{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:52:16Z","timestamp":1792065136287,"version":"4.4.0"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"unspecified","delay-in-days":287,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["J Dev Orig Health Dis"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The transition from fetal to neonatal life requires rapid adjustments in respiratory, cardiovascular, and autonomic regulation as the newborn establishes independent oxygenation. Although most infants achieve stable physiological adaptation, transient fluctuations in oxygen saturation and respiratory control are frequently observed during early neonatal life and are generally considered benign once stability is restored. However, the physiological implications of such transient instability have rarely been systematically examined.<\/jats:p>\n                  <jats:p>This article proposes the concept of subclinical neonatal hypoxic stress (SNHS) as a theoretical framework describing mild and transient oxygen-related physiological stress that may occur during neonatal transition without producing overt manifestations of clinically significant hypoxia or hypoxic injury. SNHS is conceptualized as a hypothesized subclinical physiological vulnerability state within the continuum of neonatal adaptation, distinct from both ordinary physiological variability and clinically significant hypoxic conditions. Episodes potentially consistent with SNHS may include brief transitional instability that resolves rapidly, sometimes following minimal supportive measures, after which infants are considered clinically normal.<\/jats:p>\n                  <jats:p>The paper outlines the physiological basis of neonatal oxygen variability, differentiates SNHS from established hypoxic disorders, and proposes empirically testable approaches for investigating this potential transitional state within early-life physiology. If validated, the SNHS framework could support more precise characterization of transient oxygen instability during neonatal transition and inform future monitoring strategies aimed at distinguishing benign physiological variability from potentially meaningful subclinical physiological stress.<\/jats:p>","DOI":"10.1017\/s2040174426100889","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:06:12Z","timestamp":1792062372000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Subclinical neonatal hypoxic stress: a hypothesis on transitional oxygen instability"],"prefix":"10.1017","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-6753","authenticated-orcid":false,"given":"Tareef Fadhil","family":"Raham","sequence":"first","affiliation":[{"name":"Warith Al-Anbiyaa University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"S2040174426100889_ref7","volume-title":"Neurology of the Newborn","author":"Volpe","year":"2018"},{"key":"S2040174426100889_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511544699"},{"key":"S2040174426100889_ref2","volume-title":"Fetal and Neonatal Physiology","author":"Polin","year":"2017"},{"key":"S2040174426100889_ref12","doi-asserted-by":"publisher","DOI":"10.1353\/book.21308"},{"key":"S2040174426100889_ref14","first-page":"66","article-title":"Therapeutic hypothermia for neonatal hypoxic\u2013ischemic encephalopathy","volume":"17","author":"Shankaran","year":"2012","journal-title":"Semin Fetal Neonatal Med"},{"key":"S2040174426100889_ref6","first-page":"1021","article-title":"Establishing functional residual capacity in the newborn","volume":"120","author":"Hooper","year":"2016","journal-title":"J Appl Physiol"},{"key":"S2040174426100889_ref5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1510"},{"key":"S2040174426100889_ref16","first-page":"S1","article-title":"Pathogenesis of hypoxic\u2013ischemic brain injury","volume":"173","author":"Perlman","year":"2016","journal-title":"J Pediatr"},{"key":"S2040174426100889_ref3","first-page":"F173","article-title":"Arterial oxygen saturation in healthy term neonates","volume":"76","author":"Poets","year":"1997","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"S2040174426100889_ref4","volume-title":"Fetal and Neonatal Physiology (eds. Polin RA, Fox WW, Abman SH)","author":"Martin","year":"2012"},{"key":"S2040174426100889_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2026.112021"},{"key":"S2040174426100889_ref8","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2004.10719428"},{"key":"S2040174426100889_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-017-3436-8"},{"key":"S2040174426100889_ref13","volume-title":"Foetal and Neonatal Physiology: A Comparative Study of the Changes at Birth","author":"Dawes","year":"1968"},{"key":"S2040174426100889_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2007.04561.x"},{"key":"S2040174426100889_ref11","first-page":"248","article-title":"Neonatal resuscitation and transitional physiology","volume":"20","author":"Niermeyer","year":"2015","journal-title":"Semin Fetal Neonatal Med"},{"key":"S2040174426100889_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/9781444311822"}],"container-title":["Journal of Developmental Origins of Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2040174426100889","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:06:14Z","timestamp":1792062374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2040174426100889\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":17,"alternative-id":["S2040174426100889"],"URL":"https:\/\/doi.org\/10.1017\/s2040174426100889","relation":{},"ISSN":["2040-1744","2040-1752"],"issn-type":[{"value":"2040-1744","type":"print"},{"value":"2040-1752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press in association with The International Society for Developmental Origins of Health and Disease (DOHaD)","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}],"article-number":"e52"}}