Seminars in Fetal & Neonatal Medicine RSS feed: Current Issue. Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology ) is a bi-monthly journal which publishes topic-based issues, including current 'Hot Topics' on the latest advances in fetal and neonatal medicine. The change in title relates to the growing interest amongst obstetricians, midwives and fetal medicine specialists. The Journal commissions review-based content covering current clinical opinion on the care and treatment of the neonate and draws on the necessary specialist knowledge, including that of the respiratory physician, the infectious disease physician, the surgeon, as well as the paediatrician and obstetrician. Each topic-based issue is edited by an authority in their field and contains 8-10 articles. Recent Issues have included: • Newer Concepts in Neonatal Respiratory Care • Perinatal Infection: Detection and Prevention • Multiple Births • Neonatal Jaundice • Inborn Errors of Metabolism Seminars in Fetal & Neonatal Medicine provides: • coverage of major developments in neonatal care; • value to practising neonatologists, consultant and trainee paediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field; • up-to-date information in an attractive and relevant format. http://www.sfnmjournal.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Seminars in Fetal & Neonatal Medicine1744-165X173June 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.sfnmjournal.com/article/PIIS1744165X1200042X/abstract?rss=yesTitle Page/Aims and Scope/Editorial Board10.1016/S1744-165X(12)00042-XSeminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-06-01Seminars in Fetal & Neonatal Medicine2012-06-01173S1744-165X(12)X0003-9IFCIFChttp://www.sfnmjournal.com/article/PIIS1744165X12000315/abstract?rss=yesThis edition of Seminars in Fetal and Neonatal Medicine considers birth at moderate and late preterm gestations, defined throughout as birth at 32+0−33+6 weeks and 34+0−36+6 weeks of gestation respectively. Moderate and late preterm births account for over 75% of all preterm births and around 6–7% of all births; yet research in this group has been relatively limited, with the focus having been predominantly on extreme prematurity.The late and moderate preterm babyElaine M. Boyle10.1016/j.siny.2012.02.005Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-14Seminars in Fetal & Neonatal Medicine2012-03-14173S1744-165X(12)X0003-9Editorial119119http://www.sfnmjournal.com/article/PIIS1744165X1200008X/abstract?rss=yesSummary: Preterm birth affects 12.5% of all births in the USA. Infants of Black mothers are disproportionately affected, with 1.5 times the risk of preterm birth and 3.4 times the risk of preterm-related mortality. The preterm birth rate has increased by 33% in the last 25 years, almost entirely due to the rise in late preterm births (34–36 weeks’ gestation). Recently attention has been given to uncovering the often subtle morbidity and mortality risks associated with moderate (32–33 weeks’ gestation) and late preterm delivery, including respiratory, infectious, and neurocognitive complications and infant mortality. This section summarizes the epidemiology of moderate and late preterm birth, case definitions, risk factors, recent trends, and the emerging body of knowledge of morbidity and mortality associated with moderate and late preterm birth.Epidemiology of late and moderate preterm birthCarrie K. Shapiro-Mendoza, Eve M. Lackritz10.1016/j.siny.2012.01.007Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-01-24Seminars in Fetal & Neonatal Medicine2012-01-24173S1744-165X(12)X0003-9Editorial120125http://www.sfnmjournal.com/article/PIIS1744165X1200011X/abstract?rss=yesSummary: This is a brief review of the developmental physiology of selected organ and functional systems in moderate and late preterm infants. This outline provides a discussion of the physiological underpinnings for some of the clinical conditions seen in this group of infants, including hypothermia, hypoglycemia, respiratory distress syndrome, transient tachypnea, severe respiratory failure, apnea, feeding difficulties, jaundice, and increased susceptibility to infections.Developmental physiology of late and moderate prematurityTonse N.K. Raju10.1016/j.siny.2012.01.010Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-02-10Seminars in Fetal & Neonatal Medicine2012-02-10173S1744-165X(12)X0003-9Editorial126131http://www.sfnmjournal.com/article/PIIS1744165X12000157/abstract?rss=yesSummary: The decision of when to deliver a patient for medical or obstetric complication directly affects the neonatal outcome. When the fetus is in danger due to suspected utero-placental insufficiency, the decision to deliver is thought to benefit the neonate. However, the opposite may be true when a normally developing fetus needs to be delivered for a maternal indication such as a persistently bleeding placenta praevia. These decisions are made daily by obstetric providers. The following is a review of obstetric decision-making for moderate and late preterm pregnancies.Obstetric decision-making and the late and moderately preterm infantCynthia Gyamfi-Bannerman10.1016/j.siny.2012.01.014Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-16Seminars in Fetal & Neonatal Medicine2012-03-16173S1744-165X(12)X0003-9Editorial132137http://www.sfnmjournal.com/article/PIIS1744165X12000145/abstract?rss=yesSummary: Moderate and late preterm births account for the majority of preterm babies. The common perception that birth at 32–36 weeks’ gestation carries few risks is now being challenged, as these babies