Frontiers in Pediatrics最新文献

{"title":"Incidence and epidemiological characteristics of congenital adrenal hyperplasia in Hangzhou newborns, China (2014-2024): a population-based cross-sectional study.","authors":"Yifei Dai, Linling Zhu, Yufeng Zeng, Yiming Chen, Xia Qian, Xiangjuan Li, Ting Wu","doi":"10.3389/fped.2026.1869920","DOIUrl":"https://doi.org/10.3389/fped.2026.1869920","url":null,"abstract":"<p><strong>Background: </strong>Congenital adrenal hyperplasia (CAH) is a rare but potentially life-threatening autosomal recessive disorder. Its incidence varies by region and ethnicity. This study aimed to evaluate the birth incidence, trends, and clinical characteristics of neonatal classic CAH in Hangzhou (2014-2024) to support regional clinical prevention and management.</p><p><strong>Methods: </strong>This retrospective population-based study collected data from Hangzhou's information systems. Classic CAH cases were identified through newborn screening and clinical follow-up to age 3, with diagnosis confirmed by pediatric endocrinologists. Incidence was calculated per 100,000 live births. Categorical variables were compared using chi-square or Fisher's exact test. Temporal trend was assessed by Poisson regression.</p><p><strong>Results: </strong>Among 1,235,815 live births, 40 CAH cases were identified, giving an incidence of 3.24/100,000. The annual incidence ranged from 0/100,000 (2020) to 6.56/100,000 (2017), with no significant temporal trend (<i>P</i> = 0.297). The incidence was highest in urban (4.28/100,000), followed by suburban (2.37/100,000) and rural areas (1.93/100,000) (<i>P</i> = 0.16). Males accounted for 65% (26/40) of cases and females 35% (14/40), with a male-to-female ratio of 1.86:1. The incidence was 4.03/100,000 in males and 2.37/100,000 in females (<i>P</i> = 0.104). Among the 40 cases, salt-wasting (SW) was the predominant phenotype (33/40, 82.5%), and 21-hydroxylase deficiency accounted for 95% (38/40) of cases. Two neonates (5%) presented with salt-wasting crises, and two female infants with the simple virilizing (SV) form were initially misclassified as male. Prenatal ultrasound showed increased nuchal translucency in 6 cases (15%), adrenal enlargement in 3 cases (7.5%), and ambiguous genitalia in 1 case (2.5%). CAH was strongly associated with congenital heart defects (OR: 13.93, <i>P</i> < 0.001), and congenital hypothyroidism (OR: 42.26, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The incidence of classic CAH in Hangzhou (3.24/100,000) was lower than many global estimates. Although temporal and regional differences were not statistically significant, the predominance of SW cases, the occurrence of adrenal crises, and the presence of comorbidities (congenital heart defects, hypothyroidism, and cognitive developmental delay), highlight the need for improved early recognition, strengthened diagnostic capacity in suburban and rural areas, and long-term multidisciplinary management.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1869920"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223968","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":"FeNO may serve as a noninvasive screening tool for gastroesophageal reflux disease in children under 5 years: a retrospective study.","authors":"Fang Wang, Ying Cheng, Xiaoqin Zhou, Junhua Shu, Lin Deng, Ruxin Zhang, Yi Gan, Zhongjian Wang","doi":"10.3389/fped.2026.1925154","DOIUrl":"https://doi.org/10.3389/fped.2026.1925154","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between fractional exhaled nitric oxide (FeNO) measurement and pediatric gastroesophageal reflux disease (GERD), explore potential non-invasive screening indicators for pediatric GERD.</p><p><strong>Methods: </strong>A retrospective cohort of 159 children with suspected GERD was enrolled from the Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province between April 2017 and August 2025. Data on 24 h ph and multiple intraluminal impedance monitoring and FeNO were systematically collected and analyzed.</p><p><strong>Results: </strong>Among 159 children, 32 (20.1%) were diagnosed with GERD. In the 101 children under 5 years, 23 (22.8%) were GERD-positive. The median FeNO in the GERD-positive group was significantly higher than that in the GERD-negative group (18.00 vs. 10.00 ppb, <i>P</i> < 0.001). Spearman analysis revealed that FeNO was significantly correlated with the number of reflux cycles (<i>P</i> = 0.012) and pH reflux cycles (<i>P</i> = 0.010). ROC analysis for FeNO predicting GERD yielded an AUC of 0.751 (<i>P</i> = 0.000), with an optimal cutoff of 17.5 ppb, a sensitivity of 52.2%, and a specificity of 87.2%. Multivariate logistic regression further confirmed FeNO as an independent risk factor for GERD in children under 5 years. However, in the 58 children aged ≥5 years, no significant difference in GERD-positive rate was observed between the FeNO₅₀-positive and FeNO₅₀-negative groups (<i>P</i> = 1.00).