Journal of Perinatology最新文献_第5页

Who decides? Exploring decisional dynamics for periviable resuscitation among diverse family structures. 谁决定?探索不同家庭结构中围生期复苏的决策动力学。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-16 DOI: 10.1038/s41372-025-02290-5

Erika R Cheng, Shelley M Hoffman, Victoria Schultz, Naomi Castellon-Perez, Hannah Witting, Carli King, Brownsyne Tucker Edmonds

{"title":"Who decides? Exploring decisional dynamics for periviable resuscitation among diverse family structures.","authors":"Erika R Cheng, Shelley M Hoffman, Victoria Schultz, Naomi Castellon-Perez, Hannah Witting, Carli King, Brownsyne Tucker Edmonds","doi":"10.1038/s41372-025-02290-5","DOIUrl":"https://doi.org/10.1038/s41372-025-02290-5","url":null,"abstract":"Objective: To investigate conflict resolution and decisional authority among diverse family structures in periviable resuscitation decision-making.Methods: We recruited 60 parent dyads, including 30 with prior periviable delivery experience and 30 first-time expecting dyads between 22 and 26 weeks gestation. Our diverse sample included heterosexual and same-sex partnerships, married and unmarried partners. Virtual interviews explored decision-making, engagement, and conflict resolution.Results: Four themes emerged: \"Mom is the priority,\" highlighting maternal decisional authority; \"partner involvement is crucial,\" emphasizing engagement; \"parents prioritize who will be caring for the child,\" indicating caregiver considerations; and \"parents want empathy and support,\" underscoring emotional needs.Conclusions: Findings reveal maternal priority in decision-making, the importance of partner involvement, and a challenges with lacking inclusive legal and ethical guidance for non-heteronormative families. The study highlights the need for shared decision-making that considers family structures, legal aspects, and emotional complexities to enhance inclusive, informed decision-making processes for parents facing periviable delivery.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015496","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

A narrative review of the clinical applications of renal NIRS and integration with cerebral NIRS in the NICU. 肾NIRS及脑NIRS在新生儿重症监护病房的临床应用综述。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-15 DOI: 10.1038/s41372-025-02303-3

Dimitrios Rallis, Helen Christou, Elisa Abdulhayoglu, Mohamed El-Dib

{"title":"A narrative review of the clinical applications of renal NIRS and integration with cerebral NIRS in the NICU.","authors":"Dimitrios Rallis, Helen Christou, Elisa Abdulhayoglu, Mohamed El-Dib","doi":"10.1038/s41372-025-02303-3","DOIUrl":"10.1038/s41372-025-02303-3","url":null,"abstract":"Organ perfusion and regional tissue oxygen saturation (rSO2) can be measured non-invasively using near-infrared spectroscopy (NIRS). While cerebral NIRS monitoring in neonates has been widely used, the adoption of renal NIRS is still evolving. This narrative review explores the application of renal NIRS in neonates and proposes an algorithm for integrating renal and cerebral NIRS in the neonatal intensive care unit. Decreased renal regional oxygenation (RrSO2) suggests decreased renal O2 delivery/perfusion or increased O2 consumption, warranting evaluation for acute kidney injury, anemia, hemodynamically significant patent ductus arteriosus, or hypotension. Increased RrSO2 indicates increased renal O2 delivery/perfusion or decreased O2 consumption, necessitating assessment for hyperoxia or established kidney injury. Combining cerebral and renal NIRS provides a comprehensive evaluation, allowing for the detection of early clinical changes. This integrated monitoring approach holds promise for improving neonatal outcomes. However, further large-scale studies are needed to establish normal ranges and guide therapeutic interventions.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031453","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

Hemolysis and dat positivity. 溶血和数据阳性。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-14 DOI: 10.1038/s41372-025-02305-1

Michael Kaplan, Cathy Hammerman

引用次数: 0

Interprofessional perspectives on non-invasive respiratory support practices in extremely preterm infants: a Canadian survey. 非侵入性呼吸支持实践在极早产儿中的跨专业观点：一项加拿大调查。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-12 DOI: 10.1038/s41372-025-02291-4

