The concept of small vulnerable newborns has been proposed, including preterm birth, low birth weight, and small for gestational age, leading causes of perinatal mortality. We aimed to identify high-risk factors for small vulnerable newborns and develop a predictive model through a retrospective analysis. We collected clinical data from pregnant women who met inclusion criteria between January 2015 and December 2023 and divided them into training and validation cohorts. We used univariate analysis and mean decreases in the Gini index to screen for potential risk factors. We applied the least absolute shrinkage and selection operator regression to select final predictors and construct a nomogram. We assessed model performance using receiver operating characteristic curves, calibration curves, and clinical decision analysis, with internal validation via 10-fold cross-validation and temporal internal validation. Among 129 554 women, 13 801 (10.66%) had small vulnerable newborn, with the incidence increasing from 2015 (10.15%) to 2023 (11.61%). Key risk factors included multiple pregnancies (odds ratio (OR) = 37.2), pre-pregnancy body mass index (BMI) of <18.5 (OR = 8.61) and ≥25 kg/m2 (OR = 6.40), maternal age of <25 (OR = 6.81) and ≥35 years (OR = 3.72), hypertensive disorders of pregnancy (OR = 2.81), and placental disorders (OR = 3.03). Other significant factors were assisted reproductive technology, mycoplasma/chlamydia infection, and elevated bile acids. The nomogram demonstrated strong predictive performance (area under the curve = 0.873). The incidence of small, vulnerable newborns rose notably during 2021-2023. The developed model, incorporating age, pre-pregnancy BMI, multiple pregnancies, hypertensive disorders of pregnancy, and placental disorders, is designed to be applied in the third trimester and enables risk identification, facilitating targeted interventions to reduce neonatal mortality and complications. Chinese Clinical Trial Registry, ChiCTR2400093923.

Studies on pregnancy in myasthenia gravis (MG) are limited by small sample sizes or examine a limited number of outcomes. The objective of this study was to estimate the prevalence of perinatal and infant outcomes and characterize perinatal treatment patterns in MG. We conducted a retrospective cohort study in Merative MarketScan Commercial Claims and Encounters (CCAE) and two other United States health insurance claims databases. Pregnancies in females aged 18-49 years were identified and maternal and infant records were linked. MG was defined by ≥ 1 inpatient or ≥ 2 outpatient diagnoses within a 365-day period. The prevalence of six perinatal outcomes was calculated in the MG and total populations. Treatments were summarized by class. In pregnancies from CCAE between 2000-2023, preeclampsia (10.7% vs. 7.1%), Cesarean section (42.9% vs. 36.7%), preterm birth (18.0% vs. 9.9%), and small for gestational age (4.3% vs. 1.7%) were more frequent among MG (n = 900) than the age-adjusted total population (n = 5,185,726). Lack of treatment for MG was common across the perinatal period: 54.3% were untreated in the 6 months preconception, 61.2% in pregnancy, and 57.8% in the 6 months postpartum. Of those taking acetylcholinesterase inhibitors or corticosteroids in pregnancy, 21.8% and 33.1% had not been taking them before pregnancy, respectively. MG was associated with a greater prevalence of certain perinatal outcomes, occurring in both mother and infant. In parallel, though most patients did not receive treatment in pregnancy those who did showed variation over time, suggesting a potential need for this population.

