Neha S Joshi, Kenneth M Zangwill, Henry C Lee, Peter Mendel, Chau Pham, Megan Schuler, Nabeel Qureshi, Natalie Chapkis, Allison Henry, Kurlen S E Payton
{"title":"Factorial vignettes describe suspected early onset sepsis practice variation in a multicenter NICU antibiotic stewardship collaborative.","authors":"Neha S Joshi, Kenneth M Zangwill, Henry C Lee, Peter Mendel, Chau Pham, Megan Schuler, Nabeel Qureshi, Natalie Chapkis, Allison Henry, Kurlen S E Payton","doi":"10.1038/s41372-025-02325-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02325-x","url":null,"abstract":"<p><strong>Objective: </strong>To describe provider practice preferences for term infants with suspected early-onset sepsis and preference change over time during a multicenter antibiotic stewardship collaborative.</p><p><strong>Study design: </strong>Factorial case vignette surveys conducted at baseline of a quality improvement collaborative, and follow up after the 12 month collaborative intervention.</p><p><strong>Results: </strong>Baseline and follow up surveys were completed by 252 (72%) and 195 (55%) respondents, respectively. The results describe both areas of compliance and non-compliance with national guidelines. There was a reduction in likelihood of ordering laboratory testing between surveys (p values ranging <0.001-0.033). A stewardship score was calculated and the mean score moved towards more stewardship friendly practices (0.39 vs 0.30).</p><p><strong>Conclusion: </strong>We identified specific antibiotic use practice variations as potential targets for improving clinician prescribing practice in the NICU setting. Respondents moved towards more antibiotic stewardship friendly practices from baseline to the follow up survey. Vignettes methods may help optimize quality improvement.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216158","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2024-07-12DOI: 10.1038/s41372-024-02040-z
Timmy Ho, Nikita S Kalluri, Erika G Cordova-Ramos, Molly Fraust-Wylie, Margaret G Parker
{"title":"A national survey of NICU parents and neonatologists on 21st Century Cures Act awareness.","authors":"Timmy Ho, Nikita S Kalluri, Erika G Cordova-Ramos, Molly Fraust-Wylie, Margaret G Parker","doi":"10.1038/s41372-024-02040-z","DOIUrl":"10.1038/s41372-024-02040-z","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"857-858"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600256","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":"Interprofessional perspectives on non-invasive respiratory support practices in extremely preterm infants: a Canadian survey.","authors":"Tugba Alarcon Martinez, Elissa Remmer, Stephanie Mardakis, Marisa Leone, Johanne Boyer, Shasha Lv, Marc Beltempo, Guilherme Sant'Anna, Wissam Shalish","doi":"10.1038/s41372-025-02291-4","DOIUrl":"10.1038/s41372-025-02291-4","url":null,"abstract":"<p><strong>Objective: </strong>To describe barriers and strategies amongst healthcare professionals (HCP) for optimal non-invasive respiratory support (NRS) provision in extremely preterm infants.</p><p><strong>Study design: </strong>A cross-sectional web-based anonymized 19-question survey was sent to HCPs across Canadian tertiary care NICUs. The survey inquired about perspectives on NRS devices and management strategies, respiratory event monitoring, NRS failure, and possible solutions.</p><p><strong>Result: </strong>391 responses from 61 physicians, 173 nurses, and 147 respiratory therapists were analyzed. HCP perspectives varied regarding appropriateness of different NRS settings and interfaces, documentation of cardiorespiratory events, and prevention of NRS failure. Obtaining effective NRS was deemed challenging by 48% of HCPs. NRS training was deemed adequate by 89% of respiratory therapists and 78% of physicians, but only 56% of nurses.</p><p><strong>Conclusion: </strong>Substantial interprofessional variations exist in perceived benefits of various aspects of NRS. Better evidence on NRS modalities/settings, together with development of interdisciplinary guidelines and enhanced training, might reduce variability.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"806-811"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030901","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2024-11-15DOI: 10.1038/s41372-024-02165-1
Katharine P Callahan, Anup C Katheria, Thuy Mai Luu, Rebecca Pearce, Annie Janvier
{"title":"Integrating parent voices into research at the extremes of prematurity: what are we doing and where should we go?","authors":"Katharine P Callahan, Anup C Katheria, Thuy Mai Luu, Rebecca Pearce, Annie Janvier","doi":"10.1038/s41372-024-02165-1","DOIUrl":"10.1038/s41372-024-02165-1","url":null,"abstract":"<p><p>When a baby is born premature, a landscape of potential problems replaces an imagined future. Outcomes become the measures of success. Researchers are recognizing that we need the direct input of parents to select meaningful outcomes. In this article, we describe how researchers and clinicians in neonatology have historically defined outcomes and the limitations of these methods. We chart the integration of stakeholders-patients and parents-into outcomes selection. 'Parent-important outcomes' are those deemed most important by parents, as the voices of their children. We outline a path toward determining parent-important outcomes in neonatology through mixed methods research. We conclude by suggesting how parent-important outcomes can be integrated into neonatal follow up research and clinical trial design. Ultimately, all researchers of prematurity aim in some way to improve outcomes that parents and patients care about. We hope this article will remind us of this beacon.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"699-704"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639223","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2025-07-03DOI: 10.1038/s41372-025-02342-w
