Neonatology最新文献_第3页

Early Postnatal Weight Loss: Is It a Problem? 产后早期体重减轻——这是个问题吗？

Neonatology Pub Date : 2025-03-28 DOI: 10.1159/000545565

William W Hay

引用次数: 0

Feeding Dynamics in Very Preterm Infants with Delayed Oral Feeding Attainment. 口腔喂养延迟的极早产儿的喂养动态。

Neonatology Pub Date : 2025-03-15 DOI: 10.1159/000543833

Samuel J Gentle, Vivek V Shukla, Abigail Cooley, Namasivayam Ambalavanan, Waldemar A Carlo, Sarah N Taylor, Ariel A Salas

引用次数: 0

MicroRNA Signatures in Umbilical Cord Blood of Neonates Exposed to Maternal SARS-CoV-2 Infection during Pregnancy. 妊娠期间暴露于母体SARS-CoV-2感染的新生儿脐带血中的MicroRNA特征

Neonatology Pub Date : 2025-03-14 DOI: 10.1159/000544972

Ira Winkler, Christina Fröschl, Christoph Hochmayr, Eva Huber, Martina Urbanek, Ursula Kiechl-Kohlendorfer, Elke Griesmaier, Anna Posod

{"title":"MicroRNA Signatures in Umbilical Cord Blood of Neonates Exposed to Maternal SARS-CoV-2 Infection during Pregnancy.","authors":"Ira Winkler, Christina Fröschl, Christoph Hochmayr, Eva Huber, Martina Urbanek, Ursula Kiechl-Kohlendorfer, Elke Griesmaier, Anna Posod","doi":"10.1159/000544972","DOIUrl":"10.1159/000544972","url":null,"abstract":"Introduction: Pregnant women are particularly susceptible to SARS-CoV-2 infection, which can provoke placental inflammation, potentially causing malperfusion and adverse pregnancy outcomes. The fetal immune system may respond to maternal infection, even without direct viral transmission. However, the molecular mechanisms driving these responses are not well understood. This study aimed to examine changes in microRNA (miRNA) expression in umbilical cord blood from neonates of mothers infected with SARS-CoV-2 during pregnancy.Methods: We conducted a retrospective analysis of prospectively enrolled subjects at Innsbruck University Hospital, Austria. Umbilical cord blood was collected from 58 neonates of mothers infected with SARS-CoV-2 during pregnancy (either antepartum or peripartum) born in 2020-2023 and compared with 41 healthy controls born in 2017-2018. Total RNA was extracted, followed by miRNA next-generation sequencing and differential gene expression analysis. Ingenuity pathway analysis (IPA) was used to explore potential miRNA-target interactions.Results: Differential gene expression analysis identified 14 upregulated and 36 downregulated miRNAs in the cord blood of neonates from SARS-CoV-2-infected mothers compared to controls. IPA revealed enrichment in inflammatory pathways, particularly involving cytokines such as interleukin (IL)-6 and IL-10. No significant differences in miRNA expression were observed between neonates exposed antepartum versus peripartum.Conclusion: Maternal SARS-CoV-2 infection during pregnancy is linked to altered miRNA expression in neonates' umbilical cord blood, potentially influencing inflammatory pathways. These findings shed light on the molecular mechanisms of fetal responses to maternal SARS-CoV-2 infection.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639945","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

Early Postnatal Weight Loss and Its Association with Outcomes in Very Preterm Neonates: A Systematic Review and Meta-Analysis. 产后早期体重减轻及其与极早产儿结局的关系：一项系统回顾和荟萃分析。

Neonatology Pub Date : 2025-03-06 DOI: 10.1159/000545106

Sreeja Kothapally, Chandra Rath, Bhanu B Gowda, Jay Sharma, Sanjay K Patole, Shripada Rao

