Genevieve L Buser, Horia Marginean, Mayen Dada, Savannah Woodward, Alexis Young, Chiayi Chen, Mark W Tomlinson
{"title":"Hepatitis C infection screening and connection to care among postpartum patients and exposed infants in two community hospitals, 3-year follow-up - Oregon, 2019-2024.","authors":"Genevieve L Buser, Horia Marginean, Mayen Dada, Savannah Woodward, Alexis Young, Chiayi Chen, Mark W Tomlinson","doi":"10.1038/s41372-024-02138-4","DOIUrl":"https://doi.org/10.1038/s41372-024-02138-4","url":null,"abstract":"<p><strong>Objective: </strong>Determine prevalence of hepatitis C virus (HCV) positivity among postpartum patients to inform prenatal screening recommendations, postpartum connection to care, and infant HCV screening practices.</p><p><strong>Study design: </strong>Convenience sample of postpartum patients at one urban and one suburban hospital to undergo rapid fingerstick testing for hepatitis C antibodies.</p><p><strong>Result: </strong>Of 2060 postpartum participants successfully screened, 20 (0.97%) had evidence of past or current HCV infection. One co-infection with syphilis occurred. After a median follow-up of 3.75 years, 6 of 12 participants (50.0%) with chronic HCV infection completed treatment with cure, and 9 of 20 infants (45.0%) completed screening. One neonatal transmission event occurred (5.8%).</p><p><strong>Conclusion: </strong>HCV infection was more common in our postpartum population than other viral infections routinely screened for during pregnancy. Efforts to decrease perinatal HCV transmission should focus on early postpartum connection to treatment team, early screening in infants aged 2-6 months, and pediatric test completion.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377990","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}
Albertina Lee, Joern-Hendrik Weitkamp, Angie Tune, Jim Couto, Krithika Lingappan
{"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Avery Zierk, Mary Jo Gumbel, Rachel Mackenzie, Kelle Matthews, Francis Simmons, Anna Bustin, Christina DeFelice, Heidi Morris, Leane Soorikian, Kimberly Swartz, Amanda Nickel, Kathleen Gibbs
{"title":"A quality improvement initiative to reduce excess inhaled therapy use in the neonatal intensive care unit.","authors":"Avery Zierk, Mary Jo Gumbel, Rachel Mackenzie, Kelle Matthews, Francis Simmons, Anna Bustin, Christina DeFelice, Heidi Morris, Leane Soorikian, Kimberly Swartz, Amanda Nickel, Kathleen Gibbs","doi":"10.1038/s41372-024-02132-w","DOIUrl":"https://doi.org/10.1038/s41372-024-02132-w","url":null,"abstract":"<p><strong>Objective: </strong>Inhaled medications are commonly used at our single-center, Level IV neonatal intensive care unit (NICU). We lacked a standardized process for measuring efficacy of these medications to guide optimal duration of use, potentially leading to their overuse.</p><p><strong>Methods: </strong>We utilized quality improvement methodology to reduce the length of inhaled hypertonic saline (HTS) course durations and high frequency albuterol use. Interventions included education, data sharing, and implementation of a respiratory therapy assessment tool.</p><p><strong>Results: </strong>The average inhaled HTS course duration decreased from 8.7 to 4.2 days. The percentage of q4 albuterol administrations per total albuterol doses administered monthly decreased from 39 to 20%.</p><p><strong>Conclusion: </strong>Developing a shared mental model between interprofessional providers for the indication and effect of inhaled agents and standardizing assessment of these medications' efficacy can reduce their overuse.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372106","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}
Venkatasai Devarapalli, Makenzie Niven, Jared Canonigo, Beverly Spray, Indirapriya Avulakunta, Jared Beavers, Jennifer Andrews, Vikramaditya Dumpa
