Journal of Perinatology最新文献

{"title":"Targeting discrepancies in linear growth measurements in the neonatal intensive care unit through nursing interventions: a quality improvement initiative.","authors":"Gail Snyder, Rebekah Wilkinson, Raina Evans, Meagan Owen, Akram Yazdani, Covi Tibe, Catherine Perez, Lindsay F Holzapfel","doi":"10.1038/s41372-025-02327-9","DOIUrl":"10.1038/s41372-025-02327-9","url":null,"abstract":"<p><strong>Objective: </strong>Accurate length measurements are essential for infants to identify growth deficiencies and adjust nutrition accordingly. The gold standard for length measurement in infants is using a length board with two people to obtain an accurate clinical assessment. We aimed to improve the number of measurements with the desired minimal difference, defined as a discrepancy ≤1 cm between nurse and audit measurements, in our center. Our secondary aim was to increase and maintain the number of length boards available.</p><p><strong>Methods: </strong>This quality improvement (QI) study used a before-and-after intervention comparison design in a single-level IV neonatal intensive care unit between June 2023 and December 2023, completing two Plan-Do-Study-Act (PDSA) cycles and one sustainability cycle that targeted nursing interventions. Blinded audits were performed by the QI team < 48 h after bedside nurse measurement and discrepancies between measurements were recorded. Chi-squared testing determined the significance between measurement discrepancies at each time point.</p><p><strong>Results: </strong>The QI team measured 34 infants at each time point for 136 total measurements. There was a significant improvement in the desired minimal difference between the pre-intervention and post-PDSA #2 groups (38% vs 74%, p = 0.003) and between the pre-intervention and sustainability cycle groups (38% vs 71%, p = 0.007). There was no significant difference between PDSA #2 and our sustainability cycle. There was a 32% improvement among infants with consistent length percentiles between nurse and audit measures after PDSA #2 (42% vs 74%, p = 0.012). The number of length boards was increased during the study. Anonymous nursing surveys revealed an improvement in the perceived ease of use of length boards (51-71%) and minimized knowledge gaps.</p><p><strong>Conclusions: </strong>During the time of our intervention, there was an improvement in the precision of linear measurements and length board usage. Future PDSA cycles will focus on increasing the availability of length boards and establishing continued length board education.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"680-685"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208737","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 neonatology job search: the fellow's perspective.","authors":"Patrick Myers, Heather French, Anisha Bhatia, Nicolle F Dyess","doi":"10.1038/s41372-025-02215-2","DOIUrl":"10.1038/s41372-025-02215-2","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"678-679"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256070","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 novel national women in neonatology mentorship program leads to significant benefits in career development, networking, and wellness.","authors":"Kristen T Leeman, Megan M Gray, Lindsay C Johnston","doi":"10.1038/s41372-025-02311-3","DOIUrl":"10.1038/s41372-025-02311-3","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"673-675"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008074","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 conundrum of intestinal injury in preterm infants receiving mother's own milk.","authors":"Ariadne Malamitsi-Puchner, Despina D Briana, Josef Neu","doi":"10.1038/s41372-024-02125-9","DOIUrl":"10.1038/s41372-024-02125-9","url":null,"abstract":"<p><p>\"Necrotizing enterocolitis\" (\"NEC\") is a heterogeneous group of intestinal injuries experienced primarily in preterm infants. Risk factors include among others preterm gut microbiome alterations. Maternal milk (MM), or otherwise parent milk, is protective for the developing intestine due to its constituents, which include bioactive antimicrobials, immunomodulatory molecules, human milk oligosaccharides (HMOs), secretory immunoglobulin A (sIgA), and microorganisms. However, some preterm infants receiving exclusively mother's own milk (MOM) develop intestinal injuries. Studies showed predisposition to increased risk for \"NEC\", when a decreased MM HMO, disialyllacto-N-tetraose, is combined with an altered infant's gut microbiome. The intestine may also become more prone to injury with a greater amount of bacteria not bound to IgA. Variations in MM composition may alter the offspring gut microbiome, depriving protection. The different \"NEC\" entities should be considered to play a role as to why, in many studies, MOM does not provide absolute protection against preterm intestinal injury.