American journal of perinatology最新文献

{"title":"Bacteriological Profile and Antibiotic Susceptibility Patterns of Late-Onset Neonatal Sepsis in Levels III and IV Neonatal Intensive Care Units.","authors":"Basma Dahash, Mirjana Lulic-Botica, Joe Amoah, Dafne Sanabria-Garcia, Monika Bajaj","doi":"10.1055/a-2599-4696","DOIUrl":"10.1055/a-2599-4696","url":null,"abstract":"<p><p>Late-onset sepsis (LOS), which occurs 72 hours after birth, remains an important cause of mortality and morbidity in the neonatal intensive care unit (NICU). Differences in infant populations and the complexity of care at various NICU levels may result in varying bacteriological profiles and antibiotic susceptibility patterns. The objective of the current study was to determine and compare the bacteriological profiles, antibiotic susceptibility, and risk factors for LOS in levels III and IV NICU within a single hospital system. This was a retrospective study of infants with LOS and positive blood cultures, admitted to levels III and IV NICUs between 2012 and 2021. Of the 173 infants included in our study, 105 were admitted to the level IV NICU and 68 to the level III NICU. Infants in the level III NICU had a lower gestational age and birth weight at the time of LOS. Seventy percent of the infants had a central line. Gram-positive organisms were responsible for the vast majority of infections (75%), with coagulase-negative Staphylococcus (CoNS) being the most common bacteria in both units. Gram-negative bacteria were more frequently isolated from the level IV NICU (36.2%) compared to the level III NICU (8.8%). <i>Escherichia coli</i> (<i>E. coli</i>) and <i>Enterobacter sp</i>. were the most frequently isolated gram-negative bacteria. All gram-positive bacteria were susceptible to vancomycin, and all gram-negative bacteria were susceptible to meropenem. The prevalent bacteriological profile and antibiotic susceptibility patterns in the NICU should guide the choice of empiric antibiotics for LOS. It is important to monitor sepsis and antimicrobial resistance patterns in the NICU and implement risk-specific strategies to reduce the burden of LOS. · LOS in NICUs is predominantly caused by gram-positive bacteria, mainly CoNS.. · Higher frequency of gram-negative bacteria, including E. coli and Enterobacter, in level IV NICU.. · All gram-negative isolates were meropenem-sensitive; vancomycin effective for gram-positives..</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":"143953499","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":"Perinatal Outcomes Based on Placental Cord Insertion Site.","authors":"Katherine Pressman, Lilla Markel, Anthony Odibo, Jose R Duncan","doi":"10.1055/a-2599-4764","DOIUrl":"10.1055/a-2599-4764","url":null,"abstract":"<p><p>Presently, societal guidelines differ regarding evaluation and management of variations in placental cord insertion (PCI). This variation may in part be secondary to inconsistency in reported risk associated with marginal and velamentous cord insertion (VCI). The objective of this study is to compare perinatal outcomes based on PCI site in pregnancies at risks for fetal growth disorders.This was a secondary analysis of singletons with growth assessment between 26 and 36 weeks of gestation. Fetuses with chromosomal or congenital malformations were excluded. The primary outcomes studied were neonatal small for gestational age (SGA), birthweight, and gestational age (GA) at delivery. Other outcomes included a composite of adverse neonatal outcomes, a composite score of obstetrical outcomes, and hypoglycemia. Categorical data were analyzed with χ² and continuous data with Kruskal-Wallis tests. Pairwise comparisons and Bonferroni corrections were utilized. Logistic regression model was applied to assess the association of hypoglycemia with VCI.Of the 1,054 fetuses, 660 had confirmed PCI site by pathology review. Of those, 609 (92%) had central cord insertion, 37 (5.6%) had marginal, and 14 (2.1%) had velamentous. There was no difference in SGA or preterm birth. Those with a VCI had lower GA at delivery than placentas with central cord insertion (37.6 vs. 38.6, <i>p</i> = 0.032) and higher rates of hypoglycemia than those with other types of PCIs, 26.2% for central cord insertion, 20% for marginal cord insertion, and 71.4% for VCI (<i>p</i> < 0.001). After controlling for confounders, VCI remained significantly associated with hypoglycemia (adjusted odds ratio = 5.52; 95% confidence interval: 1.54-19.82).VCI was associated with lower GA at delivery and higher rates of neonatal hypoglycemia compared with other PCIs. Additional studies are needed to assess the association of marginal cord insertion and VCI and adverse perinatal outcomes. · VCI was associated with neonatal hypoglycemia.. · VCI is associated with earlier gestational age at delivery.. · The rate of VCI is 2.1% in this cohort..