Italian Journal of Pediatrics最新文献

{"title":"Changes in lung function in children after pneumonia: a multicenter study.","authors":"Hejun Jiang, Jingsheng Dai, Guifang Zhou, Guijun Yang, Liwen Zhang, Shuhua Yuan, Jing Zhang, Jiande Chen, Mingyu Tang, Jilei Lin, Li Li, Yufen Wu, Yong Yin","doi":"10.1186/s13052-025-02092-7","DOIUrl":"10.1186/s13052-025-02092-7","url":null,"abstract":"<p><strong>Background: </strong>There are few studies on the changes in lung function after pneumonia in children. This study aims to explore the changes in lung function in children after pneumonia and analyze the risk factors for airway disorder, especially the impact of different pathogen infection on lung function.</p><p><strong>Methods: </strong>This study collected data from patients who were hospitalized due to pneumonia in ten Chinese hospitals between January 2023 and December 2024. Pulmonary function tests were performed to assess changes in lung function one week and one month after discharge.</p><p><strong>Results: </strong>A total of 566 children were included in this study, with 40.6% of patients still showing airway disorder one week after discharge. Different pathogenic infections had varying effects on pulmonary function. MP (Mycoplasma pneumoniae) infection [OR (95%CI): 1.881(1.268-2.789), P = 0.001] and RhV (rhinovirus) infection [OR (95%CI): 2.402(1.027-5.621), P = 0.043] were significant risk factors for the occurrence of SAD (Small Airway Disorder) one week after discharge. Male gender [OR (95%CI): 2.219, P = 0.001] and MP infection [OR (95%CI): 1.681(1.024-2.761), P = 0.039] were significant risk factors for the occurrence of LAD (Large Airway Disorder) one week after discharge. No positive pathogen results [OR (95%CI): 0.366(0.168-0.800), P = 0.011] were significant protective factors for the persistence of SAD one month after discharge, while RhV infection [OR (95%CI): 7.286(0.802, 66.238), P = 0.077] and lung consolidation [OR (95%CI): 1.753(0.956, 3.214), P = 0.069] showed mild significance for the persistence of SAD one month after discharge. Male gender [OR (95%CI): 2.246(1.137-4.436), P = 0.019] and RhV infection [OR (95%CI): 1.967(1.630-237.549), P = 0.019] were significant risk factors for the persistence of LAD one month after discharge, while no positive pathogen results [OR (95%CI): 0.249(0.092-0.678), P = 0.006] were a significant protective factor.</p><p><strong>Conclusions: </strong>Approximately 40.6% of children after pneumonia still had airway disorder one week after discharge, which was closely related to different pathogenic infections. Patients with RhV pneumonia, in particular, should be closely monitored for changes in lung function after discharge.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"252"},"PeriodicalIF":3.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859121","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":"Obesity‑related kidney disease: a review on ultrasound applications.","authors":"Armando Di Ludovico, Costanza Pucci, Giovanni Grassi, Gian Luca Chabert, Giuseppe Ledda, Ilaria Mascioli, Saverio La Bella, Francesca Ciarelli, Luciana Breda, Cosimo Giannini, Angelika Mohn, Francesco Chiarelli, Antonio Corsello","doi":"10.1186/s13052-025-02090-9","DOIUrl":"10.1186/s13052-025-02090-9","url":null,"abstract":"<p><p>Pediatric obesity is a growing global health concern, associated with metabolic, cardiovascular, and kidney complications. Early identification and intervention are crucial to preventing long-term morbidity. This review examines the epidemiology, pathophysiology, and clinical implications of childhood obesity, focusing on its impact on kidney health. We discuss non-invasive diagnostic tools, including kidney ultrasound, and evidence-based management strategies. Obesity in children is linked to hypertension, insulin resistance, and early signs of kidney dysfunction, including increased kidney echogenicity and hyperfiltration. Ultrasound findings may serve as early markers of kidney involvement, potentially guiding risk stratification and intervention. Addressing pediatric obesity requires a multidisciplinary approach, incorporating lifestyle modifications, medical management, and early detection of organ damage. The aim of this narrative review is to summarize the pathophysiology of pediatric obesity-related kidney damage, current evidence on ultrasound-based screening, and possible diagnostic techniques. Further research is needed to validate ultrasound as a routine screening tool for obesity-related kidney disease in children.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"251"},"PeriodicalIF":3.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835090","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":"Risk factors for spastic cerebral palsy: a retrospective cross-sectional study and literature review.","authors":"Xing Wang, Xiao-Gang Du, Siew Hoon Teh, Xing-Hua Wang","doi":"10.1186/s13052-025-02108-2","DOIUrl":"10.1186/s13052-025-02108-2","url":null,"abstract":"<p><strong>Background: </strong>Cerebral Palsy (CP), a lifelong neurodevelopmental disorder, primarily manifests in early childhood, with spastic CP constituting 70% of cases. This study investigates spastic CP risk factors through a retrospective cross-sectional analysis of medical records and literature review to guide clinical strategies for reducing its incidence.