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"686-688"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289653","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 budget impact analysis of an expanded criteria for pasteurized donor human milk use: a single center experience.","authors":"Dylan G Choi, Kelly Stapleton, Cynthia L Gong, Stephanie A Schnell, Leah Yieh","doi":"10.1038/s41372-025-02235-y","DOIUrl":"10.1038/s41372-025-02235-y","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"668-669"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468152","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":"Success and opportunities of the American Academy of Pediatrics Marshall Klaus research grant program in neonatal-perinatal medicine.","authors":"Albertina Lee, Joern-Hendrik Weitkamp, Angie Tune, Jim Couto, Krithika Lingappan","doi":"10.1038/s41372-024-02137-5","DOIUrl":"10.1038/s41372-024-02137-5","url":null,"abstract":"<p><strong>Background: </strong>Physician-scientists are a crucial link between clinical practice and research. The American Academy of Pediatrics (AAP) initiated the Marshall Klaus Perinatal Research Award to enhance the development of research skills among physicians training in Neonatal-Perinatal Medicine.</p><p><strong>Methods: </strong>In this study, we sought to identify trends in funding along with geographical and demographic variables of the applicants and mentees and assess the applicants' scholarly productivity and funding from the National Institutes of Health (NIH). We reviewed the data of applicants and awardees from 2015-2024.</p><p><strong>Results: </strong>We found that basic science applications had a higher funding likelihood than clinical/translational applications. The geographical distribution of awardees is skewed. There was a significant association between awardee status and K08 or K23 funding attainment.</p><p><strong>Conclusions: </strong>Future efforts should support more equitable award distribution and a diverse research landscape in neonatal-perinatal medicine.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"595-599"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377991","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}

{"title":"Improving well-being among women in neonatology.","authors":"Diana Yanni, Annette Scheid, Cynthia B Sinha, Kara Wong Ramsey, Bridget Hempel, Dena Hubbard, Mariann Pappagallo, Laura Vargas, Sharada Gowda, Renate Savich, Christiane Dammann, Shilpa Vyas-Read","doi":"10.1038/s41372-024-02091-2","DOIUrl":"10.1038/s41372-024-02091-2","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the factors that improve professional and personal well-being amongst women in neonatology (WiN).</p><p><strong>Study design: </strong>A 30-question survey of multiple choice, rank order, and open-ended questions focused on professional and personal factors that affect the well-being of WiN members. Quantitative and qualitative methods were used to determine leading factors and themes.</p><p><strong>Results: </strong>Of 326 respondents, 64% felt \"well\" professionally over half of the time. Professional well-being was most affected by scheduling flexibility, helping patients, administrative and staffing support, feelings of being valued, and clinical workload/acuity. Time for family and self-care, having domestic help, and scheduling flexibility were factors that most positively impacted personal well-being.</p><p><strong>Conclusion: </strong>In this national survey, WiN members identified the factors that can improve their well-being. Strategic planning and targeted interventions are urgently needed to enhance work-life integration and job satisfaction, leading to improved neonatal workforce retention and improved quality of patient care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"580-588"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108493","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":"Necrotizing enterocolitis following spontaneous intestinal perforation in very low birth weight neonates.","authors":"Goeto Dantes, Olivia A Keane, Swathi Raikot, Louis Do, Savanah Rumbika, Zhulin He, Amina M Bhatia","doi":"10.1038/s41372-024-02155-3","DOIUrl":"10.1038/s41372-024-02155-3","url":null,"abstract":"<p><strong>Purpose: </strong>Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are severe gastrointestinal complications of prematurity. The clinical presentation and treatment of NEC and SIP (peritoneal drain vs laparotomy) can overlap; however, the pathogenesis is distinct. Therefore, a patient initially treated for SIP can subsequently develop NEC. This phenomenon has only been described in case reports, and no risk factor evaluation exists. We evaluate clinical characteristics, risk factors, and outcomes of patients treated for a distinct episode of NEC after SIP.</p><p><strong>Methods: </strong>We performed a retrospective review of very low birth weight (<1500 g) neonates who presented with pneumoperitoneum between 07/2004 and 09/2022. Data was obtained from two separate neonatal intensive care units that were part of the same institution. Patients with an initial preoperative, intraoperative, or pathological diagnosis of NEC were excluded. Patients with an intraoperative diagnosis of SIP or preoperative diagnosis of SIP successfully treated with a peritoneal drain (PD) were evaluated. Patients subsequently treated (medically or surgically) for NEC after SIP were then compared to SIP-alone patients. Clinical characteristics included demographics, gestational age (GA), birth weight (BW), perinatal risk factors (chorioamnionitis, steroids, indomethacin), postoperative feeding regimen, and length of stay (LOS) were compared.