Neonatology最新文献_第2页

Maternal and Neonatal Factors Associated with Delayed Closure of Ductus Arteriosus in Term-Born Neonates: Insights from the Copenhagen Baby Heart Cohort Study. 与足月新生儿动脉导管延迟闭合有关的母体和新生儿因素：哥本哈根婴儿心脏队列研究的启示》。

Neonatology Pub Date : 2025-02-12 DOI: 10.1159/000543915

Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Raheel Altaf Raja, Anna Sellmer, Johan Navne, Henning Bundgaard, Kasper Karmark Iversen, Dorthe Lisbeth Jeppesen

{"title":"Maternal and Neonatal Factors Associated with Delayed Closure of Ductus Arteriosus in Term-Born Neonates: Insights from the Copenhagen Baby Heart Cohort Study.","authors":"Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Raheel Altaf Raja, Anna Sellmer, Johan Navne, Henning Bundgaard, Kasper Karmark Iversen, Dorthe Lisbeth Jeppesen","doi":"10.1159/000543915","DOIUrl":"10.1159/000543915","url":null,"abstract":"Introduction: The prenatal shunt, ductus arteriosus (DA), typically closes during the cardio-pulmonary transition at birth. We evaluated maternal and neonatal factors associated with delayed closure of DA in term-born neonates.Methods: We conducted a retrospective cohort study that included full-term neonates from the prospective observational Copenhagen Baby Heart cohort study. We assessed the association between maternal and neonatal factors and delayed ductal closure.Results: We included 19,566 neonates, of whom 48% were female. Echocardiography was performed at a median age of 12 (IQR: 9-15) and 8 (IQR: 2-13) days for neonates with no DA and an open DA, respectively. Associations with delayed ductal closure included maternal obesity adjusted risk ratio = 2 (95% CI: 1-3.8), maternal hypothyroidism during pregnancy aRR = 2.02 (95% CI: 1.2-3.4), low Apgar 2.6 (95% CI: 1.2-6), high weight aRR = 1.81 (95% CI: 1.2-2.6), and length at birth aRR = 1.7 (95% CI: 1.1-2.6).Conclusion: The identified risk factors for delayed ductal closure in term-born neonates may help increase clinical attention and improve neonatal care.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412175","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}

引用次数: 0

Microstructural maturation of the splenium of corpus callosum and cognitive and motor outcome in very preterm infants.

Neonatology Pub Date : 2025-02-03 DOI: 10.1159/000543328

Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier

{"title":"Microstructural maturation of the splenium of corpus callosum and cognitive and motor outcome in very preterm infants.","authors":"Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.1159/000543328","DOIUrl":"https://doi.org/10.1159/000543328","url":null,"abstract":"Introduction: Common brain injuries of preterm infants do not entirely explain the incidence of neurodevelopmental impairment observed in this population. Evidence suggests an association with microstructural maturation of the splenium of corpus callosum. This study aimed to investigate a correlation between microstructural maturation of the splenium of corpus callosum and neurodevelopmental outcome in very preterm infants.Method: In a cohort study of 373 very preterm infants, we used fractional anisotropy (FA) and apparent diffusion coefficient (ADC) derived from diffusion tensor imaging at term equivalent age (TEA) to quantitatively reflect microstructural maturation of the splenium of corpus callosum, and standardized follow-up assessments of cognitive and motor function at 24 months corrected age and five years chronological age. Correlation was tested by Spearman rank´s correlation coefficients and multivariate regression analysis.Results: At 24 months, we found significantly lower FA and higher ADC values in infants with abnormal mental indices, psychomotor developmental indices and fine motor function. Scores of all three correlated positively with FA and negatively with ADC. Aged five years, lower FA values correlated significantly with abnormal overall motor function, and higher ADC values correlated significantly with abnormal full scale intelligence quotient (FSIQ) and overall motor function. Scores of FSIQ, overall and fine motor function correlated negatively with ADC.Conclusion: The results emphasize an association between microstructural maturation of the splenium of corpus callosum at TEA and neurodevelopmental outcome, and suggest that ADC may be more strongly linked to these outcomes than FA, especially in the long-term.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124233","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}

引用次数: 0

Use of Macrogol to Accelerate Feeding Advancement in Extremely Preterm Infants.

