American journal of perinatology最新文献

{"title":"Neonatal Sepsis Epidemiology at a Major Public Hospital in Mexico City.","authors":"Hector Zavaleta, Guadalupe Cordero, Erika M Edwards, Dustin D Flannery","doi":"10.1055/a-2601-8982","DOIUrl":"10.1055/a-2601-8982","url":null,"abstract":"<p><p>This study aimed to describe the epidemiology, pathogens, and outcomes associated with early-onset and late-onset sepsis among newborns admitted to the leading public neonatal hospital in Mexico.We conducted a retrospective cohort study of infants admitted to the neonatal intensive care unit (NICU) at the Instituto Nacional de Perinatología in Mexico City from 2018 to 2023. Early-onset sepsis (EOS) was defined as a culture-confirmed bacterial infection of blood or cerebrospinal fluid within 3 days of birth, and late-onset sepsis (LOS) as culture-confirmed bacterial or fungal infection after day 3. Descriptive statistics and logistic regression were used to compare characteristics and outcomes among infants with and without EOS/LOS.Among 4,381 admitted infants, 23 (0.5%) had EOS (5.2 per 1,000 admissions), and 444 of 3,950 (11.2%) who survived >3 days had LOS (112.4 per 1,000). Prematurity was a major risk factor. <i>Escherichia coli</i> accounted for 70% of EOS, and coagulase-negative staphylococci and <i>Klebsiella</i> spp. were the leading causes of LOS. Infections were associated with higher morbidity, longer hospitalization, and reduced survival, though mortality differences were not statistically significant after adjustment.Neonatal sepsis remains a major burden in this Mexican NICU, with a predominance of gram-negative organisms and incidence rates higher than recent U.S. reports. Continued surveillance and antimicrobial stewardship are warranted to guide empiric therapy and track resistance patterns. · Prematurity was a major risk factor for both early- and late-onset sepsis.. · Gram-negative organisms, especially Escherichia coli and Klebsiella species, were the predominant pathogens.. · Sepsis was associated with increased morbidity, prolonged hospitalization, and lower survival..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966221","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":"Confusing blood group antibodies in obstetrics: focus on the risk of hemolytic disease of the fetus and newborn.","authors":"Douglas Blackall, Mark Tomlinson","doi":"10.1055/a-2622-2841","DOIUrl":"https://doi.org/10.1055/a-2622-2841","url":null,"abstract":"<p><p>During routine prenatal antibody screening, maternal reactivity is sometimes detected for which the clinical significance is unclear. As a result, the strategy for monitoring these antibodies during pregnancy, to mitigate the risk of hemolytic disease of the fetus and newborn (HDFN), may be uncertain. This review focuses on 4 such immune responses in obstetrics: anti-G, anti-M, warm reactive autoantibodies, and apparent non-specific immune responses that cannot be further classified. The relationship of these antibodies to HDFN is a primary focus. Related concerns, including maternal and neonatal transfusion considerations and candidacy for Rh immune globulin, are also addressed.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155496","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":"Vasa Previa: Factors Associated with Inpatient versus Outpatient Antepartum Management.","authors":"Sarah B Heaps, Stephen T Chasen","doi":"10.1055/a-2620-7780","DOIUrl":"https://doi.org/10.1055/a-2620-7780","url":null,"abstract":"<p><strong>Objective: </strong>When vasa previa is diagnosed, guidelines support recommendations about timing and route of delivery, as well as steroid administration. While elective admission to ensure proximity to care is common, evidence does not support a clear recommendation. Our objective was to compare patients with vasa previa managed as inpatients vs outpatients.</p><p><strong>Study design: </strong>This is a single institution cohort study of patients with a prenatal diagnosis of vasa previa from 2013-2023. Decisions about inpatient vs. outpatient management and delivery planning were made by physicians and patients. Data was obtained through chart review. Cohorts managed with elective admission for vasa previa were compared with those managed as outpatients. Mann-Whitney U and Fisher's Exact test were used for statistical comparison.</p><p><strong>Results: </strong>89 patients were included, including 72 (80.9%) electively admitted vs. 17 (19.1%) managed as outpatients. The groups were of similar age and parity. A higher proportion of patients managed as outpatients had public insurance. There were no differences in the rate of short cervix or vaginal bleeding between the cohorts, and the rates of non-scheduled Cesarean Delivery were similar. Betamethasone was administered at a median gestational age of 32-33 weeks in both groups. Elective admission was associated with earlier delivery overall, as well as earlier scheduled delivery. There were no stillbirths or neonatal deaths, and the rates of NICU admission were not significantly different.