2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T470,This study aimed to determine the influence of nosocomial bacterial and viral infections of preterm very low birth weight (VLBW) infants on neurodevelopmental outcome and on rehospitalization rates during the first two years of life. Retrospective single-center cohort study including preterm infant born between 2010 and 2018 and followed until two years of age corrected for prematurity (Bayley scales). Of 620 study infants 418 without neurodevelopmental impairment (NDI). were compared to 202 infants with NDI. Single or multiple nosocomial infections were not risk factors for NDI in a multivariate logistic regression model checked for multicollinearity. Infants with NDI were of younger gestational age, had lower birth weights and higher rates of neonatal complications (ileus, periventricular leukomalacia, and bronchopulmonary dysplasia). Nosocomial infection were also not risk factors for rehospitalizations by infectious diseases. Nosocomial infections did not significantly influence NDI and rehospitalization rates in preterm VLBW infants. The study was registered at "Deutsches Register Klinischer Studien" DRKS00019000.31:T79c,Abstract Objective This study aimed to determine the influence of nosocomial bacterial and viral infections of preterm very low birth weight (VLBW) infants on neurodevelopmental outcome and on rehospitalization rates during the first two years of life. Study design Retrospective single-center cohort study including preterm infant born between 2010 and 2018 and followed until two years of age corrected for prematurity (Bayley scales). Results Of 620 study infants 418 without neurodevelopmental impairment (NDI). were compared to 202 infants with NDI. Single or multiple nosocomial infections were not risk factors for NDI in a multivariate logistic regression model checked for multicollinearity. Infants with NDI were of younger gestational age, had lower birth weights and higher rates of neonatal complications (ileus, periventricular leukomalacia, and bronchopulmonary dysplasia). Nosocomial infection were also not risk factors for rehospitalizations by infectious diseases. Conclusions Nosocomial infections did not significantly influence NDI and rehospitalization rates in preterm VLBW infants. Trial registration number The study was registered at “Deutsches Register Klinischer Studien” DRKS00019000. 32:T54e,This study was conducted with strict adherence to the ethical principles outlined in Good Clinical Practice and the standards set by the International Council for Harmonisation (ICH) Tripartite Guideline, as well as the Japan Good Clinical Practice regulations. Moreover, this trial upholds the ethical considerations and patient rights stipulated in the Declaration of Helsinki and was performed in accordance with the ethical standards of the Independent Ethics Committee at each participating site, which approved all related materials and informed consent forms, as follows: 1. Showa Medical University Hospital Institutional Review Board. 2. Showa Medical University Koto Toyosu Hospital Institutional Review Board. 3. Showa Medical University Northern Yokohama Hospital Institutional Review Board. 4. Nara Medical University Hospital Institutional Review Board. 5. Saitama City Hospital Institutional Review Board. 6. The Central Institutional Review Board for the Fujita Health University Hospitals. 7. Bokutoh Hospital Clinical Trial Review Committee. 8. Review Board of Human Rights and Ethics for Clinical Studies. 9. Social Medical Corporation Aijinkai Group Takatsuki General Hospital Institutional Review Board. 10. Gifu Prefectural General Medical Center Institutional Review Board. 11. St. Marianna University Group Institutional Review Board.33:T619,After Neonatal Intensive Care Unit (NICU) discharge, vulnerable babies at risk of neurodevelopmental impairment and other chronic problems often require specialized follow-up care to monitor their development and address any potential issues. Typically, this involves multiple follow-up visits usually focused on neurodevelopment and growth. With advances in obstetric care, high-risk fetuses are being identified earlier, marking another timepoint in which personalized medicine can be delivered from before birth to after discharge including neuronicu care. Our program embeds this focus into a comprehensive, multi-disciplinary primary care model, which offers significant benefits for at-risk infants, and provides an integrated approach to their care. We present the benefits of integrating this model of care with other specialty clinic services into a cohesive, multi-disciplinary follow-up system that maximizes the potential for optimal care and outcomes. Through close collaboration of our multiple specialists at each point of the medical journey of each infant from "Fetus to Five," we describe our program where the priority is each child's needs to be met efficiently and comprehensively, as a pathway to thriving developmental outcomes and overall family satisfaction. IMPACT: The future of such comprehensive programs lies in expanding access to comprehensive, integrated care offering services that extend into adolescence and adulthood that supports NICU graduates throughout their lifespan, ensuring optimal health and developmental outcomes.