Journal of Perinatology最新文献

{"title":"Electrical impedance tomography imaging of ventilation and perfusion in bronchopulmonary dysplasia.","authors":"Katelyn G Enzer, Nilton Barbosa da Rosa, Christopher Rocheleau, Gary Saulnier, Jennifer L Mueller, Christopher D Baker","doi":"10.1038/s41372-025-02236-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02236-x","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586090","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":"Diagnostic evaluation to identify infection-attributable stillbirth.","authors":"Sarah A Coggins, Jourdan E Triebwasser, Karen M Puopolo","doi":"10.1038/s41372-025-02253-w","DOIUrl":"https://doi.org/10.1038/s41372-025-02253-w","url":null,"abstract":"<p><strong>Objective: </strong>To characterize stillbirth evaluations, including the frequency and yield of investigations for infections causing stillbirth.</p><p><strong>Study design: </strong>Retrospective cohort of stillbirths at three university-affiliated perinatal centers from 2017 to 2022. The primary outcome was adherence to American College of Obstetrics and Gynecology core stillbirth evaluation recommendations (placental pathology, fetal autopsy, and fetal genetic testing). We further characterized the prevalence and yield of specific testing to evaluate for infection-attributable stillbirth etiologies.</p><p><strong>Results: </strong>The cohort included 399 stillbirths. Placental pathology was performed in 387 cases (97.0%), fetal genetic testing in 163 (40.9%), and fetal autopsy in 126 (31.6%). Fetal bacterial cultures were obtained in 73 (18.2%) cases; potential pathogens were isolated in 21/73 (28.8%). Viral testing was sent infrequently, with variable yield. Six stillbirths had infections identified as probable etiologies.</p><p><strong>Conclusions: </strong>Adherence to core stillbirth evaluation recommendations was poor, and infection testing was infrequent. Infection-attributable stillbirth prevalence may be underestimated.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573259","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":"A prospective randomized pilot trial comparing weekly vs. biweekly Darbepoetin administration to preterm infants.","authors":"Timothy M Bahr, Robert D Christensen, Kimberlee A Weaver-Lewis, Danielle M Scott, Erick Gerday, Jared J Tuttle, Robin K Ohls","doi":"10.1038/s41372-025-02247-8","DOIUrl":"https://doi.org/10.1038/s41372-025-02247-8","url":null,"abstract":"<p><strong>Background: </strong>Administering darbepoetin (Darbe) to preterm infants stimulates erythropoiesis, increases red blood cell (RBC) mass, and reduces RBC transfusions. We typically administer 10 µg/kg weekly until 34 weeks corrected gestation; however, we are uncertain whether this dose could be given every other week (biweekly) with equal efficacy.</p><p><strong>Methods: </strong>Infants ≤32 weeks were randomized to receive Darbe 10 µg/kg/dose weekly or biweekly for six weeks, tracking complete blood counts, absolute reticulocyte counts (ARC), iron status (RET-He), and RBC transfusions.</p><p><strong>Results: </strong>We enrolled 71 infants (1027 ± 369 grams, 27.3 ± 2.8 weeks). During the study period, the weekly-dosed group had a higher adjusted mean ARC (48,000/μL higher, 95% C.I. 9700-87,000/μL; p = 0.019). However, RET-He, Hgb, and transfusion-free survival were not different between groups (p = 0.071, p = 0.244, and p = 0.762).</p><p><strong>Conclusions: </strong>Weekly Darbe results in a higher six-week ARC than biweekly dosing. However, given similar clinical outcomes, perhaps biweekly dosing may be a cost-effective alternative.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573253","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":"Interpersonal relationships after prenatal diagnosis of congenital heart disease: Social stressors and supports.","authors":"Emily Marshall, Colette Gramszlo, Alejandra Perez Ramirez, Anne E Kazak, Amanda J Shillingford, Cynthia M Ortinau, Sarah L Kelly, Nadine Kasparian, Lindsay A Edwards, Allison A Divanovic, Jo Ann Davis, Samantha C Butler, Katherine Braley, Erin Riegel, Erica Sood","doi":"10.1038/s41372-025-02250-z","DOIUrl":"https://doi.org/10.1038/s41372-025-02250-z","url":null,"abstract":"<p><strong>Objective: </strong>To identify social stressors and supports for expectant parents after prenatal diagnosis of congenital heart disease (CHD) and inform interventions to reduce distress.</p><p><strong>Method: </strong>Parents of children diagnosed prenatally with CHD (N = 37) were purposively sampled across eight health systems. Qualitative data were collected using crowdsourcing methods and coded/analyzed using thematic analysis.</p><p><strong>Results: </strong>Social stressors increasing distress after prenatal diagnosis were widely endorsed: (1) feelings of loneliness (most common: 68%), (2) well-meaning yet unhelpful comments, (3) loss of celebration of pregnancy, (4) information overload, and (5) untimely/insensitive discussions surrounding pregnancy termination. Social supports included: (1) emotional support and small acts of kindness, (2) hope/connection through the experiences of others, (3) informational support, (4) nurturing normalcy and the joy of pregnancy, and (5) connection through religion/spirituality.</p><p><strong>Conclusion: </strong>Interpersonal relationships are vital for coping with prenatal diagnosis. Interventions to reduce distress after prenatal diagnosis should attend to common social stressors.