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The evidence for neonatal arginine supplementation — A narrative review 新生儿补充精氨酸的证据-叙述性回顾。
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-23 DOI: 10.1016/j.earlhumdev.2025.106402
F. Callaghan , C. Morgan
Arginine is proteomic conditionally essential amino acid in the neonatal period. As well as being necessary for protein synthesis and growth, it is a highly functional amino acid playing a key role in many metabolic pathways critical to neonatal health. These include the urea cycle and ammonia detoxification, spermidine synthesis, immune modulation and acting as the key substrate for nitric oxide synthesis. The arginine-nitric oxide (NO) pathway is an important mechanism by which hypoargininaemia may contribute to neonatal morbidity, particularly necrotising enterocolitis and potentially sepsis, pulmonary disease and post-operative recovery. The role of the inhibitory metabolite asymmetric dimethylarginine in the arginine-NO pathway has been recognised but the neonatal clinical implications have yet to be established.
Neonates dependent on parenteral nutrition are particularly vulnerable to hypoargininaemia. Both parenteral and enteral arginine supplementation has been shown in a small number of clinical trials to reduce the risk of necrotising enterocolitis. This evidence has been sufficient to result in recommendations for arginine supplementation in systematic reviews and international guidelines. The potential benefits from reducing the risk of other neonatal complications such as sepsis and prolonged postoperative recovery have not been studied. No arginine side effects have been reported but the studies are not large enough to provide complete assurance. The methods of parenteral and enteral arginine supplementation also require further research to establish optimal timing, dose and target plasma level. Nevertheless, arginine supplementation relatively easy to implement in clinical practice and remains a potentially cost effective method in reducing serious neonatal morbidities.
精氨酸是新生儿期蛋白质组学条件必需氨基酸。它不仅是蛋白质合成和生长所必需的,而且是一种功能强大的氨基酸,在许多对新生儿健康至关重要的代谢途径中起着关键作用。其中包括尿素循环和氨解毒、亚精胺合成、免疫调节和作为一氧化氮合成的关键底物。精氨酸-一氧化氮(NO)途径是低精氨酸血症可能导致新生儿发病率的重要机制,特别是坏死性小肠结肠炎和潜在的败血症、肺部疾病和术后恢复。抑制性代谢物不对称二甲基精氨酸在精氨酸-一氧化氮途径中的作用已被认识到,但新生儿临床意义尚未确定。依赖肠外营养的新生儿特别容易发生低精氨酸血症。在少数临床试验中,肠外和肠内补充精氨酸均显示可降低坏死性小肠结肠炎的风险。这一证据足以在系统评价和国际指南中推荐补充精氨酸。降低其他新生儿并发症(如败血症和术后恢复时间延长)的潜在益处尚未得到研究。没有精氨酸副作用的报道,但研究的规模还不足以提供完全的保证。肠外和肠内补充精氨酸的方法也需要进一步研究,以确定最佳的时间、剂量和目标血浆水平。然而,精氨酸补充在临床实践中相对容易实施,并且仍然是降低严重新生儿发病率的潜在成本有效的方法。
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引用次数: 0
Gut microbiota as a risk and protective factor in neonatal necrotizing enterocolitis: An integrative review 肠道菌群作为新生儿坏死性小肠结肠炎的风险和保护因素:一项综合综述
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-22 DOI: 10.1016/j.earlhumdev.2025.106401
Maria Júlia Onofre , Cesar Augusto Cirino Silva , Isadora Caixeta da Silveira Ferreira , Denise Von Dolinger de Brito Röder
Necrotizing enterocolitis (NEC) is characterized by inflammation of the gastrointestinal tract and intestinal necrosis, primarily affecting premature neonates. It is one of the leading causes of morbidity and mortality in this population. This article aims to analyze, based on recent scientific literature, the relationship between intestinal microbiota and the development of NEC in premature neonates, highlighting the main pathophysiological mechanisms and prevention strategies. We conducted an integrative literature review, with search in the Virtual Health Library (VHL) and Pubmed databases, applying the Patient, Intervention, Comparison and Outcomes (PICO) strategy. A total of 178 articles were initially identified, with the application of validated tools to assess the methodological quality of the studies. The final sample included 13 international articles. The main findings show intestinal dysbiosis, activation of immune pathways and metabolic alterations as key elements in the pathogenesis of NEC. On the other