Seminars in perinatology最新文献_第7页

Adjunctive technologies to electronic fetal monitoring: Promise, pitfalls, and lessons learned 电子胎儿监护的辅助技术：前景、缺陷和经验教训。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-09-25 DOI: 10.1016/j.semperi.2025.152157

Rebecca Horgan, George Saade

引用次数: 0

Overuse of reflux medications in Neonates 新生儿过度使用反流药物

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-10-10 DOI: 10.1016/j.semperi.2025.152160

Kevin Ratnasamy, Shikib Mostamand

{"title":"Overuse of reflux medications in Neonates","authors":"Kevin Ratnasamy, Shikib Mostamand","doi":"10.1016/j.semperi.2025.152160","DOIUrl":"10.1016/j.semperi.2025.152160","url":null,"abstract":"<div><h3>Introduction</h3><div>The diagnosis, management and differentiating of gastroesophageal reflux (GER) and pathologic gastroesophageal reflux disease (GERD) in infants remains a clinical challenge. There is significant clinical and economic burden attributed to GERD in the NICU leading to longer length of stays, higher financial costs, and overuse of medications.</div></div><div><h3>Current Clinical Practice</h3><div>Current guidelines promote reduced reliance on acid suppression medication with shorter empiric trials (4 to 8 weeks) for the treatment of GERD, not attributing respiratory or laryngeal symptoms to GER due to a lack of diagnostic evidence, and a recommendation for trial of hydrolyzed formula before initiation of acid suppression. Few studies are demonstrating overall decrease use in all classes of medication for GERD, however, use of medications in infants remains high.</div></div><div><h3>Diagnostic Challenges and Drivers of Overuse</h3><div>Diagnostic challenges remain in pediatrics including interchangeable use of GER and GERD amongst clinicians, non-specific symptoms attributed to GERD, and lack of gold-standard diagnostic testing. Multichannel intraluminal impedance-pH monitoring (pH/MII) probes allow for an objective assessment of reflux episodes, reflux content, acidity, distance of reflux column or bolus direction, and symptom correlation.</div></div><div><h3>Conclusion</h3><div>For any infant with a suspicion of GERD, priority should be made to take a thoughtful and complete history and physical exam, review of growth charts, and not only reviewing charted intake and output but observing feeding and episodes of reflux. A stepwise approach emphasizing non-pharmacological care, shared decision-making, and institutional-level stewardship remains essential to providing high-value care.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 2","pages":"Article 152160"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275634","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

Physiology of gastroesophageal reflux in the neonate 新生儿胃食管反流的生理学研究。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-09-04 DOI: 10.1016/j.semperi.2025.152130

Alexandra Pottorff , Eric B. Ortigoza , Rinarani Sanghavi , Alejandro Llanos-Chea

{"title":"Physiology of gastroesophageal reflux in the neonate","authors":"Alexandra Pottorff , Eric B. Ortigoza , Rinarani Sanghavi , Alejandro Llanos-Chea","doi":"10.1016/j.semperi.2025.152130","DOIUrl":"10.1016/j.semperi.2025.152130","url":null,"abstract":"<div><div>Gastroesophageal reflux is physiologically normal in infants but can become gastroesophageal reflux disease when it leads to significant symptoms (persistent vomiting, weight loss, feeding difficulties). Gastroesophageal reflux disease is highly prevalent among infants and contributes to increased health care utilization. There are several physiologic and lifestyle factors that predispose infants to a higher degree of gastroesophageal reflux and disease related to it. Preterm infants and infants admitted to the neonatal intensive care unit, are a special population that have unique risk factors for gastroesophageal reflux disease and have a high prevalence of gastroesophageal reflux disease. To better understand gastroesophageal reflux in infants and neonates with medical complexity, this article will first review the physiology of typical swallowing and motility of the upper gastrointestinal tract in infants. Then, the pathophysiology of gastroesophageal reflux in infants will be reviewed. Finally, this article also addresses specific physiological differences in preterm infants that are important to aid in the understanding of management of gastroesophageal reflux disease in this specific population.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 2","pages":"Article 152130"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006595","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 diagnosis of gastroesophageal reflux in the Neonate 新生儿胃食管反流的诊断。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-10-08 DOI: 10.1016/j.semperi.2025.152161

Maheen Hassan , Hayat Mousa

引用次数: 0

Gastroesophageal reflux in the neonate: Introduction 新生儿胃食管反流：简介。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-10-16 DOI: 10.1016/j.semperi.2025.152162

