Frontiers in Pediatrics最新文献

{"title":"Developmental characteristics of orientation and differentiation abilities in the control of jumping distance in preschool children.","authors":"Hirohisa Kano, Alexander Kuga","doi":"10.3389/fped.2025.1365323","DOIUrl":"10.3389/fped.2025.1365323","url":null,"abstract":"<p><strong>Introduction: </strong>The development of coordination abilities and fundamental motor skills in early childhood plays a crucial role in promoting physical activity and preventing obesity. However, only a few studies have investigated the developmental characteristics of coordination abilities during early childhood. Therefore, we used jumping distance control as a motor task to examine the developmental characteristics of orientation and differentiation abilities in early childhood.</p><p><strong>Methods: </strong>We included 318 children aged 3.5-6 years. The motor task was a box target jump test in which the participants jumped from a box approximately 30 cm in height, such that their heels were aligned with a target line 40 cm away. Each participant performed the test two times. The performance results from the two box jump test trials were analyzed by comparing the mean errors of the first and second trials, along with a more detailed examination through the analysis of the performance level ratios between the two trials.</p><p><strong>Results: </strong>While the participants aged 3.5 years displayed insufficient accuracy and a strong tendency toward underdevelopment (low-performance percentage for 3.5 years: 1st = 38.3%, 2nd = 38.3%, <i>p</i> < 0.001), immediate feedback effects began to appear at the age of 4 years (low-performance percentage for 4 years: 1st = 21.3%, 2nd = 14.9%). Behavioral changes, such as improved accuracy between trials, became more evident from 4.5 years of age. These results suggest an emerging capacity for motor adjustment or imagery, although no direct assessment of motor imagery was conducted in this study, and such interpretations remain speculative. By approximately 5 years of age, participants obtained a certain level of immediate feedback effect.</p><p><strong>Conclusion: </strong>These findings provide insight into the developmental characteristics of coordination abilities in early childhood and could help inform age-appropriate physical education approaches that support movement awareness and adaptive motor control.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1365323"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215628","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":"Recombinant growth hormone therapy in children with short stature in Abu Dhabi: a cross-sectional study of indications and treatment outcomes.","authors":"Sara Salem Al Jneibi, Fatima Taha, Marwa Hammouri, Zahraa Allami, Stefan Weber, Jamal Aljubeh, Sareea Al Remeithi","doi":"10.3389/fped.2025.1516967","DOIUrl":"10.3389/fped.2025.1516967","url":null,"abstract":"<p><p>Early diagnosis of the pathological cause, if any, of short stature in children can lead to prompt intervention with recombinant growth hormone (rGH) treatment, potentially allowing them to achieve their true genetic height potential. However, it is crucial to identify children most likely to benefit from rGH treatment.</p><p><strong>Methods: </strong>This cross-sectional, retrospective study provides a broad overview of rGH prescribing patterns and evaluates both short- and long-term treatment outcomes in children treated at the Pediatric Endocrinology Clinic, Sheikh Khalifa Medical City, Abu Dhabi, UAE, between January 2011 and December 2022. One- and three-year outcome data for children treated with rGH for different diagnoses of short stature were assessed.</p><p><strong>Results: </strong>Idiopathic short stature (ISS) accounted for 34.8% of the cases for which rGH was prescribed. A significant response [mean height gain of ≥0.3 standard deviation score (SDS)/year] was seen across all assessed short-stature diagnoses, with the highest gain seen in the growth hormone deficiency (GHD) diagnosis group at the 1-year and 3-year treatment time points. More than 90% of the children diagnosed with GHD and ISS achieved normal final adult height. Younger age at rGH initiation, lower height SDS at baseline, and pre-pubertal status were associated with better outcomes post 1 and 3 years of rGH therapy. Greater response at 1 year of rGH therapy was associated with better final adult height outcome.