Seminars in perinatology最新文献_第2页

Unbound bilirubin-based management of neonatal hyperbilirubinemia: The Japanese experience and global adaptation. 基于非结合胆红素的新生儿高胆红素血症管理：日本经验和全球适应。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-04 DOI: 10.1016/j.semperi.2026.152294

Sota Iwatani, Ichiro Morioka, Hajime Nakamura

{"title":"Unbound bilirubin-based management of neonatal hyperbilirubinemia: The Japanese experience and global adaptation.","authors":"Sota Iwatani, Ichiro Morioka, Hajime Nakamura","doi":"10.1016/j.semperi.2026.152294","DOIUrl":"https://doi.org/10.1016/j.semperi.2026.152294","url":null,"abstract":"<p><p>Neonatal hyperbilirubinemia is common, but bilirubin-induced neurologic dysfunction (BIND) remains an important cause of preventable morbidity, particularly in preterm infants. Japan has developed a distinctive approach centered on unbound bilirubin (UB), the biologically active fraction. Nakamura and colleagues pioneered neonatal UB measurement in the 1970s and incorporated UB measurements into the Kobe University (Nakamura) criteria in 1991. With improved survival of extremely preterm infants, bilirubin encephalopathy was still observed despite modest total serum bilirubin (TSB) levels that persisted beyond the first postnatal week. These observations led Morioka to revise the criteria in 2017, incorporating gestational age (GA), corrected GA, UB levels, and staged treatment throughout the prolonged neonatal course. Clinical experience suggests that this approach may reduce phototherapy exposure without increasing UB levels or exchange transfusion, although multicenter evidence with long-term neurodevelopmental outcomes remains limited. The Japanese experience emphasizes longitudinal monitoring and bilirubin-albumin binding characteristics beyond TSB levels alone. Transcutaneous bilirubin, albumin, and bilirubin-albumin molar ratio may facilitate screening, while emerging fluorescence-based methods may improve UB accessibility. UB measurement should be viewed as a framework for individualized risk assessment, with principles adaptable to diverse populations and clinical settings.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152294"},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888645","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}

引用次数: 0

The role of physical examination in the identification of neonates with early-onset sepsis 体格检查在鉴别新生儿早发性败血症中的作用。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-04-02 DOI: 10.1016/j.semperi.2026.152227

Xuxin Chen, Richard A. Polin

引用次数: 0

The uprise of congenital syphilis in the United States: a preventable failure of perinatal systems 先天性梅毒在美国的爆发：围产期系统的可预防的失败。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-07-14 DOI: 10.1016/j.semperi.2026.152280

Jana Shaw

{"title":"The uprise of congenital syphilis in the United States: a preventable failure of perinatal systems","authors":"Jana Shaw","doi":"10.1016/j.semperi.2026.152280","DOIUrl":"10.1016/j.semperi.2026.152280","url":null,"abstract":"<div><div>Congenital syphilis is a preventable infection caused by vertical transmission of <em>Treponema pallidum</em> during pregnancy. Despite effective screening and curative treatment, rates in the United States have risen sharply over the past decade, paralleling increasing syphilis rates among reproductive-aged adults. This resurgence reflects systemic gaps in healthcare access, public health infrastructure, and social support systems. Adverse outcomes include stillbirth, neonatal death, prematurity, and long-term neurologic, skeletal, and auditory complications.</div><div>This review summarizes current U.S. epidemiologic trends and examines multifactorial drivers of rising congenital syphilis, including inadequate or absent prenatal care, missed or delayed screening, reinfection during pregnancy, and social determinants such as poverty, substance use, and healthcare inequities. System-level challenges such as inconsistent screening practices, treatment delays, and under-resourced public health programs-further sustain transmission.</div><div>Evidence-based prevention strategies include universal early pregnancy screening, repeat testing for high-risk patients, prompt penicillin treatment, strengthened partner services, and expanded prenatal care access. Policy initiatives and community-based outreach are essential to address structural disparities and improve care engagement.</div><div>Congenital syphilis is a sentinel marker of healthcare system performance. Coordinated clinical, public health, and policy efforts are urgently needed to reverse current trends and achieve elimination in the United States.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 6","pages":"Article 152280"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449434","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}

引用次数: 0

Advancing the science of Staphylococcus aureus infection prevention in the neonatal intensive care unit 推进新生儿重症监护室预防金黄色葡萄球菌感染的科学。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-07-29 DOI: 10.1016/j.semperi.2026.152281

Lakshmi Srinivasan, Paul J. Planet

引用次数: 0

MDRO infections in the NICU- The international perspective 新生儿重症监护室的MDRO感染-国际视角。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-06-09 DOI: 10.1016/j.semperi.2026.152257

Dhanya Dharmapalan, Nupur Sinha

{"title":"MDRO infections in the NICU- The international perspective","authors":"Dhanya Dharmapalan, Nupur Sinha","doi":"10.1016/j.semperi.2026.152257","DOIUrl":"10.1016/j.semperi.2026.152257","url":null,"abstract":"<div><div>Neonatal sepsis due to Multidrug resistant organisms (MDRO) is a huge burden in resource limited settings of South Asia and Africa. The epidemiology, risk factors, diagnostic and management challenges differ significantly in the resource limited settings as compared to the resource rich settings, particularly for Gram-negative MDROs. Lack of diagnostic facilities, limited access to therapeutic options, inability to effectively control horizontal transmission in the neonatal care units due to limited resources are major hurdles in combating MDRO infections in neonates. The low sensitivity of gold standard blood cultures and paucity of pharmacokinetic data in neonates make the overall picture grim.</div><div>Research studies over the past decade have identified high resistance to the first line and second line treatment regimens recommended by the World Health Organisation (WHO). The progress towards finding customised solutions has been slow. Novel betalactam-betalactamase antibiotics are effective against several MDROs but are expensive. Repurposed antibiotics like fosfomycin and flomoxef hold promise as therapeutic options.</div><div>The continued critical gaps need to be urgently addressed as national priorities and through international support and cooperation.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 6","pages":"Article 152257"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212524","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}