hand, the use of probiotics and enrichment of breast milk were associated with beneficial effects. In conclusion, NEC is a multifactorial disease associated with intestinal dysbiosis, with an increase in pathogenic bacteria and a reduction in beneficial bacteria such as Bifidobacterium spp. The activation of pro-inflammatory TLR4 receptors by bacterial LPS favors intestinal damage. Factors such as prematurity, use of antimicrobials, and changes in the composition of breast milk favor microbiota imbalance. Probiotics and breastfeeding are promising strategies for preventing this situation. Therefore, this article gathers pertinent information that can help in understanding the factors involved in NEC.
坏死性小肠结肠炎(NEC)以胃肠道炎症和肠道坏死为特征,主要影响早产儿。它是这一人群发病和死亡的主要原因之一。本文旨在结合近年来的科学文献,分析肠道菌群与早产儿NEC发病的关系,重点阐述其主要病理生理机制和预防策略。我们采用患者、干预、比较和结果(PICO)策略,在虚拟健康图书馆(VHL)和Pubmed数据库中进行了综合文献综述。最初共确定了178篇文章,并应用了经过验证的工具来评估研究的方法学质量。最后的样本包括13篇国际文章。主要研究结果表明,肠道生态失调、免疫途径激活和代谢改变是NEC发病的关键因素。另一方面,益生菌的使用和母乳的富集与有益效果有关。综上所述,NEC是一种与肠道生态失调相关的多因子疾病,致病菌增加,有益菌如双歧杆菌减少,细菌LPS激活促炎TLR4受体有利于肠道损伤。早产、抗菌剂的使用和母乳成分的变化等因素都有利于微生物群失衡。益生菌和母乳喂养是预防这种情况的有希望的策略。因此,本文收集了相关信息,可以帮助理解NEC所涉及的因素。
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引用次数: 0
Mutual gaze and later social attention development in infants at typical and elevated familial likelihood for ASD and/or ADHD ASD和/或ADHD的典型和高家族可能性婴儿的相互凝视和后来的社会注意发展。
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-19 DOI: 10.1016/j.earlhumdev.2025.106398
D. Ilyka , Y. Jiang , J. Begum-Ali , L. Mason , A. Gui , T. Gliga , S. Lloyd-Fox , E. Jones , T. Charman , M.H. Johnson , The BASIS/STAARS Study Team
Atypical social attention is a feature of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), yet this has not yet been studied during toy-free naturalistic parent-infant interactions in infants at elevated likelihood of developing ADHD (EL-ADHD). We coded mutual gaze from caregiver–infant free-play videos recorded at 4–7 months in infants with typical likelihood (TL; n = 37), elevated likelihood of ASD (EL-ASD; n = 55), ADHD (EL-ADHD; n = 13) or both (EL-ASD + ADHD; n = 13). Face-orienting responses were measured using an eye tracking face pop-out task at 8–12 months, and ASD research diagnosis was established at 36 months. Results showed that EL groups engaged in more mutual gaze than TL peers, revealing a broad alteration in dyadic attention across neurodevelopmental likelihood. However, mutual-gaze duration did not differentiate infants who were later given an ASD diagnosis at age 3 years (n = 14). Furthermore, only in the EL-ASD group greater early mutual gaze predicted reduced subsequent orienting to faces. This association was mainly driven by those diagnosed with ASD at age 3, potentially indicating an ASD-specific developmental pathway. These findings highlight the value of naturalistic paradigms for probing early social attention and the need for larger, jointly analysed EL-ASD and EL-ADHD cohorts to refine neurodevelopmental models of typical and atypical infant social attention.
非典型社会注意是自闭症谱系障碍(ASD)和注意缺陷/多动障碍(ADHD)的一个特征,但这一点尚未在无玩具的自然亲子互动中进行研究,这些互动可能会导致ADHD (EL-ADHD)的发生。我们对4-7个月大的婴儿在典型可能性(TL; n = 37)、ASD (EL-ASD; n = 55)、ADHD (EL-ADHD; n = 13)或两者兼有(EL-ASD + ADHD; n = 13)的婴儿中记录的看护者-婴儿自由游戏视频中的相互注视进行编码。在8-12个月时使用眼动追踪面部弹出任务测量面部定向反应,并在36个月时建立ASD研究诊断。结果显示,与TL组相比,EL组参与了更多的相互凝视,揭示了神经发育可能性中二元注意的广泛变化。然而,相互凝视的持续时间并不能区分3岁时被诊断为ASD的婴儿(n = 14)。此外,只有在EL-ASD组中,更大的早期相互凝视预示着随后对面部的定向减少。这种关联主要是由那些在3岁时被诊断为ASD的人驱动的,可能表明ASD特异性的发育途径。这些发现强调了探索早期社会注意的自然主义范式的价值,以及需要更大的联合分析EL-ASD和EL-ADHD队列来完善典型和非典型婴儿社会注意的神经发育模型。
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引用次数: 0
Associations between cardiorespiratory fitness, activity behavior, physical literacy and parental sports participation in children with a critical congenital heart disease 危重先天性心脏病患儿心肺健康、活动行为、身体素质和父母运动参与之间的关系
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-18 DOI: 10.1016/j.earlhumdev.2025.106397
J.J. Noordstar , M.C.A. Sprong , F.C. Lenderink , M.G. Slieker , E.H.J. Hulzebos , T. Takken

