Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"Development of a Predictive Model for Neonatal Near Miss at a High-Complexity Referral Hospital in Peru during 2024.","authors":"Alexandra Fiorella Marquina Mencía, Maria Paz Neira Mendoza","doi":"10.1055/a-2792-3454","DOIUrl":"10.1055/a-2792-3454","url":null,"abstract":"<p><strong>Objective: </strong>To develop a multivariable predictive model for neonatal near miss (NNM) in a high-complexity hospital in Lima to improve early identification of high-risk newborns and optimize NICU resource allocation.</p><p><strong>Study design: </strong>Retrospective cohort of 264 neonates admitted at birth to the NICU in 2024. Maternal, sociodemographic, clinical, and neonatal management variables were analyzed. Multivariable logistic regression developed the model, compared against existing international pragmatic and combined criteria approaches.</p><p><strong>Results: </strong>82.2% experienced NNM and 17.8% died. Maternal factors were not associated. Key predictors included Apgar<7, CPR, CPAP use, surfactant therapy, and phototherapy. The model achieved AUC=0.94, sensitivity=94.01%, specificity=87.23%, outperforming reference models.</p><p><strong>Conclusion: </strong>A model integrating NICU intervention indicators demonstrated high discriminatory power. Its use may enhance early detection of vulnerable neonates, guide care priorities, and rationalize resources. Further research should assess implementation feasibility and impact on outcomes across diverse healthcare settings.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"330-337"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy management in a woman with pulmonary alveolar proteinosis: a case report and review of the literature.","authors":"Mehtap Yücedağ, İbrahim Kale","doi":"10.1055/a-2869-2697","DOIUrl":"10.1055/a-2869-2697","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"345-348"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Diurnal Variation on Umbilical Artery Doppler Measurements in Pregnancies Complicated by Hypertensive Disorders.","authors":"Aykut Kından, Salim Erkaya","doi":"10.1055/a-2784-5163","DOIUrl":"10.1055/a-2784-5163","url":null,"abstract":"<p><strong>Objective: </strong>The study aims to determine whether the time of day influences these parameters compared to normotensive pregnancies.</p><p><strong>Materials and methods: </strong>This prospective, single-center study included 60 pregnant women diagnosed with hypertensive disorders (gestational hypertension, chronic hypertension, or preeclampsia) and 60 normotensive controls, all between 30 and 37 weeks of gestation. Umbilical artery Doppler measurements were performed twice daily, between 08:00-10:00 and 20:00-22:00, by the same experienced operator. Measurements were taken at both the fetal and placental ends of the umbilical artery, recording systolic/diastolic ratios, pulsatility index, and resistance index values.</p><p><strong>Results: </strong>In Doppler measurements, the morning and evening evaluations revealed that S/D, PI, and RI values near the fetus and placenta were significantly higher in the study group compared to the control group. Notably, in the preeclampsia subgroup, the morning S/D values (3.3±1.1 vs. 2.3±0.5, p<0.001) were found to reach the highest levels. Regarding neonatal outcomes, the study group demonstrated significantly higher rates of cesarean delivery (71.7% vs. 33.3%, p<0.001) and neonatal intensive care unit admission (36.7% vs. 6.7%, p<0.001), while birth weight was significantly lower (2724.9±759.1 g vs. 3241.1±422.7 g, p<0.001).</p><p><strong>Conclusion: </strong>This study demonstrates that hypertensive disorders during pregnancy have a significant adverse effect on umbilical artery Doppler measurements and neonatal outcomes. These findings underscore the importance of early diagnosis and meticulous monitoring.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"306-312"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Significance of Early 75-g OGTT for the Detection of Glucose Disorders in High-Risk Women after Late Miscarriage or Preterm Birth].","authors":"Filiz Markfeld Erol, Aaron Riedling, Ingolf Juhasz-Böss, Mirjam Kunze, Julia Meschede","doi":"10.1055/a-2784-5295","DOIUrl":"10.1055/a-2784-5295","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the proportion of pathological results in the early 75-g OGTT among women with a history of late miscarriage or preterm birth after prophylactic cerclage. The effects of early-diagnosed gestational diabetes on pregnancy outcome, neonatal parameters, preconceptional BMI, and mode of delivery were also analyzed.