Journal of Perinatology最新文献

{"title":"Sclerothrapy of giant lymphatic malformation in neonates.","authors":"Fan Hu, Fan Ma, Xiaoliang Liu, Jiayun Yu","doi":"10.1038/s41372-024-02113-z","DOIUrl":"https://doi.org/10.1038/s41372-024-02113-z","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the sclerotherapy of giant (≥8 mm) lymphatic malformations in neonates and discuss effective treatment.</p><p><strong>Methods: </strong>This was a single-center retrospective study. Twelve patients received bleomycin (BLM) (six patients) or BLM combined with polidocanol (POL) (eight patients). The safety and effects of BLM and BLM + POL were analyzed using a t-test for categorical data and likelihood ratios or Fisher's exact test for continuous data. Factors resulting in an increased number of treatment sessions were studied.</p><p><strong>Results: </strong>Treatment began 2-5 days after birth. The patients in the BLM group underwent more treatment sessions. Gestational age, lesion size and type, total response, and complications showed no significant differences between groups. Larger and mixed-ype lesions required more treatment sessions.</p><p><strong>Conclusions: </strong>Both BLM group and BLM + POL group appear relatively safe and effective in neonates with giant lymphatic malformations. The combination of the two agents reduced the number of procedures and general anesthesia required.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307972","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":"Antiseptic efficacy and plasma chlorhexidine levels following two different methods of application of 1% aqueous chlorhexidine gluconate for skin disinfection in preterm newborns: a randomized controlled trial.","authors":"Richie Dalai, Sarita Mohapatra, Thirumurthy Velpandian, Jeeva Sankar, Anu Thukral, Ankit Verma, Minu Bajpai, R Dhinakaran, Mohammad Tousifullah, Ramesh Agarwal","doi":"10.1038/s41372-024-02122-y","DOIUrl":"https://doi.org/10.1038/s41372-024-02122-y","url":null,"abstract":"<p><strong>Objective: </strong>Many neonatal units have started using Chlorhexidine gluconate for neonatal skin antisepsis. However, there is in-vitro evidence of inhibition of neurite growth. The current study aimed to compare two methods of its local application, for the extent of systemic absorption and antiseptic efficacy.</p><p><strong>Study design: </strong>Parallel group, blinded, randomised trial, at a Level III, neonatal intensive care unit. Between December 2020 to July 2022, neonates from 28 to 34 weeks gestation, were randomized to local skin antisepsis by either- (a) 1% aqueous chlorhexidine (CHG aq) followed by cleansing off the residual agent with sterile water swab (Cleansing group) or (b)1% CHG aq followed by air drying (No cleansing group). The outcome measures were the proportion of post antisepsis skin swabs with no/insignificant growth, and the plasma chlorhexidine levels.</p><p><strong>Results: </strong>Of the total of 457 enrollments (Cleansing: n = 230; No Cleansing: n = 227), 216 (93.91%) in \"Cleansing\" vs. 221 (97.36%) in \"No cleansing\" (risk difference -3.45%, 95% CI -7.2 to 0.28%; p = 0.072) had no/insignificant growth post-antisepsis. The lower bound of the confidence interval crossed the pre-specified non-inferiority limit of 5%. The median (IQR) plasma chlorhexidine levels were not significantly different between the two groups (7.9 (5.6, 17.9)) ng/mL in Cleansing vs. 6.5 (4.6, 17.7) in No cleansing groups (p = 0.437).</p><p><strong>Conclusion: </strong>Cleansing with sterile water after application of chlorhexidine in preterm neonates was not shown to be non-inferior compared to no cleansing, for skin antisepsis efficacy. Systemic absorption occurred to a similar extent despite cleansing off the residual agent.</p><p><strong>Trial registration number: </strong>CTRI/2020/10/028719.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289649","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 \"Other\" race category on birth certificates and its impact on analyses of preterm birth inequity.","authors":"Kayla R Holloway, Joshua Radack, Alejandra Barreto, Barbara H Chaiyachati, Diana Montoya-Williams, Angela M Ellison, Heather H Burris","doi":"10.1038/s41372-024-02123-x","DOIUrl":"10.1038/s41372-024-02123-x","url":null,"abstract":"<p><strong>Objective: </strong>Not all individuals self-identify with race categories on birth certificates, selecting \"Other\" and writing in identities. Our hypothesis was that curating write-in responses in the \"Other\" race category would contribute to understanding preterm birth inequities.