European Journal of Pediatrics最新文献

{"title":"Coronary artery dilation in children with MIS-C: prevalence, risk factor, and progression.","authors":"Phung Nguyen The Nguyen, Tran Thanh Thuc, Nguyen Thanh Hung, Nguyen Tri Hao, Nguyen Minh Tri Viet, Nguyen Thi Ngoc Phuong, Vu Thi Thuy Trang, Le Minh Hieu, Phan Dai Bang, Nguyen Thi Mai Thao, Huynh Nguyen Anh Thu","doi":"10.1007/s00431-025-06051-6","DOIUrl":"10.1007/s00431-025-06051-6","url":null,"abstract":"<p><p>Cardiac injury is the critical issue in children with MIS-C, particularly coronary artery dilation. This study aimed to describe the prevalence, risk factors associated with coronary artery abnormalities, and their progression after 3 months of follow-up in MIS-C children in Vietnam. A prospective multicenter case series study was conducted on MIS-C patients diagnosed per WHO criteria from September 2021 to February 2023 at the two largest pediatric hospitals in southern Vietnam. Data on demographics, clinical features, laboratory findings, and treatments during the acute phase of MIS-C were collected. Patients were followed for 3 months post-discharge and categorized into normal and abnormal coronary artery groups for comparative analysis. Among 195 patients (mean age 6.3 years; male to female ratio 1.5:1), 33.3% exhibited coronary artery abnormalities at admission. Treatment included a combination of intravenous immunoglobulin (IVIG) and corticosteroids (53.3%), corticosteroids alone (42.6%), and IVIG alone (4.1%). After 3 months, only 3.6% of patients had persistent coronary artery abnormalities. Independent risk factors for coronary artery dilation included male sex (OR 4.59; 95% CI 1.62-12.94; p = 0.004), Kawasaki-like phenotype (OR 6.42; 95% CI 2.25-18.33; p = 0.001), and mesenteric lymphadenitis (OR 8.79; 95% CI 1.74-44.31; p = 0.008).</p><p><strong>Conclusion: </strong>Coronary artery dilation in MIS-C patients shows a favorable recovery trajectory after a 3-month follow-up. Male sex, Kawasaki-like MIS-C, and mesenteric lymphadenitis are independent risk factors for coronary artery dilation in MIS-C patients.</p><p><strong>What is known: </strong>• Multisystem inflammatory syndrome in children (MIS-C) is a severe inflammatory syndrome following SARS-CoV-2 infection, often leading to cardiac complications, particularly coronary artery dilation.</p><p><strong>What is new: </strong>• Coronary artery dilation in MIS-C patients mostly resolves within three months of follow-up. Factors associated with coronary artery dilation in MIS-C patients include: male sex, Kawasaki-like phenotype and mesenteric lymphadenitis.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"221"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Relationship between overweight and obesity and cardiac dimensions and function in a paediatric population.","authors":"Juan Fernández Cabeza, Cristhian H Aristizábal-Duque, Isabel María Blancas Sánchez, Martín Ruíz Ortiz, Ana Rodríguez Almodóvar, Mónica Delgado Ortega, Fátima Esteban Martínez, Manuel Romero Saldaña, Francisco Javier Fonseca Del Pozo, Manuel Pan Álvarez-Ossorio, María Dolores Mesa Rubio","doi":"10.1007/s00431-025-06061-4","DOIUrl":"10.1007/s00431-025-06061-4","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"220"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Facilitators and barriers to the transition from outpatient clinic visits to home-based check-ups for children being treated with growth hormone: a mixed-methods study.","authors":"Anouk J W Remmits, Ghislaine A P G van Mastrigt, Silvia M A A Evers, Petra A van Setten","doi":"10.1007/s00431-025-06036-5","DOIUrl":"10.1007/s00431-025-06036-5","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"216"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of earmuff use on physiological and behavioral responses in preterm neonates: a non-randomized, controlled, before-after, quality improvement, observational prospective cohort study.","authors":"Sadhna S Ray, Leana Phebe Wilson, Zubair Khan, Pushparaj Nilkanth Patil","doi":"10.1007/s00431-025-06055-2","DOIUrl":"10.1007/s00431-025-06055-2","url":null,"abstract":"<p><p>Preterm neonates have immature body organs and even have stronger sensitivity towards environmental stress as compared with normal neonates. The NICU is a stress-causing environment because of noise produced from various sources like medical devices, monitor alarms, staff conversation, and the sound of