Frontiers in Pediatrics最新文献

{"title":"Application of fractional exhaled nitric oxide and nasal nitric oxide in the evaluation of asthma control.","authors":"Yucong Ma, Wenying Lin, Haoqi Zheng, Yang Wang, Jingjing Cui, Li Liu","doi":"10.3389/fped.2025.1567548","DOIUrl":"10.3389/fped.2025.1567548","url":null,"abstract":"<p><strong>Background: </strong>Asthma is the most common chronic respiratory disease in childhood, and effective control of airway inflammation is crucial in its management. Fractional exhaled nitric oxide (FeNO) and fractional nasally exhaled nitric oxide (FnNO) are non-invasive biomarkers that reflect airway inflammation. This study aimed to evaluate the role of FeNO and FnNO in assessing asthma control status and to explore their correlation with pulmonary function parameters in pediatric patients.</p><p><strong>Methods: </strong>This was a retrospective observational study. A total of 88 children with asthma were classified into three groups based on Childhood Asthma Control Test (C-ACT) scores: the control group, the partial control group, and the poor control group. FeNO, FnNO, and pulmonary function tests were measured and compared across the three groups. The correlation between FeNO/FnNO levels and pulmonary function indices was also analyzed.</p><p><strong>Results: </strong>The levels of FeNO and FnNO were significantly higher in the poor control group compared with those in the partial control and the control groups (<i>p</i> < 0.05). As asthma control improved, forced vital capacity (FVC) showed a statistically significant increase. The forced expiratory volume in one second (FEV₁), maximal expiratory flow at 50% of FVC (MEF_50%), and mean mid-expiratory flow (MMEF) values in the poor control group were significantly lower than those in the other two groups, and PEF was significantly reduced compared with that in the control group. However, no significant correlations were found between FeNO or FnNO levels and any of the pulmonary function parameters.</p><p><strong>Conclusion: </strong>Although FeNO and FnNO levels differed significantly among asthma control groups, no significant correlation was observed between these biomarkers and pulmonary function parameters. These findings suggest that FeNO and FnNO should be used together to assess asthma control status, but they may not directly reflect changes in pulmonary function in children with asthma.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1567548"},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682478","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 impact of a multi-micronutrient nutritional formula combined with cognitive behavioral therapy in managing symptoms of children with attention deficit hyperactivity disorder.","authors":"Yun Wang, Meng Cao","doi":"10.3389/fped.2025.1624344","DOIUrl":"10.3389/fped.2025.1624344","url":null,"abstract":"<p><strong>Background: </strong>Attention-Deficit/Hyperactivity Disorder (ADHD) characterized by symptoms of inattention, hyperactivity, and impulsivity, with substantial impacts on a child's academic performance, social interactions, and overall quality of life. This study investigates the impact of combining a multi-micronutrient nutritional formula (MNF) with cognitive behavioral therapy (CBT) in managing ADHD symptoms in children.</p><p><strong>Methods: </strong>In a retrospective analysis of 220 children aged 6-14 years diagnosed with ADHD, patients were divided into two groups: the MNF group (<i>n</i> = 112) receiving only the nutritional formula, and the MNF-CBT group (<i>n</i> = 108) receiving both the nutritional formula and CBT. The interventions were conducted over three months. Outcomes were measured using the Conners Parent Symptom Questionnaire (PSQ), SNAP-IV Teacher Form, and Dundee Difficult Times of the Day Scale (D-DTODS).</p><p><strong>Results: </strong>Both groups were comparable at baseline in terms of demographics and ADHD symptom severity. Post-treatment analyses revealed greater reductions in attention deficit scores, hyperactivity/impulsivity scores, and oppositional symptoms scores in the MNF-CBT group compared to the MNF group. Conduct scores were lower in the MNF-CBT group than in the MNF group, and learning scores also showed a similar pattern of reduction. Functional impairments across various daily activities, as measured by the D-DTODS, were also reduced in the MNF-CBT group. No adverse events or safety concerns were observed during the intervention period.</p><p><strong>Conclusion: </strong>The combination of multi-micronutrient supplementation with CBT shows potential in alleviating both neurochemical deficiencies and behavioral dysregulation in children with ADHD. These findings suggest that this integrated approach may be beneficial for managing ADHD symptoms.