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Prematurity: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Prematurity (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Prematurity\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Prematurity\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Prematurity\"}]}}"}}]],["$","$L2f",null,{"title":"Prematurity: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Prematurity with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1038/s41433-026-04813-6","pmid":"42675191","title":"Abnormal exposure of iris blood vessels in a premature infant","journal_title":"Eye","journal_issn":"0950-222X","published_at":"2026-08-31T00:00:00.000Z","url":"https://doi.org/10.1038/s41433-026-04813-6","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-06T06:22:59.701Z","updated_at":"2026-09-06T06:22:59.701Z","tags":[{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"condition","value":"Iris Vascular Abnormality","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"warning","value":"Study design is assumed to be a case report based on the singular phrasing of the title; this could not be confirmed from the text.","value_numeric":null},{"paper_doi":"10.1038/s41433-026-04813-6","tag_type":"warning","value":"The paper abstract/body was not provided — only metadata (title, DOI, journal, date) was available. All structured content is inferred solely from the title and standard case report conventions. Key details such as sample size, clinical findings, outcomes, and specific limitations could not be verified.","value_numeric":null}],"summaries":{"what_studied":"A case report describing abnormal exposure of iris blood vessels in a premature infant, as published in the journal *Eye*.","limitations":"Single case report with no comparator group; findings may not generalize beyond the individual case.","practice_takeaway":"Clinicians examining premature infants should be aware that abnormal iris vascular exposure can occur and may warrant ophthalmologic follow-up."}},{"doi":"10.3389/fped.2026.1900675","pmid":null,"title":"Inverted insulin to C-Peptide ratios in neonatal intensive care: is there something we don't know?","journal_title":"Frontiers in Pediatrics","journal_issn":"2296-2360","published_at":"2026-08-05T00:00:00.000Z","url":"https://doi.org/10.3389/fped.2026.1900675","source_score":63,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-08-10T13:22:12.845Z","updated_at":"2026-08-10T13:22:12.845Z","tags":[{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"condition","value":"Insulin Autoimmune Syndrome","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"condition","value":"Neonatal Hyperglycemia","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"generic","value":"C-peptide","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"generic","value":"insulin","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"modality","value":"Insulin Immunoassay","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"sample_size","value":"n=302","value_numeric":302},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"study_design","value":"Secondary Analysis / Mechanistic Modelling Study","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"warning","value":"Level of evidence assigned as 4 (secondary analysis/modelling); the study itself does not prospectively confirm the antibody-binding mechanism.","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"warning","value":"Sample sizes reflect matched paired samples (n=227 and n=75), not individual patients; patient-level N is smaller and not fully specified.","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"warning","value":"Study design is a secondary analysis integrating previously published datasets and mechanistic modelling — no prospective experimental data were generated; conclusions remain hypothesis-generating.","value_numeric":null},{"paper_doi":"10.3389/fped.2026.1900675","tag_type":"warning","value":"The dominant binding agent (proposed as high-affinity IgM) has not been directly measured in neonates in this context — this is an inference from convergent indirect evidence.","value_numeric":null}],"summaries":{"what_studied":"This secondary analysis integrated three evidence streams to test whether insulin-binding antibodies explain unexpectedly high insulin-to-C-Peptide (I/C) ratios in NICU pre-term neonates not receiving insulin: (1) paired I/C measurements from two NICU cohorts (n=227 and n=75 matched samples), (2) direct measurements of neonatal insulin-binding affinity and concentration across 5 independent studies, and (3) mechanistic modelling of reversible insulin-binding kinetics using a clinically validated neonatal metabolic model.","key_result":"In both cohorts, ~95% of neonates had I/C >0.2 (the accepted upper normal limit), and 40–45% had I/C >1.0 (maximum values reaching 10 and 61, respectively) — ratios traditionally interpreted as evidence of exogenous insulin. Mechanistic modelling using experimentally constrained high-affinity, low-nanomolar binding (KD ~5×10⁻¹¹–10⁻¹⁰ M) reproduced these observed I/C ratios without extreme assumptions; infection (e.g., sepsis) could amplify I/C values up to ~30.","limitations":"- The molecular identity of the dominant neonatal binding agent is unconfirmed; high-affinity IgM is the leading candidate but has not been directly measured prospectively in this context.\n- Paired I/C data come from only two related cohorts at a single NICU, limiting generalisability.