cries from different neonates. The American Academy of Paediatrics recommends sound level should be less than 45 dB in NICU. A non-randomized, controlled, before-after, quality improvement, observational prospective cohort study was conducted on 100 preterm neonates. The samples were divided into two groups of 50 each: control and experimental. Physiological parameters were recorded, and the ABSS tool was used to assess behavioral responses. The control group received routine care, while the experimental group was provided with earmuffs. The study revealed significant improvements in physiological parameters and behavioral responses in preterm neonates using earmuffs. Experimental group neonates showed better thermal stability, reduced stress, improved respiratory and cardiovascular stability, and enhanced oxygenation (p < 0.001). Behavioral improvements included increased sleep duration and reduced restlessness, with statistically significant differences observed in all parameters compared to the control group.</p><p><strong>Conclusion: </strong>We conclude that the application of Earmuff is a fruitful method for preterm neonates to improve and stabilize the physiological parameters and behavioral response.</p><p><strong>What is known: </strong>• Excessive noise in NICUs causes stress and physiological instability in preterm neonates. • Noise reduction strategies, including ear protectors, help stabilize vital signs and improve neonatal outcomes.</p><p><strong>What is new: </strong>• This study confirms the effectiveness of earmuffs in improving physiological and behavioral responses in preterm neonates. • It demonstrates the feasibility of earmuff use in routine neonatal care within the study region.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"217"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pubertal stage significantly and independently impacts C-peptide levels at type 1 diabetes diagnosis along with body mass index and age.","authors":"Emine Ayça Cimbek, Nazım Ercüment Beyhun, Gülay Karagüzel","doi":"10.1007/s00431-025-06046-3","DOIUrl":"10.1007/s00431-025-06046-3","url":null,"abstract":"<p><p>Assessment of beta-cell function in type 1 diabetes (T1D) has important implications in both clinical and research settings. Studies demonstrating the extent to which puberty influences C-peptide levels are scarce. The aim of this study was to evaluate the influence of pubertal stage, along with age and body mass index (BMI), on multiple C-peptide measures at T1D diagnosis. This study included 275 consecutive children aged between 1 and 18 years with newly diagnosed T1D. Fasting, prandial, and area under the curve (AUC) C-peptide, estimated using fasting and prandial C-peptide levels, were analyzed. Generalized linear regression models were utilized. Median age at diagnosis was 7.9 (1.1-17.3) years, and mean BMI standard deviation score (SDS) was - 0.4 ± 1.4. Of the patients, 66% were prepubertal. Median fasting and prandial C-peptide levels at diagnosis were 0.26 (0.05-1.8) ng/mL and 0.43 (0.05-3) ng/mL, respectively. Fasting C-peptide was almost perfectly correlated with prandial C-peptide (r_s = 0.80, P < 0.001). Fasting, prandial, and AUC C-peptide were positively related with BMI SDS, age, and pubertal stage at diagnosis (P < 0.001 for all). All the associations persisted when the variables were included as independent variables in regression models.</p><p><strong>Conclusions: </strong>Pubertal stage significantly and independently impacts C-peptide levels at T1D diagnosis along with body mass index and age. The adjustments demonstrating the extent to which puberty influences C-peptide levels in new-onset T1D are presented. Our observations underline the existence of distinct endotypes of T1D characterized by differing immunopathological courses.</p><p><strong>What is known: </strong>• Throughout the evaluation of beta-cell function at T1D diagnosis, it is essential to consider the factors influencing C-peptide levels.</p><p><strong>What is new: </strong>• While age and BMI at diagnosis are associated with beta-cell function, our findings set the stage for a greater understanding of the disease process with additional findings regarding puberty, supporting the existence of endotypes of T1D.