Pub Date : 2025-07-12DOI: 10.1016/j.semperi.2025.152113
Christy L. Cummings
{"title":"Ethics, obligations, and imperatives in neonatology","authors":"Christy L. Cummings","doi":"10.1016/j.semperi.2025.152113","DOIUrl":"10.1016/j.semperi.2025.152113","url":null,"abstract":"","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152113"},"PeriodicalIF":3.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627006","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}
Pub Date : 2025-07-01DOI: 10.1016/j.semperi.2025.152111
Kara Hansen , Tiffany Gladdis , Stephanie Kukora
The 2023 U.S. Surgeon General’s Advisory on the Mental Health and Well-Being of Parents highlights the critical role parents play in family and societal health and underscores the urgent need to address the growing mental health challenges faced by parents. For parents with an infant in the Neonatal Intensive Care Unit, the key stressors identified in the advisory - such as financial strain, lack of childcare, lack of paid or universal leave from employment, social isolation, and mental health stigma– are often compounded by the trauma, uncertainty, and emotional toll of hospitalization. The advisory calls for coordinated, systemic efforts to support parental mental health, which is critical in the Neonatal Intensive Care Unit where parental well-being directly impacts child outcomes.
{"title":"Parental mental health & well-being in the NICU: Addressing the surgeon general’s advisory","authors":"Kara Hansen , Tiffany Gladdis , Stephanie Kukora","doi":"10.1016/j.semperi.2025.152111","DOIUrl":"10.1016/j.semperi.2025.152111","url":null,"abstract":"<div><div>The 2023 U.S. Surgeon General’s Advisory on the Mental Health and Well-Being of Parents highlights the critical role parents play in family and societal health and underscores the urgent need to address the growing mental health challenges faced by parents. For parents with an infant in the Neonatal Intensive Care Unit, the key stressors identified in the advisory - such as financial strain, lack of childcare, lack of paid or universal leave from employment, social isolation, and mental health stigma– are often compounded by the trauma, uncertainty, and emotional toll of hospitalization. The advisory calls for coordinated, systemic efforts to support parental mental health, which is critical in the Neonatal Intensive Care Unit where parental well-being directly impacts child outcomes.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152111"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554386","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}
Pub Date : 2025-06-19DOI: 10.1016/j.semperi.2025.152102
Emilie Thivierge , Thuy Mai Luu , Peter Rosenbaum , Paige Terrien Church , Rebecca Pearce , Annie Janvier
Extreme prematurity is associated with significant risk of mortality and morbidities. Neonatal follow-up assesses health outcomes of babies as they grow older to improve care and contribute to research and quality improvement initiatives. Recent investigations demonstrate that parents and clinicians/researchers disagree about what is defined as a “severe outcome”. Families report they need balanced information about functioning rather than medical diagnoses. Many functional domains other than the presence/absence of impairment are not evaluated during neonatal follow-up. This article recommends how to shift communication with parents of preterm infants throughout the NICU hospitalization – from discussions that are medicalized and deficit-based to those that reflect the processes of growth and development. This includes understanding family-important outcomes and how to communicate with parents using the ‘F-words’ for child development based on the World Health Organization’s integrated biopsychosocial framework for health: Functioning, Family, Fitness, Fun, Friends, and Future.
