American journal of perinatology最新文献

{"title":"Improved Growth Velocity Using a New Liquid Human Milk Fortifier in Very Low Birth Weight Infants: A Multicenter, Retrospective Study.","authors":"Fernando Moya, Jennifer Fowler, Adrian Florens, Jennifer Dombrowski, Olivia Davis, Tiffony Blanks, Austin Gratton","doi":"10.1055/a-2527-4638","DOIUrl":"10.1055/a-2527-4638","url":null,"abstract":"<p><p>This study aimed to compare growth outcomes and tolerance among very low birth weight (VLBW) infants receiving a new, liquid human milk fortifier (LHMF-NEW) or a human milk fortifier-acidified liquid (HMF-AL).Retrospective, multicenter study of 515 VLBW infants in three regional neonatal intensive care units. The primary objective was to compare growth velocity (g/kg/d) during fortification between groups by repeated measures regression. Secondary outcomes of interest were feeding tolerance and the incidence of late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis. Student's <i>t</i>, analysis of variance, Wilcoxon, and Kruskal-Wallis tests were used for numeric variables, or chi-squared and Fisher's exact test for categorical variables.No demographic differences were identified between the groups (HMF-AL, <i>n</i> = 242; LHMF-NEW, <i>n</i> = 273). Growth velocity during fortification was significantly higher in the group receiving LHMF-NEW, despite relatively similar total fluid, calorie, or protein intake (<i>p</i> = 0.001). Feeding intolerance was comparable between fortifiers. Necrotizing enterocolitis and late-onset sepsis did not differ between groups and metabolic acidosis was diagnosed less frequently with the LHMF-NEW. Anthropometric measures at discharge and length of stay were comparable.Infants receiving human milk fortified with the LHMF-NEW had faster growth velocity during fortification, similar tolerance, and less metabolic acidosis compared with an earlier cohort of infants who received human milk fortified with an HMF-AL. · Among VLBW infants, using an LHMF-NEW resulted in a faster growth velocity in weight during several weeks of fortification than using the previous HMF-AL.. · The incidence of feeding intolerance (stopping feeds >8 hour) in any given week of fortification was low and not different between groups. Also, late-onset sepsis and necrotizing enterocolitis were uncommon with no differences between groups, whereas the incidence of metabolic acidosis was lower in infants receiving the LHMF-NEW.. · No differences in length of stay or anthropometrics at discharge were identified..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1729-1737"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Coronavirus Disease 2019 on the Incidence of No Prenatal Care.","authors":"Takaki Tanamoto, Misa Hayasaka, Lindsay Robbins, George Saade, Tetsuya Kawakita","doi":"10.1055/a-2535-8309","DOIUrl":"10.1055/a-2535-8309","url":null,"abstract":"<p><p>This study aimed to examine the impact of coronavirus disease 2019 (COVID-19) on the racial disparity in prenatal care utilization in the United States before and during the pandemic.This was a cross-sectional study using the National Vital Statistics Data from 2018 to 2022. Our focus was on low-risk individuals who delivered singleton pregnancies at term. The analysis was restricted to Black and White individuals to explore racial disparities. The study periods based on the last menstrual period (LMP) were prepandemic (March 2018-February 2020) and pandemic (March 2020-February 2022). The primary outcome was the rate of no prenatal care. We employed interrupted time series analysis, negative binomial regression models, adjusting for confounders, seasonality, and autocorrelation. We conducted postestimation analyses to calculate the counterfactual and actual incidences of outcomes for individuals with an LMP in March 2020 and February 2022. Difference-in-difference (DID) with 95% confidence intervals (95% CI) was estimated.The analysis included 3,511,813 individuals in the prepandemic period and 5,163,486 in the pandemic period. For individuals with LMP in March 2020, the actual incidences of no prenatal care per 100 births were 3.2 (95% CI: 3.0, 3.3) for Black individuals and 1.6 (95% CI: 1.2, 2.0) for White individuals. The difference between counterfactual and actual no prenatal care rates per 100 births for Black individuals was 0.4 (95% CI: 0.2, 0.5), indicating a significant increase in no prenatal care. Conversely, there was no significant difference for White individuals. DID analysis further demonstrated that this increase was greater in Black individuals compared with White individuals (DID per 100 births 0.3 [95% CI: 0.1, 0.5]). For individuals with LMP in February 2022, this difference in disparity further worsened (DID per 100 births 0.8 [95% CI: 0.4, 1.2]).The COVID-19 pandemic increased the incidence of no prenatal care, which disproportionately affected Black individuals. · The COVID-19 pandemic increased racial disparities.. · The increase in no prenatal care among Black individuals.. · White individuals are lower affected during this period..