</p><p><strong>Methods: </strong>The study analyzed the records of patients with spastic CP from Xi'an Encephalopathy Hospital affiliated to Shaanxi University of Chinese Medicine, between October 2021 and September 2022, aged 4-14 years old. Demographic and risk factor analysis was conducted among 231 patients, utilizing count data and percentages. Additionally, recent literature on spastic CP risk factors was reviewed.</p><p><strong>Results: </strong>Among the 231 cases, 55.41% were male, and 52.84% were urban residents. Age distribution was most concentrated at 4 years old (18.18%), followed by 5 years old (11.69%), and 8 years old (11.26%). Disease duration ranged from less than 3 months (10.82%) to 12-24 months (30.30%). Identified risk factors included neonatal diseases such as neonatal asphyxia (63.20%), premature birth (49.78%), and low birth weight (49.35%). Maternal prenatal illnesses and medication use (4.76%), delivery methods including cesarean Sect. (32.90% preterm), and environmental pollutants were also significant.</p><p><strong>Conclusion: </strong>This study enhances the understanding of spastic CP risk factors and provides actionable insights for prevention and management. Key recommendations include improved prenatal care (e.g., regular monitoring and infection control) and reducing maternal exposure to modifiable risks like environmental toxins, alcohol, and unnecessary medications. These findings support earlier, personalized interventions for at-risk cases.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"250"},"PeriodicalIF":3.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835091","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":"Timing of adiposity rebound in children with congenital hypothyroidism diagnosed by newborn screening and treated with Levothyroxine.","authors":"Cecilia Lugarà, Domenico Corica, Giorgia Pepe, Maria Francesca Messina, Mariella Valenzise, Giuseppina Zirilli, Letteria Anna Morabito, Alessandra Li Pomi, Malgorzata Gabriela Wasniewska, Tommaso Aversa","doi":"10.1186/s13052-025-02099-0","DOIUrl":"10.1186/s13052-025-02099-0","url":null,"abstract":"","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"249"},"PeriodicalIF":3.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804085","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":"Correlation analysis between patent ductus arteriosus and bronchopulmonary dysplasia in premature infants.","authors":"Hao Luo, Yibo Liu, Chongbing Yan, Bowen Weng, Laxiu Zhao, Cheng Cai","doi":"10.1186/s13052-025-02100-w","DOIUrl":"10.1186/s13052-025-02100-w","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the correlation between patent ductus arteriosus (PDA) and bronchopulmonary dysplasia (BPD) in premature infants.</p><p><strong>Methods: </strong>Retrospective analysis was performed on preterm infants with a gestational age(GA) of less than 32 weeks from 2019 to 2021. PDA premature infants with BPD ( N = 70 ) or not ( N = 224) were enrolled for multivariate logistic regression exploring independent risk factors for BPD in PDA preterm infants. The nomogram model was employed for exhibiting risk factors and receiver operating characteristic curve (ROC) was used to evaluate model performance.</p><p><strong>Results: </strong>(1) GA, birth weight (BW) and Apgar (5 min) score in BPD group were significantly lower than non-BPD group (p < 0.0001). (2) BPD group had a higher utilization rate of pulmonary surfactant, more infants receiving oxygen therapy through nasal catheters, and a longer oxygen therapy duration (p < 0.0001). (3) The proportion of haemodynamically significant patent ductus arteriosus(hsPDA)in BPD group was significantly higher than that in non-BPD group (p < 0.05). (4) The incidence of anemia and pulmonary hypertension in BPD group infants was significantly higher than that in non-BPD group (100% and > 50% in BPD, respectively, p < 0.05). (5) The goodness of fit test of calibration curve showed χ2 = 7.136, p = 0.522, and area under curve (AUC) was 0.799.</p><p><strong>Conclusions: </strong>GA, BW and PDA diameter were independent risk factors for PDA merged with BPD. The smaller GA, the lower BW, the larger PDA diameter and the lower Apgar score (5 min), and the higher the risk of BPD in PDA infants.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"248"},"PeriodicalIF":3.