{"title":"Early Postnatal Weight Loss and Its Association with Outcomes in Very Preterm Neonates: A Systematic Review and Meta-Analysis.","authors":"Sreeja Kothapally, Chandra Rath, Bhanu B Gowda, Jay Sharma, Sanjay K Patole, Shripada Rao","doi":"10.1159/000545106","DOIUrl":"10.1159/000545106","url":null,"abstract":"Introduction: Ideal early postnatal weight loss (PWL) and its association with mortality and morbidity in preterm infants are not well known. This review explored the association between early PWL and outcomes in very premature infants (<32 weeks).Methods: This is a systematic review and meta-analyses of the observational studies. PubMed, Medline, EMBASE, Cochrane Library, EMCARE, and MedNar databases were searched in April 2024. Outcomes of interest were mortality and morbidities such as intraventricular haemorrhage (IVH), chronic lung disease (CLD), patent ductus arteriosus, necrotising enterocolitis (NEC), retinopathy of prematurity, and long-term neurodevelopmental outcomes. Data were pooled separately for adjusted and unadjusted odds ratios (ORs) using random-effects model. Separate analyses were conducted for case-control and cohort studies. Data were pooled separately for the excess weight loss (EWL) group (>15% from birth weight) and inadequate weight loss (IWL) group (<5% from birth weight).Results: Eighteen studies (25,158 infants) were included. Pooling of adjusted ORs in EWL group from cohort studies found significant association with mortality (OR 1.39 confidence interval [CI; 1.10-1.75]), severe IVH (OR 1.37 CI [1.18-1.59]), NEC (OR 2.05 CI [1.05-4.03]), and \"Mortality or IVH\" (OR 1.40 CI [1.10-1.78]). Pooling adjusted ORs from case-control studies showed a significant association between EWL and CLD and between IWL and mortality or CLD. Certainty of evidence was \"Low\" or \"Very-low.\"Conclusion: EWL or IWL in very preterm infants may be associated with higher odds of mortality and morbidity. However, cofactors of severity of associated disease, insufficient nutrition, and treatments could not be assessed.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575067","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}

引用次数: 0

Deep-Learning-Based Multi-Class Classification for Neonatal Respiratory Diseases on Chest Radiographs in Neonatal Intensive Care Units. 新生儿重症监护病房胸片上基于深度学习的新生儿呼吸系统疾病多类别分类

Neonatology Pub Date : 2025-03-06 DOI: 10.1159/000545107

Hye Won Cho, Sumin Jung, Kyu Hee Park, Jin Wha Choi, Ju Sun Heo, Jaeyoung Kim, Heerim Yun, Donghoon Yu, Jinho Son, Byung Min Choi

{"title":"Deep-Learning-Based Multi-Class Classification for Neonatal Respiratory Diseases on Chest Radiographs in Neonatal Intensive Care Units.","authors":"Hye Won Cho, Sumin Jung, Kyu Hee Park, Jin Wha Choi, Ju Sun Heo, Jaeyoung Kim, Heerim Yun, Donghoon Yu, Jinho Son, Byung Min Choi","doi":"10.1159/000545107","DOIUrl":"10.1159/000545107","url":null,"abstract":"Introduction: Accurate and timely interpretation of chest radiographs is essential for assessing respiratory distress and guiding clinical management to improve outcomes of critically ill newborns. This study aimed to introduce a deep-learning-based automated algorithm designed to classify various neonatal respiratory diseases and healthy lungs using a large dataset of high-quality, multi-class labeled chest X-ray images from neonatal intensive care units.Methods: Portable supine chest X-ray images for six common conditions (healthy lung, respiratory distress syndrome [RDS], transient tachypnea of the newborn [TTN], air leak syndrome [ALS], atelectasis, and bronchopulmonary dysplasia [BPD]) and demographic variables (gestational age and birth weight) were retrospectively collected from 10 university hospitals in Korea. Ground truth for manual classification of these conditions was generated by 20 neonatologists and validated by others from different hospitals. The dataset, consisting 34,598 for training, 4,370 for validation, and 4,370 for testing, was used to train a modified ResNet50-based deep-learning model for automatic classification.Results: The automatic classification algorithm showed high concordance with human-annotated classifications, achieving an overall testing accuracy of 83.96% and an F1 score of 83.68%. The F1 score for each condition was 87.38% for \"healthy lung\" and 92.19% for \"BPD,\" 90.65% for \"ALS,\" 90.30% for \"RDS,\" 86.56% for \"atelectasis,\" and 70.84% for \"TTN.\"Conclusion: We introduced a deep-learning-based automated algorithm to classify neonatal respiratory diseases using a large dataset of high-quality, multi-class labeled chest X-ray images, incorporating non-imaging data, which could support neonatologists in making timely and accurate decisions for critically ill newborns.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575064","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