</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":"143960200","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":"Orofacial Cleft and Poor Birth Health Outcomes: A Populational Cross-Sectional Study.","authors":"Adriana Mendonça da Silva, Valéria Souza Freitas, Alexandre Rezende Vieira","doi":"10.1055/a-2598-9487","DOIUrl":"https://doi.org/10.1055/a-2598-9487","url":null,"abstract":"<p><p>This study aimed to examine whether newborns with orofacial clefts are at increased prevalence of poor birth health outcomes.This is a population-based cross-sectional study, conducted with information from 25,879,282 live births registered in the U.S. Vital Statistics Natality Birth Data from 2017 to 2023. The prevalence ratios and logistic regression models between orofacial cleft status (all, isolated, or nonisolated) and each child's birth health variables (delivery method, maternal morbidity, 5-minute Apgar score, gestational age, birth weight, abnormal conditions, infant breastfed at discharge) were calculated, assuming a <i>p</i> ≤ 0.05 as statistically significant.The prevalence ratios showed that newborns with orofacial clefts were more susceptible to being born by cesarean section (prevalence ratio [PR] = 1.18, <i>p</i> = 0.000, 95% confidence interval [CI] = 1.16-1.21), having lower birth weight (PR = 2.18, <i>p</i> = 0.000, 95% CI = 2.11-2.25), lower Apgar 5 score (PR = 4.08, <i>p</i> = 0.000, 95% CI = 4.08-4.50), prematurity (PR = 1.55, <i>p</i> = 0.000, 95% CI = 1.50-1.60), experiencing more abnormal conditions at birth (PR = 3.72, <i>p</i> = 0.000, 95% CI = 3.64-3.80), and having more difficulty to be breastfed (PR = 2.16, <i>p</i> = 0.000, 95% CI = 2.11-2.22) than newborns without clefts. These ratios were even higher among those with nonisolated orofacial clefts. Associations were statistic significant even after adjustments.This study provides evidence that newborns with orofacial clefts are at increased prevalence of poor birth health outcomes. · Orofacial clefts are associated to higher prevalence of birth outcomes.. · Newborns with orofacial clefts were more susceptible to have low birth weight.. · Newborns with orofacial clefts were more susceptible to preterm birth..</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":"144118594","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":"Outcomes of Mothers and Infants Affected by COVID-19.","authors":"Katherine B Daniel, Stefany Olague, Helen Boyle, Imtiaz Ahmed, Basharat Buchh, Giang Sinh T Truong, Brent Reyburn, Clarissa DeLeon, Grace C Lin, Kaashif A Ahmad, Barbara Carr, Meghali Singhal, Melissa Althouse, Raymond Castro, Anthony Rudine, Evelyn Rider, Melissa L Macomber-Estill, Bradley Doles, Jenelle F Ferry, Hector Pierantoni, Savannah Sutherland, Amy S Kelleher, Reese H Clark, Courtney K Blackwell, P Brian Smith, Daniel K Benjamin, Rachel G Greenberg","doi":"10.1055/a-2598-9547","DOIUrl":"10.1055/a-2598-9547","url":null,"abstract":"<p><p>The long-term effects of the novel coronavirus disease 2019 (COVID-19) infection during pregnancy are poorly characterized in mothers and their infants. The aim of this study was to assess the physical, mental, and emotional well-being of mothers and infants in the first year postpartum who were exposed to and/or diagnosed with COVID-19 infection.This direct-to-participant cohort study recruited 96 mother-infant pairs delivering at Pediatrix Medical Group sites, where mothers tested positive for COVID-19 during their pregnancy or birth hospitalization and/or infants tested positive for COVID-19 prior to hospital discharge. Main outcome measures included scored responses to surveys administered at 6 and 12 months postpartum and infant health status from newborn admission through the first year after birth.Mothers with COVID-19 infection during pregnancy often reported persistent physical, mental, and emotional stress affecting both themselves and their infants. Scores assessing infant temperament were higher than reported in prior literature. Infants were relatively healthy throughout their first year after birth.The experience of COVID-19 infection during pregnancy may create a unique set of circumstances that affects the well-being of infants and their mothers separately as well as the child-caregiver relationship. Early life events have the potential to generate lasting consequences; therefore, it is important to identify these issues to maximize support and intervene if indicated. · Experiencing COVID-19 in pregnancy is unique.. · Possible effects on temperament, and relationships.. · This impact may persist for at least 1 year postpartum..