Seminars in Fetal & Neonatal Medicine最新文献

{"title":"Fetal-neonatal neurology principles and practice: Topics in diagnostic and management skills applied to interdisciplinary care.","authors":"Mark S Scher, Sonika Agarwal, Charu Venkatesan","doi":"10.1016/j.siny.2024.101548","DOIUrl":"10.1016/j.siny.2024.101548","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101548"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631198","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":"Brain health equity and the influence of social determinants across the life cycle.","authors":"Ashley M Bach, Mary Peeler, Michelle Caunca, Bolajoko O Olusanya, Nicole Rosendale, Dawn Gano","doi":"10.1016/j.siny.2024.101553","DOIUrl":"10.1016/j.siny.2024.101553","url":null,"abstract":"<p><p>Social determinants of health are social, economic and environmental factors known to influence health and development of infants, children and adults. Advancing equity in brain health relies upon interdisciplinary collaboration and recognition of the impact of social determinants on brain health through the lifespan and across generations. Critical periods of fetal, infant and early childhood development encompass intrinsic genetic and extrinsic environmental influences with complex gene-environment interactions. This review discusses the influence of social determinants on the continuum of brain health from preconception and pregnancy health, through fetal, infant and childhood neurodevelopment into adulthood. Opportunities for intervention to address the social determinants of brain health across the life cycle are highlighted.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101553"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631214","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":"Machine-learning based prediction of future outcome using multimodal MRI during early childhood.","authors":"Minhui Ouyang, Matthew T Whitehead, Sovesh Mohapatra, Tianjia Zhu, Hao Huang","doi":"10.1016/j.siny.2024.101561","DOIUrl":"10.1016/j.siny.2024.101561","url":null,"abstract":"<p><p>The human brain undergoes rapid changes from the fetal stage to two years postnatally, during which proper structural and functional maturation lays the foundation for later cognitive and behavioral development. Multimodal magnetic resonance imaging (MRI) techniques, especially structural MRI (sMRI), diffusion MRI (dMRI), functional MRI (fMRI), and perfusion MRI (pMRI), provide unprecedented opportunities to non-invasively quantify these early brain changes at whole brain and regional levels. Each modality offers unique insights into the complex processes of both typical neurodevelopment and the pathological mechanisms underlying psychiatric and neurological disorders. Compared to a single modality, multimodal MRI enhances discriminative power and provides more comprehensive insights for understanding and improving neurodevelopmental and mental health outcomes, particularly in high-risk populations. Machine learning- and deep learning-based methods have demonstrated significant potential for predicting future outcomes using multimodal brain MRI acquired during early childhood. Here, we review the unique characteristics of various MRI techniques for imaging early brain development and describe the common approaches to analyze these modalities. We then discuss machine learning approaches in predicting future neurodevelopmental and clinical outcomes using multimodal MRI information during early childhood, highlighting the potential of identifying biomarkers for early detection and personalized interventions in atypical development.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101561"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631259","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":"Overview of reproductive and pregnancy health principles and practice used by maternal-fetal medicine specialists for fetal-neonatal neurology consultants.","authors":"Nancy Soliman, Verena Kuret, Elaine Chan, Christopher Smith, Mary Ann Thomas, Houman Mahallati, Heidi Grosjean, Erika Friebe, Leah Rusnell","doi":"10.1016/j.siny.2024.101555","DOIUrl":"10.1016/j.siny.2024.101555","url":null,"abstract":"<p><p>Unique from other fetal anatomical systems, the central nervous system (CNS) starts development early in the embryonic period shortly after fertilization before most patients are even aware they are pregnant. Maturation throughout pregnancy involve complicated structural and functional changes, most likely below the resolution of testing to detect. During this time, the fetal CNS is susceptible to lesions that reflect trimester-specific adverse events. Neonatal neurological status with childhood sequelae can result from combinations of antenatal, peripartum and neonatal adverse events. Person-specific clinical management choices must consider the timing of multiple mechanisms that can alter neurodevelopment including genetic causes, aetiologies after conception as well as communicable and non-communicable conditions that result in anomalous or destructive brain lesions. The appearance of the fetal brain also changes significantly through gestation as different structures mature and the cerebral cortex in particular increases in size and complexity. Therefore, obstetrical imagers and maternal fetal medicine physicians need to be aware of the expected evolving appearances of the healthy fetal brain as the fetus advances in gestation. Often when fetal CNS pathology is detected or anticipated during pregnancy, there is understandably significant parental anxiety regarding the long-term implications of their child's neurodevelopmental prognosis. In these instances, Maternal Fetal Medicine specialists often collaborate with Pediatric Neurologists in the antenatal period regarding diagnoses that anticipate neonatal or later childhood neurologic sequelae. Potential adverse outcomes are discussed with prospective parents to be integrated into choices based on shared decisions.