Frontiers in Pediatrics最新文献

{"title":"Global, regional, and national epidemiology of otitis media in children from 1990 to 2021.","authors":"HanYu Wang, XiaoYu Zeng, Xin Miao, BoWen Yang, ShiPeng Zhang, QinWei Fu, QinXiu Zhang, Mi Tang","doi":"10.3389/fped.2025.1513629","DOIUrl":"10.3389/fped.2025.1513629","url":null,"abstract":"<p><strong>Background: </strong>Otitis media(OM) is a prevalent ear condition, particularly among children, with a significant impact on quality of life. This study aimed to elucidate the global prevalence and disability-adjusted life years (DALYs) associated with OM in the 0-14 age group from 1990-2021, using data from the 2021 Global Burden of Disease (GBD) study.</p><p><strong>Methods: </strong>Our study conducted a comprehensive analysis of OM data from the GBD 2021 report, examining the prevalence and DALYs related to OM across 204 countries and territories over a 32-year period. Data were stratified by age, sex, year, geographic region, and sociodemographic index (SDI). Temporal trends were evaluated using estimated annual percent change (EAPC) calculations. Additionally, a global risk attribution analysis for childhood OM was conducted, and a Bayesian age-period-cohort (BAPC) model was applied to project the global burden of childhood OM from 2021-2035.</p><p><strong>Results: </strong>In 2021, the global burden of OM in children remained significant, with an incidence of 297,243,470 cases and an age-standardized prevalence of 14,775 cases per 100,000 population. OM resulted in 1,035,749 DALYs globally, with an age-standardized DALY rate of 51.48 per 100,000 population. Regionally, the highest age-standardized prevalence of OM was observed in Eastern Sub-Saharan Africa, South Asia, and Western Sub-Saharan Africa, while Central Europe, East Asia, and High-income Asia Pacific exhibited the lowest prevalence. Key risk factors identified include secondhand smoke, particulate matter pollution, low birth weight, and short gestation. Additionally, a significant inverse association was found between the SDI and the burden of OM, with age-standardized DALY rates decreasing markedly as SDI increased.</p><p><strong>Conclusion: </strong>OM in children represents an escalating global health challenge, marked by a rising incidence. Although there has been a global decline in DALYs, the burden of DALYs associated with OM in children remains significant, particularly in regions with a low SDI. A more comprehensive understanding of the epidemiology of OM in children could enhance prevention and control efforts.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1513629"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649214","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: Two children with factor XII deficiency caused by novel <i>F12</i> compound heterozygous variants.","authors":"Rui-Xue Ma, Hai-Yan Li, Yi-Hang Zhang, Xue-Min Zhang, Yan-Juan Chen, Yi-Lin Dai, Gui-Xian Li, Wen-Hai Luo, Jie Zhang, Yun-Fen Tian","doi":"10.3389/fped.2025.1555426","DOIUrl":"10.3389/fped.2025.1555426","url":null,"abstract":"<p><strong>Background: </strong>Factor XII (FXII) deficiency (OMIM 234000) is a rare hereditary coagulation disorder caused by pathogenic variants within the <i>F12</i> gene. It causes prolonged activated partial thromboplastin time without bleeding diathesis. Most patients have no obvious clinical symptoms, so the disease is difficult to be detected.</p><p><strong>Case presentation: </strong>Here, we reported two pediatric cases with FXII deficiency from Kunming, China. Patient 1 was a 10-year-old girl who was hospitalized with a fever and cough for one week and diagnosed with pneumonia. Auxiliary coagulation function examination suggested that the activated partial thrombin time (APTT) was significantly prolonged, while both the coagulation factor XII activity (FXII:C) and coagulation factor XII antigen (FXII:Ag) were decreased. Whole exome sequencing (WES) revealed this patient carries <i>F12</i> compound heterozygous variants with NM_000505.4:c.509G>A (p.Cys170Tyr) and NM_000505.4:c.800+1G>C. Patient 2 was a newborn boy with prolonged coagulation of the umbilical cord and difficult hemostasis after birth. A prolonged APTT and a decreased ratio of FXII:C were observed. WES revealed this patient carries <i>F12</i> compound heterozygous variants with NM_000505.4:c.583del (p.His195Thrfs*56) and NM_000505.4:c.805C>T (p.Pro269Ser). <i>In vivo</i> RT-PCR assays demonstrated c.800+1G>C intron mutation resulted to a 166-bp deletion (exon 8 skipping) for patient 1. Bioinformatics analysis confirmed the pathogenicity of all four variants.