\n- Few affinity studies exist specifically in neonates, and the immunoassays used cannot distinguish antibody-bound from free insulin.","practice_takeaway":"In pre-term NICU neonates, high or 'inverted' I/C ratios (>1.0) should **not** automatically be interpreted as evidence of exogenous or factitious insulin — insulin-binding activity is a plausible physiological explanation. When immunoassay I/C readings are discordant, clinical guidance supports antibody testing and/or confirmation with forensic-grade LC-MS before concluding insulin poisoning."}},{"doi":"10.1001/jamapediatrics.2026.2760","pmid":"42475081","title":"Clesrovimab in Infants at Increased Risk For Severe Disease During 2 RSV Seasons","journal_title":"JAMA Pediatrics","journal_issn":"2168-6203","published_at":"2026-07-20T00:00:00.000Z","url":"https://doi.org/10.1001/jamapediatrics.2026.2760","source_score":35,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-25T13:57:39.025Z","updated_at":"2026-07-25T13:57:39.025Z","tags":[{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"brand","value":"Synagis","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"condition","value":"Chronic Lung Disease of Prematurity","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"condition","value":"Congenital Heart Disease","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"condition","value":"Respiratory Syncytial Virus Infection","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"generic","value":"clesrovimab","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"generic","value":"palivizumab","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"modality","value":"Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"sample_size","value":"n=997","value_numeric":997},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"warning","value":"No brand name for clesrovimab was reported in the source text; brand tag for palivizumab (Synagis) was inferred from standard references.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2760","tag_type":"warning","value":"The season 2 arm was open-label and uncontrolled, so efficacy comparisons to palivizumab for a second RSV season cannot be drawn from this trial. The higher MALRI rate in season 2 (7.3%) vs season 1 (~3%) likely reflects older age and/or residual risk rather than reduced drug efficacy, but this cannot be confirmed from the available data. The paper's DOI references a 2026 publication date, which is consistent with the provided 'today's date'; content treated as legitimate.","value_numeric":null}],"summaries":{"what_studied":"This phase 3 RCT (SMART; NCT04938830) evaluated clesrovimab 105 mg vs monthly palivizumab (up to 5 doses) in 997 palivizumab-eligible infants at increased risk for severe RSV disease during season 1, and then clesrovimab 210 mg open-label in 276 of those children who remained at risk in season 2; conducted across 110 sites in 27 countries (Nov 2021–Nov 2025).","key_result":"RSV-associated MALRI rates were equivalent between clesrovimab and palivizumab in season 1 (3.2% vs 3.4% through day 150). Adverse event profiles were comparable in season 1, and clesrovimab 210 mg was well tolerated in season 2, with a MALRI incidence of 7.3% (95% CI, 4.4%–11.4%) through day 180.","limitations":"Season 2 data were open-label with no comparator arm, limiting conclusions about relative efficacy vs palivizumab in a second season. The season 2 cohort (n=276) was substantially smaller than season 1, reducing power. The trial was conducted across highly variable geographic and seasonal RSV patterns, which may affect generalizability.","practice_takeaway":"Clesrovimab (105 mg) is a single-dose alternative to monthly palivizumab for high-risk infants in their first RSV season, with comparable safety and infection rates. Children who remain at elevated risk can receive a 210 mg dose before their second RSV season with an acceptable safety profile."}},{"doi":"10.1038/s41390-026-05301-z","pmid":"42469416","title":"Prediction of bronchopulmonary dysplasia seven days after birth using respiratory and oxygenation timeseries with machine learning","journal_title":"Pediatric Research","journal_issn":"0031-3998","published_at":"2026-07-17T00:00:00.000Z","url":"https://doi.org/10.1038/s41390-026-05301-z","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-22T13:37:27.448Z","updated_at":"2026-07-22T13:37:27.448Z","tags":[{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"condition","value":"Bronchopulmonary Dysplasia","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"modality","value":"Machine Learning / Deep Learning","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"sample_size","value":"n=513","value_numeric":513},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"warning","value":"No external validation cohort was used; internal validation relied on 10-times repeated 5-fold cross-validation only.","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"warning","value":"Single-center data from 2009–2015 may not reflect current NICU practices or patient populations.","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05301-z","tag_type":"warning","value":"The full performance metric tables (Appendix C) were not fully extractable from the source text, so only AUC values from the abstract/results are reported.","value_numeric":null}],"summaries":{"what_studied":"A retrospective study (2009–2015, single NICU) of 513 preterm infants evaluated whether machine learning models incorporating respiratory and oxygenation timeseries (mode of respiratory support, FiO2, SpO2) in the first 7 days of life could better predict bronchopulmonary dysplasia (BPD) at 36 weeks postmenstrual age than models using clinical data alone.","key_result":"The best model (combined neural network + LSTM using clinical data and advanced timeseries features) achieved AUC 0.83 (95% CI 0.81–0.84), significantly outperforming clinical-data-only logistic regression (AUC 0.80, p = 0.005) and clinical data with descriptive timeseries features (AUC 0.81, p = 0.01); 102/513 infants (19.8%) developed BPD.","limitations":"- Single-center retrospective cohort limits generalizability.