{"title":"The Association between Prenatal Antibiotic Use and the Risk of Autism Spectrum Disorders among Children: An Updated Meta-Analysis.","authors":"Azam Maleki, Helen Behmanesh, Ensiyeh Jenabi","doi":"10.2174/0115733963352806250512100056","DOIUrl":"https://doi.org/10.2174/0115733963352806250512100056","url":null,"abstract":"<p><strong>Objective: </strong>Studies on prenatal antibiotic use and Autism Spectrum Disorder (ASD) risk have yielded inconsistent results.</p><p><strong>Aim: </strong>This study aimed to resolve these discrepancies by conducting a meta-analysis on the relationship between prenatal antibiotic use and ASD in children.</p><p><strong>Method: </strong>A comprehensive search was conducted in three main databases: PubMed, Scopus, and Web of Science, up to August 1, 2024. The analysis employed random-effect models to estimate effect sizes, including hazard ratios (HR) and odds ratios (OR). Publication bias was assessed using Begg's test and Egger's regression test. Subgroup analyses explored variations in the association based on the trimester of pregnancy. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).</p><p><strong>Results: </strong>In this meta-analysis, which included twelve studies with a total population of 5,065,060, prenatal antibiotic use was associated with an increased risk of Autism Spectrum Disorder (ASD). The estimated HR for this risk was 1.08 (95% CI: 1.05, 1.12), and the OR was 1.16 (95% CI: 1.09, 1.23), with no detected heterogeneity among studies. The analysis found no publication bias. Significant associations were observed for each trimester: first trimester (HR: 1.11; 95% CI: 1.04, 1.18), second trimester (HR: 1.10; 95% CI: 1.06, 1.14), and third trimester (HR: 1.09; 95% CI: 1.01, 1.18).</p><p><strong>Conclusion: </strong>The analysis reveals a significant link between prenatal antibiotic use and an increased risk of ASD, with a consistently modest elevation in risk across all trimesters. Future research should focus on elucidating the mechanisms underlying this association by examining the effects of specific antibiotic classes, dosages, and timing during critical developmental periods. Longitudinal studies with comprehensive control for confounding factors are essential for strengthening causal inferences and guiding clinical recommendations regarding antibiotic use during pregnancy.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giuseppe De Bernardo, Fabio Centanni, Marta Improta, Valeria Crisci, Maurizio Giordano, Giuseppe Buonocore, Serafina Perrone
{"title":"Effects of Breast Milk or Supplemented Formula Milk on Fecal Metabolomic Profile.","authors":"Giuseppe De Bernardo, Fabio Centanni, Marta Improta, Valeria Crisci, Maurizio Giordano, Giuseppe Buonocore, Serafina Perrone","doi":"10.2174/0115733963341570250422095946","DOIUrl":"https://doi.org/10.2174/0115733963341570250422095946","url":null,"abstract":"<p><p>Breast milk is the best option for the nutritional needs of an infant. In situations where breastfeeding is contraindicated, donor human milk and formula milk are suggested as alternatives. This study highlights findings from two studies that evaluated how different dietary patterns (standard formula, post-biotic fermented formula, and breast milk) affected the intestinal microbiota and metabolome of late preterm and full-term infants. The metabolome of late preterm newborns showed a higher presence of metabolites-such as azelaic acid, N-acetylglucosamine-6- sulfate, and 13(S)-hydroperoxylinolenic acid-in those fed postbiotic-fermented formula, similar to breastfed full-term newborns. The fecal metabolites of breast milk and substitute feeding systems are comparable in these preliminary studies, confirming the effectiveness of formula preparations as breast milk substitutes. Furthermore, newborns fed with postbiotic-supplemented formula or breast milk had several similarities in fecal metabolites. The addition of postbiotics to formula milk appears to be more efficient than standard formula milk and is considered a better alternative to breast milk.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benedetta Signorelli, Catiuscia Lisi, Luisa Galli, Elena Chiappini
