 极早产或极低出生体重婴儿吞咽困难的发生率及相关因素。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-29 DOI: 10.1038/s41372-026-02701-1

Jenny Reynolds, Mustafa Suterwala, Sujata Desai, Arpitha Chiruvolu

{"title":"Incidence and factors associated with dysphagia in infants born very preterm or very low birth weight.","authors":"Jenny Reynolds, Mustafa Suterwala, Sujata Desai, Arpitha Chiruvolu","doi":"10.1038/s41372-026-02701-1","DOIUrl":"https://doi.org/10.1038/s41372-026-02701-1","url":null,"abstract":"Objective: To determine the incidence of dysphagia and define the associated co-morbidities in infants born very preterm (VP) or very low birth weight (VLBW).Study design: This is a retrospective cohort study evaluating 158 VP or VLBW infants born over two years. Forty infants diagnosed with dysphagia confirmed by flexible endoscopic evaluation of swallowing were compared to 118 infants with no dysphagia.Results: The incidence of dysphagia was 25%. After adjusting for gestational age and birth weight, dysphagia was associated with morbidities such as necrotizing enterocolitis, bronchopulmonary dysplasia, and intracranial hemorrhage. Regression analyses indicated that dysphagia was associated with higher central line days and longer hospital length of stay. Feeds were thickened in 38 infants (95%) before discharge and 3 infants (7.5%) needed gastrostomy tube.Conclusion: Dysphagia is an important morbidity affecting a quarter of the infants born VP or VLBW. Significant associations with other major morbidities were noted.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774435","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}

引用次数: 0

Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan. 接受纯母乳饮食的极低出生体重婴儿的生长和安全性评估：日本的一项III期随机对照试验

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-27 DOI: 10.1038/s41372-026-02695-w

Katsumi Mizuno, Tokuo Miyazawa, Utako Kondo, Toshiya Nishikubo, Yutaka Yamamoto, Yuya Nakano, Takehiko Hiroma, Kazushige Ikeda, Masahiko Murase, Hitomi Jimi, Isamu Hokuto, Masafumi Miyata

{"title":"Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan.","authors":"Katsumi Mizuno, Tokuo Miyazawa, Utako Kondo, Toshiya Nishikubo, Yutaka Yamamoto, Yuya Nakano, Takehiko Hiroma, Kazushige Ikeda, Masahiko Murase, Hitomi Jimi, Isamu Hokuto, Masafumi Miyata","doi":"10.1038/s41372-026-02695-w","DOIUrl":"https://doi.org/10.1038/s41372-026-02695-w","url":null,"abstract":"Objective: To determine safety and efficacy of exclusive human milk diet (EHMD) for very low birth weight (VLBW, <1500 g) infants.Design: Prospective, controlled, open trial of VLBW infants randomized to EHMD (mother's own milk [MOM]/donor milk [DM] with human milk-based fortifiers) or Standard Diet (MOM/DM with cow milk-based fortifier/formula). Outcomes included superiority of weight gain velocity from birth to 34 weeks gestational age, time to full feeds, and safety.Result: In total, 147 infants received EHMD (n = 77) or Standard Diet (n = 70). The EHMD group had superior mean weight gain velocity versus the Standard Diet (13.44 vs 11.96 g/kg/day, p = 0.006) and earlier mean time to full feeds (20.0 vs 25.9 days, p = 0.03); adverse events were not significantly different (32.5% vs 21.4%, p = 0.13).Conclusion: EHMD is viable for management of VLBW infants, providing improved growth without reduced safety.Trial registration and id: Japan Registry of Clinical Trials: jRCT2031210384.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774388","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}

引用次数: 0

Bilirubin rate of rise during routine 6-h transcutaneous bilirubin surveillance. 常规6小时经皮胆红素监测期间胆红素上升率。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-27 DOI: 10.1038/s41372-026-02694-x