{"title":"Looking beyond diagnoses to functioning: using the F words and personalizing care in neonatology","authors":"Emilie Thivierge , Thuy Mai Luu , Peter Rosenbaum , Paige Terrien Church , Rebecca Pearce , Annie Janvier","doi":"10.1016/j.semperi.2025.152102","DOIUrl":"10.1016/j.semperi.2025.152102","url":null,"abstract":"<div><div>Extreme prematurity is associated with significant risk of mortality and morbidities. Neonatal follow-up assesses health outcomes of babies as they grow older to improve care and contribute to research and quality improvement initiatives. Recent investigations demonstrate that parents and clinicians/researchers disagree about what is defined as a “severe outcome”. Families report they need balanced information about functioning rather than medical diagnoses. Many functional domains other than the presence/absence of impairment are not evaluated during neonatal follow-up. This article recommends how to shift communication with parents of preterm infants throughout the NICU hospitalization – from discussions that are medicalized and deficit-based to those that reflect the processes of growth and development. This includes understanding family-important outcomes and how to communicate with parents using the ‘F-words’ for child development based on the World Health Organization’s integrated biopsychosocial framework for health: Functioning, Family, Fitness, Fun, Friends, and Future.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152102"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333845","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}
Pub Date : 2025-06-14DOI: 10.1016/j.semperi.2025.152101
Alaina K. Pyle , Mark R. Mercurio
Some life-limiting conditions associated with significant neurodevelopmental impairment, such as trisomy 13/18, have historically been considered lethal, thus medical or surgical treatments would be inappropriate. Evolving literature has shown that early death is not universal, and though all who survive with trisomy 13/18 will have significant impairments, some experience a positive quality of life. The presence of bias impacts counseling as well as what interventions are offered and/or provided to families of a child with anticipated significant disability. Shared decision-making processes should include parents receiving all relevant information about comfort care as well as available, indicated, and ethically permissible medical/surgical interventions. Ethical frameworks can help clarify which options would be permissible to offer or withhold on an individualized basis. Clinicians are encouraged to be open to revisiting past and sometimes long-established practices regarding patients with disability. A willingness to change should not be perceived as an indictment of past practice.
{"title":"Ethical challenges and justice concerns for infants and children with life-limiting conditions and significant disability, including trisomy 13 and 18","authors":"Alaina K. Pyle , Mark R. Mercurio","doi":"10.1016/j.semperi.2025.152101","DOIUrl":"10.1016/j.semperi.2025.152101","url":null,"abstract":"<div><div>Some life-limiting conditions associated with significant neurodevelopmental impairment, such as trisomy 13/18, have historically been considered lethal, thus medical or surgical treatments would be inappropriate. Evolving literature has shown that early death is not universal, and though all who survive with trisomy 13/18 will have significant impairments, some experience a positive quality of life. The presence of bias impacts counseling as well as what interventions are offered and/or provided to families of a child with anticipated significant disability. Shared decision-making processes should include parents receiving all relevant information about comfort care as well as available, indicated, and ethically permissible medical/surgical interventions. Ethical frameworks can help clarify which options would be permissible to offer or withhold on an individualized basis. Clinicians are encouraged to be open to revisiting past and sometimes long-established practices regarding patients with disability. A willingness to change should not be perceived as an indictment of past practice.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152101"},"PeriodicalIF":3.2,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294924","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}
Pub Date : 2025-06-14DOI: 10.1016/j.semperi.2025.152110
Kaiulani S Shulman , Kristen Fishler Malone , Hadley Stevens Smith , Bimal P. Chaudhari , Monica H Wojcik
Exome or genome sequencing (ES/GS) is increasingly used as the first-line test for postnatal diagnosis of rare genetic conditions, especially in intensive care units (ICUs). Early concerns regarding the use of broad genetic testing centered on the potential for psychosocial harm, particularly related to unexpected or uncertain findings. As the usage of ES/GS has grown and evolved, the ethical concerns initially raised have not borne out in empirical measurement of patient and family experience. We therefore review the use of diagnostic genomic sequencing in the neonatal intensive care unit with comparison to other standard diagnostic tests that have not elicited similar ethical questioning. We frame this landscape within the concept of genetic contextualism rather than exceptionalism and suggest that this approach may lead to a more productive future for applied genomic medicine, especially for sick neonates and infants in the NICU.
