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New Insights in Neonatal Intensive Care
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New Insights in Neonatal Intensive Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: 14 August 2026 | Viewed by 3308

Special Issue Editors

Dr. Benjamim Ficial

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Guest Editor
Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, Verona, Italy
Interests: neonatal hemodynamics; echocardiography; lung ultrasound; neontal intensive care; pediatric cardiology, prema-turity
Dr. Leonardo Gottin

E-Mail Website
Guest Editor
Intensive Care Unit, Department of Surgery, Dentistry, Maternity and Infant, University and Hospital Trust of Verona, Verona, Italy
Interests: intensive care medicine; cardiac anesthesia; echocardiography; extracorporeal membrane oxygenation; cardiovascular diseases
Dr. Martina Ciarcià

E-Mail
Guest Editor
Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, Verona, Italy
Interests: neonatal intensive care; neonate; preterm; neonatology; prematurity

Special Issue Information

Dear Colleagues,

The progress in neonatal intensive care has been remarkable in recent years, improving outcomes for even the smallest and most vulnerable infants. As advancements in neuroprotective strategies, respiratory care, hemodynamic support, point-of-care imaging, vascular access, nutrition, infection control, developmental support, etc., continue to reshape the landscape of neonatal care, our everyday challenge as clinicians and researchers is to customize evidence-based practice for individual patients to promote the best possible outcomes for premature and critically ill infants.

In this Special Issue, we welcome authors to submit papers on the advances in neonatal intensive care in terms of the understanding of pathogenesis of neonatal diseases, diagnosis, and management.

Dr. Benjamim Ficial
Dr. Leonardo Gottin
Dr. Martina Ciarcià
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neonatal intensive care
  • neonatal diseases
  • critically ill infants
  • premature infants
  • neonatal care
  • intensive care medicine

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Published Papers (3 papers)

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Research

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12 pages, 234 KB  
Article
Risk Factors Associated with Postnatal Growth Velocity in Preterm Infants in a Tertiary Hospital in Northeast Mexico
by Esteban López-Garrido, Sergio Alberto Márquez-Moreno, Araní Casillas-Ramírez, Rodrigo Vargas-Ruiz, Elsa Verónica Herrera-Mayorga and Hadassa Yuef Martínez-Padrón
J. Clin. Med. 2025, 14(23), 8489; https://doi.org/10.3390/jcm14238489 - 30 Nov 2025
Viewed by 689
Abstract
Background: Suboptimal growth velocity (GV)—weight < 15 g/kg/day, head circumference (HC) < 0.9 cm/week, and length < 1 cm/week—are related to neurodevelopmental problems. Comorbidities such as sepsis, patent ductus arteriosus, bronchopulmonary dysplasia, hemodynamic instability with use of inotropes, and necrotizing enterocolitis, among [...] Read more.
Background: Suboptimal growth velocity (GV)—weight < 15 g/kg/day, head circumference (HC) < 0.9 cm/week, and length < 1 cm/week—are related to neurodevelopmental problems. Comorbidities such as sepsis, patent ductus arteriosus, bronchopulmonary dysplasia, hemodynamic instability with use of inotropes, and necrotizing enterocolitis, among others, have been related to suboptimal GV. Therefore, this study aimed to evaluate GV in preterm newborns in the Neonatal Intensive Care Unit of a tertiary-level hospital in Mexico in the first 28 days of life and determine the main factors related to suboptimal GV. Methods: This was an observational, descriptive, retrospective, and longitudinal study. Thirty-one PNBs admitted to the NICU from March 2021 to February 2023 were included. Descriptive statistics were used for neonatal characteristics and factors. They were classified into group 1 (GV < 15 g/kg/day) and group 2 (>15 g/kg/day) and compared with Fisher’s exact test. Multivariate linear regression analysis was performed for factors related to suboptimal GV. Results: Among 31 preterm infants (mean GA 30 ± 3 weeks; birth weight 1241 ± 377 g), the mean growth velocity (GV) at 28 days was 16.5 ± 10 g/kg/day for weight (optimal), while length (0.7 ± 0.4 cm/week) and head circumference (0.41 ± 0.28 cm/week) remained suboptimal. Overall, 42% showed GV < 15 g/kg/day, and 58% achieved optimal GV. Multivariate analysis revealed that apnea of prematurity (β = –9.8; p = 0.023) and birth weight < 1000 g (β = –6.3; p = 0.026) were negatively associated with GV, whereas mixed feeding (breast milk + formula) had a positive effect (β = +6.3; p = 0.008). Conclusions: The 31 PNBs studied had a mean GV of optimal weight, and a mean GV of length and HC suboptimal to that suggested by the guidelines. The degree of low birth weight (LBW) and apnea of prematurity had a negative relationship with GV, while the type of feeding showed a positive relationship (p = 0.026, 0.023, and 0.008, respectively). Full article
(This article belongs to the Special Issue New Insights in Neonatal Intensive Care)