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1778-1785"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389802","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":"Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative.","authors":"Stephanie Martinez, Monika Bhola, Nori Mercuri Minich, Charlene Nauman, Kathleen Deakins, Allison Oliverio, Gulgun Yalcinkaya","doi":"10.1055/a-2533-2465","DOIUrl":"10.1055/a-2533-2465","url":null,"abstract":"<p><p>There is increasing evidence that the use of a video laryngoscope improves first-attempt intubation rates in neonates. The goal of this quality improvement initiative was to improve the first-attempt intubation success rate from 45 to 65% in 2.5 years through the introduction and increased use of a video laryngoscope in a level IV neonatal intensive care unit (NICU).We utilized the Model for Improvement with plan-do-study-act cycles targeted at increasing buy-in and comfort with the use of a video laryngoscope. Data on 418 intubations were collected from November 2021 to April 2024.Through increasing routine use of the video laryngoscope, achieved via a staggered introduction of the device, creation of reference materials, and coaching workshops, we improved the overall first-attempt intubation success rate from 45 to 57% during the intervention period.We increased the first-attempt success rate of intubations in the NICU by effectively implementing the use of a video laryngoscope into daily practice. · Neonatal intubations have low success rates, but video laryngoscopy improves success especially for those with less experience.. · This study shows that video laryngoscopy adoption in a neonatal ICU improved first-attempt intubation rates.. · This study contributes to neonatal intubation and video laryngoscopy literature from a quality improvement perspective..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1743-1753"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571825","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":"Evaluation of First-Trimester Low Percentile Nuchal Translucency Association with Adverse Perinatal Outcomes and Fetal Congenital Anomalies.","authors":"Mefkure Eraslan Sahin, Erdem Sahin, Mehmet M Kirlangic, Seyma Daglituncezdi Cam, Serhan Kutuk, Havva Can Ozdemir, Emre Genc","doi":"10.1055/a-2544-9078","DOIUrl":"10.1055/a-2544-9078","url":null,"abstract":"<p><p>This study aimed to evaluate the association of first-trimester low percentile nuchal translucency (NT) thickness values with adverse perinatal outcomes and fetal congenital anomalies.In this retrospective study, 2,150 pregnant women who screened first trimester NT and delivered at Kayseri City Hospital were divided into three groups based on their fetal NT thickness percentiles as follows: third percentile NT group (<i>n</i>: 101), 3rd to 10th percentile NT group (<i>n</i>: 242), and 10th to 90th percentile NT group (<i>n</i>: 1,807).First-trimester NT thickness was analyzed in 5 mm intervals according to gestational age, and the mean NT value was 0.76 mm in the third percentile, 0.95 mm in the 3rd to 10th percentile, 1.51 mm in the 50th percentile, and 2.36 mm in the 90th percentile. Fetal birth weight was significantly decreased in the third percentile NT group and 3rd to 10th percentile NT group compared with the 10 to 90th percentile NT group. Small for gestational age, intrauterine growth restriction with abnormal Doppler value and second-trimester spontaneous abortion rates were significantly increased in the third percentile NT group and the 3rd to 10th percentile NT group compared with the 10th to 90th percentile NT group. The study did not find an increased risk for fetal congenital anomalies in the third percentile group or the 3rd to 10th percentile group.The results indicated that first-trimester NT thickness values below the 10th percentile were associated with low fetal birth weight and adverse perinatal outcomes. Additionally, low percentile first-trimester NT thickness was not a risk factor for fetal congenital abnormalities. · First trimester NT screening is a well-explained phenomenon.. · There is little information regarding decreased NT below the 10th percentile.. · NT thickness values below the 10th percentile were associated with adverse perinatal outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1858-1863"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656028","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":"The Skincubator: A Novel Incubator for Skin-to-Skin Care (SSC) of Premature Neonates, Enables SSC within Humidified Environment and May Improve Thermoregulation during SSC.","authors":"Itamar Nitzan, Yair Kasirer, Francis B Mimouni, Tehilla Kagan, Alona Bin Nun, Tali B Weiss, Robert D White, Cathy Hammerman","doi":"10.1055/a-2526-5064","DOIUrl":"10.1055/a-2526-5064","url":null,"abstract":"<p><p>This study aimed to assess thermoregulation and humidity within the Skincubator-a novel, wearable