\n- Small sample size (n=513) precluded formal sample size calculations and model fairness evaluation.\n- No external validation was performed.","practice_takeaway":"Adding advanced ML analysis of SpO2 and FiO2 timeseries from the first week of life modestly but significantly improves BPD prediction over clinical data alone. Clinicians should anticipate future NICU decision-support tools that integrate continuous respiratory monitoring data for earlier BPD risk stratification."}},{"doi":"10.1542/peds.2025-074834","pmid":"42442768","title":"Parental Anxiety Trajectories 2 Years After NICU Discharge","journal_title":"Pediatrics","journal_issn":"0031-4005","published_at":"2026-07-14T00:00:00.000Z","url":"https://doi.org/10.1542/peds.2025-074834","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-22T13:37:59.277Z","updated_at":"2026-07-22T13:37:59.277Z","tags":[{"paper_doi":"10.1542/peds.2025-074834","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"condition","value":"Parental Anxiety","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"condition","value":"Very Low Birth Weight","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"modality","value":"Mental Health Screening","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"sample_size","value":"n=315","value_numeric":315},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"warning","value":"Attrition was substantial across timepoints (up to ~36% of mothers by 24 months), which may affect the reliability of later prevalence estimates.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"warning","value":"Sample size tags reflect the infant cohort (n=315); parental dyad counts differ (298 mothers, 234 fathers) — the numeric tag uses the infant N as the primary cohort denominator.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074834","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the finding that infant medical complexity did not predict parental anxiety, challenging a common clinical assumption — but no intervention was tested in this study.","value_numeric":null}],"summaries":{"what_studied":"Prospective cohort study following 298 mothers and 234 fathers of 315 preterm/VLBW infants (GA <30 weeks and/or birth weight <1000 g), measuring anxiety (STAI) at 6, 12, and 24 months corrected age after NICU discharge.","key_result":"At 6 months, 25.3% of mothers and 16.9% of fathers had clinically significant anxiety (STAI-state ≥40); maternal rates declined modestly to 20.0% at 24 months, while paternal rates held steady (~17%). No perinatal or neonatal risk factors (including gestational age, birth weight, or morbidities) consistently predicted anxiety levels.","limitations":"- High attrition over time (e.g., mothers: 273 → 175) may bias later-timepoint estimates.\n- Single-center or limited-population cohort design may limit generalizability.\n- No intervention arm; study describes trajectories only, not outcomes of support strategies.","practice_takeaway":"Roughly 1 in 5 mothers and 1 in 6 fathers of NICU graduates still carry clinically significant anxiety two years after discharge — regardless of how sick their baby was. Systematic, long-term mental health screening should be offered to **both** parents at every post-NICU follow-up visit, not just those whose infants had the most severe complications."}},{"doi":"10.1002/ppul.71733","pmid":"42438310","title":"Correlation of Transcutaneous pCO\n ₂\n and Capillary pCO\n ₂\n in Newborn Patients Depending on Gestational Age: A Secondary Data Analysis","journal_title":"Pediatric Pulmonology","journal_issn":"8755-6863","published_at":"2026-07-12T00:00:00.000Z","url":"https://doi.org/10.1002/ppul.71733","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-21T13:34:28.581Z","updated_at":"2026-07-21T13:34:28.581Z","tags":[{"paper_doi":"10.1002/ppul.71733","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"condition","value":"Early-Onset Bacterial Infection","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"condition","value":"Respiratory Distress In Neonates","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"modality","value":"Transcutaneous CO2 Monitoring","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"sample_size","value":"n=116","value_numeric":116},{"paper_doi":"10.1002/ppul.71733","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"study_design","value":"Secondary Data Cohort Study","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"warning","value":"No a priori power calculation was performed; the extremely preterm subgroup had only 22 patients (8 at 23–25 weeks), limiting precision of estimates in the most immature group.","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"warning","value":"Study design is labeled 'secondary data cohort study' — not a prospective validation study — which limits causal inference about tcpCO2 accuracy under routine monitoring conditions.","value_numeric":null},{"paper_doi":"10.1002/ppul.71733","tag_type":"warning","value":"The study used capillary (not arterial) pCO2 as the reference standard; the authors note arterial values would likely show more pronounced directional differences. Results may not fully apply to settings using arterial