EDITORIAL article

Front. Pediatr., 06 February 2025

Sec. Neonatology

Volume 13 - 2025 | https://doi.org/10.3389/fped.2025.1557059

Editorial: Clinical trial design and development in neonatal and perinatal medicine

  • 1. Department of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, ACT, Australia

  • 2. Discipline of Neonatology, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia

  • 3. Department of Public Health, College of Science Health and Engineering, La Trobe University, Melbourne, VIC, Australia

  • 4. Department of Neonatology, Townsville University Hospital, Townsville, QLD, Australia

  • 5. College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia

  • 6. Conjoint Research Fellow, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia

  • 7. Neonatal Medicine, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom

  • 8. Neonatal Services, Chelsea and Westminster Hospital, London, United Kingdom

  • 9. Department of Neonatology, University of Zurich, Zurich, Switzerland

  • 10. Department of Neonatology, University Hospital Zurich, Zurich, Switzerland

  • 11. Department of Pediatrics, Tufts Medical Center, Boston, MA, United States

  • 12. Pediatrics and Newborn Medicine, Tufts Clinical and Translational Science Institute, Boston, MA, United States

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Recent evidence from perinatal trials has significantly improved neonatal care, leading to a reduction in neonatal mortality, morbidity, and long-term disability. These advancements have integrated clinical trials into neonatal and perinatal practice and facilitated progress in the expanding Clinical Trial Design and Development field in Neonatal and Perinatal Medicine. Frontiers in Pediatrics has organized a series of Research Topics focused on clinical trials in Neonatal and Perinatal Medicine to highlight the latest advancements in this field. This editorial addresses new insights, novel developments, ongoing challenges, recent discoveries, and future perspectives in the field. This Research Topic aims to illuminate key advancements achieved over the past decade in Clinical Trials related to Neonatal and Perinatal Medicine. This Special Issue seeks to bridge the gap between research and clinical practice, fostering a deeper understanding of new possibilities and encouraging discussions within the perinatal and neonatal medicine communities. The thematic series covers various topics of interest to the perinatal and neonatal communities.

In the fields of pharmacokinetics and pharmacodynamics, Yeung et al. highlighted the principles and unique considerations for optimal design of neonatal clinical trials. Jilani et al., through a literature review applying the RAND/UCLA Appropriateness Method and thematic analysis, found that the interactional relationship between the opioid-exposed birthing person and the infant is the foundational principle that clinically defines the dyad to better support bedside care, surveillance, and research. Jumani et al. conducted a multicenter retrospective study to evaluate the short-term effects of opioids during therapeutic hypothermia (TH) for neonatal encephalopathy. Their study showed that opioid use during TH was associated with adverse short-term outcomes and highlighted the need for longer-term cohort studies. Köber et al. found that the gestational age at birth, birth weight, and gestational age at the time of intrauterine brain sparing determine neonatal outcomes in growth-restricted infants born before 32 weeks of gestation. Furthermore, a small subset of data showed that the nitric oxide donor pentaerythrityl tetranitrate (PETN) may ameliorate the effect of brain sparing in the affected neonates. The work of Pei and Chen explored the association between dexamethasone usage prior to elective full-term cesarean delivery and short-term adverse neonatal outcomes using a retrospective cohort study design. Their results suggest the importance of exercising caution when contemplating the use of antenatal corticosteroids-prior to elective full-term cesarean delivery. Allegaert et al. reported on the current status, trajectory, stakeholder assessment, impact, and future perspectives of the Neonatal Adverse Event Severity Scale (NAESS). This tool was developed by the International Neonatal Consortium (INC) to standardize assessment, facilitate reproducibility of results, and assess the severity and causality of adverse events in clinical trials.

Finally, Degl et al. provided the perspective of two parents of premature infants and two neonatal nurses on the partnership and strong bond that develops between parents and NICU nurses. With nurses being a constant calming presence at the bedside, a trusting bond between parents and nurses often helps to promote clinical research and becomes the lifeline to survive the NICU journey. Fully realizing this “bond” will improve outcomes for patients and families and contribute to the growth and success of the entire NICU system.

In conclusion, we hope that this collection of articles, which showcases a variety of complementary contributions from various institutions worldwide, will inform, guide, and inspire researchers in the field of perinatal and neonatal medicine and continue to lead to improvements in survival and outcomes.

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Author contributions

MA-L: Conceptualization, Project administration, Resources, Supervision, Writing – original draft, Writing – review & editing. YK: Writing – review & editing. SU: Writing – review & editing. DB: Writing – review & editing. JD: Conceptualization, Project administration, Resources, Supervision, Validation, Writing – review & editing.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The author(s) declared that they were editorial board members of Frontiers at the time of submission. This had no impact on the peer review process and the final decision.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Summary

Keywords

trial, neonate, perinatal, design, studies

Citation

Abdel-Latif ME, Kandasamy Y, Uthaya S, Bassler D and Davis JM (2025) Editorial: Clinical trial design and development in neonatal and perinatal medicine. Front. Pediatr. 13:1557059. doi: 10.3389/fped.2025.1557059

Received

07 January 2025

Accepted

22 January 2025

Published

06 February 2025

Volume

13 - 2025

Edited and reviewed by

David Warburton, Children's Hospital Los Angeles, United States

Updates

Copyright

*Correspondence: Mohamed E. Abdel-Latif

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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