Sameer Yaseen Al-Abdi

{"title":"Bilirubin rate of rise during routine 6-h transcutaneous bilirubin surveillance.","authors":"Sameer Yaseen Al-Abdi","doi":"10.1038/s41372-026-02694-x","DOIUrl":"https://doi.org/10.1038/s41372-026-02694-x","url":null,"abstract":"Objective: To evaluate the impact of routine 6-h transcutaneous bilirubin (TcB) surveillance on bilirubin rate-of-rise (ROR) values meeting American Academy of Pediatrics (AAP) age-specific cut-points.Study design: Retrospective cohort study of healthy newborns ( ≥ 35 weeks' gestation, ≥2.0 kg) undergoing routine 6-h TcB monitoring during birth hospitalization. ROR was calculated from consecutive TcB pairs and assessed as a screening test for selected hemolytic hyperbilirubinemia neurotoxicity risk factors (HNRFs).Results: Among 621 newborns (3787 TcB measurements), 71.8% had ≥1 AAP ROR cut-point. Nearly one-quarter of these events were preceded by a negative slope, indicating frequently variable TcB trajectories. Extending surveillance from 6 to 12 h reduced the odds of AAP ROR cut-points by ~60%. As a screening test for HNRFs, AAP ROR cut-points demonstrated moderate sensitivity (73%) but low specificity (28%).Conclusions: Routine 6-h TcB surveillance yields frequent AAP ROR cut-points with poor HNRF specificity, limiting short-interval ROR clinical utility.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774377","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}

引用次数: 0

Self-reported positive health outcomes during the COVID-19 pandemic among adolescents born preterm in the ECHO cohort. ECHO队列中早产青少年在COVID-19大流行期间自我报告的积极健康结果

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-27 DOI: 10.1038/s41372-026-02684-z

Elisabeth C McGowan, Monica McGrath, Andrew Law, T Michael O'Shea, Courtney K Blackwell, Judy Aschner, Jody M Ganiban, Rosemary D Higgins, Genevieve L Taylor, Nicole T Spillane, Mark L Hudak, Carlos A Camargo, Maria M Talavera-Barber, Barry M Lester

{"title":"Self-reported positive health outcomes during the COVID-19 pandemic among adolescents born preterm in the ECHO cohort.","authors":"Elisabeth C McGowan, Monica McGrath, Andrew Law, T Michael O'Shea, Courtney K Blackwell, Judy Aschner, Jody M Ganiban, Rosemary D Higgins, Genevieve L Taylor, Nicole T Spillane, Mark L Hudak, Carlos A Camargo, Maria M Talavera-Barber, Barry M Lester","doi":"10.1038/s41372-026-02684-z","DOIUrl":"https://doi.org/10.1038/s41372-026-02684-z","url":null,"abstract":"Objective: To investigate positive health perceptions during the COVID-19 pandemic of adolescents born preterm (<37 weeks' gestation).Study design: The study population included 4093 mother-child dyads from 38 pediatric cohort sites. The study used generalized estimating equations to evaluate positive health among adolescents born preterm versus term while controlling for age and date of questionnaire completion, child sex, maternal education, and site.Results: 691 individuals born preterm were compared with 3402 individuals born term. In adjusted analyses, adolescents born <28 weeks' gestation (n = 359) had higher life satisfaction (β = 2.95, 95% CI: 2.46, 3.44) and meaning and purpose (β = 2.26, 95% CI 0.73, 3.79) scores than those born at term.Conclusion: During the pandemic, adolescents born <28 weeks had a more positive outlook on their well-being than their term-born peers. Confirming findings and uncovering supportive factors that augment positive health perceptions may optimize long-term health and resiliency.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral care with human milk is associated with increased human milk feeding and breastfeeding for newborns with critical congenital heart disease. 人乳口腔护理与重症先天性心脏病新生儿母乳喂养和母乳喂养增加有关。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-27 DOI: 10.1038/s41372-026-02698-7

Kristin M Elgersma, Nancy L Slater, Kimberly Watkins, Lynn R Tanner, Nellie M Swanson, Sara E Ramel

{"title":"Oral care with human milk is associated with increased human milk feeding and breastfeeding for newborns with critical congenital heart disease.","authors":"Kristin M Elgersma, Nancy L Slater, Kimberly Watkins, Lynn R Tanner, Nellie M Swanson, Sara E Ramel","doi":"10.1038/s41372-026-02698-7","DOIUrl":"https://doi.org/10.1038/s41372-026-02698-7","url":null,"abstract":"Objective: Describe the prevalence of oral care with human milk (OHM) for infants with critical congenital heart disease (CCHD) and estimate the effect of early OHM (1st postnatal week) on lactation outcomes.Study design: Retrospective cohort including infants with CCHD from 2014-2023. Adjusted regression estimated effects of early OHM frequency (quartiles (Q); Q1 = 0-1 OHM doses, Q2 = 2-6, Q3 = 7-13, Q4 ≥ 14) on human milk intake and breastfeeding (BF) at discharge.Result: For 297 infants ≤6 months old, OHM comprised 25.5% of oral care. Early OHM frequency was associated with 42.67-57.03 mL/kg/d higher human milk intake (p < 0.001 for Q2-4 compared to Q1), and 4.7-6.03 greater odds of BF (p < 0.01 for Q2-4) at discharge.Conclusion: Increased early OHM frequency was strongly associated with lactation outcomes for newborns with CCHD. OHM may support human milk/BF exposure in this vulnerable population.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774529","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}