</p><p><strong>Methods: </strong>In 140 pregnant women, a primary cerclage and a 75-g OGTT were performed between 16 and 21 weeks of gestation. Analysis was based on OGTT results (physiological vs. pathological). The primary endpoint was pregnancy outcome; secondary endpoints included neonatal parameters, preconceptional BMI, and mode of delivery.</p><p><strong>Results: </strong>Eighty-nine women (63%) showed a pathological OGTT result substantially higher than in the general population. This was not significantly associated with late miscarriage or preterm birth (OR 2.18; p=0.13) but showed a trend toward increased risk. Neonatal outcomes were similar between groups. A preconceptional BMI>35 kg/m² was significantly related to a pathological OGTT (p=0.04). Women with a pathological OGTT had more cesarean deliveries (55.8% vs. 35.3%; p=0.02).</p><p><strong>Conclusion: </strong>In this high-risk cohort with a history of late miscarriage or preterm birth, 63% had a pathological early 75-g OGTT, indicating increased susceptibility to glucose metabolism disorders. Early glucose screening and individualized metabolic management are essential to improve pregnancy and perinatal outcomes.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"313-322"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From CRONOS to CRONOS-Kids: Investigating Neurological Development in Toddlers After Maternal SARS-CoV-2 Infection During Pregnancy - A Study Protocol For A Prospective Cohort Study.","authors":"Nadine Mand, Franziska König, Mirjam Wege, Anna-Lena Cares, Tamée Ersfeld, Ines Simone Wallot, Charlotte Hahn, Corinna Nora Keil, Janine Zöllkau, Daniela Steuernagel, Mirjam Kunze, Martin Kuntz, Kristin Andresen, Ann Carolin Longardt, Lars Mense, Ulrich Pecks, Mario Ruediger, Stefanie Weber","doi":"10.1055/a-2861-0938","DOIUrl":"10.1055/a-2861-0938","url":null,"abstract":"<p><strong>Introduction: </strong>Infection with SARS-CoV-2 during pregnancy increases the risk for adverse events in mothers and newborns. Research is increasingly exploring potential consequences of intrauterine exposure to the developing nervous system. However, there is still a lack of high-quality studies on long-term outcomes. The CRONOS-Kids study aims to investigate the global development of children after exposure to SARS-CoV-2 in utero in comparison to an unexposed control group. This paper outlines the CRONOS-Kids study protocol.</p><p><strong>Methods: </strong>The study is designed as a prospective population-based cohort study and will recruit children aged 36-60 months at the time of assessment. The exposed cohort will be recruited from the German CRONOS registry and will include only children who have been exposed to the Alpha and Delta variants of SARS-CoV-2. The unexposed cohort will be recruited by local pediatricians and via social media. For clinical evaluations, the Movement Assessment Battery for Children, 2^nd Edition will be used. Parental self-reports on development will use the Ages and Stages Questionnaire, 3^rd Edition. Additional questionnaires cover information about maternal and child health, vaccinations, healthcare usage, media consumption, and maternal quality of life. Until April 2026, we aim to recruit 125 exposed and 125 unexposed children across five study sites.</p><p><strong>Discussion: </strong>The CRONOS-Kids study will explore the impact of intrauterine SARS-CoV-2 exposure to specific virus variants on long-term neurologic outcomes in children as well as broader consequences of the pandemic.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"338-344"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resuscitation in pregnant women - the current international guidelines under close scrutiny.","authors":"Alexander Strauss, Oliver Haupt, Jan-Thorsten Gräsner, Nils Jacobsen","doi":"10.1055/a-2892-2999","DOIUrl":"10.1055/a-2892-2999","url":null,"abstract":"<p><strong>Abstract: </strong>The management of cardiac arrest in pregnant women requires adjustments to account for the physiology of pregnancy, the specific causes of cardiac arrest, and the potential need for a resuscitative delivery if a return of spontaneous circulation cannot be achieved. Successful resuscitation hinges upon the prompt availability and stringent coordination of a multidisciplinary specialized team. Resuscitation measures are often compromised by delays in initiating interventions (uterine lateralization; high-quality, minimally interrupted cardiopulmonary resus-citation; dealing with potentially difficult airways; resuscitative