Archives of Disease in Childhood - Fetal and Neonatal Edition最新文献

{"title":"Variability in the use of therapeutic hypothermia in neonates across Europe.","authors":"Daniele De Luca, Tullio Ghi","doi":"10.1136/archdischild-2025-329513","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329513","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbilical cord management strategies and risk of intraventricular haemorrhage in preterm neonates: a systematic review and meta-analysis.","authors":"Ilari Kuitunen, Marjut Haapanen, Maiju Kekki, Panu Kiviranta","doi":"10.1136/archdischild-2025-329006","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329006","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the comparative effectiveness of different umbilical cord management strategies for preventing intraventricular haemorrhage (IVH) in preterm neonates.</p><p><strong>Design: </strong>A systematic review and meta-analysis.</p><p><strong>Study sources: </strong>PubMed, Scopus and Web of Science were searched from inception to March 2025 for relevant randomised controlled trials.</p><p><strong>Participants: </strong>All preterm neonates born <37+0 weeks of gestation.</p><p><strong>Interventions: </strong>All umbilical cord management strategies, including immediate cord clamping (ICC), delayed cord clamping (DCC), intact umbilical cord milking (I-UCM), cut umbilical cord milking (C-UCM), intact cord stabilisation (ICS), physiology-based cord clamping and extrauterine placental perfusion.</p><p><strong>Main outcome measures: </strong>Any grade IVH (grades I-IV) and severe IVH (grades III-IV).</p><p><strong>Data synthesis: </strong>Random-effects meta-analyses were conducted to calculate risk ratios (RRs) with 95% CIs. Analyses were stratified for very preterm (<32 weeks) and extremely preterm neonates (<28 weeks).</p><p><strong>Results: </strong>Forty-nine studies with 8706 neonates were included. Thirty-five direct comparisons between strategies were made, but no clear evidence of benefit or harm emerged. Certainty of evidence ranged from moderate to very low, often downgraded due to imprecision, risk of bias and inconsistency. The most frequent comparison was DCC versus ICC, with 14 studies (RR 0.90, CI 0.65 to 1.26) for any grade IVH and 11 studies (RR 1.14, CI 0.69 to 1.87) for severe IVH. The second most common comparison, DCC versus I-UCM, showed no benefit: RR 1.03 (CI 0.80 to 1.32; eight studies, 2200 participants) and RR 0.77 (CI 0.35 to 1.66; seven studies, 2032 participants). ICS versus DCC was the only comparison which was rated as moderate certainty of evidence for both, any grade IVH (RR 0.96, CI 0.82 to 1.13) and severe IVH (RR 0.91, CI 0.62 to 1.35).</p><p><strong>Conclusions: </strong>No umbilical cord management strategy was clearly associated with increased or decreased IVH risk. Evidence certainty was generally low to very low, primarily due to bias and imprecision.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting long-term neurodevelopmental outcomes for children born very preterm: a systematic review.","authors":"Alice Burnett, Samuel B Axford, Abdulbasit M Seid, Peter J Anderson, Jamie L Waterland, Courtney P Gilchrist, Joy Olsen, Ngoc Nguyen, Alicia Spittle, Lex W Doyle, Jeanie Ling Yoong Cheong","doi":"10.1136/archdischild-2025-328891","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328891","url":null,"abstract":"<p><strong>Context: </strong>Children born very preterm (<32 weeks' gestation) have increased risk of neurodevelopmental difficulties compared with those born at term. While various neonatal exposures have been linked with later developmental challenges, identifying those at risk of difficulties later in childhood remains a challenge but is essential for targeting early intervention and counselling families.</p><p><strong>Objective: </strong>To systematically review and synthesise the evidence regarding early medical and environmental factors for neurodevelopmental impairment, cognitive, motor and behavioural outcomes for children born very preterm.