Objective

This study investigated associations between cardiorespiratory fitness (CRF), activity behavior (i.e. physical activity and sports participation), physical literacy (motivation, confidence, knowledge and understanding), and parental sports participation in children with critical congenital heart disease (CCHD), and explore differences in children with a single ventricle physiology (SVP) and children with biventricular physiology (BVP).

Methods

Ninety children with CCHD (median age 10.0 [7.0–13.0] years) participated in this prospective observational study. CRF was measured through cardiopulmonary exercise testing (VO₂peak). Activity behavior, physical literacy, and parental sports participation were assessed using validated questionnaires.

Results

CRF was moderately associated with physical activity (r = 0.36, p < .001) and weakly associated with motivation and confidence (r = 0.25, p = .019). No association was found between CRF and sports participation. Children's sports participation was positively associated with maternal (r = 0.23, p = .034) and paternal (r = 0.23, p = .042) sports participation, as well as with motivation and confidence (r = 0.28, p = .009). Children with a SVP (n = 11) had significantly lower CRF than those with BVP (n = 79) (p < .001). No other differences were found between children with a SVP and children with a BVP.

Conclusion

CRF is positively associated with physical activity, motivation and confidence in children with CCHD. Additionally, parental sports participation is associated with children's sports participation. These findings suggest integrating a physical literacy and family-centered approach in interventions aimed to enhance CRF in children with CCHD.
目的:探讨危重型先天性心脏病(CCHD)患儿心肺健康(CRF)、活动行为(即体力活动和运动参与)、身体素养(动机、信心、知识和理解)和父母运动参与的关系,并探讨单心室生理(SVP)患儿和双心室生理(BVP)患儿的差异。方法:90例CCHD患儿(中位年龄10.0[7.0-13.0]岁)参与本前瞻性观察研究。通过心肺运动试验(vo2峰值)测量CRF。活动行为、身体素养和父母的运动参与使用有效的问卷进行评估。结果:CRF与体力活动呈正相关(r = 0.36, p)。结论:CRF与CCHD患儿体力活动、动机和信心呈正相关。此外,父母的体育参与与孩子的体育参与有关。这些发现建议在干预措施中结合身体素养和以家庭为中心的方法,旨在提高CCHD儿童的CRF。
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引用次数: 0
Identifying cognitive vulnerability in school-aged children born preterm: The role of neonatal and early-life factors 识别早产学龄儿童的认知脆弱性:新生儿和早期生活因素的作用
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-18 DOI: 10.1016/j.earlhumdev.2025.106396
Symeon Dimitrios Daskalou , Nikolaos Gerosideris , Georgia Tsakni , Pinelopi Vlotinou , Georgios Bablekos , Ioanna Giannoula Katsouri

Background

Children born preterm are at increased risk for cognitive difficulties. While gestational age is a known predictor, the combined influence of early-life variables such as breastfeeding, NICU stay, and birth weight on later cognitive outcomes remains less understood.

Objective

To compare cognitive performance between preterm and non preterm school-aged children and identify neonatal and postnatal predictors of verbal and non verbal intelligence.