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101555"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649495","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":"Improving neurological and mental health outcomes for children with prenatal drug exposure.","authors":"Ju Lee Oei","doi":"10.1016/j.siny.2024.101557","DOIUrl":"10.1016/j.siny.2024.101557","url":null,"abstract":"<p><p>Prenatal drug exposure is a global public health problem that will never be completely eliminated. Some drugs are essential for maternal health but many others are used recreationally and for non-medical reasons. Both legal and illegal drugs of addiction and dependency have the potential to cause permanent and even intergenerational harm to the developing child and understanding the direct impact of drugs of addiction on child neurodevelopmental and mental health is difficult and confounded by many social, environmental and possibly, genetic factors. Furthermore, many drugs are not clear neuroteratogens and their impact on the child may be indolent and not appreciated for a long time after exposure has occurred. Despite this, there are numerous windows of opportunity to improve the eventual outcomes of the child including utilising the enormous benefits of neuroplasticity and general principles of basic health care and support. This chapter will discuss current understanding of the impact of drugs of addiction on the growing child and offer possible mitigation strategies to improve outcomes.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101557"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631202","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":"Revisiting the functional monitoring of brain development in premature neonates. A new direction in clinical care and research.","authors":"Fabrice Wallois, Sahar Moghimi","doi":"10.1016/j.siny.2024.101556","DOIUrl":"10.1016/j.siny.2024.101556","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The first 1000 days of life are of paramount importance for neonatal development. Premature newborns are exposed early to the external environment, modifying the fetal exposome and leading to overexposure in some sensory domains and deprivation in others. The resulting neurodevelopmental effects may persist throughout the individual's lifetime. Several neonatal neuromonitoring techniques can be used to investigate neural mechanisms in early postnatal development. EEG is the most widely used, as it is easy to perform, even at the patient's bedside. It is not expensive and provides information with a high temporal resolution and relatively good spatial resolution when performed in high-density mode. Functional near-infrared spectroscopy (fNIRS), a technique for monitoring vascular network dynamics, can also be used at the patient's bedside. It is not expensive and has a good spatial resolution at the cortical surface. These two techniques can be combined for simultaneous monitoring of the neuronal and vascular networks in premature newborns, providing insight into neurodevelopment before term. However, the extent to which more general conclusions about fetal development can be drawn from findings for premature neonates remains unclear due to considerable differences in environmental and medical situations. Fetal MEG (fMEG, as an alternative to EEG for preterm infants) and fMRI (as an alternative to fNIRS for preterm infants) can also be used to investigate fetal neurodevelopment on a trimester-specific basis. These techniques should be used for validation purposes as they are the only tools available for evaluating neuronal dysfunction in the fetus at the time of the gene-environment interactions influencing transient neuronal progenitor populations in brain structures. But what do these techniques tell us about early neurodevelopment? We address this question here, from two points of view. We first discuss spontaneous neural activity and its electromagnetic and hemodynamic correlates. We then explore the effects of stimulating the immature developing brain with information from exogenous sources, reviewing the available evidence concerning the characteristics of electromagnetic and hemodynamic responses. Once the characteristics of the correlates of neural dynamics have been determined, it will be essential to evaluate their possible modulation in the context of disease and in at-risk populations. Evidence can be collected with various neuroimaging techniques targeting both spontaneous and exogenously driven neural activity. A multimodal approach combining the neuromonitoring of different functional compartments (neuronal and vascular) is required to improve our understanding of the normal functioning and dysfunction of the brain and to identify neurobiomarkers for predicting the neurodevelopmental outcome of premature neonate and fetus. Such an approach would provide a framework for exploring early neurodevelopment, paving the way for the d","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101556"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631267","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":"A practical guide to reducing/eliminating red blood cell transfusions in the neonatal intensive care unit.","authors":"Robin K Ohls, Timothy M Bahr, Thomas G Peterson, Robert D Christensen","doi":"10.1016/j.siny.2024.101545","DOIUrl":"https://doi.org/10.1016/j.siny.2024.101545","url":null,"abstract":"<p><p>Red