blood gas as the comparator.","value_numeric":null}],"summaries":{"what_studied":"This single-center secondary data cohort study (NICU, RWTH Aachen) evaluated whether gestational age affects the accuracy of transcutaneous CO₂ (tcpCO₂) monitoring compared to capillary pCO₂ (pcCO₂) in 116 neonates during the first postnatal week, using 926 simultaneous paired measurements analyzed with linear mixed-effects models.","key_result":"Extremely preterm infants (<28 weeks) had a median tcpCO₂ overestimation (ΔpCO₂) of 7.6 mmHg [IQR 2.4–13.9], versus 3.1 mmHg for very preterm (28–32 weeks), 0.6 mmHg for late preterm (32–37 weeks), and −0.5 mmHg for term infants. In multivariable analysis, gestational age, early-onset bacterial infection (EOBI), and capillary pCO₂ were independently associated with ΔpCO₂; birth weight was not after adjustment.","limitations":"- Single-center study with a small number of extremely preterm infants (n=22), limiting generalizability.\n- Sensor temperature was set at 40.2°C (below the recommended 42°C), which is known to increase bias and was not adjustable in this dataset.\n- Blood sampling was clinically driven, not protocolized, potentially overrepresenting periods of instability and biasing agreement estimates.","practice_takeaway":"When using tcpCO₂ monitoring in extremely preterm infants (<28 weeks), clinicians should expect a systematic overestimation of ~7–8 mmHg compared to capillary values — more frequent blood gas confirmation is warranted in this group. Early-onset bacterial infection further widens the gap and should prompt additional caution when interpreting tcpCO₂ readings."}},{"doi":"10.1038/s41390-026-05237-4","pmid":"42362701","title":"Automated neonatal sleep positioning assessment by video monitoring and machine learning","journal_title":"Pediatric Research","journal_issn":"0031-3998","published_at":"2026-06-26T00:00:00.000Z","url":"https://doi.org/10.1038/s41390-026-05237-4","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-11T13:33:07.280Z","updated_at":"2026-07-11T13:33:07.280Z","tags":[{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"condition","value":"Neonatal Positioning Complications","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"modality","value":"Machine Learning / Computer Vision","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"sample_size","value":"n=50","value_numeric":50},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"study_design","value":"Proof-of-Concept Study","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"warning","value":"Sample size is reported as 50 neonates (1,510 images); performance metrics should be interpreted cautiously given the small cohort and single proof-of-concept framing.","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"warning","value":"Sex distribution of the neonatal cohort is not explicitly reported in the abstract; 'mixed' sex tag is assumed based on typical NICU population studies.","value_numeric":null},{"paper_doi":"10.1038/s41390-026-05237-4","tag_type":"warning","value":"The study design is retrospective with no prospective clinical validation; generalizability to diverse NICU settings is uncertain.","value_numeric":null}],"summaries":{"what_studied":"A proof-of-concept study evaluated a video-based machine learning system for automated sleep posture classification (supine, prone, right/left lateral, semi-prone) and suboptimal positioning detection in 50 stable preterm neonates (GA 23–36 weeks) using 1,510 images from two NICUs, benchmarked against IPAT scores.","key_result":"Posture classification across five categories achieved a macro F1-score of 0.80 (95% CI: 0.74–0.86). Suboptimal positioning prediction reached AUROC = 0.86 and AUPRC = 0.69; an end-to-end image-to-decision pipeline achieved AUROC = 0.87 and AUPRC = 0.70.","limitations":"- Small sample (n=50 neonates, 1,510 images) from only two NICUs limits generalizability.\n- Performance ceiling appeared to be driven by labeling inconsistency rather than model complexity, suggesting ground-truth quality is a key bottleneck.\n- Retrospective, proof-of-concept design with no prospective clinical validation or outcome data.","practice_takeaway":"Continuous incubator camera feeds can be used with ML models to flag positioning deterioration between routine nursing checks in the NICU. This technology is not yet clinically validated, but early results support feasibility for 24/7 automated repositioning alerts in preterm infants."}},{"doi":"10.1038/s41372-026-02745-3","pmid":"42259949","title":"Equipping perinatal teams to practice climate-smart healthcare","journal_title":"Journal of Perinatology","journal_issn":"0743-8346","published_at":"2026-06-08T00:00:00.000Z","url":"https://doi.org/10.1038/s41372-026-02745-3","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:52.194Z","updated_at":"2026-06-17T13:29:52.194Z","tags":[{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"condition","value":"Adverse Perinatal Outcomes","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"condition","value":"Congenital Anomalies","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"condition","value":"Low Birth Weight","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"condition","value":"Stillbirth","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"study_design","value":"Perspective / Expert Opinion","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"warning","value":"No primary data or systematic review; this is an opinion/perspective piece — findings reflect expert consensus, not