Neonatology最新文献

{"title":"Association of intrauterine growth with retinopathy of prematurity risk in very preterm infants: a multicenter cohort study.","authors":"Juan Du, Xinyue Gu, Siyuan Jiang, Jianguo Zhou, Liyuan Hu, Jie Yang, Yujie Han, Yun Cao, Lizhong Du, Wenhao Zhou, Shoo K Lee, Xiaoping Lei, Mingyan Hei","doi":"10.1159/000548929","DOIUrl":"https://doi.org/10.1159/000548929","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of intrauterine growth status as measured by BW percentiles on retinopathy of prematurity (ROP) pathogenesis remains inadequately characterized. The objectives of the study was to establish BW percentile-specific risk gradients for ROP development.</p><p><strong>Methods: </strong>A multicenter cohort study was conducted with data were collected from Chinese Neonatal Network between January, 2019 and December, 2021. The exposure was GA- and sex-specific BW percentile. The primary outcome was incidence of ROP. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, adjusted for potential confounders, and stratified by GA, infant sex, maternal hypertension, singleton/multiple birth.</p><p><strong>Results: </strong>Totally 17 882 preterm infants were enrolled, BW was 1300.0 (1100.0-1500.0) g and GA was 29.9 (28.6-31.0) weeks. The incidence was 27% for any stage ROP and 3.7% for severe ROP (stage 3 or above). Each decrease of BW percentile by 10% was associated with 15% increase of odds for either any stage ROP (aOR 0.85 [95% CI 0.83-0.86]) or severe ROP (aOR 0.85 [95% CI 0.82-0.89]). The optimal discriminative BW percentile on ROC curve was 26% for predicting any stage ROP and 19% for predicting severe ROP. Lower BW percentile under these cut-offs were associated with elevated odds of any stage ROP (aOR 2.20 [95% CI 1.97-2.47] and severe ROP (aOR 2.91 [95% CI 2.22-3.80]).</p><p><strong>Conclusions: </strong>ROP incidence was negatively associated with BW percentile. Each 10% decreased BW percentile was associated with 15% increased odds of any stage ROP and severe ROP.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310514","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":"Auditory impairment in infants with neonatal hypoxic-ischaemic encephalopathy: a systematic review and meta-analysis.","authors":"Carla Fernandes, Filipa Andrade Silva, Bárbara Oliveiros, Carla Regina Pinto","doi":"10.1159/000548779","DOIUrl":"https://doi.org/10.1159/000548779","url":null,"abstract":"<p><p>Rationale and objectives Hypoxic-ischaemic encephalopathy (HIE) due to perinatal asphyxia (PA) remains a significant cause of neonatal morbidity and mortality. Despite therapeutic hypothermia (TH), a considerable proportion of survivors experience a wide range of deficits, including auditory impairment (AI), which needs deeper knowledge. This review aims to describe AI outcomes in infants with HIE. Methods A systematic literature review was performed using standard methods outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. A qualitative synthesis of all the included studies and a meta-analysis with seven eligible studies were conducted. Results In the sixteen studies comprised, a mean incidence of 4.54% of AI occurred among participants meeting the inclusion criteria. In the meta-analysis, in subgroup A (healthy newborns vs. newborns with HIE), an OR=10.74 with a 95% CI 2.02-57.16 and a p-value 0.010 was observed, indicating tenfold higher odds of AI in HIE newborns; subgroup B (newborns with HIE who received standard care vs. those who underwent TH) exhibited an OR= 0.77 with a 95% CI 0.35-1.68 and a p-value 0.510, demonstrating that newborns who received TH had a 0.77 fold lower odds of developing AI. Conclusion This review highlights HIE as a risk factor for AI and the possibility of TH being a protective factor. However, the variations in participant characteristics, HIE criteria, and methods of hearing assessment contribute to significant variability between studies, identifying the need for a standard evaluation of auditory outcomes in this setting, and extended over long-term.