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Seminars in perinatology最新文献

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Effects of pain, sedation and analgesia on neonatal brain injury and brain development 疼痛、镇静和镇痛对新生儿脑损伤和脑发育的影响
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151928
{"title":"Effects of pain, sedation and analgesia on neonatal brain injury and brain development","authors":"","doi":"10.1016/j.semperi.2024.151928","DOIUrl":"10.1016/j.semperi.2024.151928","url":null,"abstract":"<div><p>Critically ill newborns experience numerous painful procedures as part of lifesaving care in the Neonatal Intensive Care Unit. However, painful exposures in the neonatal period have been associated with alterations in brain maturation and poorer neurodevelopmental outcomes in childhood. The most frequently used medications for pain and sedation in the NICU are opioids, benzodiazepines and sucrose; these have also been associated with abnormalities in brain maturation and neurodevelopment making it challenging to know what the best approach is to treat neonatal pain. This article provides clinicians with an overview of how neonatal exposure to pain as well as analgesic and sedative medications impact brain maturation and neurodevelopmental outcomes in critically ill infants. We also highlight areas in need of future research to develop standardized neonatal pain monitoring and management strategies.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146000524000624/pdfft?md5=d710888fa8c40a2ddbb5249b10529286&pid=1-s2.0-S0146000524000624-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394217","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
Protecting and healing the newborn brain through non-pharmacologic and pharmacologic measures 通过非药物和药物措施保护和修复新生儿大脑
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151931
{"title":"Protecting and healing the newborn brain through non-pharmacologic and pharmacologic measures","authors":"","doi":"10.1016/j.semperi.2024.151931","DOIUrl":"10.1016/j.semperi.2024.151931","url":null,"abstract":"","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408686","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
Parental impact during and after neonatal intensive care admission 新生儿重症监护期间和之后对父母的影响
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151926
{"title":"Parental impact during and after neonatal intensive care admission","authors":"","doi":"10.1016/j.semperi.2024.151926","DOIUrl":"10.1016/j.semperi.2024.151926","url":null,"abstract":"<div><p><span>Parents play a pivotal role in neurodevelopmental outcomes of their children in the neonatal intensive care unit (NICU) and beyond. Integration of parents in clinical care and research is synergistic. Engaged parents yield more comprehensive clinical care and more robust and meaningful research products. Subsequently, successful clinical and research efforts improve outcomes for children. We review strategies for parental integration into NICU clinical care and research, including parental involvement in therapeutic interventions and neurodevelopmental care, and effective communication strategies for clinicians and researchers. We discuss challenges in neonatal trials and emphasize the need for building a culture of research, collaborative partnerships with </span>patient advocacy organizations, and ongoing support beyond the NICU. Overall, we call for recognizing and fostering the impactful role of parents as teammates with clinicians and researchers in optimizing neurodevelopmental outcomes in the NICU and beyond.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393235","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
Racial and geographic disparities in neonatal brain care 新生儿脑部护理的种族和地域差异
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151925
{"title":"Racial and geographic disparities in neonatal brain care","authors":"","doi":"10.1016/j.semperi.2024.151925","DOIUrl":"10.1016/j.semperi.2024.151925","url":null,"abstract":"<div><p>In this review, we explore race-based disparities in neonatology and their impact on brain injury and neurodevelopmental outcomes. We discuss the historical context of healthcare discrimination, focusing on the post-Civil War era and the segregation of healthcare facilities. We highlight the increasing disparity in infant mortality rates between Black and White infants, with premature birth being a major contributing factor, and emphasize the role of prenatal factors such as metabolic syndrome and toxic stress in affecting neonatal health. Furthermore, we examine the geographic and historical aspects of racial disparities, including the consequences of redlining and limited access to healthcare facilities or nutritious food options in Black communities. Finally, we delve into the higher incidence of brain injuries in Black neonates, as well as disparities in adverse neurodevelopmental outcome. This evidence underscores the need for comprehensive efforts to address systemic racism and provide equitable access to healthcare resources.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146000524000594/pdfft?md5=22f404a6ca4e469dd12b81fe680a8f89&pid=1-s2.0-S0146000524000594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407722","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
