Neonatology today最新文献

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Newborn Screening for Congenital Cytomegalovirus (cCMV) Infection: Universal, Targeted, Expanded-Targeted, or None-of-the-Above? 新生儿先天性巨细胞病毒 (cCMV) 感染筛查：普遍筛查、定向筛查、扩展定向筛查，还是非此即彼？

Neonatology today

Pub Date : 2024-08-01

Mark R Schleiss

Congenital cytomegalovirus (cCMV) infection is the most common cause of neurodevelopmental sequelae in the United States (US). The most common long-term disability associated with cCMV is sensorineural hearing loss (SNHL). Among children with cCMV-associated SNHL, over 40% will pass their newborn hearing screen (NHS). Therefore, to maximize the identification of infants at risk for SNHL, there is a strong rationale for universal cCMV screening. Early identification of cCMV also allows for the timely commencement of antiviral therapies for some infants, which in turn can improve clinical outcomes. Congenital infection must be diagnosed in the newborn infant in the first 21 days of life since demonstration of CMV infection beyond this time point commonly reflects postnatal acquisition, typically from breastfeeding. Although many advocates are enthusiastic about universal cCMV screening (1-3), other experts express hesitancy in embracing such a policy recommendation until there is more evidence of cost-effectiveness. Moreover, since most infants with cCMV are asymptomatic and have a good prognosis for normal neurodevelopmental outcomes, there is concern that universal screening may raise undue anxiety for parents of infants with asymptomatic cCMV infection (4). This review considers the pros and cons of different cCMV screening approaches, emphasizing enhancing awareness of new and emerging approaches for neonatologists in clinical practice.

先天性巨细胞病毒（cCMV）感染是美国最常见的神经发育后遗症病因。与 cCMV 相关的最常见的长期残疾是感音神经性听力损失（SNHL）。在患有 cCMV 相关性 SNHL 的儿童中，超过 40% 将通过新生儿听力筛查 (NHS)。因此，为了最大限度地识别有 SNHL 风险的婴儿，有充分的理由进行普遍的 cCMV 筛查。早期识别 cCMV 还能使一些婴儿及时开始接受抗病毒治疗，从而改善临床疗效。新生儿先天性感染必须在出生后 21 天内确诊，因为超过这个时间点的 CMV 感染通常是产后感染，通常是通过母乳喂养感染。尽管许多倡导者热衷于普及 cCMV 筛查（1-3），但其他专家表示，在获得更多成本效益证据之前，他们对接受这样的政策建议还很犹豫。此外，由于大多数感染 cCMV 的婴儿并无症状，且预后良好，神经发育结果正常，因此有人担心普遍筛查可能会让无症状 cCMV 感染婴儿的父母过度焦虑（4）。本综述探讨了不同 cCMV 筛查方法的利弊，强调要提高新生儿科医生在临床实践中对新兴方法的认识。

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引用次数: 0

Lessons Learned from Remote Assessment of Mother-Infant Interactions Among Women with Postpartum Depression. 从远程评估产后抑郁妇女的母婴互动中吸取经验教训。

Neonatology today

Pub Date : 2024-04-01

Rhonda C Boyd, Talia Charidah, Michael Luethke, Roseanne Clark, Marjie Mogul, Knashawn H Morales, David S Mandell, James P Guevara

Purpose: The COVID-19 pandemic posed challenges to measuring mother-infant interactions, a critical outcome for many interventions to support mothers with postpartum depression symptoms and their new infants. The current study describes the process and lessons learned from implementing a remote assessment of mother-infant interactions during the pandemic.

Description: At the onset of the COVID-19 pandemic, we pivoted from in-person to using two different strategies to remotely assess mother-infant interactions: (1) participants independently recorded and uploaded videos of free-play with their child; and (2) research team conducted a live-video recording of the free-play.

Assessment: We found initial barriers including technical and video quality issues but overall, a remote option could increase enrollment and retention rates in a sample of postpartum women across various racial/ethnic groups and economic levels.

Conclusion: Our experiences in conducting remote assessments with postpartum women add to growing evidence for the feasibility and validity of remote visits. This showed how our methods can be implemented in future research and in practice with postpartum mothers and their infants.

目的：COVID-19 大流行给测量母婴互动带来了挑战，而母婴互动是许多干预措施的关键结果，这些干预措施旨在为有产后抑郁症状的母亲及其新生婴儿提供支持。本研究介绍了在大流行期间实施母婴互动远程评估的过程和经验教训：在COVID-19大流行之初，我们从面对面转为使用两种不同的策略来远程评估母婴互动：（1）参与者独立录制并上传与孩子自由玩耍的视频；（2）研究团队对自由玩耍进行现场视频录制：评估：我们发现最初的障碍包括技术和视频质量问题，但总体而言，远程选项可以提高不同种族/民族群体和经济水平的产后妇女样本的注册率和保留率：我们对产后妇女进行远程评估的经验为远程访问的可行性和有效性提供了更多证据。这表明我们的方法可以在未来的研究和实践中应用于产后母亲及其婴儿。

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