引用次数: 0

Neonatal early-onset sepsis: A changing paradigm of pathogens and high-risk cohorts 新生儿早发脓毒症：病原体和高危人群的变化范式。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-05-13 DOI: 10.1016/j.semperi.2026.152248

Noa Fleiss, Matthew J. Bizzarro

引用次数: 0

Congenital cytomegalovirus: Screening strategies and diagnostic challenges 先天性巨细胞病毒：筛查策略和诊断挑战。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-07-02 DOI: 10.1016/j.semperi.2026.152278

Karen Ravin, Terri Stillwell

引用次数: 0

Seminars in perinatology preface: Neonatal infectious diseases: shifts, challenges and strategies 围产期研讨会前言：新生儿传染病：转变、挑战和战略。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-08-06 DOI: 10.1016/j.semperi.2026.152291

Noa Fleiss, Thomas S. Murray

引用次数: 0

Candida auris in the neonatal intensive care unit 新生儿重症监护室的耳念珠菌。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 Epub Date: 2026-05-16 DOI: 10.1016/j.semperi.2026.152249

Nathan L’Etoile, Thomas S. Murray

{"title":"Candida auris in the neonatal intensive care unit","authors":"Nathan L’Etoile, Thomas S. Murray","doi":"10.1016/j.semperi.2026.152249","DOIUrl":"10.1016/j.semperi.2026.152249","url":null,"abstract":"<div><div><em>Candida (a.k.a.Candidozyma) auris</em> is a healthcare-associated yeast that has attracted attention due to its increased antimicrobial resistance and ability to spread rapidly within the healthcare environment. Infants admitted to the neonatal intensive care unit (NICU) have risk factors such as broad spectrum antibiotic exposure, prematurity and congenital heart disease that predispose them to serious infection with <em>C. auris.</em> Consequently, there have been global reports of <em>C. auris</em> outbreaks in NICUs associated with high mortality. The clinical presentation of late onset sepsis with <em>C. auris</em> is indistinguishable from other etiologies. Echinocandins remain the empiric therapy of choice along with amphotericin B in select cases. Identification of an invasive case of <em>C. auris</em> in the NICU requires implementation of infection prevention and control measures including contact precautions, enhanced environmental cleaning and disinfection, and the screening of other infants for colonization. Areas where research is needed include optimal antifungal therapy for treatment and prophylaxis, the ideal body sites to screen for colonization, the length of time infants remain colonized with <em>C. auris,</em> and the risk of infant colonization from breast feeding and skin-to-skin practices with colonized or infected caregivers. Continued reporting of the clinical experience of NICUs that experience <em>C. auris</em> is essential to expand our knowledge and to protect neonates and infants from this evolving pathogen.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 6","pages":"Article 152249"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960263","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}

引用次数: 0

Cochlear implantation for sensorineural hearing loss caused by neonatal hyperbilirubinemia. 新生儿高胆红素血症致感音神经性听力损失的人工耳蜗植入治疗。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-09-01 DOI: 10.1016/j.semperi.2026.152293

Melodyanne Y Cheng, John S Oghalai

{"title":"Cochlear implantation for sensorineural hearing loss caused by neonatal hyperbilirubinemia.","authors":"Melodyanne Y Cheng, John S Oghalai","doi":"10.1016/j.semperi.2026.152293","DOIUrl":"10.1016/j.semperi.2026.152293","url":null,"abstract":"<p><strong>Background: </strong>Hyperbilirubinemia is a leading cause of sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD) in neonates. This review synthesizes current evidence to describe key aspects of cochlear implantation (CI) in neonates with hyperbilirubinemia.</p><p><strong>Objective: </strong>To educate a wide audience on the pathophysiology, audiometric challenges, hearing aid trial considerations, optimal timing, and expected outcomes of CI in neonates with bilirubin-induced hearing loss.</p><p><strong>Methods: </strong>A comprehensive review was conducted on PubMed and Cochrane databases to explore current clinical practice guidance for evaluating neonates with hyperbilirubinemia for CI.</p><p><strong>Results: </strong>Bilirubin has neurotoxic effects on the auditory pathway in neonates, making it challenging to have strict audiometric criteria for CI. Hearing trials serve the dual purpose of diagnosis and therapy for infants with hearing loss and can identify strong candidates for CI or, conversely, exclude children who may not benefit from CI. Optimal timing of CI balances diagnostic certainty with earlier intervention. Provider counseling is crucial in preparing families for expected outcomes after CI, which are generally favorable, but can vary among infants depending on factors such as interdisciplinary care coordination.</p><p><strong>Conclusion: </strong>Audiologic monitoring, careful CI decision-making, and realistic outcome counseling optimize candidate selection and care for neonates with bilirubin-induced hearing loss.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152293"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875038","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}

引用次数: 0