Key Points Normal fetal growth is determined by a number of factors. The pattern of normal fetal growth involves rapid increases in fetal weight, length, and head circumference during the last half of gestation. Year-over-year increases in birth weight for…
Key Points The placenta is the first organ to form in mammals and is required for establishment of a maternal–fetal vascular interface capable of supplying the bioenergetic needs of the developing conceptus. Multiple placental cell types engage in highly varied…
Key Points Increasingly available data in neonatal intensive care may help guide ethical decision-making about sick infants. Despite better ability to predict outcomes for sick infants, prognostic efforts are imperfect. When using data to guide decision-making in the neonatal intensive…
Key Points Maternal and child health in the population have traditionally been assessed by monitoring two key statistics—the maternal mortality ratio and the infant mortality rate. The infant mortality rate is the sum of the neonatal mortality and post-neonatal mortality…
Overall Principles Vaccination has been the most effective medical intervention in the modern era. Historically, the focus on vaccine development and implementation programs has been on preventing infectious diseases during infancy and early childhood. The current vaccine schedule for early…
Effective antimicrobial treatment typically begins with empirical therapy at a dose that is most likely to cure the infection with the minimal risk of toxic effects. To select the correct dosage, clinicians need to understand and apply the principles of…
For years, investigators have sought a test or panel of tests able to diagnose neonatal sepsis accurately and more rapidly than is possible with the recovery of microorganisms from specimens of sterile body fluids or tissues. Although results of some…
Neonates, especially premature neonates who require intensive medical care, are among the patients at highest risk for nosocomial or health care–associated infections (HAIs). Although the rate of HAIs varies with the specific patient population and institution, many institutions have achieved…
Fungal infections, other than those caused by Candida spp., rarely are considered in the differential diagnosis for an acutely ill newborn infant because disorders of bacterial and viral etiology are vastly more common. Nevertheless, fungal infections do occur in neonates,…
Candida species are important pathogens in the neonate. After a significant increase in the incidence of systemic candidiasis in neonatal intensive care (NICU) patients in the late 1990s, since 2000 the incidence has remained stable or even decreased slightly. However,…