</p><p><strong>Conclusion: </strong>Patients electively admitted for vasa previa do not appear to have been at higher risk for emergent delivery, though admission was associated with earlier delivery, including scheduled deliveries. The lower rate of admission in those with public insurance could indicate a disparity in management, though further study is necessary. While our data do not rule out a benefit to routine admission, the benefits remain unproven.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148847","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":"https://doi.org/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":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","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}

{"title":"Comparing Umbilical Cord Management Strategies in Nonvigorous Newborns: A Systematic Review and Network Meta-analysis.","authors":"Mohamed A Aldemerdash, Mohammed Abdellatif, Doha Refaey, Yaser AbuSammour, Mahmoud Refaey, Abdelrhman Muwafaq Janem, Mohammed Tarek Hasan, Ahmed Aldemerdash, Huda Shihab, Naema Hamouda","doi":"10.1055/a-2598-7291","DOIUrl":"10.1055/a-2598-7291","url":null,"abstract":"<p><p>Nonvigorous newborns often require immediate resuscitation, and early cord clamping (ECC) is the conventional approach. Alternative strategies, such as intact cord resuscitation (ICR) and umbilical cord milking (UCM), may provide additional benefits without compromising safety. To compare the effectiveness and safety of different umbilical cord management strategies for nonvigorous newborns.We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and searched six databases for randomized controlled trials comparing different umbilical cord management approaches in nonvigorous newborns. Outcomes assessed included resuscitation effectiveness, hematological parameters, neonatal morbidities, and mortality. The Cochrane Collaboration tool RoB2 was used to assess the risk of bias.Ten studies with 2,541 newborns were included, with seven studies contributing to the meta-analysis. No significant differences were observed in resuscitation requirements, Apgar scores, or mortality between ECC, ICR, and UCM. However, at 5 minutes, ICR showed a small but statistically significant higher Apgar score compared with other interventions (mean difference [MD] = 0.3, 95% confidence interval [CI] [0.05, 0.55]). Additionally, heart rate was lower in the intact ICM (I-UCM) group (MD = -34.75 beats/min, 95% CI [-61.84, -7.66]). Cut UCM was associated with significantly higher serum ferritin levels at 6 weeks (MD = 40.44 µg/L, 95% CI [26.45, 54.43]). Initial hematocrit levels were also higher in the ICR group compared with ECC.ICR and UCM might be safe and effective alternatives to ECC for nonvigorous newborns, with potential hematological benefits. However, further large-scale studies are needed to confirm these findings and evaluate long-term neurodevelopmental outcomes. · ICR and UCM might be safe and effective alternatives to ECC for nonvigorous newborns.. · Heart rate was lower in the I-UCM group.. · ICR showed statistically significant higher Apgar.. · Cut UCM was associated with significantly higher serum ferritin levels at 6 weeks..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958430","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":"Decreased Newborn Size following COVID-19 Infection during Pregnancy: The Role of Timing of Infection.","authors":"Hannah Yang, Eleanor Nguyen, Yosra Elsayed, Victoria Zablocki, Beth A Bailey","doi":"10.1055/a-2599-4867","DOIUrl":"10.1055/a-2599-4867","url":null,"abstract":"<p><p>The objective of this study was to examine the effect of coronavirus disease 2019 (COVID-19) infection during pregnancy on birth outcomes, including the relationship between the trimester of COVID-19 infection and newborn size. Findings could be used to better inform appropriate management of COVID-19 during pregnancy.This retrospective chart review study included patients diagnosed with COVID-19 who received care at a single university-affiliated obstetrics practice. Pregnant patients with a diagnosis of COVID-19 between April 2022 and April 2023 were included in this study. Participant demographics and birth outcomes were extracted and analyzed.Our sample included 141 women who had COVID-19 during pregnancy, grouped based on the trimester of COVID-19 infection. In analyses adjusted for confounding background factors, those with a COVID-19 infection during the second trimester (<i>n</i> = 57) and third trimester (<i>n</i> = 50) had newborns with significantly decreased head circumference at birth compared with those infected during the first trimester (<i>p</i> < 0.05). In addition, compared with those with a COVID-19 infection during the first trimester, those who had COVID-19 during the third trimester had an average 1.3 cm decreased birth length.In the current study, COVID-19 infection later in pregnancy, especially in the third trimester, significantly predicted decreased birth weight, length, and head circumference. · COVID-19 infection may impact newborn size.. · Third-trimester infection was most detrimental.. · Late-term monitoring may be warranted..