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"219"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance signs of intracranial hypertension in children: a retrospective case-control study.","authors":"Luz Angela Moreno-Gómez, Daniel Quintero-Pulgarín, Oscar Mauricio Espitia Segura, Leidy Carolina Chiquiza-Garzón, Juan David Farfán-Albarracín, Cristina Lorena Ramírez-Sierra, Yenny Carolina Zuñiga-Zambrano, Leydi Alexandra Ceballos-Inga","doi":"10.1007/s00431-025-06025-8","DOIUrl":"10.1007/s00431-025-06025-8","url":null,"abstract":"<p><p>The diagnostic accuracy of magnetic resonance (MRI) signs of intracranial hypertension (ICH) in children remains unclear. This study aims to assess how brain MRI signs of ICH correlate with cerebrospinal fluid opening pressure (CSFOP). A retrospective case-control study was conducted with 77 children aged 1 to 18 years, who underwent brain MRI and lumbar puncture with CSFOP measurement. A blinded radiologist evaluated key ICH signs, including distension of the perioptic subarachnoid space, optic nerve (ON) tortuosity, posterior scleral flattening, intraocular protrusion, and enhancement of the prelaminar ON, among others. Odds ratios, likelihood ratios, predictive values, sensitivity, specificity, and the area under the ROC curve (AUROC), were calculated in relation to CSFOP, adjusted for age and sex. The ICH group included 38 patients (49.3%) and the control group 39 (50.7%). The presence of four or more MRI signs of ICH provided the best diagnostic performance (specificity 92%, sensitivity 40%, AUROC 0.759) for identifying elevated CSFOP, particularly with intraocular protrusion of the prelaminar ON (p = 0.006, median CSFOP 49.6 cm H₂O, p < .001) and papilledema (p = 0.042).</p><p><strong>Conclusion: </strong>The presence of four or more MRI signs is associated with elevated CSFOP in children with non-structural ICH.</p><p><strong>What is known: </strong>• The diagnostic accuracy of magnetic resonance imaging (MRI) signs of intracranial hypertension (ICH) in children remains unclear. • In children, there is no consensus about the most appropriate diagnostic criteria or robust evidence regarding the diagnostic performance of imaging signs for ICH.</p><p><strong>What is new: </strong>• The presence of four or more MRI signs is associated with elevated cerebrospinal fluid opening pressure (CSFOP) in children with non-structural ICH. • Intraocular protrusion of the prelaminar ON, and papilledema are particularly relevant signs for identifying elevated CSFOP.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"218"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective bi-centric observational study comparing primary anastomosis or suturing vs enterostomy for spontaneous intestinal perforations in extremely preterm infants.","authors":"Emeric Genet, Erasti Gounfle, Arnaud Bonnard, Olivier Jaby, Xavier Xu Wang, Camille Jung, Valérie Biran, Aline Rideau, Xavier Durrmeyer","doi":"10.1007/s00431-025-06043-6","DOIUrl":"10.1007/s00431-025-06043-6","url":null,"abstract":"<p><p>The purpose of this study was to compare two initial surgical strategies for spontaneous intestinal perforation (SIP) in a bi-centric cohort of extremely preterm and/or extremely low birthweight infants. Observational, retrospective study including infants born before 28 weeks of gestation and/or with birthweight < 1000 g, born between 2010 and 2020, operated for SIP in two type 3 centers. Infants were attributed to groups according to the surgical technique of the first intervention: primary anastomosis or suturing (PAS) or enterostomy (ES). The primary endpoint was the duration of parenteral nutrition (PN) analyzed using multivariate Cox model. Secondary endpoints included total number of surgeries under general anesthesia, morbidity and mortality at discharge, and outcomes at 2 years. Among 65 included patients, those in the PAS group (n = 46) had a higher median [IQR] CRIB II score than those from the ES group (n = 19) (11.5 [10-13] vs 8 [4-10], p = 0.01) and were more frequently operated in Robert Debré (78% vs 21%, p < 0.001) but had comparable other clinical characteristics at birth and at the time of surgery. As compared to the ES group, infants from the PAS group had a significantly higher probability of NP weaning after adjustment (adjusted hazard ratio 3.05, 95% CI [1.43-6.49]) and a significantly lower median [IQR] number of general anesthesia (1 [1-1] vs 2 [2-2], p < 0.001). At discharge and at age 2, there was no significant difference in outcomes between groups. Conclusion: Initial one-stage surgery for SIP in extremely preterm infants was associated with shorter NP duration and fewer general anesthesia in this study.