have increased risk of neonatal mortality and morbidity. However, spontaneous labour at this gestation frequently has no specific, easily identifiable precursor, although preterm birth per se has a number of epidemiological and clinical associations. Prediction and prevention of preterm birth is currently largely aimed at identifying women at high risk such as those with previous preterm birth, and targeting intervention at this group. Both cervical length assessment and fibronectin testing permit some modification of the likelihood of preterm birth in this group. Progesterone treatment for the prevention of preterm birth is currently being researched widely, and appears a potentially promising strategy. Babies born at 32–36 weeks’ gestation need careful monitoring in labour, with modification of intervention in labour due to their prematurity.Obstetric management of moderate and late preterm labourP.C. McParland10.1016/j.siny.2012.01.013Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-14Seminars in Fetal & Neonatal Medicine2012-03-14173S1744-165X(12)X0003-9Editorial138142http://www.sfnmjournal.com/article/PIIS1744165X12000133/abstract?rss=yesSummary: Multiple gestations have an increased risk of pregnancy complications compared with singletons. Delay in childbearing and assisted reproductive techniques have remained common reasons for the increase in multiple gestations over the last few decades. Higher rates of both spontaneous and indicated preterm birth in twins and triplets lead to a significant proportion of the moderate preterm birth and late preterm birth rates. The article is a review of the causes of preterm birth and morbidities associated with these pregnancies.Impact of multiple births on late and moderate prematurityJerrie S. Refuerzo10.1016/j.siny.2012.01.012Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-02-27Seminars in Fetal & Neonatal Medicine2012-02-27173S1744-165X(12)X0003-9Editorial143145http://www.sfnmjournal.com/article/PIIS1744165X12000224/abstract?rss=yesSummary: Late and moderate preterm infants account for >80% of premature births. These newborns experience considerable mortality and morbidity in comparison with full-term born infants. The purpose of this paper is to summarise the most common morbidities of late and moderate preterm infants in the neonatal period, their incidence, severity, risk factors and need for admission to the different levels of care. The recent findings on preventive strategies and management priorities for clinical care of these vulnerable babies are also reviewed.Neonatal problems of late and moderate preterm infantsJ.-B. Gouyon, S. Iacobelli, C. Ferdynus, F. Bonsante10.1016/j.siny.2012.01.015Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-02-20Seminars in Fetal & Neonatal Medicine2012-02-20173S1744-165X(12)X0003-9Editorial146152http://www.sfnmjournal.com/article/PIIS1744165X12000303/abstract?rss=yesSummary: Late and moderate preterm infants form the majority of admissions for prematurity to special care neonatal nurseries. Although at risk for acute disorders of prematurity, they do not suffer the serious long term risks and chronic illnesses of the extremely premature. The special challenges addressed here are of transition and of thermal adaptation, nutritional compensation for postnatal growth restriction, the establishment of early feeding, and the avoidance of post-discharge jaundice or apnea. These ‘healthy’ premature infants provide challenges for discharge planning, in that opportunities may be available for discharge well before the expected date of delivery, which should be pursued. Barriers to early discharge are rigid conservative protocols and unwarranted investigations; facilitators of discharge are individualized care by nurses expert in cue-based feeding, early management of the thermal environment, support of family preferences and encouragement of mother–baby interactions. Safe discharge depends on recognizing these opportunities and applying strategies to address them.Neonatal management and safe discharge of late and moderate preterm infantsRobin K. Whyte10.1016/j.siny.2012.02.004Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-02-27Seminars in Fetal & Neonatal Medicine2012-02-27173S1744-165X(12)X0003-9Editorial153158http://www.sfnmjournal.com/article/PIIS1744165X12000285/abstract?rss=yesSummary: There has been a long-held belief that outcomes for babies born at moderate and late preterm gestations do not differ substantially from those of infants born at full term. This has recently been challenged by studies highlighting an increased risk of adverse neonatal outcomes, and of poorer cognitive, behavioural and educational outcomes in this population. Data about the effects of birth at moderate and late preterm gestations on later health outcomes are limited, but emerging evidence suggests that ongoing physical health may also be worse in those born just a few weeks before full term. This review summarises the available evidence, considers the factors influencing health outcomes and discusses the implications for the planning and provision of children’s health care services.Health outcomes in infancy and childhood of moderate and late preterm infantsPooja Harijan, Elaine M. Boyle10.1016/j.siny.2012.02.002Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-15Seminars in Fetal & Neonatal Medicine2012-03-15173S1744-165X(12)X0003-9Editorial159162http://www.sfnmjournal.com/article/PIIS1744165X12000297/abstract?rss=yesSummary: A large number of children (6 to 11% of all births) are born at a gestational age between 32 