</p><p><strong>Conclusions: </strong>We presented two pediatric cases with FXII deficiency caused by novel <i>F12</i> compound heterozygous variants. Pediatricians should raise awareness of this rare and underdiagnosed disorder and improve diagnostic and intervention strategies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1555426"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649212","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":"Mechanical tricuspid valve thrombosis in pregnancy: a case report and literature review on anticoagulation challenges and fetal protection strategies.","authors":"San Zhu, Can Luo, Bing Luo, Yaoyao Zhang, Qiang Wei","doi":"10.3389/fped.2025.1596199","DOIUrl":"10.3389/fped.2025.1596199","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy in women with mechanical heart valves (MHVs) poses significant challenges in balancing maternal thromboprophylaxis and fetal safety. Anticoagulation strategies must simultaneously prevent life-threatening valve thrombosis and minimize fetal risks, yet optimal management remains controversial. While warfarin offers effective thromboprophylaxis, its embryotoxicity at higher doses (>5 mg/day) contrasts with low molecular weight heparin (LMWH), which lacks consensus on thrombotic efficacy despite fetal safety advantages.</p><p><strong>Case presentation: </strong>We report a case of a 30-year-old woman with mechanical mitral and tricuspid valves. She was maintained on low-dose warfarin (target INR 2.5-3.0) during early pregnancy. At 26-28 weeks of gestation, she developed exertional dyspnea; initial imaging showed stable valve function. At 33 + 2 weeks, worsening symptoms and echocardiographic evidence of tricuspid valve dysfunction prompted anticoagulation transition from warfarin to LMWH combined with vitamin K. After achieving an INR <1.4, cesarean delivery was performed at 33 + 3 weeks under general anesthesia, resulting in a live male infant without cardiac anomalies. Three days postpartum, mechanical tricuspid valve thrombosis with severe regurgitation was confirmed, necessitating bioprosthetic valve replacement on postoperative day 4. Maternal and neonatal outcomes were favorable.</p><p><strong>Conclusions: </strong>This case highlights the importance of individualized anticoagulation management, multidisciplinary coordination, and vigilant monitoring in optimizing outcomes for pregnant patients with MHVs. Tailored pharmacologic strategies represent key modifiable prenatal factors influencing both maternal safety and child health.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1596199"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649216","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":"Rib osteochondroma with intraspinal extension and cord compression in chlidren: case report and literature review.","authors":"Weihua Ye, Guanghui Zhu, Zheng Liu","doi":"10.3389/fped.2025.1454139","DOIUrl":"10.3389/fped.2025.1454139","url":null,"abstract":"<p><strong>Objective: </strong>To report a rare case of costal osteochondroma resulting in spinal cord compression in a 5-year-old patient, and to review the existing literature on costal osteochondromas.</p><p><strong>Methods: </strong>A retrospective review was conducted on a case involving a 5-year-old male patient with hereditary multiple exostoses (HME), presenting with acute paraparesis due to a costal osteochondroma. The tumor's origin within the rib, associated myelopathic symptoms, and extensive erosion and fusion of vertebral elements were notable. The patient underwent total laminectomy, resection of the tumor, and thoracic fixation and fusion. A comprehensive literature review was performed using the keywords \"Rib Osteochondroma\" and \"Spinal cord compression\" to search the PubMed database.</p><p><strong>Results: </strong>A dumbbell-shaped bony tumor originating from the left seventh rib at the costovertebral junction was identified, causing intraspinal and extraforaminal mass effect and spinal cord compression. Surgical intervention included total laminectomy and tumor excision, followed by thoracic fixation and fusion. Histopathological analysis confirmed the diagnosis of osteochondroma. Postoperative recovery was uneventful, with significant improvement in neurological symptoms and complete resolution of lower extremity weakness at the ten-month follow-up. A mere nine cases of such presentation have been documented in the corpus of English-language literature.