Sara Todo Bom Costa, Patrícia Costa Reis, André Mendes Graça
{"title":"Evaluation of risk factors and outcomes of neonates with hypoxic ischemic encephalopathy and acute kidney injury","authors":"Sara Todo Bom Costa, Patrícia Costa Reis, André Mendes Graça","doi":"10.1038/s41372-025-02379-x","DOIUrl":"10.1038/s41372-025-02379-x","url":null,"abstract":"To assess risk factors for acute kidney injury (AKI) in neonates with hypoxic ischemic encephalopathy (HIE) using KDIGO and Gupta definitions, and evaluate long-term kidney function. Retrospective study including 72 neonates with HIE and prospective evaluation of long-term kidney health data of 33 survivors. AKI was detected in 49% using KDIGO and 32% using Gupta’s definition. KDIGO-defined AKI correlated with thrombocytopenia, low pH, transfusions need, nephrotoxic drugs, and furosemide use (p < 0.05). The Gupta definition showed additional associations with hypotension, cardiac dysfunction, and death (p < 0.05). In a logistic regression model, both definitions linked AKI to nephrotoxic drug exposure and transfusions. Follow-up assessments revealed elevated blood pressure in 12%, hyperfiltration in 18%, and proteinuria in 6% of survivors. The Gupta definition may help identify AKI in an additional number of neonates with HIE. Long-term monitoring is essential for the early detection of kidney dysfunction.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"45 8","pages":"1040-1046"},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784505","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}
María V Fraga, Shazia Bhombal, Courtney Juliano, Minso Kim, Alan M Groves, Belinda Chan, Yogen Singh
{"title":"Neonatal point-of-care ultrasound-guidelines for training, credentialing and quality assurance.","authors":"María V Fraga, Shazia Bhombal, Courtney Juliano, Minso Kim, Alan M Groves, Belinda Chan, Yogen Singh","doi":"10.1038/s41372-025-02367-1","DOIUrl":"10.1038/s41372-025-02367-1","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) has become essential for diagnosing and managing critically ill newborns. This technology offers rapid, non-invasive assessments and supports bedside clinical decision-making. Although POCUS applications in neonatology continue to expand, there remains a lack of standardized training, certification, and credentialing processes. This paper provides expert-based perspectives and guidelines for implementing neonatal POCUS, focusing on the core components of competency, credentialing, and quality assurance (QA). Recommendations include performing a minimum number of scans for various neonatal applications, integrating competency assessments into training programs, and ensuring a robust image repository and reporting pathway. Neonatal POCUS improves patient care, and establishing clear standards and frameworks will enhance provider performance, and ensure patient safety in neonatal intensive care units (NICUs).</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765016","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}
Shazia Bhombal, Yogen Singh, Stephanie Marshall, Shanmukha Mukthapuram, María V Fraga
{"title":"Neonatal point-of-care ultrasound-steps for program development.","authors":"Shazia Bhombal, Yogen Singh, Stephanie Marshall, Shanmukha Mukthapuram, María V Fraga","doi":"10.1038/s41372-025-02359-1","DOIUrl":"10.1038/s41372-025-02359-1","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) is increasingly being utilized in the neonatal field; however, there is a lack of standardized guidance on the development of POCUS programs in neonatology. While subspecialties with decades of POCUS experience have established pathways for program development and training guidelines, such frameworks are absent in neonatal and perinatal medicine. Recent national and international publications have highlighted the need for structured program development and have established recommendations regarding standards for POCUS use, including minimum number of scans, competency-based assessments, and a strong quality improvement (QI) framework. This publication aims to provide steps toward program development for neonatal intensive care units eager to establish POCUS to augment the care of their patients.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765017","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}
Brian King, Jake Dove, Scott J McGonigle, Warwick A Ames, Zachary A Vesoulis