Stephanie M Teixeira-Poit, Bonnie Fields, Marjorie Jenkins, Susan Jones, Candace Matthews, Vannessa Gharbi, Serena Lowe, Frances A Kendrick, Sal Ryman, Raven Funderburk
{"title":"Nurse and parent perspectives of a neonatal intensive care unit redesign from open-bay to single-family rooms.","authors":"Stephanie M Teixeira-Poit, Bonnie Fields, Marjorie Jenkins, Susan Jones, Candace Matthews, Vannessa Gharbi, Serena Lowe, Frances A Kendrick, Sal Ryman, Raven Funderburk","doi":"10.1038/s41372-025-02342-w","DOIUrl":"10.1038/s41372-025-02342-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess nurse and parent perspectives of a neonatal intensive care unit (NICU) redesign from open-bay (OPBY) to single-family rooms (SFR).</p><p><strong>Study design: </strong>We analyze interviews with NICU nurses and surveys with parents/guardians of neonates discharged from the NICU in the OPBY compared to SFR settings.</p><p><strong>Results: </strong>The SFR design increased privacy, eased facilitation of sterile and isolation procedures, and improved perceived comfort of parent participation in breastfeeding and kangaroo, or skin-to-skin, care. Increased privacy in the SFR design also resulted in unintended consequences including limited visibility of the healthcare team and increased need for clinician-parent communication. Policies and procedures meant to keep families safe during COVID-19 further decreased parents' perceived access to and responsiveness of the healthcare team.</p><p><strong>Conclusions: </strong>Supportive policies and procedures promoting increased clinician-parent communication and additional parental supports may need to accompany transitions to SFRs to realize improvements in parental assessments of quality of care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"851-856"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560447","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2025-01-14DOI: 10.1038/s41372-024-02206-9
Haifeng Zong, Bingchun Lin, Yingsui Huang, Yichu Huang, Hongyan Sun, Qingling Xu, Zile Lin, Jiamin Wu, Chuanzhong Yang
{"title":"Accuracy of lung ultrasound in predicting successful extubation in preterm infants born ≤ 25 weeks.","authors":"Haifeng Zong, Bingchun Lin, Yingsui Huang, Yichu Huang, Hongyan Sun, Qingling Xu, Zile Lin, Jiamin Wu, Chuanzhong Yang","doi":"10.1038/s41372-024-02206-9","DOIUrl":"10.1038/s41372-024-02206-9","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the predictive value of the lung ultrasound score (LUS) for successful extubation in preterm infants born at ≤25<sup>+6</sup> weeks.</p><p><strong>Methods: </strong>This was a single-center, prospective cohort study. Preterm infants with gestational age (GA) ≤ 25<sup>+6</sup> weeks who received invasive mechanical ventilation (IMV) for ≥72 h were included. Lung ultrasound was performed every day. Multivariate logistic regression analysis was used to evaluate factors that predict extubation outcomes.</p><p><strong>Results: </strong>Ninety-three infants with GA ≤ 25<sup>+6</sup> weeks were included. The mean GA was 24.5 ± 1.2 weeks. Extubation failure occurred in 55 (59.1%) neonates, and success occurred in 38 (40.9%) neonates. The LUS was significantly lower in the successful group than in the failed group (24.0 ± 2.5 vs. 32.1 ± 3.1 p < 0.001). Logistic regression analysis showed that LUS was an independent predictor of successful extubation (odd ratio 0.15 [95% CI 0.045-0.508], P = 0.002). The area under the receiver operating characteristic curve was 0.98 (p < 0.001) for LUS, and a cutoff value of ≥ 28 had 94.6% sensitivity and 92.7% specificity in detecting extubation failure.</p><p><strong>Conclusion: </strong>The LUS has good accuracy for predicting successful extubation in extremely preterm infants with GA ≤ 25<sup>+6</sup> weeks.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"830-836"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983446","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2025-02-20DOI: 10.1038/s41372-025-02229-w
Nikita S Kalluri, Rachel E Witt, Zuzanna Kubicka, Margaret G Parker, Erika G Cordova-Ramos
