{"title":"Amplitude-integrated electroencephalogram (aEEG): A bedside window into newborn brain function in the NICU.","authors":"Emily M Herzberg, Mohamed El-Dib","doi":"10.1016/j.siny.2026.101774","DOIUrl":"https://doi.org/10.1016/j.siny.2026.101774","url":null,"abstract":"<p><p>Amplitude-integrated electroencephalography (aEEG) remains an important tool for bedside neonatal brain monitoring. The rapid application of aEEG offers critical practical advantages for bedside clinicians assessing infants at risk for brain injury. aEEG has a distinct clinical niche in evaluations for hypoxic-ischemic encephalopathy (HIE) and as a first-line tool for seizure detection, alongside conventional video electroencephalogram (cEEG). Ultimately, the integration of aEEG with a broader multimodal neuromonitoring framework enhances neurodevelopmental prognostication and facilitates individualized bedside interventions, solidifying its relevance in contemporary neonatal neurocritical care.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101774"},"PeriodicalIF":2.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225401","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":"Update on neonatal pulse oximetry: A narrative review.","authors":"Christoph E Schwarz, Christian F Poets","doi":"10.1016/j.siny.2026.101773","DOIUrl":"https://doi.org/10.1016/j.siny.2026.101773","url":null,"abstract":"<p><p>The standard monitoring approach to neonatal oxygenation is pulse oximetry. Utilized for decades, it seems fully integrated into clinical workflows. However, as with all other monitoring devices, it has limitations clinicians need to be aware of. Furthermore, various technical and clinical influencing factors may impair signal validity and should be taken into account. Beyond oxygen saturation, pulse oximetry also provides information on pulse rate and peripheral perfusion. This chapter will review technical and clinical factors and limitations of pulse oximetry in various clinical scenarios such as delivery room management and neonatal intensive care, including potential complications like sepsis. We aim to highlight current limitations, thereby setting goals for future research and integration into clinical practice.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101773"},"PeriodicalIF":2.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197239","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":"Non-invasive cardiac output monitoring in neonates: From technologic promise to clinical practice.","authors":"Lizelle van Wyk, Silvia Martini","doi":"10.1016/j.siny.2026.101772","DOIUrl":"https://doi.org/10.1016/j.siny.2026.101772","url":null,"abstract":"<p><p>Due to the clinical importance of early detection of hemodynamic compromise and the limitations of transthoracic echocardiography (TTE) as an intermittent, operator-dependent assessment, the introduction of non-invasive cardiac output monitoring (NICOM) in the neonatal population has generated considerable interest. Electrical biosensing technology (EBT), one type of NICOM modality, offers non-invasive, continuous, bedside assessment of multiple hemodynamic parameters, yet its clinical utility is limited by variable accuracy and precision, lack of interchangeability with TTE and limited trending studies. Despite this, EBT is progressively being used in research and even clinical domains. Advancing continuous EBT-enabled cardiac output monitoring from technologic promise to clinical accountability requires specific neonatal-based refinements of the technology and a strategic shift in research emphasis, moving from method-comparison studies to rigorously designed, outcome-based trials, in order to determine whether EBT-informed management can meaningfully improve neonatal morbidity and mortality.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101772"},"PeriodicalIF":2.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842012","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}
Daniele De Luca , Roberta Onesimo , Alexandra Benachi , Satoshi Kusuda , Elizabeth Foglia , Ola Saugstad , Steven Abman
{"title":"Enhancing research and development to innovate neonatology and improve newborn health","authors":"Daniele De Luca , Roberta Onesimo , Alexandra Benachi , Satoshi Kusuda , Elizabeth Foglia , Ola Saugstad , Steven Abman","doi":"10.1016/j.siny.2026.101735","DOIUrl":"10.1016/j.siny.2026.101735","url":null,"abstract":"<div><div>Neonatology suffers from a chronic lack of innovation, and several neonatal disorders still lack appropriate diagnostic or therapeutic tools. Here, we expand on the recent analysis of this situation by the Lancet Child and Adolescent Commission for the Future of Neonatology, highlighting the similarities between adult and neonatal critical care, the need for greater interdisciplinary collaboration, and the importance of clearly defining neonatology as a distinct specialty. We also discuss the peculiarities of medical devices. We analyse the rarity of neonatal malformative and non-malformative disorders and diseases in light of the opportunities related to the definition of rare disease. We provide a culture-based definition of neonatology and advocate for creating a separate residency program, discussing its benefits in both developed and low-middle-income countries.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 3","pages":"Article 101735"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724420","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":"From constraints to solutions: leveraging low-cost, scalable simulation for safer neonatal resuscitation","authors":"Juin Yee Kong , Nicole K. Yamada","doi":"10.1016/j.siny.2026.101736","DOIUrl":"10.1016/j.siny.2026.101736","url":null,"abstract":"<div><div>Neonatal mortality remains a major global health challenge, disproportionately affecting low-resource settings where access to timely and effective resuscitation is limited. Simulation-based training provides a safe and effective method to develop and sustain the cognitive, technical, and behavioural skills essential for neonatal resuscitation, while improving teamwork, confidence, and patient safety. Despite established evidence of its effectiveness in enhancing these skills, widespread implementation of simulation-based training remains limited in resource-constrained settings due to financial, infrastructural, human resource and organizational barriers. This review proposes simulation as a patient safety intervention that supports the shift from traditional error-focused to system resilience approaches. Scalable innovations including low-cost manikins, in situ simulation, telesimulation, and structured debriefing offer practical and sustainable solutions. Future research linking simulation-based training to measurable improvements in neonatal outcomes is essential to inform policy, guide investment, and promote global health equity.