skin-to-skin incubator designed to attach to the caregiver.Preterm neonates (PN; born between 24 and 33 weeks gestational age [GA]) received skin-to-skin care (SSC) either via the Skincubator or traditional SSC (t-SSC) with continuous axillary temperature monitoring.Twenty PN were enrolled in the study and treated in the Skincubator. One couple who consented to Skincubator care during delivery subsequently revoked their consent and the baby was excluded from further analysis. Fifty-four paired sessions of Skincubator and t-SCC were performed and compared for 19 babies. The average GA was 29 weeks (range: 26-32), the average weight was -1,296 ± 271 g, and the average day of life was 5 ± 2. The temperature drop after transfer to Skincubator care was smaller than in t-SSC (0.2°C [0.2-0.3] vs. 0.4°C [0.3-0.6]; Wilcoxon's signed rank test [WSRT], <i>p</i> < 0.001). The average hypothermia time per session was a median (25th-75th%) of 8.2 minutes (0-9) for Skincubator, compared to 27.8 minutes (0-56) for t-SSC, respectively (WSRT, <i>p</i> = 0.002). No baby had moderate hypothermia (35.5-35.9°C) during Skincubator care as compared with eight babies who experienced moderate hypothermia during t-SSC (Fisher's exact test <i>p</i> = 0.003). The average Skincubator humidity was 85 ± 7% and was above 70% during 93% of the time.Skincubator SSC was superior to t-SSC in maintaining PN temperature while also maintaining an optimally humidified environment. The Skincubator may promote early SSC in very and extremely PN. (Trial registration number MOH_2021-12-13_010470 registration date 24/10/21.) · Early prolonged SSC improves preterm infants' outcomes but may be challenging to perform.. · To mitigate several SSC barriers we invented the Skincubator, a wearable incubator for SSC.. · We have shown that the Skincubator reduces transient moderate hypothermia at SSC initiation.. · Average Skincubator humidity was 85 ± 7% and above 70% during 93% of SSC time..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1721-1728"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073301","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":"Risk and Causes of Early Mortality among Extremely Preterm Infants Born Small for Gestational Age.","authors":"Olasunkanmi Kehinde, Dmitry Tumin, Uduak S Akpan, Martha Naylor","doi":"10.1055/a-2533-2533","DOIUrl":"10.1055/a-2533-2533","url":null,"abstract":"<p><p>Extreme preterm (EPT) delivery, occurring before 28 weeks of gestation, carries high morbidity and mortality risks. Small for gestational age (SGA) infants, approximately 8 to 20% of EPT neonates, face increased risks. Mortality risk varies with gestational age and birth weight, with mixed reports on specific morbidities. This study aims to determine mortality rates and common causes of death among EPT SGA infants.The study used data from the CDC National Vital Statistics System, covering births and deaths from 2016 to 2021, with follow-up through 2022. It included infants born between 22 and 27 weeks gestation who were admitted to the neonatal intensive care unit. The outcome was all-cause in-hospital mortality within 30 days of birth, with causes of mortality classified based on the International Classification of Diseases, 10th revision codes. SGA was the primary independent variable.Based on a sample of <i>n</i> = 96,134 infants, we estimated 13% were born SGA and 30-day mortality rates were higher among SGA compared with non-SGA infants (31 vs. 13%). On multivariable analysis, SGA infants had higher 30-day mortality than non-SGA (odds ratio: 3.82; confidence interval 95% [CI]: 3.64, 4.01; <i>p</i> < 0.001), and were more likely to have death ascribed to complications of short gestation rather than other causes of death (relative risk ratio: 1.42; 95% CI: 1.27, 1.59; <i>p</i> < 0.001).SGA infants receiving intensive care have a high mortality risk, especially due to complications of short gestation and low birth weight complications. · EPT infants face high mortality risk.. · Mortality risk is increased for infants born SGA.. · Mortality in SGA EPT infants is frequently attributed to complications of prematurity and small size..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1754-1762"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254353","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 versus Late Brain Magnetic Resonance Imaging and Spectroscopy in Infants with Neonatal Encephalopathy following Therapeutic Hypothermia.","authors":"Tatiana A Nuzum, Pradeep Mally, Elena V Wachtel","doi":"10.1055/a-2540-2956","DOIUrl":"10.1055/a-2540-2956","url":null,"abstract":"<p><p>This study aimed to evaluate the utility of early and late magnetic resonance imaging (MRI) in infants with neonatal encephalopathy (NE) after therapeutic hypothermia (TH), and to determine the concordance between magnetic resonance spectroscopy (MRS) and early MRI findings.We conducted a retrospective, observational study including encephalopathic neonates born between 2017 and 2023 at