</p><p><strong>Design: </strong>Ovid MEDLINE, Embase and PubMed were searched for articles between 1 January 1990 and 29 April 2024 reporting on a representative, prospective geographical, network-based or multisite cohorts of children born <32 weeks' gestation.</p><p><strong>Main outcome measures: </strong>Neurodevelopmental impairment, cognitive, motor and emotional-behavioural functioning in children aged 36 months to 18 years. Data were extracted and reported descriptively due to heterogeneity in study measures.</p><p><strong>Results: </strong>From 18 012 records, 29 studies from 16 cohorts were included. Brain injury, bronchopulmonary dysplasia, male sex and lower socioeconomic status were the most consistent predictors of neurodevelopmental impairment, IQ, working memory, cerebral palsy, fine motor skills and some behavioural measures. Emotional problems were generally not associated with neonatal variables investigated to date.</p><p><strong>Conclusion: </strong>Numerous factors are independently associated with childhood outcomes after being born very preterm, with specific predictors varying across domains of functioning and limited available evidence for some predictor-outcome combinations. Knowledge of these factors may assist in targeting those at highest risk for closer surveillance and early intervention.PROSPERO registration numberCRD42022368957.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does whole-body in-utero MRI in those with suspected fetal abnormalities improve antenatal care? A single-centre retrospective cohort study.","authors":"Hang Cheong Derek Ng, Christopher Harris, Victoria Stern, Anthony R Hart, Elspeth Helen Whitby","doi":"10.1136/archdischild-2025-328547","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328547","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether full body in-utero MRI (iuMRI) rather than targeted imaging adds useful clinical information when a fetal anomaly is suspected in the brain or the body.</p><p><strong>Design: </strong>Single-centre retrospective cohort study, from October 2011 to May 2022.</p><p><strong>Setting: </strong>Regional fetal MRI service in Sheffield, UK.</p><p><strong>Patients: </strong>All pregnant people undergoing iuMRI.</p><p><strong>Interventions: </strong>iuMRI of the brain and body was reviewed by a fetal radiologist, and the results discussed by a multidisciplinary team.</p><p><strong>Main outcome measures: </strong>Additional abnormalities detected on iuMRI outside of the initial area of interest on ultrasound.</p><p><strong>Results: </strong>1876 participants: 916 participants had a fetus with brain anomalies only on ultrasound, of which 12 (1.3%) had additional body abnormalities on iuMRI. 960 participants had body anomalies only on ultrasound, of whom 8 (0.8%) had an additional brain abnormality. The additional findings from 12 cases (0.6% of whole cohort) added useful clinical information to guide care or counselling.</p><p><strong>Conclusion: </strong>If brain or body anomalies are found on ultrasound in the fetus, whole-body iuMRI reveals additional abnormalities in a small number of cases. However, these may provide important information that changes counselling or care. Further research is required to determine how significant this impact is for clinicians and families, whether normal findings reassure families, how long whole-body iuMRI adds to the MRI acquisition time and the health economics implications.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving outcomes for very preterm babies in England: does place of birth matter? Findings from OPTI-PREM, a national cohort study.","authors":"Thillagavathie Pillay, Sarah E Seaton, Miaoqing Yang, Vasiliki Bountziouka, Victor Banda, Helen Campbell, Kelvin Dawson, Bradley N Manktelow, Elizabeth S Draper, Neena Modi, Elaine M Boyle, Oliver Rivero-Arias","doi":"10.1136/archdischild-2024-327474","DOIUrl":"10.1136/archdischild-2024-327474","url":null,"abstract":"<p><strong>Objective: </strong>Babies born between 27⁺⁰ and 31⁺⁶ weeks of gestation contribute substantially towards infant mortality and morbidity. In England, their care is delivered in maternity services colocated with highly specialised neonatal intensive care units (NICU) or less specialised local neonatal units (LNU). We investigated whether birth setting offered survival and/or morbidity advantages to inform National Health Service delivery.