Neonatology最新文献

{"title":"Tabula Rasa? A History of Fetal Learning and Neonatal Perception.","authors":"Michael Obladen","doi":"10.1159/000546893","DOIUrl":"https://doi.org/10.1159/000546893","url":null,"abstract":"<p><strong>Background: </strong>Sensory capacities of the fetus and newborn are still incompletely known. This paper delineates the history of understanding and evidence.</p><p><strong>Summary: </strong>In the 2nd century, Galen propagated the tabula rasa theory comparing newborns to a blank writing tablet, without senses of sight, hearing, taste, or smell. Somatosensory: once the microscope was available, tactile receptors were identified in mid-17th century. But the tabula rasa theory persisted, and physicians maintained until the 1980s that neonates feel no pain. Auditory: the inner ear's development begins at 10 weeks of gestation at the cochlear basis and ends at its apex at 24 weeks. Researchers believed still into the 19th century that the fetus lacked auditory sensitivity. The uterus is not a quiet place, as the fetus hears uterine vessels, maternal voice, peristalsis, diaphragmatic movement, and heartbeat. In 1980, DeCasper proved that newborns preferred hearing their mothers' voice when compared to that of another mother. The evidence is weaker for sounds originating outside the maternal body. Despite little in-utero stimulation, the newborn's visual apparatus functions from birth. Infants enter the world with innate perceptual knowledge of the human face. Olfactory: human infants are attracted by the smell of their mother's breast. It took 1500 years to discard the tabula rasa theory and to grant the newborn full personhood in the 20th century.</p><p><strong>Key messages: </strong>Fetal sensory organs are developed by mid-gestation. Neonates know their mother's voice and smell, which encourages maternal contact, prudent disinfectant use, and reduced noise in the nursery.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499930","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":"Impact of implementing nasal high flow therapy on body growth in preterm infants.","authors":"Rosemarie de Ridder, Trixie Andrea Katz, Anton H van Kaam, Suzanne M Mugie, Elske H Weber, Femke de Groof, Annemieke Kunst, Maria E N van den Heuvel, Clare E Counsilman, Maarten Rijpert, Irene A Schiering, Janneke Wilms, Fenna Visser, Cornelieke S H Aarnoudse-Moens, Aleid G Leemhuis, Wes Onland","doi":"10.1159/000546969","DOIUrl":"https://doi.org/10.1159/000546969","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to determine the impact of nasal high flow (nHF) implementation on lung growth at six months corrected age (CA) in preterm infants.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included preterm infants born <30 weeks gestation' and surviving to six months CA at the neonatal intensive care unit of the Amsterdam University Medical Centers. In the nCPAP cohort (2009-2012), continuous distending pressure (CDP) was applied solely with nasal continuous positive airway pressure support. In the nHF cohort (2015-2018) nCPAP was used and followed by nHF therapy to deliver CDP. Bodyweight and length at six months CA were used as a proxy for lung growth. We also assessed the impact on respiratory management and neonatal morbidity. Multivariate analysis was performed after multiple imputation, using a linear regression adjusting for confounding variables.</p><p><strong>Results: </strong>Of the 598 eligible infants, 313 infants were included in the nCPAP cohort, and 285 infants in the nHF cohort. The analyses showed no differences between the nCPAP and nHF cohort in body weight (7.29 vs 7.31 kilogram, 95%CI -0.14-0.20, p=0.71), and length (66.6 vs 66.8 centimeters (95%CI -0.30- 0.81, p=0.26) at six months CA. No differences in moderate/severe bronchopulmonary dysplasia (BPD) were reported, but nHF implementation was associated with longer CDP duration, a trend towards more days on supplemental oxygen, and shift from moderate to severe BPD.</p><p><strong>Conclusions: </strong>Implementation of nHF did not impact body growth, which is associated with lung growth, at six months CA in preterm infants born <30 weeks.