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952080","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 Gestational Weight Gain with Adverse Pregnancy Outcomes in Individuals with Obesity.","authors":"Kazuma Onishi, Tetsuya Kawakita","doi":"10.1055/a-2597-8542","DOIUrl":"10.1055/a-2597-8542","url":null,"abstract":"<p><p>This study aimed to determine optimal gestational weight gain (GWG) considering adverse infant and maternal outcomes among individuals with obesity, with detailed classification for body mass index (BMI) of 40 kg/m² or higher.This study was a population-based retrospective cohort study, using U.S. birth certificate data from 2017 to 2021. We included nulliparous individuals with singleton pregnancies delivering live births between 37^0/7 and 41^6/7 weeks' gestation, excluding those with pregestational diabetes or hypertension, gestational diabetes, preeclampsia, major fetal anomalies, or chromosomal disorders. The study focused on three main outcomes: primary cesarean delivery, small for gestational age (SGA), and large for gestational age (LGA). GWG was evaluated in 2-kg increments, from weight loss >8 kg to gains ≥28 kg. Prepregnancy BMI was stratified into four categories: BMI of 30 to <35, 35 to <40, 40 to <50, and ≥50 kg/m². Odds ratios and absolute risk reduction were used to identify GWG ranges with balanced risks for three outcomes within each BMI category.Among 1,677,968 individuals with obesity, increased GWG was associated with higher absolute risks of cesarean delivery and LGA and lower risk of SGA across all BMI categories. Optimal GWG ranges varied by prepregnancy BMI: >12 to ≤14 kg for BMI of 30 to <35 kg/m²; >10 to ≤12 kg for BMI of 35 to <40 kg/m²; >6 to ≤10 kg for BMI of 40 to <50 kg/m²; >0 to ≤8 kg for BMI of 50 kg/m² or higher.We identified higher upper and lower GWG limits for individuals with BMI of 30 to 50 kg/m², and lower limits for those with BMI ≥50 kg/m², compared with the guidelines recommended by the U.S. National Academy of Medicine. These findings suggest the need to tailor GWG recommendations based on the severity of obesity. · Optimal GWG varies by obesity class, requiring tailored guidelines.. · Those with BMI ≥50 kg/m may need lower target for gestational gain than current recommendation.. · The optimal GWG range could be changed based on the outcomes of interest..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964261","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":"Single Center Implementation of a Postpartum Pharmacologic Thromboprophylaxis Protocol.","authors":"Ann M Bruno, Amanda A Allshouse, Christine M Warrick, Torr D Metz","doi":"10.1055/a-2597-8735","DOIUrl":"10.1055/a-2597-8735","url":null,"abstract":"<p><p>This study aimed to evaluate trends in the frequency of pharmacologic prophylaxis following the implementation of a postpartum venous thromboembolism (VTE) prevention protocol. Secondarily, to evaluate the association between protocol implementation and incidence of VTE and complications.Retrospective cohort of patients delivering from 2015 to 2022 at a single academic institution. Those with an antepartum VTE or receiving therapeutic anticoagulation were excluded. An inpatient thromboprophylaxis protocol was implemented in January 2017 and further updated in July 2020 to expand risk factors to qualify for prophylaxis and extend the length of therapy to the outpatient setting (total 14 days). The cohort was divided into three time periods: preimplementation (January 1, 2025-December 31, 2016), initial protocol (January 1, 2017-June 30, 2020), and updated (July 1, 2020-December 31, 2022) protocol. The primary outcome was the receipt of inpatient heparin-based pharmacologic prophylaxis. Secondary outcomes included filling an outpatient pharmacologic prophylaxis prescription, VTE, and wound complications observed through 6 weeks postpartum. Baseline characteristics and outcomes were compared across the three protocol periods. Logistic regression modeling estimated the association between outcomes and the updated protocol period compared with prior periods.Overall, 22.6% (95% confidence interval [CI]: 22.1-23.0) of 34,217 included deliveries received inpatient pharmacologic prophylaxis: 7.7% (7.1-8.2%) preimplementation, 15.8% (15.2-16.4%) initial protocol, and 41.2% (40.4-42.1%) during the updated protocol period. The rates of inpatient and outpatient prophylaxis increased significantly over time (<i>p</i> < 0.001 test of trend). Delivery in the updated protocol period was not associated with differences in VTE (pre: 0.1%, initial: 0.2%, and updated: 0.1%) nor wound complications (pre: 3.4%, initial: 2.7%, and updated: 2.7%).Single-center implementation of a postpartum prophylaxis protocol resulted in increased use of inpatient and outpatient pharmacologic prophylaxis without changes in rates of VTE or wound complications. · Implementation of a postpartum thromboprophylaxis protocol resulted in increased rates of pharmacologic prophylaxis.. · No differences in wound complications were observed by the protocol period.. · Rates of VTE did not change over time..