</p><p><strong>Design: </strong>Retrospective national cohort study.</p><p><strong>Setting: </strong>LNU, NICU, England.</p><p><strong>Patients: </strong>UK National Neonatal Research Database whole population data for births between 27⁺⁰ and 31⁺⁶ weeks of gestation, discharged from/died within neonatal units between 1 January 2014 and 31 December 2018. We linked baby-level data to mortality information from the Office for National Statistics.</p><p><strong>Outcome measures: </strong>Death during neonatal care, up to 1 year (infant mortality), surgically treated necrotising enterocolitis, retinopathy of prematurity, severe brain injury (SBI), bronchopulmonary dysplasia.</p><p><strong>Intervention: </strong>Birth in NICU versus LNU setting. We used an instrumental variable (maternal excess travel time between the nearest NICU and LNU) estimation approach to determine treatment effect.</p><p><strong>Results: </strong>Of 18 847 babies (NICU: 10 379; LNU: 8468), 574 died in NICU/LNU care, and 121 postdischarge (infant mortality 3.7%). We found no effect of birth setting on neonatal or infant mortality. Significantly more babies born into LNU settings experienced SBI (mean difference -1.1% (99% CI -2.2% to -0.1%)). This was attenuated after excluding births at 27 weeks, and early postnatal transfers.</p><p><strong>Conclusions: </strong>In England, LNU teams should use clinical judgement, risk assessing benefits of transfer versus risk of SBI for preterm births at 27 weeks of gestation. 28 weeks of gestation is a safe threshold for preterm birth in either NICU/LNU settings.</p><p><strong>Trial registration number: </strong>NCT02994849/ISRCTN74230187.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"444-451"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral injury and long-term neurodevelopment impairment in children following severe fetomaternal transfusion: a retrospective cohort study.","authors":"Salma El Emrani, Marie-Louise van der Hoorn, Ratna N G B Tan, Sylke J Steggerda, Linda S de Vries, Monique C Haak, Jeanine M M van Klink, Masja de Haas, Lotte E van der Meeren, Enrico Lopriore","doi":"10.1136/archdischild-2024-328135","DOIUrl":"10.1136/archdischild-2024-328135","url":null,"abstract":"<p><strong>Objective: </strong>Fetomaternal transfusion (FMT) is associated with increased perinatal mortality and morbidity, but data on postnatal outcomes are scarce. Our aim was to determine the incidence of adverse short-termand long-term sequelae of severe FMT.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Dutch tertiary neonatal intensive care unit.</p><p><strong>Patients: </strong>Liveborn neonates with FMT admitted in 2017-2022.</p><p><strong>Main outcome measures: </strong>Severe FMT was defined as ≥30 mL of fetal red blood cells in the maternal circulation diagnosed with positive Kleihauer-Betke/flow cytometry test. Adverse outcomes were compared between severe and mild FMT (10-30 mL blood loss) to highlight the impact of FMT severity. Primary outcome was an adverse composite outcome consisting of neonatal mortality or severe neurological morbidity (ie, severe cerebral injury and/or neurodevelopmental impairment (NDI) at 2 years). Secondary outcome was perinatal asphyxia.</p><p><strong>Results: </strong>109 neonates with FMT were included, 16 with severe FMT and 93 with mild FMT. Neonatal mortality occurred in 19% (3/16) of neonates with severe FMT and in 4% (4/93) with mild FMT (p=0.063). Perinatal asphyxia was diagnosed in 25% (4/16) of neonates with severe FMT compared with 6% (6/93) with mild FMT (p=0.038). Long-term outcome was assessed in 60 neonates. NDI occurred in 22% (2/9) of children with severe FMT compared with 16% (8/51) with mild FMT (p=0.637). Adverse outcome occurred in 43% (95% CI 38 to 50%) of neonates with severe FMT compared with 18% (95% CI 17% to 24%) with mild FMT (p=0.074).