Neonatology Pub Date : 2025-02-03 DOI: 10.1159/000543050

Kirstin Barbara Faust, Mariia Lupatsii, Frederike Römer, Simon Graspeuntner, Silvio Waschina, Sina Zimmermann, Alexander Humberg, Mats Ingmar Fortmann, Kathrin Hanke, Kai Böckenholt, Johannes Dirks, Christine Silwedel, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel

{"title":"Use of Macrogol to Accelerate Feeding Advancement in Extremely Preterm Infants.","authors":"Kirstin Barbara Faust, Mariia Lupatsii, Frederike Römer, Simon Graspeuntner, Silvio Waschina, Sina Zimmermann, Alexander Humberg, Mats Ingmar Fortmann, Kathrin Hanke, Kai Böckenholt, Johannes Dirks, Christine Silwedel, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel","doi":"10.1159/000543050","DOIUrl":"10.1159/000543050","url":null,"abstract":"Introduction: Delayed enteral nutrition is associated with a higher risk for adverse outcomes in extremely preterm infants. Limited evidence exists on therapeutic options to support meconium evacuation and increase gastrointestinal motility. The aim of this study was to determine the effect of macrogol on feeding tolerance and microbiome establishment in preterm infants <27 weeks of gestation.Methods: We investigated the impact of early macrogol administration in two observational cohort studies: the multi-center German-Neonatal-Network (GNN) study comparing extremely preterm infants born in neonatal intensive care units (NICUs) using macrogol in the first week of life in >30% of their infants as compared to the remaining units, and the single-center Immunoregulation-of-the-Newborn (IRoN) study including gut microbiome assessment of infants born before and after implementation of macrogol use in this NICU.Results: In the GNN study cohort including 4,290 infants, advancement to full enteral feedings was significantly faster in macrogol-using NICUs compared to the remaining NICUs (median/IQR: 14/12 vs. 16/14 days, p = 0.001). Risk for short-term outcomes such as sepsis or abdominal complications was not elevated in units with regular use of macrogol. In the IRoN cohort (n = 68), macrogol treated infants had a shorter time to reach full enteral feeding (median/IQR: macrogol 12/6, control 16/6 days, p = 0.004). Higher Bifidobacterium longum abundance in the gut microbiome correlated with acceleration to full enteral nutrition.Conclusion: Our observational data suggests that early off-label use of macrogol may support feeding advancement in highly vulnerable babies. These data provide a basis for a randomized controlled trial.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124234","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}

引用次数: 0

Validation of a New Classification for Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants: Insights from a Large Japanese Cohort.

Neonatology Pub Date : 2025-01-27 DOI: 10.1159/000543810

Hidehiko Nakanishi, Masato Ito, Shin Kato, Makoto Saito, Naoyuki Miyahara, Hirokazu Arai, Erika Ota, Fumihiko Namba

{"title":"Validation of a New Classification for Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants: Insights from a Large Japanese Cohort.","authors":"Hidehiko Nakanishi, Masato Ito, Shin Kato, Makoto Saito, Naoyuki Miyahara, Hirokazu Arai, Erika Ota, Fumihiko Namba","doi":"10.1159/000543810","DOIUrl":"10.1159/000543810","url":null,"abstract":"Introduction: A recent scoping review identified histological chorioamnionitis (HCA), small for gestational age (SGA), and bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as risk factors for severe bronchopulmonary dysplasia (BPD). To further validate these results, a large-scale database was analyzed.Methods: This retrospective multicenter cohort study included infants born at <28 weeks' gestational age between 2003 and 2016. The validated risk factors identified from the scoping review were analyzed for independent associations with severe BPD using multivariable logistic regression. Additionally, the association of these factors with long-term outcomes at 3 years, including home oxygen therapy (HOT) and neurodevelopmental impairments (NDIs), was analyzed.Results: Among 15,834 extremely preterm infants, HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were significantly and independently associated with severe BPD (adjusted odds ratio, 1.20; 95% confidence interval, 1.06-1.36) (1.73; 1.51-1.98) (1.79; 1.60-2.01), respectively. These three factors were also linked to HOT at 3 years (1.54; 1.14-2.08) (1.70; 1.21-2.39) (2.63; 1.94-3.56), respectively. Their combination significantly increased the prevalence of severe BPD and HOT at 3 years, particularly with bubbly/cystic CXR. Only SGA was independently associated with NDIs in BPD infants (1.55; 1.32-1.83).Conclusions: HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were identified as important risk factors for severe BPD and long-term respiratory outcomes. While further research is needed to validate their role in endotype-specific classification of BPD, these findings may contribute to early prognostic strategies and targeted interventions before 36 weeks' postmenstrual age.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054711","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}

引用次数: 0

Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.