empirical study results.","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"warning","value":"Sample size tag omitted as no study population is enrolled.","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02745-3","tag_type":"warning","value":"The DOI year (2026) matches the stated publication date; the paper appears to be very recently published as of today's date.","value_numeric":null}],"summaries":{"what_studied":"This perspective outlines the content of a proposed climate curriculum for perinatal healthcare professionals, covering climate change health effects (stillbirth, prematurity, low birth weight, congenital anomalies, neurodevelopment), environmental and social justice, disaster planning, and mitigation strategies.","key_result":"The authors argue that pregnant people and infants are disproportionately harmed by climate change, and that targeted education — from medical school through continuing professional development — is essential to prepare perinatal teams to recognize and address these harms.","limitations":"This is an expert perspective without primary data, systematic review, or outcome measurement; no curriculum has been formally implemented or evaluated in this paper.","practice_takeaway":"Perinatal clinicians should seek out or advocate for climate health education in their training programs, with attention to disaster preparedness and health equity. Advocacy for climate-protective policies is framed as a professional responsibility for this specialty."}},{"doi":"10.1038/s41372-026-02712-y","pmid":"42225922","title":"Probiotics and necrotizing enterocolitis in preterm infants after the food and drug administration warning actions","journal_title":"Journal of Perinatology","journal_issn":"0743-8346","published_at":"2026-06-02T00:00:00.000Z","url":"https://doi.org/10.1038/s41372-026-02712-y","source_score":56,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:48.714Z","updated_at":"2026-06-11T13:42:48.714Z","tags":[{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"condition","value":"Necrotizing Enterocolitis","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"condition","value":"Prematurity","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"modality","value":"Probiotic","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"sample_size","value":"n=10083","value_numeric":10083},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"study_design","value":"Natural Experiment / Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"warning","value":"Level of evidence assigned as 3 (observational cohort with comparator group); no randomization was performed.","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"warning","value":"Sex distribution is not explicitly reported in the abstract; 'mixed' is assumed based on the population type.","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"warning","value":"The paper's DOI year (2026) is consistent with today's date but is unusually early for a published article with a 2025 data endpoint — confirm publication details if citing formally.","value_numeric":null},{"paper_doi":"10.1038/s41372-026-02712-y","tag_type":"warning","value":"The study is observational with a difference-in-differences design; causal attribution of increased NEC to probiotic cessation (vs. other concurrent practice changes) should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"This natural experiment compared NEC rates in preterm infants at high probiotic-use centers (HUCs, n=2,785) vs. low-use centers (LUCs, n=7,298) before and after the 2023 FDA warning actions on probiotics, using difference-in-differences analysis over two 12-month windows (Oct 2022–Sep 2023 vs. Apr 2024–Mar 2025).","key_result":"After FDA action, probiotic use dropped sharply in HUCs (86% → 6.9%). NEC incidence rose in HUCs (2.7% → 4.4%) but stayed flat in LUCs (~3.6%), yielding an adjusted difference-in-differences of +1.18% (95% CI 0.03–2.33%, P = 0.045).","limitations":"Observational design limits causal inference; residual confounding between center types cannot be excluded. Rapid, unplanned cessation of probiotics (rather than a controlled withdrawal) makes it hard to separate the effect of stopping from other simultaneous practice changes.","practice_takeaway":"Centers that routinely used probiotics in preterm infants saw a significant rise in NEC after abruptly stopping following the FDA warning. Clinicians at such centers should weigh the NEC risk of sudden discontinuation and consider structured transition plans if changing probiotic practice."}},{"doi":"10.1038/s41372-026-02681-2","pmid":"42086726","title":"Impact of nosocomial infections on neurodevelopmental outcome and rehospitalization rate in preterm infants with birth weight below 1500 g (NINO study)","journal_title":"Journal of Perinatology","journal_issn":"0743-8346","published_at":"2026-05-06T00:00:00.000Z","url":"https://doi.org/10.1038/s41372-026-02681-2","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1038/s41372-026-02681-2","days":"7","issn":"0743-8346","rank":"2","field":"Clinical Medicine","score":"10","category":"Obstetrics & Gynecology","categories":["Obstetrics & Gynecology"],"_categories":["Obstetrics & Gynecology"]},"pubmed":{"doi":"10.1038/s41372-026-02681-2","title":"Impact of nosocomial infections on neurodevelopmental outcome and rehospitalization rate in preterm infants with birth weight below 1500 g (NINO study).","journal":"Journal of perinatology : official journal of the California Perinatal Association","methods":"","results":"Of 620 study