</p><p><strong>Conclusions: </strong>ISS was the most common indication for which rGH was prescribed in this study. A favorable increment in the height SDS of the rGH-treated children during their 1- and 3-year follow-ups was observed. Age, pubertal status, baseline height SDS, and rGH response at 1 year were directly associated with significantly improved short- and long-term response to rGH treatment. These findings provide a broad overview of the baseline and therapeutic response characteristics of rGH-treated children with short stature in the UAE and can help in optimizing and personalizing treatment strategies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1516967"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215634","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 profile and outcome of pediatric heart surgeries at semi-urban tertiary care cardiac center of Gujarat, India: a 54-month single-center retrospective chart review.","authors":"Rahul Tandon, Vishal V Bhende, Amit Kumar, Naresh Dhedhi, Mamta R Patel, Krutika Rahul Tandon","doi":"10.3389/fped.2025.1543755","DOIUrl":"10.3389/fped.2025.1543755","url":null,"abstract":"<p><strong>Context: </strong>The most common congenital condition, congenital heart disease (CHD), is often left untreated or doesn't get timely attention for various reasons. Nowadays, many pediatric cardiac centers in India offer surgical management, even in semi-urban or rural areas. Our center is one of them.</p><p><strong>Aims: </strong>This study aims to generate regional data from the Western part of India, primarily to determine the outcome of patients who had surgical intervention at our pediatric cardiac center.</p><p><strong>Methods and material: </strong>The present study retrospectively analyzed the data of the operated pediatric patients by reviewing the charts of patients admitted to the pediatric division of the cardiac center between April 2018 and October 2022. All demographic details, anthropometry, preoperative evaluation, operative procedures, postoperative issues, outcomes, etc. were reviewed, and the collected data were entered into Microsoft Excel.</p><p><strong>Statistical analysis: </strong>Descriptive statistics were used to present demographic data. Chi-square and Fisher exact tests were applied to find an association, and a <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Out of the 422 pediatric admissions during the period studied, 386 underwent cardiac surgeries. The median (Q1, Q3) age of patients in months was 12 (6, 60), and 251 (61.2%) were males. The most prevalent CHD was ventricular septal defect (VSD), accounting for 88 patients (21.6%). Out of the 386 total patients who underwent cardiac surgery, 16 (4.1%) patients experienced mortality. The most common surgeries performed were VSD closure, patent ductus arteriosus ligation, and intracardiac repair for tetralogy of Fallot (TOF).</p><p><strong>Conclusions: </strong>Pediatric heart surgery was offered for a varied CHD with comparable mortality and morbidity with other centers.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1543755"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215627","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":"Differential impact of neutrophil-to-lymphocyte ratio and time-weighted NLR on mortality and survival in critically ill children: insights from a retrospective study.","authors":"Dongqing Ma, Wei Wang, June Ma, Wei Liu","doi":"10.3389/fped.2025.1559405","DOIUrl":"10.3389/fped.2025.1559405","url":null,"abstract":"<p><strong>Background: </strong>The intensive care of critically ill children is challenging due to diverse etiologies and rapid disease progression. Early identification of high-risk patients is crucial for improving outcomes. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential biomarker reflecting the balance between innate and adaptive immune responses, with studies in adults showing its correlation with mortality and survival in intensive care settings. However, its application in pediatric intensive care units (PICU) is less explored.</p><p><strong>Objective: </strong>To examine the impact and predictive value of NLR on in-hospital mortality and 90-day survival rates in critically ill children using data from the Pediatric Intensive Care (PIC) database at the Children's Hospital of Zhejiang University School of Medicine.</p><p><strong>Methods: </strong>This retrospective cohort study included 3,350 patients from the PIC database, with patients older than 28 days and an ICU stay of at least 48 h. Data on demographic information, ICU admission type, laboratory test results, and clinical outcomes were collected. The normal range of NLR was calculated using the percentile method. Time-weighted NLR was calculated using the trapezoidal rule to estimate the area under the curve of NLR values over time. Statistical analyses included chi-square tests, Mann-Whitney <i>U</i> tests, and multivariable logistic regression to assess the association between NLR and outcomes.</p><p><strong>Results: </strong>Higher time-weighted NLR levels were significantly associated with increased in-hospital mortality (OR = 1.15, 95% CI: 1.08-1.22, <i>p</i> < 0.001) and shorter ICU length of stay. The Kaplan-Meier survival analysis showed significantly different 90-day survival rates among NLR groups (<i>p</i> = 0.034). Subgroup analysis revealed the highest predictive value of time-weighted NLR in patients under 1 year old with an initial NLR less than 0.48 (AUC = 0.832).