Neonatology Pub Date : 2025-01-22 DOI: 10.1159/000543605

Ekaterina Dianova, Nara S Higano, Kera M McNelis, Shelley R Ehrlich, Chunyan Liu, Jason C Woods, Paul S Kingma

{"title":"Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.","authors":"Ekaterina Dianova, Nara S Higano, Kera M McNelis, Shelley R Ehrlich, Chunyan Liu, Jason C Woods, Paul S Kingma","doi":"10.1159/000543605","DOIUrl":"10.1159/000543605","url":null,"abstract":"Introduction: Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates.Methods: In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed.Results: The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p < 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p < 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04).Conclusion: Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026061","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}

引用次数: 0

Association between Early Postnatal Hydrocortisone and Retinopathy of Prematurity in Extremely Preterm Infants. 产后早期氢化可的松与极早产儿视网膜病变的关系。

Neonatology Pub Date : 2025-01-21 DOI: 10.1159/000543659

Mariya Petrishka-Lozenska, Aldina Pivodic, Anders Flisberg, Ingrid Hansen-Pupp, Lois E H Smith, Pia Lundgren, Ann Hellström

{"title":"Association between Early Postnatal Hydrocortisone and Retinopathy of Prematurity in Extremely Preterm Infants.","authors":"Mariya Petrishka-Lozenska, Aldina Pivodic, Anders Flisberg, Ingrid Hansen-Pupp, Lois E H Smith, Pia Lundgren, Ann Hellström","doi":"10.1159/000543659","DOIUrl":"10.1159/000543659","url":null,"abstract":"Introduction: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness. We investigated the association of early postnatal low-dose intravenous hydrocortisone used for the prevention of bronchopulmonary dysplasia (BPD) with ROP outcome among extremely preterm infants in a Swedish cohort.Methods: This retrospective cohort study included extremely preterm infants born before 28 weeks of gestational age (GA). Infants born September 2020-August 2022, treated with low-dose intravenous hydrocortisone for prevention of BPD, were compared to untreated controls born September 2016-August 2020. Hydrocortisone was administered postnatally with a dose of 0.5 mg/kg twice daily for 7 days, followed by 0.5 mg/kg per day for 3 days. Logistic regression, adjusted for GA, birth weight (BW), sex, and parenteral nutrition, was used in the primary analysis. For robustness, we performed 1:1 propensity score (PS) matching followed by logistic regression.Results: Of 245 preterm infants included, 65 were treated with low-dose hydrocortisone and 180 were untreated controls. Incidence of ROP treatment was reduced in the hydrocortisone group 18.5% (12/65) versus controls 32.2% (58/180), p = 0.038. One-to-one PS matching (n = 62 + 62) confirmed the reduced incidence of ROP treatment in the hydrocortisone-treated infants (odds ratio [OR]: 0.38, 95% confidence interval [95% CI]: 0.16-0.88, p = 0.025). After adjusting for GA, BW, sex, and parenteral nutrition ≥14 days, the reduced risk of ROP treatment after early hydrocortisone treatment persisted (OR: 0.31, 95% CI: 0.16-0.60, p = 0.0005).Conclusion: Early postnatal low-dose intravenous hydrocortisone used to prevent BPD may reduce the risk of ROP treatment among extremely preterm infants.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019200","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}

引用次数: 0

A New Tool to Assess Patient-Ventilator Synchrony in Preterm Infants Receiving Non-Invasive Ventilation: A Randomized Crossover Pilot Study. 评估接受无创通气的早产儿患者-呼吸机同步性的新工具：一项随机交叉先导研究。

Neonatology Pub Date : 2025-01-21 DOI: 10.1159/000543413

Francesco Cresi, Elena Maggiora, Carlotta Rubino, Mattia Ferroglio, Elena Ruzzante, Enrico Piga, Isaac Giraudo, Marco Limone, Gianluca Terrin, Alessandra Coscia