{"title":"Identifying performance differences between two pulse oximetry systems in simulated critical neonatal conditions.","authors":"Brian King, Jake Dove, Scott J McGonigle, Warwick A Ames, Zachary A Vesoulis","doi":"10.1038/s41372-025-02364-4","DOIUrl":"10.1038/s41372-025-02364-4","url":null,"abstract":"<p><strong>Objective: </strong>Pulse oximetry is used to guide critical clinical decisions in neonatology. We used a vital signs simulator to compare performance of two pulse oximetry systems in conditions not tested in standardized clinical verification studies.</p><p><strong>Study design: </strong>We devised a set of simulated tissue translucency, perfusion, peripheral oxygen saturation (SpO<sub>2</sub>)<sub>,</sub> and heart rate (HR) parameters to mimic challenging real-world neonatal data and applied them to two marketed pulse oximetry systems (Nellcor™ and Masimo®). At each combination of input parameters, we used the response from both systems to assess SpO<sub>2</sub> error.</p><p><strong>Results: </strong>The mean SpO<sub>2</sub> error for Nellcor™ was below 1.1% across all parameters explored, while Masimo® showed significantly higher (p < 0.005) error at lower translucencies.</p><p><strong>Conclusion: </strong>Significant performance differences can be observed when comparing pulse oximeters at low translucency and perfusion conditions. Patient simulators cannot replace clinical testing but provide a safe and cost-effective method for additional performance profiling.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753639","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}
Srinivasan Mani, Mausma Bawa, Nishant Srinivasan, Valerie Elberson, Anne Marie Reynolds, Jeremy Killion, Mary Emborsky, Bree Kramer, Shahzad Waheed, Mary Kasu, Arun Prasath, Mary Miller, Munmun Rawat, Praveen Chandrasekharan
{"title":"Resuscitation after birth and beyond in the neonatal intensive care unit: NRP or PALS?","authors":"Srinivasan Mani, Mausma Bawa, Nishant Srinivasan, Valerie Elberson, Anne Marie Reynolds, Jeremy Killion, Mary Emborsky, Bree Kramer, Shahzad Waheed, Mary Kasu, Arun Prasath, Mary Miller, Munmun Rawat, Praveen Chandrasekharan","doi":"10.1038/s41372-025-02348-4","DOIUrl":"10.1038/s41372-025-02348-4","url":null,"abstract":"Newborns requiring resuscitation present a unique challenge compared to pediatric and adult patients due to the physiological differences at birth. This paper explores the distinction between the Neonatal Resuscitation Program (NRP) and Pediatric Advanced Life Support (PALS) in neonatal intensive care units (NICUs), with a focus on the optimal approaches for resuscitation in newborns. Through clinical studies and case scenario analysis, the paper underscores the importance of ventilation, tailored algorithms, and collaborative resuscitation efforts in NICU settings, focusing on respiratory versus cardiac causes. It evaluates the necessity of NRP over PALS, the resuscitation techniques, and the impact of combining the two protocols. A perspective on the challenges and costs of implementing such protocols has also been discussed.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"45 8","pages":"1171-1176"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742306","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}
Su Ren Wong, Ingrid M Wilson, Lester E Jones, Eunice Jun Lu Teo, Sing Ting Joy Chong, Jasmine Ling Xuan Chia, Gregory Sin, Zubair Amin
{"title":"Parental perception of pain in premature babies in neonatal intensive care unit: a qualitative study.","authors":"Su Ren Wong, Ingrid M Wilson, Lester E Jones, Eunice Jun Lu Teo, Sing Ting Joy Chong, Jasmine Ling Xuan Chia, Gregory Sin, Zubair Amin","doi":"10.1038/s41372-025-02341-x","DOIUrl":"10.1038/s41372-025-02341-x","url":null,"abstract":"<p><strong>Objective: </strong>To examine parents' awareness and perceptions of their premature baby's experience of pain, due to invasive procedures performed during admission to the Neonatal Intensive Care Unit (NICU).</p><p><strong>Study design: </strong>Parents of premature babies, who had been admitted to NICU, were recruited from a tertiary hospital in Singapore. Fifteen semi-structured interviews, with individual parents, were conducted. Data were analyzed using a Constructivist Grounded Theory approach including constant comparison and iterative coding. and theoretical sampling.</p><p><strong>Results: </strong>Eleven mothers and four fathers were interviewed. A central theme of 'Adjustment' was identified with four key aspects: (1) Acknowledging the pain, (2) Seeking assurance, (3) Parental presence, and (4) Learning entrustment.</p><p><strong>Conclusion: </strong>Attention to parent's needs associated with their perception of neonatal pain, will facilitate the transition to parenthood and support development of parental identity and competence in those with premature infants in NICU.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731891","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}
Timothy M Bahr, Robin K Ohls, Thomas R Christensen, Martha C Monson, Jessica M Page, Heather A Dabling, James Cole Elliott, Sarah J Ilstrup, Robert D Christensen
