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  1. Article ; Online: Use of Telehealth Methods to Track Infant Neurodevelopment After In Utero SARS-CoV-2 Exposure.

    Mulkey, Sarah B

    JAMA network open

    2023  Volume 6, Issue 4, Page(s) e237403

    MeSH term(s) Humans ; Infant ; SARS-CoV-2 ; COVID-19 ; Child Development ; Telemedicine
    Language English
    Publishing date 2023-04-03
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.7403
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  2. Article ; Online: Contemporary Understanding of the Central Autonomic Nervous System in Fetal-Neonatal Transition.

    Mulkey, Sarah B

    Seminars in pediatric neurology

    2023  Volume 47, Page(s) 101081

    Abstract: THE CRITICAL ROLE OF THE CENTRAL AUTONOMIC NERVOUS SYSTEM IN FETAL-NEONATAL TRANSITION: Sarah B. Mulkey, Adre dú Plessis Seminars in Pediatric Neurology Volume 28, December 2018, Pages 29-37 The objective of this article is to understand the complex role ...

    Abstract THE CRITICAL ROLE OF THE CENTRAL AUTONOMIC NERVOUS SYSTEM IN FETAL-NEONATAL TRANSITION: Sarah B. Mulkey, Adre dú Plessis Seminars in Pediatric Neurology Volume 28, December 2018, Pages 29-37 The objective of this article is to understand the complex role of the central autonomic nervous system in normal and complicated fetal-neonatal transition and how autonomic nervous system dysfunction can lead to brain injury. The central autonomic nervous system supports coordinated fetal transitional cardiovascular, respiratory, and endocrine responses to provide safe transition of the fetus at delivery. Fetal and maternal medical and environmental exposures can disrupt normal maturation of the autonomic nervous system in utero, cause dysfunction, and complicate fetal-neonatal transition. Brain injury may both be caused by autonomic nervous system failure and contribute directly to autonomic nervous system dysfunction in the fetus and newborn. The central autonomic nervous system has multiple roles in supporting transition of the fetus. Future studies should aim to improve real-time monitoring of fetal autonomic nervous system function and in supporting typical autonomic nervous system development even under complicated conditions.
    MeSH term(s) Infant, Newborn ; Child ; Humans ; Autonomic Nervous System ; Fetus/physiology ; Brain Injuries
    Language English
    Publishing date 2023-09-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1290000-x
    ISSN 1558-0776 ; 1071-9091
    ISSN (online) 1558-0776
    ISSN 1071-9091
    DOI 10.1016/j.spen.2023.101081
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    Zs.A 4772: Show issues Location:
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  3. Article ; Online: Lessons learned in caring for newborns from one viral outbreak to the next.

    Mulkey, Sarah B

    Pediatric research

    2023  Volume 95, Issue 2, Page(s) 416–417

    MeSH term(s) Humans ; Infant, Newborn ; Disease Outbreaks ; Virus Diseases
    Language English
    Publishing date 2023-12-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-023-02937-z
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    Zs.A 564: Show issues Location:
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  4. Article ; Online: Viral infections in pregnancy and impact on offspring neurodevelopment: mechanisms and lessons learned.

    Yates, Emma F / Mulkey, Sarah B

    Pediatric research

    2024  

    Abstract: Pregnant individuals with viral illness may experience significant morbidity and have higher rates of pregnancy and neonatal complications. With the growing number of viral infections and new viral pandemics, it is important to examine the effects of ... ...

