Frontiers in Pediatrics最新文献

{"title":"Cystoscopy to investigate the prevalence of prostatic utricle cyst in boys with proximal hypospadias and its implications in medium-term follow-up.","authors":"Yuenshan Sammi Wong, Yuk Him Tam","doi":"10.3389/fped.2025.1514695","DOIUrl":"10.3389/fped.2025.1514695","url":null,"abstract":"<p><strong>Purpose: </strong>Prostatic utricle cyst (PUC) is known to be associated with hypospadias. We aimed to investigate the prevalence of PUC in children with proximal hypospadias by cystoscopy, and risk of symptom development after hypospadias repair.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of patients who underwent 2-stage repair for proximal hypospadias and had cystoscopy for PUC assessment over the period of January 2017-September 2022.</p><p><strong>Results: </strong>A total of 34 patients with penoscrotal, scrotal or perineal hypospadias were included for review. First-stage repair was performed at a median age of 12 months. The median ventral curvature was 70 degrees (range 45-90). 4 patients had differences of sex development including 45,X/46,XY mosaicism (<i>n</i> = 2) and 46,XY partial gonadal dysgenesis (<i>n</i> = 2). PUC was detected by cystoscopy in 25/34(73.5%) patients, with longitudinal dimensions 10-35 mm (media<i>n</i> = 15 mm). At a mean follow-up of 30 months after hypospadias repair, 3/25(12%) patients developed symptoms associated with PUC including recurrent epididymoorchitis (<i>n</i> = 1), post-void dribbling (<i>n</i> = 1) and pyuria (<i>n</i> = 1). 3/10 PUC ≥20 mm became symptomatic compared with none of PUC <20 mm (<i>p</i> = 0.024). The patient with recurrent epididymoorchitis eventually underwent definitive surgery of PUC excision by robot-assisted approach.</p><p><strong>Conclusions: </strong>PUC is highly prevalent in proximal hypospadias. The use of the smallest-sized cystoscope as a screening tool can increase the diagnostic yield. Integrating cystoscopy in hypospadias surgery for concurrent PUC assessment can be considered as an option for patients with proximal hypospadias. Although the vast majority of PUC remains asymptomatic, those ≥20 mm in longitudinal dimensions may be associated with an increased risk of subsequent symptom development.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1514695"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614598","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":"Associations of maternal age with outcomes in very low birth weight singleton infants: a retrospective study.","authors":"Junfang Sun, Mengya Sun, Lulu Zhang, Chunchi Lai, Hong Jiang","doi":"10.3389/fped.2025.1444471","DOIUrl":"10.3389/fped.2025.1444471","url":null,"abstract":"<p><strong>Background: </strong>With advances in perinatal medicine, there has been a rise in the preterm birth rate, especially the rate of very low birth weight (VLBW) and extremely low birth weight infants. Studies have shown that maternal age during pregnancy and at the time of delivery is associated with pregnancy complications and poor neonatal outcomes. Little is known about the effect of maternal age on the outcome of very low birth weight infants.</p><p><strong>Objectives: </strong>To investigate the effects of maternal age on the adverse outcomes of singleton very low birth weight neonates.</p><p><strong>Methods: </strong>We used data of VLBW infants from the neonatal database of our hospital. Maternal age was categorized as 20-24, 25-34 (reference group), 35-39 and ≥40 years. Statistical analyses included univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>The study ultimately included 603 singleton, very low birth weight infants. After adjustment, neonatal outcomes in the group of older mothers were similar to those of the reference group for bronchopulmonary dysplasia, necrotizing enterocolitis, respiratory distress syndrome, severe asphyxia, retinopathy of prematurity and intraventricular hemorrhage grades 3-4. In the 20-24 year age group higher odds were present for sepsis [Odds ratio (OR) = 6.021; 95% confidence interval (CI), 1.741-20.818, <i>p</i> < 0.05] and for mortality (OR = 7.784; 95% CI, 2.198-27.568, <i>p</i> < 0.05). Higher odds for asphyxia (OR = 1.891; 95% CI, 1.238-2.890, <i>p</i> < 0.05) and death (OR = 2.101, 95% CI, 1.004-4.395, <i>p</i> < 0.05) were observed in infants of mothers in the 35-39 year age group. The incidence of sepsis was significantly higher in the age group of ≥40 years (OR = 2.873; 95% CI, 1.186-6.958, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>In singleton very low birth weight neonates, neonatal outcomes were associated with maternal age, and adverse outcomes were more pronounced in infants of advanced maternal age (AMA) mothers.