The Lancet Child & Adolescent Health Commission on the future of neonatology

Daniele De Luca¹, Neena Modi², Peter Davis³, Satoshi Kusuda⁴, Saskia N de Wildt⁵, Martin Keszler⁶, Allyah Abbas-Hanif⁷, Sandra E Juul⁸, Mark Turner⁹, J Jane Pillow¹⁰, Nikki Robertson¹¹, Manuel Sanchez-Luna¹², David G Tingay¹³, Alexandra Benachi¹⁴, Flavia Bustreo¹⁵, Gianluca Ianiro¹⁶, Mark Hanson¹⁷, Jan Deprest¹⁸, Paolo De Coppi¹⁹, Agnes van den Hoogen²⁰, William Tarnow-Mordi²¹, Anna Zanin²², Ju-Lee Oei²³, Huayan Zhang²⁴, Victor Javier Lara-Diaz²⁵, Lloyd Tooke²⁶, Heidi Flori²⁷, Walter Ricciardi²⁸, Steven H Abman²⁹

Affiliations

¹ Physiopathology and Therapeutic Innovation INSERM-U999, Paris Saclay University, Paris, France; Division of Paediatrics and Neonatal Critical Care, "A. Beclere" Medical Centre, APHP-Paris Saclay University, Paris, France. Electronic address: dm.deluca@icloud.com.
² Section of Neonatal Medicine, School of Public Health, Imperial College, London, UK; Chelsea and Westminster Hospital, London, UK; Institute of Human Development and Potential, Agency for Science, Technology and Research, Singapore.
³ Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Melbourne, VIC, Australia; Department of Neonatal Services, The Royal Women's Hospital, Melbourne, VIC, Australia.
⁴ Department of Paediatrics, Kyorin University, Tokyo, Japan; Neonatal Research Network of Japan, Tokyo, Japan.
⁵ Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands; Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands.
⁶ Alpert Medical School of Brown University, Providence, RI, USA.
⁷ Primary Care and Public Health, School of Public Health, Imperial College, London, UK.
⁸ Division of Neonatology, Seattle Children's Hospital and Institute on Human Development and Disability, University of Washington, Seattle, WA, USA.
⁹ Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, UK.
¹⁰ School of Human Sciences, University of Western Australia, Perth, WA, Australia; Wal-yan Respiratory Research Centre, The Kids Research Institute of Australia, Perth, WA, Australia.
¹¹ Centre for Clinical Brain Sciences, The Roslin Institute, University of Edinburgh, Edinburgh, UK.
¹² University Hospital Gregorio Marañon, Universidad Complutense, Madrid, Spain.
¹³ Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Department of Neonatology, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia; Neonatal Research, Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia.
¹⁴ Division of Obstetrics and Gynaecology, "A. Beclere" Medical Centre, APHP-Paris Saclay University, Paris, France.
¹⁵ Partnership for Maternal, Newborn and Child Health, Botnar Foundation, Geneva, Switzerland.
¹⁶ Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; UOC Gastroenterologia and UOC CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
¹⁷ Institute of Developmental Sciences, University of Southampton, Southampton, UK.
¹⁸ Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Elizabeth Garett Anderson Institute for Women's Health, University College of London, London, UK.
¹⁹ Stem Cell and Regenerative Medicine Section, Developmental Biology and Cancer Research and Teaching Department, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Hospital, London, UK; NIHR GOSH Biomedical Research Centre, Great Ormond Street Hospital, London, UK.
²⁰ Division Woman and Baby, Neonatology, Wilhelmina Children's Hospital University Medical Centre and Utrecht University, Utrecht, Netherlands.
²¹ Department of Newborn Care, Royal Hospital for Women and School of Paediatrics, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; NHMRC Clinical Trial Centre, University of Sydney, Sydney, NSW, Australia.
²² Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Padova, Italy.
²³ Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
²⁴ Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania Perlman School of Medicine, Philadelphia, PA, USA; Centre for Newborn Care, Division of Neonatology, Guangzhou Women and Children's Medical Centre, Guangzhou, China.
²⁵ Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Medicine and Health Sciences, Tecnológico de Monterrey School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico.
²⁶ Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
²⁷ Paediatric Critical Care Medicine, Division of Paediatrics, University of Michigan School of Medicine, Ann Arbor, MI, USA.
²⁸ Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
²⁹ Paediatric Heart Lung Centre, Department of Paediatrics, University of Colorado Anschutz School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.