</p><p><strong>Methods: </strong>We analyzed Pennsylvania birth certificates (2006-2014). Two independent coders reviewed each write-in response among those who selected \"Other\" race. We compared preterm birth rates across subpopulations within \"Other\" race category using a Monte Carlo simulated Chi-square test.</p><p><strong>Results: </strong>Among 1,196,125 singleton births, 72,891 (6.1%) exclusively selected \"Other\" race; Hispanic more often than non-Hispanic individuals (54.5% vs 0.7%), p < 0.0001). Only 545 (0.8%) of Hispanic individuals wrote in responses aligned with preestablished race categories compared to 2,601 (33.2%) of non-Hispanic individuals. Preterm birth rates varied significantly across identities within the \"Other\" group (P < 0.001).</p><p><strong>Conclusion: </strong>Utilizing combinations of self-identified race, ethnicity, and continental origin may facilitate public health efforts focused on birth outcome equity.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289652","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":"Opioid equipotency conversions for hospitalized infants: a systematic review","authors":"Madeleine C. Ing,&nbsp;Olivia A. Keane,&nbsp;Ashwini Lakshmanan,&nbsp;Eugene Kim,&nbsp;Henry C. Lee,&nbsp;Lorraine I. Kelley-Quon","doi":"10.1038/s41372-024-02121-z","DOIUrl":"10.1038/s41372-024-02121-z","url":null,"abstract":"Hospitalized infants commonly receive opioids to reduce pain and minimize distress during invasive procedures. However, infant neurodevelopment is significantly impacted by cumulative and prolonged opioid exposures. While opioid conversion has been studied extensively in adults, no standardized equipotency opioid conversions exist for hospitalized infants and opioid stewardship efforts are inconsistent. We performed a systematic review to identify opioid dosing conversions commonly used in hospitalized infants &lt;1 year of age, finding fourteen articles which documented or cited a calculation of cumulative opioid exposure. Morphine milligram equivalents (MME) conversion factors varied widely, with nine studies citing conversion equivalent equations commonly used in adults. Efforts to expand safe opioid stewardship to hospitalized infants will require evidence-based consensus for opioid equipotency dose conversions which acknowledge the unique physiology of infants.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"44 12","pages":"1709-1718"},"PeriodicalIF":2.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41372-024-02121-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289651","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","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":"Is fluid balance in the first 14 days of life associated with respiratory outcomes in extremely premature neonates? EBM Lesson: Covariate selection in an observation study","authors":"Matthew R. Michienzi, Ashly Dunham, Andrew J. Groberg","doi":"10.1038/s41372-024-02119-7","DOIUrl":"https://doi.org/10.1038/s41372-024-02119-7","url":null,"abstract":"<p>Starr MC, Griffin R, Gist KM, Segar JL, Raina R, et al. Association of Fluid Balance with Short- and Long-term Respiratory Outcomes in Extremely Premature Neonates: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2022 [1].</p><p>Secondary Analysis of a Randomized Clinical Trial.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"121 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253430","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":"Neurological outcomes and associated perinatal factors in infants born between 22 and 25 weeks with active care","authors":"Yu Ariyoshi, Takayuki Iriyama, Takahiro Seyama, Seisuke Sayama, Eriko Yano, Kensuke Suzuki, Taiki Samejima, Mari Ichinose, Masatake Toshimitsu, Kenbun Sone, Atsushi Ito, Yoshihiko Shitara, Keiichi Kumasawa, Kohei Kashima, Satsuki Kakiuchi, Yasushi Hirota, Naoto Takahashi, Yutaka Osuga","doi":"10.1038/s41372-024-02093-0","DOIUrl":"https://doi.org/10.1038/s41372-024-02093-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This is a single-center retrospective study on infants born at 22–25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"50 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268851","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":"Reporting nasal pressure injuries in neonates receiving non-invasive ventilation: a scoping review","authors":"Alexander E. Graf,&nbsp;Simon Bellido,&nbsp;Chellapriya Vythinathan,&nbsp;Jigar Govind,&nbsp;Lawrence Fordjour,&nbsp;Sydney C. Butts,&nbsp;Ann Woodhouse Plum","doi":"10.1038/s41372-024-02006-1","DOIUrl":"10.1038/s41372-024-02006-1","url":null,"abstract":"Although neonates receiving Non-Invasive Ventilation (NIV) for respiratory support are at risk for nasal pressure injuries, efforts to standardize reporting are limited. A scoping review was conducted to identify the reporting systems used for describing these injuries. PubMed, Embase, and Web of Science were queried for papers reporting nasal injury with NIV usage in neonates. The primary outcome was reporting system usage. 