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573316","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":"Voices of parents of children with major congenital anomalies admitted to the NICU: initial diagnosis, hospitalization, and discharge home.","authors":"Jessica Lyon, Natalie McAndrew, Alexis Geich, Tala AbuZahra, Steven R Leuthner, Joanne Lagatta, Krishna Acharya","doi":"10.1038/s41372-025-02255-8","DOIUrl":"10.1038/s41372-025-02255-8","url":null,"abstract":"<p><strong>Objective: </strong>To identify challenges vs. supports in the NICU and after NICU discharge for parents of an infant with a major congenital anomaly.</p><p><strong>Study design: </strong>Qualitative study.</p><p><strong>Results: </strong>We interviewed 18 parents (13 mothers, 5 fathers) whose children were admitted to our our NICU with a major congenital anomaly. In the NICU, challenges were navigating parenthood with significant impact on parent mental health, adjusting to changing healthcare providers, and need for better interdisciplinary communication. After discharge home, challenges were an initial adjustment to life without NICU monitoring, loss of NICU medical resources, burden of caregiving, continued healthcare utilization, and financial impact.</p><p><strong>Conclusion: </strong>Key supports that were helpful to families were empathetic and consistent healthcare teams throughout their care journey, especially nurses; healthcare team members who went beyond medical care, consistent communication, parent engagement in NICU care, ongoing parent mental health support, and peer resources after discharge home.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557200","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":"Extended-spectrum β-lactamase-producing Enterobacterales infections among infants following vertical colonization in a neonatal intensive care unit.","authors":"Mimori Abe, Yuto Otsubo, Tomoyuki Tame, Kaoru Okazaki, Yuho Horikoshi","doi":"10.1038/s41372-025-02256-7","DOIUrl":"10.1038/s41372-025-02256-7","url":null,"abstract":"<p><strong>Objective: </strong>Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) has become prevalent among neonates. The present study aimed to describe the incidence of ESBL-E colonization among neonates admitted to a NICU and the incidence of subsequent ESBL-E infection among those with ESBL-E colonization.</p><p><strong>Study design: </strong>Patients admitted to the NICU at Tokyo Metropolitan Children's Medical Center between April 2011 and March 2023 were enrolled. On admission, the subjects were routinely screened for ESBL-E using pharyngeal and rectal swabs, and those colonized with ESBL-E were assessed for the development of an invasive ESBL-E infection during their NICU stay.</p><p><strong>Results: </strong>ESBL-E was isolated in 105 of the 8247 neonates (1.3%) admitted to the NICU. Among these patients, 12 (11.4%) experienced the development of an invasive ESBL-E infection.</p><p><strong>Conclusion: </strong>Although ESBL-E colonization occurred in only 1.3% of the neonates admitted to the NICU, 11.4% of them experienced the development of an ESBL-E infection.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557194","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":"Diagnostic accuracy and short-term implications of prenatally diagnosed vascular rings: a single center study.","authors":"Nicolle M Ceneri, Michelle L Udine, Manan H Desai, Steven J Staffa, Wendy Ho, Leanne Buckels, Stephanie R Lacey, Mary T Donofrio","doi":"10.1038/s41372-025-02244-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02244-x","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic accuracy and postnatal outcomes of fetuses with a suspected vascular ring (VR).</p><p><strong>Study design: </strong>Single-center retrospective study of patients with suspected VR by fetal echocardiography. Postnatal evaluation included echocardiography +/- cross-sectional imaging. Outcomes, including symptomatology and surgery, were recorded and compared between VR types.</p><p><strong>Results: </strong>Of 68 suspected fetal VRs, 81% were confirmed postnatally. Concordance between fetal and postnatal anatomy was 76%. Five neonates required resuscitation unrelated to VR. Symptoms presented in 13 patients (median 45 days), independent of VR type. Surgical intervention was performed in 15 patients (median 99 days); 80% were symptomatic. At a median follow-up of 6 months, 4 patients were symptomatic including 3 postoperative.</p><p><strong>Conclusions: </strong>Fetal echocardiography accurately identifies and characterizes VR anatomy in most instances. Specialized delivery planning in uncomplicated cases is unnecessary given absence of symptoms at birth. Fetal diagnosis may not indicate surgical disease, as symptoms do not occur in all and early surgery does not guarantee symptom resolution.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557191","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":"Piloting the better research interactions for every family (BRIEF) researcher intervention to support recruitment for a neonatal clinical trial: parent experience and infant enrollment.","authors":"Elliott Mark Weiss, Devan M Duenas, Andrea Kelsh, Megan M Gray, Ellie Oslin, Devinae Mcneil, Sandra E Juul, Stephanie A Kraft","doi":"10.1038/s41372-025-02245-w","DOIUrl":"https://doi.org/10.1038/s41372-025-02245-w","url":null,"abstract":"<p><strong>Objective: </strong>Recruiting for neonatal clinical trials is difficult for families and participation rates are low. We partnered with the DIVI (Darbepoetin plus slow-release IntraVenous Iron) trial for pilot feasibility evaluation of the BRIEF (Better Research Interactions for Every Family) intervention.