</p><p><strong>Conclusion: </strong>The study confirms NLR, particularly in its time-weighted form, as a robust prognostic indicator for critically ill children. Elevated time-weighted NLR levels are associated with increased in-hospital mortality and shorter ICU stays, highlighting its potential for risk stratification and guiding clinical decisions in PICU. The dynamic nature of the time-weighted NLR provides a more accurate reflection of the patient's inflammatory burden over time. However, the retrospective and single-center design of the study limits the generalizability of the results. Future research should address these limitations and explore the integration of NLR with other clinical and laboratory parameters to enhance prognostic accuracy in pediatric critical care settings.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1559405"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215629","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 gestational diabetes mellitus on maternal-fetal pregnancy outcomes and fetal growth: a multicenter longitudinal cohort study.","authors":"Mi Su, Yangyang Wang, Qinqin Yuan, Dongmei Tang, Yu Lu, Xixi Wu, Wen Xiong, Yalan Li, Tianjiao Liu, Siyuan Zeng, Sumei Wei","doi":"10.3389/fped.2025.1592550","DOIUrl":"10.3389/fped.2025.1592550","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of gestational diabetes mellitus (GDM) on maternal and neonatal pregnancy outcomes and fetal growth patterns.</p><p><strong>Methods: </strong>A cohort of 418 pregnant women was analyzed, comprising 203 with normal glucose tolerance and 215 diagnosed with GDM. Key maternal factors, including age, pre-pregnancy body mass index (BMI), gestational weight gain, and gestational hypertension, were assessed for their association with infant growth and food allergy outcomes. At six months of corrected gestational age, weight-for-age z-scores (WAZ) and food allergy incidence were compared between the two groups. Binary logistic regression and linear regression analyses were performed to identify significant predictors of these outcomes.</p><p><strong>Results: </strong>Infants born to mothers with GDM exhibited significantly higher WAZ scores (<i>p</i> = 0.026) and an increased neonatal susceptibility to food allergies (<i>p</i> = 0.043) compared to those born to mothers with normal glucose tolerance. Maternal factors such as advanced age, higher pre-pregnancy BMI, gestational hypertension, and twin pregnancy were identified as key risk factors for GDM. Additionally, preterm birth, birth weight, and parental history of allergies were independently associated with the development of food allergies in infants.</p><p><strong>Conclusion: </strong>GDM exerts a notable influence on infant growth trajectories and elevates the risk of food allergies. Effective glycemic management during pregnancy, early monitoring of infant development, and targeted interventions addressing risk factors such as preterm birth and parental allergy history are critical for mitigating long-term health risks in children exposed to GDM <i>in utero</i>. Further research is warranted to explore the underlying mechanisms and potential preventive strategies for this at-risk population.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1592550"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215635","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":"Application of ultrasound-guided coaxial needle biopsy combined with gelatin sponge plugging in pediatric liver biopsy.","authors":"Keyu Zeng, Boyang Yu, Zhe Wu, Jiehong Zhou, Qiang Lu","doi":"10.3389/fped.2025.1477711","DOIUrl":"10.3389/fped.2025.1477711","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the performance of utilizing the coaxial technique in conjunction with gelatin sponge slurry plugging for ultrasound-guided liver biopsy in children.</p><p><strong>Methods: </strong>We conducted a retrospective study of children undergoing ultrasound-guided coaxial liver biopsy at our institution between March 2020 and March 2025. Participants were stratified into two intervention groups: those receiving gelatin sponge tract embolization vs. batroxobin administered through needle tract. Through comprehensive electronic medical record review, we systematically extracted and compared the following outcome measures: (a) overall complication rates, (b) hemorrhage rates.</p><p><strong>Results: </strong>This study included 48 children, with 30 allocated to the gelatin sponge group and 18 to the batroxobin group. The gelatin sponge group demonstrated 9 complications (30.0%, 9/30), consisting of 5 pain events and 4 febrile episodes, while the batroxobin group experienced 6 complications (33.3%, 6/18), including 2 hemorrhage cases, 3 pain events, and 1 febrile episode. The overall complication rates showed no statistically significant difference between groups (30.0% vs. 33.3%, <i>P</i> = 0.809). However, a significant divergence was observed in hemorrhage incidence, with the gelatin sponge group demonstrating superior safety (0% vs. 11.1%, <i>P</i> = 0.044).