Journal of Perinatology最新文献

{"title":"Characterization of plasma proteomic signatures of extubation outcomes in extremely premature neonates: a pilot study.","authors":"Jennifer K Fitzgerald, Vera Ignjatovic, John M Morrison, Jamie L Fierstein, Steven Bruzek, Taekyung Ryu, Chan Hyun Na, Joseph Manipadam, Joana Silva Machry","doi":"10.1038/s41372-026-02859-8","DOIUrl":"https://doi.org/10.1038/s41372-026-02859-8","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712786","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":"From theory to practice: implementing an education bundle for neurally adjusted ventilatory assist (NAVA) in the intensive care unit.","authors":"Brianna K Brei, Abhineet Sharma, Kara Mickas, Chelsey Marion, Junghyae Lee, Kendra Christensen, Jeffrey Salomon","doi":"10.1038/s41372-026-02854-z","DOIUrl":"https://doi.org/10.1038/s41372-026-02854-z","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate objective knowledge acquisition, subjective comfort, confidence, and barriers to NAVA implementation following a multimodal educational intervention. Demonstrate clinical use of NAVA post-education.</p><p><strong>Study design: </strong>Prospective study of 59 intensive care providers in a standalone children's hospital undergoing a four-part NAVA education bundle from March to June 2022. Providers completed pre- and post-education surveys. Analysis performed with descriptive statistics, independent and paired t-tests.</p><p><strong>Results: </strong>Prior to education, most providers had no clinical experience with NAVA (n = 44, 80%). The mean knowledge score of providers increased post-education by 3.48 points (4.40 (SD 1.65) vs. 7.88 (SD 1.76), p < 0.001). Perceived provider comfort and confidence increased, and barriers decreased, resulting in increased NAVA utilization.</p><p><strong>Conclusions: </strong>A multimodal education intervention for ventilator technology can increase provider objective knowledge, comfort, and confidence while decreasing barriers to implementation.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706982","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":"Barriers and facilitators to neurodevelopmental follow-up among at-risk newborns across Washington State.","authors":"Sara K Neches, Megan Woods, Krystle Perez, Kendell German, Ulrike Mietzsch, John Feltner, Niranjana Natarajan, Cindy Trevino, Rebecca Penders, Sharilyn Emhoff, Bat-Sheva Stein, Sandra Juul, Brent R Collett, Gregory C Valentine","doi":"10.1038/s41372-026-02870-z","DOIUrl":"10.1038/s41372-026-02870-z","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707069","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":"Correspondence: Comment on \"Impact of delayed cord clamping and immediate kangaroo mother care on oxygen saturation and heart rate in moderate and late preterm infants\".","authors":"Daniele Caratozzolo, Andrea Calandrino","doi":"10.1038/s41372-026-02864-x","DOIUrl":"10.1038/s41372-026-02864-x","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707072","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 hypertension and acute hypoxic respiratory failure in preterm neonates","authors":"Marwa M. Elgendy,&nbsp;Sfurti Nath","doi":"10.1038/s41372-026-02858-9","DOIUrl":"10.1038/s41372-026-02858-9","url":null,"abstract":"Pulmonary hypertension (PH) in preterm infants is a complex and heterogeneous condition that significantly contributes to hypoxic respiratory failure (HRF), bronchopulmonary dysplasia (BPD), and mortality. Unlike term infants, PH in preterm neonates arises from multiple overlapping pathophysiological mechanisms and distinct hemodynamic phenotypes. These diverse phenotypes complicate diagnosis and limit the effectiveness of uniform treatment approaches. Despite increasing recognition of this heterogeneity, current literature and clinical guidelines provide limited clarity on the optimal diagnosis and management of HRF with PH in preterm infants. In particular, the role of inhaled nitric oxide (iNO) remains highly controversial in this population. Although advances in targeted neonatal echocardiography and functional hemodynamic assessment have enhanced our ability to characterize cardiovascular physiology at the bedside, the integration of these tools into standardized management strategies remains inconsistent. As a result, clinical decision-making in preterm infants with PH is often variable and not clearly guided by evidence-based frameworks. This narrative review