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"215"},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A snapshot of country-specific dietary habits and obesity in European children: the Feel4Diabetes study.","authors":"Lubna Mahmood, Luis A Moreno, Peter Schwarz, Ruben Willems, Greet Cardon, Soukaina Hilal, Imre Rurik, Violeta Iotova, Yuliya Bazdarska, Roumyana Dimova, Kostas Anastasiou, Yannis Manios, Esther M Gonzalez-Gil","doi":"10.1007/s00431-025-06037-4","DOIUrl":"10.1007/s00431-025-06037-4","url":null,"abstract":"<p><p>This study assessed the dietary intake of European children by country, gender, and obesity degree across six European countries participating in the Feel4Diabetes study. It also compared food group intakes with European food-based dietary guidelines. The Feel4Diabetes study included 9,847 children (50.4% girls) from six European countries. Families provided baseline data on energy balance-related behaviors and socioeconomic factors via questionnaires. Children's dietary intake and breakfast consumption were assessed using semi-quantitative food frequency questionnaires, and anthropometric measurements were taken. Intake from 11 food groups was analyzed by country, gender, and obesity degree. Chi-square analyses compared food intake with dietary guidelines. \"Nutrient-dense \" foods (e.g., fruits, vegetables, whole grains) and \"energy-dense, low-nutrient\" foods (e.g., high in added sugars, saturated fats) were categorized based on the European food-based guideline. Over 85% of children consumed breakfast 5-7 days a week, with no significant differences by Body Mass Index (BMI) or country. Mean intakes of nutrient-dense food groups fell below recommendations, while the intake of energy-dense, low-nutrient foods exceeded limits, particularly in children with overweight/obesity (p = 0.048). No significant gender differences were observed in most food groups.</p><p><strong>Conclusions: </strong> Dietary intake varied by country and obesity degree among European children. Across the six countries, children's diets did not align with food-based dietary guidelines. These findings underscore the need for interventions promoting healthier eating habits among European children.</p><p><strong>Trial registration: </strong>The Feel4Diabetes-study is registered with the clinical trials registry (NCT02393872),  http://clinicaltrials.gov What is Known: • Childhood obesity is a growing concern across Europe, with some variations in food consumption observed between European countries • Previous studies have highlighted the role of diet in childhood obesity, but few have examined cross-country comparisons while accounting for gender and BMI status.</p><p><strong>What is new: </strong>• This study provides a comprehensive cross-country analysis of children's dietary intake, considering gender, BMI status, and adherence to European dietary guidelines. • New insights into gender differences in sweets consumption and the positive association between BMI and food intake (such as soft drinks and sweets) are presented, which can inform targeted dietary interventions.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"214"},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple office blood pressure monitoring for the diagnosis of hypertension in children.","authors":"Letizia Dato, Maria Cristina Mancuso, Thomas Ria, Laura Viola, Patrizia Salice, Matteo Vidali, Daniele Rossetti, Giacomo Tamburini, Teresa Nittoli, Chiara Tamburello, Teodora Munteanu, Chiara Orsenigo, Loredana Simionato, Andrea Gualtieri, Elena Sacchini, Gianluigi Ardissino","doi":"10.1007/s00431-025-06040-9","DOIUrl":"10.1007/s00431-025-06040-9","url":null,"abstract":"<p><p>The measurement (M) of blood pressure (BP) in children may be challenging, and the ideal approach, free of critical issues (such as the interference due to the white coat effect or to the high variability), has yet to be identified. Herein, we compare BP as measured with multiple office BP monitoring (mOBPM) with the standard approach as suggested by guidelines. A cohort of healthy children underwent two mOBPMs 1 year apart. Mean systolic and diastolic values obtained by mOBPM were compared with the 1st, 2nd, 3rd, and 4th measurements (repeated measures ANOVA). mOBPMs with a coefficient of variation (CV) > 15% were