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1624344"},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682482","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":"Molecular mechanism, diagnosis, and treatment of VACTERL association.","authors":"Manluan Sun, Qiyu Zhao, Bingyu Yang, Lili Liu, Caiquan Zhou, Xinbo Yao, Jia Bu, Jiang Bian, Sai Ge, Zhuangyan Zhu, Binyu Liu","doi":"10.3389/fped.2025.1609624","DOIUrl":"10.3389/fped.2025.1609624","url":null,"abstract":"<p><p>The VACTERL association is a non-random cluster of congenital malformations involving six distinct conditions: vertebral defects (V), anal atresia (A), cardiac defects (C), tracheoesophageal malformation (TE), renal defects (R), and limb anomalies (L), and is diagnosed when a fetus exhibits three or more of these. Its prevalence is approximately 0.47-0.58 per 10,000 live births. This paper examines the effect of disruptions in the Sonic Hedgehog and cilia-associated signaling pathways, genetically related developmental variations, and maternal environmental factors on the development of VACTERL. In the SHH signaling pathway, we focus on the effects of Sonic Hedgehog ligands, GLI transcription factors, and factors influencing GLI activity (RAC1 and ZIC3), as well as downstream targets (FOXF1 and HOXD13) and other genes and proteins involved in the regulation of SHH signaling (FGF8 and LPP), in the pathogenesis of VACTERL. In this context, ZIC3, which was shown to play a major role in VACTERL pathogenesis in large-scale resequencing, and TRAP1, which was associated with VACTERL pathogenesis in whole-exome resequencing, were highlighted. We also examine the cilia-associated signaling pathways, particularly the role of IFT172 and candidate ciliopathy genes. In addition, we describe the influence of TRAP1, COL11A2, SALL4, WBP11, Copy Number Variants, and maternal environmental factors on VACTERL. We also discuss current diagnostic, therapeutic, and prognostic approaches including prenatal and postnatal treatment options. Furthermore, we highlight the advantages of thoracoscopic surgery over traditional open-surgical treatment while discussing the differential diagnosis of VACTERL from other neonatal malformations with similar symptoms, such as Townes-Brocks syndrome, Baller-Gerold syndrome, and CHARGE syndrome.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1609624"},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682480","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":"Efficacy and safety of bisphosphonates in pediatric glucocorticoid-induced osteoporosis: a meta-analysis and pharmacovigilance study.","authors":"Xiaolin Xu, Luquan Wang, Mengyang Yang, Yan Li, Changqing Yang, Dong Mei, Peng Guo, Huawei Mao","doi":"10.3389/fped.2025.1571381","DOIUrl":"10.3389/fped.2025.1571381","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of glucocorticoids (GCs) administration in pediatric populations has resulted in numerous adverse reactions, notably osteoporosis. Given its role in managing glucocorticoid-induced osteoporosis, the efficacy and safety of bisphosphonates hold considerable importance. This study conducted a meta-analysis by systematically reviewing and incorporating relevant literature on the efficacy and safety of bisphosphonates in the management of osteoporosis or bone infarction induced by GCs therapy in pediatric populations. Additionally, the analysis of potential adverse reactions was augmented by utilizing real-world data from the FAERS database. The primary objective of this study is to offer insights and guidance for the treatment of glucocorticoid induced osteoporosis in pediatric patients.</p><p><strong>Methods: </strong>A meta-analysis was performed on existing literature to assess the efficacy and safety of bisphosphonates for managing glucocorticoid-induced osteoporosis. Additionally, a retrospective pharmacovigilances study was carried out to investigate adverse reactions and medication variations in pediatric patients with glucocorticoid-induced osteoporosis, using data from the FDA Adverse Event Reporting System (FAERS) database between Q1 2004 and Q4 2023.</p><p><strong>Results: </strong>The meta-analysis incorporated a total of 14 articles encompassing 572 patients. The findings of this study indicate that bisphosphonate therapy is more effective in enhancing bone mineral density (BMD) and BMD <i>Z</i>-scores in children compared to the control group, albeit with a heightened risk of adverse reactions. Furthermore, there was no significant disparity observed between the impact of bisphosphonate treatment and control groups on fracture outcomes. Subsequently, in the ensuing Pharmacovigilance investigation, 668 instances of adverse reactions associated with bisphosphonates are analyzed. The findings indicated that the most prevalent adverse reactions, as evidenced by the highest number of positive signals were various examinations, musculoskeletal and connective tissue diseases, injuries, poisoning and operational complications, as well as systemic diseases and reactions at the administration site.