Methods

A total of 140 children aged 6–12 years (70 preterm, 70 non preterm) were assessed using Raven's Coloured Progressive Matrices (CPM) and Crichton Vocabulary Scale (CVS). Mann–Whitney U tests and multiple linear regressions were used to examine group differences and predictors of cognitive scores. Predictors included gestational age, NICU stay, socioeconomic status (SES), breastfeeding, birth weight, age, and sex. VIF values were used to assess multicollinearity.

Results

Preterm children scored significantly lower than non preterm peers on both CPM (p < 0.001, r = − 0.27) and CVS (p < 0.001, r = − 0.43). Regression models showed that gestational age was a consistent predictor across both scales. Breastfeeding and higher SES were associated with higher CPM and CVS scores, while prolonged NICU stay negatively impacted CVS performance. No multicollinearity issues were detected (VIF < 2.6).

Conclusion

Preterm birth is linked to reduced cognitive performance during middle childhood, especially in verbal reasoning. Breastfeeding and shorter NICU stay may offer protective benefits. These findings highlight the importance of early-life factors and support targeted developmental surveillance and interventions for preterm populations.
早产儿童出现认知障碍的风险增加。虽然胎龄是一个已知的预测因素,但早期生活变量(如母乳喂养、新生儿重症监护室住院时间和出生体重)对后期认知结果的综合影响尚不清楚。目的比较早产儿和非早产儿学龄儿童的认知表现,探讨言语和非言语智力的新生儿和产后预测因素。方法采用Raven's彩色递进矩阵(CPM)和Crichton词汇量表(CVS)对140例6-12岁儿童(早产儿70例,非早产儿70例)进行评估。使用Mann-Whitney U检验和多元线性回归来检验组间差异和认知得分的预测因子。预测因素包括胎龄、新生儿重症监护室住院时间、社会经济地位(SES)、母乳喂养、出生体重、年龄和性别。VIF值用于评估多重共线性。结果早产儿的CPM (p < 0.001, r = - 0.27)和CVS (p < 0.001, r = - 0.43)得分均显著低于非早产儿。回归模型显示胎龄是两个尺度上一致的预测因子。母乳喂养和较高的SES与较高的CPM和CVS评分相关,而延长新生儿重症监护病房的时间会对CVS表现产生负面影响。未检测到多重共线性问题(VIF < 2.6)。结论早产与儿童中期认知能力下降有关,尤其是言语推理能力下降。母乳喂养和较短的新生儿重症监护病房可能提供保护作用。这些发现强调了早期生活因素的重要性,并支持对早产儿群体进行有针对性的发育监测和干预。
{"title":"Identifying cognitive vulnerability in school-aged children born preterm: The role of neonatal and early-life factors","authors":"Symeon Dimitrios Daskalou ,&nbsp;Nikolaos Gerosideris ,&nbsp;Georgia Tsakni ,&nbsp;Pinelopi Vlotinou ,&nbsp;Georgios Bablekos ,&nbsp;Ioanna Giannoula Katsouri","doi":"10.1016/j.earlhumdev.2025.106396","DOIUrl":"10.1016/j.earlhumdev.2025.106396","url":null,"abstract":"<div><h3>Background</h3><div>Children born preterm are at increased risk for cognitive difficulties. While gestational age is a known predictor, the combined influence of early-life variables such as breastfeeding, NICU stay, and birth weight on later cognitive outcomes remains less understood.</div></div><div><h3>Objective</h3><div>To compare cognitive performance between preterm and non preterm school-aged children and identify neonatal and postnatal predictors of verbal and non verbal intelligence.</div></div><div><h3>Methods</h3><div>A total of 140 children aged 6–12 years (70 preterm, 70 non preterm) were assessed using Raven's Coloured Progressive Matrices (CPM) and Crichton Vocabulary Scale (CVS). Mann–Whitney <em>U</em> tests and multiple linear regressions were used to examine group differences and predictors of cognitive scores. Predictors included gestational age, NICU stay, socioeconomic status (SES), breastfeeding, birth weight, age, and sex. VIF values were used to assess multicollinearity.</div></div><div><h3>Results</h3><div>Preterm children scored significantly lower than non preterm peers on both CPM (<em>p</em> &lt; 0.001, <em>r</em> = − 0.27) and CVS (p &lt; 0.001, <em>r</em> = − 0.43). Regression models showed that gestational age was a consistent predictor across both scales. Breastfeeding and higher SES were associated with higher CPM and CVS scores, while prolonged NICU stay negatively impacted CVS performance. No multicollinearity issues were detected (VIF &lt; 2.6).</div></div><div><h3>Conclusion</h3><div>Preterm birth is linked to reduced cognitive performance during middle childhood, especially in verbal reasoning. Breastfeeding and shorter NICU stay may offer protective benefits. These findings highlight the importance of early-life factors and support targeted developmental surveillance and interventions for preterm populations.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106396"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of internalising trajectories in adult wealth and social relationships following very preterm birth/very low birth weight 内化轨迹在非常早产/非常低出生体重后的成人财富和社会关系中的作用。
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-16 DOI: 10.1016/j.earlhumdev.2025.106395
Yanlin Zhou , Elif Gonen , Peter Bartmann , Dieter Wolke