</p><p><strong>Conclusion: </strong>Compared to batroxobin tract injection, coaxial technique in conjunction with gelatin sponge slurry plugging significantly reduced hemorrhagic complications in liver biopsies for children, demonstrating superior safety. The finding supported its adoption as the preferred hemostatic method in children undergoing percutaneous liver biopsy.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1477711"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215626","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":"Machine learning-driven strategies for enhanced pediatric wheezing detection.","authors":"Hye Jeong Moon, Hyunmin Ji, Baek Seung Kim, Beom Joon Kim, Kyunghoon Kim","doi":"10.3389/fped.2025.1428862","DOIUrl":"10.3389/fped.2025.1428862","url":null,"abstract":"<p><strong>Background: </strong>Auscultation is a critical diagnostic feature of lung diseases, but it is subjective and challenging to measure accurately. To overcome these limitations, artificial intelligence models have been developed.</p><p><strong>Methods: </strong>In this prospective study, we aimed to compare respiratory sound feature extraction methods to develop an optimal machine learning model for detecting wheezing in children. Pediatric pulmonologists recorded and verified 103 instances of wheezing and 184 other respiratory sounds in 76 children. Various methods were used for sound feature extraction, and dimensions were reduced using t-distributed Stochastic Neighbor Embedding (t-SNE). The performance of models in wheezing detection was evaluated using a kernel support vector machine (SVM).</p><p><strong>Results: </strong>The duration of recordings in the wheezing and non-wheezing groups were 89.36 ± 39.51 ms and 63.09 ± 27.79 ms, respectively. The Mel-spectrogram, Mel-frequency Cepstral Coefficient (MFCC), and spectral contrast achieved the best expression of respiratory sounds and showed good performance in cluster classification. The SVM model using spectral contrast exhibited the best performance, with an accuracy, precision, recall, and F-1 score of 0.897, 0.800, 0.952, and 0.869, respectively.</p><p><strong>Conclusion: </strong>Mel-spectrograms, MFCC, and spectral contrast are effective for characterizing respiratory sounds in children. A machine learning model using spectral contrast demonstrated high detection performance, indicating its potential utility in ensuring accurate diagnosis of pediatric respiratory diseases.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1428862"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215632","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":"Progress in research on nutrition, neuroinflammation and dopaminergic alterations in Tic disorders.","authors":"Lu Bai, Mei Jin, Qi Zhang, Suzhen Sun","doi":"10.3389/fped.2025.1526117","DOIUrl":"10.3389/fped.2025.1526117","url":null,"abstract":"<p><p>Tic disorders (TD) represent a prevalent neurodevelopmental condition in children, characterised by involuntary, sudden motor or vocal tics. Dysfunction of the dopamine system plays a pivotal role in the pathogenesis of TD. Recent findings indicate that deep brain stimulation, by modulating striatal dopamine release, substantially alleviates tic symptoms. Neuroimaging studies have shown increased dopamine transporter binding and decreased serotonin levels in patients with TD. The presence of anti-dopamine D2 receptor autoantibodies, which correlate with disease severity, suggests immune involvement in the onset of TD. Nutritional factors influence the dopaminergic system's functionality by affecting neurotransmitter synthesis and metabolism, modulating gut microbiota and contributing to neuroinflammation. Clinical studies have demonstrated that interventions combining probiotics and fructooligosaccharides can help regulate neurotransmitter metabolism, whereas dietary patterns such as the ketogenic, Mediterranean and Mediterranean-DASH intervention for neurodegenerative delay diets exhibit anti-inflammatory and neuroprotective effects. The risk of TD in offspring is significantly associated with maternal autoimmune diseases and inflammatory states, with metabolic syndrome further affecting the dopaminergic system via AT1 receptor autoantibodies. Nutritional intervention-based treatment strategies present promising directions for TD management, warranting further investigation into the nutrition-immune-neurotransmitter network, the development of personalised nutritional plans and the validation of their clinical efficacy through large-scale randomised controlled trials. This review summarises the alterations in the dopaminergic system in TD, the regulatory effects of nutritional factors on dopamine levels, the interactions between neuroinflammation and the dopaminergic system and treatment strategies based on nutritional interventions, laying a theoretical foundation for understanding TD pathogenesis and advancing novel therapeutic approaches.