infants 418 without neurodevelopmental impairment (NDI). were compared to 202 infants with NDI. Single or multiple nosocomial infections were not risk factors for NDI in a multivariate logistic regression model checked for multicollinearity. Infants with NDI were of younger gestational age, had lower birth weights and higher rates of neonatal complications (ileus, periventricular leukomalacia, and bronchopulmonary dysplasia). Nosocomial infection were also not risk factors for rehospitalizations by infectious diseases.","abstract":"$30","keywords":[],"pubmed_id":"42086726","conclusions":"","publication_date":"2026-05-06T00:00:00"},"crossref":{"DOI":"10.1038/s41372-026-02681-2","URL":"https://doi.org/10.1038/s41372-026-02681-2","ISSN":["0743-8346","1476-5543"],"link":[{"URL":"https://www.nature.com/articles/s41372-026-02681-2.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41372-026-02681-2","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41372-026-02681-2.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Impact of nosocomial infections on neurodevelopmental outcome and rehospitalization rate in preterm infants with birth weight below 1500 g (NINO study)"],"author":[{"given":"Elisabeth","family":"Resch-Poteralski","sequence":"first","affiliation":[]},{"given":"Ute","family":"Maurer-Fellbaum","sequence":"additional","affiliation":[]},{"given":"Julia","family":"Eichberger","sequence":"additional","affiliation":[]},{"given":"Volker","family":"Strenger","sequence":"additional","affiliation":[]},{"given":"Robert","family":"Krause","sequence":"additional","affiliation":[]},{"given":"Elisabeth","family":"Pichler-Stachl","sequence":"additional","affiliation":[]},{"given":"Alexander","family":"Avian","sequence":"additional","affiliation":[]},{"given":"Bernhard","family":"Resch","sequence":"additional","affiliation":[]},{"given":"Berndt","family":"Urlesberger","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,5,5]]},"member":"297","prefix":"10.1038","source":"Crossref","volume":null,"created":{"date-time":"2026-05-05T08:16:08Z","timestamp":1777968968000,"date-parts":[[2026,5,5]]},"indexed":{"date-time":"2026-05-05T09:11:28Z","timestamp":1777972288473,"date-parts":[[2026,5,5]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000,"date-parts":[[2026,5,5]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000,"date-parts":[[2026,5,5]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://www.nature.com/articles/s41372-026-02681-2"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"23 January 2026"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"6 March 2026"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"31 March 2026"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"5 May 2026"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":1,"value":"The authors declare no competing interests."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"},"order":2,"value":"by the local ethic committee of the Medical University of Graz ID 31-396 ex 18/19. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki."}],"deposited":{"date-time":"2026-05-05T08:16:09Z","timestamp":1777968969000,"date-parts":[[2026,5,5]]},"issn-type":[{"type":"print","value":"0743-8346"},{"type":"electronic","value":"1476-5543"}],"published":{"date-parts":[[2026,5,5]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.1016/S0140-6736(17)31002-4","key":"2681_CR1","year":"2017","issue":null,"author":"AL Shane","volume":"390","first-page":"1770","unstructured":"Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet. 2017;390:1770–80.","article-title":null,"journal-title":"Lancet","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.cmi.2023.04.017","key":"2681_CR2","year":"2024","issue":null,"author":"R Thomas","volume":"30","first-page":"28.e37","unstructured":"Thomas R, Bijlsma MW, Goncalves BP, Nakwa FL, Velaphi S, Heath PT. 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NDI was instead associated with younger gestational age, lower birth weight, and higher rates of ileus, periventricular leukomalacia, and bronchopulmonary dysplasia.","limitations":"Retrospective single-center design limits generalizability. Follow-up only to 2 years corrected age may miss later neurodevelopmental effects. No detail provided on infection types, severity, or pathogens.","practice_takeaway":"Nosocomial infections alone do not appear to drive NDI or rehospitalization risk in VLBW preterm infants — prematurity severity and neonatal complications (BPD, PVL) remain the dominant risk factors. Clinicians should focus neurodevelopmental surveillance resources on the youngest, smallest, and most complication-prone infants."}},{"doi":"10.1038/s41372-026-02695-w","pmid":"42045666","title":"Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan","journal_title":"Journal of Perinatology","journal_issn":"0743-8346","published_at":"2026-04-28T00:00:00.000Z","url":"https://doi.org/10.1038/s41372-026-02695-w","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-27","doi":"10.1038/s41372-026-02695-w","days":"30","issn":"0743-8346","rank":"7","field":"Clinical Medicine","score":"14","category":"Obstetrics & Gynecology","categories":["Obstetrics & Gynecology"],"_categories":["Obstetrics & Gynecology"]},"pubmed":{"doi":"10.1038/s41372-026-02695-w","title":"Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan.","journal":"Journal of perinatology : official journal of the California Perinatal Association","methods":"","results":"","abstract":"To determine safety and efficacy of exclusive human milk diet (EHMD) for very low birth weight (VLBW, <1500 g) infants.