How do we reach the goal of personalized medicine for neuroprotection in neonatal hypoxic-ischemic encephalopathy? 如何实现新生儿缺氧缺血性脑病神经保护的个性化医疗目标？
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151930
{"title":"How do we reach the goal of personalized medicine for neuroprotection in neonatal hypoxic-ischemic encephalopathy?","authors":"","doi":"10.1016/j.semperi.2024.151930","DOIUrl":"10.1016/j.semperi.2024.151930","url":null,"abstract":"<div><p>Therapeutic hypothermia is now standard of care for neonates with hypoxic-ischemic encephalopathy (HIE) in high income countries (HIC). Conversely, compelling trial evidence suggests that hypothermia is ineffective, and may be deleterious, in low- and middle-income countries (LMIC), likely reflecting the lower proportion of infants who had sentinel events at birth, suggesting that injury had advanced to a stage when hypothermia is no longer effective. Although hypothermia significantly reduced the risk of death and disability in HICs, many infants survived with disability and in principle may benefit from targeted add-on neuroprotective or neurorestorative therapies. The present review will assess biomarkers that could be used to personalize treatment for babies with HIE – to determine first whether an individual infant is likely to respond to hypothermia, and second, whether additional treatments may be beneficial.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146000524000648/pdfft?md5=ead39b4a98d93ad966f805f4f2126896&pid=1-s2.0-S0146000524000648-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443305","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
Nutrition and the gut-brain axis in neonatal brain injury and development 营养与新生儿脑损伤和发育中的肠脑轴
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151927
{"title":"Nutrition and the gut-brain axis in neonatal brain injury and development","authors":"","doi":"10.1016/j.semperi.2024.151927","DOIUrl":"10.1016/j.semperi.2024.151927","url":null,"abstract":"<div><p><span>Early nutritional exposures, including during embryogenesis and the immediate postnatal period, affect offspring outcomes in both the short- and long-term. Alterations of these modifiable exposures shape the developing </span>gut microbiome<span><span>, intestinal development, and even neurodevelopmental outcomes. A gut-brain axis exists, and it is intricately connected to early life feeding and nutritional exposures. Here, we seek to discuss the (1) origins of the gut-brain access and relationship with neurodevelopment, (2) components of human milk (HM) beyond nutrition and their role in the developing </span>newborn, and (3) clinical application of nutritional practices, including fluid management and feeding on the development of the gut-brain axis, and long-term neurodevelopmental outcomes. We conclude with a discussion on future directions and unanswered questions that are critical to provide further understanding and insight into how clinicians and healthcare providers can optimize early nutritional practices to ensure children not only survive, but thrive, free of neurodevelopmental impairment.</span></p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141416349","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
Mesenchymal Stromal Cell therapy for Hypoxic Ischemic Encephalopathy: Future directions for combination therapy with hypothermia and/or melatonin 间充质基质细胞治疗缺氧缺血性脑病：与低温疗法和/或褪黑素联合疗法的未来方向
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151929
{"title":"Mesenchymal Stromal Cell therapy for Hypoxic Ischemic Encephalopathy: Future directions for combination therapy with hypothermia and/or melatonin","authors":"","doi":"10.1016/j.semperi.2024.151929","DOIUrl":"10.1016/j.semperi.2024.151929","url":null,"abstract":"<div><p>Hypoxic ischemic encephalopathy (HIE) remains a leading cause of neonatal mortality and lifelong disability across the world. While therapeutic hypothermia (HT) is beneficial, it is only partially protective and adjuvant treatments that further improve outcomes are urgently needed. In high-income countries where HT is standard care, novel treatments are tested in conjunction with HT. Mesenchymal stromal cells (MSC) represent a paradigm shift in brain protection, uniquely adapting to the host cellular microenvironment. MSC have low immunogenicity and potent paracrine effects stimulating the host tissue repair and regeneration and reducing inflammation and apoptosis. Preclinical studies in perinatal brain injury suggest that MSC are beneficial after hypoxia-ischemia (HI) and most preclinical studies of MSC with HT show protection. Preclinical and early phase clinical trials have shown that allogenic administration of MSC to neonates with perinatal stroke and HIE is safe and feasible but further safety and efficacy studies of HT with MSC in these populations are needed. Combination therapies that target all stages of the evolution of injury after HI (eg HT, melatonin and MSC) show promise for improving outcomes in HIE.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146000524000636/pdfft?md5=faa9a0b7c827fc4ff65b4e16d146e535&pid=1-s2.0-S0146000524000636-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403138","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