Tugba Alarcon Martinez, Elissa Remmer, Stephanie Mardakis, Marisa Leone, Johanne Boyer, Shasha Lv, Marc Beltempo, Guilherme Sant'Anna, Wissam Shalish

{"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":"https://doi.org/10.1038/s41372-025-02291-4","url":null,"abstract":"Objective: To describe barriers and strategies amongst healthcare professionals (HCP) for optimal non-invasive respiratory support (NRS) provision in extremely preterm infants.Study design: 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.Result: 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.Conclusion: 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.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","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}

引用次数: 0

Three is Better Than Two: Dose-related Efficacy of Dextrose Gel for Neonatal Hypoglycemia in At-Risk Infants, a Quality Improvement Initiative. 三比二好：葡萄糖凝胶治疗高危新生儿低血糖的剂量相关疗效，质量改进倡议。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-12 DOI: 10.1038/s41372-025-02298-x

Melanie Gao, Jenny Jin, Jillian Schon, Erin Kelly, Snezana Nena Osorio, Rae-Jean Hemway, Abie Iyare, Jeffrey Perlman, Priyanka Tiwari

{"title":"Three is Better Than Two: Dose-related Efficacy of Dextrose Gel for Neonatal Hypoglycemia in At-Risk Infants, a Quality Improvement Initiative.","authors":"Melanie Gao, Jenny Jin, Jillian Schon, Erin Kelly, Snezana Nena Osorio, Rae-Jean Hemway, Abie Iyare, Jeffrey Perlman, Priyanka Tiwari","doi":"10.1038/s41372-025-02298-x","DOIUrl":"https://doi.org/10.1038/s41372-025-02298-x","url":null,"abstract":"Objective: Using a quality improvement (QI) framework, we aimed to use dextrose gel (DG) to reduce admissions for neonatal hypoglycemia by 20% and IV dextrose fluid needs by 10% in at-risk infants.Methods: This is a prospective QI study using the Model for Improvement and planned sequential experimentation through three Plan-Do-Study-Act (PDSA) cycles: pathway creation, EMR implementation, and dose increase. Data were analyzed using Shewhart P-charts and chi-square tests.Results: Our interventions increased the percentage of at-risk infants with hypoglycemia who received DG from 67% to 98%. Implementing three doses of DG caused a special cause variation, reducing neonatal hypoglycemia admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7% (46% and 37% reduction, respectively).Conclusion: Three doses of dextrose gel administered to at-risk infants with neonatal hypoglycemia reduced the need for additional intervention, suggesting the dose-related efficacy of dextrose gel in mitigating the consequences of neonatal hypoglycemia.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022921","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

Short-term and four-year feeding and respiratory outcomes of infants with micrognathia. 小颌畸形婴儿的短期和四年喂养和呼吸结局。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-12 DOI: 10.1038/s41372-025-02224-1

Kuan-Chi Lai, Laura M Walker, Kevin Moran, Jordan W Swanson, Jesse A Taylor, Janet Lioy, Christopher M Cielo

{"title":"Short-term and four-year feeding and respiratory outcomes of infants with micrognathia.","authors":"Kuan-Chi Lai, Laura M Walker, Kevin Moran, Jordan W Swanson, Jesse A Taylor, Janet Lioy, Christopher M Cielo","doi":"10.1038/s41372-025-02224-1","DOIUrl":"https://doi.org/10.1038/s41372-025-02224-1","url":null,"abstract":"Objective: To describe feeding and respiratory outcomes at discharge and at the most recent follow-up visit prior to four years old in infants evaluated for micrognathia.Study design: Single-center retrospective analysis of 218 patients admitted and evaluated with congenital micrognathia during infancy. Outcomes were compared based on treatment (medical, mandibular distraction osteogenesis, or tracheostomy), and also compared based on syndromic status.Results: Tube feeding was required by 81% of infants at discharge and 41% at follow-up. Respiratory support was required by 32% at discharge and 22% at follow-up. There were no differences in feeding and respiratory support at discharge and at follow-up between medical treatment and mandibular distraction osteogenesis. Tracheostomy was associated with more tube feeding and respiratory support at both discharge and at follow-up. Genetic syndromes were more likely to require tube feeding and respiratory support.Conclusion: Long-term feeding and respiratory support are common in infants hospitalized with micrognathia.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998368","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