</p><p><strong>Conclusions: </strong>Elevated FeNO is independently associated with GERD in children under 5 years, showing moderate diagnostic value as a potential non-invasive screening tool, but not in those aged ≥5 years.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1925154"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223994","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":"A multicenter study on the profile of fungal infections in children infected with HIV in tertiary hospitals in South Western Nigeria.","authors":"Olusola Adetunji Oyedeji, Joseph Babafunso Ayinde, Odunayo Oluseun Afolayan, Funso Abidemi Olagunju, Temitope Ajibola Oyelami, Ayobami Oyetunji Alabi, Olanrewaju Olayemi, Samuel Olorunyomi Oninla, Michaeline Asuquo Isawumi, Omomayowa Omotola Fawale, Adenike Oluwakemi Oladimeji, Olusola Ojurongbe","doi":"10.3389/fped.2026.1812083","DOIUrl":"https://doi.org/10.3389/fped.2026.1812083","url":null,"abstract":"<p><strong>Background: </strong>Fungal infections in children infected with human immunodeficiency virus (HIV) are a significant cause of morbidity and mortality. However, there are no reports on this subject in Nigerian children.</p><p><strong>Objective: </strong>This study aimed to document the spectrum of fungal infections and their outcomes in Nigerian children infected with HIV.</p><p><strong>Methodology: </strong>The case records of all children infected with HIV in three South West Nigerian tertiary hospitals were studied. Data on the identified fungal infection, clinical presentation, and outcomes were obtained and analyzed.</p><p><strong>Results: </strong>A total of 175 children infected with HIV, comprising 89 (50.9%) boys and 86 (49.1%) girls, with ages ranging from 2 months to 16 years, were studied. Of the population studied, 83 (47.4%) had dermatophytosis and 24 (13.7%) had invasive fungal infections (IFIs). Tinea capitis, thrush (pityriasis versicolor), and tinea corporis constituted more than 75% of the dermatophytosis. Invasive candidiasis, <i>Pneumocystis</i> pneumonia, cryptococcal disease, and aspergillosis accounted for more than 95% of the IFIs. Among the 175 children, 61 (34.9%) admissions and 12 (6.9%) deaths were recorded. Nine of the 12 deaths were due to IFIs. Infants and children not on Highly Active Anti-Retroviral Therapy had higher rates of IFIs (<i>p</i> < 0.01). Admission and death rates were higher among those with IFIs (<i>p</i> < 0.01). Higher rates of IFIs and dermatophytosis were found among those with a low socioeconomic status (<i>p</i> < 0.05). Appropriate diagnostics were lacking for <i>Pneumocystis</i> pneumonia and cryptococcal disease diagnosis. Fluconazole was the only antifungal available and accessible for cryptococcal meningitis management.</p><p><strong>Conclusion: </strong>Fungal infections cause significant morbidity and mortality in children infected with HIV. Appropriate diagnostics and medications must be made accessible to reverse IFI treatment outcomes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1812083"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223942","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":"Association of probiotics combined with glutamine with postoperative outcomes in children with Hirschsprung disease: a retrospective propensity score-matched cohort study.","authors":"Peiyu Zhao, Qingqing Wang, Fang Wei, Guoqi Zheng, Shanshan Su","doi":"10.3389/fped.2026.1953553","DOIUrl":"https://doi.org/10.3389/fped.2026.1953553","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between postoperative use of probiotics combined with glutamine and intestinal function recovery, Hirschsprung disease-associated enterocolitis (HAEC), nutritional status, and immune-inflammatory indicators following radical surgery for Hirschsprung disease (HD).