Neonatology最新文献

{"title":"Evaluation of mothers' recollection of the consistency of information from antenatal consultations with their postnatal experiences.","authors":"Cosima Babinet, Hélène Gauthier-Moulinier, Nicolas Romain-Scelle, Marine Butin","doi":"10.1159/000552256","DOIUrl":"https://doi.org/10.1159/000552256","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of the study was to assess mothers' perception of the consistency of information retained from antenatal consultations relative to their experience of their neonate's hospitalization. Secondary aims included evaluating the quality of information delivered on foetal status, management and prognosis, and identifying factors associated with perceived inconsistencies between retained information and experience.</p><p><strong>Methods: </strong>This questionnaire-based study involved the mothers of neonates treated in a tertiary neonatal intensive care unit (Hôpital Femme-Mère-Enfant, Lyon, France). Mothers were included if they had attended a prenatal diagnosis consultation and gave birth between January 2020 and December 2022 to a newborn admitted to the NICU. The main dependent variable was the perceived consistency of information provided during prenatal consultations compared with mothers' experiences of hospitalization. A descriptive statistical analysis was performed, quantitative variables summarised as medians and qualitative variables as counts and percentages.</p><p><strong>Results: </strong>Of 106 eligible mothers, 64(60%) responded to the questionnaire. Among the latter, 68%(43/63) reported that the information received during antenatal consultations was mostly or fully consistent with their experience of their neonate's hospitalization. Among the 20 mothers who reported disparities (32%), 7(35%) reported inconsistencies with information provided by other specialists and 5(25%) reported not receiving information on their newborn's condition or prognosis.</p><p><strong>Conclusion: </strong>This study highlights the need to improve the consistency and clarity of information provided during antenatal consultations, particularly in a multidisciplinary context, and to better convey prognostic uncertainties. Further studies are required on the impact of these interventions on maternal experiences, preferably with a prospective design to limit recall bias.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated brain segmentation to establish reference ranges for regional brain volumes in normally developing very preterm infants at term-equivalent age.","authors":"Marlene Hammerl, Sophie Biermeier, Stephanie Mangesius, Anna Posod, Christoph Birkl, Florian Krismer, Elke Griesmaier, Elke Ruth Gizewski, Astrid Ellen Grams, Ursula Kiechl-Kohlendorfer, Vera Neubauer","doi":"10.1159/000552135","DOIUrl":"https://doi.org/10.1159/000552135","url":null,"abstract":"<p><strong>Aim: </strong>To establish reference ranges for regional brain volumes in normally developing very preterm infants without brain injury at term-equivalent age, using automated brain segmentation, and to explore associations with sex and gestational age.</p><p><strong>Method: </strong>This was a cross-sectional study of very preterm infants (gestational age <32 weeks) with structurally normal magnetic resonance imaging at term-equivalent age and normal neurodevelopmental outcomes up to 2 years of age. 3-Tesla MRI scans were processed using Infant Free Surfer, a fully automated segmentation tool, yielding 26 regional brain structures. MRIs were acquired on the same scanner. Only scans of highest quality, confirmed by expert consensus, were included. Associations between regional brain volumes and gestational age, as well as sex differences were assessed using Pearson correlations and Mann-Whitney U tests.</p><p><strong>Results: </strong>The final cohort included 55 infants (24 male) with a median gestational age of 29.4 (interquartile range: 27.6-31.0) weeks. Reference volumes and sex-stratified centiles (3rd-97th) are provided. Male infants had significantly larger volumes of the putamen (p=0.031) and the hippocampus (p=0.003). Gestational age showed weak or no correlations with regional brain volumes.</p><p><strong>Interpretation: </strong>This study establishes normative data on regional brain volumes in a well-defined cohort of normally developing very preterm infants without brain injury at term-equivalent age. These data provide a reference for future research on early brain development and may support studies investigating whether deviations from typical brain development can be detected and inform early interventions.