PMID: 40580970
DOI: 10.1016/S2352-4642(25)00106-3

Review

The Lancet Child & Adolescent Health Commission on the future of neonatology

Daniele De Luca et al. Lancet Child Adolesc Health. 2025 Aug.

. 2025 Aug;9(8):578-612.

doi: 10.1016/S2352-4642(25)00106-3. Epub 2025 Jun 25.

Authors

Affiliations

¹ Physiopathology and Therapeutic Innovation INSERM-U999, Paris Saclay University, Paris, France; Division of Paediatrics and Neonatal Critical Care, "A. Beclere" Medical Centre, APHP-Paris Saclay University, Paris, France. Electronic address: dm.deluca@icloud.com.
² Section of Neonatal Medicine, School of Public Health, Imperial College, London, UK; Chelsea and Westminster Hospital, London, UK; Institute of Human Development and Potential, Agency for Science, Technology and Research, Singapore.
³ Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Melbourne, VIC, Australia; Department of Neonatal Services, The Royal Women's Hospital, Melbourne, VIC, Australia.
⁴ Department of Paediatrics, Kyorin University, Tokyo, Japan; Neonatal Research Network of Japan, Tokyo, Japan.
⁵ Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands; Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands.
⁶ Alpert Medical School of Brown University, Providence, RI, USA.
⁷ Primary Care and Public Health, School of Public Health, Imperial College, London, UK.
⁸ Division of Neonatology, Seattle Children's Hospital and Institute on Human Development and Disability, University of Washington, Seattle, WA, USA.
⁹ Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, UK.
¹⁰ School of Human Sciences, University of Western Australia, Perth, WA, Australia; Wal-yan Respiratory Research Centre, The Kids Research Institute of Australia, Perth, WA, Australia.
¹¹ Centre for Clinical Brain Sciences, The Roslin Institute, University of Edinburgh, Edinburgh, UK.
¹² University Hospital Gregorio Marañon, Universidad Complutense, Madrid, Spain.
¹³ Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Department of Neonatology, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia; Neonatal Research, Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia.
¹⁴ Division of Obstetrics and Gynaecology, "A. Beclere" Medical Centre, APHP-Paris Saclay University, Paris, France.
¹⁵ Partnership for Maternal, Newborn and Child Health, Botnar Foundation, Geneva, Switzerland.
¹⁶ Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; UOC Gastroenterologia and UOC CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
¹⁷ Institute of Developmental Sciences, University of Southampton, Southampton, UK.
¹⁸ Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Elizabeth Garett Anderson Institute for Women's Health, University College of London, London, UK.
¹⁹ Stem Cell and Regenerative Medicine Section, Developmental Biology and Cancer Research and Teaching Department, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Hospital, London, UK; NIHR GOSH Biomedical Research Centre, Great Ormond Street Hospital, London, UK.
²⁰ Division Woman and Baby, Neonatology, Wilhelmina Children's Hospital University Medical Centre and Utrecht University, Utrecht, Netherlands.
²¹ Department of Newborn Care, Royal Hospital for Women and School of Paediatrics, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; NHMRC Clinical Trial Centre, University of Sydney, Sydney, NSW, Australia.
²² Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, Padova, Italy.
²³ Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
²⁴ Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania Perlman School of Medicine, Philadelphia, PA, USA; Centre for Newborn Care, Division of Neonatology, Guangzhou Women and Children's Medical Centre, Guangzhou, China.
²⁵ Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Medicine and Health Sciences, Tecnológico de Monterrey School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico.
²⁶ Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
²⁷ Paediatric Critical Care Medicine, Division of Paediatrics, University of Michigan School of Medicine, Ann Arbor, MI, USA.
²⁸ Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
²⁹ Paediatric Heart Lung Centre, Department of Paediatrics, University of Colorado Anschutz School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.