Background/Objectives: Emergency department (ED) physicians may hesitate to order medically indicated imaging (MI) for pregnant patients, potentially delaying or omitting necessary diagnostic procedures. This study aimed to assess the attitudes and practices of ED physicians regarding MI procedures in pregnant patients, considering their level of training. Methods: A total of 300 physicians participated, including ED general practitioners (n = 100), emergency medicine (EM) residents (n = 100), and EM specialists (n = 100). The first section of the questionnaire collected demographic data, professional experience, and previous training related to the subject. The second section included questions based on a modified version of the American College of Radiology (ACR) Appropriateness Criteria to assess attitudes and behaviors. Results: A majority (88.7%) of participants found the management of pregnant trauma patients challenging and expressed a preference to avoid such cases. A statistically significant difference was observed between physician groups regarding the approach to unstable pregnant patients, with EM specialists and residents more likely to disregard gestational age when deciding on imaging (p &lt; 0.001). Physicians who had received relevant training were significantly more likely to advocate immediate imaging regardless of gestational age in unstable patients (p = 0.001). Conclusions: This study highlights the diversity and statistical heterogeneity in ED physicians’ attitudes and behaviors toward MI use in pregnant patients. These variations are influenced by training, clinical experience, and accessibility of updated guidelines. Enhancing education and standardizing procedural guidance may improve decision-making and ultimately reduce maternal and fetal morbidity and mortality. Based on these findings, we propose a clinical algorithm to support imaging decisions in emergency settings.

ABSTRACT Background Staphylococcus (S.) aureus remains a frequent pathogen for neonatal late-onset bloodstream infections (BSIs). The impact of colonization screening on BSI incidence is less understood. Methods We assessed the epidemiology of late-onset S. aureus BSI in two independent multicenter cohorts of preterm infants born at < 33 weeks' gestation, the German Neonatal Network (GNN, very low birth weight infants) and PRIMAL (infants with a gestational age 28−32 weeks). In the PRIMAL cohort, we determined S. aureus colonization in fecal samples by culture and shotgun metagenomic sequencing (metaG) during the first year of life. In addition, we integrated publicly available metaG data from preterm infant cohorts born at 23–34 weeks' gestation. Results Late-onset S. aureus BSI was noted in 1.5% (336/21491) in preterm infants in the GNN cohort and 0.5% (3/638) in the PRIMAL cohort, respectively. At day 30 of life, 7.6% (42/553) of fecal samples were positive for S. aureus, while available metaG data of corresponding samples revealed S. aureus positivity in 36.6% (159/434). Every 10-fold increase in S. aureus relative abundance (metaG) was associated with a 2.9-fold higher odds of S. aureus detection in blood culture. We also confirmed S. aureus detection in 22% (393/1782) of samples across several published cohorts of preterm infants by metaG, while 95 samples carried at least one Staphylococcus-specific virulence gene (SVG). Conclusion Our study demonstrates that metagenomic quantification of pathobionts such as S. aureus in intestinal samples provides a stronger predictor of colonization than culture. Future prevention strategies should focus on promoting S. aureus colonization resistance through microbiome-informed approaches.

Preterm birth presents long-term neurodevelopmental complications imposing substantial burdens on affected children and families. Early intervention (EI) programs have shown promise in mitigating these challenges, but their long-term efficacy remains unclear. The aim of the study was to assess the long-term neurodevelopmental outcomes of preterm infants following participation in a parent-based EI program during NICU stay. Additionally, the study investigates the modulation of LINE1 promoter methylation at early school age. We conducted a secondary analysis of a larger RCT that included preterm infants (25-29weeks gestational age) randomized to receive Standard Care (SC) or Early Intervention (EI), including parental training and multisensory experiences. At 5-6years, neurodevelopmental assessments were conducted and LINE1 promoter methylation levels were analyzed in buccal swab samples. 36 infants (21 EI, 15 SC) completed the long-term follow-up and were included in the present analysis. EI children exhibited significantly higher Griffiths scores compared to the SC group (mean General Developmental Quotient: EI = 90.4 SC = 82.3, p = 0.003). Longitudinal analysis performed with a mixed model revealed sustained benefits of EI, with increasing divergence in developmental outcomes over time. LINE1 methylation analysis did not reveal significant variations between groups. This study demonstrates the potential of EI programs in improving long-term neurodevelopmental outcomes for preterm infants. These findings underscore the need for continued research into effective intervention strategies to optimize outcomes for preterm-born children.Trial registration: ClinicalTrial.gov (NCT02983513).

Hormonal trends during reproductive stages and ultrasonographic monitoring of gestational age in British Shorthair cats.

