Abstract:
:Billions of dollars are spent yearly in perinatal medicine on studies designed to improve outcomes for mothers and their neonates. However, implementing research findings is challenging and imperfect. Strategies for implementation must be multifaceted and comprehensive. These implementation challenges extend to, and are often greater in, translational and basic science research. The purpose of this review is to discuss current challenges in the provision of quality perinatal and neonatal medical care, particularly those related to preterm birth, and provide examples of prematurity-related perinatal quality collaborative initiatives. Finally, the authors review considerations in implementing both clinical and translational/basic science prematurity research.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Manuck TA,Fry RC,McFarlin BLdoi
10.1016/j.clp.2018.01.003subject
Has Abstractpub_date
2018-06-01 00:00:00pages
155-163issue
2eissn
0095-5108issn
1557-9840pii
S0095-5108(18)30003-4journal_volume
45pub_type
杂志文章,评审abstract::There is now clear evidence that dietary supplementation of omega-3 fatty acid is essential for normal eye and brain development. Corn oil-based diets induce omega-3 deficiency in preterm infants, affecting retinal responses to light, cortical visual evoked potentials, and behavioral measures of visual acuity. Preterm...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::The Healthy People 2000 objectives for breastfeeding were to move the breastfeeding initiation rate to 75% from 54% and the breastfeeding continuation rate to 50% at age 6 months from the 1988 baseline of 21%. The 1996 data indicated that the goal will not be met either for initiation or duration in spite of governmen...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract::Although hyperbilirubinemia is extremely common among neonates and is usually mild and transient, it sometimes leads to bilirubin-induced neurologic damage (BIND). The auditory pathway is highly sensitive to the effects of elevated total serum/plasma bilirubin (TB) levels, with damage manifesting clinically as auditor...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2016.01.006
更新日期:2016-06-01 00:00:00
abstract::Stridor, a common presenting sign of respiratory distress in a newborn, has many systemic causes. It may arise from the larynx or the tracheobronchial airway. This article presents the most common pathologic conditions in this anatomic region, with highlights on management. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2018.07.015
更新日期:2018-12-01 00:00:00
abstract::Discussed in this article are the effects of pregnancy-induced hypertension on the renin-angiotensin-aldosterone system; the possible role of prostanoids, deoxycorticosterone, and deoxycorticosterone sulfate in blood pressure control; and the effect of pregnancy-induced hypertension upon the endocrinology of the mater...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1983-10-01 00:00:00
abstract::This article discusses the management of short bowel syndrome during the neonatal period. It includes information regarding etiology and pathophysiology and parenteral and enteral nutrition therapy. Finally, a discussion of the role of intestinal transplantation in the treatment of short bowel syndrome is included. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Beta-sympathomimetic agents are used extensively in obstetrics to inhibit premature labor. Knowledge of the pharmacology, mode of action on smooth muscle, and cardiovascular and metabolic side effects of these agents is essential for the obstetrician and perinatologist. This review article draws extensively on recent ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::The last decades of bilirubin research seem to have clarified the basic mechanisms by which bilirubin enters the brain. Clinical studies have so far failed to show any value of the presently known risk factors in predicting bilirubin toxicity in the newborn infant, however. This indicates that bilirubin entry into the...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-06-01 00:00:00
abstract::Moderate preterm, late preterm, and early term deliveries represent a major and growing public health concern. These deliveries are associated with significant financial burden and pose serious risks to mothers and newborns. Women who deliver at moderate and late gestational ages in one pregnancy are at increased risk...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2013.07.001
更新日期:2013-12-01 00:00:00
abstract::This chapter describes the utility of event-related potential recordings in the assessment of auditory and visual system integrity in the newborn infant. A battery of electrophysiologic tests is described that permits the evaluation of sequential levels of processing within these sensory system. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::The treatment of cocaine abuse among pregnant women involves attention not only to the cocaine use, but also to the pregnancy and constellation of medical and social problems substance-abusing women experience. Writing about the needs of women who enter treatment for drug-dependence treatment, Reed has offered suggest...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::The incidence of neonatal abstinence syndrome owing to prenatal opioid exposure has grown rapidly in recent decades and it disproportionately affects rural, non-white, and public insurance-dependent populations. Treatment consists of pharmacologic and nonpharmacologic interventions with wide variability in approaches ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.08.012
更新日期:2019-12-01 00:00:00
abstract::Normal pregnancy produces profound metabolic alterations that occur, in large part, by the conclusion of the first trimester. Although necessary to support the metabolic needs of the conceptus, the metabolic and cardiovascular changes of pregnancy are well established weeks before the metabolic needs of the fetus and ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::This article explains the mechanisms underlying choices of pharmacotherapy for hypoxic-ischemic insults of both preterm and term babies. Some preclinical data are strong enough that clinical trials are now underway. Challenges remain in deciding the best combination therapies for each age and insult. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2013.09.004
更新日期:2014-03-01 00:00:00