{"title":"Three studies needed to inform the design of the U-BET (umbilical cord blood for extremely low-gestational-age transfusions) clinical trial.","authors":"Timothy M Bahr, Robin K Ohls, Thomas R Christensen, Martha C Monson, Jessica M Page, Heather A Dabling, James Cole Elliott, Sarah J Ilstrup, Robert D Christensen","doi":"10.1038/s41372-025-02345-7","DOIUrl":"10.1038/s41372-025-02345-7","url":null,"abstract":"<p><strong>Objective: </strong>To perform three studies needed to design the \"U-BET\" trial (Umbilical cord Blood for Extremely-low-gestational-age Transfusions).</p><p><strong>Study design: </strong>(1) Survey-based self-assessment of Intermountain Health obstetricians regarding drawing umbilical cord blood. (2) Determine the percentage of the potentially donating neonates who have type O blood (to be utilized in U-BET). (3) Quantify cord blood drawn using American Red Cross collection kits.</p><p><strong>Results: </strong>(1) 72% of respondents declared experience drawing cord blood; 62% with the placenta in utero. (2) Of the past 100,000 women delivering, 48% were type O, and 66% of neonates born to them were type O. (3) The volume of cord blood obtained at 10 births ranged from 20 to 86 mL after the placenta was delivered vs. 14 to157 mL when in utero.</p><p><strong>Conclusion: </strong>The U-BET trial will consent type O women and use Red Cross kits to draw term umbilical cord blood while the placenta is still in utero.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731892","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}
Jeffrey E. King, Jill C. Newman, Olivia Kinsinger, Molly Mead, Megan D. Rodgers, Amy L. Ruddy-Humphries, Cassandra Coleman, David T. Selewski, Heidi J. Steflik
{"title":"Neonatal acute kidney injury and neurodevelopmental impairment: investigating associations in very low birthweight infants","authors":"Jeffrey E. King, Jill C. Newman, Olivia Kinsinger, Molly Mead, Megan D. Rodgers, Amy L. Ruddy-Humphries, Cassandra Coleman, David T. Selewski, Heidi J. Steflik","doi":"10.1038/s41372-025-02370-6","DOIUrl":"10.1038/s41372-025-02370-6","url":null,"abstract":"Associations between neonatal acute kidney injury (AKI) and neurodevelopmental impairment (NDI) remains understudied. We hypothesized AKI is associated with NDI in very low birthweight (VLBW) infants. A single-center, retrospective cohort study of VLBW infants with and without AKI during hospitalization evaluated in developmental clinic at 18 to 35 months of age. Associations between AKI and NDI were examined using bivariate and multivariable generalized linear mixed modeling. Of 203 infants included, 64 (32%) experienced neonatal AKI and 76 (37%) developed NDI. The relative risk of NDI was significantly higher in those with AKI (RR 1.67, 95% CI 1.18–2.36; p < 0.01). In multivariable analysis, AKI was not an independent predictor of NDI (aRR 1.07, 95% CI 0.68–1.68; p = 0.77). In bivariate analyses, AKI was a significant predictor of NDI. In a multivariable model, AKI was no longer an independent predictor of NDI. Further investigation is warranted.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"45 10","pages":"1462-1468"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41372-025-02370-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707780","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}
Diane Wilson, Sara Breitbart, Lee DiFonzo, Edmond Kelly, Yenge Diambomba, Dilkash Kajal, Kamini Raghuram, Sabrina Wong, Eugene Ng, Paige Church, Elizabeth Asztalos, Phyllis Glanc, Mehmet Cizmeci, Rosanna Pais, Jeffery Traubici, Lara M Leijser, Steven P Miller, Abhaya V Kulkarni, Linh G Ly
{"title":"Implementation of an early intervention strategy for post hemorrhagic ventricular dilatation in preterm infants.","authors":"Diane Wilson, Sara Breitbart, Lee DiFonzo, Edmond Kelly, Yenge Diambomba, Dilkash Kajal, Kamini Raghuram, Sabrina Wong, Eugene Ng, Paige Church, Elizabeth Asztalos, Phyllis Glanc, Mehmet Cizmeci, Rosanna Pais, Jeffery Traubici, Lara M Leijser, Steven P Miller, Abhaya V Kulkarni, Linh G Ly","doi":"10.1038/s41372-025-02371-5","DOIUrl":"https://doi.org/10.1038/s41372-025-02371-5","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate earlier intervention on short- and longer-term outcomes in preterm infants with post-hemorrhagic ventricular dilatation (PHVD) born at ≤32 weeks' gestation.</p><p><strong>Study design: </strong>Retrospective, multi-center, observational study.</p><p><strong>Results: </strong>One hundred patients met eligibility criteria. Of 70 survivors, PHVD resolved spontaneously in 32 (46%). The 38 infants needing intervention were managed with: lumbar puncture (LP) alone (n = 23, 60%); LP and ventricular access device (VAD) only (n = 6, 16%); LP, VAD, ventricular-peritoneal shunt (n = 9, 24%). There were no differences in incidence of cerebral palsy or Bayley Scales of Infant and Toddler Development (BSID-III) composite score between the intervention and non-intervention group (p > 0.5). Neurosurgical intervention was initiated at smaller ventricle size and BSID-III scores improved significantly compared to a historical cohort with late intervention, (p < 0.05).</p><p><strong>Conclusion: </strong>Initiation of early intervention for PHVD was feasible and was associated with improved neurodevelopmental outcomes compared to late intervention.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718082","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":"Associations, Outcomes, and Adjustment.","authors":"Olaf Dammann","doi":"10.1038/s41372-025-02349-3","DOIUrl":"10.1038/s41372-025-02349-3","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718081","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}