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surfactant-budesonide combination to prevent death or bronchopulmonary dysplasia: a systematic review and meta-analysis.","authors":"Ilari Kuitunen, Giulia Res, Kati Räsänen, Alessia Vassallo, Chiara Autilio, Maria Rosaria Gualano, Daniele De Luca","doi":"10.1159/000552203","DOIUrl":"https://doi.org/10.1159/000552203","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchopulmonary dysplasia (BPD) remains a major complication of prematurity. We aimed to assess whether intratracheal administration of budesonide mixed with surfactant reduces mortality and BPD in preterm infants.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized and observational studies enrolling preterm neonates. PubMed, Scopus, and Web of Science were searched from inception to October 2025 without language or year restrictions. Studies comparing bolus administration of bovine or porcine surfactant mixed with budesonide versus surfactant alone were included. Random-effects meta-analyses using inverse variance weighting were performed to estimate risk ratios (RRs) with 95% confidence intervals (CIs). Certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Twenty randomized and five observational studies were included. Surfactant-budesonide combination therapy reduced mortality (RR 0.83, 95% CI 0.69-0.99; 18 studies, 5,117 infants) and BPD (RR 0.84, 95% CI 0.75-0.94; 25 studies, 5,732 infants). Mortality reduction was observed when all studies were pooled, with no significant difference between study designs. Prenatal steroid exposure was associated with greater mortality reduction. Reduction in BPD remained significant when restricted to randomized trials, irrespective of surfactant type. Sensitivity analyses excluding studies at high risk of bias yielded similar results. Certainty of evidence was moderate for both outcomes.</p><p><strong>Conclusions: </strong>Surfactant combined with budesonide may reduce mortality and BPD in preterm infants. However, the evidence remains insufficient to recommend the combination as generalized primary treatment for all preterm neonates. Future studies should incorporate pathophysiological phenotyping to identify infants most likely to benefit.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthodontic Airway Plate Therapy for Infants with Robin Sequence: Clinical Principles, Current Evidence, and Evolving Innovations.","authors":"Mi Sook Lee, Marcio Guelmann, Barbara Sheller","doi":"10.1159/000552259","DOIUrl":"https://doi.org/10.1159/000552259","url":null,"abstract":"<p><strong>Background: </strong>Robin sequence (RS) is characterized by the triad of mandibular micrognathia, glossoptosis, and upper airway obstruction (UAO), posing significant airway and feeding challenges in affected infants. Although mandibular distraction osteogenesis (MDO) is effective in selected cases, less invasive treatment approaches are emerging. The orthodontic airway plate (OAP), including the Tübingen Palatal Plate and Pre-Epiglottic Baton Plate, can be a reliable non-surgical modality for infants across a broad spectrum of UAO severity, alleviating airway obstruction by anteriorly repositioning the tongue and restoring pharyngeal patency.</p><p><strong>Summary: </strong>This narrative review describes the biomechanical principles, clinical applications, therapeutic outcomes, and recent technological advances in OAP therapy in infants with RS. OAP treatment improves airway stability and promotes coordinated suck-swallow-breathe function, thereby facilitating oral feeding and growth. Clinical studies demonstrate improvements in polysomnographic parameters, oxygenation, feeding efficiency, and weight gain, with most infants avoiding surgical intervention. Emerging evidence also suggests potential functional orthopedic effects of OAP on mandibular development during early growth. Innovations including imaging-guided planning and CAD/CAM fabrication have enhanced treatment precision and reproducibility. However, long-term follow-up data indicate that soft tissue adaptation may remain incomplete, and risks of orthodontic complications and recurrent obstructive sleep apnea persist into childhood. These findings highlight the need for structured long-term surveillance.</p><p><strong>Key messages: </strong>OAP therapy represents an effective, reversible, and non-invasive first-line option for infants with UAO associated with RS across a broad spectrum of UAO severity. Integration of digital technologies and multidisciplinary care pathways may further enhance the clinical applicability of OAP.