{"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":"48 5","pages":"Article 151927"},"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}
{"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":"48 5","pages":"Article 151929"},"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}
{"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":"48 5","pages":"Article 151924"},"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}
{"title":"The role of sleep protection in preventing and treating postpartum depression","authors":"Nicole Leistikow , Milena H. Smith","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":"48 6","pages":"Article 151947"},"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}
Sarah Nagle-Yang , Lindsay G. Lebin , Lindsay R. Standeven , Megan Howard , Marika Toscano
{"title":"Reproductive psychiatry training: A critical component of access to perinatal mental health treatment","authors":"Sarah Nagle-Yang , Lindsay G. Lebin , Lindsay R. Standeven , Megan Howard , Marika Toscano","doi":"10.1016/j.semperi.2024.151949","DOIUrl":"10.1016/j.semperi.2024.151949","url":null,"abstract":"<div><p>Perinatal Mental Health Disorders (PMHDs) pose significant challenges to the well-being of perinatal individuals, infants, and families. Despite their prevalence and impact, PMHDs often go undetected and untreated due to gaps in clinician education and training. This manuscript reviews the current state of perinatal mental health training, identifies emerging initiatives, and discusses innovative models of care aimed at enhancing the clinical preparedness of healthcare providers. Key findings highlight disparities in PMHD detection and treatment, the need for standardized education across disciplines, and the role of interdisciplinary collaboration in improving care outcomes. The manuscript emphasizes the urgency of prioritizing reproductive psychiatry education to mitigate the adverse effects of PMHDs on maternal and infant health. By standardizing education and fostering interdisciplinary collaboration, we can ensure that all perinatal individuals receive the care they need to thrive.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"48 6","pages":"Article 151949"},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705874","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}
Lauren A. Gimbel , Sarah J. Weingarten , Marcela C. Smid , M. Camille Hoffman
{"title":"Maternal mental health as a major contributor to maternal mortality","authors":"Lauren A. Gimbel , Sarah J. Weingarten , Marcela C. Smid , M. Camille Hoffman","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":"48 6","pages":"Article 151943"},"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}
{"title":"The importance of perinatal non-birthing parents’ mental health and involvement for family health","authors":"Sheehan D. Fisher , Tova Walsh , Clare Wongwai","doi":"10.1016/j.semperi.2024.151950","DOIUrl":"10.1016/j.semperi.2024.151950","url":null,"abstract":"<div><p>Perinatal mental health research typically focuses on the birthing parent's experiences and their influence on birth/child outcomes, while not considering non-birthing parents in similar depth. Non-birthing parents are also at increased risk for mental illness during the perinatal period, and non-birthing parents’ health and involvement affect the health of birthing people, fetuses, and newborns, necessitating greater understanding of non-birthing parents’ contributions to family functioning. This review examines perinatal mental health disorders in non-birthing parents, their relationship quality with the birthing parent, and how the non-birthing parent's mental health and involvement affects the health outcomes of the birthing parent and the child. Recommendations are provided for healthcare professionals who work with perinatal patients and their families to engage non-birthing parents, learn about non-birthing parent health, and facilitate connections to care. By doing so, professionals working with perinatal patients can optimize health outcomes for their patients and the family as a whole.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"48 6","pages":"Article 151950"},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141717096","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}
Andrew T. Drysdale , Ellen Poleshuck , MaKenzie H. Ramsey , Catherine Monk
{"title":"New treatments: Opportunities and challenges","authors":"Andrew T. Drysdale , Ellen Poleshuck , MaKenzie H. Ramsey , Catherine Monk","doi":"10.1016/j.semperi.2024.151941","DOIUrl":"10.1016/j.semperi.2024.151941","url":null,"abstract":"<div><p>Across the spectrum of perinatal mental illness, there exist a variety of effective treatments. However, the available treatments are not always matched to the presentation, resources, constraints, or values of each patient. Furthermore, provider, local, and systemic factors complicate access to current treatment options. New and emerging approaches offer the potential of more effective treatment for specific perinatal psychiatric disorders. From neuroactive steroid medications to accelerated psychotherapy interventions, recent innovations have demonstrated enhanced efficacy on a faster timeline. Optimally, these developments will also lower barriers to care but this is not necessarily true. We review novel and upcoming interventions across perinatal mental illness and place them in the context of existing treatments and common challenges.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"48 6","pages":"Article 151941"},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694146","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}
Victoria Adewale , Rodolfo Fernandez-Criado , Alexandra Turco , Cynthia Battle , Ana Sofia De Brito , Emily Feinberg , Emily S Miller
{"title":"Models of care: Opportunities and challenges","authors":"Victoria Adewale , Rodolfo Fernandez-Criado , Alexandra Turco , Cynthia Battle , Ana Sofia De Brito , Emily Feinberg , Emily S Miller","doi":"10.1016/j.semperi.2024.151940","DOIUrl":"10.1016/j.semperi.2024.151940","url":null,"abstract":"<div><p>Perinatal mental health models can broadly be described by scope and structure. Within these two broad domains lies an array of diverse methodologies that have attempted to increase access and coordination of care. These efforts have uncovered many opportunities that, if addressed, may improve our current parent and infant outcomes within our healthcare system and community. Furthermore, there are several opportunities that, if addressed, will result in more equitable, inclusive care. These include being attentive to the unique needs of vulnerable populations, emphasizing community efforts, and closing the current gaps in legislation.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"48 6","pages":"Article 151940"},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698254","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}
Jihye Kim Scroggins , Sarah E. Harkins , Sevonna Brown , Victoria St. Clair , Guramrit K. LeBron , Veronica Barcelona
{"title":"A systematic review of community-based interventions to address perinatal mental health","authors":"Jihye Kim Scroggins , Sarah E. Harkins , Sevonna Brown , Victoria St. Clair , Guramrit K. LeBron , Veronica Barcelona","doi":"10.1016/j.semperi.2024.151945","DOIUrl":"10.1016/j.semperi.2024.151945","url":null,"abstract":"<div><p><span><span><span>Little is known about the scope and effectiveness of community-based interventions to address maternal perinatal mental health in the US. We searched PubMed, </span>CINAHL, and </span>PsychINFO<span> in January 2024 to conduct a systematic review<span> of studies using community-based interventions for maternal mental health from pregnancy to 1 year postpartum in the US. We reviewed 22 quantitative studies, and assessed methodological quality and effectiveness of interventions. Most were randomized trials (</span></span></span><em>n</em> = 16) with strong or good methodological quality. The majority of the studies included racially and ethnically diverse participants (<em>n</em><span><span> = 14), delivered interventions through community health workers, nurses, midwives, and </span>doulas (</span><em>n</em> = 18), and had mixed effectiveness of interventions (<em>n</em><span> = 14). Limitations included small sample sizes, interventions not specifically developed for mental health, limited community involvement in designing interventions, and focus on participants with no mental health issues. Community partners augment this review with lived experience and recommendations for research and clinical practice.</span></p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"48 6","pages":"Article 151945"},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691871","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}