</p><p><strong>Conclusions: </strong>This study conducted a comprehensive analysis of the efficacy and safety of bisphosphonates in the treatment of osteoporosis caused by GCs use in pediatric patients, laying the groundwork for future research. Nevertheless, the constraints of retrospective studies highlight the need for additional investigation through prospective studies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1571381"},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682479","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 clinical application of subcutaneous thoracic ratio and capillary leakage index on the occurrence of capillary leak syndrome in neonates with sepsis.","authors":"Luying Cao, Yuhong Song, Li Zhang, Xiaolu Liu, Yiying Yin, Zhenrong Yu, Yu Zhang, Kun Feng, Weihong Yue, Ya Hu, Ziyu Hua, Hong Wei","doi":"10.3389/fped.2025.1603378","DOIUrl":"10.3389/fped.2025.1603378","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive and prognostic value of the subcutaneous-thoracic ratio (S/T) and capillary leakage index (CLI) for capillary leak syndrome (CLS) in neonatal sepsis.</p><p><strong>Materials and methods: </strong>A cohort of 196 neonates with sepsis, admitted to a tertiary children's hospital in southwestern China between January 2019 and March 2021, was included in the study. The neonates were divided into two groups: the CLS group (<i>n</i> = 55) and the non-CLS group (<i>n</i> = 55). Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were performed to identify key predictors of CLS.</p><p><strong>Results: </strong>Both S/T and CLI were found to be independent risk factors for CLS in neonatal sepsis (<i>P</i> < 0.05). The median S/T values for the CLS group and non-CLS group were 9.0% and 7.1%, respectively, while the median CLI values were 8.5 and 3.2. The optimal thresholds for predicting CLS were identified as 8.1% for S/T (sensitivity: 67.3%, specificity: 70.9%) and 3.3 for CLI (sensitivity: 78.2%, specificity: 56.4%). Notably, the combination of S/T and CLI yielded improved predictive performance, with a sensitivity of 81.8% and specificity of 60.0%. However, neither S/T nor CLI were significantly associated with prognosis, as no difference was observed between survivors and non-survivors (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>The combined application of S/T and CLI provides an effective tool for predicting the occurrence of CLS in neonatal sepsis. However, these indicators do not demonstrate prognostic value for survival outcomes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1603378"},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682481","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":"Comparative analysis of indwelling time and complications of mid-line catheters in different punctured veins of neonates.","authors":"Lijuan Yang, Yixin Wang, Song Luo, Yanju Tao, Xinxin Shi, Wenda Xu, Yanling Li, Caixia Sun, Tingting Lei, Bing Xu","doi":"10.3389/fped.2025.1577791","DOIUrl":"10.3389/fped.2025.1577791","url":null,"abstract":"<p><strong>Objective: </strong>We aims to evaluate the effects and complications associated with mid-line catheters inserted via different puncture veins in neonates, ultimately providing a foundation for selecting the most suitable puncture site for catheterization in clinical neonatal practice.</p><p><strong>Methods: </strong>A retrospective data analysis was conducted, involving 244 neonates with indwelling mid-line catheters who were admitted to a Class III Grade A general hospital in Anhui Province between August 2020 and December 2023. The study compared catheter indwelling duration, the incidence of catheter-related complications, and the first puncture success among neonates with catheterization through various veins.</p><p><strong>Results: </strong>The analysis revealed a statistically significant difference in indwelling duration across different puncture veins (<i>H</i> <i>=</i> <i>28.65, P</i> <i><</i> <i>0.001</i>). Specifically, significant differences were observed in the indwelling duration between the median cubital vein, axillary vein, and superficial temporal vein (adj. <i>P</i> < 0.05), whereas no significant differences were found among the other puncture sites (adj. <i>P</i> > 0.05). A statistically significant variation in catheter complications was observed among different puncture veins (<i>P</i> < 0.001). Specifically, the incidence of complications was lower in the median cubital and axillary veins compared to other puncture sites, with these differences