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral oxygenation during the first 15 minutes after birth and short-term outcome measured by the Motor Optimality Score - Revised (MOS-R) in preterm infants.","authors":"Anna Scheuchenegger, Christina H Wolfsberger, Alexander Avian, Bernhard Schwaberger, Maria Waltner-Romen, Marlene Hammerl, Ursula Kiechl-Kohlendorfer, Elke Griesmaier, Gerhard Pichler","doi":"10.1159/000551959","DOIUrl":"https://doi.org/10.1159/000551959","url":null,"abstract":"<p><strong>Background: </strong>Monitoring cerebral regional oxygen saturation (crSO₂) using near-infrared spectroscopy (NIRS) during immediate postnatal transition may help detect and mitigate cerebral hypoxia. General Movement Assessment (GMA), including fidgety movements (FMs) and the Motor Optimality Score-Revised (MOS-R), is widely used to evaluate early motor development.</p><p><strong>Objective: </strong>To assess differences in early motor outcome at 6-20 weeks corrected age ac-cording to group allocation in the randomized multicenter COSGOD III trial.</p><p><strong>Design: </strong>Retrospective ancillary observational study.</p><p><strong>Patients and setting: </strong>Preterm infants (<32 weeks' gestation) enrolled in COSGOD III at two Austrian centers (Graz and Innsbruck) with available GMA video recordings at 6-20 weeks corrected age were included. MOS-R was scored retrospectively from these recordings.</p><p><strong>Intervention: </strong>In COSGOD III, infants randomized to the NIRS group received continuous crSO₂ monitoring during immediate postnatal transition to guide resuscitation; in the control group, crSO₂ values were not displayed.</p><p><strong>Main outcome measures: </strong>MOS-R (range 5-28) derived from GMA video analysis.</p><p><strong>Results: </strong>A total of 162 infants were included (NIRS: n=76; control: n=86; median gestational age 29.6 vs. 28.8 weeks; p=0.357). Normal FMs were present in 95% of infants (96% vs. 94%). However, MOS-R scores were significantly higher in the NIRS group (median [IQR]: 26 [24-28] vs. 24 [22-26]; p=0.003), with more infants showing an age-adequate motor repertoire (83% vs. 66%; p=0.003).</p><p><strong>Conclusion: </strong>Although FM presence was similar between groups, NIRS-guided management during immediate transition was associated with improved early motor performance, sug-gesting that targeted cerebral oxygenation may influence early neurodevelopment.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehospitalization in Preterm Infants: Machine Learning Prediction Model &amp; Associated Risk Factors.","authors":"Dana Benni, Roni Ramon-Gonen, Gil Klinger, Orly Weinstein, Racheli Magnezi","doi":"10.1159/000552171","DOIUrl":"https://doi.org/10.1159/000552171","url":null,"abstract":"<p><strong>Background and objectives: </strong>Preterm birth is a major global health concern, with preterm infants (PI) at increased risk of morbidity and rehospitalization in the first year after Neonatal Intensive Care Unit (NICU) discharge. Few studies have applied predictive modeling in this domain. This study aimed to develop a machine learning model to predict rehospitalization within one year of NICU discharge and to identify clinical characteristics associated with increased rehospitalization risk.</p><p><strong>Patients and methods: </strong>A retrospective cohort study of 2,226 PI born between 2018 and 2023 at a tertiary-care pediatric hospital in Israel. Data were obtained from NICU and inpatient records, including clinical history, laboratory results, and hospitalization outcomes. A machine learning model was developed using the eXtreme Gradient Boosting algorithm (XGBoost) with 20 clinical predictors.</p><p><strong>Results: </strong>Rehospitalization within one-year occurred in 358 of 2,226 (16.1%) PI, with one-third occurring within 30 days. The predictive model achieved an AUC of 0.69 (95% CI: 0.59-0.78), sensitivity of 0.38, specificity of 0.87, positive predictive value of 0.38, and negative predictive value of 0.87. Key predictors included early gestational age, lower birth weight, discharge weight >2000 g, prolonged NICU stay, trisomy, low socioeconomic score, gastrointestinal and neurological conditions, bronchopulmonary dysplasia, surgical interventions, and abnormal laboratory values.</p><p><strong>Conclusions: </strong>This study introduces one of the first machine learning models for predicting one-year rehospitalization in preterm infants, combining predictive modeling with interpretability through the integration of novel parameters. The model provides insight into high-risk profiles and may support early targeted interventions in an underexplored clinical area.