{"title":"A New Tool to Assess Patient-Ventilator Synchrony in Preterm Infants Receiving Non-Invasive Ventilation: A Randomized Crossover Pilot Study.","authors":"Francesco Cresi, Elena Maggiora, Carlotta Rubino, Mattia Ferroglio, Elena Ruzzante, Enrico Piga, Isaac Giraudo, Marco Limone, Gianluca Terrin, Alessandra Coscia","doi":"10.1159/000543413","DOIUrl":"10.1159/000543413","url":null,"abstract":"Introduction: Nasal synchronized intermittent positive pressure ventilation (nSIPPV) is an effective non-invasive ventilation technique, especially for preterm infants. Patient-ventilator synchrony is essential for providing effective respiratory support; however, no automated system is currently available for monitoring this parameter. A new tool for automatic assessment of patient-ventilator synchrony, the SyncNIV system, was developed and applied in this pilot study to evaluate differences between nSIPPV and non-synchronized nasal intermittent positive pressure ventilation (nIPPV) in preterm infants with respiratory distress.Methods: This study involved designing a custom algorithm for signal analysis. Data were collected through a polygraph that could simultaneously gather respiratory data from the patients and the ventilator. Patient-ventilator synchrony was evaluated by applying the SyncNIV system in a randomized crossover study designed to compare nSIPPV and nIPPV. The primary outcome was the mean instant Synchrony Index (i-SI), defined as the portion of the inspiration effort sustained by ventilator inflation, expressed as a percentage.Results: Fourteen infants with a median (IQR) gestational age of 28.6 (25.6-30.3) were enrolled. We analyzed 43,304 ventilator inflations and 50,221 patient breaths. The i-SI was 54.69% (44.49-60.09) in nSIPPV and 39.54% (33.40-48.75) in nIPPV, p < 0.05.Conclusion: The SyncNIV system confirmed better i-SI during nSIPPV than during nIPPV, demonstrating its effectiveness in assessing the differences between these two modes of non-invasive ventilation in preterm infants. The SyncNIV system could be a useful tool for optimizing the ventilation parameters and improving the effectiveness and comfort of respiratory support systems.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019197","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}

引用次数: 0

The Prevalence of Neonatal Hypoglycemia in Twins versus Singletons following Exposure to Antenatal Steroid Therapy Is Comparable: A Retrospective Study in a Single Center.

Neonatology Pub Date : 2025-01-06 DOI: 10.1159/000542266

Rakefet Yoeli-Ullman, Roni Zemet, Keren Zloto, Arik Toren, Heli Alexandroni, Irit Schushan Eisen, Shalom Mazaki-Tovi

{"title":"The Prevalence of Neonatal Hypoglycemia in Twins versus Singletons following Exposure to Antenatal Steroid Therapy Is Comparable: A Retrospective Study in a Single Center.","authors":"Rakefet Yoeli-Ullman, Roni Zemet, Keren Zloto, Arik Toren, Heli Alexandroni, Irit Schushan Eisen, Shalom Mazaki-Tovi","doi":"10.1159/000542266","DOIUrl":"https://doi.org/10.1159/000542266","url":null,"abstract":"Introduction: Antenatal corticosteroids (ACS) administration before anticipated preterm birth is one of the most important interventions available to improve neonatal outcomes. Nevertheless, this treatment is associated with an increased risk of neonatal hypoglycemia. The aim of this study was to determine whether preterm twins who receive ACS are at increased risk for developing neonatal hypoglycemia.Methods: This was a retrospective cohort study of indicated and spontaneous preterm births of twins at a single center between 2011 and 2018. The study population included 3 groups matched for gestational age at delivery and birth weight: (1) Twin neonates who received a course of ACS 1-7 days before birth (n = 532); (2) twins who did not receive ACS at that time interval (n = 532); and (3) singletons receiving ACS 1-7 days before birth (n = 266). The primary outcome was neonatal hypoglycemia (<40 mg/dL/2.2 mmol/L) within the first 24 h and 48 h of life.Results: The rate of neonatal hypoglycemia during the first 24 h of life was significantly higher in singletons exposed to ACS compared to twins not exposed to ACS (p = 0.019) and in twins exposed to ACS compared to twins not exposed to ACS (p = 0.047). The rate of neonatal hypoglycemia was almost identical between twins and singletons exposed to ACS (p = 0.72). Regression analysis revealed that exposure to ACS and birth weight were independently associated with neonatal hypoglycemia after adjustment for maternal age, body mass index, gravidity, gestational diabetes mellitus, and gestational age at delivery.Conclusion: Exposure to ACS, rather than plurality, is associated with short-lived neonatal hypoglycemia.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384580","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}

引用次数: 0

Third-Trimester Development of Central Autonomic Network Connectivity Is Altered in an Extrauterine Environment. 孕晚期中枢自主神经网络连通性的发展在子宫外环境中发生改变。