PMID: 40580970
DOI: 10.1016/S2352-4642(25)00106-3

Erratum in

Correction to Lancet Child Adolesc Health 2025; 9: 578-612.
[No authors listed] [No authors listed] Lancet Child Adolesc Health. 2025 Sep;9(9):e17. doi: 10.1016/S2352-4642(25)00215-9. Lancet Child Adolesc Health. 2025. PMID: 40774786 No abstract available.

Abstract

Neonatal mortality remains unacceptably high throughout the world. Survival of sick infants in their first month of life has improved over the past six decades. However, many comorbidities persist, with lifelong implications for health. The current ecosystem for research and development of drugs and medical devices to treat neonatal disorders is hindering further improvements to neonatal outcomes, especially infants born preterm or needing critical care. Innovation is lagging, and this is a public health problem characterised by multifactorial challenges in leadership, collaboration, regulation, funding, and commercial viability. The Lancet Child & Adolescent Health Commission on the future of neonatology was created to consider these challenges and design a roadmap of strategies to accelerate research and development that will innovate and improve health care for neonates. We call for regulatory agencies, governments, funders, industry partners, and clinical researchers from diverse medical fields to invest in effective pathways for drug and medical device development and to unite in responsive and dynamic collaborations with diverse patients, families, and advocacy groups whose engagement in clinical research and advocacy can help neonatologists to achieve the best science and health equity for neonates worldwide, now and in the future.

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Conflict of interest statement