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369989","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":"MicroRNA expression profiles in very preterm infants with patent ductus arteriosus - a pilot study.","authors":"Ira Winkler, Anna Posod, Anna Staudt, Eva Huber, Martina Urbanek, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.1159/000546934","DOIUrl":"https://doi.org/10.1159/000546934","url":null,"abstract":"<p><strong>Introduction: </strong>Very preterm infants are at risk for developing hemodynamically significant patent ductus arteriosus (hsPDA), which contributes to increased morbidity. The optimal management of hsPDA remains controversial, and treatment options are associated with complications. Developing accurate prediction tools for hsPDA closure is essential to guide management strategies. The aim of the present pilot study was to investigate microRNA expression profiles in very preterm infants with and without hsPDA and to assess their potential as biomarkers for hsPDA.</p><p><strong>Methods: </strong>We prospectively enrolled preterm infants with a birth weight of ≤1250 g and a gestational age of <30 weeks at Innsbruck Medical University Hospital, Austria. Infants with spontaneous ductus closure within the first week comprised the control group, while those with persistent hsPDA formed the hsPDA group. Total RNA was extracted from dried blood spots (umbilical cord blood and infant blood of week 1), followed by microRNA sequencing and differential gene expression analysis.</p><p><strong>Results: </strong>The study included 25 infants (control group: n = 14; hsPDA group: n = 11). Differential expression analysis of umbilical cord blood identified significant downregulation of hsa-miR-218-5p in the hsPDA group compared to the control group (Log2 Fold Change = -3.444; FDR = 0.099, Benjamini-Hochberg corrected). In the analysis of infant blood of week 1, no significant differences in miRNA expression profile between hsPDA and control group were detected.</p><p><strong>Conclusion: </strong>MicroRNAs could be potential biomarkers for hsPDA closure in preterm infants. Larger studies are needed to validate our findings of this pilot study and to assess clinical applicability.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369990","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":"Unveiling the Hidden Burden: An Umbrella Review of Congenital Anomalies among Newborns in Low and Middle-Income Countries.","authors":"Alemu Birara Zemariam, Tegene Atamenta Kitaw, Ribka Nigatu Haile, Befkad Deresse Tilahun, Gizachew Yilak, Mulat Ayele, Molla Azmeraw Bizuayehu, Habtamu Setegn Ngusie, Addis Wondmagegn Alamaw","doi":"10.1159/000543832","DOIUrl":"https://doi.org/10.1159/000543832","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies (CAs) are a major cause of newborn mortality and long-term disabilities, especially in developing countries. Research on CAs is limited and inconclusive. This umbrella review evaluates the pooled prevalence, patterns, and determinants of CAs among newborns in low- and middle-income countries.</p><p><strong>Methods: </strong>We conducted a comprehensive search across databases, including PubMed and Cochrane Library, until 31 December 2024. Study quality was assessed using the AMSTAR checklist. Heterogeneity was measured with the I² test and Cochrane Q test, while publication bias was evaluated through funnel plots, Egger's, and Begg's tests. The pooled prevalence of CAs and determinants was calculated using the DerSimonian and Laird random-effects model.</p><p><strong>Results: </strong>Seven studies revealed a pooled prevalence of CAs at 15 per 1,000 births (95% CI: 9.00, 21.00), with the highest rate in low-income countries at 18 per 1,000 (95% CI: 8.00, 27.00). Musculoskeletal and urogenital anomalies were the most prevalent, at 8 and 4 per 1,000 births, respectively. Key predictors include lack of folic acid supplementation (AOR 4.18, 95% CI: 2.35, 6.02), khat chewing (AOR 3.5, 95% CI: 2.97, 4.03), maternal illness (AOR 3.55, 95% CI: 3.37, 4.73), and drug use during pregnancy (AOR 4.37, 95% CI: 1.21, 7.54).</p><p><strong>Conclusion: </strong>The pooled prevalence of CAs is significantly higher than WHO reports, with musculoskeletal and urogenital defects being the most common. Key risk factors include maternal illness, unidentified drug use, khat chewing, and lack of folic acid supplementation. Enhancing folic acid intake and targeting these risk factors are essential for policymakers.