Seminars in perinatology最新文献_第3页

Albumin priming prior to an exchange transfusion: Is it time to prime for neuroprotection? 换血前的白蛋白启动：是时候启动神经保护了吗？

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-24 DOI: 10.1016/j.semperi.2026.152292

Jon F Watchko

{"title":"Albumin priming prior to an exchange transfusion: Is it time to prime for neuroprotection?","authors":"Jon F Watchko","doi":"10.1016/j.semperi.2026.152292","DOIUrl":"https://doi.org/10.1016/j.semperi.2026.152292","url":null,"abstract":"<p><p>Albumin is the crux of the exchangeable (i.e., miscible) bilirubin pool, controlling via its high affinity binding the distribution of bilirubin within and across the intravascular and extravascular spaces. It follows that clinicians should leverage the administration of bilirubin free albumin in the management of hazardous hyperbilirubinemia to avoid or reverse bilirubin neurotoxicity. A standard double volume exchange transfusion does exactly that via the albumin laden fresh frozen plasma used to reconstitute the blood infused during the procedure. Albumin priming - the infusion of bilirubin-free albumin prior to a double volume exchange transfusion - augments the infant's pre-exchange albumin mass and albumin bilirubin binding capacity. As such, albumin priming can enhance bilirubin clearance over the course of the subsequent exchange transfusion and provide an immediate stepwise gain in neuroprotection during the pre-exchange period. The potential for neuroprotection against worsening bilirubin-induced neurological dysfunction is the principal reason to albumin prime and prime early when caring for a neonate with signs of intermediate to advanced stage acute bilirubin encephalopathy. Albumin priming should also be considered in asymptomatic infants whose bilirubin - albumin molar ratios approach or exceed albumin's saturable binding limits, as a preventive measure to attenuate bilirubin neurotoxicity risk.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152292"},"PeriodicalIF":3.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814110","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

A dilemma of parental inclusion? Parent perspectives of NICU feeding practices and neonatal nutritional research 父母包容的困境？新生儿重症监护病房喂养实践和新生儿营养研究的家长观点。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-24 DOI: 10.1016/j.semperi.2026.152275

Krystle M. Perez, Ashley Jochim, Aloka L. Patel, Gregory C. Valentine

引用次数: 0

Initial nutrition in preterm infants: Evidence, uncertainty, and research priorities 早产儿的初始营养：证据、不确定性和研究重点。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-20 DOI: 10.1016/j.semperi.2026.152274

Lindsay F. Holzapfel, Melissa K. Thoene, Daniel T. Robinson, Gregory C. Valentine

{"title":"Initial nutrition in preterm infants: Evidence, uncertainty, and research priorities","authors":"Lindsay F. Holzapfel, Melissa K. Thoene, Daniel T. Robinson, Gregory C. Valentine","doi":"10.1016/j.semperi.2026.152274","DOIUrl":"10.1016/j.semperi.2026.152274","url":null,"abstract":"<div><div>Initial nutrition during the fetal-to-neonatal transition is critical for preterm infants and requires balancing physiologic adaptation, metabolic tolerance, and risk of morbidity. Although traditional approaches favored delayed enteral feeding with prolonged parenteral nutrition to protect the immature gastrointestinal tract, accumulating evidence supports earlier initiation of enteral nutrition and more selective use of parenteral nutrition based on gestational age, illness severity, and antenatal factors.</div><div>This review synthesizes evidence guiding initial nutrition-defined as the period from birth to sustained full enteral feeding-with a focus on clinical application. We review enteral strategies including oropharyngeal colostrum administration, timing and volume of early feeds, duration of trophic feeding, early total enteral feeding, and feeding advancement rates, highlighting populations with robust evidence and those underrepresented in trials. Parenteral fluid practices are discussed in relation to physiologic postnatal weight loss, fetal growth restriction, and risks of both fluid overload and nutrient under delivery.</div><div>We further address parenteral macronutrient and micronutrient provision, transition from parenteral to enteral nutrition, and limitations of peripheral parenteral nutrition delivery, noting areas reliant on expert consensus. We identify key evidence gaps and research priorities. Optimizing individualized initial nutrition strategies remains essential to improve growth, reduce morbidity, and support neurodevelopmental outcomes in preterm infants.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 5","pages":"Article 152274"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296159","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

Standardizing outcome measures in preterm infant nutrition research: Use of anthropometry and body composition in the neonatal intensive care unit 标准化早产儿营养研究的结果测量：在新生儿重症监护病房使用人体测量和身体成分。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-24 DOI: 10.1016/j.semperi.2026.152271

Katherine A. Bell, Kara L. Calkins, Laura A. Gollins, Kera McNelis, Katie M. Strobel