blood cell transfusions can be lifesaving for neonates with severe anemia or acute massive hemorrhage. However, it is imperative to understand that red cell transfusions convey unique and significant risks for neonates. The extremely rare risks of transmitting a viral, bacterial, or other microbial infection, or causing circulatory overload are well known and are part of blood transfusion informed consent. Less well known, and not always part of the consent process, are more common risks of transfusing the smallest and most immature NICU patients; specifically, multiple transfusions may worsen inflammatory conditions (particularly pulmonary inflammation), and in certain subsets are associated with retinopathy of prematurity and neurodevelopmental delay. Instituting non-pharmacological transfusion-avoidance techniques reduces transfusion rates. Pharmacological transfusion-avoidance, specifically erythropoietic stimulating agents, further reduces the risk of needing a transfusion. The protocols described herein constitute an efficient and cost-effective transfusion-avoidance program. Using these protocols, many NICU patients can remain transfusion-free.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101545"},"PeriodicalIF":2.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548565","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":"Neonatal/perinatal diagnosis of hemolysis using ETCOc.","authors":"Robert D Christensen, Timothy M Bahr, Robin K Ohls, Kenneth J Moise","doi":"10.1016/j.siny.2024.101547","DOIUrl":"https://doi.org/10.1016/j.siny.2024.101547","url":null,"abstract":"<p><p>Hemolysis is a pathological shortening of the red blood cell lifespan. When hemolysis occurs in a neonate, hazardous hyperbilirubinemia and severe anemia could result. Hemolysis can be diagnosed, and its severity quantified, by the non-invasive measurement of carbon monoxide (CO) in exhaled breath. The point-of-care measurement is called \"End-tidal CO corrected for ambient CO\" (ETCOc). Herein we explain how ETCOc measurements can be used to diagnose and manage various perinatal/neonatal hemolytic disorders. We provide information regarding five clinical situations; 1) facilitating a precise diagnosis among neonates presenting with anemia or jaundice of unknown etiology, 2) monitoring fetal hemolysis with serial measurements of mothers during pregnancy, 3) measuring the duration of hemolysis in neonates with hemolytic disease, 4) measuring neonates who require phototherapy, to determine whether they have hemolytic vs. non-hemolytic jaundice, and 5) measuring all neonates in the birth hospital as part of a jaundice-detection and management program.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101547"},"PeriodicalIF":2.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511654","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":"Term umbilical cord blood, fully tested and processed, as the source of red blood cell transfusions for extremely-low-gestational age neonates.","authors":"Timothy M Bahr, Thomas R Christensen, Sarah J Ilstrup, Robin K Ohls, Robert D Christensen","doi":"10.1016/j.siny.2024.101546","DOIUrl":"https://doi.org/10.1016/j.siny.2024.101546","url":null,"abstract":"<p><p>ELGANs (Extremely-Low-Gestational-Age Neonates; those born before 28 weeks gestation) are at risk for developing significant morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and cognitive impairment. The pathogenesis of each of these morbidities is complex, but a growing literature suggests that repeated transfusions of adult donor red blood cells (RBC) conveys a propensity to develop these disorders. The biological rationale for the propensities might vary with each morbidity. For instance, hemoglobin A in adult red cells increases oxygen delivery to the developing retina, potentiating ROP, while a proinflammatory nature of adult donor RBC might potentiate BPD. It is possible that fetal RBC harvested from otherwise discarded umbilical cord blood after healthy term births would be a more physiologically appropriate transfusion product for anemic ELGANs. Such a product might result in a lower incidence or severity of the common morbidities. Herein we review our progress, and that of others, toward testing that theory.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101546"},"PeriodicalIF":2.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548567","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":"Diverse childhood neurologic disorders and outcomes following fetal neurologic consultation","authors":"Dawn Gano ,&nbsp;Andrea C. Pardo ,&nbsp;Orit A. Glenn ,&nbsp;Elliott Sherr","doi":"10.1016/j.siny.2024.101524","DOIUrl":"10.1016/j.siny.2024.101524","url":null,"abstract":"<div><p>Fetal neurology encompasses the full spectrum of neonatal and child neurology presentations, with complex additional layers of diagnostic and prognostic challenges unique to the specific prenatal consultation. Diverse genetic and acquired etiologies with a range of potential outcomes may be encountered. Three clinical case presentations are discussed that highlight how postnatal phenotyping and longitudinal follow-up are essential to address the uncertainties that arise in utero, after birth, and in childhood, as well as to provide continuity of care.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"29 1","pages":"Article 101524"},"PeriodicalIF":3.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1744165X24000064/pdfft?md5=0c922e23eeba4dbb7ef8306e69224a04&pid=1-s2.0-S1744165X24000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603513","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}