</p><p><strong>Conclusion: </strong>Neonatal mortality or long-term neurological morbidity occurred in 38%-50% of children with fetal blood loss and anaemia due to severe FMT.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"473-478"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel human milk fortifier supports adequate growth in very low birth weight infants: a non-inferiority randomised controlled trial.","authors":"Jean-Charles Picaud, Peter Robert Reynolds, Paul Clarke, Edith van den Hooven, Mirjam M van Weissenbruch, Richard A van Lingen, Annemiek Goedhart, Akke Botma, Ralf Boettger, Elke van Westering-Kroon, Christoph Fusch, J M Hascoet","doi":"10.1136/archdischild-2024-327282","DOIUrl":"10.1136/archdischild-2024-327282","url":null,"abstract":"<p><strong>Objective: </strong>To compare growth, tolerance and safety parameters in very preterm infants receiving human milk (HM) fortified with a multicomponent cow's milk-based HM fortifier (HMF; control) versus a novel HMF-containing lipids (including docosahexaenoic acid and arachidonic acid), higher protein and lower carbohydrate levels (test). Our hypothesis was that weight growth velocity in the test group would be non-inferior to that in the control group.</p><p><strong>Design: </strong>Double-blind, randomised controlled trial.</p><p><strong>Setting: </strong>Nine European neonatal intensive care units.</p><p><strong>Patients: </strong>HM-fed infants born at <32-week gestational age.</p><p><strong>Interventions: </strong>Fortification of HM with Test or Control HMF for a minimum of 21 days.</p><p><strong>Primary outcome: </strong>Weight growth velocity between baseline and intervention day 21.</p><p><strong>Results: </strong>From March 2018 to July 2020, 102 and 103 infants were enrolled in the test and control groups, respectively. Weight growth velocity during the first 21 days in the test group (mean 18.4 g/kg/day) was non-inferior to that of controls (mean 18.5 g/kg/day), with a difference in estimated means of -0.175 g/kg/day (90% CI -1.34 to +0.99 g/kg/day; per-protocol population). No significant differences between groups were observed for gain in length, head circumference or anthropometric Z-scores. Rates of digestive intolerance, stool frequency and consistency were comparable. No significant differences were reported in common neonatal morbidities including necrotising enterocolitis (test: 2.9%, control: 6.9%, mean difference -4.0% (95% CI -11.1% to 2.2%); all subjects treated population).</p><p><strong>Conclusions: </strong>Use of the novel HMF containing lipids, higher protein and lower carbohydrate levels supports adequate postnatal growth and appears safe and well tolerated in very preterm infants.</p><p><strong>Trial registration number: </strong>NCT03315221.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"512-519"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success and safety of neonatal endotracheal tube exchanges: a NEAR4NEOS multicentre retrospective cohort study.","authors":"Kathleen Miller, Nicole Pouppirt, Paul Wildenhain, Ayman Abou Mehrem, Ivana Brajkovic, Cassandra DeMartino, Kristen Glass, Kate Alison Hodgson, Philipp Jung, Ahmed Moussa, Mihai Puia-Dumitrescu, Binhuey Quek, Jennifer Rumpel, Rebecca Shay, David Tingay, Michelle D Tyler, Jennifer Unrau, Michael Wagner, Justine Shults, Akira Nishisaki, Elizabeth E Foglia, Heidi M Herrick","doi":"10.1136/archdischild-2024-328287","DOIUrl":"10.1136/archdischild-2024-328287","url":null,"abstract":"<p><strong>Objectives: </strong>To compare success and safety of endotracheal tube (ETT) exchanges with primary intubations and identify factors associated with ETT exchange outcomes.</p><p><strong>Design: </strong>Retrospective observational study of prospectively collected National Emergency Airway Registry for Neonates data. ETT exchanges are the placement of a new ETT when one is already in place, whereas primary intubations do not have a pre-existing ETT. The primary outcome was first-attempt success. Secondary outcomes included number of attempts, adverse tracheal intubation-associated events (TIAEs), severe TIAEs, desaturation and bradycardia. Descriptive statistics compared characteristics for ETT exchanges and primary intubations. Univariable and multivariable analyses compared primary and secondary outcomes and identified factors independently associated with ETT exchange outcomes.