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Source: Seminars in Fetal and Neonatal Medicine - May 31, 2020 Category: Perinatology & Neonatology Source Type: research

Patent Ductus Arteriosus and Cerebral, Cardiac, and Gut Hemodynamics in Premature Neonates
Patent ductus arteriosus is associated with multiple comorbidities in premature infants, however a causal link or strategy to decrease these morbidities has not been found. The association between the PDA and morbidities has biologic plausibility as, like any cardiac mixing lesion, a significant systemic to pulmonic shunt may lead to pulmonary over-circulation and systemic hypoperfusion. Understanding the underlying pathophysiology of associated morbidities in the setting of a patent ductus arteriosus may aid in risk stratifying infants and offer a patient targeted approach to infants with a pathological ductal shunt. (Sou...
Source: Seminars in Fetal and Neonatal Medicine - May 31, 2020 Category: Perinatology & Neonatology Authors: J.L. Ruoss, C. Bazacliu, Regan E. Giesinger, P.J. McNamara Source Type: research

Prevention of Preeclampsia
Preeclampsia is an obstetric disorder that affects 3-8% of pregnant women and remains a leading cause of short- and long-term neonatal and maternal morbidity and mortality. Professional societies recommend the use of low dose aspirin to prevent preeclampsia in high-risk women. However, interest in prevention of this disease and better understanding of its pathophysiology have led to growing research on other agents. This review focuses on the main therapeutic agents evaluated or in use for preeclampsia prevention. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 31, 2020 Category: Perinatology & Neonatology Authors: Marwan MA ’AYEH, Maged M. COSTANTINE Source Type: research

Management of Neonatal Hypotension and Shock
The current standard approach to manage circulatory insufficiency is inappropriately simple and clear: respond to low blood pressure to achieve higher values. However, the evidence for this is limited affecting all steps within the process: assessment, decision making, therapeutic options, and treatment effects. We have to overcome the ‘one size fits all’ approach and respect the dynamic physiologic transition from fetal to neonatal life in the context of complex underlying conditions. Caregivers need to individualize their approaches to individual circumstances. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 19, 2020 Category: Perinatology & Neonatology Authors: Christoph E. Schwarz, Eugene M. Dempsey Source Type: research

Superior Vena Cava Flow: Role, Assessment and Controversies in the Management of Perinatal Perfusion
The superior vena cava (SVC) is a large vein responsible for the venous return of blood from structures located superior to the diaphragm. The flow in the SVC can be assessed with Doppler ultrasound and can be used as a proxy for cerebral perfusion. Early clinical research studies showed that low SVC flow, particularly if for a prolonged period, was associated with short term morbidity such as intraventricular haemorrhage, mortality, and poorer neurodevelopmental outcomes. However, these findings have not been consistently reported in more recent studies, and the role of SVC flow in early management and as a predictor of p...
Source: Seminars in Fetal and Neonatal Medicine - May 19, 2020 Category: Perinatology & Neonatology Authors: Koert de Waal, Martin Kluckow Source Type: research

Long-term motor outcomes of very preterm and/or very low birth weight individuals without cerebral palsy: A review of the current evidence
We reviewed literature on long-term motor outcomes of individuals aged five years or older born very preterm (VP: ≤32 weeks of gestation) or with very low birth weight (VLBW: ≤1500g), without cerebral palsy (CP). PubMed produced 2827 articles, whereof 38 were eligible. Assessed by standardised and norm-based motor tests, the Movement Assessment Battery for Children being the most widely used, VP/VLBW indivi duals showed poorer motor skills compared with term-born controls with differences of approximately 1 SD in magnitude. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 18, 2020 Category: Perinatology & Neonatology Authors: Kari Anne I. Evensen, Tordis Ustad, Marjaana Tikanm äki, Peija Haaramo, Eero Kajantie Source Type: research

Late Adolescent & Young Adult Functioning and Participation Outcomes after Prematurity
There has been an increased emphasis on optimizing health, developmental, and behavioral outcomes over the life course after prematurity. An important framework for examining adolescent and young adult outcomes is the International Classification of Functioning Disability and Health Children (ICF) developed by the World Health Organization (WHO) in 2001 and expanded to children and youth (ICF-CY) under age 19 years in 2007. The ICF and the ICF-CY can be used as a statistical tool in population studies, a research tool to measure outcomes, quality of life, and environmental factors, a clinical tool for outcomes of rehabilit...
Source: Seminars in Fetal and Neonatal Medicine - May 14, 2020 Category: Perinatology & Neonatology Authors: Mary C. Sullivan, Emma Lynch, Michael E. Msall Source Type: research