{"title":"Experiences of communication in the neonatal intensive care unit for mothers with a preferred language other than English.","authors":"Nikita S Kalluri, Rachel E Witt, Zuzanna Kubicka, Margaret G Parker, Erika G Cordova-Ramos","doi":"10.1038/s41372-025-02229-w","DOIUrl":"10.1038/s41372-025-02229-w","url":null,"abstract":"<p><strong>Objective: </strong>To understand the experiences of mothers with a preferred language other than English (PLOE) in communicating with staff and engaging in the care of their hospitalized infant.</p><p><strong>Design: </strong>We qualitatively analyzed a previously collected and a prospective dataset comprised of transcripts of 36 interviews with Spanish-, Haitian Creole-, and Brazilian Portuguese-speaking mothers of preterm infants from 3 NICUs. We applied the constant comparative method to develop codes and themes, which were inductively structured using the socio-ecological framework.</p><p><strong>Results: </strong>We identified themes across socio-ecological levels: Individual (unaddressed language barriers, varied maternal empowerment, and justification of suboptimal interpreter use); Interpersonal (family-staff language concordance facilitating engagement, positive impact of non-interpreted informal interactions, and differential treatment based on maternal language status); Institutional (system-level interpretation barriers and varied interpreter service quality).</p><p><strong>Conclusion: </strong>Mothers with PLOE face multilevel communication and engagement barriers in the NICU; we discuss potential interventions to improve equity in these areas.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"767-772"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468245","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2024-12-07DOI: 10.1038/s41372-024-02187-9
Ashley D Osborne, Daphna Yasova Barbeau, Tiffany Gladdis, Kara Hansen, Tonia Branche, Emily R Miller, Christine C Pazandak, Margaret K Hoge, Michelle Spencer, Diana Montoya-Williams, Ryan Barbeau, Heather Padratzik, Stephen Lassen
{"title":"Understanding and addressing mental health challenges of families admitted to the neonatal intensive care unit.","authors":"Ashley D Osborne, Daphna Yasova Barbeau, Tiffany Gladdis, Kara Hansen, Tonia Branche, Emily R Miller, Christine C Pazandak, Margaret K Hoge, Michelle Spencer, Diana Montoya-Williams, Ryan Barbeau, Heather Padratzik, Stephen Lassen","doi":"10.1038/s41372-024-02187-9","DOIUrl":"10.1038/s41372-024-02187-9","url":null,"abstract":"<p><p>This article reviews the psychological distress experienced by NICU families, including anxiety, postpartum depression (PPD), and post-traumatic stress disorder (PTSD), in addition to providing recommendations for clinicians at the individual, institutional, and national level. Currently, mental health screenings, specialized evaluations, and treatment options are not routinely offered to NICU families and are frequently under-utilized when offered. Here we provide expert opinion recommendations to address challenges in supporting universal screening, offering bedside interventions, including trained mental health professionals in care plans, updating neonatology training competencies, and advocating for policies that support the mental health of NICU families. We advocate that mental health of NICU families be incorporated into the standard of care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"873-880"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791751","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2025-06-06DOI: 10.1038/s41372-025-02328-8
Belinda Chan, Joseph Y Ting, Eugene Yoon, Sarah D McDonald, Melissa Orton, Ivah Floyd, Marc M Beltempo, Amit Mukerji, Sajit Augustine, Kevin Coughlin, Prakesh S Shah
{"title":"Factors associated with rates and durations of cord clamping practice compliance in preterm neonates of <33 weeks' gestation.","authors":"Belinda Chan, Joseph Y Ting, Eugene Yoon, Sarah D McDonald, Melissa Orton, Ivah Floyd, Marc M Beltempo, Amit Mukerji, Sajit Augustine, Kevin Coughlin, Prakesh S Shah","doi":"10.1038/s41372-025-02328-8","DOIUrl":"10.1038/s41372-025-02328-8","url":null,"abstract":"<p><strong>Objectives: </strong>To determine maternal, neonatal, and hospital factors influencing deferred cord clamping (DCC) compliance rates in preterm neonates.</p><p><strong>Methods: </strong>Neonates born <33 weeks' gestational age (GA) within the Neonatal Intensive Care Units of Canadian Neonatal Network during 2018-2022 were included. Units' DCC quality improvement (QI) efforts were surveyed. The factors were stratified by <15 seconds (s) immediate cord clamping, 15-59 s early cord clamping, or ≥60 s DCC.</p><p><strong>Results: </strong>Of 16,217 eligible neonates, only 45% received DCC ≥ 60 s. Maternal hypertension and antenatal steroid was asscoiated with higher DCC rates. Cesarean delivery (aOR 0.39, 95% CI 0.33-0.47), <26 weeks GA (aOR 0.25, 95% CI 0.21-0.30), and small-for-gestational-age status had lower DCC odds. Singleton birth, preterm labor, and fetal indications for delivery increased DCC likelihood. Hospital size and QI efforts did not impact DCC compliance.</p><p><strong>Conclusion: </strong>Extreme preterm neonates or cesarean delivery are actionable QI targets to improve DCC compliance and neonatal outcomes.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"843-850"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248323","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}
Journal of PerinatologyPub Date : 2025-06-01Epub Date: 2025-03-23DOI: 10.1038/s41372-025-02267-4
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":"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":"817-822"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","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}