</p><p><strong>Conclusion: </strong>This case highlights the rarity and clinical significance of costal osteochondromas causing spinal cord compression, particularly in a young pediatric patient. Early recognition and surgical intervention are crucial for favorable outcomes. Comprehensive imaging and careful surgical planning are essential to ensure complete tumor excision and maintain spinal stability.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1454139"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649218","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":"An anterior mediastinal cystic lesion pathologically confirmed as a mediastinal pancreatic pseudocyst after thoracoscopic resection: a rare case report and literature review.","authors":"Kui Zhai, Xingpeng Miao, Guiling Xue, Zhanyu Yuan, Mao Jia, Mingyan Chen, Renzhong Zha","doi":"10.3389/fped.2025.1613764","DOIUrl":"10.3389/fped.2025.1613764","url":null,"abstract":"<p><strong>Background: </strong>Mediastinal lesions have diverse etiologies, with thymoma, cystic teratoma, and lymphoma being relatively prevalent. In contrast, a pancreatic pseudocyst within the mediastinum is exceedingly rare and can often be mistaken for a thymic cyst or teratoma.</p><p><strong>Case presentation: </strong>A 17-year-old female presented with a cough and sputum production. Chest CT revealed an anterior mediastinal mass, initially raising the suspicion of a thymic cyst. Thoracoscopic exploration and resection revealed a cystic lesion with a thick wall and brownish fluid. Both frozen section and final histopathological analysis confirmed a mediastinal cyst. Immunohistochemical markers (SYN positive, CK7 positive) led to a diagnosis of mediastinal pancreatic pseudocyst. The patient experienced significant recovery post-surgery, with a marked improvement in symptoms.</p><p><strong>Conclusion: </strong>This case highlights the importance of including mediastinal pancreatic pseudocyst in the differential diagnosis of anterior mediastinal cystic lesions. A thorough clinical and radiological assessment, along with surgical pathology and immunohistochemical profiling, is essential for accurate diagnosis and appropriate management.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1613764"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649290","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":"Surgical delay in appendicitis among children: the role of social vulnerability.","authors":"Villa-Aguilar Estefany, Marín-Morales Karen, Ayala-Galvan Citlali, Gonzalez-Ortiz Ailema, Gonzalez-Zamora Jose Francisco","doi":"10.3389/fped.2025.1591200","DOIUrl":"10.3389/fped.2025.1591200","url":null,"abstract":"<p><strong>Background: </strong>Appendicitis is the most common abdominal emergency in pediatrics and is suggested as a quality indicator for timely access to care in time-sensitive conditions. Despite advances in diagnostics, the incidence of complicated appendicitis (CA) remains high due to delays in pediatric surgical care, which can increase disease severity. Social vulnerability has been associated with surgical access, particularly in low- and middle-income populations. This study examines the relationship between surgical delay and social determinants of complicated appendicitis in children without social security in the Metropolitan Zone of México.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted in a pediatric public hospital. Consecutive cases from 2018 to 2021 with confirmed appendicitis diagnoses were included. The primary outcome variable was the type of appendicitis (acute/complicated), while two independent variables were the time of evolution (patient and hospital timing) and socioeconomic factors associated with social vulnerability. A logistic regression analysis assessed the relationship between appendicitis type and covariates.</p><p><strong>Results: </strong>A total of 943 pediatric cases of appendicitis were included. Out of these, 62.67% presented CA, with a mean age 10 ± 4 years. 60.9% were well-nourished, and 16% had at least one comorbidity. Most subjects (76%) met at least two criteria for social vulnerability, and 74.7% of families held unskilled jobs. The median symptom-to-admission time was 2 days, with a median hospital-to-surgery time of 19.5 h (p25-p75). Prehospital delays affected 57.8% of cases (<i>n</i> = 545), and 39% (<i>n</i> = 365) experienced intrahospital delays. In the multivariable logistic regression, prehospital delay ≥48 h (OR 3.27, 95% CI 2.43-4.39) and children under 5 years (OR 1.76, 95% CI 1.09-2.84) were associated with higher odds of CA.