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal tadalafil exposure increases pulmonary blood flow and reduces right to left heart shunting through the foramen ovale.","authors":"Janna L Morrison, Georgia K Williams, Steven K S Cho, Ashley S Meakin, Stacey L Holman, Megan Quinn, Michael D Wiese, Christopher K Macgowan, Mike Seed, Jack R T Darby","doi":"10.1159/000552021","DOIUrl":"https://doi.org/10.1159/000552021","url":null,"abstract":"<p><strong>Introduction: </strong>Fetal growth restriction (FGR) increases the risk of poor in utero, neonatal and long-term health outcomes. Tadalafil is the focus of a phase II exploratory trial (TADAFER IIb) to determine its efficacy as an intervention for FGR. Herein, we aimed to determine the impact that tadalafil has on fetal haemodynamics.</p><p><strong>Methods: </strong>At 116-117 days gestational age (dGA), pregnant ewes carrying normally grown fetuses (n=9) underwent fetal catheterisation surgery before undergoing MRI scans at 119-123dGA to measure blood flow and oxygenation within the major fetal vessels using phase contrast MRI and T2 oximetry. Baseline measures were performed after a fetal vehicle infusion and then repeated after a fetal tadalafil infusion. Fetal tadalafil concentrations were measured by LC-MS/MS.</p><p><strong>Results: </strong>Tadalafil did not impact right or left ventricular (LV) output but was associated with an increase in pulmonary blood flow with reduced blood flow through both the ductus arteriosus and foramen ovale (FO). The difference in blood oxygenation between the ascending aorta and main pulmonary artery was significantly reduced but cerebral oxygen delivery was maintained by increased carotid artery blood flow.</p><p><strong>Conclusion: </strong>Fetal tadalafil exposure alters pulmonary haemodynamics and reduces the proportion of the LV preload blood pool that is made up of oxygen-rich blood from the FO. Given fetal exposure to sildenafil increases the rate of persistent pulmonary hypertension after birth and that the tadalafil exposed fetuses studied herein exhibited similar haemodynamic profiles as those exposed to sildenafil, further studies investigating neonatal outcomes of fetuses exposed to tadalafil are warranted.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Metabolic Stability in Preterm Infants Using Continuous Glucose Monitoring: A Randomized Study.","authors":"Marcella Battaglini, Andrea Calandrino, Samuele Caruggi, Irene Bonato, Francesco Vinci, Chiara Andreato, Paolo Massirio, Sara Uccella, Mariagrazia Calevo, Giorgia Brigati, Luca Antonio Ramenghi","doi":"10.1159/000550797","DOIUrl":"https://doi.org/10.1159/000550797","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants are particularly susceptible to glycemic instability, which has been associated with enhanced risks of morbidity and adverse neurodevelopmental outcomes. Continuous glucose monitoring (CGM) may offer advantages in minimizing glycemic fluctuations. Study aim is to determine whether real-time CGM improves glycemic control and neurodevelopmental outcomes compared to standard care in preterm infants.</p><p><strong>Methods: </strong>this single-centre, prospective, randomized trial was conducted in our NICU between January 2022 and August 2023. Infants were randomly allocated within six hours of life to either a real-time CGM group or a control group with blinded CGM. In the intervention group, glycemic management was guided by CGM data; in the control group, it was based on intermittent blood glucose measurements. Primary outcomes included the frequency and duration of hypoglycemic (<47 mg/dL) and hyperglycemic (>180 mg/dL) episodes. Neurodevelopment was assessed at two years of corrected age using the Griffiths Scales of Child Development.</p><p><strong>Results: </strong>53 infants were included (CGM group: n=26; control group: n=27). Infants in the real-time CGM group demonstrated significantly fewer episodes of both hypoglycemia and hyperglycemia during the first week of life (hypoglycemia:339 vs 934, p=0.0001; hyperglycemia: 145 vs 830, p = 0.0001 ) and at 32 weeks of postmenstrual age (hypoglycemia:260 vs 785, p=0.0001; hyperglycemia: 1 vs 38, p = 0.0001). No significant differences were observed in neurodevelopmental outcomes.</p><p><strong>Conclusions: </strong>use of CGM allows therapeutic metabolic strategies to be employed the enhance glycaemic control in preterm during the early neonatal period. The trial protocol was registered under EudraCT number 2020-005739-65 (protocol code PN-CGM).