reaching statistical significance (<i>P</i> < 0.05). Furthermore, the basilic vein exhibited a lower incidence of complications than the cephalic vein, superficial temporal vein, and great saphenous vein, with the difference being statistically significant only when compared to the great saphenous vein (<i>P</i> < 0.05). Additionally, no statistically significant difference was found in the success rate of single puncture among the various puncture veins (<i>P</i> > 0.05). However, the one-time successful catheter insertion rate was significantly higher for the median cubital and axillary veins compared to other veins (<i>P</i> < 0.05), while no statistically significant differences were observed among the remaining veins.</p><p><strong>Conclusion: </strong>The insertion of mid-line catheters into the axillary vein and the median cubital vein has been shown to extend catheter indwelling time, enhance the ease of catheter insertion, and decrease the incidence of complications. Consequently, it is advisable to prioritize the axillary vein and median cubital vein for the insertion of mid-to-long catheters in neonates.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1577791"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674524","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":"Prevalence of IVIG resistance in Kawasaki disease: a systematic review and meta-analysis.","authors":"Shuting Zou, Bingyu Hu","doi":"10.3389/fped.2025.1566590","DOIUrl":"10.3389/fped.2025.1566590","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki Disease (KD) is an acute vasculitis primarily affecting children, with intravenous immunoglobulin (IVIG) being the standard treatment and leading to increased risk of coronary artery abnormalities.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aim to evaluate the prevalence of IVIG resistance in KD and identify potential predictors and outcomes associated with this resistance.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Medline, Embase, and other relevant databases was conducted to identify studies reporting IVIG resistance in KD patients. Data on prevalence rates, patient demographics, and associated factors were extracted and analyzed.</p><p><strong>Results: </strong>The analysis included 26 studies with a total of 46,461 patients. The overall prevalence of IVIG resistance was found to be 14% (95% CI: 12%-16%), and The prevalence among males and females was 9% (95% CI; 7% to 10%) and 4% (95% CI; 3.7% to 4.3%), respectively.</p><p><strong>Conclusion: </strong>IVIG resistance remains a significant challenge in the management of KD. Identifying patients at higher risk for IVIG resistance and developing alternative treatment strategies are crucial for improving outcomes in this population.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1566590"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674527","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: Child with Menkes syndrome complicated by bladder diverticula.","authors":"Guoxing Wu, Pengfei Gao, Wenbin Zhang, Honghui Li, Zhaoying Li, Ruifa Wu, Zuoqing Li, Mingchuan Huang, Zhe Xu","doi":"10.3389/fped.2025.1571582","DOIUrl":"10.3389/fped.2025.1571582","url":null,"abstract":"<p><strong>Background: </strong>Menkes syndrome is a rare X-linked genetic disorder of copper metabolism caused by variants in the <i>ATP7A</i> gene. It is characterized by developmental delay, hair abnormalities, hypotonia, and organ dysfunction. Bladder diverticula are a rare but recognized urological complication, and its rupture can lead to severe clinical consequences.</p><p><strong>Methods: </strong>We report a case of a 3-year-old boy diagnosed with Menkes syndrome, presenting with multiple bladder diverticula and diverticular rupture, resulting in acute abdominal effusion. The patient underwent excision of multiple bladder diverticula guided by imaging and urodynamic evaluation. Postoperative functional recovery was assessed through follow-up imaging and urodynamic studies.</p><p><strong>Results: </strong>Postoperative urodynamic parameters showed significant improvement. Follow-up revealed satisfactory voiding function without evidence of recurrence or increased residual urine. Imaging and urodynamic studies were instrumental in both preoperative localization and postoperative functional assessment.</p><p><strong>Conclusions: </strong>Early diagnosis and surgical excision of bladder diverticula in patients with Menkes syndrome can significantly improve prognosis. Imaging and urodynamic studies provide reliable support for comprehensive management and are invaluable for long-term postoperative follow-up.