</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":"143958267","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":"References Supporting Recommendations in Obstetrical Green Top Guidelines: An Overview of RCOG Clinical Guidelines.","authors":"Halime Meryem Soylu, Hector Mendez-Figueroa, Suneet P Chauhan, Benjamin J F Huntley","doi":"10.1055/a-2601-8900","DOIUrl":"10.1055/a-2601-8900","url":null,"abstract":"<p><p>Green-top Guidelines (GTGs) by the Royal College of Obstetrics and Gynecology (RCOG) guide clinical practices similar to Practice Bulletins (PBs) by the American College of Obstetrics and Gynecology (ACOG). Previous analyses reveal that most recommendations lack Grade A evidence and are not based on randomized clinical trials (RCTs). This descriptive study evaluates the quality of evidence supporting RCOG Obstetrical recommendations.We reviewed obstetrical RCOG GTGs available as of September 2024, checking each citation in PubMed for RCT status. Quality assessments were not made independently. The senior author verified a random 10% of the data (B.J.F.H.). Data were recorded and summarized in Excel.RCOG lists 37 obstetrical GTGs with 1,861 recommendations. About 1,288 (69%) of recommendations are supported by 3,674 references. A total of 43% of GTGs rely on consensus and expert opinion. When omitting recommendations based on expert opinion, 98 (9%) of RCOG recommendations are Grade A (based on high-quality evidence), and of the cited references, 5% of GTGs are Evidence Level 1 + + (highest quality), while 7% are RCTs.Among the recommendations, 69% of GTGs have identifiable references. However, 43% of GTG references are nonanalytical studies or expert opinions. Our findings highlight the need for more high-quality evidence in guidelines and suggest further research in evidence-based obstetrical care. · Of 1,861 obstetrical recommendations, 69% cite references, but 43% rely on expert opinion.. · Only 9% of the GTGs meet Grade A standards, showing limited high-quality references.. · About 43% of the guidelines are based on clinical experience, with 5% having the highest evidence strength.. · Only 7% of references come from RCTs.. · The research highlights the need for stronger, evidence-based guidelines..</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":"143959447","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":"Proportion of Time in Category II Fetal Heart Rate Tracing and Adverse Outcomes.","authors":"Kristen A Cagino, Rachel L Wiley, Aaron W Roberts, Fabrizio Zullo, Hector Mendez-Figueroa, Suneet P Chauhan","doi":"10.1055/a-2601-8862","DOIUrl":"10.1055/a-2601-8862","url":null,"abstract":"<p><p>The primary objective was to ascertain if the proportion of time in category II fetal heart rate tracing (FHRT) prior to birth among term (≥ 37 weeks) singletons in labor was associated with composite adverse neonatal outcomes (CANO).The inclusion criteria for this retrospective cohort study were nonanomalous singletons at term, whose FHRT was reviewed by obstetricians blinded to the maternal characteristics and neonatal outcomes. According to ACOG's criteria, the last 20 to 120 minutes of the tracing were reviewed in 20-minute epochs. The cohorts were divided into three groups: group A, category II for < 33% of the available tracing; group B, for ≥ 33 and <66%; and, group C, for ≥ 66% of the FHRT. CANO was any of the following: Apgar score < 7 at 5 minutes, mechanical ventilation, hypoxic-ischemic encephalopathy, neonatal seizure, confirmed sepsis, or neonatal death. Group A was compared with groups B and C, using an adjusted odds ratio (aOR).FHRT for 5,160 consecutive deliveries was reviewed, and 2,780 (53.8%) met the inclusion criteria. Of the 321,980 minutes of FHRT reviewed, 223,000 minutes (69.2%) were category II. The overall CANO among the cohorts was 1.4% (38/2,780), and it did not vary significantly between group A versus B (aOR: 1.11; 95% confidence interval [CI]: 0.35-3.48), or between group A versus C (aOR: 0.80; 95% CI: 0.27-2.35). The overall rate of cesarean delivery for nonreassuring FHRT was 9.7% (270/2,780), and it did not differ between group A versus B (aOR: 0.86; 95% CI: 0.51-1.47) or group A versus C (aOR: 1.18; 95% CI: 0.73-1.91).Among term deliveries, in the last 20 to 120 minutes before birth, 70% of the time FHRT was category II, and the proportion of time in Category II did not significantly influence adverse neonatal outcomes. · In the last 20 to 120 minutes before birth, 69.2% of FHRT were category II.. · In 2,780 parturients with category II FHRT, CANO occurred in 1.4%.. · Category II FHRT, for 20 to 120 min before birth, was not assocated with adverse outcomes.