{"title":"An end to genetic exceptionalism: reframing the ethics of genomic sequencing for rapid neonatal diagnosis","authors":"Kaiulani S Shulman , Kristen Fishler Malone , Hadley Stevens Smith , Bimal P. Chaudhari , Monica H Wojcik","doi":"10.1016/j.semperi.2025.152110","DOIUrl":"10.1016/j.semperi.2025.152110","url":null,"abstract":"<div><div><span>Exome or genome sequencing (ES/GS) is increasingly used as the first-line test for postnatal diagnosis of rare genetic conditions, especially in </span>intensive care units<span> (ICUs). Early concerns regarding the use of broad genetic testing centered on the potential for psychosocial harm, particularly related to unexpected or uncertain findings. As the usage of ES/GS has grown and evolved, the ethical concerns initially raised have not borne out in empirical measurement of patient and family experience. We therefore review the use of diagnostic genomic sequencing in the neonatal intensive care unit with comparison to other standard diagnostic tests that have not elicited similar ethical questioning. We frame this landscape within the concept of genetic contextualism rather than exceptionalism and suggest that this approach may lead to a more productive future for applied genomic medicine, especially for sick neonates and infants in the NICU.</span></div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152110"},"PeriodicalIF":3.2,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302765","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}
Pub Date : 2025-06-12DOI: 10.1016/j.semperi.2025.152099
McKenna F Parnes , Luke Mosley , Heather H Burris , Elliott Mark Weiss
Climate change has severe consequences for neonatal health. Neonates are uniquely vulnerable to the impacts of climate change due to their developing bodies and immature immune and thermoregulatory systems. Climate change increases the risk of severe weather events, including extreme heat and natural disasters, as well as pollution and chemical exposures. The physiologic fragility of neonates and dependence on a stable environment require healthcare systems and policymakers to ensure protections are in place to mitigate health risks and potential impacts that will have long-lasting effects on individual development and well-being. The current article details the impacts of climate change on neonatal health across the lifecycle as well as the disproportionate consequences for communities most vulnerable to climate change. We provide evidence as to why this is a bioethical issue and offer recommendations for policies to protect neonatal health and promote environmental and climate justice.
{"title":"Climate change and environmental degradation: bioethical considerations and impact for neonatal care","authors":"McKenna F Parnes , Luke Mosley , Heather H Burris , Elliott Mark Weiss","doi":"10.1016/j.semperi.2025.152099","DOIUrl":"10.1016/j.semperi.2025.152099","url":null,"abstract":"<div><div>Climate change has severe consequences for neonatal health. Neonates are uniquely vulnerable to the impacts of climate change due to their developing bodies and immature immune and thermoregulatory systems. Climate change increases the risk of severe weather events, including extreme heat and natural disasters, as well as pollution and chemical exposures. The physiologic fragility of neonates and dependence on a stable environment require healthcare systems and policymakers to ensure protections are in place to mitigate health risks and potential impacts that will have long-lasting effects on individual development and well-being. The current article details the impacts of climate change on neonatal health across the lifecycle as well as the disproportionate consequences for communities most vulnerable to climate change. We provide evidence as to why this is a bioethical issue and offer recommendations for policies to protect neonatal health and promote environmental and climate justice.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152099"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294923","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}
Pub Date : 2025-06-11DOI: 10.1016/j.semperi.2025.152098
Anne Sullivan , Jennifer Arnold , Sheria Wilson , Kaiulani Shulman , Fabiana Bacchini , Paige Church
Ableism plays a pervasive yet often unexamined role in decision-making at extreme prematurity. This review examines how ableist assumptions about quality of life, normalcy, and parental burden can shape clinical counseling and influence decisions regarding resuscitation and intensive care for extremely preterm infants. Drawing on literature from neonatology, disability studies, and bioethics, the article explores the historical and sociocultural roots of ableist thinking in medicine and its manifestations in prognostic framing, risk communication, and institutional norms. Strategies for recognizing and addressing ableism in clinical practice are reviewed, including approaches to anti-ableist communication, family-centered care, and medical education reform. The article argues that adopting an explicitly anti-ableist stance is essential for promoting ethical, inclusive, and genuinely shared decision-making in the neonatal intensive care unit (NICU) and calls for greater interdisciplinary collaboration to support systemic change.