cesarean delivery). Resuscitative cesarean delivery is one of the rarest, yet physically and emotionally demanding procedures in dealing with obstetric emergencies potentially leading to the birth of a viable newborn infant in need of resuscitation itself. Timely access to the resources and personnel capable of coordinating this multidisciplinary endeavor varies based on the local environment. Therefore, unequivocal treatment recommendations are of paramount clinical importance. Despite broad consensus, differences between the current recommendations released October 2025 by the American Heart Association (AHA) and the European Resuscitation Council Guidelines (ERC) may cause confusion. Clinical implementation therefore remains a challenge, particularly when resuscitation takes place outside a hospital and/or in the absence of a trained team. The complexity of this clinical scenario underscores the need for teams to prepare and train for these rare emergency situations.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"291-299"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Experience With Less Invasive Surfactant Administration Under Heated Humidified High-Flow Nasal Cannula in Preterm Infants: An Observational Pilot Study.","authors":"Melek Büyükeren, Tolga Celik, Sule Yigit, Murat Yurdakok","doi":"10.1055/a-2910-1023","DOIUrl":"https://doi.org/10.1055/a-2910-1023","url":null,"abstract":"<p><strong>Background: </strong>Less invasive surfactant administration (LISA) is commonly performed under nasal continuous positive airway pressure (CPAP). Evidence regarding its use under heated humidified high-flow nasal cannula (HHHFNC) support is limited.</p><p><strong>Objective: </strong>To describe the feasibility of performing LISA under ongoing HHHFNC support and to explore short-term physiological observations compared with nasal CPAP in preterm infants.</p><p><strong>Methods: </strong>This observational pilot study was conducted in a tertiary neonatal intensive care unit between January and December 2017. Preterm infants with respiratory distress syndrome requiring surfactant therapy within the first 72 hours of life were included. Infants received non-invasive respiratory support with either nasal CPAP or HHHFNC. Vital signs, blood gas parameters, perfusion index (PI), and pleth variability index (PVI) were recorded before and at predefined time points after surfactant administration.</p><p><strong>Results: </strong>A total of 34 preterm infants was analyzed (CPAP: n=22; HHHFNC: n=12). No statistically significant differences were observed between groups in vital signs, blood gas parameters, PI, or PVI values at any time point. Oxygen saturation at 360 minutes was higher in the HHHFNC group (p=0.030). No major short-term physiological instability was observed during the monitoring period.</p><p><strong>Conclusions: </strong>This observational pilot study suggests that LISA can be technically performed under ongoing HHHFNC support in selected preterm infants. However, because of the observational design, small sample size, and baseline imbalances, no conclusions regarding comparative safety or efficacy relative to CPAP can be drawn.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Infant-driven versus Practitioner-driven Feeding of Preterm Infants: A Systematic Review of Randomized Controlled Trials].","authors":"Kevin Bernhard Arnolds, Frank Peinemann","doi":"10.1055/a-2894-2931","DOIUrl":"https://doi.org/10.1055/a-2894-2931","url":null,"abstract":"<p><strong>Hintergrund: </strong>Voraussetzung für eine erfolgreiche orale Ernährung ist die Berücksichtigung des individuellen Entwicklungsstands der Frühgeborenen. Pflegekräfte und Eltern sollten geschult sein, wie sie Verhaltenssignale des Säuglings während des Fütterns erkennen und darauf angemessen reagieren können. Diese Art der Ernährung wird in dieser Arbeit als \"signalorientiertes und co-reguliertes\" Füttern von Frühgeborenen bezeichnet. Im Unterschied zeichnet sich das \"herkömmliche\" Füttern dadurch aus, dass eine vorab festgelegte Flüssigkeitsmenge zu einer festgelegten Zeit verabreicht wird.</p><p><strong>Zielsetzung: </strong>Es soll untersucht werden, ob das \"signalorientierte und co-regulierte\" Füttern im Vergleich zum \"herkömmlichen\" Füttern zu einer früheren vollständigen oralen Ernährung führen kann.