Standardizing clinician training and patient care in the neonatal neurocritical care: A step-by-step guide 规范新生儿神经重症监护中的临床医生培训和患者护理：逐步指南
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-08-01 DOI: 10.1016/j.semperi.2024.151924
{"title":"Standardizing clinician training and patient care in the neonatal neurocritical care: A step-by-step guide","authors":"","doi":"10.1016/j.semperi.2024.151924","DOIUrl":"10.1016/j.semperi.2024.151924","url":null,"abstract":"<div><p>Neonatal neurocritical care (NNCC) has emerged as an important specialty to address neurological conditions affecting newborns including a wide spectrum of brain injuries and developmental impairment. Despite the discipline's growth, variability in NNCC service delivery, patient care, and clinical training poses significant challenges and potentially adversely impacts patient outcomes. Variations in neuroprotective strategies, postnatal care, and training methodologies highlight the urgent need for a unified approach to optimize both short- and long-term neurodevelopmental outcomes for these vulnerable population. This paper presents strategic blueprints for establishing standardized NNCC clinical care and training programs focusing on collaborative effort across medical and allied health professions. By addressing these inconsistencies, the paper proposes that standardizing NNCC practices can significantly enhance the quality of care, streamline healthcare resource utilization, and improve neurodevelopmental outcome, thus paving the way for a new era of neonatal neurological care.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146000524000582/pdfft?md5=a3adef20f845267e935c30a0943eba48&pid=1-s2.0-S0146000524000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141409336","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
Maternal mental health as a major contributor to maternal mortality 孕产妇心理健康是导致孕产妇死亡的一个主要因素
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-07-14 DOI: 10.1016/j.semperi.2024.151943
{"title":"Maternal mental health as a major contributor to maternal mortality","authors":"","doi":"10.1016/j.semperi.2024.151943","DOIUrl":"10.1016/j.semperi.2024.151943","url":null,"abstract":"<div><p>Perinatal mental health conditions affect up to 20 % of pregnant or postpartum individuals, and nearly 15 % of pregnant individuals meet criteria for substance use disorder (SUD). All providers taking care of pregnant or postpartum individuals will encounter patients in these scenarios. Maternal Mortality Review Committees (MMRCs) have determined maternal mental health conditions, including SUD, to be the leading cause of preventable maternal death during pregnancy or in the first year postpartum. Lessons learned from MMRCs to prevent these deaths include the recommendation that screening and identification of mental health conditions need to be linked with evidence-based, patient-centered, and accessible treatments. Obstetricians and gynecologists, midwives, family medicine providers, and pediatricians, are in unique positions not only to screen and diagnose, but also to treat individuals with mental health concerns, including SUD, during pregnancy and postpartum.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716235","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 sleep protection in preventing and treating postpartum depression 睡眠保护在预防和治疗产后抑郁症中的作用
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2024-07-14 DOI: 10.1016/j.semperi.2024.151947
{"title":"The role of sleep protection in preventing and treating postpartum depression","authors":"","doi":"10.1016/j.semperi.2024.151947","DOIUrl":"10.1016/j.semperi.2024.151947","url":null,"abstract":"<div><p>Postpartum sleep disruption is a risk factor for postpartum depression<span> (PPD) as well as a potential treatment target. In the first 6 months after delivery, when the risk of PPD is greatest, fragmented maternal sleep is most often related to necessary infant night feedings. Clinicians’ conversations about planning for and navigating postpartum sleep should include questions about patient expectations, cultural traditions, and available support. For women at high risk of PPD, or with moderate to severe PPD or other symptoms of mental illness, protecting one 4–5 hour period of consolidated nighttime sleep may be necessary and effective. This can be achieved by having another adult step in for 1–2 infant night feedings or by employing other strategies. OBs can encourage high-risk patients to develop a postpartum plan for sleep protection by initiating this conversation during pregnancy.</span></p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697327","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
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