Have outcomes following extremely preterm birth improved over time?
Increased survival of infants born preterm, especially those born extremely preterm ( (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 13, 2020 Category: Perinatology & Neonatology Authors: Jeanie LY. Cheong, Alicia J. Spittle, Alice C. Burnett, Peter J. Anderson, Lex W. Doyle Source Type: research

Genetic and Epigenetic Factors and Early Life Inflammation as Predictors of Neurodevelopmental Outcomes
Among individuals born very preterm, perinatal inflammation, particularly if sustained or recurring, is highly likely a contributor to adverse neurodevelopmental outcomes, including cerebral white matter damage, cerebral palsy, cognitive impairment, attention-deficit/hyperactivity disorder, and autism spectrum disorder. Antecedents and correlates of perinatal inflammation include socioeconomic disadvantage, maternal obesity, maternal infections, fetal growth restriction, neonatal sepsis, necrotizing enterocolitis, and prolonged mechanical ventilation. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 13, 2020 Category: Perinatology & Neonatology Authors: Kirsi S. Oldenburg, T. Michael O ’Shea, Rebecca C. Fry Source Type: research

The neurobiological correlates of cognitive outcomes in adolescence and adulthood following very preterm birth
Very preterm birth ( (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 13, 2020 Category: Perinatology & Neonatology Authors: Laila Hadaya, Chiara Nosarti Source Type: research

Early developmental interventions for infants born very preterm – what works?
Interventions are needed to enhance early development and minimise long-term impairments for children born very preterm (VP, (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - May 13, 2020 Category: Perinatology & Neonatology Authors: Peter J. Anderson, Karli Treyvaud, Alicia J. Spittle Source Type: research

Mental Health Outcomes of Adults Born Very Preterm or with Very Low Birth Weight: A systematic review
Preterm birth research is poised to explore the mental health of adults born very preterm(VP; (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 27, 2020 Category: Perinatology & Neonatology Authors: Rachel Robinson, Marius Lahti-Pulkkinen, Daniel Schnitzlein, Falk Voit, Polina Girchenko, Dieter Wolke, Sakari Lemola, Eero Kajantie, Kati Heinonen Source Type: research

Therapeutic Interventions for Fetal Inflammatory Response Syndrome (FIRS)
Fetal inflammatory response syndrome (FIRS) is a condition defined by systemic inflammation in the fetus, a rapid increase of pro-inflammatory cytokines into the fetal circulation (including interleukin-1 and interleukin-6), as well as a cellular response (such as increased neutrophils, monocyte/macrophages, and T cells) and the presence of funisitis. FIRS can lead to death and multisystem organ damage in the fetus and newborn. Brain injuries and subsequent risk of cerebral palsy and cognitive impairments are the most threatening long-term complications. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 10, 2020 Category: Perinatology & Neonatology Authors: Xiong Ying, Pia Wintermark Source Type: research

Mechanisms of Brain Injury in Newborn Infants Associated with the Fetal Inflammatory Response Syndrome
The fetal inflammatory response syndrome (FIRS) is characterized by umbilical cord inflammation and elevated fetal pro-inflammatory cytokines. Surviving neonates, especially very preterm infants, have increased rates of neonatal morbidity including neurodevelopmental impairment. The mechanism of brain injury in FIRS is complex and may involve “multiple hits.” Exposure to in utero inflammation initiates a cascade of the fetal immune response, where pro-inflammatory cytokines can cause direct injury to oligodendrocytes and neurons. (Source: Seminars in Fetal and Neonatal Medicine)
Source: Seminars in Fetal and Neonatal Medicine - April 8, 2020 Category: Perinatology & Neonatology Authors: Vivien Yap, Jeffrey M. Perlman Source Type: research

Neonatal white matter damage and the fetal inflammatory response
In 1962 a long-recognized pathologic abnormality in neonatal brains characterized by multiple telencephalic focal white matter necroses was renamed periventricular leukomalacia (PVL) and the authors inappropriately asserted that their entity was caused by anoxia. They also failed to include three other white matter histologic abnormalities.In this essay, we identify the breadth of white matter pathology, especially in very preterm newborns, and show that none of the four histologic expressions of white matter damage, including focal necrosis, are associated with hypoxemia or correlates as hypotension, but are instead assoc...
Source: Seminars in Fetal and Neonatal Medicine - April 8, 2020 Category: Perinatology & Neonatology Authors: F.H. Gilles, A. Leviton Source Type: research