Background

Individuals born very preterm (VPT; <32 weeks) and/or with very low birth weight (VLBW; <1500 g) are at higher risk for internalising problems and adulthood difficulties. However, internalising symptoms fluctuate over time, and it remains unclear how these patterns of change relate to adult outcomes after VPT/VLBW birth.

Objective

To examine whether internalising trajectories from childhood to early adulthood mediate or moderate the association between VPT/VLBW birth and adult wealth and social relationship difficulties.

Methods

Data were drawn from the Bavarian Longitudinal Study (252 VPT/VLBW, 228 term-born), followed from birth to 34 years. Internalising symptoms were parent-reported at four waves (ages 6, 8, 13 and 26 years) and modelled into trajectories. Path analysis tested direct and indirect effects of VPT/VLBW status on outcomes at 34 years via these trajectories. Moderation was tested using analysis of variance. Covariates included sex, socioeconomic status (SES) at birth, and neurosensory impairments (NSI).

Results

Three internalising trajectories emerged: consistently low (70.4 %), decreasing (15 %), and increasing (14.6 %). The increasing trajectory mediated the association between VPT/VLBW birth and both lower wealth and greater social relationship difficulties. After adjusting for sex, SES, and NSI, only the mediation effect on wealth remained significant. Indirect effects accounted for approximately 15–18 % of the total effects. Interactions between birth group (VPT/VLBW vs. term-born) and internalising trajectory on adult outcomes were non-significant.