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1444471"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614596","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":"Perinatal testicular torsion diagnosed as an intraperitoneal mass: case report and literature review.","authors":"Cheng Huang, Yan Ma, Dongsheng Bai, Chunsheng Hao","doi":"10.3389/fped.2025.1501645","DOIUrl":"10.3389/fped.2025.1501645","url":null,"abstract":"<p><p>Perinatal testicular torsion is not common in clinic. We report our experience in treating such a condition in a 50-day boy with an intraperitoneal mass. The clinical manifestations, physical examination, imaging examination and treatment of the boy were retrospectively analyzed and the related literatures were reviewed. Laparoscopic exploration, resection of abdominal mass, high ligation of left processus vaginalis and left orchiopexy were performed after admission. According to the results of intraoperative frozen-section examination and paraffin section after operation, combined with the history of children, consider the diagnosis of \"right cryptorchidism with perinatal testicular torsion\". We reported the case for the purpose of exploring the characteristics, diagnosis, differential diagnosis and treatment of perinatal testicular torsion (Perinatal testicular torsion, PTT), and improving the understanding of cryptorchidism with perinatal testicular torsion.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1501645"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614599","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 between maternal khat use and other determinants and low birth weight in Halaba Zone, South Ethiopia: an unmatched case-control study.","authors":"Biruk Wogayehu, Tsegaye Demissie, Eskinder Wolka, Mekuriaw Alemayehu","doi":"10.3389/fped.2025.1416027","DOIUrl":"10.3389/fped.2025.1416027","url":null,"abstract":"<p><strong>Introduction: </strong>Early newborn mortality, morbidity, and long-term health outcomes are significantly predicted by birth weight. Many babies are born underweight in Ethiopia, but few case-control studies have previously examined the risk variables associated with khat consumption and low birth weight (LBW). Therefore, the aim of this study was to identify maternal khat use and maternal sociodemographic and obstetric risk factors associated with LBW in the Halaba Kulito General Hospital, southern Ethiopia.</p><p><strong>Methods: </strong>A hospital-based case-control study design was used on 334 neonates (111 cases and 223 controls) at Halaba General Hospital in Halaba Zone, southern Ethiopia, from 01 October 2023 to 27 February 2024. A consecutive sampling method was used to select both the cases and controls. Bi-variable and multivariable logistic regression models were fitted using Stata 14.0 to estimate the effect of maternal khat use and other factors on low birth weight. A <i>p</i>-value of <0.05 was considered a significant difference in low birth weight between the cases and controls.</p><p><strong>Results: </strong>We found that the mean age of the cases and controls at birth was 25.4 ± 4.57 years and 24.2 ± 3.96 weeks, respectively. Illiteracy [adjusted OR (AOR) = 3.7, 95%CI 1.34, 10.45], rural residence (AOR = 4.1, 95%CI 1.51, 11.35), gestational age <37weeks (AOR = 16.5, 95%CI 7.05, 38.55), maternal mid-upper arm circumference (MUAC) <23 cm (AOR = 4.7, 95%CI 1.89, 11.65), weight gain <12 kg (AOR = 4.8, 95%CI 1.22, 18.59), monthly khat use (AOR = 9.5, 95%CI 2.13, 41.98), weekly khat use (AOR = 11.1, 95%CI 3.69, 33.40), and daily khat use (AOR = 14.1, 95%CI 4.74, 42.03) were the determinant factors for delivering a newborn with low birth weight.</p><p><strong>Conclusion: </strong>The evidence from this study suggests that illiteracy, rural residence, gestational age <37weeks, maternal MUAC <23 cm, weight gain <12 kg, monthly khat use, weekly khat use, and daily khat use were independent predictors of low birth weight. Suggested strategies involve the early identification and management of identified modifiable variables. We recommend that stakeholders in khat control commit to providing health education and awareness, incorporating khat use among women in the khat control policy, and designing interventions for the cessation of khat use among women.