Fetal renal ultrasonography in canine pregnancy: relationship with maternal and fetal metrics for assessing fetal maturity.

Selective fetal growth restriction (sFGR) in monochorionic twin pregnancies is a major contributor to perinatal morbidity and mortality with unique pathophysiological mechanisms and management challenges. sFGR is defined by significant intertwin discordance in estimated fetal weight and abnormal Doppler findings, employing the Gratacós classification (types I, II, and III) for risk stratification and management. Epidemiological data indicate sFGR affects 10% to 26% of monochorionic twins, with early-onset cases associated with the highest risk of adverse outcomes. Surveillance strategies include frequent ultrasound and Doppler assessment, and management is tailored to sFGR type, gestational age, and fetal condition. Expectant management is favored for type I sFGR, while type II and III may require fetal intervention, including fetoscopic laser photocoagulation or selective reduction, though practice variation remains substantial. Recent meta-analyses highlight the importance of Doppler progression, gestational age at diagnosis, and ductus venosus findings as predictors of fetal demise. Advances in imaging, biomarkers, and intervention techniques are shaping future practice, but randomized trials are needed to clarify optimal strategies. Controversies persist regarding timing of intervention, ethical considerations, and outcome prediction. In conclusion, individualized, multidisciplinary management is essential, and ongoing research should focus on refining diagnostic criteria, improving neurodevelopmental outcomes, and developing evidence-based guidelines.

Identifying cognitive vulnerability in school-aged children born preterm: The role of neonatal and early-life factors.

Population health impacts of national health insurance coverage for neonatal intensive care unit admission in South Korea: evidence from regression discontinuity analyses.

Implementation of a novel surveillance and clinical decision support technology for the management of severe maternal hypertension.

ntroduction. The recently approved vaccine against respiratory syncytial virus (RSV) is administered to pregnant women and confers immunity to their babies; however, the evaluation of its effectiveness is limited. Objective. To evaluate the effectiveness of the vaccine against hospitalization due to RSV in children under 6 months of age during the vaccination campaign for pregnant women. Population and methods. Case-control study nested in a cohort of newborns whose mothers were indicated for RSV vaccination in Córdoba, Argentina. We included 180 cases with positive laboratory results for RSV and 1,069 asymptomatic controls who attended routine check-ups. Multiple logistic regression models were performed considering the presence of RSV as the primary response variable, adjusted for maternal age, gestational age, birth weight, maternal influenza vaccination, maternal education level, and multiple births. Vaccine effectiveness was calculated using the formula EV = (1 - OR) × 100. Results. The RSV vaccine reduces the likelihood of becoming ill with RSV by 74.0% (OR: 0.26; CI: 0.170.39); the influenza vaccine reduces it by 70% (OR: 0.30; CI: 0.21-0.43). For each completed week of gestational age, protection against the disease increases by 10% (OR: 0.90; CI: 0.81-0.99). Conclusion. The vaccine is effective against hospitalization due to RSV in children under 6 months of age, who are the most vulnerable population, and could be an essential tool for reducing morbidity and mortality due to RSV.

Faltering weight in infants with cleft lip and palate.

Twin pregnancy with the first twin in breech presentation: Survival and neurodevelopmental outcome of preterm infants at a corrected age of 2 years.

Predicting mid-term hearing and developmental outcome in clinically inapparent congenital cytomegalovirus infection with hearing loss at birth.

Extremely-to-very preterm birth and being small for gestational age increase the risk of severe airflow obstruction in patients with asthma.

Predictors for the efficacy of methotrexate and mifepristone treatment in ectopic pregnancy.

Inequalities in neonatal unit mortality in England and Wales between 2012 and 2022: a retrospective cohort study.

Impact of procedural pain during NICU hospitalization on sleep, physical growth, brain maturation and neurobehavioral development in preterm infants: A prospective longitudinal study.

Implementation of Placental Growth Factor in a Tertiary Western Canadian Centre: Association with Ultrasound Findings and Perinatal Outcomes.