{"title":"Disability, ableism, and decision-making at extreme prematurity","authors":"Anne Sullivan , Jennifer Arnold , Sheria Wilson , Kaiulani Shulman , Fabiana Bacchini , Paige Church","doi":"10.1016/j.semperi.2025.152098","DOIUrl":"10.1016/j.semperi.2025.152098","url":null,"abstract":"<div><div><span>Ableism plays a pervasive yet often unexamined role in decision-making at extreme prematurity. This review examines how ableist assumptions about quality of life, normalcy, and parental burden can shape clinical counseling and influence decisions regarding resuscitation and </span>intensive care<span><span><span> for extremely preterm infants. Drawing on literature from neonatology, disability studies, and bioethics, the article explores the historical and sociocultural roots of ableist thinking in medicine and its manifestations in prognostic framing, risk communication, and institutional norms. Strategies for recognizing and addressing ableism in clinical practice are reviewed, including approaches to anti-ableist communication, family-centered care, and </span>medical education<span> reform. The article argues that adopting an explicitly anti-ableist stance is essential for promoting ethical, inclusive, and genuinely shared decision-making in the neonatal intensive care unit (NICU) and calls for greater </span></span>interdisciplinary collaboration to support systemic change.</span></div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152098"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275896","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}
Pub Date : 2025-06-04DOI: 10.1016/j.semperi.2025.152097
Matthew Lin , Sophie Bertaud , Dominic Wilkinson
Perinatal palliative care (PnPC) is a relatively new branch of pediatric palliative care (PPC), which focuses on providing holistic care in the antenatal, delivery, and neonatal settings. In this paper, we address previously unexplored justice-based ethical questions related to the provision of PnPC. We examine why some families who receive the diagnosis of a potentially life-limiting condition in their baby before or after birth receive PnPC support whilst others do not. We describe current inequities in the access to, and delivery of, PnPC. Drawing on philosophical theory (the Capabilities Approach) we argue that palliative care represents a valuable capability for babies with life limiting illness and their families. Health professionals should advocate for and promote access to this option for all families, regardless of whether it is ultimately taken up.
{"title":"Injustice and inequality in the provision of perinatal palliative care","authors":"Matthew Lin , Sophie Bertaud , Dominic Wilkinson","doi":"10.1016/j.semperi.2025.152097","DOIUrl":"10.1016/j.semperi.2025.152097","url":null,"abstract":"<div><div>Perinatal palliative care<span> (PnPC) is a relatively new branch of pediatric palliative care<span> (PPC), which focuses on providing holistic care in the antenatal, delivery, and neonatal settings. In this paper, we address previously unexplored justice-based ethical questions related to the provision of PnPC. We examine why some families who receive the diagnosis of a potentially life-limiting condition in their baby before or after birth receive PnPC support whilst others do not. We describe current inequities in the access to, and delivery of, PnPC. Drawing on philosophical theory (the Capabilities Approach) we argue that palliative care represents a valuable capability for babies with life limiting illness and their families. Health professionals should advocate for and promote access to this option for all families, regardless of whether it is ultimately taken up.</span></span></div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152097"},"PeriodicalIF":3.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226559","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}
The integration of artificial intelligence (AI) into neonatology offers improved patient care while raising ethical challenges across four principles: beneficence, non-maleficence, justice, and autonomy. AI enhances prediction and early detection capabilities, but introduces concerns including the “black box” nature of many algorithms, which compromises transparency and may propagate existing biases. Justice considerations arise from potential inequities in AI development and deployment. Autonomy is challenged when clinicians cannot fully explain algorithmic decision-making, affecting shared decision-making with families. These ethical tensions are particularly acute in neonatology, where decisions impact vulnerable patients who cannot advocate for themselves. Mitigating these challenges requires developing transparent AI systems, ensuring diverse training data, maintaining human oversight of clinical decisions, and conducting rigorous validation across diverse healthcare settings. Responsible implementation requires balancing technological benefits with ethical principles.