</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":"143960201","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 between Elevated Postnatal Blood Pressure and Postpartum Acute Care Utilization in a Southeastern U.S. Health Care System, 2021 to 2023.","authors":"Clara E Busse, Catherine J Vladutiu, Brian W Pence, Christine Tucker, Katherine Tumlinson, Alison M Stuebe","doi":"10.1055/a-2591-8090","DOIUrl":"https://doi.org/10.1055/a-2591-8090","url":null,"abstract":"<p><p>Hypertensive disorders of pregnancy are a leading cause of pregnancy-related deaths in the United States and approximately 70% occur after birth. We estimated the crude and adjusted association between elevated postnatal blood pressure (BP) and acute care utilization (visits to the Emergency Department, obstetric triage, urgent care facility, or hospital readmission) in the first 12 weeks after discharge from the birth hospitalization.We constructed a retrospective cohort of birthing people aged ≥18 years who gave birth to ≥1 liveborn infant at >20 weeks of gestation from July 1, 2021, to December 31, 2022, at a quaternary maternity hospital in the Southeastern United States using electronic health records. Elevated BP was defined as ≥3 values of systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg between birth and discharge from the birth hospitalization. Crude and adjusted multivariable binomial regression models estimated risk differences comparing the 12-week risk of the postpartum acute care utilization (PACU) outcomes among birthing people with elevated postnatal BP to those without.In this cohort of 6,041 birthing people, 13.3% (<i>n</i> = 804) had any PACU within 12 weeks of discharge from the birth hospitalization. The unadjusted 12-week risk of PACU was 6.5 percentage points higher among those with elevated postnatal BP compared to those without (95% confidence interval [CI]: 4.7 and 8.4). After adjusting for potential confounders, the 12-week risk of PACU was 6.0 percentage points higher among those with elevated postnatal BP compared to those without (95% CI: 4.2 and 7.8).Postnatal BP is a simple indicator of postpartum health status that may be used to flag individuals in need of more intensive postpartum counseling and follow-up. · Elevated postnatal BP is associated with postpartum acute care use.. · People used acute care for BP-related reasons and reasons not related to BP.. · Tracking postnatal BPs may be a simple way to find people who need extra support..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101102","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":"Using measures of psychological resilience to predict burnout amongst NICU nurses.","authors":"Timothy G Elgin, Emily Spellman, Paul O'Connor, Emily O'Dowd, Angela O'Dea","doi":"10.1055/a-2607-2706","DOIUrl":"https://doi.org/10.1055/a-2607-2706","url":null,"abstract":"<p><strong>Introduction: </strong>Psychological resilience (PR) is a trait that supports individuals as they attempt to overcome the negative factors and stressors experienced in life. Neonatal intensive care unit (NICU) nurses encounter considerable stress while providing care for medically vulnerable infants and because of this, are at risk for emotional burnout (EB). Literature suggests that PR may protect against burnout but investigation of PR and its relationship with emotional burnout in NICU nurses is limited.</p><p><strong>Methods: </strong>The ResMed PR questionnaire and the Emotional Burnout scale (EBS) were distributed to both day and night shift neonatal nurses with over 6 months of experience working at a large academic NICU in order to investigate the relationship between these two concepts.</p><p><strong>Results: </strong>In total 92 of 124 NICU nurses returned the survey, resulting in a response rate of 74%. Mean years of NICU nursing experience was 9.30. The average total ResMed score was 68.65 with domain scores of 21.78 for job related gratification, 28.69 for protective practices and 18.2 for protective attitudes. Regression analysis demonstrated a negative relationship between PR and emotional burnout, indicating that higher PR was associated with lower EB and suggesting a protective effect of PR against emotional burnout.</p><p><strong>Conclusions: </strong>This study provides insight into levels of PR and burnout amongst NICU nurses within a large academic NICU. These findings allow for the development of programs and strategies by healthcare leaders and institutions to maximize neonatal nursing health and wellbeing.