Eric B. Ortigoza

引用次数: 0

Bronchopulmonary dysplasia, pulmonary hypertension, and neonatal gastroesophageal reflux: Association, causation, or neither? 支气管肺发育不良、肺动脉高压和新生儿胃食管反流：相关性、因果关系还是两者都没有？

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-09-26 DOI: 10.1016/j.semperi.2025.152158

Erik A. Jensen

{"title":"Bronchopulmonary dysplasia, pulmonary hypertension, and neonatal gastroesophageal reflux: Association, causation, or neither?","authors":"Erik A. Jensen","doi":"10.1016/j.semperi.2025.152158","DOIUrl":"10.1016/j.semperi.2025.152158","url":null,"abstract":"<div><div>Bronchopulmonary dysplasia (BPD) is among the most common and serious complications of prematurity. The pathobiology of BPD and BPD associated pulmonary arterial hypertension (BPD-PH) is multifactorial and not yet fully defined. Gastroesophageal reflux (GER), a physiologic process that occurs in most preterm infants and is typically benign, has been proposed as a potential contributor to the development or worsening of BPD and BPD-PH. Infants who develop BPD compared to those who do not are more frequently diagnosed with symptomatic GER and undergo therapeutic interventions to treat GER. However, current evidence does not support a direct causal relationship between GER and the onset or progression of BPD or BPD-PH in preterm infants. While GER may contribute to respiratory morbidity in individual cases, population-level data do not implicate it as a major driver of BPD pathogenesis. Moreover, the limited available data from clinical trials and observational studies does not consistently demonstrate improved outcomes in patients with BPD who are treated for GER. This narrative review summarizes the current literature evaluating the relationship between GER, BPD, and BPD-PH.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 2","pages":"Article 152158"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178282","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

Gastroesophageal reflux and apnea in the preterm infant 早产儿胃食管反流与呼吸暂停

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-09-22 DOI: 10.1016/j.semperi.2025.152151

Eric C. Eichenwald

引用次数: 0

Medical and surgical treatment of gastroesophageal reflux in the neonate 新生儿胃食管反流的内科和外科治疗。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-03-01 Epub Date: 2025-09-30 DOI: 10.1016/j.semperi.2025.152159

Suzanna Hirsch MD

引用次数: 0

Who you gonna call? Understanding the shortages of the pediatric subspecialty workforce 你要打给谁？了解儿科专科劳动力的短缺。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-02-01 Epub Date: 2025-12-03 DOI: 10.1016/j.semperi.2025.152189

Margaret Nguyen , Suma Bhat Hoffman , Alan Chin , Deborah Lehman , Josephine M. Enciso

引用次数: 0

Nowhere to go: An overview of maternity care access across the U.S․ 无处可去：美国各地产妇保健服务概览。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.semperi.2025.152188

Ashley Stoneburner , Ripley Lucas , Jazmin F․ Chestnut , Erin E. Jones , Andrea L. DeMaria

{"title":"Nowhere to go: An overview of maternity care access across the U.S․","authors":"Ashley Stoneburner , Ripley Lucas , Jazmin F․ Chestnut , Erin E. Jones , Andrea L. DeMaria","doi":"10.1016/j.semperi.2025.152188","DOIUrl":"10.1016/j.semperi.2025.152188","url":null,"abstract":"<div><div>Significant portions of the U.S. population face barriers to maternity care, contributing to rising rates of maternal and infant morbidity and mortality, particularly among rural and historically marginalized communities. Over 35 % of U.S. counties are designated as “maternity care deserts”, lacking obstetric clinicians and birthing facilities. These counties are home to more than 2.3 million reproductive-aged women and account for over 150,000 births annually. Limited access to maternity care is associated with delayed prenatal care, increased preterm birth rates, and higher maternal mortality. Contributing factors include hospital closures, clinician shortages, restrictive policies, and gaps in insurance coverage, disproportionately affecting Medicaid recipients and communities of color. Addressing this crisis requires multifaceted policy solutions. Expanding Medicaid coverage and increasing payment rates can incentivize provider participation and reduce financial barriers to care. Integrating midwifery care offers safe, patient-centered options for low-risk births, yet restrictive state policies and limited training opportunities hinder growth in this workforce. Telehealth presents a promising approach to extending access, particularly in rural areas, by enabling remote consultations, monitoring, and perinatal education. Additionally, fostering regionalized perinatal care networks and investing in workforce development are critical to strengthening the maternity care system. Action is needed to close persistent gaps in maternity care access and ensure equitable, high-quality care for all birthing people. Policymakers, clinicians, and advocates must implement evidence-based solutions to mitigate disparities and improve maternal and infant health outcomes across the U.S.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 1","pages":"Article 152188"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582493","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