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 3","pages":"Article 101736"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787314","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 future neonatologist","authors":"Josef Neu","doi":"10.1016/j.siny.2026.101740","DOIUrl":"10.1016/j.siny.2026.101740","url":null,"abstract":"<div><div>The field of Neonatal Intensive Care is rapidly changing. Technological innovations are emerging rapidly, and family-centered and holistic approaches need to keep pace. Promising areas include artificial intelligence, multiomic integrations for description and understanding of pathogenic processes using systems biology. This review will discuss where we have been, our status and the future of neonatal intensive care. Topics to be addressed include some of the most significant future technical innovations, how these might improve global health and equity, the training of the future neonatologist and ethical and financial decisions that will need to be made as we progress.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 3","pages":"Article 101740"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822877","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":"Benefits of neonatal resuscitation training in high- and low-resource settings","authors":"Amy Mackay, Waldemar A. Carlo","doi":"10.1016/j.siny.2026.101739","DOIUrl":"10.1016/j.siny.2026.101739","url":null,"abstract":"<div><div>Globally, around 1.9 million stillbirths occur each year, and around 2.3 million newborns die in the first 28 days after birth each year. Many of these deaths are preventable. The burden of stillbirths is likely even higher, as many are unreported. A disproportionate number of fresh stillbirths and neonatal deaths occur in low-resource settings. About 1 million neonatal deaths occur in the first 24 h after birth, with preterm birth and birth asphyxia/intrapartum-related death being the leading causes. For newborns who have difficulty establishing effective breathing at birth, prompt and effective resuscitation is usually lifesaving. Training providers in high- and low-resource settings have been instrumental in equipping healthcare professionals to support a newborn's breathing at birth and continued care in the first month after birth to mitigate stillbirths and neonatal deaths. This review focuses on educational programs in both high- and low-resource settings designed to enable providers to perform timely and effective neonatal resuscitation and early newborn care. The highest level of available evidence that investigates the effects of these programs on provider knowledge and skills, as well as neonatal mortality and stillbirths, will be discussed. Where strong evidence may be lacking, it will be reviewed. Current complementary interventions to neonatal resuscitation training programs that are being researched will be addressed.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 3","pages":"Article 101739"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787270","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":"Psychological safety in healthcare – helping everyone to speak up","authors":"Sanjay Patole","doi":"10.1016/j.siny.2026.101738","DOIUrl":"10.1016/j.siny.2026.101738","url":null,"abstract":"<div><div>Psychological safety is important for excellence in team performance. Team performance is compromised when team members fear the consequences of speaking up to raise concerns about wrongdoing or an individual.</div><div>Consistent delivery of safe and the best quality of care is the prime responsibility of healthcare teams. Those involved in neonatal intensive care are not an exception. The importance of psychological safety in healthcare cannot be overemphasised considering the unique nature and complexity of this industry. It is also important for teaching hospitals with added responsibility for high-quality training, education and research. The issue of psychological safety is more relevant for healthcare organizations considering their strict hierarchy where careers depend on performance appraisals. Facilitating a culture of psychological safety is the responsibility of everyone holding a leadership role in an organization.</div><div>We briefly review the history of psychological safety, the reasons why it matters in healthcare, impact on all stakeholders when it is missing, tools for assessing its presence and balance in a team, and the role of leaders at all levels in facilitating a culture of psychological safety in an organization. The barriers and facilitators of psychological safety and key issues about the phenomenon of whistleblowing are discussed.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 3","pages":"Article 101738"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787344","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":"International collaborations in neonatal and fetal medicine — Low-and-middle income countries have the patients and high-income countries have the technology: Consensus, conundrums and controversies","authors":"Sourabh Dutta","doi":"10.1016/j.siny.2026.101737","DOIUrl":"10.1016/j.siny.2026.101737","url":null,"abstract":"<div><div>International collaborations between investigators in low-and-middle-income countries (LMICs) and high-income countries (HICs) in neonatal and fetal medicine have expanded over the past decade. This narrative review documents a rise in HIC–LMIC publications since 2014, with a plateau and transient dip during the COVID-19 pandemic. It analyses leadership, patient recruitment, and how HIC-based technologies and laboratory platforms shape research agendas. Many influential trials are conceived and sponsored by HIC institutions, with recruitment concentrated in LMICs because of higher disease burden, larger eligible populations and lower costs. Meanwhile, LMIC centers report growing readiness to support randomized controlled trials, and LMIC-conceived, led and completed multicentre studies are increasingly reported. Ongoing concerns include misalignment between donor priorities and national agendas, inequities in authorship and leadership, and ethical challenges related to standards of care, post-trial access, consent and compensation. The review compares regulatory, consent and insurance processes in India and the United States, and highlights enabling factors such as harmonised guidelines, global registries, political goodwill and professional networks. It anticipates a doubling of HIC–LMIC collaborative studies over the next decade, rapid growth of South–South partnerships, and gradual, though incomplete, correction of authorship and leadership imbalances in global neonatal and fetal medicine.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 3","pages":"Article 101737"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730520","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}
David L. Weisoly , Mathew A. Rysavy , Joseph Kaempf , Robert Ursprung , John Lantos
{"title":"Ethical tensions in decisions about treatment for babies born at the borderline of viability: Discussion and consensus","authors":"David L. Weisoly , Mathew A. Rysavy , Joseph Kaempf , Robert Ursprung , John Lantos","doi":"10.1016/j.siny.2026.101715","DOIUrl":"10.1016/j.siny.2026.101715","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"31 2","pages":"Article 101715"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391451","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}