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The perinatal period is a time of fast physiological change, including epigenetic programming. Adverse events may lead to epigenetic changes, with implications for health and disease. Our review covers the basics of clinical epigenetics and explores the latest research, including the role of epigenetic processes in complex disease phenotypes, such as neurodevelopmental, neurodegenerative and immunological disorders. Some studies suggest that epigenetic alterations are linked to early life environmental stressors, including mode of delivery, famine, psychosocial stress, severe institutional deprivation and childhood abuse. Conclusion Epigenetic modifications due to perinatal environmental exposures can lead to lifelong, but potentially reversible, phenotypic alterations and disease.

Aim Current care of very preterm infants in an incubator implies separation of the mother‐infant dyad. The aim of this study was to determine whether skin‐to‐skin contact (SSC) between parent and very preterm infant from birth and during the first postnatal hour is feasible. Methods Infants born in 2014‐16 in Stockholm at gestational age 28 + 0‐33 + 6 weeks were randomised to care provided in SSC with a parent or on a resuscitaire and later in an incubator or bed during the first postnatal hour. Infant body temperature was measured on admission to the neonatal unit and at one postnatal hour. Data on respiratory support and breastfeeding were prospectively collected. Results We studied 55 infants at 32 + 0 ± 1.4 weeks (range 28 + 2‐33 + 6), with birthweight 1760 g ± 449 g (range 885‐2822). 60% were boys. Mean body temperature in the SSC group was 0.3°C lower 1 hour after birth, 36.3°C ± 0.52 (range 34.4‐37.2) vs 36.6°C ± 0.42 (range 36.0‐37.4, P = .03). No differences between groups were seen in respiratory support or breastfeeding. Conclusion Stabilisation of very preterm infants can be performed while in SSC with a parent, but caution needs to be paid to maintain normothermia.

patients who were confirmed with COVID-19 postoperatively (20.4%) compared with preoperatively (9.1%). Care and staffing needs differ, so preoperative COVID-19 testing and diagnoses can be helpful to ensure needs are met before complications arise. Strategies can be implemented to address more emergent surgeries where prior testing is not feasible. When making discussions, the mother, neonate, and HCWs should be considered to minimize risk and improve safety for all involved. Future research and studies should look at the clinical benefits and risks of the testing pathway, PPE use and its impact on HCW outcomes, and risks and benefits of maternal-neonate interaction after the mother tests positive for COVID-19.