Neonatal Network最新文献

Syphilis is primarily a sexually transmitted infection caused by the bacteria Treponema pallidum Cases of syphilis have surged in the United States, with an estimated increase of 80% between 2018 and 2022. Likewise, cases of congenital syphilis (CS) have increased by 740% over the past decade. Congenital syphilis is the second leading cause of stillbirth worldwide and is associated with a mortality risk of nearly 40%. Among fetuses who acquire CS and survive, complications include growth restriction, hydrops fetalis, premature birth, permanent sensorineural hearing loss, facial and dental defects, ocular abnormalities, musculoskeletal deformities, and impaired neurodevelopment in childhood. Consistent educational outreach, increased access to prenatal care and testing, and treatment with benzathine penicillin G are essential to reduce the spread of syphilis in communities and protect the developing fetus. In this article, we present a case report of a preterm neonate with CS and a discussion of the state of the science of syphilis infection.

The skeletal system of neonates may have intrinsic or acquired differences. Challenges that arise in the neonatal period include growth concerns affected by calcium and phosphorus, positional or developmental concerns, or injuries, which could be isolated or related to genetics. Malformations, deformations, and disruptions can be present in any part of the body, from the skull to the feet. The purpose of this article is to provide a brief review of embryologic bone development, bone minerals, and orthopedic anomalies. Injuries and infections that affect the neonatal skeletal system are also discussed. Common orthopedic concerns are highlighted as a primer for novice neonatal caregivers.

The NICU imposes numerous stressors on parents, including infant separation, role uncertainty, and communication barriers, often resulting in emotional and psychological consequences. This stress, if unaddressed, contributes to postpartum depression and posttraumatic stress disorder, affecting parent-infant bonding. Social determinants, including socioeconomic status, race, and health literacy, further influence parental experiences in the NICU. To mitigate these challenges, health care providers should incorporate trauma-informed care and supportive communication, empowering parents to navigate the NICU with resilience. Ultimately, a holistic, family-centered approach is essential to address the multifaceted nature of NICU-related stress, promoting positive outcomes for parents and infants.

A transition from a pharmacological-based model of care, such as Finnegan scoring, to a behavioral-based model, such as the Eat-Sleep-Console, for newborns experiencing neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS) has resulted in shorter lengths of stay and a decreased need for pharmacological management. However, many newborns continue to be exposed to opioids. Use of opioids for NAS/NOWS prolongs the length of stay and often the separation of mothers and their newborns as well. Additionally, opioids may have detrimental neurodevelopmental consequences for newborns. Researchers are seeking safe and effective pharmacological adjuncts to behavioral-based NAS/NOWS management. Could ondansetron be an answer? This column provides a brief review of a meta-analysis supporting the benefits of a behavioral approach to NOWS, a discussion about why ondansetron may be useful in NOWS, an overview of a pharmacokinetic study of ondansetron in mother-infant dyads, and a review of a recently published clinical trial of ondansetron for NOWS.

The Prefeeding Pathways Framework is the first comprehensive, developmentally grounded model designed to guide clinical reasoning in neonatal prefeeding habilitation. The framework centers on three distinct pathways-foundation, guided progression, and performance-providing primary objectives with clear, actionable goals. The framework offers deliberate and dynamic treatment planning supported by broad therapeutic objectives. Relevant empirical evidence was identified through a focused review process and aligned with each pathway to support clinical decision-making. The framework's goal-oriented design ensures the advancement of clinical practice by allowing adaptability as new research and interventions emerge. It enhances clinical expertise by providing a clear structure for adapting treatment to the evolving needs of premature infants.

This column interviews the leaders of the Adult Preemie Advocacy Network, focusing on awareness about patients born prematurely who are now adults. The challenges in life are real but are sometimes not as obvious. However, they are all extremely important for practitioners of all patients young and old to be aware of, as well as the larger community.