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287685","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":"Routine Emollient Therapy with Coconut Oil in Preterm Infants and Allergic Sensitization at 1-Year Corrected Age.","authors":"Terri Williams, Jemma Weidinger, Jessica R Metcalfe, Samantha Thomas, Jenny Mountain, Andrew Currie, Michael O'Sullivan, Tobias Strunk","doi":"10.1159/000546309","DOIUrl":"10.1159/000546309","url":null,"abstract":"<p><strong>Introduction: </strong>Skin care for very and extremely preterm infant is an important and previously underappreciated topic. Coconut oil skin care for preterm infants is a promising option, but several important questions remain including the theoretical potential for allergic sensitization.</p><p><strong>Methods: </strong>This prospective study conducted skin prick testing and allergy questionnaires in a cohort of very preterm infants who received routine skin care with virgin coconut oil during their neonatal admission.</p><p><strong>Results: </strong>Ninety infants (median GA 28.2 weeks, median BW 1,048 g) were assessed at corrected age 15 months. A total of 8 children had positive skin prick tests to 1 or more of the most common allergens (egg, peanut, cashew, dust mite). No child was sensitized to coconut oil or extract.</p><p><strong>Conclusions: </strong>We did not find evidence of allergic sensitization following neonatal skin care with coconut oil in children born preterm.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236345","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":"Severe neonatal anemia with multi-organ failure, extreme placentomegaly and placental megaloblastic erythroblastosis as features in identifying congenital dyserythropoietic anemia type 1: a case report.","authors":"Olivia Roose, Carole Gengler, Simona Stoykova, Jean-Marc Good, Jean-Francois Tolsa, Lydie Beauport","doi":"10.1159/000546794","DOIUrl":"https://doi.org/10.1159/000546794","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital dyserythropoietic anemia type 1 (CDA-1) is a rare inherited erythroid disorder. The neonatal clinical presentation is non-specific, making diagnosis challenging and requiring a multidisciplinary approach. To date, no specific placental characteristics have been associated to this condition, highlighting the importance of placental examination and pathologic investigations.</p><p><strong>Case presentation: </strong>We present the case of a term newborn affected by CDA-1. The patient displayed poor neonatal adaptation with severe anemia, persistent pulmonary arterial hypertension, right ventricular dysfunction, hypotensive shock, cholestasis, hepatitis, severe hyperferritinemia, disseminated intravascular coagulation, thrombocytopenia, acute renal failure and transient hyperinsulinism. Placentomegaly was noted and histology demonstrated severe megaloblastic erythroblastosis. Genetic research confirmed the diagnosis. The patient required intensive care during the first weeks of life and blood cell transfusions every five weeks until six months. The outcome was favorable.</p><p><strong>Conclusion: </strong>CDA-1 is a rare, serious disorder requiring a complex diagnostic approach. Placental analysis provides additional clues for establishing a diagnosis.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236346","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":"International Variation and Trends of Intraventricular Hemorrhage in Very Preterm Infants.","authors":"Georgia Hollens, Tim Schindler, Malcolm Battin, Gil Klinger, Mark Adams, Maximo Vento, Antonino Santacroce, Stellan Håkansson, Tetsuya Isayama, Mikael Norman, Satoshi Kusuda, Liisa Lehtonen, Kjell Helenius, Neena Modi, Prakesh S Shah, Kei Lui","doi":"10.1159/000546714","DOIUrl":"10.1159/000546714","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to investigate international variation in gestational age (GA) specific severe intraventricular hemorrhage (IVH) rates, among infants of <30 weeks' GA from the neonatal networks of 11 high-income countries/region.