</p><p><strong>Study design: </strong>Pre/post design to compare infant data and parent surveys and interviews before and after the BRIEF intervention as well as comparing DIVI enrolled and DIVI not enrolled.</p><p><strong>Results: </strong>Enrollment rates and parental experiences were similar in pre- and post-BRIEF eras. Most respondents reported positive interactions with researchers. Parents who declined DIVI reported somewhat  worse experiences compared to those who enrolled. Interview respondents reported widely variable experiences. The narrow enrollment window emerged as particularly important to parents' recruitment experience.</p><p><strong>Conclusions: </strong>The BRIEF intervention was well received and is ready for larger scale testing to assess its impact on parental experience and enrollment rates. Future work should address short enrollment windows common in neonatal clinical trials.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557197","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":"Pulmonary function tests in the neonatal intensive care unit and beyond: a clinical review.","authors":"Mitzi A Go, Kelvin D MacDonald, Manuel Durand, Cindy T McEvoy","doi":"10.1038/s41372-025-02243-y","DOIUrl":"https://doi.org/10.1038/s41372-025-02243-y","url":null,"abstract":"<p><p>Pulmonary function tests (PFTs) in the Neonatal Intensive Care Unit (NICU) have played a pivotal role in neonatal care. They have helped quantify the effects of therapeutic interventions, guide ventilator management, and serve as endpoints in clinical trials. Preterm delivery, the most common cause of altered lung development, establishes early lung function trajectories that persist into later life. Early PFTs in preterm infants can enhance our understanding of factors influencing these trajectories. This review summarizes techniques performed in the NICU and early infancy and the evolution of continuous lung function monitoring through the bedside ventilator. It provides examples incorporating PFTs in the NICU and early infancy to improve outcomes and identifies evolving technology in this area. This review does not include studies of control of breathing in newborn infants. Looking ahead, the field would greatly benefit from developing a sustainable, non-invasive PFT technique that can be applied across the lifespan.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531541","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":"Clinical characteristics and treatment analysis of neonatal testicular torsion.","authors":"Chengpin Tao, Yongsheng Cao, Zhikang Yu","doi":"10.1038/s41372-025-02249-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02249-6","url":null,"abstract":"<p><strong>Background: </strong>Neonatal testicular torsion is a rare but critical condition that requires prompt diagnosis and treatment. While early surgical intervention may offer some benefit, in many prenatal cases, preventing testicular loss remains challenging, even with timely intervention. Early recognition remains challenging due to subtle clinical presentations in newborns.</p><p><strong>Objective: </strong>This study aims to analyze the clinical characteristics, diagnostic methods, and treatment outcomes of neonatal testicular torsion, providing a reference for early diagnosis and intervention of the disease.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on cases of neonatal testicular torsion admitted to Anhui Provincial Children's Hospital from August 2014 to June 2024. Information collected included the infants' age, at diagnosis onset time, clinical manifestations, diagnostic methods, surgical treatment, and postoperative follow-up results.</p><p><strong>Results: </strong>This study included 21 cases of neonatal testicular torsion. Among them, 1 case involved bilateral testicular torsion, and the remaining 20 cases involved unilateral torsion, with 11 cases on the right side and 9 on the left. The median age at diagnosis of the patients was 1 day (IQR: 1-3), and the median onset time was 24 h (IQR: 10-60). All patients underwent surgical exploration, revealing a median torsion angle of 720 degrees (IQR: 360-720). The average surgery duration was 57.9 min (SD: 25.9). In the case of bilateral testicular torsion, the blood supply was restored after detorsion, and the testicles were preserved. However, in the 20 cases of unilateral torsion, necrotic testicles were removed. Postoperative follow-up over an average period of 31.3 months (SD: 11.5) showed no atrophy in the preserved testicles, with good development of the contralateral testicles and no recurrence of torsion.</p><p><strong>Conclusion: </strong>Neonatal testicular torsion is rare and urgent, often prenatally occurring with high testicular necrosis risk. Ultrasound is crucial for diagnosing cryptorchid testicular torsion. Clinical uncertainty requires prompt surgical exploration to save the testicle.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523116","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}