    Abstract Pregnant individuals with viral illness may experience significant morbidity and have higher rates of pregnancy and neonatal complications. With the growing number of viral infections and new viral pandemics, it is important to examine the effects of infection during pregnancy on both the gestational parent and the offspring. Febrile illness and inflammation during pregnancy are correlated with risk for autism, attention deficit/hyperactivity disorder, and developmental delay in the offspring in human and animal models. Historical viral epidemics had limited follow-up of the offspring of affected pregnancies. Infants exposed to seasonal influenza and the 2009 H1N1 influenza virus experienced increased risks of congenital malformations and neuropsychiatric conditions. Zika virus exposure in utero can lead to a spectrum of abnormalities, ranging from severe microcephaly to neurodevelopmental delays which may appear later in childhood and in the absence of Zika-related birth defects. Vertical infection with severe acute respiratory syndrome coronavirus-2 has occurred rarely, but there appears to be a risk for developmental delays in the infants with antenatal exposure. Determining how illness from infection during pregnancy and specific viral pathogens can affect pregnancy and neurodevelopmental outcomes of offspring can better prepare the community to care for these children as they grow. IMPACT: Viral infections have impacted pregnant people and their offspring throughout history. Antenatal exposure to maternal fever and inflammation may increase risk of developmental and neurobehavioral disorders in infants and children. The recent SARS-CoV-2 pandemic stresses the importance of longitudinal studies to follow pregnancies and offspring neurodevelopment.
    Language English
    Publishing date 2024-03-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-024-03145-z
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  5. Article ; Online: Early life exposure to SARS-CoV-2 and offspring neurodevelopment: detecting a non-linear relationship requires a complex approach.

    Mulkey, Sarah B / Ursini, Gianluca

    Pediatric research

    2024  

    Language English
    Publishing date 2024-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-024-03104-8
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  6. Article ; Online: Neurodevelopmental outcomes in congenital and perinatal infections.

    Fortin, Olivier / Mulkey, Sarah B

    Current opinion in infectious diseases

    2023  Volume 36, Issue 5, Page(s) 405–413

    Abstract: Purpose of review: Congenital infections are a major cause of childhood multidomain neurodevelopmental disabilities. They contribute to a range of structural brain abnormalities that can cause severe neurodevelopmental impairment, cerebral palsy, ... ...

    Abstract Purpose of review: Congenital infections are a major cause of childhood multidomain neurodevelopmental disabilities. They contribute to a range of structural brain abnormalities that can cause severe neurodevelopmental impairment, cerebral palsy, epilepsy, and neurosensory impairments. New congenital infections and global viral pandemics have emerged, with some affecting the developing brain and causing neurodevelopmental concerns. This review aims to provide current understanding of fetal infections and their impact on neurodevelopment.
    Recent findings: There are a growing list of congenital infections causing neurodevelopmental issues, including cytomegalovirus, Zika virus, syphilis, rubella, lymphocytic choriomeningitis virus, and toxoplasmosis. Fetal exposure to maternal SARS-CoV-2 may also pose risk to the developing brain and impact neurodevelopmental outcomes, although studies have conflicting results. As Zika virus was a recently identified congenital infection, there are several new reports on child neurodevelopment in the Caribbean and Central and South America. For many congenital infections, children with in-utero exposure, even if asymptomatic at birth, may have neurodevelopmental concerns manifest over time.
    Summary: Congenital infections should be considered in the differential diagnosis of a child with neurodevelopmental impairments. Detailed pregnancy history, exposure risk, and testing should guide diagnosis and multidisciplinary evaluation. Children with congenital infections should have long-term follow-up to assess for neurodevelopmental delays and other neurosensory impairments. Children with confirmed delays or high-risk should be referred for rehabilitation therapies.
    MeSH term(s) Infant, Newborn ; Pregnancy ; Child ; Female ; Humans ; Zika Virus Infection/complications ; Zika Virus Infection/epidemiology ; Zika Virus Infection/congenital ; COVID-19 ; SARS-CoV-2 ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/diagnosis ; Communicable Diseases ; Zika Virus
    Language English
    Publishing date 2023-07-19
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 645085-4
    ISSN 1473-6527 ; 1535-3877 ; 0951-7375 ; 1355-834X
    ISSN (online) 1473-6527 ; 1535-3877
    ISSN 0951-7375 ; 1355-834X
    DOI 10.1097/QCO.0000000000000946
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    Zs.A 2462: Show issues Location:
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  7. Article ; Online: Congenital infectious encephalopathies from the intrapartum period to postnatal life.

    Fortin, Olivier / DeBiasi, Roberta L / Mulkey, Sarah B

    Seminars in fetal & neonatal medicine

    2024  , Page(s) 101526

    Abstract: Congenital infections are a common but often underrecognized cause of fetal brain abnormalities, as well as fetal-neonatal morbidity and mortality, that should be considered by all healthcare professionals providing neurological care to fetuses and ... ...

