Journal of Perinatal Medicine最新文献

{"title":"Quo vadis neonatologia? Where is neonatology heading in the 21st century?","authors":"Milan Stanojević, Bożena Kociszewska-Najman, Amos Grünebaum, Frank Chervenak, Asim Kurjak","doi":"10.1515/jpm-2025-0339","DOIUrl":"https://doi.org/10.1515/jpm-2025-0339","url":null,"abstract":"<p><strong>Introduction: </strong>This comprehensive narrative review examines current paradigms, emerging trends, and future directions in neonatology through systematic analysis of contemporary literature, clinical practice patterns, and expert consensus. We synthesized evidence from recent publications, international guidelines, and clinical innovations to identify key transformation areas.</p><p><strong>Content: </strong>Several critical areas are reshaping neonatology. Gestational age has emerged as a lifelong health determinant with implications extending far beyond the neonatal period, affecting cardiovascular, metabolic, and neurodevelopmental outcomes throughout life. Global disparities in neonatal care remain unconscionably large, with survival rates for 28-week infants exceeding 90 % in high-income countries while similar infants in low-resource settings often die from preventable causes. Artificial intelligence applications are revolutionizing predictive analytics, real-time monitoring, and decision support systems, though implementation requires careful attention to bias, transparency, and human oversight. The neonatal microbiome's crucial role in immune development and long-term health has prompted interventions targeting healthy colonization. Salutogenic approaches emphasizing health promotion rather than disease treatment are gaining recognition. Most significantly, the systematic marginalization of mothers in neonatal care is being challenged, with growing recognition of the mother-infant dyad as the fundamental unit of care.</p><p><strong>Summary and outlook: </strong>Future neonatal care must balance technological advancement with humanistic values, addressing global disparities while maintaining scientific rigor. Success requires committing to global health equity, embracing ethical complexity at viability margins, recognizing maternal centrality, thoughtfully integrating emerging technologies, implementing salutogenic principles, and adopting lifelong health perspectives. The field's future depends on interdisciplinary collaboration, ethical reflection, and unwavering commitment to ensuring every newborn receives compassionate, high-quality care.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fetus as a patient: professional responsibility in contemporary Perinatal Medicine.","authors":"Frank A Chervenak, Asim Kurjak, Milan Stajonevic, Joachim Dudenhausen, Amos Grünebaum","doi":"10.1515/jpm-2025-0338","DOIUrl":"https://doi.org/10.1515/jpm-2025-0338","url":null,"abstract":"<p><p>The concept of the fetus as a patient has evolved over the past several decades, driven by advances in fetal medicine, neonatology, and bioethics. Pioneering international work by Erich Saling, Ian Donald, William Liley, L. Stanley James, and Roberto Caldeyro-Barcia transformed the fetus from a passive presence into an active subject of medical diagnosis and intervention, laying the groundwork for a dual-patient ethical model in obstetric care. The Society \"The Fetus as a Patient,\" established in the early 1990s, galvanized international collaboration among clinicians and ethicists, promoting the recognition of the fetus as a patient. Since its inception, the <i>Journal of Perinatal Medicine</i> has served as the official and essential publication of the Society for the Fetus as a Patient, disseminating many of its most influential papers. Central to this evolution is the professional responsibility model, which delineates clinicians' ethical obligations to both pregnant and fetal patients, emphasizing evidence-based advocacy and beneficence while respecting maternal autonomy. The model defines the fetus as a patient when the pregnant woman seeks care and when interventions can reasonably benefit the fetus, with viability as an inflection point serving as a key ethical threshold. Technological advances in the 21st century, such as fetal surgery and gene therapy, have further advanced the ethical landscape, necessitating nuanced, preventive ethics and transparent communication. The 2009 and 2024 International Academy of Perinatal Medicine New York declarations have reinforced the global commitment to equitable, ethically sound perinatal care, balancing maternal rights and fetal interests. As maternal-fetal medicine continues to advance, ongoing ethical reflection, institutional support, and interdisciplinary international collaboration remain essential for aligning clinical innovation with professional integrity and justice in perinatal care.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and reproducibility of speckle tracking echocardiography in routine assessment of the fetal heart in a low-risk population: a letter reply.","authors":"Adalina Sacco, Ayisha Kazi, Diane Lambo, Victoria Jowett, Pranav Pandya","doi":"10.1515/jpm-2025-0326","DOIUrl":"https://doi.org/10.1515/jpm-2025-0326","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum biomarkers in the early detection of necrotizing enterocolitis: a systematic review.","authors":"Sara Pimenta, Susana Pissarra, Paulo Soares, Inês Azevedo, Joana Pereira-Nunes","doi":"10.1515/jpm-2025-0180","DOIUrl":"https://doi.org/10.1515/jpm-2025-0180","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease with high morbidity and mortality that predominantly affects preterm infants. Early diagnosis remains challenging due to nonspecific symptoms and delayed detection of radiological signs.