Neonatal Perinatal Infections An Update An Issue Of Clinics In Perinatology

In this issue the Guest Editors provide a contemporary look at the epidemiology, clinical manifestations, treatment and outcomes for neonatal-perinatal infections. Contributors include neonatologists, infectious disease, and critical care specialists with a wide variety of research interests in this arena. Readers will be exposed to the latest information on dosing of antibiotics, antivirals, and antifungals. This information is critical in the infant population given the rapid changes in physiology, metabolic pathways and renal elimination that occur over the first months of life. There is an extensive examination of infectious processes that commonly present in infants including meningitis, bloodstream infections, and urinary tract infections. Additional topics include infectious processes affecting the newborn (chorioamnionitis and TORCH infections) and premature infants (necrotizing enterocolitis). Specific pathogens are highlighted in articles on HSV, CMV/VZV, staphylococcal species, and Candida. Finally, the rationale for the most recent changes to guidelines for initiating therapy for early-onset neonatal sepsis are reviewed.

In this issue of Clinics in Perinatology, guest editors Joseph B. Cantey and Andi Shane bring their considerable expertise to the topic of Perinatal and Neonatal Infections. Provides in-depth, clinical reviews on Perinatal and Neonatal Infections, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

In this issue of Clinics in Perinatology, guest editors Joseph B. Cantey and Andi Shane bring their considerable expertise to the topic of Perinatal and Neonatal Infections. Provides in-depth, clinical reviews on Perinatal and Neonatal Infections, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

Bronchopulmonary dysplasia (BPD) as a chronic lung disease affecting preterm infants has been recognized for more than 45 years. However, little progress has been made in the prevention and treatment of the disease. BPD continues to be a major morbidity affecting preterm infants. Studies in pre-adolescent children demonstrate that the abnormal lung function from BPD persists well into childhood. Infants with BPD also have an increased risk for adverse neurodevelopmental outcome. Thus BPD imposes a significant burden of adverse health outcomes in preterm infants. The major risk factors for BPD are prematurity, mechanical ventilation, exposure to noxious insults such as oxygen, infections. New research data both in basic science and clinical studies have shed light on the pathogenesis, and possible new treatment or management strategies for the future. In the proposed issue of the Clinics in Perinatology, we would like to comprehensively cover BPD both from a basic science and clinical perspective. Our attempt is to balance new information along with classic topics. The proposed authors for the issue are recognized experts in the topic area/s. We hope that the issue will be of interest to a broad array of readership.

Recent advances in neonatal hematology, largely made by the authors of these chapters, are likely to generate wide spread and long-term improvements in outcomes, as well as reductions in costs of care. Publication of these advances in a single volume will facilitate dissemination of these techniques and practices. The advances include neuroprotection from erythropoietic stimulators, improved guidelines for platelet transfusions, evidence-based guidelines for FFP administration, improved diagnostic methods for genetic causes of severe neonatal jaundice, more accurate definitions of hematological perturbations in necrotizing enterocolitis and sepsis, and reduction in transfusions and in IVH rates by cord milking/delayed clamping.

Kidney anomalies are the most frequent abnormality detected on prenatal ultrasound. Some are inconsequential and others are life-threatening. All must be addressed by neonatologists. This edition of Pediatric Clinics of Perinatology covers these anomalies. In addition, it addresses a variety of other nephrology and urology issues that neonatologists confront. Some are rare and the chapter may then serve as an important resource. Others are common, and thus will provide updated information on diagnosis and management.

Neonatal-perinatal medicine has a strong history of evidence based practice but unfortunately there remain many areas of uncertainty and unproven hypotheses and treatments that may harm our highly vulnerable patients. When new ideas are introduced into the labor and delivery room or the NICU we have to evaluate these procedures and therapies before they become accepted as standards of care. We need to learn from the past lessons of grey baby syndrome and chloramphenicol and of kernicterus and sulfonamide antibiotics where therapeutic good intentions actually did more harm than good and increased the mortality rate of premature babies in the NICU.This proposed edition addresses a broad range of current topics in perinatal neonatal practice. The AAP has just issued new guidelines for the approach to a neonate exposed to maternal genital herpes virus infection. The recommendations were not evidence based and are highly controversial as well as confusing. These topics are addressed in a scholarly and objective manner to both address the controversy and help the practitioner make informed decisions.

The Guest Editors have collaborated on a state-of-the-art presentation of current clinical reviews on Quality in Neonatal Care. Top experts have prepared articles in the following areas: Standardizing Practices: How and why to standardize, using checklists, measuring variation; Health Informatics and Patient Safety; Using Statistical Process Control to Drive Improvement in Neonatal Care; Improving Value in Neonatal Intensive Care; Culture and Context in Quality of Care: Improving Teamwork and Resilience; Has Quality Improvement Improved Neonatal Outcomes; National Quality Measures in Perinatal Care; Perinatal and Obstetric Quality Initiatives; Family Involvement in Quality Improvement; Perinatal Quality Improvement: A Global Perspective; Delivery Room Care / Golden Hour; Respiratory Care and Bronchopulmonary Dysplasia; Reducing Incidence of Necrotizing Enterocolitis; Alarm Safety and Alarm Fatigue; and Patient Safety: Reducing Unplanned Extubations. Readers will come away with the clinical information they need improve quality in the NICU.