{"title":"Prophylactic dextrose gel use in newborns at risk for hypoglycemia","authors":"Venkatasai Devarapalli, Makenzie Niven, Jared Canonigo, Beverly Spray, Indirapriya Avulakunta, Jared Beavers, Jennifer Andrews, Vikramaditya Dumpa","doi":"10.1038/s41372-024-02133-9","DOIUrl":"10.1038/s41372-024-02133-9","url":null,"abstract":"To assess the impact of prophylactic dextrose gel on short-term outcomes in infants at risk for hypoglycemia. Retrospective, single-center, observational study of neonates at risk for hypoglycemia -infants of diabetic mothers, large and small for gestational age infants, born between January 2015 and May 2023. Infants were categorized into two groups for analysis. 1. Pre- dextrose gel (01/2015 to 04/2018, n = 788) and 2. Dextrose gel (01/2019 to 05/2023, n = 1495). Infant demographic data and outcome variables were compared between the two groups. 2283 infants were eligible. Prophylactic dextrose gel use was associated with decreased admission rates to NICU secondary to hypoglycemia (2.7% vs. 6.5%), reduced incidence of hypoglycemia (32% vs. 43.3%), and higher exclusive breastmilk use at discharge (47% vs. 37.3%). The use of prophylactic dextrose gel in certain high-risk newborns was associated with improved patient outcomes.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"44 11","pages":"1640-1646"},"PeriodicalIF":2.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372107","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}
Pradeep Kumar Velumula, Praveen Kumar Boddu, Luna Khanal, Sanket Jani, Nithi Fernandes, Ronald Thomas, Monika Bajaj, Sanjay Chawla
{"title":"Association of antenatal steroid administration with neonatal morbidities among late preterm multiple gestation infants.","authors":"Pradeep Kumar Velumula, Praveen Kumar Boddu, Luna Khanal, Sanket Jani, Nithi Fernandes, Ronald Thomas, Monika Bajaj, Sanjay Chawla","doi":"10.1038/s41372-024-02130-y","DOIUrl":"https://doi.org/10.1038/s41372-024-02130-y","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence on the efficacy of antenatal steroids (ANS) among women with multiple gestations at risk of late preterm delivery.</p><p><strong>Study design: </strong>This retrospective study included multiple gestation, late preterm infants (34<sup>0/7</sup>-36<sup>6/7</sup> weeks' gestational age), born between January 2013 and December 2022. The primary outcome was composite respiratory outcome, defined as the need for respiratory support by 72 hours of age. Logistic and linear regressions were performed to compare the primary and secondary outcomes with and without exposure to any ANS, adjusted for gestational age, sex of infant, histologic chorioamnionitis, and intrauterine growth restriction.</p><p><strong>Results: </strong>The composite respiratory outcome was significantly lower in any ANS group compared to no ANS group (28.6% vs. 33.7%) [adjusted odds ratio 0.50, 95% CI, 0.33-0.75, p < 0.001].</p><p><strong>Conclusion: </strong>In late preterm multiple gestation infants, any ANS exposure was associated with lower risk of composite respiratory outcome.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361687","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":"Variation in NICU utilization: a narrative review and path forward.","authors":"David A Paul, Stephen A Pearlman","doi":"10.1038/s41372-024-02129-5","DOIUrl":"https://doi.org/10.1038/s41372-024-02129-5","url":null,"abstract":"<p><p>Utilization of the Neonatal Intensive Care Unit (NICU) varies widely in the United States. Over recent decades, there has been a growth in NICUs, that varies by region, and has not been correlated to changes in demand or illness severity. Unnecessary NICU admissions are costly, stressful to families, may increase the risk of hospital acquired morbidities, and decrease breast feeding. Most of the variation in NICU utilization is based on the care of late preterm, early term, and term babies and is related to hospital level factors, including financial incentives, driving utilization. Improvement strategies to reduce variation include regionalization of care, certificate of need legislation, improving discharge processes, and caring for babies with some conditions such as Neonatal Opioid Withdrawal Syndrome or those with risk factors for sepsis outside of the NICU.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361688","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}
Harkirat Bhullar, Amelie Stritzke, Sue Makarchuk, Selphee Tang, Abhay Lodha