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952081","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":"A Nomogram Model for Prenatal Predicting Survival in Infants with Congenital Diaphragmatic Hernia.","authors":"Weipeng Wang, Wenting Xu, Weihua Pan, Wenjie Wu, Wei Xie, Ming Liu, Lei Wang, Jun Wang","doi":"10.1055/a-2592-0474","DOIUrl":"10.1055/a-2592-0474","url":null,"abstract":"<p><p>The study aimed to combine prenatal risk factors associated with early survival of patients with prenatally diagnosed congenital diaphragmatic hernia (CDH) into a predictive nomogram.We retrospectively analyzed 217 neonates with prenatally diagnosed CDH. The patients who underwent surgery in an earlier period comprised the training cohort (<i>n</i> = 158) for nomogram development, while those who underwent surgery subsequently constituted the validation cohort (<i>n</i> = 59) to verify the model's performance. The survival rate at discharge was regarded as the primary outcome. Multivariate Logistic analysis was performed, and a nomogram was developed using data from the training cohort. The performance of the nomogram was determined. We also evaluated the nomogram's performance in the independent validation cohorts.On multiple analyses, independent factors for early survival were O/E LHR, presence of liver herniation, and gestational age at diagnosis, which were all selected into the nomogram. The nomogram had good discrimination with an area under the receiver operator curve of 0.875 (95% confidence interval [CI]: 0.819-0.930). The nomogram was calibrated to predict survival in the best possible way compared with the actual results. Using the decision curve analysis, the nomogram was proved to be useful in clinical practice. In the validation cohort, the nomogram model was also found with good discrimination with an area under the receiver operator curve of 0.917 (95% CI: 0.847-0.986).The proposed nomogram incorporating prenatal risk factors offered an individualized predictive tool for early survival of patients with CDH, which will help guide prenatal counseling and perinatal management.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960995","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":"Unmet Health and Childcare Needs After Neonatal Intensive Care Unit Discharge.","authors":"Tamiko Younge, Marni Jacobs, Lamia Soghier, Karen Fratantoni","doi":"10.1055/a-2593-8807","DOIUrl":"https://doi.org/10.1055/a-2593-8807","url":null,"abstract":"<p><p>This study aimed to identify unmet health and childcare needs and associations with infant characteristics, parent characteristics, and parent self-efficacy after neonatal intensive care unit (NICU) discharge.We conducted a secondary mixed-methods analysis of data from a single-center randomized control trial. Twelve months after discharge, parents reported if their child did not need, need and received, or needed but did not receive seven health and childcare services. Associations with infant characteristics, parent characteristics, and parent self-efficacy were assessed using logistic regression. Open-ended responses were analyzed for themes.A total of 241 families completed assessments 12 months after discharge. Thirty-three respondents (14%) reported at least one unmet need. Increasing gestational age decreased the odds of unmet needs (odds ratio [OR]: 0.91; 95% confidence interval [CI]: 0.84-0.97), while longer length of stay and moderate or severe infant functional status increased odds (OR: 1.01; 95% CI: 1.01-1.02; OR: 2.93; 95% CI: 1.14-8.17). Greater self-efficacy was associated with lower odds of unmet needs (OR: 0.91; 95% CI: 0.85-0.97). Black parents had 2.8 times the odds of unmet needs compared to White parents after adjusting for length of stay (95% CI: 1.15-7.54). Self-efficacy may have a moderating effect on this racial disparity. Parents reported needing childcare, psychosocial support, and financial assistance in open-ended responses.We found families experienced unmet health and childcare needs with evident racial disparities in the year after NICU discharge. Greater parental self-efficacy may reduce this racial gap. Pediatric practices and health care systems, especially NICU follow-up programs, should continue to screen and connect this high-risk population to support and resources. · Greater unmet needs after NICU discharge were associated with greater infant illness severity.. · Black parents had greater odds of reporting unmet needs compared to White parents.. · Greater parent self-efficacy was associated with lower odds of unmet needs..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118597","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}