excluded. The number of children with BP > 90th centile was determined based on (a) each of the initial three readings, (b) the mean of the 2nd and 3rd Ms, (c) the 4th M, (d) the mOBPM at baseline, and (e) 1 year apart. Out of 164 enrolled children, 13 (7.9%) were excluded because of a CV > 15%. The analysis on the remaining 151 children showed that the first three Ms provided a significantly higher BP than the mOBPM. The 4th M was the first one to be aligned with the results of the mOBPM. Based on the 1st, 2nd, 3rd, and 4th Ms, a BP > 90th centile was observed in 29, 20, 21, and 16 children, respectively. The mean of the 2nd and 3rd Ms identified 12 children with high BP, while the mOBPM revealed elevated BP in only 6 children and this finding was confirmed only in 3 of them 1 year later.</p><p><strong>Conclusion: </strong>The first three readings systematically overestimate BP, while the 4th one better aligns with the mOBPM. If the 4th reading is abnormal, the complete mOBPM will likely offer a more reliable BP assessment.</p><p><strong>What is known: </strong>• Blood pressure measurement may be challanging and initial readings systematically overestimate real values.</p><p><strong>What is new: </strong>• The 4th blood pressure reading better aligns with the mean of 10 measurements. In daily clinical practice, if the 4th reading is abnormal, the complete mOBPM (www.mobpm.com) will likely offer a more reliable BP assessment.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"213"},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Cut umbilical cord milking (C-UCM) in preterm twin gestational births-a randomized controlled trial\".","authors":"Ashadur Zamal, Rajib Losan Bora, Saugata Chaudhuri, Bijan Saha, Sambhunath Bandyopadhyay, Abhijit Hazra","doi":"10.1007/s00431-025-06042-7","DOIUrl":"10.1007/s00431-025-06042-7","url":null,"abstract":"<p><p>Delayed cord clamping (DCC) is now the standard of care in singleton vigorous neonates. But consensus is lacking on the appropriate approach to placental transfusion in multifetal gestational births. In this study, we tried to determine the effect of cut umbilical cord milking (C-UCM) as compared to early cord clamping (ECC) on hematological and clinical hemodynamic parameters in preterm twin neonates of 30-37 weeks gestation. The primary outcome assessed was venous hematocrit (Hct) at 48 (± 4) h of postnatal age. Venous Hct at 6 weeks of age, mean blood pressure during the transitional period, significant neonatal morbidities, and possible sequelae were the significant secondary outcomes evaluated. In this single-center stratified randomized controlled trial, 84 pairs of twin births of 30-37 weeks gestation were allocated in a 1:1 ratio to either C-UCM (n = 84) or ECC (n = 84). For statistical analysis, unpaired Student t and Chi square or Fisher's exact test were used. The C-UCM group had a higher mean Hct at 48 h than the control group, 49.74 (4.463) vs. 41.11 (4.898), p < 0.0001. The mean Hct at 12 h and 6 weeks was also significantly greater in the milked group (p < .0001). Additionally, the milked arm had significantly higher mean blood pressure at 1, 6, and 48 h of life. Similar statistically significant differences were also observed in subgroup analysis (stratified according to gestational age of 30-34 weeks, 34-37 weeks). The groups did not differ significantly in terms of potential complications.</p><p><strong>Conclusion: </strong>C-UCM raises the venous hematocrit and stabilizes initial blood pressure. For twin preterm neonates born between 30 and 37 weeks of gestation, it may be a useful placental transfusion technique. Further large multicentric studies are needed to fully establish its efficacy and safety.</p><p><strong>Trial registration: </strong>CTRI/2024/01/061865; registration date January 25, 2024.</p><p><strong>What is known: </strong>• DCC is the standard of care for singleton vigorous neonates, but no consensus exist for multifetal gestation. • C-UCM is feasible, but studies are lacking in the preterm multifetal population.</p><p><strong>What is new: </strong>• C-UCM is an effective placental transfusion strategy in preterm neonates of 30-37 weeks born out of twin gestation. • C-UCM can serve as a substitute for DCC in multifetal gestation especially in low resource settings.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 3","pages":"212"},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}