{"title":"Special Health Care Needs in Internationally Adopted Children: Prevalence of Chronic Conditions and Interesting Origin-correlated Risk Factors.","authors":"Benedetta Signorelli, Catiuscia Lisi, Luisa Galli, Elena Chiappini","doi":"10.2174/0115733963350631250220130025","DOIUrl":"https://doi.org/10.2174/0115733963350631250220130025","url":null,"abstract":"<p><strong>Introduction: </strong>The Federal Maternal and Child Health Bureau defines Children with special health care needs (CSHCN) as those who have, or are at increased risk for, chronic physical, developmental, behavioral, or emotional conditions, and require health and related services beyond what is generally required by other children. More than half of the entire Italian internationally adopted children (IAC) population has special needs. This monocentric retrospective study aims to describe the demographic features and prevalence of several chronic conditions in a large cohort of IAC.</p><p><strong>Methods: </strong>Between 1 January 2009 and 31 October 2023, we consecutively enrolled all IAC referred to Anna Meyer Children's University Hospital, in Florence. This process followed a standardized operative protocol developed internationally. Then, univariate logistic regression analyses were performed.</p><p><strong>Results: </strong>Among 2694 IAC, 315 children (11.89%) were found to be affected by a chronic condition. Asia appears to have 101/561 (18.00%) prevalence of diseases in the total number of IAC from this region of origin, followed by Eastern Europe with 135/1030 (13.11%), Latin America 63/598 (10.54%) and Africa 16/435 (3.68%). The countries of origin with higher prevalence of chronic conditions were China (57.75%), India (15.89%), Russia (15.44%), and Ukraine (13.79%). Children adopted from China and India have a high prevalence of malformations (p = 0.016), while children adopted from Russia accounted for 69.77% of the total fetal alcohol syndrome affected in our cohort. Mental and behavioral disorders appear significantly more prevalent in children from Latin America (p = 0.015), whereas endocrinological disorders predominate in children from Africa (p = 0.014). High rates of precocious puberty were recorded in Asia (p = 0.018) and Africa (p = 0.001) in comparison with the other regions of origin.</p><p><strong>Conclusion: </strong>A revision of the current definition of special needs for adoptive purposes is recommended. Italian screening of the adopted child could be tailored considering the country of origin, and the study of mental health should definitively become part of it.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Salvatore Aversa, Guglielmo Riccio, Brunetta Guaragni, Lorenzo Pinelli, Francesco Maria Risso
{"title":"Parvovirus B19 Intrauterine Infection and Cerebral Cortical Dysplasia: A Case Report.","authors":"Salvatore Aversa, Guglielmo Riccio, Brunetta Guaragni, Lorenzo Pinelli, Francesco Maria Risso","doi":"10.2174/0115733963349333250407065521","DOIUrl":"https://doi.org/10.2174/0115733963349333250407065521","url":null,"abstract":"<p><strong>Background: </strong>Intrauterine parvovirus B19 infection usually causes fetal anemia, hydrops, and stillbirth. Less commonly, central nervous system injuries have also been described.</p><p><strong>Case presentation: </strong>We report an atypical case of severe brain injury with diffuse malformation of cortical development and severely immature gyration in a preterm infant with profound fetal anemia and hydrops due to congenital parvovirus B19 infection. The fetus was treated with multiple intrauterine transfusions. Postnatal magnetic resonance imaging of the brain showed extensive encephalomalacia with severe volume loss of both hemispheres, associated with a deranged, markedly immature gyration.</p><p><strong>Conclusion: </strong>This case provides the first description of severe delay in brain maturation in intrauterine parvovirus B19 infection and represents evidence of a possible teratogenic effect of parvovirus B19 on the brain tissue.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Role of Immune Markers in Predicting Infectious Complications in Children with Congenital Heart Defects.","authors":"Degtyareva Elena, Mwela Bupe Mumba, Prodeus Andrey, Ovsyannikov Dmitry, Kantemirova Marina, Alekseeva Olga, Kudlay Dmitry, Kim Alexey, Nefedova Inessa, Rogova Tatyana, Tumanyan Margarita, Korsunsky Iliya","doi":"10.2174/0115733963325523250320065040","DOIUrl":"https://doi.org/10.2174/0115733963325523250320065040","url":null,"abstract":"<p><p>The literature review presents data from a limited number of available studies conducted over the last two decades on immunological deficiency in congenital heart defects (CHDs), which is the cause of frequent infectious complications before and after cardiac surgery. Several studies based on screenings at various levels indicate the presence of primary and secondary immunodeficiency in CHDs, in particular about 13 genetic syndromes in which CHD is combined with immunodeficiency. The available data suggests a greater severity of immunological disorders in patients with critical CHDs, cyanotic CHDs, and conotruncal defects with T-cell dysfunction and deficiency of immunoglobulins (especially the IgG class, mainly IgG4) than in patients with shunts and obstructive defects. To identify defects in the T- and B-cell components of the immune system, quantification of the DNA of T-cell receptor excision circles (TRECs) and K-deleting recombination excision circles (KRECs)-by-products of the maturation of T- and B-cell receptors- has proven helpful in the world practice of neonatal screening. It allows the evaluation of a number of functionally mature T- and B-cells. In Russia, however, its widespread use started only in 2023. Data on the use of this assay in infants with CHDs are represented by isolated case reports. In Russia, a combination of CHD and primary immunodeficiency was found in 37% of cases in the Sverdlovsk Region. We conducted our own study of 200 children with CHD; 5% of cases were syndromic forms of CHD. 48.5% of children were admitted to the cardiac surgery clinic in critical condition. A decrease in the TREC level was detected in 23.5% of cases, including all children with syndromic CHD. In the group of patients with immunological disorders, there were significantly more children with cyanotic CHD, children admitted in critical condition, and children with conotruncal defects. Infectious complications in the postoperative period (sepsis, pneumonia, tracheobronchitis, postoperative wound infection) were observed significantly more often in 47 children with reduced TREC levels compared to children with normal TREC levels (P = .00000, in 36% and 3.6%, respectively). The analysis of publications confirms the prognostic value of TREC and KREC screening for targeted preoperative preparation to reduce postoperative complications and decrease the risk of mortality in CHDs.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Twins and Necrotizing Enterocolitis: Genetic Relevance.","authors":"Vineet Bhandari","doi":"10.2174/0115733963369969250212072155","DOIUrl":"https://doi.org/10.2174/0115733963369969250212072155","url":null,"abstract":"<p><p>In preterm infants, necrotizing enterocolitis (NEC) is one of the most devastating complications seen in the neonatal intensive care unit (NICU), with both short- and long-term sequelae. Outcomes reported for mono- (versus di-) chorionic twins suggest an increased incidence in the monochorionic twins, usually attributed to abnormal placental vascular connections. Same sex concordance and zygosity data suggest shared genetic and environmental factors as important contributing factors to the pathogenesis of NEC. This concept is further supported by fecal microbiome data from preterm twins. However, there is also some uncertainty in these observations because studies that controlled for gestational age did not show significant differences between singletons and twins in the occurrence of NEC. This mini-review was undertaken as a critical appraisal of the published literature in terms of twin studies to establish the genetic relevance vis-àvis NEC. There is a need for further evaluation of genetic and confounding factors arising from the environment and the gut microbiome in these infants using cohorts with larger sample sizes.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Majd Masadeh, Sabariah Noor Harun, Tareq Mukattash, Nasr Alrabadi
{"title":"Parental Knowledge and Attitudes Towards Antibiotic Resistance in Children: A Review Article.","authors":"Majd Masadeh, Sabariah Noor Harun, Tareq Mukattash, Nasr Alrabadi","doi":"10.2174/0115733963365501250210062038","DOIUrl":"https://doi.org/10.2174/0115733963365501250210062038","url":null,"abstract":"<p><p>Antibiotic misuse among children continues to be one of the major critical public health issues worldwide, particularly in developing countries such as Jordan. Incorrect antibiotic use is hugely influenced by parents' knowledge and attitudes on the subject at hand. This review, therefore, seeks to establish the current state of parental knowledge and attitudes toward antibiotics in Jordanian children, with particular emphasis on those gaps in awareness and knowledge that underpin the inappropriate use of antibiotics. Despite prescription regulations, many still depend on over-the-counter purchases, usually due to misconceptions about the efficiency of antibiotics in viral infections or a lack of insight into the risks of misuse. The results strongly suggest that focused educational programs are needed to improve parents' knowledge of prudent antibiotic use. It integrated an analysis of the socio-cultural factors affecting parental decisions and recommended improvising the public health strategies in their fight against antibiotic resistance. The study concluded that emphasis must be laid on both regulatory enforcement and public awareness about appropriate antibiotic use in pediatric care to bring about better health outcomes in Jordanian children.