{"title":"Standardizing outcome measures in preterm infant nutrition research: Use of anthropometry and body composition in the neonatal intensive care unit","authors":"Katherine A. Bell, Kara L. Calkins, Laura A. Gollins, Kera McNelis, Katie M. Strobel","doi":"10.1016/j.semperi.2026.152271","DOIUrl":"10.1016/j.semperi.2026.152271","url":null,"abstract":"<div><div>Nutritional care and growth patterns in the neonatal intensive care unit (NICU) can impact lifelong health. Standardized measurement and reporting of growth outcomes are critical to improve the quality of information generated in research and population surveillance, facilitate comparisons and meta-analyses across individual studies, and strengthen the evidence used to generate clinical practice recommendations<em>.</em> Anthropometrics, specifically weight, length, and head circumference, are feasible and practical methods to monitor nutritional status. For research purposes, we recommend these anthropometrics be measured at birth (as a measure of fetal growth), 28 days old (to assess short-term growth), and 36 weeks postmenstrual age (PMA) (to determine the postnatal growth pattern in the NICU). We also encourage recording number of days to regain birthweight as a measure of short-term growth. Research publications should describe clearly the methods used to measure anthropometrics and reference curves used to calculate z-scores. Body composition is a complementary marker of nutritional status, but currently validated techniques have practical limitations in the NICU. When body composition tools are available, fat-free mass and fat mass should be measured at ∼36 weeks PMA. We also describe key knowledge gaps and research priorities regarding growth patterns of preterm infants in the NICU.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 5","pages":"Article 152271"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318812","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

Enteral nutrition to optimize health and neurodevelopmental outcomes in very preterm infants 肠内营养优化极早产儿的健康和神经发育结局。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-26 DOI: 10.1016/j.semperi.2026.152270

K.L. Santoro, G. Valentine, A.B. Hair

{"title":"Enteral nutrition to optimize health and neurodevelopmental outcomes in very preterm infants","authors":"K.L. Santoro, G. Valentine, A.B. Hair","doi":"10.1016/j.semperi.2026.152270","DOIUrl":"10.1016/j.semperi.2026.152270","url":null,"abstract":"<div><h3>Background</h3><div>Very preterm infants are born before a critical window of nutrient accrual that occurs during the third trimester, resulting in a nutritional deficit that is vital to restore to support further growth and development. Although the gut is underdeveloped, optimizing administration of nutrition via the enteral route has been linked to improved long term outcomes, particularly when mother’s own milk is prioritized as the initial source of nutrition.</div></div><div><h3>Objective</h3><div>The goal of this review was to synthesize current evidence on best enteral nutrition practices for very preterm infants focusing on strategies that optimize long term neurodevelopment and infant health outcomes.</div></div><div><h3>Content</h3><div>This review examines the physiological importance of early enteral nutrition to support growth and neurodevelopment of very preterm infants. Clinical outcomes data related to different types of enteral nutrition sources are reviewed, as well as evidence-based practices regarding initiation of enteral nutrition, advancement, supplementation and fortification. Additionally, limitations in the existing literature are identified to inform future research directions.</div></div><div><h3>Conclusions</h3><div>The collective evidence reviewed in this manuscript supports early, consistent, and human milk–based enteral nutrition as a central modifiable factor to improve growth, brain development, and long-term neurodevelopmental outcomes. While there are remaining uncertainties regarding the ideal timing for initiation, specific advancement strategies, and fortification methods, the available data supports the following: minimizing enteral fasting, prioritizing mother’s own milk, and using protocolized feeding guidelines.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 5","pages":"Article 152270"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340075","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

Metabolic bone disease of prematurity: current knowledge, controversies, and research priorities 早产儿代谢性骨病：目前的知识、争议和研究重点。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-05-24 DOI: 10.1016/j.semperi.2026.152253