705 titles and abstracts were screened. 40 papers met inclusion criteria. Most studies were Randomized Clinical Trials (37.5%) or cohort studies (37.5%). Most commonly, nasal injuries were reported using a unique, descriptive scale developed by the authors (10 studies, 25%). The Fischer et al 2010 scale, a three-stage reporting system, was used in 8 studies (20%). While 15 studies (38.0%) reported on specific anatomic subsite injury, only 2 studies (5.0%) employed endoscopy for assessment. Wide heterogeneity in pressure injury reporting secondary to NIV exists across specialties, institutions, and literature.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"44 12","pages":"1-9"},"PeriodicalIF":2.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253433","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":"Mental health in pregnancy complicated by fetal anomaly: depression screening and referrals in a single fetal care center","authors":"Kara Hansen, Stephanie K. Kukora, Ashley Sherman, Keith Feldman","doi":"10.1038/s41372-024-02118-8","DOIUrl":"https://doi.org/10.1038/s41372-024-02118-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To quantify depression screening rates in a fetal care center, identify characteristics associated with screenings and identify mental health referral uptake rates</p><h3 data-test=\"abstract-sub-heading\">Study design</h3><p>This retrospective cohort study of 166 patients in a single fetal care center investigated patients screened during pregnancy with the Edinburgh Postnatal Depression Scale</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Patients screened positive for depression at a rate of 31.9% using 10 as the cut-off score at their first mental health consult following diagnosis. Patients with a prior mental health diagnosis and lacked insurance or had state insurance were more likely to screen positive. Additionally, patients were more likely to screen positive with a severe fetal diagnosis or uncertain fetal prognosis. Patients were likely to accept a referral for therapy; fewer accepted a referral for pharmacotherapy</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Fetal care center patients are at risk of depressed mood and may be identified through universal screening. Particular attention should be provided to patients with an uncertain fetal prognosis and other identified characteristics.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"64 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253432","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":"Neonatal reference values and nomograms of systemic vascular resistances estimated with electrical cardiometry","authors":"Valeria Bisceglie, Barbara Loi, Ottavio Vitelli, Alice Proto, Maria Elena Ferrari, Laura Vivalda, Matteo Di Nardo, Stefano Martinelli, Daniele De Luca","doi":"10.1038/s41372-024-02115-x","DOIUrl":"https://doi.org/10.1038/s41372-024-02115-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>Scanty data are available about neonatal systemic vascular resistances (SVR). We aim to provide reference values and nomograms for neonatal SVR.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>Multicenter, cross-sectional,descriptive study performed in France and Italy. Neonates with complete hemodynamic stability were enrolled. Non-invasive measurements of SVR by electrical cardiometry performed once, after the first 72 h and before the 7th day of postnatal age.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We studied 1094 neonates: SVR was correlated with gestational age (ρ = −0.55, adj-<i>r</i> = −0.46, <i>p</i> &lt; 0.001) and birth weight (ρ = −0.59, adj-<i>r</i> = −0.45, <i>p</i> &lt; 0.001) irrespective of newborn sex. The relationships between SVR, gestational age and birth weight were represented by power equations and SVR was decreasing with increasing age and weight. Age- and weight-based SVR nomograms had optimal goodness-of-fit (non-linear R² ≥0.74). Similar results were obtained for body surface indexed-SVR.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>In hemodynamically stable neonates, SVR decrease with increasing gestational age and birth weight. Specific gestational age and birth weight-based nomograms are provided for the clinical interpretation.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":"25 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253431","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}