Review

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12 pages, 599 KB  
Review
Neonatal Esophageal Perforation: A Comprehensive Review of the Literature
by Gregorio Serra, Veronica Notarbartolo, Maria Rita Di Pace, Ingrid Anne Mandy Schierz, Valeria Guarneri, Marco Pensabene, Maria Sergio, Mario Giuffrè and Giovanni Corsello
J. Clin. Med. 2026, 15(4), 1603; https://doi.org/10.3390/jcm15041603 - 19 Feb 2026
Viewed by 343
Abstract
Background/Objectives: Neonatal esophageal perforation (EP) is a rare but potentially life-threatening condition, primarily affecting preterm and very low birth weight infants. Iatrogenic injury—most commonly related to malpositioned naso- or orogastric tubes—represents the leading cause. Methods: We conducted a comprehensive review of [...] Read more.
Background/Objectives: Neonatal esophageal perforation (EP) is a rare but potentially life-threatening condition, primarily affecting preterm and very low birth weight infants. Iatrogenic injury—most commonly related to malpositioned naso- or orogastric tubes—represents the leading cause. Methods: We conducted a comprehensive review of EP cases diagnosed within the first 28 days of life and reported between 2004 and October 2025 in PubMed and Scopus databases. The analysis focused on clinical presentation, risk factors, diagnostic modalities, management strategies, and outcomes. Only English-language case reports, case series, and observational studies (retrospective, cross-sectional and multicenter analyses) were included. Previously published narrative and systematic reviews were screened for relevant primary studies and contextual comparison, but were not included as primary data sources. Additionally, the emotional impact of iatrogenic complications on neonatal teams was also explored, through a focus on the importance of safety culture, reflective practice, and professional learning. Results: A total of 84 neonatal EP cases, were identified across 11 publications. The literature consistently indicates that iatrogenic EP predominantly affects infants born <28 weeks of gestational age and weighing <1000 g. Conservative management is effective in the majority of cases, whereas surgical intervention is reserved for complicated or refractory presentations. Prevention relies on standardized tube insertion techniques and early imaging verification. Conclusions: Although rare, neonatal EP demands high clinical vigilance, timely imaging-based diagnosis, and cautious conservative treatment. This review aims to consolidate available evidence while emphasizing the role of preventive strategies, safety culture, and team awareness in neonatal intensive care. By integrating clinical findings with reflections on iatrogenic risk, it seeks to support standardized practices, multidisciplinary learning, and continuous improvement in patient safety. Full article
(This article belongs to the Special Issue New Insights in Neonatal Intensive Care)
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14 pages, 656 KB  
Review
Cardio-Metabolic Risk in Adults Born Preterm: A Narrative Review
by Benjamim Ficial, Leonardo Gottin and Claudio Maffeis
J. Clin. Med. 2026, 15(1), 256; https://doi.org/10.3390/jcm15010256 - 29 Dec 2025
Cited by 1 | Viewed by 1151
Abstract
Preterm birth has evolved from being an acute neonatal challenge to a lifelong health determinant, as advances in neonatal care have markedly improved the survival of very and extremely preterm infants. This narrative review synthesizes epidemiological and mechanistic evidence linking preterm birth with [...] Read more.
Preterm birth has evolved from being an acute neonatal challenge to a lifelong health determinant, as advances in neonatal care have markedly improved the survival of very and extremely preterm infants. This narrative review synthesizes epidemiological and mechanistic evidence linking preterm birth with heightened cardiometabolic risk across the life course. In adulthood, individuals born preterm demonstrate increased rates of heart failure, ischemic heart disease, stroke, atrial fibrillation, and diabetes. Beneath these overt clinical outcomes lies a distinct phenotype characterized by increased adiposity, insulin resistance, dyslipidemia, hypertension, and atypical growth trajectories, with rapid catch-up growth amplifying long-term risk. Mechanistic pathways highlight adipose tissue maldevelopment, predisposing to metabolic syndrome, alongside cardiac maldevelopment with reduced ventricular size, impaired diastolic function, and diminished exercise capacity. Furthermore, vascular growth arrest, impaired elastin synthesis, and nephron deficiency contribute to sustained elevations in blood pressure, establishing an early substrate for hypertension and cardiovascular remodeling. These alterations reflect the developmental origins of health and disease, whereby early-life disruption of growth and maturation exerts lasting effects on organ structure and function. Collectively, the evidence identifies adults born preterm as a growing yet under-recognized patient population with a unique clinical and biochemical profile and accelerated vulnerability to non-communicable diseases. Greater awareness among pediatric and adult physicians, structured transition of care, and targeted prevention strategies are urgently needed to mitigate early cardiometabolic morbidity and optimize long-term health outcomes in this high-risk group. Full article
(This article belongs to the Special Issue New Insights in Neonatal Intensive Care)
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