</p><p><strong>Results: </strong>Of the 278 patients included, 31 (11.2%) patients had NEC after SIP. There was no difference in GA (25 weeks vs 25 weeks, p = 0.933) or BW (760 g vs 735 g, p = 0.370) between NEC after SIP vs SIP alone cohorts, respectively. Twenty (64%) of NEC after-SIP patients were previously treated with LP. NEC after SIP occurred with a median onset of 56 days. Pneumatosis was the most frequent (81%) presenting symptom and 12 (39%) patients had hematochezia. Four (12.9%) patients required LP for NEC and all had NEC intraoperatively and on pathology. A majority (77.4%) of patients were on breast milk (BM) at time of NEC diagnosis. NEC after SIP patients had lower maternal age at delivery (29.0 vs 25.0, p = 0.055) and the incidence of NEC after LP (primary or failed drain) was higher than PD alone (16.7% vs 6.2%, p = 0.007). NEC after SIP patients had longer LOS (135 vs 81, p < 0.001).</p><p><strong>Conclusion: </strong>We report an 11.2% incidence of NEC at a median of 56 days following successful treatment of SIP, resulting in increased LOS. SIP patients are a high-risk cohort and protocols to prevent this phenomenon should be investigated.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"642-649"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502487","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":"Early exclusive enteral feeding in 30-33 weeks gestation infants: a randomized controlled trial.","authors":"Belal N Alshaikh, Ossama Hassan, Wissam Alburaki, Dinesh Dharel, Adel Elsharkawy, Nalini Singal, Kamran Yusuf, Essa Al Awad","doi":"10.1038/s41372-025-02217-0","DOIUrl":"10.1038/s41372-025-02217-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate feasibility and efficacy of early exclusive enteral feeding (EEEF) in reducing time to achieve full enteral feeds.</p><p><strong>Methods: </strong>A pragmatic randomized controlled trial of infants born at 30^0/7-33^6/7 weeks gestation. Infants were randomly assigned to receive EEEF (60-80 mL/kg/day) or conventional feeding (20-30 mL/kg/day) with intravenous fluids after birth. Feed volumes were increased by 20-30 mL/kg/day. Primary outcome was time to reach full enteral feeds.</p><p><strong>Results: </strong>Seventy infants were enrolled. Infants in EEEF group achieved full feeds sooner [Mean difference (MD) -1.2 (95%CI -1.8, -0.7)], required fewer hours of parenteral nutrition [0 (IQR 0, 19) vs. 91 (IQR 48, 132) hours, P < 0.001], had less need for central venous access (11.4% vs. 37.1%, P = 0.01) and had shorter hospital stays [MD -6.6 (95%CI -12.9, -0.2) days].</p><p><strong>Conclusion: </strong>Early exclusive enteral feeding in 30^0/7-33^6/7 weeks gestation infants is feasible and reduces time required to achieve full enteral feeds and length of hospital stay.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT03708068.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"628-634"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080275","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":"Effects of rapid enteral feed advancement with early human milk fortification in very low birth weight preterm infants > 30 weeks gestation in a resource limited setting- a randomized controlled trial.","authors":"Anitha Ananthan, Ganesh Bhatkar, Haribalakrishna Balasubramanian, Muthu Vijayanathan, Lakshmi Srinivasan","doi":"10.1038/s41372-024-02164-2","DOIUrl":"10.1038/s41372-024-02164-2","url":null,"abstract":"<p><strong>Objective: </strong>To study the effects of rapid enteral feed advancement with early feed fortification in stable very low birth weight (VLBW) infants >30 weeks gestation.</p><p><strong>Study design: </strong>Preterm infants (N = 92) were randomized to a) rapid feed advancement-early fortification - REF group (enteral feed advanced at 25-30 ml/kg/day, fortification at 50 ml/kg/day) or b) slow feed advancement-late fortification-SLF group (feed advanced at 15-20 ml/kg/day, fortification at 100 ml/kg/day).</p><p><strong>Results: </strong>The primary outcome-time to regain birth weight was significantly lower in REF group (9 days vs 13 days, P = 0.02). REF group reached full enteral feeds earlier (6 days vs 9 days, P = 0.001), had lower rates of sepsis (13% vs 38%, P = 0.007) and shorter hospital stay (10 days vs 15 days, P = 0.01). At one year, the median Z-scores for weight [-1.5 vs -2.2, P < 0.001] and head circumference [1.1 vs 0, P < 0.001) were significantly higher in the REF group.</p><p><strong>Conclusions: </strong>In VLBW preterm infants >30 weeks, rapid feed advancement with early fortification resulted in early postnatal regain of birth weight with positive effects on growth at one year.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":"650-656"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605048","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}