provides a comprehensive, physiology-based overview of the diagnosis and management strategies for acute PH and HRF in preterm infants, with a focus on the controversies surrounding iNO use and the role of inotropic and vasoactive agents in optimizing hemodynamics. While iNO may improve oxygenation in selected cases, randomized trials have not demonstrated reductions in mortality or BPD in preterm infants, and concerns persist regarding an increased risk of severe intraventricular hemorrhage. Accordingly, management should be guided by the underlying physiological phenotype, integrating clinical assessment, serial functional echocardiographic evaluations, and targeted therapeutic strategies to optimize outcomes in this vulnerable population.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"46 10","pages":"1831-1844"},"PeriodicalIF":2.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697456","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":"Revisiting time to blood culture positivity: can we decrease antibiotic exposure in the NICU?","authors":"Rachel J Graf, Amy Edwards, Moira A Crowley, Devashis Mukherjee, Rita M Ryan","doi":"10.1038/s41372-026-02838-z","DOIUrl":"https://doi.org/10.1038/s41372-026-02838-z","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678904","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":"Vasopressin for hemodynamic support in neonates: current evidence and clinical applications.","authors":"Aimann Surak, Mohamed Sewidan, Mimi T Y Kuan, Megan Kennedy, Manoj Kumar, Joseph Y Ting","doi":"10.1038/s41372-026-02837-0","DOIUrl":"https://doi.org/10.1038/s41372-026-02837-0","url":null,"abstract":"<p><strong>Objective: </strong>To systematically map and synthesize the available evidence on the use of vasopressin for hemodynamic support in neonates.</p><p><strong>Study design: </strong>We conducted a scoping review to synthesize available data on indications, dosing, clinical effects, and safety.</p><p><strong>Results: </strong>Twelve studies were included (one randomized trial, eleven observational), encompassing heterogeneous neonatal populations. Vasopressin was primarily used as rescue therapy in refractory shock, including sepsis, persistent pulmonary hypertension of the newborn, and congenital diaphragmatic hernia. Dosing regimens varied widely. Most studies reported improvements in mean arterial blood pressure, with some demonstrating reduced vasoactive support and improved oxygenation. Effects on urine output were variable. Safety reporting was inconsistent; hyponatremia was the most commonly described adverse event, while serious ischemic complications were rarely reported.</p><p><strong>Conclusion: </strong>Vasopressin may improve short-term hemodynamic parameters, but evidence is limited and heterogeneous, with insufficient data to guide optimal use.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678837","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":"Postnatal weight trajectories drives beter head circumference growth in preterm infants ≤32 weeks: a multicenter Latin American cohort study.","authors":"Angela B Hoyos, Pablo Vásquez-Hoyos, Carlos A Fajardo, Horacio Osiovich, Martha Baez, Carolina Villegas Álvarez","doi":"10.1038/s41372-026-02813-8","DOIUrl":"https://doi.org/10.1038/s41372-026-02813-8","url":null,"abstract":"<p><strong>Background: </strong>Postnatal weight loss is nearly universal in preterm infants, and its relationship to head circumference (HC) growth remains incompletely characterized. Growth standards were recently updated with the Fenton 2025 charts, which modify Z-score parameters compared to the 2013 version.</p><p><strong>Objective: </strong>To evaluate the association between postnatal weight trajectory and HC growth from birth to discharge in preterm infants ≤32 weeks of gestation across a large multicenter Latin American cohort, using Fenton 2025 growth standards.</p><p><strong>Methods: </strong>This observational cohort study by secondary analysis of a prospective cohort study using data from EpicLatino, a quality improvement registry of 35 neonatal intensive care units (NICUs) across Latin America and the Caribbean (2015-2024). Infants ≤32 weeks admitted within 48 h of birth were included. The exposure was the change in weight Z-score (Fenton 2025) from birth to discharge, categorized into 10 groups at 0.4-unit intervals. The primary outcome was the change in HC Z-score (Fenton 2025). Multivariable linear regression with average marginal predictions was used, adjusting for gestational age, necrotizing enterocolitis (NEC), sepsis, SNAP-II score, length of stay, treated patent ductus arteriosus, Apgar score at 5 min, HC Z-score at birth, and outborn status.