Conclusions

Increasing internalising symptoms partially mediate the impact of VPT/VLBW birth on adult wealth and social relationships. Findings highlight the value of continuing mental health support, particularly for those born VPT/VLBW.
背景:非常早产(VPT)个体;目的:研究从童年到成年早期的内化轨迹是否介导或调节了非常早产/VLBW出生与成年财富和社会关系困难之间的关联。方法:数据来自巴伐利亚纵向研究(252名VPT/VLBW, 228名足月出生),从出生到34岁。父母在四个阶段(6岁、8岁、13岁和26岁)报告了内化症状,并建立了轨迹模型。通径分析通过这些轨迹测试了VPT/VLBW状态对34岁时预后的直接和间接影响。使用方差分析检验适度性。协变量包括性别、出生时的社会经济地位(SES)和神经感觉障碍(NSI)。结果:出现了三种内化轨迹:持续低(70.4%)、下降(15%)和增加(14.6%)。增加的轨迹在VPT/VLBW出生与低财富和更大的社会关系困难之间起中介作用。在对性别、社会经济地位和自伤进行调整后,只有财富的中介效应仍然显著。间接效应约占总效应的15- 18%。出生组(VPT/VLBW vs足月出生)和内化轨迹对成年结局的相互作用不显著。结论:内化症状的增加部分介导了VPT/VLBW出生对成人财富和社会关系的影响。研究结果强调了持续心理健康支持的价值,特别是对那些出生时患有VPT/VLBW的人。
{"title":"The role of internalising trajectories in adult wealth and social relationships following very preterm birth/very low birth weight","authors":"Yanlin Zhou ,&nbsp;Elif Gonen ,&nbsp;Peter Bartmann ,&nbsp;Dieter Wolke","doi":"10.1016/j.earlhumdev.2025.106395","DOIUrl":"10.1016/j.earlhumdev.2025.106395","url":null,"abstract":"<div><h3>Background</h3><div>Individuals born very preterm (VPT; &lt;32 weeks) and/or with very low birth weight (VLBW; &lt;1500 g) are at higher risk for internalising problems and adulthood difficulties. However, internalising symptoms fluctuate over time, and it remains unclear how these patterns of change relate to adult outcomes after VPT/VLBW birth.</div></div><div><h3>Objective</h3><div>To examine whether internalising trajectories from childhood to early adulthood mediate or moderate the association between VPT/VLBW birth and adult wealth and social relationship difficulties.</div></div><div><h3>Methods</h3><div>Data were drawn from the Bavarian Longitudinal Study (252 VPT/VLBW, 228 term-born), followed from birth to 34 years. Internalising symptoms were parent-reported at four waves (ages 6, 8, 13 and 26 years) and modelled into trajectories. Path analysis tested direct and indirect effects of VPT/VLBW status on outcomes at 34 years via these trajectories. Moderation was tested using analysis of variance. Covariates included sex, socioeconomic status (SES) at birth, and neurosensory impairments (NSI).</div></div><div><h3>Results</h3><div>Three internalising trajectories emerged: consistently low (70.4 %), decreasing (15 %), and increasing (14.6 %). The increasing trajectory mediated the association between VPT/VLBW birth and both lower wealth and greater social relationship difficulties. After adjusting for sex, SES, and NSI, only the mediation effect on wealth remained significant. Indirect effects accounted for approximately 15–18 % of the total effects. Interactions between birth group (VPT/VLBW vs. term-born) and internalising trajectory on adult outcomes were non-significant.</div></div><div><h3>Conclusions</h3><div>Increasing internalising symptoms partially mediate the impact of VPT/VLBW birth on adult wealth and social relationships. Findings highlight the value of continuing mental health support, particularly for those born VPT/VLBW.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106395"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Parental satisfaction on moving from open bay to single-family rooms neonatal intensive care unit 新生儿重症监护病房从开放式病房搬到单人家庭病房的家长满意度。
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-13 DOI: 10.1016/j.earlhumdev.2025.106394
Wielenga Joke , Pascual April , Ruhe Kiki , de Ligt Chantal , van Kaam Anton
The purpose of the study was to assess the impact of moving from open bay units (OBU) to single-family rooms (SFR) on parental satisfaction in the Neonatal Intensive Care Unit (NICU) An observational longitudinal cohort study was conducted between February 2021 until January 2024, during which time the setting changed from OBU to SFR with a mixed transitional phase in between. All parents of infants admitted were eligible for inclusion. The Empathic-N was used to measure parental satisfaction. The Empathic-N was filled out by 110 mothers and 76 partners of 148 infants. The overall satisfaction when moving from an OBU and SFRs showed no statistical significant increase for both parents. Partners showed a statistically significant increase in the domains Communication and information (p = .012) and Organization (p = .012) after moving to SFRs. For mothers, only several statements within these domains showed a significant increase after transitioning to SFRs. In conclusion, parental satisfaction increased in specific domains after the transition from an OBU to SFR environment in a level III NICU. However, this improvement was modest and differed between mothers and partners. In case of pre-existing high parental satisfaction rates moving from OBU to SFR is not an important contributor to parental satisfaction.
