Seminars in perinatology最新文献

{"title":"The importance of iron in neonatal and infant nutrition","authors":"Kendell German ,&nbsp;Michael K Georgieff","doi":"10.1016/j.semperi.2026.152235","DOIUrl":"10.1016/j.semperi.2026.152235","url":null,"abstract":"<div><h3>Objective</h3><div>Summarize the role of iron in fetal and neonatal nutrition.</div></div><div><h3>Findings</h3><div>Iron is an essential micronutrient that plays key roles in growth and development of the fetus and neonate. Iron deficiency compromises erythropoiesis, immune competency, and when present during critical periods of brain development, long-term neurodevelopmental outcomes. Due to the critical role of iron in shaping brain structure and development, these deficits may be irreversible with later repletion. Conversely, oversupplementation with iron, a potential pro-oxidant, may also have detrimental effects. Therefore, neonatal iron supplementation should be individualized and monitored through iron measures in those at high-risk for iron deficiency to optimize outcomes. A variety of enteral and parenteral iron approaches are available to meet the needs of infants at low and high risk of iron deficiency.</div></div><div><h3>Conclusion</h3><div>Optimizing iron status in neonates is key to improving growth and development in infants. Preterm infants are at particular risk for disruptions in iron status and thus warrant iron supplementation and close surveillance of iron status.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 4","pages":"Article 152235"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780151","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":"Practical strategies to incorporate maternal nutrition into neonatology practice to impact infant outcomes","authors":"Christina J. Valentine ,&nbsp;Lucille Beseler ,&nbsp;Katina L. Langley","doi":"10.1016/j.semperi.2026.152233","DOIUrl":"10.1016/j.semperi.2026.152233","url":null,"abstract":"<div><h3>Background</h3><div>Maternal diet is an important clinical adjunct to care for optimal infant outcome. Clinicians should have a heightened awareness to the importance of the first 1000 days from conception to 2 years for key critical nutrients. The Registered Dietitian can be a key partner to ensure mothers are assessed nutritionally for food insecurity and dietary adequacy in pregnancy and lactation.</div></div><div><h3>Methods</h3><div>A clinical review of the PubMed literature was done to establish recent guidelines for pregnancy and lactation- highlighting key dietary patterns, calories and nutrients that have been associated with pregnancy, human milk composition, and impacting fetal, neonatal, and lifelong health outcomes.</div></div><div><h3>Results</h3><div>Critical nutrients such as calories, Docosahexaenoic acid (DHA), choline, folate, Vitamin B1,B2, B12, D, minerals, trace elements, and fiber were found to play key roles in optimizing pregnancy and lactation and resultant infant growth, development, and the microbiome.</div></div><div><h3>Conclusion</h3><div>The perinatal provider should incorporate key maternal nutrient recommendations into dietary guidelines to ensure a healthy trajectory for the mother-infant dyad.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 4","pages":"Article 152233"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780101","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":"Expert recommendations for preterm neonates’ growth goals: Considerations for clinicians","authors":"Tanis R. Fenton ,&nbsp;Nicholas D Embleton ,&nbsp;Marc Beltempo ,&nbsp;Amy B. Hair ,&nbsp;Steven Abrams ,&nbsp;Deborah L O’Connor ,&nbsp;Belal Alshaikh","doi":"10.1016/j.semperi.2026.152228","DOIUrl":"10.1016/j.semperi.2026.152228","url":null,"abstract":"<div><div>Neonatal nutrition experts traditionally recommend that preterm infants achieve postnatal growth approximating intrauterine fetal growth rates. Preterm infant growth has three phases: postnatal weight loss, approximately parallel growth, and catch-up growth. Growth approximately parallel to growth chart curves can be appropriate even when plotting below any given percentile. Growth patterns are influenced by genetic potential, health determinants, pre-birth environment (maternal morbidities), post-birth morbidity, nutrition and feeding ability. To achieve genetic potential, some infants need growth to catch-up and some catch-down. There is considerable overlap between the growth of healthy infants and those with growth faltering. Growth expectations must be individualized in order to account for normal physiological and genetic variations and to help identify modifiable factors. No specific percentile, z-score or change in z-scores should be set as universal growth goals; rather, individual variability should be expected. The expert groups did not favour the words “failure” and “restriction” to describe postnatal growth perhaps because these words are usually based on arbitrary percentile/z-score cut-offs using one-point-in-time measures and ignore that postnatal weight loss places infants lower on growth chart curves. The word “failure” is pejorative while “faltering” suggests a temporary problem.