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-17"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282446","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":"Early Electroencephalography and Amplitude-Integrated Electroencephalography for the Prediction of Neurodevelopmental Outcomes in Neonates with Hypoxic Ischemic Encephalopathy: A Systematic Review and Diagnostic Test Accuracy Meta-analysis.","authors":"Vijay Kumar Krishnegowda, Viraraghavan Vadakkencherry Ramaswamy, Prathik Bandiya, Tapas Bandyopadhyay, Thangaraj Abiramalatha, Arun Prasath, Daniele Trevisanuto","doi":"10.1159/000548737","DOIUrl":"https://doi.org/10.1159/000548737","url":null,"abstract":"<p><strong>Introduction: </strong>Electroencephalography (EEG), including both conventional EEG (cEEG) and amplitude-integrated EEG (aEEG), are early prognostic tools utilized in neonates with hypoxic ischemic encephalopathy (HIE). However, the reported predictive accuracy of EEG varies widely.</p><p><strong>Methods: </strong>We evaluate the diagnostic accuracy of EEG in predicting neurodevelopment impairment (NDI) among neonates > 35 weeks with any stage HIE. MEDLINE, Embase, Cochrane Library and Scopus were searched from inception until 24th December 2024. Observational studies evaluating EEG performed in the first 72 hours of life in neonates with HIE, and reporting NDI outcomes assessed after 12 months were included. Two authors independently extracted data. A Bayesian random-effects bivariate model was used for diagnostic test accuracy meta-analysis. Risk of bias was assessed using QUADAS-2, and certainty of evidence (CoE) with GRADE. NDI, defined as cognitive/motor scores <1 SD below the mean or presence of motor disability.</p><p><strong>Results: </strong>62 studies (n=3929) were included. In neonates who underwent therapeutic hypothermia (TH) (34 studies, n=2538), EEG showed a sensitivity of 88.3% (95% Credible Interval(CrI): 83.7%, 92.8%) and specificity of 63.9% (53.6%, 72.8%). In no TH group (33 studies, n= 1,391), the sensitivity was 87.2% (77.5%, 93.5%) and specificity was 76.3% (61.5%, 86.8%). Further, in neonates who received TH (12 studies, n=868), cEEG had an acceptable sensitivity of 84.1% (77.3%, 89.9%) and specificity of 76.7% (66.9%, 84.3%). CoE being predominantly moderate.</p><p><strong>Conclusion: </strong>EEG has good sensitivity in predicting NDI regardless of TH status, and may aid in identifying high-risk neonates for further evaluation.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282436","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":"Brain injury and microstructural brain development in very preterm infants with patent ductus arteriosus.","authors":"Christina Schreiner, Maria Sappler, Michaela Höck, Stephanie Mangesius, Miriam Michel, Elke Griesmaier, Ursula Kiechl-Kohlendorfer, Vera Neubauer","doi":"10.1159/000548673","DOIUrl":"https://doi.org/10.1159/000548673","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence regarding the association between patent ductus arteriosus (PDA) and brain development in very preterm infants is inconclusive. The aim of the current study was to systematically evaluate brain injury and microstructural brain maturation as assessed by magnetic resonance imaging (MRI) at term-equivalent age in a contemporary cohort of very preterm infants with and without PDA.</p><p><strong>Methods: </strong>This was a retrospective, single-centre study. Preterm infants born at <32 weeks' gestation with PDA and cerebral MRI were eligible for this study. They were matched 1:1 according to gestational age (GA) to infants without PDA. MRI was assessed for brain injury. We measured fractional anisotropy and apparent diffusion coefficient in 12 brain regions as indicators for microstructural brain maturation.</p><p><strong>Results: </strong>We included 148 infants with PDA and 148 matched controls. We found no significant differences in brain injury rates between the groups. The evaluation of microstructural brain maturation revealed differences in some regions. After adjusting for differences in neonatal characteristics, a significant difference was seen only in the right middle cerebellar peduncle. Among infants with PDA, those who underwent surgical ligation exhibited elevated rates of both, cerebellar hemorrhage and severe IVH, and further showed a more immature brain maturation pattern. Statistical difference was lost for all variables after adjusting for GA.