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075431","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":"Use of Artificial Intelligence in Recognition of Fetal Open Neural Tube Defect on Prenatal Ultrasound.","authors":"Manisha Kumar, Urvashi Arora, Debarka Sengupta, Shilpi Nain, Deepika Meena, Reena Yadav, Miriam Perez","doi":"10.1055/a-2589-3554","DOIUrl":"https://doi.org/10.1055/a-2589-3554","url":null,"abstract":"<p><p>To compare the axial cranial ultrasound images of normal and open neural tube defect (NTD) fetuses using a deep learning (DL) model and to assess its predictive accuracy in identifying open NTD.It was a prospective case-control study. Axial trans-thalamic fetal ultrasound images of participants with open fetal NTD and normal controls between 14 and 28 weeks of gestation were taken after consent. The images were divided into training, testing, and validation datasets randomly in the ratio of 70:15:15. The images were further processed and classified using DL convolutional neural network (CNN) transfer learning (TL) models. The TL models were trained for 50 epochs. The data was analyzed in terms of Cohen kappa score, accuracy score, area under receiver operating curve (AUROC) score, F1 score validity, sensitivity, and specificity of the test.A total of 59 cases and 116 controls were fully followed. Efficient net B0, Visual Geometry Group (VGG), and Inception V3 TL models were used. Both Efficient net B0 and VGG16 models gave similar high training and validation accuracy (100 and 95.83%, respectively). Using inception V3, the training and validation accuracy was 98.28 and 95.83%, respectively. The sensitivity and specificity of Efficient NetB0 was 100 and 89%, respectively, and was the best.The analysis of the changes in axial images of the fetal cranium using the DL model, Efficient Net B0 proved to be an effective model to be used in clinical application for the identification of open NTD. · Open spina bifida is often missed due to the nonrecognition of the lemon sign on ultrasound.. · Image classification using DL identified open spina bifida with excellent accuracy.. · The research is clinically relevant in low- and middle-income countries..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970303","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":"Implementation of Nasogastric Tube Feedings at Discharge in a Large Quaternary NICU: A Literature Review, Proposed Algorithm, and Our Center Experience.","authors":"John Ibrahim, Abeer Azzuqa, Jennifer Kloesz, Arcangela Balest","doi":"10.1055/a-2592-0565","DOIUrl":"https://doi.org/10.1055/a-2592-0565","url":null,"abstract":"<p><p>The aim of this study is to provide an extensive review of the published literature regarding the use of nasogastric (NG) feeds at discharge in the neonatal population as well as our experience with the implementation of an NG feeds at discharge program in our level IV neonatal intensive care unit.We reviewed and compared the use of NG tubes at discharge and gastrostomy tubes in the neonatal population. We provide an extensive review of previous publications regarding programs of NG feeds at discharge in neonates across the United States and Europe including preterm neonates, neonates with chronic lung disease, and neurological injury. We also reviewed parents' perspectives on NG use at discharge in the neonatal population as well as the use of telehealth in remote monitoring of neonates discharged on NG feeds. We reviewed the economic benefits of such programs. We finally provide our center's algorithm and workflow as well as our center's experience.Twenty-five patients have been discharged so far from this program since its implementation in December 2020. Only 1 patient of the 25 patients discharged on NG tube feeds required gastrostomy tube placement.Discharge with NG tube feeds in a carefully selected population is safe, and feasible and can lead to increased parent satisfaction, besides offering a developmental advantage for the neonates when the only remaining inpatient need is achieving full oral feeds. · Discharge with NG tube feeds in a carefully selected neonatal population is safe and feasible.. · Nasogastric feeds at discharge can lead to increased parent satisfaction and a developmental advantage for the neonates when the only remaining inpatient need is achieving full oral feeds.. · Carefully structured education at discharge, as well as follow-up programs in place can ensure adequate parental support during this process.. · Telehealth can play a key role in implementation of such programs..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963674","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}