</p><p><strong>Content: </strong>This systematic review provides an updated overview of the available evidence on serum biomarkers for early NEC detection, focusing on their diagnostic accuracy and clinical utility. A structured search was conducted in MEDLINE, Scopus, and web of science, identifying 40 studies evaluating biomarkers across various categories, including hematological indices, acute phase reactants, immunological markers, tissue damage and tissue repair markers, and metabolic markers.</p><p><strong>Summary: </strong>Our findings highlight intestinal fatty acid-binding protein (I-FABP) as a promising biomarker for NEC prediction within the first 24 h of life. Ischemia-modified albumin (IMA) and certain multi-marker panels also showed high diagnostic accuracy. Despite these promising results, small sample sizes and heterogeneity in study design, biomarker thresholds, and patient populations limit immediate clinical implementation.</p><p><strong>Outlook: </strong>Future multicenter studies are essential to validate promising biomarkers, particularly I-FABP and IMA, and establish standardized cut-off values. Integrating biomarkers into multi-marker panels, alongside clinical and non-invasive approaches, may improve early NEC detection, enhance diagnostic accuracy, and guide timely interventions to optimize neonatal outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of gestational diabetes mellitus using clinical and ultrasonographic parameters: development of independent maternal and fetal models.","authors":"Sinem Tekin, Aydın Ocal, Filiz Yarsilikal Guleroglu, Cagseli Göksu Ozgün Selcuk, Omer Gökhan Eyisoy, Emine Ufuk Büyükkaya Ocal, Ali Cetin","doi":"10.1515/jpm-2025-0135","DOIUrl":"https://doi.org/10.1515/jpm-2025-0135","url":null,"abstract":"<p><strong>Objectives: </strong>To develop predictive models for gestational diabetes mellitus (GDM) using maternal clinical and ultrasonographic parameters, as well as fetal ultrasonographic measurements obtained during routine second-trimester obstetric examination.</p><p><strong>Methods: </strong>Our prospective case-control study included 80 pregnant participants (32 with GDM and 48 healthy controls) between 24 and 28 weeks of gestation. We evaluated maternal parameters including anthropometric measurements such as neck circumference and waist-hip ratio, ultrasonographic measurements like maternal adipose thickness, as well as fetal ultrasonographic parameters including pancreatic hyperechogenicity, soft tissue measurements, and cardiac parameters. Following ultrasonographic examination, all participants underwent a 75-g oral glucose tolerance test (OGTT). Two separate logistic regression models were developed for maternal and fetal parameters to evaluate their association with the presence or absence of GDM.</p><p><strong>Results: </strong>The maternal model achieved 90.0 % accuracy through a stepwise integration of suprapubic subcutaneous adipose tissue thickness (OR=1.35, 95 % CI: 1.11-1.64), visceral adipose tissue (OR=1.68, 95 % CI: 1.18-2.40), gravidity (OR=2.09, 95 % CI: 1.32-3.33), and family history of diabetes. The fetal model reached 82.5 % accuracy using two parameters: pancreatic hyperechogenicity (OR=0.02, 95 % CI: 0.00-0.14) and fetal abdominal subcutaneous tissue thickness (OR=5.09, 95 % CI: 1.75-14.78). The maternal model demonstrated excellent discriminative ability with an AUC of 0.95.</p><p><strong>Conclusions: </strong>Both maternal and fetal ultrasonographic parameters can serve as effective predictors of GDM when combined with clinical risk factors. These models, which can be easily incorporated into routine second-trimester ultrasound examinations, offer potential for early identification of high-risk patients without additional patient visits or invasive testing.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copy number variation sequencing detection technology for identifying fetuses with abnormal soft indicators: a comprehensive study.","authors":"Guangting Lu, Weiwu Liu","doi":"10.1515/jpm-2024-0449","DOIUrl":"10.1515/jpm-2024-0449","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the value of copy number variation sequencing (CNV-seq) in prenatal diagnosis of abnormal ultrasound markers to reduce fetal birth defects.</p><p><strong>Methods: </strong>Between June 2021 and December 2022, Yulin Maternal and Child Health Care Hospital examined 295 pregnant women with abnormal ultrasound indicators. We were categorized by the number of abnormalities and age. Karyotype analysis and CNV-seq were conducted, and the CNV-seq detection rate was statistically analyzed.</p><p><strong>Results: </strong>CNV-seq detected abnormal chromosomes in 43 out of 295 pregnant women with abnormal fetal ultrasound soft indicators, resulting in a detection rate of 14.58 %, compared to 5.76 % with traditional karyotype analysis. CNV-seq identified all aneuploidy abnormalities found by karyotype analysis and an additional 5 abnormalities, increasing the detection rate by 1.69 %. However, CNV-seq missed one case of chromosome equilibrium translocation. The detection rate of CNV-seq in fetuses with Several abnormal soft indexes was 29.41 %, significantly higher than individual soft indexes (p<0.05). The study compared abnormality rates of single and multiple ultrasound soft markers in two age groups. Abnormal detection rates were 12.38 % for the younger group and 13.73 % for the older group, with no significant difference. However, the younger group had a significantly higher detection rate for multiple soft markers compared to the older group (χ²=5.517, p<0.05).