</p><p><strong>Conclusion: </strong>The high frequency of CA in uninsured children at a public hospital is due to surgical delays of two or more days. Social vulnerabilities, as observed globally, hinder access to quality care. Thus, appendicitis should be recognized as both a medical and social issue, requiring a comprehensive approach that addresses social vulnerability.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1591200"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649273","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":"Adolescent late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency manifesting with severe multi-organ failure: a case report.","authors":"Yunhua Zhao, Zhichao Li, Lili Cui, Jun Chen, Wangtao Zhong","doi":"10.3389/fped.2025.1513288","DOIUrl":"10.3389/fped.2025.1513288","url":null,"abstract":"<p><strong>Background: </strong>Multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare autosomal recessive disorder characterized by dysfunctional acyl-CoA dehydrogenases, leading to lipid accumulation in various tissues, including skeletal muscles, liver, and cardiac muscles, etc. Late-onset MADD presents with progressive muscular symptoms (muscle weakness, atrophy, and myalgia) and even multisystem disorders (metabolic encephalopathy, dilated cardiomyopathy, liver failure, acute kidney injury, respiratory failure, and cardiac arrest). Over the past decade, only one case of childhood late-onset MADD with severe multi-organ failure has been reported.</p><p><strong>Case presentation: </strong>We report a 15-year-old girl with worsening muscle weakness, atrophy, myalgia, hepatic insufficiency, respiratory failure and even cardiac arrest. Laboratory tests showed significantly elevated levels of creatine kinase MB isoenzyme (CK-MB) and lactate dehydrogenase (LDH). A weakly positive serum small ubiquitin-like modifier 1 activating enzyme (SAE1) antibody suggested antibody-negative polymyositis (PM), but serum acylcarnitine analysis indicated increased concentrations of various acylcarnitines, while urine organic acids was normal. Muscle biopsy revealed significant lipid deposition within muscle fibers pointing to the diagnosis of lipid storage myopathy (LSM). Genetic testing identified a homozygous c.250G>A (p.Ala84Thr) mutation in electron transfer flavoprotein dehydrogenase (ETFDH), inherited from her parents. Although this pathogenic mutation is known in MADD, it has not been associated with adolescent late-onset MADD with severe multi-organ failure. After riboflavin supplementation, the patient regained mobility without ventilator support, with no recurrence of myopathic symptoms upon follow-up.</p><p><strong>Conclusion: </strong>MADD is a rare but treatable disease and its diagnosis is challenging due to its high clinical heterogeneity. Therefore, based on clinical, biochemical and pathological findings, gene analysis is critical for accurate diagnosis and clinical intervention, as riboflavin supplementation has shown lifesaving therapeutic benefit even in adolescent late-onset MADD with severe multi-organ failure.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1513288"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649289","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":"Parent and perinatal professional priorities and perspectives for the pre-birth periviable conversation: a thematic analysis of semi-structured interviews.","authors":"J Peterson, E J Johnstone, A Mahaveer, D M Smith","doi":"10.3389/fped.2025.1552911","DOIUrl":"10.3389/fped.2025.1552911","url":null,"abstract":"<p><strong>Background: </strong>Periviable birth (22 + 0-23 + 6 weeks) presents clinicians and parents with numerous ethical, psychological and practical difficulties. The study aimed to identify key features within pre-birth periviable conversations for both professionals and parents, including priorities and challenges.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with participants from the key stakeholder groups: neonatologists/paediatricians (<i>n</i> = 5), obstetricians (<i>n</i> = 5), midwives (<i>n</i> = 5) and parents (<i>n</i> = 7). Interviews explored their experience of periviable counselling including priorities, challenges and perceptions. Thematic analysis was used to develop across parents and professionals.