</p><p><strong>Methods: </strong>This retrospective observational cohort study included children who underwent radical surgery for HD at our hospital between January 2023 and December 2025. According to the actual postoperative regimen received, patients were divided into an observation group receiving probiotics combined with glutamine in addition to conventional postoperative management (<i>n</i> = 46) and a control group receiving conventional postoperative management alone without the probiotic preparation or glutamine supplementation used in the observation group (<i>n</i> = 48). A 1:1 propensity score matching (PSM) was performed to reduce confounding from measured baseline characteristics and improve covariate balance between the non-randomized treatment groups, resulting in 40 matched pairs. Postoperative recovery of bowel sounds, time to first defecation, length of hospital stay, HAEC incidence at 6 months postoperatively, and changes in nutritional markers (albumin, prealbumin, transferrin), peripheral blood T lymphocyte subsets (CD4⁺, CD4⁺/CD8⁺ ratio), and inflammatory cytokines (IL-10, IL-6) were compared between the two groups.</p><p><strong>Results: </strong>After PSM, the observation group exhibited significantly shorter times for recovery of bowel sounds, first defecation, and hospital stay compared to the control group [(22.5 ± 7.8) h vs. (34.6 ± 9.5) h, (38.5 ± 10.1) h vs. (51.8 ± 12.5) h, (10.5 ± 3.0) d vs. (14.4 ± 4.2) d, all <i>P</i> < 0.001]. At 6 months postoperatively, the incidence of HAEC was lower in the observation group than in the control group [10.0% (4/40) vs. 32.5% (13/40), <i>P</i> = 0.014]. Baseline nutritional, inflammatory, and cellular immune indicators were comparable between the matched groups (all <i>P</i> > 0.05). From baseline to 3 months, the observation group showed greater increases in albumin, prealbumin, transferrin, IL-10, CD4 percentage, and CD4/CD8 ratio and a greater decrease in IL-6 than the control group (all <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>In this retrospective observational cohort, postoperative use of probiotics combined with glutamine was associated with earlier intestinal function recovery, shorter hospitalization, a lower incidence of HAEC, and more favorable nutritional, cellular immune, and inflammatory indicators after PSM. These findings should be interpreted as associations rather than evidence of a causal treatment effect and require confirmation in prospective randomized studies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1953553"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223883","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":"Case Report: When cardiomyopathy is the clue: late-presenting propionic acidemia manifesting as acute heart failure.","authors":"Belinda Kwartemaa Nti, Noah Trapp, Asma Ali, Brendan Lanpher, Jeffrey Weatherhead","doi":"10.3389/fped.2026.1891137","DOIUrl":"https://doi.org/10.3389/fped.2026.1891137","url":null,"abstract":"<p><strong>Background: </strong>Propionic acidemia (PA) is a rare inborn error of metabolism that typically presents in infancy; however, late-onset variants may manifest with atypical features, including cardiac involvement. Dilated cardiomyopathy (DCM) is an uncommon but serious complication.</p><p><strong>Case summary: </strong>A 15-year-old with no prior medical history but a significant maternal family history of cardiomyopathy of unknown etiology from an Amish background presented with altered mental status, increased work of breathing, and progressive edema in the context of preceding viral illness. Evaluation revealed severe biventricular dysfunction, chamber dilation, and findings consistent with chronic DCM. Despite supportive management, her course was complicated by ventricular arrhythmias and clinical deterioration. Metabolic workup demonstrated elevated propionylcarnitine and increased urinary 2-methylcitric acid, confirming late-onset variant PA. She was treated with intravenous carnitine and a specialized metabolic formula; however, cardiac function remained severely impaired. In accordance with family wishes, she was discharged home on hospice care.</p><p><strong>Conclusion: </strong>Late-onset PA can present as isolated cardiomyopathy in adolescence. Early consideration of metabolic etiologies is essential in unexplained DCM, particularly in high-risk populations.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1891137"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223985","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":"Effects of non-nutritive sucking combined with kangaroo care during blood sampling from the heel of newborns.","authors":"Xiao-Ping Shi, Ying Chen","doi":"10.3389/fped.2026.1936904","DOIUrl":"10.3389/fped.2026.1936904","url":null,"abstract":"<p><strong>Background: </strong>The quality of heel blood sampling is critical to the accuracy of neonatal disease screening. However, neonates inevitably experience pain during heel-lance procedures, and repeated painful stimuli may adversely affect neural development. This study aimed to evaluate the effectiveness of non-nutritive sucking combined with kangaroo care in improving procedural outcomes during heel blood sampling in newborns.