Inhaled Nitric Oxide for Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Systematic Review and Narrative Synthesis. 吸入一氧化氮治疗支气管肺发育不良相关肺动脉高压：系统综述和叙事综合。

Neonatology Pub Date : 2025-03-03 DOI: 10.1159/000545034

Hiroki Kitaoka, Ryota Kobayashi, Kosuke Tanaka, Masahiko Watanabe, Tetsuya Isayama

{"title":"Inhaled Nitric Oxide for Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Systematic Review and Narrative Synthesis.","authors":"Hiroki Kitaoka, Ryota Kobayashi, Kosuke Tanaka, Masahiko Watanabe, Tetsuya Isayama","doi":"10.1159/000545034","DOIUrl":"10.1159/000545034","url":null,"abstract":"Introduction: Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator. However, its effectiveness in the treatment of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) and severe BPD remains uncertain. Here we systematically reviewed whether iNO treatment increased or decreased mortality and morbidity among preterm infants with severe BPD or BPD-PH.Methods: We systematically searched the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane CENTRAL, and ICHUSHI databases for randomized and non-randomized studies that compared the effects of iNO in patients with severe BPD or BPD-PH. The primary outcome was mortality. Two authors independently screened the articles and extracted the data. A meta-analysis and certainty of evidence assessment using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation criteria were planned.Results: Among the 1,710 articles, none had a relevant control group and no studies met the eligibility criteria. Using a post hoc analysis, we summarized the ineligible studies that evaluated patients with severe BPD or BPD-PH who received iNO therapy. Although some studies included in the narrative review indicated a decreased pulmonary arterial pressure in patients with severe BPD or BPD-PH at the initiation of iNO therapy, none included a comparator group.Conclusion: Despite the use of iNO in patients with severe BPD and BPD-PH, no published studies compared the outcomes among patients with BPD treated with versus without iNO. Although some studies without comparator groups reported the effectiveness of iNO in patients with severe BPD and BPD-PH, our results suggest that iNO therapy should be initiated with caution and careful consideration of the target population.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545482","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. 极早产儿胼胝体脾的微观结构成熟与认知和运动结果。

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":"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 5 years chronological age. Correlation was tested by Spearman's rank 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 5 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":"1-12"},"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

Diagnostic Utility of Preserved Dried Umbilical Cord Polymerase Chain Reaction in Intrauterine Herpes Simplex Virus Infection: A Case Report and Literature Review. 保存的干脐带聚合酶链反应在宫内单纯疱疹病毒感染中的诊断作用：病例报告与文献综述

Neonatology Pub Date : 2025-01-01 Epub Date: 2024-08-13 DOI: 10.1159/000540506

Yasumasa Tsuda, Takeshi Matsushige, Hirofumi Inoue, Madoka Hoshide, Hiroki Hamano, Keiko Hasegawa, Masako Moriuchi, Hiroyuki Moriuchi, Shunji Hasegawa