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1571582"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674523","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":"Defining post-obstructive diuresis following posterior urethral valve ablation.","authors":"Callum Lavoie, Brian Chun, Christine Do, Zoë Baker, Philippe Friedlich, Andy Y Chang","doi":"10.3389/fped.2025.1584878","DOIUrl":"10.3389/fped.2025.1584878","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior urethral valves (PUV) are the most common cause of congenital lower urinary tract obstruction. Patients are at risk for post-obstructive diuresis (POD) following management of this obstruction which may prolong and/or complicate their subsequent hospital course. Despite this known physiologic effect, there is minimal data to define which patients are at highest risk for POD. Our objective was to define an initial urine output threshold for neonatal post-obstructive diuresis.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patients that were admitted to our Newborn and Infant Critical Care Unit (NICCU), in a tertiary care children's hospital, between 2004 and 2019 and underwent cystoscopic valve ablation for PUV. Outcomes of interest were length of hospital stay after posterior urethral valve ablation, serum creatinine and electrolyte values, fluid intake, and urine output at 4- and 24-h post-valve ablation. Chi-squared, Fisher's exact, and <i>T</i>-tests were conducted for descriptive statistical analyses as appropriate. Logistic regression analyses were conducted with adjusted models including patient demographic and clinical data.</p><p><strong>Results: </strong>Forty patients met inclusion criteria and the mean age at time of valve ablation was 11.2 days. Pre-operatively, maximum creatinine levels (ng/dl) achieved had a median value of 0.7 (IQR: 0.5-1.5). Post-operatively, the mean urine output (mL/kg/h) at 4-h was 4.2 ± 3.7, and at 24-h was 4.5 ± 2.2. Logistic regression analyses showed that those with a post-operative 24-h UOP > 3.5 ml/kg/h had more than 5 times the odds of a prolonged hospital length of stay (LOS) > 3 days (OR: 5.50; 95% CI: 1.23-24.51).</p><p><strong>Discussion: </strong>Neonates with PUV who undergo valve ablation are at risk of POD. Our findings suggest greater urine output after ablation to be a predictor of increased hospital length of stay. Utilizing a urine output (UOP) of >3.5 mL/kg/h may serve as a starting point for defining POD after posterior urethral valve ablation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1584878"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674525","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 chorioamnionitis on necrotizing enterocolitis in preterm infants: a multicenter cohort study.","authors":"Xin Guo, Jiaming Xian, Xianhong Chen, Meifen Li, Fengji Lin, Defei Ma, Rongrong Zhang, Guichao Zhong, Huiying Tu, Shujuan Zeng, Houxin Kang, Ya Pan, Xiaoli Li, Xueli Zhang, Zhangxing Wang, Hanni Lin, Shihua Yuan, Jing Han","doi":"10.3389/fped.2025.1620101","DOIUrl":"10.3389/fped.2025.1620101","url":null,"abstract":"<p><strong>Background: </strong>To explore the association between maternal chorioamnionitis (CAM) exposure and necrotising enterocolitis (NEC) in very preterm infants (VPI) or very low birth weight (VLBWI).</p><p><strong>Methods: </strong>The aim of this multicentre cohort study was to investigate the impact of maternal CAM and its different staging on VPI or VLBWI NEC in six medical centres in Shenzhen between 2022 and 2023. The primary outcome was NEC (Bell staging ≥ II) and secondary outcomes included NEC or in-hospital mortality. Logistic regression adjusted for confounders identified through directed acyclic graphs (DAG) and literature review. The interaction effect of premature rupture of membranes was assessed using stratification and likelihood ratio tests.</p><p><strong>Results: </strong>In the cohort study, the prevalence of CAM was 44.31%, the prevalence of NEC was 5.38%, and the prevalence of NEC or death was 7.69%. Of the 288 participants whose mothers had been exposed to CAM, 1.04% had clinical CAM, 96.53% had histological CAM, and 2.43% were diagnosed with confirmed CAM. CAM was associated with NEC or death (aOR = 1.90, 95% CI 1.02-3.55); the confirmed CAM group showed a stronger association (aOR = 7.14, 95% CI 1.20-42.35). In preterm infants, CAM was significantly associated with NEC or death in cases of preterm membrane rupture (aOR = 2.18, 95% CI 1.07-4.44).</p><p><strong>Conclusions: </strong>There was a significant positive association between CAM and NEC or death in VLBWs or VPIs, which was mainly from the population with confirmed CAM. In premature rupture of membranes, the association between CAM and NEC or death was more significant.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1620101"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674526","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}