</p><p><strong>Conclusions: </strong>CNV-seq technology is valuable for identifying fetuses with abnormal soft markers, guiding its future use in perinatal diagnosis and aiding clinical genetic counseling.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"338-349"},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI and early diagnostics: mapping fetal facial expressions through development, evolution, and 4D ultrasound.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2024-0602","DOIUrl":"10.1515/jpm-2024-0602","url":null,"abstract":"<p><p>The development of facial musculature and expressions in the human fetus represents a critical intersection of developmental biology, neurology, and evolutionary anthropology, offering insights into early neurological and social development. Fetal facial expressions, shaped by Cranial Nerve VII, reflect evolutionary adaptations for nonverbal communication and exhibit minimal asymmetry in universal expressions. Advancements in 4D ultrasound imaging and artificial intelligence (AI) have introduced innovative methods for analyzing these movements, revealing their potential as diagnostic tools for neurodevelopmental disorders like Bell's Palsy and Ramsay Hunt Syndrome before birth. These technologies promise early interventions that could significantly improve neonatal outcomes. By integrating imaging, AI, and longitudinal studies, researchers propose a multidisciplinary approach to establish diagnostic criteria for fetal facial movements. However, translating these advancements into clinical practice requires addressing ethical and practical challenges, refining imaging and AI methodologies, and fostering interdisciplinary collaboration. The review highlights the universality of fetal expressions while emphasizing the importance of distinguishing typical variability from pathological markers. In conclusion, these findings suggest transformative potential for maternal-fetal medicine, paving the way for proactive strategies to manage neurodevelopmental risks. Focused research is essential to fully harness these innovations and establish a new frontier in perinatal science.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"263-285"},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trisomy 18 mosaicism - are we able to predict postnatal outcome by analysing the tissue-specific distribution?","authors":"Iris Dressler-Steinbach, Miriam Kinzel, Holger Janke, Rainer Wimmer, Alexander Weichert, Rabih Chaoui, Lars Garten, André Weber, Stefan Verlohren, Wolfgang Henrich, Markus Stumm","doi":"10.1515/jpm-2024-0543","DOIUrl":"10.1515/jpm-2024-0543","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"407-409"},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A crisis in U.S. maternal healthcare: lessons from Europe for the U.S.","authors":"Amos Grünebaum, Joachim Dudenhausen, Frank A Chervenak","doi":"10.1515/jpm-2024-0606","DOIUrl":"10.1515/jpm-2024-0606","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"297-304"},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of cardiac remodeling and cardiac function on fetuses conceived via artificial reproductive technologies: a review.","authors":"Konstantinos Tasias, Maria Papamichail, Zacharias Fasoulakis, Marianna Theodora, Georgios Daskalakis, Panos Antsaklis","doi":"10.1515/jpm-2024-0346","DOIUrl":"10.1515/jpm-2024-0346","url":null,"abstract":"<p><p>The prevalence of artificial reproductive technologies (ART), such as intra-uterine insemination (IUI), <i>in vitro</i> fertilization (IVF), and intracytoplasmic sperm injection (ICSI), has surged in response to the global increase in infertility rates, now impacting 17.5 % of couples. With over nine million babies born through ART, the safety and efficacy of these methods are largely recognized; however, emerging concerns regarding their association with prenatal and long-term health risks, especially cardiovascular disease (CVD), necessitate a thorough examination. This review synthesizes recent findings on the cardiac remodeling observed in ART-conceived fetuses, highlighting the potential for sub-clinical dysfunction and subsequent cardiovascular anomalies that may extend into adolescence. It delves into the perinatal complications linked to ART and examines the contribution of the renin-angiotensin system, epigenetic modifications, and altered microRNA expressions to fetal cardiovascular development. The analysis further differentiates the cardiac effects of fresh vs. frozen ART cycles and investigates the enduring nature of these changes beyond birth. Addressing the elevated CVD risk among ART individuals, the review suggests proactive measures, including lifestyle adjustments initiated early in life, to mitigate potential adverse outcomes. It emphasizes the critical need for ongoing research and intervention strategies to safeguard the cardiovascular health of the increasing number of ART-conceived individuals.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"286-296"},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}