</p><p><strong>Results: </strong>A total of 1572 ETT exchanges and 9999 primary intubations across 21 sites were included from October 2014 to September 2022. ETT exchanges represented 2.3%-31.2% (mean 13.6%) of intubations across sites. Patient, provider and practice characteristics varied significantly between ETT exchanges and primary intubations. In univariable analyses, ETT exchanges were associated with higher first-attempt success (70.5% vs 53.6%; p<0.001) and fewer safety events. In multivariable analyses, ETT exchanges were associated with an increased adjusted OR (aOR) of first-attempt success (1.71; 95% CI 1.57 to 1.86; p<0.001). ETT exchanges were associated with lower aOR of all safety outcomes except severe TIAEs. Factors independently associated with ETT exchange first-attempt success included video laryngoscopy and paralytic premedication.</p><p><strong>Conclusion: </strong>Compared with primary intubations, ETT exchanges were associated with higher first-attempt success and fewer safety events. Video laryngoscope and paralytic premedication were associated with improved ETT exchange outcomes.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"498-503"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fantoms.","authors":"Ben J Stenson","doi":"10.1136/archdischild-2025-329511","DOIUrl":"10.1136/archdischild-2025-329511","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":"110 5","pages":"433"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal mask ventilator-delivered versus face maskT-piece resuscitator positive pressure ventilation during resuscitation of preterm neonates: a cohort study.","authors":"Nosheen Akhtar, Aman Hemani, Bonny Jasani, Brittany Lindsay, Brent Morgan, Amish Jain, Michelle Baczynski","doi":"10.1136/archdischild-2024-327966","DOIUrl":"10.1136/archdischild-2024-327966","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical impact of nasal mask ventilator-delivered positive pressure ventilation (PPV) versus face mask manual T-piece resuscitator PPV during resuscitation of preterm neonates.</p><p><strong>Design: </strong>We conducted a pre-post cohort study in a tertiary neonatal unit, comparing consecutive neonates born 25^0/7-28^6/7 weeks of gestational age (GA) who received PPV ≤10 min after birth, before and after changing the approach during resuscitation from face mask manual T-piece resuscitator PPV (epoch 1, April 2018-April 2020) to nasal mask ventilator-delivered PPV (epoch 2, May 2020-February 2022). The association between birth epoch and the primary outcome of emergent intubation (EI) during resuscitation was examined by multivariable logistic regression and inverse probability of treatment weighting models. Additional outcomes compared between epochs were rates of advanced resuscitation, and early (≤7 days) and late (>7 days) prematurity-related morbidities.</p><p><strong>Results: </strong>Of 545 eligible births, 336 (62%) received PPV; 176 (58%) in epoch 1 and 160 (66%) in epoch 2. Neonates in epoch 1 had lower GA (26.7 (25.9-27.9) vs 27.4 (26.0-28.1) weeks; p=0.02) but similar birth weight (900 (730-1060) vs 880 (740-1085) g; p=0.53). Neonates in epoch 2 had lower rates of EI (16% vs 44%; p<0.001) and less use of post-resuscitation invasive ventilation (22% vs 59%; p<0.001). After accounting for confounders, nasal mask ventilator-delivered PPV remained associated with lower odds of EI (adjusted OR 0.23 (95% CI 0.13 to 0.42)). Secondary outcomes were similar between groups.</p><p><strong>Conclusion: </strong>Nasal mask ventilator-delivered PPV may reduce EI during resuscitation of preterm neonates. Our observations support a large trial of nasal mask ventilator-delivered PPV in this context.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"485-491"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}