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1416027"},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604547","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":"Femoral fractures in non-accidental trauma and child abuse: biomechanical perspective and insights.","authors":"Giorgio di Laura Frattura, Blaise Cochard, Giacomo De Marco, Oscar Vazquez, Romain Dayer, Dimitri Ceroni","doi":"10.3389/fped.2025.1484920","DOIUrl":"10.3389/fped.2025.1484920","url":null,"abstract":"<p><p>Physical abuse remains a global problem that affects children in every country, from every ethnic group, and of all social backgrounds. The fracture of an infant's femur should constitute a red flag to a pediatrician; it must be recognized, recorded, investigated, and potentially result in measures to protect that child. Certain confounding factors, such as the reported mechanism of trauma, could negatively influence the physician's appropriate and unbiased judgment. Indeed, some physically abusive parents may try to explain a femoral fracture as the result of an accidental fall from a changing table or the child's leg getting stuck in bed barriers. This narrative review aimed to provide an overview of this topic and discuss the currently available scientific evidence to better understand the biomechanical mechanisms of femur fractures in infants, thereby definitively putting an end to some popular misconceptions.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1484920"},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604619","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-identified intrinsic and extrinsic factors that influence performance across developmental domains and participation in their communities.","authors":"Rachel Bican, Sydney Shaffer, Jayna Kinkade, Quinn McAdams, Allyson S Hughes","doi":"10.3389/fped.2025.1472743","DOIUrl":"10.3389/fped.2025.1472743","url":null,"abstract":"<p><p>Children with neurodevelopmental disabilities living in rural and low-resourced regions within the United States, such as Appalachia, face gaps and barriers to accessing healthcare services due to a shortage of providers, specialists, hospitals, and clinics. Without access to specialized medical and rehabilitation services, their performance across developmental domains and participation within their communities is likely suboptimal. The purpose of this study was to identify both intrinsic and extrinsic factors using a mixed-methods approach to better understand factors that may impact performance across developmental domains and participation for children with disabilities living in Appalachia. Parents completed one study visit in which they completed a total of 4 surveys and a semi-structured interview. The surveys included a parent survey (demographic information, medical history for the child, and barriers to receiving healthcare for their child), health literacy screen, the F-Words Life Wheel, and the Pediatric Evaluation of Disability Inventory (PEDI-CAT). The semi-structured interview asked questions in five primary categories: (1) background, (2) understanding of their child's medical diagnosis and management of their disability, (3) insurance coverage, (4) barriers to receiving healthcare, and (5) social support. This cross-sectional study included <i>n</i> = 17 parents of <i>n</i> = 26 children with neurodevelopmental disabilities. Themes from the interviews were coded both inductively and deductively. Most of the children had delays in important developmental domains, indicating a need for rehabilitation services. Participants reported significant difficulty finding specialists due to the distance from their house to the specialist, they experienced long waitlists and delayed diagnoses, they had difficulties finding caregivers for their children, they frequently had multiple children with disabilities, and they experience sleep disruptions due to their child(ren) with neurodevelopmental disabilities. The authors provide clinical research recommendations and policy changes that may be considered to help mitigate barriers to healthcare for children with neurodevelopmental disabilities living in rural and low-resourced regions.