Declaration of interests AA-H was Chair of Policy and Communications and co-Chair of the Paediatrics and Women's Heath Expert Group at the Faculty of Pharmaceutical Medicine, Royal College of Physicians, London, UK, and co-Chair of the Maternal Health Project Group at the Association of the British Pharmaceutical Industry. SHA received consultancy or lecturer fees from Chiesi Farmaceutici and was a data safety monitoring board (DSMB) member for a clinical trial organised by Bayer Pharmaceuticals in the field of pulmonary hypertension. PDC received funding from the BREATH Consortium for Lung Regeneration, UK Regenerative Medicine Platform Immunology/Medical Research Council, UCL Therapeutic Acceleration Support (TAS), Wellcome and Engineering and Physical Sciences Research Council (EPSRC), and the EU, and has a patent in the field of neonatology. DDL received grants from the Laerdal Foundation, European Society for Paediatric Research (ESPR), and the ESPNIC, paid to the institution; received consulting fees for honoraria for lectures from Medtronic, Masimo, Airway Therapeutics, Vyaire, Chiesi Farmaceutici, AstraZeneca, BI, Natus, BD, and Getinge; is the chair of the DSMB for the phase 1 trial on exosomes to treat bronchopulmonary dysplasia; is a member of the DSMB for a phase 3 trial about surfactant to treat severe bronchiolitis; is the Immediate Past President of ESPNIC (non-profit); has stock options from Ophirex Pharmaceuticals (not vested); received technical research from Getinge and Chiesi Farmaceutici; received fees from Elsevier as an author and from Springer as an editor, and as royalties for books and publications; has one patent in the field of neonatology; and served as WHO temporary adviser on matters of perinatal health. SNDW received paid expert testimony by the Erasmus MC University Medical Center; has a pending patent in the field of neonatology; was a member of the Khondrion Advisory Board, Director of the Board of the (non-profit) Foundation Dutch Knowledge Center Pharmacotherapy for Children (as such responsible for the Dutch Pediatric Formulary), and Director of the Board of the Kinderformulary (full subsidiary of the Foundation Dutch Knowledge Center Pharmacotherapy for Children, and as such responsible for the international collaborations of the Dutch Pediatric Formulary [Austria, Germany, and Norway]), with all payments made to the institution and not to her personally; and board member of the Dutch Society of Clinical Pharmacology and Biopharmaceutics, Vice Chair of the ESPNIC Pharmacology Section, Scientific Chair Dutch Foundation KiddyGoodPills, advisory board member of Dutch Medicines Evaluation Board, and President of the European Society of Developmental Pediatric Perinatal Pharmacology, all unpaid. HF received grants from the US National Institutes of Health (NIH) and was Vice-Chair of the Pediatric Acute Lung Injury and Sepsis Investigators Network. SEJ received NIH and Patient-Centered Outcomes Research Institute grants, Elsevier royalties for editing Avery's Diseases of the Newborn, and travel support from the NIH to attend Pediatric Academic Society; and was a DSMB member for the Albino and Tina Ho's K23 trials, Chair of the DSMB on a trial of enteral iron supplementation and intestinal health in preterm infants, and Chair of the COOL PRIME DSMB. MK received lecturer fees from Drager; is the Chair of a DSMB organised by the US National Heart, Lung, and Blood Institute and a member of a DSMB organised by the NIH and by the Canadian MVP; holds a leadership position in the IPOKRaTES Foundation; and is on the Executive Board of the BPD Collaborative. SK received a grant from the Japan Food Institute for a Bifidobacterium study; received lecture fees from AstraZeneca, ATOM Medical, Mallinckrodt Pharma, and Sanofi; is a member of JR-031 trial for hypoxic-ischaemic encephalopathy by JCR Pharmaceuticals; received consulting fees from the Japan Council for Quality Health Care and Japan Cranial Medical Examination and Treatment Society; is director of the board of the non-profit organisation of the Neonatal Research Network of Japan; and served as an adviser to the Federation of Asia and Oceania Perinatal Societies, Japanese Organization for NICU Families, and Japan Indonesia Medical Collaboration Association without payment. VJL-D received a Pfizer's Medical Grant (paid to his institution); honoraria as a lecturer and travel support from Chiesi Farmacuetici; and is President of the Comité de Ética en Investigación (IRB) at Escuela de Medicina del Instituto Tecnológico y de Estudios Superiores de Monterrey, in Monterrey, México. J-LO received grants from the Australian and New Zealand Society of Blood Transfusion and the Australian Government Fetal Alcohol Spectrum Disorder Expansion Services (paid to her institution); received honoraria for lecturing and educational activities from the Hunan Children's Hospital fellowship programme, UN Office of Drug Control, and the NSW Ministry of Health; received travel support from several academic societies and non-profit organisations to attend conferences; was a member of the DSMB for the LIFT trial; served as Chair of the Perinatal Substance Use Group, Aust NZ, the Tow Research Committee, South East Sydney Area Health Service, and the UN Office on Drugs and Crime long-term prenatal opioid exposure strategy; received payment for expert testimony from Queensland Coroners Court; and received consulting fees from Mallinkrodt. JJP received grants from the Australian National Health and Medical Research Council, Wellcome Trust, Perron Research Foundation, and CRC-P (Australia); received honoraria from Drager Medical; was a DSMB member for a clinical trial organised by the Hudson Institute; is a member of the Scientific Advisory Committee of and has stock options in VitalTrace. NR has one patent in the field of neonatology. MS-L received research support from AbbVie; consulting fees, lecture honoraria, and meeting support from AstraZeneca; is a member of the DSMB for the first-in-human phase 1 trial on exosomes to treat bronchopulmonary dysplasia by Exobiologics; and was the President of the Union of European Neonatal and Perinatal Societies (non profit). DGT received grants from the National Health and Medical Research Council, the Victorian Government (Australia); received consulting fees or honoraria for lectures from Getinge, Fischer & Paykel, and Chiesi Farmaceutici; is a member of the DSMB for a trial managed by Getinge; and received research materials or assistance from Sentec and SLE. MT received grants from the EU Innovative Medicines Initiative and the Innovative Health Initiative and the UK National Institute for Health and Care Research; received consulting fees from Takeda, OakHillBio, and the International Neonatal Consortium hosted by the Critical Path Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development; served as President of the European Society for Developmental, Perinatal, and Paediatric Pharmacology and co-Director of International Neonatal Consortium hosted by the Critical Path Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. FB had travel support for conferences provided by academic societies and non-profit organisations and is Chair of Governance and Ethics Committee for the Partnership for Maternal, Newborn and Child Health, International Advisory Board Chair of the UN University International Institute for Global Health, and Vice President of Fondation Botnar. AB, PD, JD, MH, WR, WT-M, LT, GI, AvdH, AZ, HZ, and NM declare no competing interests.

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The Lancet Child & Adolescent Health Commission on the future of neonatology

Affiliations

The Lancet Child & Adolescent Health Commission on the future of neonatology

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Publication types

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LinkOut - more resources

Full Text Sources

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