</p><p><strong>Methods: </strong>This was a single-centre, non-randomised, quasi-experimental historical-control study. A total of 186 full-term newborns delivered vaginally and undergoing heel blood sampling for neonatal disease screening in the Department of Obstetrics at Huzhou Maternal and Child Health Hospital between July 2024 and June 2025 were included. According to the calendar period, newborns were included in a historical control group receiving routine care from July to December 2024 (<i>n</i> = 102) or an intervention group receiving non-nutritive sucking with a pacifier combined with kangaroo care from January to June 2025 (<i>n</i> = 84). Outcomes assessed included first-attempt success rate, blood drop diameter, bleeding time, and Neonatal Infant Pain Scale (NIPS) score. Adverse events such as hematoma, bleeding, and ecchymosis were also documented.</p><p><strong>Results: </strong>The intervention group demonstrated a significantly higher first-attempt success rate (97.62%) compared with the control group (83.33%; <i>P</i> < 0.05). The blood drop diameter in the intervention group (11.28 ± 2.03 mm) was greater than that in the control group (10.02 ± 1.85 mm; <i>P</i> < 0.05), while bleeding time was significantly shorter (2.48 ± 0.37 s vs. 3.51 ± 0.30 s; <i>P</i> < 0.05). The NIPS score during sampling was also markedly lower in the intervention group (3.36 ± 0.41) than in the control group (5.23 ± 0.68; <i>P</i> < 0.05). Additionally, the overall incidence of adverse puncture events was 10.71% in the intervention group, significantly lower than that the 22.55% observed in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The combination of non-nutritive sucking and kangaroo care was associated with favourable outcomes in neonatal heel-prick blood sampling, including higher first-attempt success, larger blood-drop diameter, shorter bleeding duration, lower procedural pain, and fewer puncture-related adverse events. These findings suggest that the combined intervention may be a feasible non-pharmacological approach for neonatal procedural pain management.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1936904"},"PeriodicalIF":2.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215817","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":"<i>Mycoplasma pneumoniae</i> PCR positivity rate among children in Chengdu, China: a retrospective cross-sectional epidemiological study.","authors":"Zhiyong Liao, Xiaomei Zou, Jing Liang, Meimei Lai, Qin Wang, Shuzhe Yang, Yao Deng, Chenggui Liu, Weijun He","doi":"10.3389/fped.2026.1903122","DOIUrl":"10.3389/fped.2026.1903122","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma pneumoniae</i> (MP) is one of the most common pathogens responsible for respiratory infections in children. The objective of this study was to investigate MP positivity rate and its distribution characteristics across different clinical diagnostic groups among children in Chengdu, China.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted at a single center in Chengdu, China, involving children aged 0-18 years who underwent MP polymerase chain reaction (PCR) testing based on clinician requisition or self-requested laboratory testing (SRLT) between January 1 and December 31, 2024. <i>χ</i>2 tests and multivariable logistic regression models were applied for statistical analyses.</p><p><strong>Results: </strong>Among 94,889 children (51,105 males and 43,784 females), the overall MP positivity rate was 12.3%, with no significant difference between sexes. Across five clinical diagnostic groups, MP positivity rate was highest in the acute lower respiratory tract infections (ALRTIs) group (13.9%), followed by the SRLT group (12.8%); both were significantly higher than those in the chronic respiratory diseases (CRDs) group (8.8%), the acute upper respiratory tract infections (AURTIs) group (6.6%), and the non-respiratory diseases (NRDs) group (4.8%). MP positivity rates in the ALRTIs, AURTIs, NRDs, and SRLT groups showed significant seasonal variation, peaking in winter, followed by spring; both seasons exhibited significantly higher positivity rates than summer and autumn. Monthly MP positivity rate peaked in January and February across all groups, after which it generally decreased with mild fluctuations, with the ALRTIs group consistently exhibiting the highest positivity rate. Among children with ALRTIs and AURTIs, MP positivity rates were significantly higher in school-aged, preschool, and adolescent children than in toddlers, infants, and newborns (<i>p</i> < 0.001). Multivariable logistic regression analysis revealed that MP positivity was independently associated with healthcare setting (inpatient vs. outpatient/emergency, OR: 1.24, 95% CI: 1.15-1.35), and PCR assay type (multiplex vs. singleplex, OR: 2.45, 95% CI: 2.25-2.67).