Neonatology最新文献

{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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 5 weeks until 6 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":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"10.1159/000546675","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was 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 was conducted. 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 1-7.</p><p><strong>Results: </strong>A total of 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":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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}

{"title":"Non-Invasive Intermittent Positive Pressure Ventilation: Addressing the \"Achilles Heel\" of Systematic Reviews on Non-Invasive Ventilation in Premature Infants - An Argument for More Contemporaneous, Well-Conducted Trials.","authors":"Hannah Farley, Shalini Ojha, Charles C Roehr","doi":"10.1159/000546573","DOIUrl":"10.1159/000546573","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Safety of a Continuous Noninvasive Blood Pressure Monitor in Neonates.","authors":"R Brandon Hunter, Michele S Saruwatari, Nathan D Bliss, Sarah Kim, Rodica Turcu, Brooke A Krbec, Kamran Yusuf, Anoop Rao, Xina Quan, Lamia Soghier","doi":"10.1159/000546187","DOIUrl":"10.1159/000546187","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate and continuous blood pressure (BP) monitoring in neonates is crucial in the intensive care unit. Invasive arterial lines (IALs), oscillometric cuffs, and current noninvasive continuous BP monitoring devices have significant limitations. The Boppli® device is a novel, continuous, noninvasive BP device that requires no calibration, designed for neonates.</p><p><strong>Methods: </strong>This prospective, multicenter study evaluated the performance, usability, and safety of the Boppli device in neonates <5 kg. We compared mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) measurements from the Boppli with IAL reference values by calculating average values of mean average error (MAE) and standard deviation (SD) for each patient, then averaging those means. Safety and usability were evaluated by analysis of adverse events and survey data, respectively.</p><p><strong>Results: </strong>The Boppli device demonstrated good performance, meeting the FDA requirements of MAE and SD of the entire cohort: MAE (SD) 0.7 (5.3) mm Hg for MAP, -0.8 (7.7) mm Hg for SBP, and 1.4 (4.7) mm Hg for DBP. Patients with elevated MAPs, Asian ethnicity, and lower extremity IALs were the subgroups with MAE >±5 mm Hg. Various subgroups had SDs >8 mm Hg attributed to low sample sizes. The device received high usability scores from clinicians and parents. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>The Boppli device is a promising alternative for continuous noninvasive BP monitoring in neonates, offering good accuracy and usability. The device, which received 510(k) clearance in September 2023, was well received by clinicians and parents, with a low-risk profile.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103445","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":"Association between Pneumothorax and Neonatal Outcomes among Very Preterm Infants: A Multicenter Cohort Study.","authors":"Mengya Sun, Hong Jiang, Liang Zhao, Yun Cao, Lin Yuan, Liyuan Hu, Shoo K Lee, Lizhong Du, Jie Yang, Xianghong Li","doi":"10.1159/000546364","DOIUrl":"10.1159/000546364","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate whether the incidence of pneumothorax is associated with adverse neonatal outcomes in very preterm infants.</p><p><strong>Methods: </strong>This multicenter cohort study included all infants with a gestational age of 24-31 weeks, admitted to the tertiary neonatal intensive care units of the Chinese Neonatal Network, from 2019 to 2022. Pneumothorax was diagnosed via chest X-ray or lung computed tomography. The primary outcome was a composite measure of mortality and/or any severe neonatal morbidity. Multivariable logistic or linear regression analyses were performed to assess the association between pneumothorax and neonatal outcomes. Propensity score matching was used to ensure the robustness of the results.</p><p><strong>Results: </strong>Among the 37,917 infants in the study, 465 (1.2%) developed pneumothorax. Pneumothorax was significantly associated with a higher risk of mortality and/or severe neonatal morbidity (adjusted odds ratio = 3.15, 95% confidence interval: 2.36, 4.20). Pneumothorax exposure was also independently associated with increased mortality, severe intraventricular hemorrhage, moderate or severe bronchopulmonary dysplasia, and the need for invasive ventilation and its duration. Additionally, pneumothorax was associated with an increased length of hospital stay among survivors (adjusted odds ratio = 7.62, 95% confidence interval: 4.33, 10.91). The usage of high-frequency invasive mechanical ventilation before pneumothorax and pneumothorax treated with an intercostal chest drain seemed to have the most significant harmful effect (adjusted odds ratios were 3.34 and 3.27, respectively).</p><p><strong>Conclusion: </strong>Our study underscores the significant impact of pneumothorax on increasing mortality and severe morbidities in very preterm infants.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096538","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":"POCUS for Vascular Access in Neonatology Is Here to Stay.","authors":"Almudena Alonso-Ojembarrena, Ignacio Oulego-Erroz","doi":"10.1159/000546404","DOIUrl":"10.1159/000546404","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096539","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}