</p><p><strong>Methods: </strong>Retrospective cohort study of outcomes of grade 3/4 IVH rates and composite of g3/4 IVH or death in GA groups of 22-23, 24-25, 26-27, and 28-29 weeks infants admitted to networks of Australia and New Zealand, Canada, Finland, Israel, Italy (Tuscany), Japan, Spain, Sweden, Switzerland, and the UK. Their risk adjusted trends across 3 epochs (2007-11, 2012-15, and 2016-19) were also evaluated.</p><p><strong>Results: </strong>Outcomes of 165,329 infants (median GA 27 weeks, birthweight 950 g) were analyzed. Overall, the lowest grade 3/4 IVH rate was observed in Japan (6.4%) and the highest in Israel (16.1%). The overall gestation-specific rate of IVH grade 3/4 were 25.8%, 18.6%, 9.0%, and 3.8% and composite outcome of grade 3/4 IVH/death rates 52.2%, 33.6%, 15.6%, and 6.7% for the 22-23, 24-25, 26-27, and 28-29 weeks' GA groups, respectively. These inter-network variations were greater at lower GA. In epoch comparisons, almost all networks showed significant decreases in GA specific composite outcome rates, particularly in the 26-27 week' GA group. Japan and Canada demonstrated significant decreases in each GA group while Spain demonstrated significant decreases in each GA group except for 22-23 weeks' gestation.</p><p><strong>Conclusions: </strong>Rates of grade 3/4 IVH and composite outcome rates varied internationally and have decreased over time. Identification of the driving factors behind variations may allow for opportunities for practice review and improvement.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201200","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 Saturation and Fractional Tissue Oxygen Extraction Are Associated with Anterior Cerebral Artery Doppler Parameters in Neonates with Congenital Heart Defects.","authors":"Pasinee Kanaprach, Carolina Michel-Macias, Matthew Mazzarello, Marina Mir, Emmanouil Rampakakis, Punnanee Wutthigate, Jessica Simoneau, Daniela Villegas, Shiran Sara Moore, Sam D Shemie, Marie Brossard-Racine, Adrian Dancea, Gianluca Bertolizio, Pia Wintermark, Gabriel Altit","doi":"10.1159/000546675","DOIUrl":"https://doi.org/10.1159/000546675","url":null,"abstract":"<p><strong>Introduction: </strong>To explore the relationship between near-infrared spectroscopy parameters (Cerebral Saturation [CSat] and corresponding cerebral fractional tissue oxygen extraction [cFTOE]) with Resistive (RI) and Pulsatility indices (PI) of the anterior cerebral artery (ACA) obtained simultaneously in neonates with congenital heart defect (CHD) during the first week of life.</p><p><strong>Methods: </strong>Prospective observational study on neonates ≥35 weeks with CHD. Cerebral FTOE was based on concomitant pre-ductal oxygen saturation (SpO2) during CSat measurement. ACA was assessed via Doppler ultrasound (US). Continuous CSat/SpO2 monitoring was collected during the first week of life. Daily ACA-doppler was obtained from day 1 to 7.</p><p><strong>Results: </strong>142 concomitant measurements of NIRS and US parameters during the first week of life were collected in 34 neonates with various CHD. Mixed effect models showed significant association between CSat/cFTOE and time-corresponding RI-ACA (p=0.02 and 0.005) and PI-ACA (p=0.006 and 0.002), respectively. A 0.1-point increase in RI was associated to a 2.3% decrease in CSat and a 3-point increase in cFTOE. A 0.1-point increase in PI was associated to a 0.9% decrease in CSat and 1.1-point increase in cFTOE.</p><p><strong>Conclusions: </strong>In neonates with CHD during their first week of life, lower CSat and higher cerebral FTOE were associated with elevated RI and PI values of the ACA obtained simultaneously. Future research should assess whether a multimodal bedside approach to monitoring cerebrovascular hemodynamics can facilitate early detection of cerebral hypoperfusion and prevent brain injury, as well as adverse neurodevelopmental outcomes in this vulnerable population.  .</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201199","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":"Transfusion Practices in 12 Neonatal Networks: Are We Closer to Adopting a Restrictive Transfusion Approach?","authors":"Gil Klinger, Kjell Helenius, Maximo Vento, Satoshi Kusuda, Mikael Norman, Renato Soibelman Procianoy, Neha Goswami, Valerie Biran, Dirk Bassler, Brian Reichman, Aleksandra Skubisz, Malcolm Battin, Liisa Lehtonen, Kei Lui, Annalisa Mori, Marc Beltempo, Mark Adams, Laura San Feliciano, Tetsuya Isayama, Prakesh S Shah","doi":"10.1159/000546612","DOIUrl":"10.1159/000546612","url":null,"abstract":"<p><strong>Introduction: </strong>Recent evidence suggests a restrictive approach toward blood transfusions for management of preterm infants. Objective was to survey blood transfusion practises in preterm neonates <29 weeks' gestation among 12 population-based neonatal networks participating in the International Network for Evaluating Outcomes in Neonates (iNeo).