</p><p><strong>Conclusions: </strong>Among children in Chengdu in 2024, MP PCR positivity peaked in winter (January-February) and was highest in school-aged children. These single-year findings may help inform local surveillance and guide future long-term epidemiological monitoring.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1903122"},"PeriodicalIF":2.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216116","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":"Regional and socioeconomic inequalities and factors associated with low birth weight in Ghana: a multilevel analysis of the 2022 Ghana Demographic and Health Survey.","authors":"Samuel Antwi, Mabel Pokua Amoako-Boateng, John Kuumuori Ganle, Kofi Agyabeng, Godwin Adzakpah, Morrison Asiamah, Welbeck Amoani Twum, Victor Luckyboy Dzramado, Rebecca Ofosu, Eric Koka","doi":"10.3389/fped.2026.1846424","DOIUrl":"10.3389/fped.2026.1846424","url":null,"abstract":"<p><strong>Introduction: </strong>Low birth weight (LBW) remains a major public health challenge globally, particularly in low- and middle-income countries (LMICs). In Ghana, socioeconomic and regional inequalities in birth outcomes persist. This study examined LBW prevalence, socioeconomic and regional inequalities, and factors associated with LBW using nationally representative data.</p><p><strong>Methods: </strong>A secondary analysis of the 2022 Ghana Demographic and Health Survey (GDHS) was conducted using a weighted sample of 5,768 live births to women aged 15-49 years. Multilevel binary logistic regression was used to assess factors associated with LBW, with a random intercept specified at the DHS cluster level. Socioeconomic inequality was assessed using a concentration curve ranked by household wealth. Regional differences were described using regional prevalence estimates, while between-cluster variation was assessed using the intraclass correlation coefficient (ICC) and median odds ratio (MOR).</p><p><strong>Results: </strong>The overall prevalence of LBW was 11.0%. Prevalence was highest among births in the poorest and poorer wealth quintiles (13%) and lowest in the richest quintile (6%). Regionally, prevalence was highest in Ashanti (15%) and Northern (14%) and lowest in Greater Accra (6%). In the fully adjusted multilevel model (<i>n</i> = 3,421), multiple pregnancy was associated with substantially higher odds of LBW (AOR = 10.09, 95% CI: 6.19-16.44), while adequate ANC attendance (≥8 visits) was associated with lower odds of LBW (AOR = 0.46, 95% CI: 0.32-0.66). The association between household wealth and LBW was not statistically significant after adjustment. Cluster-level ICC was 11.1% in the final model, indicating meaningful between-cluster variation.</p><p><strong>Conclusions: </strong>LBW prevalence varied across socioeconomic and regional groups in Ghana. Multiple pregnancy and adequate ANC attendance were the principal factors associated with LBW in the fully adjusted model, while household wealth was not statistically significant after adjustment. The findings support strengthening quality ANC, particularly for pregnancies at higher risk, alongside equity-oriented maternal and newborn health services.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1846424"},"PeriodicalIF":2.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216007","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":"White blood cell and neutrophil trends in likely early-onset neonatal sepsis: a sex-stratified analysis before and after antibiotic therapy.","authors":"Isaline Eggermont, Andrea Nebbioso, Alfredo Vicinanza, Phu-Quoc Lê, Nancy Vitali, Gwenaëlle Augé, Nicolas Lefèvre","doi":"10.3389/fped.2026.1917831","DOIUrl":"10.3389/fped.2026.1917831","url":null,"abstract":"<p><strong>Introduction: </strong>Early-onset neonatal sepsis (EONS) requires rapid diagnosis, yet the interpretation of white blood cell (WBC) and absolute neutrophil count (ANC) is complicated by physiological postnatal changes. While sex differences in neutrophil responses are known in older populations, limited data exist in neonates. This study aimed to investigate the kinetics of WBC and ANC in neonates with likely EONS and evaluate potential sex differences, including responses to antibiotic initiation.