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 4","pages":"Article 152228"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780073","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":"Human milk composition through the lens of donor human milk banking","authors":"Ting Ting Fu ,&nbsp;Jessica F. Hukill ,&nbsp;Kim Updegrove","doi":"10.1016/j.semperi.2026.152231","DOIUrl":"10.1016/j.semperi.2026.152231","url":null,"abstract":"<div><div>Much has been learned about breast milk composition in recent decades, but little is documented on donor human milk (DHM). Breast milk becomes DHM when it is donated by screened and approved lactating persons, pasteurized, and tested for absence of biological pathogens before being dispensed to hospitals and families for infants in need. However, DHM is different from a parent’s own milk. DHM composition is affected by individual milk donor characteristics and expression and storage processes, as well as milk bank thawing and pooling practices, mixing, and heat processing. In this review, we discuss what is known regarding macronutrient, micronutrient, and bioactive content in Holder-pasteurized DHM, how it differs from parent’s own milk, and how infrared milk analysis is utilized by non-profit milk banks.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 4","pages":"Article 152231"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717974","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":"Current approaches to parenteral nutrition in preterm infants","authors":"Katie M. Strobel ,&nbsp;Camilia R. Martin","doi":"10.1016/j.semperi.2026.152237","DOIUrl":"10.1016/j.semperi.2026.152237","url":null,"abstract":"","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 4","pages":"Article 152237"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780087","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 complex interaction of enteral feeding in the pathogenesis of necrotizing enterocolitis","authors":"Katherine E. Chetta ,&nbsp;Misty Good","doi":"10.1016/j.semperi.2026.152230","DOIUrl":"10.1016/j.semperi.2026.152230","url":null,"abstract":"<div><div>NEC is a multifactorial gastrointestinal disorder affecting medically fragile infants in the neonatal intensive care unit (NICU) and is associated with significant morbidity and mortality. Although the precise pathogenesis of NEC is not well understood, prematurity remains a significant risk factor. Immature intestinal immunity, altered microbial colonization (dysbiosis), and dysregulated inflammatory responses contribute to NEC susceptibility in the preterm intestine.¹ During NEC, an exaggerated inflammatory response can lead to intestinal tissue damage and in severe cases, surgical resection of necrotic bowel may be required. NEC affects 5–7% of very low birth weight (VLBW) infants according to large-scale estimates of &gt;500,000 infants.² In addition to biologic vulnerability related to prematurity, epidemiologic studies have identified associations between NEC and maternal health, racial and ethnic disparities, and socioeconomic factors.^3-7 Herein we discuss the complex relationship between enteral feeding and NEC, focused on the complex relationships between environment, nutrient composition, and feeding practices on disease susceptibility.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 4","pages":"Article 152230"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780122","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":"Disparities in low dose aspirin use for preeclampsia risk reduction and opportunities for improvement.","authors":"E Nicole Teal, Cynthia Gyamfi-Bannerman","doi":"10.1016/j.semperi.2026.152255","DOIUrl":"10.1016/j.semperi.2026.152255","url":null,"abstract":"<p><p>Low-dose aspirin (LDA) is a safe, inexpensive, and evidence-based intervention that reduces the risk of preeclampsia among pregnant individuals at elevated risk. Despite strong evidence and national guideline recommendations, implementation of LDA prophylaxis remains inconsistent, and emerging evidence suggests that disparities in LDA use may contribute to inequities in maternal health outcomes. This review summarizes the current literature on disparities in LDA use for preeclampsia prevention and explores opportunities for equitable implementation. Existing studies demonstrate disparities across multiple stages of the LDA prevention pathway, including preeclampsia risk identification, clinician counseling and prescribing, patient uptake, and adherence. National data suggest that Black and Hispanic patients, publicly insured patients, non-English-speaking patients, and individuals receiving care in resource-constrained settings may be less likely to receive or use LDA prophylaxis. Patients eligible based on multiple moderate-risk factors appear particularly vulnerable to missed prescribing opportunities. Importantly, disparities persist even after LDA recommendation, highlighting the role of barriers related to trust, communication, health literacy, and structural determinants of health. Conceptualizing LDA delivery as a multistep implementation process provides a framework for understanding how inequities emerge and propagate throughout the care continuum. Emerging quality improvement and implementation initiatives suggest that standardized risk screening, electronic health record tools, clinician education, multilingual patient resources, workflow redesign, and team-based care approaches may improve equitable delivery of LDA prophylaxis. However, long-term outcome data remain limited. Addressing disparities in preeclampsia prevention will require equity-centered implementation strategies that move beyond guideline dissemination alone and focus on ensuring consistent delivery of evidence-based care across diverse patient populations.