引用次数: 0

The role of early administration of erythropoiesis-stimulating agents in preterm neonatal neuroprotection: a systematic review and meta-analysis. 早期给药促红细胞生成素在早产儿神经保护中的作用：一项系统回顾和荟萃分析。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-24 DOI: 10.1038/s41372-026-02700-2

Maria Argyropoulou, Eleftheria Fotopoulou, Dimitra Kousi, Tania Siahanidou

{"title":"The role of early administration of erythropoiesis-stimulating agents in preterm neonatal neuroprotection: a systematic review and meta-analysis.","authors":"Maria Argyropoulou, Eleftheria Fotopoulou, Dimitra Kousi, Tania Siahanidou","doi":"10.1038/s41372-026-02700-2","DOIUrl":"https://doi.org/10.1038/s41372-026-02700-2","url":null,"abstract":"Background: Prematurity remains a leading cause of neonatal mortality and morbidity; with neurodevelopmental disorders among its most significant complications. Erythropoiesis-stimulating agents (ESAs) have been explored for their neuroprotective potential.Objective: To evaluate whether early prophylactic administration of ESAs in preterm neonates ( < 37 weeks' gestation) improves neurodevelopmental outcomes up to 36 months of age.Study design: A systematic search of MEDLINE, Embase, Cochrane Library, and ICTRP identified 1142 studies, of which ten met the inclusion criteria. The meta-analysis included only randomized control trials (RCTs) reporting Bayley Scales of Infant Development scores or cerebral palsy diagnosis.Results: Among the ten included studies (eight RCTs, two retrospective cohorts), comprising 2861 preterm infants, narrative synthesis was inconclusive. Meta-analysis showed reduced odds of adverse cognitive outcomes (OR: 0.55; 95% CI: 0.35-0.85), and cerebral palsy (OR: 0.66; 95% CI: 0.45-0.97) in ESA-treated group, with no evidence of publication bias. Sensitivity analyses indicated potential fragility of pooled estimates.Conclusion: Εarly ESAs administration may provide cognitive benefits. Standardized methodologies and longer-term studies are needed to confirm neurodevelopmental effects and clinical relevance.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774536","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}

引用次数: 0

Neonatal management and outcomes in the setting of disseminated coccidioidomycosis in pregnancy. 妊娠播散性球孢子菌病的新生儿管理和结局。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-23 DOI: 10.1038/s41372-026-02659-0

Daphne O Darmawan, Roshni Mathew, Anca M Pasca, Natali Aziz, Xiaoming Zhang, Shanthi Kappagoda, Anne R Waldrop, Metabel Markwei, Lauren E O'Brien

{"title":"Neonatal management and outcomes in the setting of disseminated coccidioidomycosis in pregnancy.","authors":"Daphne O Darmawan, Roshni Mathew, Anca M Pasca, Natali Aziz, Xiaoming Zhang, Shanthi Kappagoda, Anne R Waldrop, Metabel Markwei, Lauren E O'Brien","doi":"10.1038/s41372-026-02659-0","DOIUrl":"https://doi.org/10.1038/s41372-026-02659-0","url":null,"abstract":"Coccidioidomycosis is a dimorphic fungal infection endemic to the southwestern United States and parts of the Americas. Pregnant individuals have an increased risk of disseminated disease, yet the diagnosis and management of neonatal coccidioidomycosis remain poorly defined. Neonatal coccidioidomycosis is rare but associated with significant morbidity and mortality. Transmission may occur via transplacental spread, aspiration of infected decidua at delivery, or early postnatal exposure. Diagnosis is challenging due to overlapping signs with prematurity and limitations of current serologic, antigen-based, and molecular assays. Placental pathology can provide insight, but does not reliably predict neonatal infection. Herein, we review the current literature on neonatal coccidioidomycosis and propose a risk-stratified, multidisciplinary approach to the evaluation and management of at-risk neonates, using illustrative cases to demonstrate the challenges of diagnosis and management. This practical approach includes maternal history, placental evaluation, targeted neonatal testing, and consideration of empiric antifungal therapy.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774518","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}

引用次数: 0

Decreasing packed red blood cell (pRBC) transfusions in neonates through quality improvement. 通过改善质量来减少新生儿充血性红细胞（pRBC）输注。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2026-04-23 DOI: 10.1038/s41372-026-02699-6

Valerie Elberson, Kavya Rao, Sheetal Chepuri, Praveen Chandrasekharan

引用次数: 0