Recommendations to improve recruitment and retention of underrepresented in medicine trainees in neonatal-perinatal medicine.

Physicians who identify as Black, Latinx, American Indian, Pacific Islander, and certain Asian subgroups represent racial and ethnic populations that are underrepresented in medicine (URM). While the proportion of URM pediatric trainees has remained unchanged, that of Neonatal-Perinatal Medicine (NPM) fellows has decreased. Informed by the medical literature and our lived experiences, we compiled and developed a list of recommendations to support NPM fellowship programs in the recruitment, retention, and promotion of URM trainees.

Implications of racial/ethnic perinatal health inequities on long-term neurodevelopmental outcomes and health services utilization.

Infants born preterm and with low birth weight have increased risk for neurodevelopmental challenges later in life compared to term-born peers. These include functional motor impairment, cognitive and speech delays, neurobehavioral disorders, and atypical social development. There are well-documented inequities in the population distributions of preterm birth and associated short-term morbidities by race, ethnicity, language, and nativity.

Perinatal and early childhood biomarkers of psychosocial stress and adverse experiences.

The human brain develops through a complex interplay of genetic and environmental influences. During critical periods of development, experiences shape brain architecture, often with long-lasting effects. If experiences are adverse, the effects may include the risk of mental and physical disease, whereas positive environments may increase the likelihood of healthy outcomes.

COVID-19 preparedness-a survey among neonatal care providers in low- and middle-income countries.

Objective: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents.

Study Design: Cross-sectional, web-based survey administered between May and June, 2020.

Results: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries.

Influence of Health Beliefs on Adherence to COVID-19 Preventative Practices: International, Social Media-Based Survey Study.

Background: Health behavior is influenced by culture and social context. However, there are limited data evaluating the scope of these influences on COVID-19 response.

Objective: This study aimed to compare handwashing and social distancing practices in different countries and evaluate practice predictors using the health belief model (HBM).

COVID-19: neonatal-perinatal perspectives.

The coronavirus disease 2019 (COVID-19) pandemic, resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused severe and widespread illness in adults, including pregnant women, while rarely infecting neonates. An incomplete understanding of disease pathogenesis and viral spread has resulted in evolving guidelines to reduce transmission from infected mothers to neonates. Fortunately, the risk of neonatal infection via perinatal/postnatal transmission is low when recommended precautions are followed.

Glucose concentrations in enterally fed preterm infants.

Objectives: Determine the prevalence of glucose concentrations below the Pediatric Endocrine Society (PES) term and late preterm-focused guideline target for mean glucose concentrations (≥70 mg/dL) among preterm NICU infants on full enteral nutrition and assess the impact on monitoring practices.

Study Design: Retrospective cohort study.

Results: We analyzed 1717 infants who were at least 2 days old and 48 hours after parenteral fluids were discontinued.

Workforce Shortage for Retinopathy of Prematurity Care and Emerging Role of Telehealth and Artificial Intelligence.

Retinopathy of prematurity (ROP) is the leading cause of childhood blindness in very-low-birthweight and very preterm infants in the United States. With improved survival of smaller babies, more infants are at risk for ROP, yet there is an increasing shortage of providers to screen and treat ROP. Through a literature review of new and emerging technologies, screening criteria, and analysis of a national survey of pediatric ophthalmologists and retinal specialists, the authors found the shortage of ophthalmology workforce for ROP a serious and growing concern.

Psychosocial Stress and Adversity: Effects from the Perinatal Period to Adulthood.

Early exposure to stress and adversity can have both immediate and lasting effects on physical and psychological health. Critical periods have been identified in infancy, during which the presence or absence of experiences can alter developmental trajectories. There are multiple explanations for how exposure to psychosocial stress, before conception or early in life, has an impact on later increased risk for developmental delays, mental health, and chronic metabolic diseases.

Trends of caesarean delivery from 2008 to 2017, Mexico.

Caesarean delivery rates in Mexico are among the highest in the world. Given heightened public and professional awareness of this problem and the updated 2014 national guidelines to reduce the frequency of caesarean delivery, we analysed trends in caesarean delivery by type of facility in Mexico from 2008 to 2017. We obtained birth-certificate data from the Mexican General Directorate for Health Information and grouped the total number of vaginal and caesarean deliveries into five categories of facility: health-ministry hospitals; private hospitals; government employment-based insurance hospitals; military hospitals; and other facilities.

Understanding Barriers to Early Intervention Services for Preterm Infants: Lessons From Two States.

Objective: To explore existing barriers and challenges to Early Intervention (EI) referral, enrollment, and service provision for very low birth weight (VLBW; <1500 g) infants.

Methods: We conducted 10 focus groups with parents of VLBW children (n = 44) and 32 interviews with key informants from EI (n = 7), neonatal intensive care units (n = 17), and outpatient clinics (n = 8) at 6 sites in 2 states. We used grounded theory to identify themes about gaps in services.

Pasteurized human donor milk use among US level 3 neonatal intensive care units.

Background: Pasteurized human donor milk (DM) is recommended by the World Health Organization and American Academy of Pediatrics for preterm infants when mother's own milk is unavailable, yet the extent and predictors of use and criteria for use in US neonatal intensive care units (NICUs) are unknown.

Objective: This study aimed to evaluate current DM use in US level 3 NICUs and predictors and criteria of use.

Methods: We sent mail surveys to 302 US level 3 NICU directors.

Maternal note-taking and infant care: a pilot randomised controlled trial.

Design: A pilot randomised controlled trial was conducted with postpartum mothers to assess the feasibility and impact of note-taking during newborn teaching. Controls received standard teaching; the intervention group received pen and paper to take notes. Subjects were called 2 days post-discharge to assess infant sleep position, breastfeeding, car seat use, satisfaction and information recall.

Communication of urgent public health messages to urban populations: lessons from the Massachusetts water main break.

Objective: To study when and how an urgent public health message about a boil-water order reached an urban population after the Massachusetts water main break.

Methods: In-person surveys were conducted in waiting areas of clinics and emergency departments at a large urban safety net hospital within 1 week of the event.

Results: Of 533 respondents, 97% were aware of the order; 34% of those who lived in affected cities or towns were potentially exposed to contaminated water.