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152255"},"PeriodicalIF":3.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056376","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":"Re-evaluating the impact of prenatal low-dose aspirin on child neurodevelopment.","authors":"Jing Zhu, Yanlin Wang, Zhiwei Liu, Jun Zhang","doi":"10.1016/j.semperi.2026.152256","DOIUrl":"https://doi.org/10.1016/j.semperi.2026.152256","url":null,"abstract":"<p><p>Prophylactic use of low-dose aspirin starting from 12 weeks of gestation has been recommended to women at high risk of preeclampsia by clinical guidelines. Aspirin can cross the placenta and may exert its pharmacological effects on both the mother and the fetus. However, it remains uncertain whether prenatal low-dose aspirin exposure has influences on child neurodevelopment. Current evidences indicate that prenatal low-dose aspirin exposure is not associated with harmful effects and may even offer potential benefits on child neurodevelopment. This article reviews pharmacokinetic characteristics of aspirin in maternal and fetal circulation and discusses potential pathways between prenatal aspirin exposure and child neurodevelopment. Due to the deficiencies in current studies, further observational and experimental studies are warranted to explore the influence and underlying mechanisms of prenatal low-dose aspirin on child neurodevelopment.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152256"},"PeriodicalIF":3.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035019","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":"Universal vs risk-based aspirin prophylaxis in pregnancy: Time for a paradigm shift?","authors":"Maura Jones Pullins, Kim Boggess","doi":"10.1016/j.semperi.2026.152251","DOIUrl":"https://doi.org/10.1016/j.semperi.2026.152251","url":null,"abstract":"<p><p>Low-dose aspirin is an evidence-based intervention that reduces the risk of preeclampsia and related maternal morbidity. Current U.S. guidelines recommend a risk-based approach, targeting individuals at high or moderate risk. However, implementation remains inconsistent, and risk stratification may fail to identify a substantial proportion of patients who ultimately develop preeclampsia. This paper evaluates the evidence supporting low-dose aspirin, the limitations of current risk-based strategies, and the potential benefits and harms of a universal prophylaxis approach. We argue that universal aspirin prophylaxis offers advantages in simplicity, equity, and implementation.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152251"},"PeriodicalIF":3.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988791","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":"Beyond preeclampsia: low dose aspirin as a preventative strategy for spontaneous preterm birth.","authors":"Jasper T Lamens, James A L Meliëzer, Martijn A Oudijk, Marjon A de Boer","doi":"10.1016/j.semperi.2026.152254","DOIUrl":"https://doi.org/10.1016/j.semperi.2026.152254","url":null,"abstract":"<p><p>Spontaneous preterm birth (PTB) remains a substantial challenge in healthcare worldwide. The etiology is multifactorial and includes placental insufficiency, which overlaps with the pathophysiology of preterm pre-eclampsia (PE). Low-dose aspirin (LDA) is an established preventative strategy for preterm PE by targeting placental insufficiency. This narrative summarizes current evidence for LDA as a preventive strategy for spontaneous PTB. In patients at risk of preterm PE, daily LDA (particularly when initiated before 16 weeks of gestation and at a dose ≥100 mg) prevents total PTB. Emerging evidence suggests that daily LDA also reduces total PTB in nulliparous patients. However, findings have not been confirmed in national cohort studies, largely due to suboptimal treatment adherence. Recent studies also suggest a preventive effect of LDA in patients with a history of spontaneous PTB, although these studies are underpowered to draw firm conclusions. Overall, trends point towards a preventive effect of LDA, providing a safe and inexpensive treatment for spontaneous PTB. The effectiveness may be limited to subgroups based on the underlying mechanism of spontaneous PTB. Future research should focus on large population-based implementation studies focusing on treatment adherence, as well as identifying subgroups most likely to benefit from LDA.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152254"},"PeriodicalIF":3.2,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964475","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}