</p><p><strong>Methods: </strong>We reviewed neonates treated at our center with antibiotics for likely EONS (suspected EONS with elevated CRP) between 2017 and 2022. WBC and ANC values were collected at standardized intervals before and after antibiotic initiation. Data were analyzed using piecewise linear mixed-effects regression models stratified by sex and timing of antibiotic initiation.</p><p><strong>Results: </strong>Of the 506 neonates included, 304 (60.1%) were males and 202 (39.9%) females. Female neonates had higher ANC at birth (10,366 <i>vs.</i> 9,573 cells/<i>μ</i>L, <i>p</i> = 0.012) and after antibiotic initiation (14,519 <i>vs.</i> 13,359 cells/μL, <i>p</i> = 0.042). During the first 12 h of life, ANC increased in both sexes (673 cells/μL/hour in females, 603 cells/μL/hour in males, <i>p</i> = 0.001), with no difference in rate. Among neonates treated at birth, WBC counts increased more rapidly in females (557 <i>vs.</i> 380 cells/μL/hour, <i>p</i> = 0.020). In contrast, neonates treated after birth showed a similar decline in WBC and ANC regardless of sex.</p><p><strong>Conclusion: </strong>Female neonates with likely EONS consistently demonstrated higher ANC values and a more pronounced WBC increase in the early hours of life and after antibiotic initiation. This may reflect sex differences, potentially due to X-linked genes involved in the innate immune response. These findings support sex-specific interpretation of inflammatory markers in the evaluation of likely EONS evaluation and warrant further investigation into underlying immune differences.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1917831"},"PeriodicalIF":2.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216135","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":"Vitamin B12 deficiency in children in a high-income country: clinical features and outcomes from a 10-year retrospective study.","authors":"Riccardo Pagani, Marco Salvi, Davide Colombo, Martina Paredi, Fabiola Guerra, Adriana Cristina Balduzzi, Giulia Maria Ferrari, Paola Corti","doi":"10.3389/fped.2026.1951202","DOIUrl":"10.3389/fped.2026.1951202","url":null,"abstract":"<p><strong>Background: </strong>Vitamin B12 deficiency in children can cause severe hematological and neurological complications, yet epidemiological data from high-income countries remain limited. This study aimed to characterize the clinical, hematological, and etiological features of vitamin B12 deficiency in children referred to a pediatric hematology center in a high-income country.</p><p><strong>Methods: </strong>A retrospective single-center study was conducted at a pediatric hematology clinic in Northern Italy, analyzing data collected over a 10-year period. Children with serum vitamin B12 levels ≤250 pg/mL were included. Patients were stratified by total vitamin B12 into very low (≤100 pg/mL), low (101-200 pg/mL), and marginal (201-250 pg/mL) B12 levels. Clinical, laboratory, and etiological data were analyzed.</p><p><strong>Results: </strong>Of 461 eligible patients, 8.6% had serum B12 levels ≤250 pg/mL. The median age was 12 years, with a bimodal distribution peaking in infants/toddlers (35%) and adolescents (53%). The main referral reasons were anemia (52.5%), hemoglobinopathy traits (15%), isolated macrocytosis (10%), pancytopenia (12.5%), and CNS involvement (17.5%). Patients with B12 levels ≤100 pg/mL had significantly lower hemoglobin concentrations and higher biochemical markers of ineffective erythropoiesis compared to other groups.</p><p><strong>Conclusions: </strong>Vitamin B12 deficiency should be systematically considered in the differential diagnosis of unexplained cytopenias and neurological manifestations in pediatric patients, particularly in specialized hematology settings. In our cohort, serum B12 concentrations ≤100 pg/mL were associated with more pronounced hematological abnormalities and frequently observed among patients with neurological involvement; however, this finding does not establish a validated pediatric severity threshold. Early recognition and prompt treatment are essential to prevent potentially irreversible complications.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1951202"},"PeriodicalIF":2.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216079","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}