\nProspective, controlled, open trial of VLBW infants randomized to EHMD (mother's own milk [MOM]/donor milk [DM] with human milk-based fortifiers) or Standard Diet (MOM/DM with cow milk-based fortifier/formula). Outcomes included superiority of weight gain velocity from birth to 34 weeks gestational age, time to full feeds, and safety.\nIn total, 147 infants received EHMD (n = 77) or Standard Diet (n = 70). The EHMD group had superior mean weight gain velocity versus the Standard Diet (13.44 vs 11.96 g/kg/day, p = 0.006) and earlier mean time to full feeds (20.0 vs 25.9 days, p = 0.03); adverse events were not significantly different (32.5% vs 21.4%, p = 0.13).\nEHMD is viable for management of VLBW infants, providing improved growth without reduced safety.\nJapan Registry of Clinical Trials: jRCT2031210384.","keywords":[],"pubmed_id":"42045666","conclusions":"EHMD is viable for management of VLBW infants, providing improved growth without reduced safety.","publication_date":"2026-04-28T00:00:00"},"crossref":{"DOI":"10.1038/s41372-026-02695-w","URL":"https://doi.org/10.1038/s41372-026-02695-w","ISSN":["0743-8346","1476-5543"],"link":[{"URL":"https://www.nature.com/articles/s41372-026-02695-w.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41372-026-02695-w","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41372-026-02695-w.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan"],"author":[{"given":"Katsumi","family":"Mizuno","sequence":"first","affiliation":[]},{"given":"Tokuo","family":"Miyazawa","sequence":"additional","affiliation":[]},{"given":"Utako","family":"Kondo","sequence":"additional","affiliation":[]},{"given":"Toshiya","family":"Nishikubo","sequence":"additional","affiliation":[]},{"given":"Yutaka","family":"Yamamoto","sequence":"additional","affiliation":[]},{"given":"Yuya","family":"Nakano","sequence":"additional","affiliation":[]},{"given":"Takehiko","family":"Hiroma","sequence":"additional","affiliation":[]},{"given":"Kazushige","family":"Ikeda","sequence":"additional","affiliation":[]},{"given":"Masahiko","family":"Murase","sequence":"additional","affiliation":[]},{"given":"Hitomi","family":"Jimi","sequence":"additional","affiliation":[]},{"given":"Isamu","family":"Hokuto","sequence":"additional","affiliation":[]},{"given":"Masafumi","family":"Miyata","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,4,27]]},"member":"297","prefix":"10.1038","source":"Crossref","volume":null,"created":{"date-time":"2026-04-27T07:00:35Z","timestamp":1777273235000,"date-parts":[[2026,4,27]]},"indexed":{"date-time":"2026-04-27T07:48:56Z","timestamp":1777276136229,"date-parts":[[2026,4,27]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc-nd/4.0","start":{"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000,"date-parts":[[2026,4,27]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by-nc-nd/4.0","start":{"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000,"date-parts":[[2026,4,27]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://www.nature.com/articles/s41372-026-02695-w"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"7 April 2025"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"18 March 2026"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"10 April 2026"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"27 April 2026"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":1,"value":"The authors declare no competing interests."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"},"order":2,"value":"$32"}],"deposited":{"date-time":"2026-04-27T07:00:49Z","timestamp":1777273249000,"date-parts":[[2026,4,27]]},"issn-type":[{"type":"print","value":"0743-8346"},{"type":"electronic","value":"1476-5543"}],"published":{"date-parts":[[2026,4,27]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":null,"key":"2695_CR1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Neonatal Research Network of Japan. 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It describes referral criteria, volumes, demographics, operations, and cites prior randomized evidence supporting comprehensive follow‑up care.","key_result":"A cited randomized trial of very‑low‑birth‑weight infants (n=887) comparing routine vs comprehensive clinic‑based care from NICU discharge to age 1 year found fewer life‑threatening illnesses (33 vs 63), fewer ICU admissions (23 vs 53), fewer ICU days (254 vs 440), and lower mean cost ($6265 vs $9913), with more clinic visits (+3.1) and phone contacts (+6.7). The program also reports research follow‑up rates exceeding 90% into school age for multiple trials.","limitations":"The randomized evidence summarized was conducted decades earlier (infants born 1988–1996), which may limit contemporaneous applicability. This article is a descriptive program review and does not present new comparative outcome data.","practice_takeaway":"For high‑risk NICU graduates, a comprehensive, integrated medical‑home follow‑up model with coordinated subspecialty care and 24/7 access can reduce serious illness and ICU use without increasing costs. Health systems planning NICU follow‑up should integrate fetal consultation, NeuroNICU protocols, and a centralized clinic to improve continuity and research follow‑up (>90%)."}}],"initialOffset":13,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Prematurity"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Prematurity"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Prematurity"}}}]]

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