本研究的目的是评估从开放式病房(OBU)转移到单户病房(SFR)对新生儿重症监护病房(NICU)父母满意度的影响。在2021年2月至2024年1月期间进行了一项观察性纵向队列研究,在此期间,设置从OBU转变为SFR,并在两者之间进行混合过渡阶段。所有入院婴儿的父母均符合入选条件。共情因子n用于衡量父母满意度。共情问卷由148名婴儿的110名母亲和76名伴侣填写。从OBU和SFRs转移后,父母双方的总体满意度没有统计学上的显著提高。合作伙伴在转移到SFRs后,在沟通和信息(p = 0.012)和组织(p = 0.012)领域显示统计学上显著增加。对于母亲来说,这些领域中只有几个陈述在过渡到srr后显着增加。综上所述,三级新生儿重症监护室从OBU环境过渡到SFR环境后,父母在特定领域的满意度有所提高。然而,这种改善是温和的,并且在母亲和伴侣之间存在差异。在已经存在的高父母满意度的情况下,从OBU转移到SFR并不是父母满意度的重要因素。
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引用次数: 0
Hidden placental damage in stillbirths with idiopathic polyhydramnios 特发性羊水过多死产的隐性胎盘损伤
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-12 DOI: 10.1016/j.earlhumdev.2025.106393
Laura Avagliano , Martina Benuzzi , Francesca Monari , Gaetano Bulfamante
Idiopathic polyhydramnios is clinically linked to stillbirth; however, its placental histopathology remains poorly characterized. This is the first study analyzing placentas from stillbirths with idiopathic polyhydramnios, revealing frequent lesions of fetal and maternal vascular malperfusion. Findings support a previously unrecognized role of placental dysfunction in fetal compromise.
特发性羊水过多在临床上与死产有关;然而,其胎盘组织病理学特征仍然很差。这是第一个分析特发性羊水过多死产胎盘的研究,揭示了胎儿和母体血管灌注不良的频繁病变。研究结果支持了先前未被认识到的胎盘功能障碍在胎儿损害中的作用。
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引用次数: 0
Optimizing antenatal corticosteroid therapy: Balancing benefit and risk in the era of precision medicine 优化产前皮质类固醇治疗:精准医学时代的利益与风险平衡。
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-06 DOI: 10.1016/j.earlhumdev.2025.106389
Hannah R.S. Watson , Matthew W. Kemp , Erin L. Johnson
Antenatal corticosteroid (ACS) therapy is a cornerstone of modern perinatal care and remains an effective intervention for reducing neonatal morbidity and mortality associated with preterm birth. However, emerging evidence highlights the need for a more refined approach to ACS use, especially with contemporary expansion of the ACS therapy eligible population. A relatively small pool of evidence exists for several sub-populations exposed to ACS therapy, including multiple pregnancies, intrauterine growth restriction and in the setting of chorioamnionitis. This review synthesized current evidence on the pharmacokinetics, efficacy, and safety of ACS, with particular focus on dose optimization, long-term outcomes, and variability in fetal treatment response. We examined the potential of developing tools to assess fetal lung maturation and thus pregnancies that would most benefit from ACS therapy. Additionally, we sought to address emerging concerns regarding ACS overexposure and unintended effects on non-pulmonary fetal systems. The review highlights key knowledge gaps, particularly in relation to long-term neurodevelopmental outcomes, optimal dosing strategies, and tools for individualized risk prediction. Development of precision-based approaches to ACS therapy is essential to ensure maximal benefit and minimal harm across varied clinical contexts in which this intervention is used.
产前皮质类固醇(ACS)治疗是现代围产期护理的基石,仍然是降低与早产相关的新生儿发病率和死亡率的有效干预措施。然而,新出现的证据强调需要一种更精细的方法来使用ACS,特别是随着当代ACS治疗合格人群的扩大。对于暴露于ACS治疗的几个亚群,包括多胎妊娠、宫内生长受限和绒毛膜羊膜炎,存在相对较小的证据池。本综述综合了ACS的药代动力学、疗效和安全性方面的现有证据,特别关注剂量优化、长期结局和胎儿治疗反应的可变性。我们研究了开发工具来评估胎儿肺成熟的潜力,从而评估从ACS治疗中获益最多的妊娠。此外,我们试图解决有关ACS过度暴露和对非肺胎儿系统的意外影响的新问题。这篇综述强调了关键的知识差距,特别是在长期神经发育结果、最佳给药策略和个性化风险预测工具方面。发展基于精确的ACS治疗方法对于确保在使用这种干预的不同临床环境中获得最大的益处和最小的危害至关重要。
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引用次数: 0
Corrigendum to “Effectiveness of an oral-motor intervention for premature infants: Feeding and maternal self-efficacy” [Early Human Development 210 (2025) 106382] “早产儿口腔运动干预的有效性:喂养和母亲自我效能”的更正[早期人类发展210(2025)106382]。
IF 2 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-05 DOI: 10.1016/j.earlhumdev.2025.106390
Zohar Meroz , Jennifer R. Budman , Aviva Yochman , Alona Bin-Nun , Anat Golos
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引用次数: 0
期刊
Early human development
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