</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-17"},"PeriodicalIF":3.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Randomized Controlled Trial of 24-h Webcam Access in the Neonatal Intensive Care Unit.","authors":"Yuri Ozawa, Aya Sasagawa, Kazuto Kikuchi, Michiyo Mogi, Nao Douo, Kiyoko Takemata, Kenichiro Hosoi, Masami Naritra, Satoshi Kusuda","doi":"10.1159/000551980","DOIUrl":"https://doi.org/10.1159/000551980","url":null,"abstract":"<p><strong>Introduction: </strong>Although interest is increasing, 24-h live-streaming webcams are rare in neonatal intensive care units (NICUs), underscoring the need for evidence to support their use. Therefore, we evaluated the effect of 24-h webcam access on parental anxiety, bonding, and postpartum depression in a NICU setting and examined the impact on the workflows of healthcare providers.</p><p><strong>Methods: </strong>This study was conducted from April 2023 to March 2024 in a tertiary NICU in Japan, as a pilot randomized controlled trial designed to assess feasibility and estimate the potential effect size. Parents of infants expected to stay >1 month in the NICU were enrolled. Participants were randomized to receive 24-h webcam access or no webcam access (control). The primary outcome was the Mother-to-Infant Bonding Scale (MIBS) score at 1 month after birth. Secondary outcomes included the State-Trait Anxiety Inventory (STAI), Edinburgh Postnatal Depression Scale, salivary oxytocin levels, breastfeeding volume, and staff perceptions assessed birth and at 1 month.</p><p><strong>Results: </strong>Eighty parents of 41 infants were enrolled. MIBS scores did not differ significantly between groups (mothers: 2.4±2.1 vs 2.3±1.8; fathers: 3.4±2.8 vs 4.2±2.1). In contrast, STAI scores decreased significantly in the webcam group at 1 month (mothers: 48.0 to 37.3; fathers: 44.3 to 35.6; both p<0.001), with a significant between-group difference (p<0.05, difference-in-differences analysis). Staff surveys indicated that 92% of nurses supported webcam use, and no adverse events occured.</p><p><strong>Conclusion: </strong>Continuous 24-h webcam access reduced parental anxiety and was well accepted by staff and families. Larger multicenter studies are warranted to validate our findings.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labor matters: thromboelastometry shows differences in newborn hemostasis.","authors":"Ewelina Kolańska-Dams, Inga Dziembowska, Piotr Korbal, Ewa Żekanowska","doi":"10.1159/000551596","DOIUrl":"https://doi.org/10.1159/000551596","url":null,"abstract":"<p><strong>Background: </strong>Neonatal coagulation differs quantitatively from adult physiology, and conventional plasma-based tests provide limited functional insight into clot formation in newborns. Rotational thromboelastometry (ROTEM) enables dynamic, whole-blood assessment of clot initiation, propagation, and firmness. This study examined whether mode of delivery is associated with differences in early postnatal ROTEM profiles in term neonates.</p><p><strong>Methods: </strong>In this single-center cohort study, peripheral venous blood from 60 healthy term neonates (10 elective cesarean section, 24 intrapartum cesarean section, and 26 vaginal deliveries) was analyzed using ROTEM EXTEM and INTEM assays. Evaluated parameters included clotting time (CT), clot formation time (CFT), α-angle, clot amplitudes (A10-A30), maximum clot firmness (MCF), and maximum lysis (ML). Group differences were assessed using non-parametric tests, and independent associations were examined using multivariable regression models adjusting for neonatal and maternal variables.</p><p><strong>Results: </strong>Elective cesarean neonates demonstrated faster clot propagation and greater clot firmness compared with labor-exposed infants, reflected by shorter INTEM CFT, higher INTEM α-angles, and higher EXTEM and INTEM amplitudes. EXTEM MCF increased progressively from vaginal delivery through intrapartum cesarean to elective cesarean section. In contrast, CT and ML did not differ significantly between groups. Mode of delivery remained independently associated with parameters of clot propagation and firmness after multivariable adjustment.</p><p><strong>Conclusions: </strong>Mode of delivery, particularly exposure to labor. seems to be associated with differences in early postnatal ROTEM profiles in term neonates. These findings underscore the importance of perinatal context when interpreting viscoelastic coagulation testing in newborns and support development of delivery-specific reference intervals.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}