</p><p><strong>Results: </strong>Three themes were identified summarising the parent and professional perspectives within the pre-birth periviable conversations: chronology and narrative within pre-birth conversations, different perspectives on uncertainty and the role of transparency within periviable trauma. The trauma experienced by parents through periviable birth can be compounded through poor communication practices of perinatal professionals. These themes demonstrate that the information provided to parents should consistently outline all available care options relevant to their baby, including compassionately delivered, but honest and descriptive accounts of emotive options, such as comfort care. Information should be individualised to the specific circumstances and risk factors of that individual family and incorporate discussion of topics key to the 'good parent belief' to empower parents within their role.</p><p><strong>Conclusion: </strong>Perinatal professionals need to be able to utilise transparent communication, individualisation of information and understand the necessary role that narrative plays within decision-making. Future research is required to better understand the educational methods best suited to train perinatal professionals to incorporate these, and other trauma-informed care principles, within their communication and interactions with future parents.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1552911"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649217","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":"Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study.","authors":"Chongchong Liu, Yi Zhang, Run Yang, Shiwen Xia","doi":"10.3389/fped.2025.1540173","DOIUrl":"10.3389/fped.2025.1540173","url":null,"abstract":"<p><strong>Background: </strong>Perinatal cerebral infarction (PCI) is a common cause of neurological complications in neonates. This study aimed to compare the clinical characteristics and risk factors of perinatal arterial ischemic stroke (PAIS) and perinatal hemorrhagic stroke (PHS) to inform early recognition and intervention strategies.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 124 neonates diagnosed with PCI, admitted to the neonatal intensive care unit (NICU) between June 2015 and December 2023. The neonates were divided into two groups-PAIS and PHS-based on clinical symptoms and cranial imaging findings.</p><p><strong>Results: </strong>Of the 124 patients, 87 (70.2%) were diagnosed with PAIS, while 37 (29.8%) had PHS. Clonic seizures were observed in 78 cases (62.9%), with apnoea noted in 11 cases (12.6%) within the PAIS group and jaundice in 8 cases (21.6%) within the PHS group. Lesions were primarily located in the left cerebral hemisphere in 53 cases (41.4%), whereas PHS lesions frequently involved the thalamus and basal ganglia (12 cases, 32.4%). Statistical analysis revealed significant differences in risk factors between the PAIS and PHS groups. The PAIS group had a higher rate of conversion from failed trial of labor to cesarean section compared to the PHS group (<i>P</i> = 0.012). Additionally, postnatal thrombocytopenia was more commonly associated with the PHS group than the PAIS group (<i>P</i> = 0.034).</p><p><strong>Conclusions: </strong>Our findings indicate that PAIS is more prevalent within the studied population, with a notable correlation between failed labor trials resulting in cesarean sections and the incidence of PAIS. This suggests a potential link between complications during labor and the occurrence of ischemic strokes. In contrast, postnatal thrombocytopenia was found to be significantly more common in the PHS group, indicating a possible association between low platelet counts and hemorrhagic strokes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1540173"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642442","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":"Editorial: Management of congenital heart disease: challenges, implications, innovations and pitfalls.","authors":"Stefano Carmelo Di Bernardo","doi":"10.3389/fped.2025.1599311","DOIUrl":"https://doi.org/10.3389/fped.2025.1599311","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1599311"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642444","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}