{"title":"Long-term neurodevelopmental outcomes at three years in preterm infants born before 29 Weeks gestation following Preterm Premature Rupture of Membranes (PPROM).","authors":"Harkirat Bhullar, Amelie Stritzke, Sue Makarchuk, Selphee Tang, Abhay Lodha","doi":"10.1038/s41372-024-02134-8","DOIUrl":"https://doi.org/10.1038/s41372-024-02134-8","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental impairment (NDI) at 3 years corrected age (CA) in infants born before 29 weeks of gestational age (GA).</p><p><strong>Design/methods: </strong>Infants born before 29 weeks GA between 2005 and 2017 were included. The primary outcome was a composite of death or NDI (full-scale intelligence quotient<85, cerebral palsy, vision or hearing impairment) at 3 years of CA. Infants were stratified by maternal PPROM status. Associations were explored using multivariate models.</p><p><strong>Results: </strong>Of 1231 participants, 481 were in the PPROM group, and 750 were in the No PPROM group. After adjusting for factors, the odds ratio of death or NDI for PPROM vs. No PPROM was 1.22 (95% Confidence Interval 0.93-1.59).</p><p><strong>Conclusion: </strong>Our study suggests that PPROM was not associated with an increased risk of a composite outcome of death or NDI at 3 years CA.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348704","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}
Maria S. Rueda, Lamia Soghier, Joseph Campos, Burak Bahar, James E. Bost, Jiaxiang Gai, Rana F. Hamdy
{"title":"Blood volume collected for cultures in infants with suspected neonatal sepsis","authors":"Maria S. Rueda, Lamia Soghier, Joseph Campos, Burak Bahar, James E. Bost, Jiaxiang Gai, Rana F. Hamdy","doi":"10.1038/s41372-024-02120-0","DOIUrl":"10.1038/s41372-024-02120-0","url":null,"abstract":"To evaluate blood culture sample volumes, identify factors linked to insufficient samples, and compare volumes among neonates treated for culture-negative-sepsis, sepsis-rule-outs, and bloodstream infections (BSI). Observational cohort of blood cultures collected during NICU stay. Association of age, weight, gender, source, and collection time with lower-than-recommended volumes was determined by logistic regression. Blood culture inocula of patients with culture-negative-sepsis, sepsis rule-out, and BSI were compared using ANOVA. 742 blood cultures were obtained from 292 neonates. Median inoculum was 1 mL (IQR:0.6–1.4), and 259 bottles (35%) had inocula <0.9 mL. Night shift sample collection was associated with lower-than-recommended volumes (p = 0.006). No difference in sample volumes was observed between culture-negative-sepsis, sepsis-rule-outs, and BSI (p = 0.5). Median NICU blood culture volumes align with recommendations. Night shift collections correlate with lower volumes. Sample volumes don’t differ in patients with culture-negative-sepsis, BSI, and sepsis-rule-out, and should not be a justification for longer duration of antibiotics.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"44 12","pages":"1800-1804"},"PeriodicalIF":2.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348702","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}
Lucy E Geraghty, Greta Gambacorta, Colm P F O'Donnell
{"title":"Direct laryngoscopy versus indirect videolaryngoscopy for intubating newborn manikins: a randomised crossover study.","authors":"Lucy E Geraghty, Greta Gambacorta, Colm P F O'Donnell","doi":"10.1038/s41372-024-02110-2","DOIUrl":"https://doi.org/10.1038/s41372-024-02110-2","url":null,"abstract":"<p><p>Gaining and maintaining proficiency at endotracheal intubation is challenging. Recent clinical trials suggest videolaryngoscopy is beneficial for teaching inexperienced clinicians to intubate newborn infants, but may take longer compared to standard laryngoscopy. Preferences for devices among clinicians are unclear. Simulation studies using manikins have shown that use of videolaryngoscopes (VLs) likely improves intubation outcomes, at least in the short term. This study is the first to compare different VLs and SL as they are designed in clinicians with varying levels of experience in term and preterm manikins. This setup more closely mimics real-life clinical practice in comparison to trials exclusively of novices or using VL devices to intubate directly. Our study is relevant to members of the perinatal and neonatal clinical care team and related to using technology to improve neonatal outcomes. It is of particular importance in the current environment of reduced opportunities to learn and maintain neonatal intubation skills due to changes in neonatal practice and clinical care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348703","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}