two regional perinatal centers. All subjects underwent early diffusion-weighted MRI (DWI) with or without MRS (day: 4-5), and late conventional T1/T2-weighted MRI (day: 12-14). Both MRIs were assigned an injury severity score based on the National Institute of Child Health and Human Development (NICHD) neonatal research network (NRN) pattern of injury, reflecting the injury apparent on the MR modality obtained. MRS injury was defined as the presence of a lactate peak.The majority of the cohort (<i>n</i> = 98) was moderately encephalopathic (78%). Early and late MR imaging was performed at an average of 5.7 and 13.6 days, respectively. Fifteen percent of infants had evidence of hypoxic-ischemic (HI) injury on early imaging only, and 6% on late imaging only. Forty percent of infants exhibited a change in NICHD score severity between early and late MRI. Twenty-three infants (24%) were found to have a milder injury and 16 (16%) were found to have more severe injury on late imaging, when scores were compared with early imaging scores. The concordance of injury between early MRS and MRI was 62.5%. Among the cases of discordant MRI/MRS, MRS detected additional injury in 70% of cases, and MRI detected additional injury in 30% of cases.Both early and late imaging are important to fully define injury and provide accurate neurodevelopmental prognoses in cases of encephalopathic infants following TH. Failure to perform imaging at two intervals would have potentially resulted in missed diagnoses in 6 to 15% of cases and misestimation of injury in up to 40% of cases. · Early and late neuroimaging is important for accurate neurodevelopmental prognostication of encephalopathic neonates.. · The NICHD NRN MRI scoring system is a helpful tool for clinical practice.. · MR spectroscopy shows promise for HI injury but requires more validation..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1786-1792"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727446","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":"Predictive Capacity of First-Trimester Diagnosis of Placenta Previa.","authors":"Minhazur Sarker, Rachel Feiner, Dana Canfield, Madison Kent, Rachel Wiley, Leah Lamale-Smith, Elizabeth N Teal","doi":"10.1055/a-2572-1646","DOIUrl":"10.1055/a-2572-1646","url":null,"abstract":"<p><p>First-trimester transabdominal ultrasound (TAUS) is sometimes used to diagnose placenta previa and counsel patients accordingly. We aimed to determine the predictive capacity of a first-trimester transabdominal ultrasonographic placenta previa diagnosis for persistence to the second trimester.Retrospective cohort study of patients with singleton pregnancies and first-trimester transabdominal ultrasonographic placenta previa diagnoses from January to December 2022. The primary outcome was the predictive capacity of a first-trimester TAUS diagnosis of placenta previa for placenta previa persistence into the second trimester. Secondary outcomes included the predictive capacity of a first-trimester TAUS for placenta previa persistence to delivery and risk factors associated with placenta previa persistence. Chi-square and student's <i>t</i>-test were used to determine statistical significance, and a multivariable logistic regression determined the strength of associations.Of the 185 patients with a first-trimester TAUS diagnosis of placenta previa, 159 (86.0%) resolved by the second-trimester resulting in a predictive capacity for persistence to the second-trimester of 14.0%. Moreover, 182 (98.4%) were resolved by delivery, resulting in a predictive capacity for persistence to delivery of 1.6%. Among the 27 patients with a prior cesarean delivery, the predictive capacity of a first-trimester placenta previa diagnosis for persistence to the second-trimester was 22.2% and to delivery was 7.4%. Advanced maternal age and posterior placenta in the first trimester were risk factors for previa persistence to the second trimester, while prior cesarean delivery and reproductive assistance were not.First-trimester transabdominal ultrasonographic placenta previa diagnosis has a poor predictive capacity for placenta previa persistence to the second trimester and even lower for persistence to delivery. Counseling patients regarding placenta previa diagnosis in the first trimester may result in unnecessary patient anxiety and activity restrictions. · First-trimester transabdominal placenta previa diagnosis has poor predictive capacity.. · Counseling regarding first-trimester placenta previa may result in unnecessary patient anxiety.. · Studies are needed to see whether patients prefer placenta previa disclosure in the first trimester..