The science of uncertainty guides fetal-neonatal neurology principles and practice: diagnostic-prognostic opportunities and challenges

Frontiers in Neurology, Год журнала: 2024, Номер 15

Опубликована: Янв. 30, 2024

Fetal-neonatal neurologists (FNNs) consider diagnostic, therapeutic, and prognostic decisions strengthened by interdisciplinary collaborations. Bio-social perspectives of the woman’s health influence evaluations maternal-placental-fetal (MPF) triad, neonate, child. A dual cognitive process integrates “fast thinking-slow thinking” to reach shared that minimize bias maintain trust. Assessing science uncertainty with uncertainties in improves diagnostic choices across developmental-aging continuum. Three case vignettes highlight challenges illustrate this approach. The first maternal-fetal dyad involved a woman who had been recommended terminate her pregnancy based on an incorrect diagnosis encephalocele. meningocele was subsequently identified when she sought second opinion normal outcome for vignette two pregnancies during which fetal cardiac rhabdomyoma identified, suggesting tuberous sclerosis complex (TSC). One out-of-state termination without confirmation using brain MRI or postmortem examination. requested care postnatal evaluations. Her adult child experiences associated TSC sequelae. third prenatal open neural tube defect arthrogryposis multiplex congenita. family surgical closure at another institution their personal expense despite receiving grave prognosis. subsequent Management Myelomeningocele Study (MOMS) would not have procedure. Their requires medical global developmental delay, intractable epilepsy, autism. These three requiring clinical among all stakeholders. Falsely negative misleading positive interpretation results reduced chances optimal outcomes. FNN skills require understanding dynamic gene-environment interactions affecting reproductive followed exposomes MPF triad neuroplasticity consequences. Toxic stressor interplay can impair exposome, expressed as anomalous and/or destructive lesions. Functional improvements permanent sequelae may be lifespan. Equitable compassionate healthcare women families preserve health, guided person-specific racial-ethnic, religious, bio-social perspectives. Applying origins theory neurologic principles practice supports capital strategy persons each generation.

Язык: Английский

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Greater Neighborhood Disadvantage Is Associated with Alterations in Fetal Functional Brain Network Structure

The Journal of Pediatrics, Год журнала: 2024, Номер 274, С. 114201 - 114201

Опубликована: Июль 18, 2024

Язык: Английский

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Neonatal Encephalopathy is a Complex Phenotype Representing Reproductive and Pregnancy Exposome Effects on the Maternal-Placental-Fetal Triad

Clinics in Perinatology, Год журнала: 2024, Номер 51(3), С. 535 - 550

Опубликована: Май 16, 2024

Язык: Английский

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Particulate matter 2.5 (PM _2.5 ) - associated cognitive impairment and morbidity in humans and animal models: a systematic review

Journal of Toxicology and Environmental Health Part B, Год журнала: 2025, Номер unknown, С. 1 - 31

Опубликована: Янв. 18, 2025

Particulate matter with an aerodynamic diameter of less than 2.5 µm (PM2.5) is one the criteria air pollutants that (1) serve as essential carrier airborne toxicants arising from combustion-related events including emissions industries, automobiles, and wildfires (2) play important role in transient to long-lasting cognitive dysfunction well several other neurological disorders. A systematic review was conducted address differences study design various biochemical molecular markers employed elucidate disorders PM2.5 -exposed humans animal models. Out 340,068 scientific publications screened 7 databases, 312 studies were identified targeted relationship between exposure dysfunction. Equivocal evidence pre-clinical (animal model) human contributes dementia, Parkinson disease, multiple sclerosis, stroke, depression, autism spectrum disorder, attention deficit hyperactivity neurodevelopment. In addition, there substantial also associated Alzheimer's anxiety, neuropathy, brain tumors. The exposome characterizing neurobehavioral anomalies opportunities available leverage neuroexposome initiative for conducting longitudinal discussed. Our provided some areas warrant consideration, which unraveling microbiome, climate change exposure-induced

Язык: Английский

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Season of conception and neurodevelopmental outcomes in singleton preterm infants less than 29 weeks gestation

Frontiers in Pediatrics, Год журнала: 2025, Номер 13

Опубликована: Март 27, 2025

Background Environmental factors vary with the seasons and affect fetal development. Our objective was to assess impact of season conception on neurodevelopmental outcomes at 18–21 months corrected age in singleton infants <29 weeks’ gestation. Methods A retrospective cohort study born between 2006 2015 a tertiary-level neonatal intensive care unit conducted. The date calculated as birth minus gestational plus 14 days, dates were then divided into winter non-winter months. primary composite score <85 any cognitive, language, or motor components Bayley Scales Infant Toddler Development, 3rd edition (Bayley-III), age, scores individual components. Multivariate logistic regression used confounders. Results Of 493 eligible infants, 162 (32.8%) conceived winter. There no difference adjusted odds ratios (aORs) Bayley-III two groups. aORs cognitive language group significantly higher [2.78, 95% confidence interval (CI) 1.37–5.65 1.97, CI 1.07–3.62, respectively]. Conclusion Singleton gestation have worse outcomes. results need validation other larger cohorts.

Язык: Английский

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The Role of N-terminal Pro-B-Type Natriuretic Peptide, Troponins, and D-dimer in Acute Cardio-Respiratory Syndromes: A Multi-specialty Systematic Review

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Май 20, 2025

Язык: Английский

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Education and Training of Child Neurologists and Workforce Issues

Elsevier eBooks, Год журнала: 2025, Номер unknown, С. 155 - 162.e1

Опубликована: Июнь 2, 2025

Язык: Английский

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Fetal-neonatal neurology principles and practice: Current curriculum development

Seminars in Fetal and Neonatal Medicine, Год журнала: 2024, Номер 29(1), С. 101519 - 101519

Опубликована: Фев. 1, 2024

Язык: Английский

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We need a formal framework based on neuroscience for training in developmental neurology

Developmental Medicine & Child Neurology, Год журнала: 2024, Номер 66(8), С. 962 - 963

Опубликована: Май 15, 2024

This editorial is linked to Letter the editor by Gogou on pages 1106–1107 of this issue.

Язык: Английский

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Single-Base Gene Variants in MIR-146A and SCN1A Genes Related to the Epileptogenic Process in Drug-Responsive and Drug-Resistant Temporal Lobe Epilepsy—A Preliminary Study in a Brazilian Cohort Sample

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(11), С. 6005 - 6005

Опубликована: Май 30, 2024

The drug-resistant temporal lobe epilepsy (TLE) has recently been associated with single nucleotide variants (SNVs) in microRNA(miR)-146a (

Язык: Английский

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