Neonatology Pub Date : 2025-01-02 DOI: 10.1159/000543277

Kelsey Christoffel, Josepheen De Asis Cruz, Kevin Michael Cook, Kushal Kapse, Nickie Andescavage, Sudeepta Basu, Catherine Limperopoulos, Adre du Plessis

{"title":"Third-Trimester Development of Central Autonomic Network Connectivity Is Altered in an Extrauterine Environment.","authors":"Kelsey Christoffel, Josepheen De Asis Cruz, Kevin Michael Cook, Kushal Kapse, Nickie Andescavage, Sudeepta Basu, Catherine Limperopoulos, Adre du Plessis","doi":"10.1159/000543277","DOIUrl":"10.1159/000543277","url":null,"abstract":"Introduction: The central autonomic network (CAN), which involves complex interconnected brain regions that modulate the autonomic nervous system, may be key to understanding higher risk for psychosocial and behavioral challenges in preterm neonates.Methods: We compared resting-state functional connectivity of the CAN in 94 healthy term-born controls and 94 preterm infants at term-equivalent age. In preterm infants, we correlated CAN connectivity with postmenstrual age (PMA). The preterm cohort underwent the Infant-Toddler Social and Emotional Assessment at 18-month follow-up, and these scores were correlated with CAN connectivity.Results: CAN connectivity at the amygdala (p < 0.001), hippocampus (p < 0.001), insula (p < 0.001), brainstem (p = 0.003), and thalamus (p = 0.032) was significantly higher in term (n = 94) than preterm (n = 94) neonates. In preterm neonates, CAN connectivity positively correlated with PMA at the thalamus (r = 0.438, p < 0.001), insula (r = 0.304, p < 0.001), precuneus (r = 0.288, p < 0.001), hippocampus (r = 0.283, p < 0.001), and amygdala (r = 0.142, p = 0.034). At 18-month follow-up (n = 30, mean age 19.8 ± 3.4 months), CAN connectivity at the insula was negatively correlated with externalizing behaviors (r = -0.529, p = 0.003).Conclusion: In preterm neonates, the CAN evolves dynamically over the extrauterine third trimester and is measurably different compared to term-born neonates in ways that impact developmental outcomes. This is the first study to describe CAN connectivity using resting-state functional MRI in large cohort of term and preterm neonates and to report an association of CAN connectivity and behavioral outcomes.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923309","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}

引用次数: 0

Association between Enteral Protein Intake and Fat-Free Mass Accretion in Very Preterm Infants. 早产儿肠内蛋白质摄入与无脂肪堆积之间的关系。

Neonatology Pub Date : 2025-01-02 DOI: 10.1159/000543326

Maggie Jerome, Emily Gunawan, Natalia Aristizabal, Paula Chandler-Laney, Ariel A Salas

{"title":"Association between Enteral Protein Intake and Fat-Free Mass Accretion in Very Preterm Infants.","authors":"Maggie Jerome, Emily Gunawan, Natalia Aristizabal, Paula Chandler-Laney, Ariel A Salas","doi":"10.1159/000543326","DOIUrl":"10.1159/000543326","url":null,"abstract":"Introduction: For preterm infants, the first 2 weeks after birth are a time when nutrition and protein intake is variable and often falls below recommended intakes. Our objective was to investigate the relationship between protein intake, including source of protein, during the first 2 weeks after birth and fat-free mass (FFM) accretion in a group of very preterm infants.Methods: In this observational cohort study, body composition was assessed using air displacement plethysmography in eligible infants <32 weeks gestational age at 2 weeks after birth and prior to discharge. FFM accretion was calculated as difference between the two measurements. We collected daily nutrition data for the first 2 weeks. Multivariable linear regression was used to assess the relationship between protein intake and body composition and weight gain.Results: Seventy-eight infants were included (mean birthweight: 1,408±278 g). Mean cumulative protein intake of this cohort in the first 2 weeks was 2.4±0.8 g/kg/day of which 74±19% was enteral (1.7±0.6 g/kg/day). Enteral protein intake was associated with higher FFM while parenteral protein was associated with lower FFM. Total protein intake from both sources during the first 2 weeks after birth was positively associated with greater weight gain.Conclusion: Enteral protein intake during the first 2 weeks after birth is associated with higher FFM and weight in preterm infants. Future interventional studies should investigate the effects of higher enteral protein intake during the first 2 weeks after birth on growth and body composition.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924406","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}

引用次数: 0