Key Points Lung organogenesis is organized into five stages, beginning at embryonic day 25 in humans. The mechanisms of lung organogenesis, including branching morphogenesis, stretch/mechanotransduction, alveolarization, microvascular maturation, and cellular differentiation, depend on transcriptional regulation of cell–cell and cell–extracellular matrix…
Key Points Healthcare-associated infections (HAIs) are important preventable causes of morbidity and death in neonates. Central line–associated bloodstream infections cause the bulk of HAIs in the neonatal intensive care unit; other HAIs include ventilator-associated pneumonias, urinary tract infections, surgical site…
Key Points Fungal infections account for approximately 12% of neonatal late-onset sepsis, with a mortality rate of approximately 32%, and the most important risk factor remains the gestational age at birth. When a lumbar puncture is performed, 10% to 50%…
Key Points Maternal transmission of Toxoplasma gondii in the first trimester causes the greatest damage to the fetus, while infections later in pregnancy are more readily transmissible to the fetus. No neonate should be discharged from a birth hospital without…
Key Points Viral infections of the fetus and newborn are common problems in neonatology practice. Fetal (congenital) viral infections should be considered in the differential diagnosis of newborns with intrauterine growth retardation, physical examination and laboratory abnormalities, and illness in…
Key Points Group B streptococcus and Escherichia coli account for most of the cases of neonatal early-onset bacterial sepsis. Prevention of infection by maternal treatment is the main factor accounting for the decreased incidence of early-onset group B streptococcus sepsis…
Key Points The fetus and newborn express a distinct and evolving immune system that mediates transition from intrauterine life to the microbe- and antigen-rich world. Multiple mechanisms including regulatory T cells help ensure maternofetal immune compatibility. Newborns are highly reliant…
Key Points The phenotypic spectrum of glycosylation disorders is broad and ranges from mild to severe and from single-organ system to multisystem disease; glycosylation defects should be considered in any unexplained clinical condition, but especially in multiorgan disease with neurologic…
Key Points Lysosomal storage diseases are a genetically and phenotypically heterogeneous group of metabolic disorders caused by multisystemic accumulation of complex substrates. Clinical manifestations of lysosomal storage diseases in the neonatal period are myriad, including nonimmune hydrops fetalis, respiratory distress,…
Acute, life-threatening disease during the newborn period is a feature of many inborn errors of metabolism, including those of ammonia, carbohydrate, amino acid, fatty acid, ketone, and mitochondrial energy metabolism. Therefore, it is critical that neonatologists are familiar with the…