Mar Romero-Lopez, Melissa Thoene, Katherine Ottolini, Sarah Taylor

{"title":"Metabolic bone disease of prematurity: current knowledge, controversies, and research priorities","authors":"Mar Romero-Lopez, Melissa Thoene, Katherine Ottolini, Sarah Taylor","doi":"10.1016/j.semperi.2026.152253","DOIUrl":"10.1016/j.semperi.2026.152253","url":null,"abstract":"<div><div>Despite decades of research and significant improvements in neonatal nutrition, clinicians still struggle with fundamental questions about metabolic bone disease of prematurity diagnosis, treatment, and long-term consequences. This review examines what we know about metabolic bone disease of prematurity, the gaps in our understanding, and highlights the controversies in clinical practice. Typical practices include biochemical screening, which may begin at 3–4 weeks for at-risk infants, with alkaline phosphatase and phosphate levels serving as primary markers of disease. Nutritional optimization through adequate parenteral and enteral provisions, such as via fortified human milk or specialized preterm formulas, represents the main prevention and treatment approach. However, given the lack of consensus on diagnostic thresholds and definitions for metabolic bone disease of prematurity, there remain inconsistent prevention and treatment strategies. This review offers practical guidance based on current evidence, while identifying critical areas where additional research is needed to continue to improve outcomes.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 5","pages":"Article 152253"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006527","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 impact of gastrointestinal motility on feeding tolerance in the very preterm infant 极早产儿胃肠运动对喂养耐受性的影响。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-07-09 DOI: 10.1016/j.semperi.2026.152269

Katie M. Strobel, Eric B. Ortigoza, Geoanna M. Bautista

引用次数: 0

Current barriers and opportunities in neonatal nutrition research 当前新生儿营养研究的障碍和机遇。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-19 DOI: 10.1016/j.semperi.2026.152276

Katherine Chetta, Mar Romero-Lopez, Gustave H. Falciglia

{"title":"Current barriers and opportunities in neonatal nutrition research","authors":"Katherine Chetta, Mar Romero-Lopez, Gustave H. Falciglia","doi":"10.1016/j.semperi.2026.152276","DOIUrl":"10.1016/j.semperi.2026.152276","url":null,"abstract":"<div><div>Neonatal nutrition research is pivotal for optimizing long-term health outcomes in high-risk infants, particularly preterm and critically ill neonates, where the foundational \"first 1000 days\" concept increasingly links early nutritional interventions to lifelong neurodevelopmental, metabolic, and socio-economic trajectories. Despite substantial advances, translating this evolving pre-clinical knowledge base into consistent clinical improvements remains slow. This review synthesizes persistent barriers hindering progress in the field, including inconsistent definitions and reporting standards for nutritional intake and growth metrics, inadequate electronic health record infrastructure for automated nutrient calculations across parenteral and enteral sources, restrictive regulatory and consent frameworks that limit equitable enrollment in high-risk populations, and mounting institutional pressures that erode the physician-scientist pipeline. Natural variability in human milk further complicates precise nutritional delivery, where nutrient delivery scales predictably with caloric density, yet routine direct measurement remains underutilized. To accelerate meaningful advancements, the field requires standardized reporting guidelines, enhanced decision-support tools, innovative trial designs, and strengthened career support for physician-scientists. Addressing these interconnected barriers through collaboration, technological integration, and multi-level policy reform holds the potential to shift neonatal nutrition science from incremental gains to rapid improvements in infant survival, growth, and lifelong health.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 5","pages":"Article 152276"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284334","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 diet and nutritional status during pregnancy and lactation: a review of implications on milk composition and lactation outcomes 孕期和哺乳期产妇饮食和营养状况：对乳成分和哺乳期结局影响的综述。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-20 DOI: 10.1016/j.semperi.2026.152273

Ruthfirst Ayande, Sarbattama Sen, Daniel T. Robinson

{"title":"Maternal diet and nutritional status during pregnancy and lactation: a review of implications on milk composition and lactation outcomes","authors":"Ruthfirst Ayande, Sarbattama Sen, Daniel T. Robinson","doi":"10.1016/j.semperi.2026.152273","DOIUrl":"10.1016/j.semperi.2026.152273","url":null,"abstract":"<div><div>Maternal diet and nutritional status during lactation have important implications for human milk composition and lactation outcomes, yet the strength and consistency of these associations remain incompletely understood. This narrative review synthesizes current evidence on (1) the role of maternal dietary intake on human milk macronutrients, fatty acids, human milk oligosaccharides (HMOs), and other bioactive compounds; (2) the influence of maternal nutritional status, including body mass index (BMI), gestational weight gain, gestational diabetes, food insecurity, and biochemical nutrient markers, on milk composition; and (3) the relationship between maternal diet and nutritional status and lactation outcomes, including initiation, duration, and milk production. Methodological heterogeneity in dietary assessment, milk sampling protocols, and definitions of nutritional status limits comparability across studies. Standardized approaches and mechanistic research are needed to clarify causal pathways and identify modifiable targets to optimize milk composition and support successful lactation.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 5","pages":"Article 152273"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296129","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 society for neonatal nutrition and lifelong health: Building science and translating research to inform neonatal nutritional care 新生儿营养和终身健康协会：建立科学和翻译研究，以告知新生儿营养护理。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-08-01 Epub Date: 2026-06-27 DOI: 10.1016/j.semperi.2026.152277

Sarah N. Taylor, Camilia R. Martin

引用次数: 0