</p><p><strong>Methoden: </strong>Wir haben am 26. Juni 2024 in den elektronischen Datenbanken MEDLINE und Cochrane Library nach thematisch relevanten randomisierten Studien gesucht. Als primärer Endpunkt wurde die Anzahl der Tage bis zur vollständigen oralen Ernährung und als Effektmaß die mittlere Differenz gewählt. Die Metaanalyse wurde unter Verwendung der inversen Varianzmethode und des Random-Effects-Modells durchgeführt, und wir verwendeten den GRADE-Ansatz (Grading of Recommendations Assessment, Development, and Evaluation) für die Bewertung der Evidenz.</p><p><strong>Ergebnisse: </strong>In der Studienauswahl fanden sich 12 randomisierte Studien, die den Einschlusskriterien entsprachen. Von diesen wurden 5 Studien in eine Metaanalyse einbezogen. Die geschätzte mittlere Differenz favorisierte die Gruppen mit signalorientiertem und co-reguliertem Füttern im Vergleich zu den Gruppen mit herkömmlicher Fütterung: -4,93 (95%-Konfidenzintervall -6,60 bis -3,26, p<0,00001, I² =66%). Die Qualität der Evidenz wurde als moderat eingestuft.</p><p><strong>Schlussfolgerungen: </strong>Die Daten der Studienteilnehmer sind mit einem leicht vorteilhaften Effekt für die signalorientierte und co-regulierte Ernährung von Frühgeborenen im Vergleich zur herkömmlichen Ernährung von Frühgeborenen vereinbar. Zukünftige Studien könnten weitere Daten zu unerwünschten Ereignissen während der Ernährung und Informationen zur häuslichen Nachsorge ergänzen.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Revisiting Risk Classification in the German Maternity Record: First Results from the FeMaR Study].","authors":"Julia Sommer, Eva Jansen, Stephanie Roll, Barbara Tabernig, Jon Barrenetxea, Elias Grünewald, Kerstin Rubarth, Katarina Braune, Felix Balzer, Louisa Sommer, Tanja Groten, Brigitte Strizek, Ulrich Gembruch, Thomas Reinhold, Udo Schneider, Florian Recker, Silke Wegener","doi":"10.1055/a-2881-9120","DOIUrl":"https://doi.org/10.1055/a-2881-9120","url":null,"abstract":"<p><strong>Background: </strong>In Germany, antenatal risk assessment in the first trimester is guided by Catalogue A of the maternity record (Mutterpass), whose criteria do not always allow for a differentiated classification. As a first step of the FeMaR study, we therefore assessed the current risk catalogue in a survey.</p><p><strong>Methods: </strong>From early May to the end of July 2025, physicians and midwives were surveyed in a nationwide online questionnaire regarding the current risk classification in the maternity record and requirements for a new assessment approach. Data were analyzed using descriptive statistics and qualitative content analysis.</p><p><strong>Results: </strong>Of 381 respondents, 97% indicated a need to adapt the existing risk catalogue: 46% supported weighting of risk factors, 27% favored more differentiated stratification, and 24% advocated for the inclusion of previously unconsidered risk factors. Analysis of the free-text responses showed that the feedback focused less on individual factors than on broader aspects of terminology, structure, and the overall framework of the risk classification.</p><p><strong>Outlook and conclusion: </strong>The survey findings suggest that the current risk classification should be reviewed and potentially refined. FeMaR may contribute to a more targeted and needs-based approach to care in the future.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Omega-3 polyunsaturated fatty acids for risk reduction of preterm birth: Evidence and current recommendations].","authors":"Werner Rath","doi":"10.1055/a-2884-3883","DOIUrl":"https://doi.org/10.1055/a-2884-3883","url":null,"abstract":"<p><strong>Abstract: </strong>Omega-3 polyunsaturated fatty acids for risk reduction of preterm birth: Evidence and current recommendations Due to an increased need, pregnant women are recommended to take 350-450 mg docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) daily from food or supplements. Pregnant women with a low intake of DHA (<150 mg/day) or low blood levels of DHA (omega-3 index<4%) are at increased risk of preterm birth<34 weeks of gestation. Numerous studies have shown controversial results regarding a reduction in preterm birth rates through supplementation with omega-3 polyunsaturated fatty acids. In pregnant women with a low omega-3 index, daily supplementation of up to 1000 mg DHA was found to be associated with a significant decrease in the rate of preterm birth<34 weeks of gestation. Hence, these pregnant women are advised to take 600-1000 mg DHA+EPA/day or DHA alone in the same dosages commencing before 20 weeks of gestation until 37 weeks of gestation. Identification of women at increased risk of preterm birth is achievable by screening using the DHA food frequency questionnaire or assessing the omega-3 index.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}