{"title":"Diagnostic Utility of Preserved Dried Umbilical Cord Polymerase Chain Reaction in Intrauterine Herpes Simplex Virus Infection: A Case Report and Literature Review.","authors":"Yasumasa Tsuda, Takeshi Matsushige, Hirofumi Inoue, Madoka Hoshide, Hiroki Hamano, Keiko Hasegawa, Masako Moriuchi, Hiroyuki Moriuchi, Shunji Hasegawa","doi":"10.1159/000540506","DOIUrl":"10.1159/000540506","url":null,"abstract":"Introduction: Intrauterine herpes simplex virus (HSV) infection is uncommon and challenging to diagnose, requiring detection of HSV in skin lesions within 48 h post-birth.Case presentation: A preterm female infant presented with the typical triad of blisters, microcephaly, and chorioretinitis, but the initial diagnostic approach was elusive due to negative results for TORCH pathogens from vesicles/serum. Referred at 7 months for developmental delay and epilepsy, her brain imaging showed calcification and cortical dysplasia. Polymerase chain reaction (PCR) of her preserved dried umbilical cord detected HSV-2 DNA, diagnosing intrauterine HSV infection. HSV-2 was later found in relapsed blisters at 8 months but not in cerebrospinal fluid or brain tissue. A literature review identified 104 congenital/intrauterine HSV cases; 28.8% presented the typical triad, and 50% were diagnosed using specimens collected 48 h post-birth.Conclusion: This case marks the first retrospective diagnosis of intrauterine HSV infection via PCR on preserved umbilical cord, underscoring its diagnostic value.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977592","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

Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Umbilical Venous Catheter Placement in Neonates: A Retrospective, Observational Study. 在新生儿脐静脉导管置入过程中，实时超声波尖端定位可减少错位和辐射暴露：一项回顾性观察研究。

Neonatology Pub Date : 2025-01-01 Epub Date: 2024-06-21 DOI: 10.1159/000538905

Vito D'Andrea, Giorgia Prontera, Francesco Cota, Alessandro Perri, Rosellina Russo, Giovanni Barone, Giovanni Vento

{"title":"Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Umbilical Venous Catheter Placement in Neonates: A Retrospective, Observational Study.","authors":"Vito D'Andrea, Giorgia Prontera, Francesco Cota, Alessandro Perri, Rosellina Russo, Giovanni Barone, Giovanni Vento","doi":"10.1159/000538905","DOIUrl":"10.1159/000538905","url":null,"abstract":"Introduction: The umbilical venous catheter is a vital access device in neonatal intensive care units for preterm and critically ill infants. Correct positioning is crucial, as malpositioning can lead to severe complications. According to international guidelines, the position of the umbilical venous catheter tip must be assessed in real time; traditionally, the catheter is visualized with a thoracoabdominal X-ray, but one of the most effective and safest methods is therefore real-time ultrasound.Methods: This study compares real-time ultrasound and traditional X-ray methods for assessing umbilical venous catheter tip location in 461 cases. The rate of tip malposition was analyzed retrospectively. The secondary aim was to assess indwelling time of umbilical venous catheters and reasons of removal.Results: Real-time ultrasound tip location, found to be more reliable and efficient, demonstrated a significantly lower incidence of primary malpositioning compared to X-ray assessments (9.6 vs. 75.9%). The study also highlighted the association of real-time ultrasound with reduced catheter manipulation, fewer radiographs, and higher indwelling times of umbilical venous catheter. The multiple logistic regression showed a high probability of the central safe position of the umbilical venous catheter tip using real-time ultrasound tip location (odds ratio 29.5, 95% confidence interval: 17.4-49.4).Conclusion: The findings support the adoption of real-time ultrasound in clinical settings to enhance umbilical venous catheter placement accuracy and minimize associated risks. A minimal training investment is needed to attain the proficiency to visualize the umbilical venous catheters, offering a substantial advantage in terms of both cost-effectiveness for the procedure and enhanced patient safety.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461447","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

Response to Härtel et al.: "Less Invasive Surfactant Administration for Preterm Infants - State of the Art". 对 Härtel 等人 "早产儿的微创表面活性剂给药--技术现状 "的回应。

Neonatology Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1159/000542538

Christian A Maiwald, Christian F Poets, Axel R Franz

引用次数: 0