</p><p><strong>Methods: </strong>An online survey based on 2023 practices was sent to 608 neonatal intensive care units (NICUs): Australia/New Zealand (30), Brazil (20), Canada (32), Finland (5), France (70), Israel (26), Japan (292), Poland (56), Spain (55), Sweden (9), Switzerland (9), and Tuscany, Italy (4). Transfusion thresholds in 4 different scenarios were surveyed: (a) infants invasively ventilated within first 7 postnatal days, (b) infants invasively ventilated after 7 days, (c) stable infants on noninvasive respiratory support, and (d) stable infants requiring no respiratory support.</p><p><strong>Results: </strong>A total of 382 NICUs (63%) responded. Transfusion practices varied within networks and between countries. For invasively ventilated infants, the transfusion threshold during first 7 days after birth was a hematocrit <underline>≤</underline>35% in 79% of NICUs, and at an age ≥8 days, the transfusion threshold was a hematocrit <underline>≤</underline>30% in 68% of NICUs. For stable infants on noninvasive ventilation, the transfusion threshold was a hematocrit <underline>≤</underline>30% in 80%, and in those without respiratory support, the transfusion threshold was a hematocrit of <underline>≤</underline>25% in 68% of NICUs.</p><p><strong>Conclusions: </strong>Variations exist in blood transfusion practises between countries and within networks. A restrictive transfusion approach based on recent recommendations has been adopted by more than two-thirds of NICUs. Additional research is needed to evaluate whether practices align with intentions and how they impact outcomes.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176373","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":"Intermittent Hypoxemia and Neurodevelopmental Impairment at 12 and 24 Months in Preterm Infants.","authors":"Juliann M Di Fiore, Deanne Wilson-Costello, Zhengyi Chen, Nori M Minich, Richard J Martin, Anna Maria Hibbs","doi":"10.1159/000544925","DOIUrl":"10.1159/000544925","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal studies have shown a relationship between intermittent hypoxemia (IH) and long-term sequelae although definitions of IH have varied. Employing multiple thresholds of IH and a wider gestational aged cohort of preterm infants, we hypothesized that increased IH exposure during the first month of life was associated with neurodevelopmental impairment (NDI) at 12 and 24 months corrected age.</p><p><strong>Methods: </strong>IH (<80% or <90%) were documented from day of life 8 to 28 (n = 175 infants <31 weeks gestation). Referral for NDI was identified (Ages and Stages Questionnaire, ASQ-3) at 12- and 24-month corrected age (>2 SD below the mean for gross motor, communication, fine motor, problem solving, and/or personal-social skills).</p><p><strong>Results: </strong>Unadjusted models revealed a significant association between increased IH and scores in referral range for gross motor, and communication skills (12 months) and gross motor, communication, fine motor, problem solving, and personal-social skills (24 months). In adjusted models, a greater % time <90% and referral scores for communication skills (p = 0.0158) at 12 months remained significant. Subgroup analyses revealed an association between greater % time <80% (12 months, p = 0.0311) and longer IH duration <90% (24 months, p = 0.0374) and scores in referral range for any domain in infants ≥29 weeks gestation.</p><p><strong>Conclusion: </strong>There was a limited relationship between IH and ASQ-3 scores in referral range for NDI with an association between IH and ASQ-3 referral at 12 and 24 months in infants ≥29 weeks gestation suggesting IH may be a risk factor for NDI in older infants with less competing morbidities.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153151","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}