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1472743"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596730","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":"Dentoskeletal characteristics of non-syndromic pierre robin sequence and isolated incomplete cleft palate children: a retrospective case control study.","authors":"Xiang Zhang, Shuang Yang, Xudong Yang, Zhibo Zhou","doi":"10.3389/fped.2025.1519266","DOIUrl":"10.3389/fped.2025.1519266","url":null,"abstract":"<p><strong>Background: </strong>Pierre Robin sequence (PRS) is characterized by micrognathia, glossoptosis, and upper airway obstruction. This study aimed to compare the dentoskeletal characteristics of children diagnosed with non-syndromic PRS and those with cleft palate.</p><p><strong>Methods: </strong>This study was conducted on the non-syndromic PRS patients in the database of our hospital. The control group of non-syndromic isolated incomplete cleft palate patients was matched from the same database by age, gender and weight in a 1:3 ratio. The dentoskeletal characteristics were compared between the PRS and control groups.</p><p><strong>Results: </strong>The study included 14 patients in the PRS group and 42 patients in the control group. A point-Nasion-B point (ANB) angle was significantly greater in the PRS group compared with the control group. The PRS group exhibited a significantly lower ratio of the linear distance between Articulare and Gonion (ArGo) to the distance between Gonion and Pogonion (GoPo) compared to the control group. Additionally, the anteroposterior length and area of the lower pharyngeal airway space (LPAS) were markedly reduced in the PRS group.</p><p><strong>Conclusion: </strong>The ANB angle, the ArGo/GoPO ratio and the anteroposterior length and area of LPAS could serve as valuable indicators to identify micrognathia in patients with non-syndromic PRS.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1519266"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596729","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":"Role of artificial intelligence in pediatric intensive care: a survey of healthcare staff perspectives in Saudi Arabia.","authors":"Khouloud Abdulrhman Al-Sofyani","doi":"10.3389/fped.2025.1533877","DOIUrl":"10.3389/fped.2025.1533877","url":null,"abstract":"<p><strong>Background: </strong>Artificial Intelligence (AI) has the potential to revolutionize Pediatric Intensive Care Units (PICUs) by enhancing diagnostic accuracy, improving patient outcomes, and streamlining routine tasks. However, integrating AI into PICU environments poses significant ethical and data privacy challenges, necessitating effective governance and robust regulatory frameworks to ensure safe and ethical implementation. This study aimed to explore valuable insights into healthcare professionals' current perceptions and readiness to adopt AI in pediatric critical care, highlighting the opportunities and challenges ahead.</p><p><strong>Methods: </strong>A cross-sectional study conducted an online survey among healthcare practitioners at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. The survey included questions about professional roles, experience, and familiarity with AI, their opinions on AI's role, trust in AI-driven decisions, and ethical and privacy concerns. Statistical analyses were performed using IBM SPSS.</p><p><strong>Results: </strong>Results found varying familiarity with AI among healthcare professionals, with many expressing limited knowledge of AI applications in PICU settings. Despite this, there was growing recognition of AI's current applications. Trust in AI-driven decisions for PICU management was mixed, with most expressing partial trust. Opinions on AI's role in enhancing diagnostic accuracy and improving patient outcomes varied. Ethical considerations, data privacy, and effective governance to address regulatory and ethical challenges were highlighted as critical concerns.</p><p><strong>Conclusion: </strong>Healthcare practitioners in the PICU preferred using AI for routine patient monitoring but had concerns about its use in diagnoses and advanced healthcare. Concerns were held regarding data privacy, security breaches, and patient confidentiality.