    Abstract Congenital infections are a common but often underrecognized cause of fetal brain abnormalities, as well as fetal-neonatal morbidity and mortality, that should be considered by all healthcare professionals providing neurological care to fetuses and newborns. Maternal infection with various pathogens (cytomegalovirus, Toxoplasmosis, Rubella virus, Parvovirus B19, lymphocytic choriomeningitis virus, syphilis, Zika virus, varicella zoster virus) during pregnancy can be transmitted to the developing fetus, which can cause multisystem dysfunction and destructive or malformative central nervous system lesions. These can be recognized on fetal and neonatal imaging, including ultrasound and MRI. Imaging and clinical features often overlap, but some distinguishing features can help identify specific pathogens and guide subsequent testing strategies. Some pathogens can be specifically treated, and others can be managed with targeted interventions or symptomatic therapy based on expected complications. Neurological and neurodevelopmental complications related to congenital infections vary widely and are likely driven by a combination of pathophysiologic factors, alone or in combination. These include direct invasion of the fetal central nervous system by pathogens, inflammation of the maternal-placental-fetal triad in response to infection, and long-term effects of immunogenic and epigenetic changes in the fetus in response to maternal-fetal infection. Congenital infections and their neurodevelopmental impacts should be seen as an issue of public health policy, given that infection and the associated complications disproportionately affect woman and children from low- and middle-income countries and those with lower socio-economic status in high-income countries. Congenital infections may be preventable and treatable, which can improve long-term neurodevelopmental outcomes in children.
    Language English
    Publishing date 2024-04-10
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2174416-6
    ISSN 1878-0946 ; 1744-165X
    ISSN (online) 1878-0946
    ISSN 1744-165X
    DOI 10.1016/j.siny.2024.101526
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    Zs.A 4798: Show issues Location:
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  8. Article ; Online: Head Circumference as a Measure of In Utero Zika Virus Exposure and Outcomes.

    Mulkey, Sarah B

    JAMA network open

    2020  Volume 3, Issue 7, Page(s) e209461

    MeSH term(s) Child ; Female ; Head/diagnostic imaging ; Humans ; Microcephaly ; Pregnancy ; Zika Virus ; Zika Virus Infection/diagnosis
    Language English
    Publishing date 2020-07-01
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2020.9461
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  9. Article ; Online: A Neurologist's Practical Guide to Conducting a Fetal Consultation.

    Ream, Margie A / Mulkey, Sarah B

    Seminars in pediatric neurology

    2022  Volume 42, Page(s) 100957

    Abstract: Fetal and neonatal neurology is increasingly recognized as a subspecialty within child neurology and fellowship training programs are emerging. Most child neurologists have not received formal training in the interpretation of fetal data and the practice ...

    Abstract Fetal and neonatal neurology is increasingly recognized as a subspecialty within child neurology and fellowship training programs are emerging. Most child neurologists have not received formal training in the interpretation of fetal data and the practice of fetal neurology consultation. However, they can be valuable members of the fetal care team and bring important perspective to the diagnosis of fetal neurologic conditions. With a systematic approach and a planned format for counseling, child neurologists without formal training in fetal consultations can apply their postnatal neurology expertise to the prenatal neurology patient. In this article we offer a brief practical guide to assist child neurologists in their approach to and practice of fetal neurology consultation.
    MeSH term(s) Female ; Fetal Diseases ; Humans ; Infant, Newborn ; Nervous System Diseases ; Neurologists ; Neurology ; Referral and Consultation
    Language English
    Publishing date 2022-03-25
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1290000-x
    ISSN 1558-0776 ; 1071-9091
    ISSN (online) 1558-0776
    ISSN 1071-9091
    DOI 10.1016/j.spen.2022.100957
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  10. Article ; Online: Importance of Neuroimaging in the Evaluation of Zika Virus-Exposed Infants.

    Mulkey, Sarah B

    JAMA network open

    2019  Volume 2, Issue 7, Page(s) e198137

    MeSH term(s) Brazil ; Humans ; Infant ; Infant, Newborn ; Neuroimaging ; Zika Virus ; Zika Virus Infection
    Language English
    Publishing date 2019-07-03
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2019.8137
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