</p><p><strong>Conclusion: </strong>Our results indicate that the presence of PDA is not intrinsically associated with brain injury or impaired brain development.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228650","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":"Changes in healthy infant gut microbiota over the past decades.","authors":"Teo Oksanen, Martina Baizán-Urgell, Maria Carmen Collado, Samuli Rautava, Erika Isolauri","doi":"10.1159/000548421","DOIUrl":"https://doi.org/10.1159/000548421","url":null,"abstract":"<p><p>Introduction Bifidobacteria typify the gut microbiota of healthy, breast-fed infants. Altered gut microbiota composition in early infancy characterized by decreased Bifidobacterium abundance has been linked with a heightened risk of non-communicable diseases. Our goal was to assess factors impacting on the gut microbiota composition in infants throughout the allergy and obesity epidemics of the past decades. Methods We studied deliveries from a series of clinical studies, grouped by the year of birth into three time periods (1997-2001, 2005-2009, 2015-2022). Altogether 48 full-term breastfed infants' having fecal samples available at the age of 1-3 months were studied for microbiota profiling by 16S rRNA gene amplicon sequencing. Perinatal factors including mode of birth and antibiotic exposure during pregnancy and at birth were taken into account. Results The richness and diversity of the infant gut microbiota decreased significantly over the three time periods. Reduced abundance of the phylum Actinobacteriota, and its genus Bifidobacterium was detected in children born in 2015-2022 as compared to those born during the time periods 1997-2001 and 2005-2009. The time period of birth was the strongest determinant of the gut microbiota composition, followed by maternal pre-pregnancy body mass index, antibiotic exposure during pregnancy and mode of birth. The relative abundance of members of the genus Bifidobacterium was significantly associated with elapsed time (1997-2022) and intrapartum antibiotic exposure. Conclusions The depletion of gut microbiota richness and diversity, and the selective reduction of relative abundance of the genus Bifidobacterium have occurred parallel to the increase in the prevalence of non-communicable diseases.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214874","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":"Response to letter from Dr. Arti Maria: \"Priority neonatal interventions are powerful - when rooted in nurturing care\".","authors":"Zulfiqar A Bhutta, Tyler Vaivada, Jai K Das","doi":"10.1159/000548645","DOIUrl":"https://doi.org/10.1159/000548645","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194202","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":"Priority neonatal interventions are powerful - when rooted in nurturing care.","authors":"Arti Maria","doi":"10.1159/000548459","DOIUrl":"https://doi.org/10.1159/000548459","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088583","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":"The Future of Neonatal Medicine - Reducing global neonatal mortality is a matter of political will.","authors":"Ola Didrik Saugstad, Waldemar A Carlo, Haresh Kirpalani, Satyan Lakshminrusimha, Christian P Speer","doi":"10.1159/000548520","DOIUrl":"https://doi.org/10.1159/000548520","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088603","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":"Management of apnoea in extremely preterm infants - a European Survey.","authors":"Anna Lavizzari, G Jeroen Hutten, Christian Heiring, Moniek van de Loo, Wes Onland, Almudena Alonso-Ojembarrena, Harald Ehrhardt, Merih Cetinkaya, Tomasz Szczapa, Victor Sartorius, Gustavo Rocha, Martin Wald, Hanna Soukka, Olivier Danhaive, Theodore Dassios, Manuela Camelia Cucerea, Andrea Calkovska, Gabriel Dimitriou, Bernard Barzilay, Boris Filipovic-Grcic, Roland Hentschel, Ulrich H Thome, Kajsa Bohlin, Gianluca Lista, Sven Schulzke, Richard Plavka, Rasa Tameliene, Colm Patrick Finbarr O Apos Donnell, Anton H van Kaam, Richard Sindelar, Claus Klingenberg","doi":"10.1159/000547546","DOIUrl":"https://doi.org/10.1159/000547546","url":null,"abstract":"<p><p>Introduction Episodes of apnoea are common in extremely preterm infants and usually