Seminars in Fetal and Neonatal Medicine This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Recovery of the Brain after Intraventricular Hemorrhage
Intraventricular hemorrhage (IVH) remains a major complication of prematurity, worldwide. The severity of IVH is variable, ranging from a tiny germinal matrix bleed to a moderate-to-large ventricular hemorrhage or periventricular hemorrhagic infarction. Survivors with IVH often suffer from hydrocephalus and white matter injury. There is no tangible treatment to prevent post-hemorrhagic cerebral palsy, cognitive deficits, or hydrocephalus in these infants. White matter injury is attributed to blood-induced damage to axons and maturing oligodendrocyte precursors, resulting in reduced myelination and axonal loss. (Source: Sem...
Source: Seminars in Fetal and Neonatal Medicine - February 26, 2021 Category: Perinatology & Neonatology Authors: Bokun Cheng, Praveen Ballabh Source Type: research

Tissue Engineering: Relevance to Neonatal Congenital Heart Disease
Congenital heart disease (CHD) represents a large clinical burden, representing the most common cause of birth defect-related death in the newborn. The mainstay of treatment for CHD remains palliative surgery using prosthetic vascular grafts and valves. These devices have limited effectiveness in pediatric patients due to thrombosis, infection, limited endothelialization, and a lack of growth potential. Tissue engineering has shown promise in providing new solutions for pediatric CHD patients through the development of tissue engineered vascular grafts, heart patches, and heart valves. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 26, 2021 Category: Perinatology & Neonatology Authors: Kevin M. Blum, Gabriel Mirhaidari, Christopher K. Breuer Source Type: research

BPD treatments: The never-ending smorgasbord
Despite important advances in neonatal care, rates of bronchopulmonary dysplasia (BPD) have remained persistently high. Numerous drugs and ventilator strategies are used for the prevention and treatment of BPD. Some, such as exogenous surfactant, volume targeted ventilation, caffeine, and non-invasive respiratory support, are associated with modest but important reductions in rates of BPD and long-term respiratory morbidities. Many other therapies, such as corticosteroids, diuretics, nitric oxide, bronchodilators and anti-reflux medications, are widely used despite conflicting, limited or no evidence of efficacy and safety...
Source: Seminars in Fetal and Neonatal Medicine - February 25, 2021 Category: Perinatology & Neonatology Authors: Amir M. Zayegh, Peter G. Davis Source Type: research

Can we back off using antibiotics in the NICU?
Antibiotics are extensively and inconsistently prescribed in neonatal ICUs, and usage does not correlate with rates of culture positive sepsis. There is mounting data describing the short and long-term adverse effects associated with antibiotic overuse in neonates, including the increased burden of multi-drug resistant organisms. Currently there is considerable variation in antibiotic prescribing practice among neonatologists. Applying the practice of antibiotic stewardship in the NICU is crucial for standardizing antibiotic use and improving outcomes in this population. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Noa Fleiss, Thomas A. Hooven, Richard A. Polin Source Type: research

The implications of routine milk fortification for the short and long-term health of preterm babies
Fortification refers to the practice of enriching human milk feeds for very preterm babies with macronutrients, minerals and vitamins. Though standard of care in some parts of the world, adoption of fortification is not universal. Fortification entered into use on the assumption that human milk macronutrient content, principally protein, is insufficient to support the growth and development of very preterm babies. However, because of the substantial variability in human milk composition, routine fortification risks exposing some babies to very high protein intakes, which may be dangerous. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Neena Modi Source Type: research

Escaping the Finnegan – Is It Time?
Neonatal Abstinence Syndrome (NAS) has significantly increased worldwide secondary to a marked increase in the incidence of opioid use disorders (OUD) in women of childbearing age. Since first described in 1975, the Finnegan Neonatal Abstinence Scoring Tool (FNAST) remains the mainstay of monitoring NAS severity and its clinical management. The complexity of the tool (21 independent variables), the need for external validation, excessive subjectivity, poor inter-rater reliability, and uncertainty regarding the clinical relevance of some items has resulted in the need to develop an alternate scoring tool. (Source: Seminars ...
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Rachana Singh, Jonathan M. Davis Source Type: research

Patent Ductus Arteriosus management and the drift towards therapeutic nihilism – what is the evidence?
The published literature on patent ductus arteriosus (PDA) management is challenging to interpret due to poorly designed trials with high rates of open label treatments, homogenisation of patients with varying physiological subtypes, poor treatment efficacy, and spontaneous closure in more mature infants. The perceived lack of clinical benefit has led to a drift away from medical and surgical treatment of all infants with a PDA. This therapeutic nihilism as a default response to PDA management fails to recognise the physiological relevance of a left-to-right shunt with early haemodynamic instability after birth and subsequ...
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Koert de Waal, Rahul Prasad, Martin Kluckow Source Type: research