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Aberrant Expressions of EDNRB and EDN3 in a Multifactorial Hirschsprung Disease.","authors":"Gunadi, Khanza Adzkia Vujira, Verrell Christopher Amadeus, Gita Christy Gabriela, Adisrasti Rejeki Amaragati, Esensi Tarian Geometri, Laudria Stella Eryvinka, Kevin Eliezer Ferdinandus, Nabila Ardia Pramono, Andi Dwihantoro","doi":"10.2174/0115733963343518241223193627","DOIUrl":"https://doi.org/10.2174/0115733963343518241223193627","url":null,"abstract":"<p><strong>Background: </strong>Hirschsprung disease (HSCR) is a multifactorial disorder due to the enteric nervous system (ENS) development failure. At least 35 genes have been responsible for HSCR, including EDNRB and EDN3. Here, we aimed to determine the EDRNB and EDN3 expressions effects in HSCR subjects.</p><p><strong>Methods: </strong>Our study analyzed EDNRB and EDN3 expressions in the colon of HSCR subjects and controls by a quantitative PCR. The EDNRB and EDN3 expressions were analyzed by the Livak method (2-ΔΔC T).</p><p><strong>Results: </strong>Twenty-seven HSCR patients and 20 controls were ascertained. EDNRB and EDN3 expressions downregulated was found in ganglionic and aganglionic HSCR than control colons (EDNRB: ΔCT 6.78 ± 1.38 vs. 1.71 ± 2.79; p = 0.0001 (ganglionic); ΔCT 4.41 ± 1.63 vs. 1.71 ± 2.79; p = 0.0005 (aganglionic); and EDN3: ΔCT 7.60 ± 1.93 vs. 1.81 ± 2.89; p = 0.0001 (ganglionic); ΔCT 9.72 ± 4.32 vs. 1.81 ± 2.89; p = 0.0001 (aganglionic)). A significant difference in EDNRB and EDN3 expressions was also noted between the HSCR colon: ganglionic vs. aganglionic segment (p = 0.00002 and 0.017).</p><p><strong>Conclusion: </strong>We report the downregulated EDNRB and EDN3 expressions in HSCR subjects, indicating EDNRB/EDN3 expressions have a significant responsibility in HSCR pathogenesis. Nevertheless, we further clarify the complexity of the development of ENS.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annabelle Wagner, Yeliz Akarsu, Marc Remke, Dominik Schoendorf, Johannes Huebner, Thomas Lehrnbecher, Markus Hufnagel, Konrad Bochennek, Arne Simon
{"title":"The Outcomes of Pediatric, Adolescent, and Young Adult Oncology Patients With Non-neutropenic Fever: A Scoping Review of the Literature.","authors":"Annabelle Wagner, Yeliz Akarsu, Marc Remke, Dominik Schoendorf, Johannes Huebner, Thomas Lehrnbecher, Markus Hufnagel, Konrad Bochennek, Arne Simon","doi":"10.2174/0115733963322621250113083851","DOIUrl":"https://doi.org/10.2174/0115733963322621250113083851","url":null,"abstract":"<p><strong>Background: </strong>There are established and well-followed guidelines for pediatric oncology patients who have neutropenic fever. However, there are no explicit criteria for this patient group, and over 50% of pediatric oncology patients with fever do not present with neutropenia.</p><p><strong>Objective: </strong>In this scoping review, we have explored the outcomes of non-neutropenic fever in pediatric, adolescent, and young adult patients with cancer-directed treatment. The results of this scoping review should assist in the creation of a guideline for the management of non-neutropenic fever in this group of patients.</p><p><strong>Method: </strong>Multiple electronic databases and reference lists were searched (PubMed, MEDLINE CENTRAL, and Google (first 100 results only)). Included are retrospective and prospective cohort studies on the management and outcome of pediatric oncology patients with non-neutropenic fever that have been published after the year 2000.</p><p><strong>Results: </strong>Seventeen studies with a total of 10.845 fever episodes were included, that address the treatment and outcome of patients with non-neutropenic fever. The rate of bacteremia was 1.6 - 14.4% (mean 5.8%). The mortality rate was low due to non-bacterial causes. Across different studies, proposed risk factors for bacteremia were higher temperature, prolonged fever over 72 hours, ill-appearing patients, chills, hypotension, leukocytosis, infancy, and the presence of a Broivac/ Hickman catheter. Limitations to this study are the risk of bias, and potential incomplete identification of relevant studies pertinent to the research questions asked.</p><p><strong>Conclusion: </strong>Due to significant heterogeneity, the published data so far are not sufficient to propose evidence-based guidelines for pediatric oncology patients with non-neutropenic fever. Prospective, multicenter registries based on uniform definitions are needed. No funding was received for this manuscript.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}