Implementation of a nurse facilitated, structured, clinical event debriefing initiative in four neonatal intensive care units. 在四个新生儿重症监护病房实施护士促进、结构化、临床事件汇报倡议。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-12 DOI: 10.1038/s41372-025-02297-y

Krystyna Ediger, Vanessa Godbout, Faith Trinh, Shannon Bartlett, Patricia Peckham, Stuart Rose, Brenda Hiu Yan Law

{"title":"Implementation of a nurse facilitated, structured, clinical event debriefing initiative in four neonatal intensive care units.","authors":"Krystyna Ediger, Vanessa Godbout, Faith Trinh, Shannon Bartlett, Patricia Peckham, Stuart Rose, Brenda Hiu Yan Law","doi":"10.1038/s41372-025-02297-y","DOIUrl":"https://doi.org/10.1038/s41372-025-02297-y","url":null,"abstract":"Background: Neonatal intensive care units (NICUs) often experience high acuity clinical events and can benefit from clinical event debriefing. Post-event team debriefs can reinforce success, identify areas for improvement, and support healthcare providers' (HCP) psychological coping. However, barriers exist to debriefing regularly.Objective: To implement and evaluate a structured clinical event debriefing program in four NICUs within a regional neonatal program.Methods: We assembled a multi-disciplinary team of clinicians and debriefing specialists, adapted an existing tool, and identified site champions. A database, debrief triggers, and feedback processes were developed. We chose charge nurses as facilitators. Facilitators were trained in 2-h virtual sessions. Debriefs were started and tracked. A post-implementation survey was conducted after 6 months.Results: Eighty-one HCPs responded to the pre survey. Respondents identified time constraints and skill /availability of facilitators as barriers to clinical event debriefs. Most were comfortable with debriefs prior to implementation. Ninety-five debriefs were conducted over 6 months. Median 7 (IQR 5-8) HCPs attended. Most were led by trained nurse facilitators. Debriefs took a median 12 min (IQR 8-17), and generated recommendations for equipment, teamwork, and process issues. Barriers to implementation included availability of trained facilitators, time constraints and competing quality improvement (QI) priorities. The post-implementation survey showed positive views of structured debriefs. Participants still listed time constraints as the main barrier to debriefs, although less than prior.Conclusion: Nurse-led, structured clinical event debriefing can be implemented in NICUs. Clinical event debriefs allow HCPs to participate in identifying systems issues and solutions.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970538","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

A survey of long-term NICU developmental follow-up practices in gastroschisis patients. 胃裂患者长期新生儿重症监护病房发展随访实践调查。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-11 DOI: 10.1038/s41372-025-02300-6

Maddie R Rundell, Lauren E Miller, Barbara B Warner, Amy J Wagner

{"title":"A survey of long-term NICU developmental follow-up practices in gastroschisis patients.","authors":"Maddie R Rundell, Lauren E Miller, Barbara B Warner, Amy J Wagner","doi":"10.1038/s41372-025-02300-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02300-6","url":null,"abstract":"Objective: To (1) elucidate current practices of NICU developmental follow-up (NDFU) programs for gastroschisis (GS) patients, (2) identify potential gaps in knowledge and care, and (3) identify future directions for research and clinical care.Study design: An online survey was distributed to academic centers caring for GS patients who also participate in the Gastroschisis Outcomes of Delivery (GOOD) Study to evaluate practices of NDFU programs.Results: There was an 89% response rate, with 18 centers participating. Sixty-one percent of NDFU programs did not routinely follow GS patients. The remaining 39% had variable guidelines for follow-up. Eligibility criteria, frequency of visits, gestational age cutoff for inclusion, and duration of follow-up were all inconsistent.Conclusion: Many NDFU programs do not routinely follow GS patients despite previous literature demonstrating they are at potentially elevated risk for worse developmental outcomes. Substantial variability in NDFU practice patterns demonstrates the need for quality long-term data.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019646","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