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1664-1670"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Infants Discharged from Birth Hospitalization with Gastrostomy versus Nasogastric Feeding Tube.","authors":"Hartlee Lidsky, Emily Anderson, Neal A deJong, Adriana Herrera, Ashley G Sutton","doi":"10.1055/a-2550-5510","DOIUrl":"10.1055/a-2550-5510","url":null,"abstract":"<p><p>Many infants, particularly those born premature or with medical complexity, require supplemental enteral nutrition upon discharge from birth hospitalization. Recent literature supports the safety of discharging infants with nasogastric tube (NG) feeding. However, further evidence is needed to characterize populations suited for home NG feeding compared to gastrostomy tube (GT) placement. This study aimed to describe demographic and clinical differences between infants discharged from birth hospitalization with NG versus GT feeding.This retrospective cohort study included infants discharged from birth hospitalization with NG or GT feeding between April 2014 and December 2022 at a single quaternary care hospital with a neonatal intensive care unit (NICU). Routinely collected health data were used to investigate associations between patient characteristics and discharge feeding modality, as well as assess feeding outcomes 12 months after discharge.Of 346 infants, 72 (20.8%) were discharged with NG and 274 (79.2%) with GT. Infants with GT were more often discharged from the NICU (71.2 vs. 26.4%) with lower birth weights (median 2.40 vs. 2.92 kg) and longer hospitalizations (median 84 vs. 51.5 days). Twelve months after discharge, 77.4% of NG infants achieved full oral feeding compared to 16.6% of GT infants with earlier tube discontinuation in NG infants (19 vs. 236 days).Home NG feeding is a viable, less invasive alternative to GT for selected infants, particularly those with less medical complexity. Prospective studies are needed to further delineate optimal discharge feeding modalities for various infant subpopulations. · Infants discharged with gastrostomies had lower birth weights.. · More NG tube infants achieved oral feeding than gastrostomy infants.. · NG tubes were removed much sooner than GT.. · Home NG feeding is an alternative to gastrostomy for less medically complex infants..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1897-1907"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555477","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":"Association of Pregnancy-Adjusted Sepsis Screening Criteria with Risk of Maternal Infectious Morbidity in the Setting of Intrapartum Intraamniotic Infection.","authors":"Kathryn Ruymann, Eshika Agarwal, Martinique Ogle, Huda B Al-Kouatly, Rupsa C Boelig","doi":"10.1055/a-2599-4813","DOIUrl":"10.1055/a-2599-4813","url":null,"abstract":"<p><p>The California Maternal Quality Care Collaborative (CMQCC) developed a pregnancy-adjusted sepsis screen that includes temperature ≥100.4°F, heart rate > 110 bpm, respiratory rate > 24 bpm, and white blood cell count > 15,000/mm³. This tool was not validated in the intrapartum state. We aim to evaluate the performance of the first part of the CMQCC sepsis screen to identify infection-related morbidity in patients diagnosed with intraamniotic infection.A retrospective cohort study was performed of 541 patients diagnosed with suspected intraamniotic infection prior to delivery at a single center from July 2017 to June 2021. The primary outcome was composite maternal infectious morbidity (end-organ injury, bacteremia, intensive care unit admission, postpartum endometritis, postpartum readmission for infection, or maternal death) in birthing people who screened positive (two or more CMQCC sepsis screen criteria) compared with those who screened negative. Binary logistic multivariable regression was performed with backward selection including overall sepsis screen results as well as individual screening criteria. Data presented as odds ratio (OR) with a two-sided <i>p</i>-value of 0.05 was used for significance.Of the 541 reviewed cases, 336 (62%) screened positive while 205 (38%) screened negative. Birthing people with a positive sepsis screen in labor had a higher rate of composite maternal infectious morbidity compared with those with a negative screen, although this did not reach statistical significance (17.6% vs. 11.7%; <i>p</i> = 0.07; OR: 1.6 [0.96-2.68]). In evaluating individual criteria, heart rate > 110 bpm (<i>p</i> = 0.003; OR: 2.1 [1.3-3.4]) and respiratory rate > 24 bpm (<i>p</i> = 0.039; 5.7 [1.09-29.8]) were significantly associated with composite maternal infectious morbidity.Most birthing people with intraamniotic infection screen positive prior to delivery using the CMQCC sepsis screen. When looking at the sepsis screen's individual components, elevated heart rate and respiratory rate may be useful in identifying those at increased risk of infectious morbidity. · Most patients with intraamniotic infection screen positive prior to delivery using the CMQCC screen.. · The overall CMQCC sepsis screen was not associated with infectious morbidity.. · Elevated heart rate and respiratory rate may identify those at increased risk of morbidity..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1793-1797"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132012","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}