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1526117"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215633","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 iron supplementation in healthy exclusively breastfed infants: a systematic review and meta-analysis.","authors":"Ke Tian, Wenli Liu, Yi Huang, Rong Zhou, Yan Wang","doi":"10.3389/fped.2025.1587457","DOIUrl":"10.3389/fped.2025.1587457","url":null,"abstract":"<p><strong>Background and objectives: </strong>Exclusively breastfed infants are at risk of iron deficiency due to the low iron content in breast milk. This study aims to evaluate the benefits and risks of daily oral iron supplementation on growth, cognitive outcomes, and hematologic parameters in these infants.</p><p><strong>Methods: </strong>Data sources include Cochrane Central Register of Controlled Trials, PubMed, and Embase from inception to December, 2024. Randomized controlled trials were included. The Cochrane risk of bias tool was used to assess the methodological quality of included trials. The continuous outcomes were analyzed by calculating the mean difference (MD) and the binary categorical variables were analyzed using relative risk (RR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>This study included 8 trials (685 participants) comparing iron supplementation to no iron. At 6 months of age, compared to infants who were exclusively breastfed without iron supplementation, those who received oral iron supplementation showed an increase in hemoglobin (Hb) levels (MD 0.42, 95% CI 0.19-0.66, <i>p</i> < 0.001, <i>I</i> ² = 76%) and a reduction in the incidence of iron deficiency (ID) (RR 0.38, 95% CI 0.15-1.00, <i>p</i> = 0.050, <i>I</i> ² = 29%) and iron-deficiency anemia (IDA) (RR 0.58, 95% CI 0.40-0.84, <i>p</i> = 0.004, <i>I</i> ² = 0). However, by 12 months of age, the supplementation had no effect on Hb levels, ID, the incidence of IDA or mental development index (MDI). Iron supplementation appeared to reduce weight gain (MD = -0.04, 95%CI -0.07 to -0.01, <i>p</i> = 0.004, <i>I</i> ² = 0) and head circumference gain (MD = -0.14, 95% CI -0.18 to -0.09, <i>p</i> < 0.001, <i>I</i> ² = 25%).</p><p><strong>Conclusions: </strong>Limited available evidence suggests that iron supplementation is beneficial for hematologic parameters and the incidence of IDA in healthy exclusively breastfed infants. However, it may delay weight gain and head circumference growth.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42024610082].</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1587457"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215630","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":"Faster postnatal decline in hepatic erythropoiesis than granulopoiesis in human newborns.","authors":"Petra Janovska, Kristina Bardova, Zuzana Prouzova, Ilaria Irodenko, Tatyana Kobets, Eliska Haasova, Lenka Steiner Mrazova, Viktor Stranecky, Stanislav Kmoch, Martin Rossmeisl, Petr Zouhar, Jan Kopecky","doi":"10.3389/fped.2025.1572836","DOIUrl":"10.3389/fped.2025.1572836","url":null,"abstract":"<p><strong>Background: </strong>During human foetal development, the liver is the primary site of blood cell production, but this activity declines in the third trimester and postnatally as haematopoiesis shifts to bone marrow. In humans, this postnatal decline is not well characterized due to the scarcity of appropriate samples.</p><p><strong>Objective: </strong>To characterize the effect of (i) gestational age at birth and (ii) length of survival after birth on hepatic haematopoiesis across various cell lineages involved.</p><p><strong>Methods: </strong>Liver autopsy samples from 25 born-alive infants, predominantly extremely preterm newborns who died mainly between 1 day and 3 weeks after birth, were analysed. Haematopoiesis was characterized using immunohistochemical staining of established cell type-specific protein markers. RNA-sequencing data from our previous study using the same samples were also explored.</p><p><strong>Results: </strong>Haematopoiesis negatively correlates with both the duration of prenatal development and the length of postnatal survival. The effect of these two factors varies across different haematopoietic cell lineages. Prenatally and early postnatally, erythropoietic cells dominated hepatic haematopoiesis but were rapidly suppressed within three days after birth. Granulopoietic activity declined more gradually after birth. Analysis of the gene expression data revealed the possible involvement of several transcription factors in lineage-specific regulatory mechanisms.</p><p><strong>Conclusion: </strong>This study enhances our understanding of the postnatal decline of hepatic haematopoiesis in human newborns, highlighting the differential regulation of erythropoiesis and granulopoiesis after birth. These factors bring new in-depth knowledge about the biological processes critical for postnatal adaptation of human newborns.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1572836"},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215631","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}