{"title":"Preserving medical ethics in the era of artificial intelligence: Challenges and opportunities in neonatology","authors":"Tanima Arora , Habeebah Muhammad-Kamal , Kristyn Beam","doi":"10.1016/j.semperi.2025.152100","DOIUrl":"10.1016/j.semperi.2025.152100","url":null,"abstract":"<div><div><span>The integration of artificial intelligence (AI) into neonatology offers improved patient care while raising ethical challenges across four principles: </span>beneficence, non-maleficence, justice, and autonomy. AI enhances prediction and early detection capabilities, but introduces concerns including the “black box” nature of many algorithms, which compromises transparency and may propagate existing biases. Justice considerations arise from potential inequities in AI development and deployment. Autonomy is challenged when clinicians cannot fully explain algorithmic decision-making, affecting shared decision-making with families. These ethical tensions are particularly acute in neonatology, where decisions impact vulnerable patients who cannot advocate for themselves. Mitigating these challenges requires developing transparent AI systems, ensuring diverse training data, maintaining human oversight of clinical decisions, and conducting rigorous validation across diverse healthcare settings. Responsible implementation requires balancing technological benefits with ethical principles.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 6","pages":"Article 152100"},"PeriodicalIF":3.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235076","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}
Congenital infections are an ongoing relevant cause of congenital and perinatal abnormalities since effective vaccination is not available for many diseases. Moreover, climate change, mutational evolution of pathogens, or their vectors associated with intense human traveling predispose to outbreaks and modification of the geographic distribution of traditionally limited infectious diseases. Here, we review the so-called TORCH infections (toxoplasmosis, others, rubella, cytomegalovirus, herpes) with a special emphasis on the arboviral infections (zika, dengue, chikungunya, oropouche). Although respiratory viruses are rarely transmitted through the placenta, the maternal condition itself can cause adverse effects on the developing embryo/fetus (COVID-19, influenza). Some perinatal-acquired infections will also be briefly discussed due to their relevance in the child's development. The majority of teratogenic congenital and some perinatal-acquired infections have effects on the central nervous system or sensory organs with long-lasting disabilities. Vaccines are unavailable for several teratogenic or perinatal infections, and treatment options are still limited, particularly for arboviral and other emergent diseases. Social inequalities are associated with the prevalence, fetal outcomes and long-term disabilities of these diseases. The One Health approach could be an essential way to reduce the burden of these diseases in the population.
{"title":"Infections during pregnancy: An ongoing threat","authors":"Claudia Fernandes Lorea , Katherine Pressman , Lavinia Schuler-Faccini","doi":"10.1016/j.semperi.2025.152075","DOIUrl":"10.1016/j.semperi.2025.152075","url":null,"abstract":"<div><div>Congenital infections are an ongoing relevant cause of congenital and perinatal abnormalities since effective vaccination is not available for many diseases. Moreover, climate change, mutational evolution of pathogens, or their vectors associated with intense human traveling predispose to outbreaks and modification of the geographic distribution of traditionally limited infectious diseases. Here, we review the so-called TORCH infections (toxoplasmosis, others, rubella, cytomegalovirus, herpes) with a special emphasis on the arboviral infections (zika, dengue, chikungunya, oropouche). Although respiratory viruses are rarely transmitted through the placenta, the maternal condition itself can cause adverse effects on the developing embryo/fetus (COVID-19, influenza). Some perinatal-acquired infections will also be briefly discussed due to their relevance in the child's development. The majority of teratogenic congenital and some perinatal-acquired infections have effects on the central nervous system or sensory organs with long-lasting disabilities. Vaccines are unavailable for several teratogenic or perinatal infections, and treatment options are still limited, particularly for arboviral and other emergent diseases. Social inequalities are associated with the prevalence, fetal outcomes and long-term disabilities of these diseases. The One Health approach could be an essential way to reduce the burden of these diseases in the population.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 4","pages":"Article 152075"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796294","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}
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