treated with caffeine and respiratory support. Understanding differences in apnoea definitions, monitoring practices, and use of respiratory stimulants is essential to improve future treatment. Methods Between March and July 2024, one lead consultant at European tertiary neonatal intensive care units (NICUs) was invited to complete to a web-based survey on respiratory practices in extremely preterm infants. We sought information how they defined apnoea and monitored for it, and how they treated it with caffeine, doxapram and non-invasive respiratory support. Results We received replies from 447/721 (62%) NICUs across 24 European countries. Most NICUs (74%) use both electrocardiogram electrodes and pulse oximetry for apnoea monitoring. All NICUs reported using caffeine citrate, with 102 centres (23%) starting it in the delivery room (DR). The median loading, maintenance and maximum maintenance doses used are 20 mg/kg, 5 and 10 mg/kg/day respectively. Caffeine is occasionally given twice daily in some NICUs (30%) and stopped at 34-35 weeks' postmenstrual age at most of them (74%). Doxapram is used at 111 (25%) NICUs, with geographical differences. Strategies for the use and escalation of non-invasive respiratory support in case of persistent apnoea are not clearly defined. Automatic closed-loop oxygen delivery is used at 25% of NICUs. Conclusion: Despite consistency in the dosing and weaning of caffeine, there is much variation in the management of apnoea in preterm infants across Europe. Future research should focus on timing and dosage of caffeine, the use of doxapram, and strategies for optimising non-invasive respiratory support.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016983","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":"Early magnetic resonance imaging predicts 12 month outcome in neonates with congenital diaphragmatic hernia.","authors":"Anne Christin Ulrike Groteklaes, Till Dresbach, Florian Kipfmüller, Sonja Stutte, Soyhan Bagci, Tamara Grass, Patrizia Nitsch-Felsecker, Christos Pantazis, Joachim Schmitt, Lukas Schroeder, Andreas Müller, Linda S de Vries, Hemmen Sabir","doi":"10.1159/000548071","DOIUrl":"https://doi.org/10.1159/000548071","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in neonatology, neonatal surgery, and extracorporeal membrane oxygenation (ECMO) have improved the prognosis of congenital diaphragmatic hernia (CDH). However, CDH survivors are at considerable risk of long-term neurological morbidity. Magnetic resonance imaging (MRI) abnormalities are reported in up to 84% of CDH-survivors but have only been rarely compared with neurodevelopmental outcomes. This study aims to investigate whether assessment of postnatal MRI in CDH-survivors allowed association with and prediction of long-term outcome.</p><p><strong>Methods: </strong>Brain MRI was performed in 36 neonates with CDH using the Weeke-score, assessing the mammillary bodies, the corpus callosum, cortical folding and cerebrospinal fluid space (CSF). Outcomes were measured using Bayley-III-examinations at 12 months.</p><p><strong>Results: </strong>91.6% of the neonates exhibited MRI-abnormalities. Among them, 83.3% showed white matter (WM), 16.6% grey matter abnormalities, 8.3% cerebellar abnormalities, and 20% had an intracranial hemorrhage. 30.5% showed abnormal mammillary bodies, 44.4% enlarged CSF , 5.5% reduced cortical folding, and 8.3% reduced corpus callosum thickness. While the use of the Weeke-score was not helpful for outcome prediction, specific MRI abnormalities were associated with adverse long-term outcomes. Based on these findings, a novel MRI-scoring- system was developed. This easy-to-perform score effectively predicted adverse outcomes at 12 months. Conclusion Interpretation of MRI in neonates with CDH should focus on WM pathologies, CSF enlargement, internal capsule involvement, mammillary body abnormalities, and IVH. Our novel simple scoring system helps to identify neonates at risk for adverse neurological outcomes at discharge and aids to implement therapeutic strategies at an early point.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-22"},"PeriodicalIF":3.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017000","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}