and 36 weeks. Little is known of long term outcomes for these moderate and late preterm children. In this review, results of 28 studies on school outcome, cognitive functioning, behaviour problems, and psychiatric disorders are presented. Overall, more school problems, less advanced cognitive functioning, more behaviour problems, and higher prevalence of psychiatric disorders were found in moderate and late preterm born infants, children, and adults compared with full term peers. Suggestions for future research are discussed.School outcome, cognitive functioning, and behaviour problems in moderate and late preterm children and adults: A reviewMarjanneke de Jong, Marjolein Verhoeven, Anneloes L. van Baar10.1016/j.siny.2012.02.003Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-02-27Seminars in Fetal & Neonatal Medicine2012-02-27173S1744-165X(12)X0003-9Editorial163169http://www.sfnmjournal.com/article/PIIS1744165X12000273/abstract?rss=yesSummary: Despite constituting the vast majority of preterm births, relatively little is known about the clinical and economic outcomes of children born either moderately or late preterm. This paper outlines the economic consequences of moderate and late preterm birth for the health services, for other sectors of the economy, for families and carers and, more broadly, for society. The paper reviews both the peer-reviewed literature and additional sources for information on the economic consequences of moderate and late preterm birth. It then goes on to present the results of a decision-analytic modelling study that aimed to estimate the societal costs associated with moderate and late preterm birth throughout the childhood years. Finally, the requirements for future methodological and applied research in this area are briefly outlined.Economic costs associated with moderate and late preterm birth: Primary and secondary evidenceStavros Petrou, Kamran Khan10.1016/j.siny.2012.02.001Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-02-27Seminars in Fetal & Neonatal Medicine2012-02-27173S1744-165X(12)X0003-9Editorial170178http://www.sfnmjournal.com/article/PIIS1744165X12000340/abstract?rss=yesWe are writing with reference to the article ‘Myth: Group B streptococcal infection in pregnancy: Comprehended and conquered’ published in volume 16 (2011) pp 254–258. We are concerned about the accuracy of some of the article’s key assumptions relating to screening.Re: ‘Myth: Group B streptococcal infection in pregnancy: Comprehended and conquered’ published in volume 16 (2011) pp 254–258John Marshall, Catherine Peckham10.1016/j.siny.2012.02.006Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-09Seminars in Fetal & Neonatal Medicine2012-03-09173S1744-165X(12)X0003-9Letters to the Editor179179http://www.sfnmjournal.com/article/PIIS1744165X12000352/abstract?rss=yesThank you for allowing us to respond to the letter from Mr Marshall and Professor Peckham. Marshall and Peckham state that in our article we estimated that in the ‘absence of any antibiotic prophylaxis 700 babies will be affected by early onset group B streptococcal disease (eogbs) each year’. In fact, we referred to ‘serious GBS infections’, which includes late onset. While it is true that the Royal College of Obstetricians and Gynaecologists’ (RCOG) 2003 guidelines recommended risk factor screening, according to a survey commissioned by the National Screening Committee, carried out by the RCOG and published in 2007 (http://www.rcog.org.uk/our-profession/good-practice/audit/prevention-neonatal-group-b-streptoccocal-disease-audit), these guidelines have resulted in only “a slight improvement in the proportion of units offering IAP to appropriate women since the previous surveys in 1999 and 2001”. Moreover, recent UK cost-effectiveness surveys have repeatedly concluded that “Testing (only) high-risk women for maternal GBS colonisation would not be cost-effective”, “The current strategy of risk-factor-based screening is not cost-effective compared with screening based on culture” and that “screening, based on a culture test at 35–37 weeks’ gestation, with the provision of antibiotics to all women who screened positive (is) most cost-effective”. While historically, the rate of culture proven eogbs in the UK was low, the Health Protection Agency (HPA) reports that voluntarily reported cases in England Wales and Northern Ireland have risen from 229 in 2003 to 302 in 2010. This rising trend is contrary to the major falls seen in the many countries that have introduced culture based screening, and we see no reason why such falls could not be replicated in the UK.Reply to Letter to the Editor Re: ‘Myth: Group B streptococcal infection in pregnancy: Comprehended and conquered’ published in volume 16 (2011) pp. 254–258Philip Steer, Jane Plumb10.1016/j.siny.2012.02.007Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-09Seminars in Fetal & Neonatal Medicine2012-03-09173S1744-165X(12)X0003-9Letters to the Editor180181http://www.sfnmjournal.com/article/PIIS1744165X12000376/abstract?rss=yesIn this retrospective cohort study, the authors investigate the relationship between prolonged (≥5 days) empirical antibiotic administration to n = 365 premature infants (≤32 weeks GA and ≤1500 g birth weight), who survived free of sepsis and necrotizing enterocolitis (NEC) for 7 days during their first week of lifeProlonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infantsLuc Cornette10.1016/j.siny.2012.02.009Seminars in Fetal & Neonatal Medicine 17, 3 (2012)2012-03-02Seminars in Fetal & Neonatal Medicine2012-03-02173S1744-165X(12)X0003-9182182