</p><p><strong>Results: </strong>3926 infants were included (analytical sample n = 3757). Median gestational age was 30 [IQR 29-32] weeks. Adjusted HC Δ Z-score ranged from -0.34 (95% CI -0.38 to -0.30) in infants with weight Δ Z-score >0, to -2.71 (95% CI -2.83 to -2.58) in those with weight Δ Z-score ≤-3.2. All group comparisons were statistically significant (p < 0.001). The model explained 37.6% of the variance in HC growth.</p><p><strong>Conclusions: </strong>Postnatal weight trajectory is independently and progressively associated with HC growth in preterm infants ≤32 weeks across Latin America. Supporting weight recovery toward birth Z-score is a key nutritional target to promote adequate HC growth in the NICU.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678441","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":"Resilience in families of children with dextro-transposition of the great arteries.","authors":"Karen J Eagleson, Nadine A Kasparian, Robert N Justo, Samudragupta Bora","doi":"10.1038/s41372-026-02767-x","DOIUrl":"https://doi.org/10.1038/s41372-026-02767-x","url":null,"abstract":"<p><strong>Objective: </strong>Describe parent-reported family and individual parental resilience while caring for a child with dextro-Transposition of the Great Arteries (d-TGA) and identify family resilience correlates.</p><p><strong>Study design: </strong>The sample comprised 47 families of children with d-TGA and a comparator of 26 families of children with Ventricular Septal Defect (VSD). Parents completed the Walsh Family Resilience Questionnaire (family resilience) and Connor-Davidson Resilience Scale (individual resilience).</p><p><strong>Results: </strong>d-TGA and VSD groups did not significantly differ in family resilience (Cohen's d = -0.43, p = 0.09) or individual resilience (Cohen's d = -0.24, p = 0.34). After adjusting for cardiac diagnosis, greater family resilience was associated with greater perceived social support (ß = 0.60, p < 0.001), parental well-being (ß = 0.27, p = 0.01), and family health risk (ß = 0.19, p = 0.04).</p><p><strong>Conclusions: </strong>In this cross-sectional study, parents of children with d-TGA report similar family and individual parental resilience to parents of children with surgically repaired VSD. Integrated tiered models of psychosocial care and interventions targeting social support and well-being are recommended to promote family resilience.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678888","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":"Gestational age-specific metabolic biomarkers for early prediction of bronchopulmonary dysplasia following standardized enteral feeding.","authors":"Pingjiao Gu, Yang Yang, Jipeng Shi, Weiji Li, Qiaoyi Shao, Yiheng Dai","doi":"10.1038/s41372-026-02850-3","DOIUrl":"https://doi.org/10.1038/s41372-026-02850-3","url":null,"abstract":"<p><strong>Background: </strong>Early prediction of Bronchopulmonary dysplasia (BPD) remains challenging. Utilizing the NRN 2019 definition and a standardized feeding protocol, this study aimed to identify gestational age (GA)-specific metabolic signatures to optimize early prediction.</p><p><strong>Methods: </strong>This retrospective study enrolled 455 preterm infants (GA < 32 weeks). Dried blood spots collected at ~14 days postnatal age following standardized nutritional management were analyzed for 83 metabolites via LC-MS/MS to construct GA-stratified predictive models.</p><p><strong>Results: </strong>Distinct GA-specific metabolic signatures involving specific amino acid and acylcarnitine alterations were identified. Incorporating these biomarkers significantly improved predictive models compared to baseline clinical models: the AUC increased from 0.765 to 0.852 in the GA < 28 weeks subgroup, and from 0.629 to 0.707 in the GA 28-31⁺⁶ weeks subgroup (both P < 0.05).</p><p><strong>Conclusions: </strong>Post-standardized feeding metabolic profiling at 2 weeks captures distinct GA-specific alterations. Integrating these biomarkers with NRN 2019 criteria significantly enhances early BPD prediction, offering clinical utility for targeted risk stratification.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669733","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}