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1533877"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596731","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":"The influence of genetic polymorphisms on cytokine profiles in pediatric COVID-19: a pilot study.","authors":"Kateryna Kozak, Halyna Pavlyshyn, Oleksandr Kamyshnyi, Oksana Shevchuk, Mykhaylo Korda, Sandor G Vari","doi":"10.3389/fped.2025.1523627","DOIUrl":"10.3389/fped.2025.1523627","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies have underscored the importance of genetic factors in predicting COVID-19 susceptibility and severity. While cytokine storms are crucial in disease severity, genetic predisposition significantly influences immune responses. Our study examined genes related to SARS-CoV-2 invasion <i>(ACE2 rs2074192</i>) and interferon-induced immunity (<i>IFNAR2 rs2236757, TYK2 rs2304256, OAS1 rs10774671, OAS3 rs10735079</i>). Additionally, we investigated genes linked to Kawasaki disease (<i>CD40 rs4813003, FCGR2A rs1801274, CASP3 rs113420705</i>) that play roles in immunogenesis.</p><p><strong>Methods: </strong>The pilot study, which involved 75 pediatric patients aged one month to 17 years [43 patients with active COVID-19, 17 children with multisystem inflammatory syndrome in children (MIS-C), and 15 healthy controls], was conducted in Ternopil, Ukraine. Gene polymorphism was studied for all patients. ELISA kits were used for interleukin studies, including Human IL-1β (Interleukin 1 Beta), Human IL-6 (Interleukin 6), Human IL-8 (Interleukin 8), Human IL-12 (Interleukin 12), Human IFN-α (Interferon Alpha), and Human TNF-α (Tumor Necrosis Factor Alpha). Statistical analysis was performed using IBM SPSS Statistics 21 and GraphPad Prism 8.4.3.</p><p><strong>Results: </strong>The analysis identified significant gene-cytokine associations in pediatric COVID-19 patients. The <i>ACE2 rs2074192</i> T allele correlated with increased IL-1β, IL-6, IL-8, and TNF-α. The <i>IFNAR2 rs2236757</i> A allele was linked to elevated IL-1β and IL-12 levels and low IFN-α levels, while <i>OAS1 rs10774671</i> A allele carriers also exhibited lower IFN-α levels. <i>OAS1 rs10774671</i> was prognostically crucial for determining IL-8 levels in children infected with SARS-CoV-2. <i>OAS3</i> gene polymorphism <i>rs10735079</i> was associated with changes in IL-6 levels, precisely a high level. The <i>CD40 rs4813003</i> T allele increased IFN-α levels, while carriers of allele C had higher levels of IL-12. The results of our study revealed a correlation between IL-8 levels and the <i>FCGR2A</i> gene polymorphism <i>rs1801274</i> (A/G). The <i>CASP3</i> gene polymorphism <i>rs113420705</i> led to an increase in IL-6.</p><p><strong>Conclusion: </strong>These findings enhance our understanding of pediatric COVID-19 and may hold promise for developing targeted interventions and providing a personalized medical approach for each patient.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1523627"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596732","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":"Early caffeine therapy decreases bronchopulmonary dysplasia but might increase mortality in preterm infants? a systematic review and meta-analysis.","authors":"Juan Ma, Long Chen, Kaihong Mu, Shifang Tang, Yuan Shi","doi":"10.3389/fped.2025.1528054","DOIUrl":"10.3389/fped.2025.1528054","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of early vs. late caffeine therapy for bronchopulmonary dysplasia (BPD) in infants.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane databases were searched up to October 2024. Studies comparing early and late caffeine therapy for BPD in infants were included. The primary outcomes were the incidence of BPD, severe BPD, and mortality.</p><p><strong>Results: </strong>Eleven studies (1 RCT and 10 cohorts) with 64,749 patients (34,175 early and 30,574 late) were included. Meta-analysis revealed a significantly lower incidence of BPD (OR: 0.67; 95% CI: 0.56, 0.79; <i>P</i> < 0.00001) but higher mortality (OR: 1.20; 95% CI: 1.12, 1.29; <i>P</i> < 0.00001) in the early group. Subgroup analysis showed a significant difference in BPD incidence in retrospective studies (OR: 0.57; 95% CI: 0.44, 0.74; <i>P</i> < 0.0001), but not in prospective studies (OR: 0.84; 95% CI: 0.44, 1.61; <i>P</i> = 0.61). No significant difference was observed in severe BPD incidence (OR: 0.89; 95% CI: 0.34, 2.35; <i>P</i> = 0.81).</p><p><strong>Conclusions: </strong>Early caffeine therapy may reduce BPD incidence but increase mortality risk in infants. More large-scale, prospective studies are needed to further evaluate the efficacy of early vs. late caffeine therapy for BPD.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=474351, PROSPERO (CRD42023474351).</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1528054"},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585427","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}