abstract::Familial hypothyroidism results from both thyroidal and extrathyroidal dysfunction. Specific intrathyroidal abnormalities in thyroid hormone synthesis causing goitrous hypothyroidism are iodide trap defect, organification defect, "coupling" defect, iodoprotein defect, and dehalogenase defect. The diagnostic studies fo...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1976-03-01 00:00:00
abstract::Based on the authors' review of the literature on pediatric postoperative pain assessment with special attention to groups of vulnerable infants, this article (1) reports on type of surgery and its relationship to postoperative pain intensity; (2) reviews the characteristics of existing postoperative pain instruments ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(02)00015-5
更新日期:2002-09-01 00:00:00
abstract::Several microangiopathic disorders that are encountered during pregnancy provide physicians with a formidable diagnostic challenge. Severe pre-eclampsia with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and many other obstetric and medical or surgical conditions produce similar clinical presen...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2004.06.007
更新日期:2004-12-01 00:00:00
abstract::Congenital diaphragmatic hernia (CDH) is a common birth anomaly. Absence or presence of liver herniation and determination of lung-to-head ratio are the most accurate predictors of prognosis for fetuses with CDH. Though open fetal CDH repair has been abandoned, fetal endoscopic balloon tracheal occlusion promotes lung...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2012.04.005
更新日期:2012-06-01 00:00:00
abstract::History has always been a series of pendulum swings, and there is perhaps no better example in obstetrics than that of vaginal birth after cesarean. Vaginal birth after cesarean (VBAC) rates rose steadily in the early 1990s. However, VBAC rates have declined dramatically over recent years, while the cesarean delivery ...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:10.1016/j.clp.2011.03.005
更新日期:2011-06-01 00:00:00
abstract::Preterm birth remains a significant health concern. Maternal reproductive infections such as bacterial vaginosis pose increased risk for preterm birth, although treatment of bacterial vaginosis has not proven to be universally effective in preterm birth prevention. Maternal oral infection such as clinical periodontal ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2005.05.002
更新日期:2005-09-01 00:00:00
abstract::Neonatal sepsis continues to take a devastating toll globally. Although adequate to protect against invasive infection in most newborns, the distinct function of neonatal innate host defense coupled with impairments in adaptive immune responses increases the likelihood of acquiring infection early in life, with subseq...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2010.04.001
更新日期:2010-06-01 00:00:00
abstract::Babies of extremely low birthweight and elderly adults both require expensive and scarce resources, and both have a relatively poor prognosis for survival if they require intensive care. Thus, proposals for rationing often target one or both of these groups. We suspected that although mortality rates might be higher i...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::The development of the flow-directed pulmonary artery catheter in the early 1970s moved invasive monitoring from the laboratory to the patient's bedside. Its current use in obstetrics is directed toward definition of certain pathophysiologic states unique to pregnancy and toward diagnosis and management of critically ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 00:00:00
abstract::Complex biochemical consequences are the result of a series of secondary biochemical changes caused by oxygen depletion. Hypoxia in the fetus and neonate results in decreased GI blood flow, especially to the GI mucosa. Although severe O2 deprivation cannot be entirely compensated for, an increase in tissue O2 extracti...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-03-01 00:00:00
abstract::This article reviews key recent findings in the field of human cortical development. This development is divided into three major time-dependent phases: neural proliferation of inhibitory and excitatory neurons in spatially distinct regions, migration through multiple cellular boundaries, and maturation through morpho...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2009.06.008
更新日期:2009-09-01 00:00:00
abstract::The authors believe that the literature provides sufficient evidence that antenatal corticosteroid administration is beneficial and safe even in conditions of ruptured membranes. The evidence by now is remarkably robust and one can be reasonably confident regarding the benefits of antenatal corticosteroids in the sett...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(03)00078-2
更新日期:2001-12-01 00:00:00
abstract::Many aspects of the forward propulsion of enteral nutrients are not fully mature in the preterm and term neonate. Because the regulation of motor activity in the gastrointestinal tract is complex and multifaceted, many levels of regulation of this activity are immature in the preterm infant; however, as neonatologists...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Mitochondrial disorders present in a myriad of ways, which causes them to be included in the differential diagnosis for many patients with undiagnosed disease. A subset of mitochondrial disorders are caused by intrinsic defects in the mitochondrial replication machinery, leading to loss of cellular mitochondrial conte...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.10.008
更新日期:2020-03-01 00:00:00
abstract::Intraventricular hemorrhage (IVH) occurs in 20% to 25% of very low birthweight preterm neonates and may be associated with significant sequelae. Infants who have IVH are at risk for posthemorrhagic hydrocephalus and periventricular leukomalacia; as many as 75% of those who have parenchymal involvement of hemorrhage su...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2008.07.014
更新日期:2008-12-01 00:00:00
abstract::Phototherapy is now the preferred method of treatment for neonatal hyperbilirubinemia by virtue of its noninvasive nature and its relative freedom from major complications. It is also convenient, easy to use, and inexpensive in terms of personnel, equipment, and disposals. Long-term experience with phototherapy has de...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00