Oxygen saturation (SpO2) targeting for newborn infants at delivery: Are we reaching for an impossible unknown?
For more than 200 years, pure oxygen was given ad libitum to newborn infants requiring resuscitation. Due to oxidative stress and injury concerns, a paradigm shift towards using “less” oxygen, including air (21% oxygen) instead of pure oxygen, occurred about twenty years ago. A decade later, clinicians were advised to adjust fractional inspired oxygen (FiO2) to target oxygen saturations (SpO2) that were derived from spontaneously breathing, healthy, mature infants. Whet her these recommendations are achievable, beneficial, harmful or redundant is uncertain. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Sasi Bhushan GOTTIMUKKALA, James Xavier SOTIROPOULOS, Sheila LORENZO-POZO, Abhineet Monti SHARMA, Maximo VENTO, Ola Didrik SAUGSTAD, Ju Lee OEI Source Type: research

Delayed cord clamping in healthy term infants: more harm or good?
It is recommended to delay cord clamping in healthy term infants for at least 60- and 180-seconds in high- and limited-resource environments, as delayed cord clamping lowers the incidence of anemia and iron deficiency and improves neurodevelopment. There are improvements in hemodynamic parameters such as peripheral arterial oxygen saturation, heart rate, cardiac output, and cerebral oxygenation. Historically, delayed cord clamping caused a higher rate of hyperbilirubinemia and phototherapy, but more recent evidence suggests this may no longer be the case. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Marlies Bruckner, Anup Katheria, Georg M. Schm ölzer Source Type: research

Hemodynamic support of the micropreemie: should hydrocortisone never be left out?
Hemodynamic support for a micropreemie is critically important for preventing mortality and morbidity. An essential consideration in hemodynamic support is insufficient transition from fetal to neonatal circulation and inadequate cortisol production. The first 72 hours of life are the most critical, especially when myocardial function is immature and impaired. Therefore, there is a need to determine and adjust preload, myocardial contractility, and afterload appropriately using repeated functional echocardiography. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 24, 2021 Category: Perinatology & Neonatology Authors: Kenichi Masumoto, Satoshi Kusuda Source Type: research

Low blood sugar levels in the newborn infant: do changing goal posts matter?
Glucose supply and metabolism are essential for growth and normal brain development in both the fetus and newborn. Disorders of glucose availability and metabolism can result in either hypoglycemia or hyperglycemia. The first section of this manuscript will contrast recommendations from the American Academy of Pediatrics and the Pediatric Endocrine Society on the approach to defining neonatal hypoglycemia. Recent studies will be reviewed which add to the controversy. This review aims to discuss the evidence-based guidelines, definitions, pathogenesis, outcomes and management options in this field. (Source: Seminars in Feta...
Source: Seminars in Fetal and Neonatal Medicine - February 13, 2021 Category: Perinatology & Neonatology Authors: David H. Adamkin Source Type: research

Harnessing Mobile Technology to Deliver Evidence-Based Maternal-Infant Care
mHealth, the use of wireless and portable communication technology to improve the health status of the population, has seen widespread adoption in low- and middle-income countries. It has been used to increase awareness and knowledge of healthcare, to collect health-related data, to deliver healthcare information such as results of investigations or appointment reminders, to aid decision-making by healthcare providers, and to improve communication between various stakeholders of the health system. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 12, 2021 Category: Perinatology & Neonatology Authors: Deepak Chawla, Anu Thukral, Praveen Kumar, Ashok Deorari Source Type: research

Quality Improvement for NICU Graduates: Feasible, Relevant, Impactful
Continuous quality improvement (CQI) has become a vital component of newborn medicine. Applying core principles – robust measurement, repeated small tests of change, collaborative learning through data sharing – have led to improvements in care quality, safety, and outcomes in the Neonatal Intensive Care Unit (NICU). High-risk infant follow-up programs (HRIF) have historically aided such quality improveme nt efforts by providing outcomes data about NICU interventions. Though as a discipline, HRIF has not universally embraced CQI for its own practice. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 8, 2021 Category: Perinatology & Neonatology Authors: Jonathan S. Litt, Susan R. Hintz Source Type: research

The use of data in resource limited settings to improve quality of care
Quality improvement is driven by benchmarking between and within institutions over time and the collaborative improvement efforts that stem from these comparisons. Benchmarking requires systematic collection and use of standardized data. Low- and middle-income countries (LMIC) have great potential for improvements in newborn outcomes but serious obstacles to data collection, analysis, and implementation of robust improvement methodologies exist. We review the importance of data collection, internationally recommended neonatal metrics, selected methods of data collection, and reporting. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 3, 2021 Category: Perinatology & Neonatology Authors: Alexander G. Stevenson, Lloyd Tooke, Erika M. Edwards, Marcia Mangiza, Delia Horn, Michelle Heys, Simbarashe Chimhuya, Danielle E.Y. Ehret, Mahlet Abayneh Source Type: research

Editorial Board
(Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - February 1, 2021 Category: Perinatology & Neonatology Source Type: research