Increasing length board use in a neonatal intensive care unit: a quality improvement initiative. 增加新生儿重症监护病房长度板的使用：一项质量改进倡议。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-11 DOI: 10.1038/s41372-025-02286-1

Yvette Penner, Sabah Sabir, Kathleen Quirk, Julia Foster, Kristen Earley Lindamood, Jaclyn Mello, Jimena Gayol Ortega, Sophia Tate, Kristen T Leeman, Coral Rudie, Sarah U Morton

{"title":"Increasing length board use in a neonatal intensive care unit: a quality improvement initiative.","authors":"Yvette Penner, Sabah Sabir, Kathleen Quirk, Julia Foster, Kristen Earley Lindamood, Jaclyn Mello, Jimena Gayol Ortega, Sophia Tate, Kristen T Leeman, Coral Rudie, Sarah U Morton","doi":"10.1038/s41372-025-02286-1","DOIUrl":"https://doi.org/10.1038/s41372-025-02286-1","url":null,"abstract":"Objective: To increase length board use for eligible neonatal intensive care unit (NICU) infants.Study design: We implemented a quality improvement study involving 704 infants in our level IV NICU. A multidisciplinary workgroup developed guidelines for length measurement technique and completed Plan-Do-Study-Act cycles. Outcome measure was the weekly proportion of eligible infants who received a length board measurement. Process measures were the weekly proportion of infants with any length measurement or had method documented. Balancing measure was the incidence of unplanned dislodgements of drains, tubes, or catheters.Results: After the guideline launch, both process measure proportions increased. Weekly mean percentage of length board increased from 11 to 63%. There were no dislodgement events. Length board measurements were less likely to demonstrate a negative change week-to-week (10% vs 18%, 16/161 vs 59/326, Fisher p = 0.02).Conclusion: In a level IV NICU, a quality improvement initiative increased the safe use of length boards.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026937","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

Unconditional cash transfers to low-income preterm infants and their families: a pilot randomized controlled trial. 无条件现金转移给低收入早产儿及其家庭：一项随机对照试验。

IF 2.4 3区医学

Journal of Perinatology Pub Date : 2025-04-11 DOI: 10.1038/s41372-025-02293-2

Zoe M Bouchelle, Timothy D Nelin, Elizabeth G Salazar, Sydney Ragland, Destiny Uwawuike, Joshua K Radack, Andrea F Duncan

{"title":"Unconditional cash transfers to low-income preterm infants and their families: a pilot randomized controlled trial.","authors":"Zoe M Bouchelle, Timothy D Nelin, Elizabeth G Salazar, Sydney Ragland, Destiny Uwawuike, Joshua K Radack, Andrea F Duncan","doi":"10.1038/s41372-025-02293-2","DOIUrl":"https://doi.org/10.1038/s41372-025-02293-2","url":null,"abstract":"Objective: Unconditional cash transfers (UCTs)-no strings attached monthly payments-to low-income families may reduce financial stress and improve health outcomes. We sought to determine the feasibility and acceptability of randomizing low-income caregivers of preterm infants to a high- or low-value UCT for 4 months.Study design: Parallel, pilot randomized controlled trial that was preregistered (ClinicalTrials.gov NCT05930327). We enrolled 24 birthing parent-infant dyads. The intervention was a $325 monthly UCT and the active control was a $25 monthly UCT.Result: The intervention was feasible and universally acceptable among families in the high-value cash transfer arm. Exploratory outcomes revealed a high degree of financial strain, stress, and depressive symptoms.Conclusion: This study provides feasibility, acceptability, and preliminary efficacy data to inform a future, larger trial to examine the impacts of UCTs to low-income birthing parents of preterm infants.Clinical trial registration: ClinicalTrials.gov ID NCT05930327.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998440","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