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A core curriculum for pediatric lung ultrasound: an expert consensus.","authors":"Anna Maria Musolino, Lorenzo Di Sarno, Danilo Buonsenso, Paolo Tomà, Gian Luigi Natali, Caterina Bock, Maria Alessia Mesturino, Simona Scateni, Antonio Corsello, Antonio Chiaretti, Alberto Villani, Rino Agostiniani","doi":"10.1186/s13052-025-02089-2","DOIUrl":"10.1186/s13052-025-02089-2","url":null,"abstract":"<p><strong>Background: </strong>Lung ultrasound is a valuable tool for pediatricians, aiding in diagnosis and procedural safety while reducing radiation exposure. Its application has significantly increased. However, unlike some other medical specialties, structured ultrasound training is not consistently integrated into pediatric residency programs, resulting in variable skill acquisition among national practitioners. This lack of standardization necessitates the development of a comprehensive educational framework.</p><p><strong>Main body: </strong>A standardized, longitudinal core curriculum for pediatric lung ultrasound is developed through a consensus of nationally recognized experts. The proposed model defines progressive proficiency levels, each with specific clinical competencies, skills, and measurable milestones. An integrated assessment strategy, combining written examinations and objective structured clinical examinations, is recommended to evaluate both theoretical knowledge and practical application. Furthermore, the curriculum outlines a hands-on practical pathway, requiring supervised clinical procedures and tutor validation at each proficiency level. The article also addresses key challenges hindering the widespread adoption of curricula in pediatrics, including a shortage of qualified instructors, limited access to resources and training time, and the need for robust quality assurance measures and standardized image interpretation protocols.</p><p><strong>Conclusion: </strong>The proposed core curriculum offers a structured educational platform to promote the systematic acquisition of lung ultrasound skills among pediatricians. Addressing the identified barriers is essential for the successful integration of lung ultrasound into pediatric clinical practice, ultimately improving diagnostic accuracy and enhancing patient care.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"246"},"PeriodicalIF":3.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789091","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":"Serum expression of ESM-1 and Syndecan-1 and its relationship with disease severity in children with Mycoplasma pneumoniae pneumonia.","authors":"Yanjuan Yu, Yanyan Su, Xiuhong Jin, Xiangfeng Zhang, Yeran Yang, Yuelin Shen","doi":"10.1186/s13052-025-02105-5","DOIUrl":"10.1186/s13052-025-02105-5","url":null,"abstract":"<p><strong>Background: </strong>This study aim to investigate the role of endothelial damage in the pathogenesis of Mycoplasma pneumoniae pneumonia (MPP) by comparing serum levels of endothelial cell-specific molecule 1 (ESM-1) and Syndecan-1 in patients with varying degrees of MPP severity. Additionally, we aim to explore the relationship between the production of ESM-1 and Syndecan-1 and the severity of MPP, inflammation, as well as hypercoagulative state in children.</p><p><strong>Methods: </strong>A prospective, observational study that included clinical manifestations, laboratory tests, and serum ESM-1 and Syndecan-1 assays. The correlation between ESM-1 and Syndecan-1 levels with inflammatory markers and coagulation markers was analyzed. Multivariate logistic regression analysis was conducted to identify significant risk factors for Severe Mycoplasma pneumoniae pneumonia (SMPP).</p><p><strong>Results: </strong>A total of 179 children with MPP and 40 healthy volunteers were enrolled. Serum ESM-1 and Syndecan-1 levels were significantly elevated in children with MPP compared to the healthy children (all P < 0.05). A multivariate analysis revealed that ESM-1, Syndecan-1, D-dimer and LDH were the significant predictors of SMPP, with odds ratios of 1.034, 1.002, 5.042 and 1.014, respectively. The optimal cutoff values of ESM-1, Syndecan-1, D-dimer and LDH for predicting SMPP were 79.67 ng/mL, 3219.35 pg/mL, 0.67 µg/mL and 365.00 U/L, respectively.</p><p><strong>Conclusions: </strong>ESM-1, Syndecan-1, D-dimer, and LDH can serve as independent predictors for SMPP. The interaction between endothelial damage, excessive inflammatory response, and hypercoagulable state collectively contributes to the development and progression of SMPP.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"247"},"PeriodicalIF":3.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789092","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 prognostic value of repeat CSF parameter measurements in neonatal bacterial meningitis following initial antimicrobial therapy.","authors":"Dongdong You, Xiaoyu Wang, Ping Lu, Feng Li","doi":"10.1186/s13052-025-02000-z","DOIUrl":"10.1186/s13052-025-02000-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Bacterial meningitis (BM) in neonates leads to high mortality rates and long-term complications. Current guidelines recommend repeat cerebrospinal fluid (CSF) examinations to assess treatment efficacy, but their clinical value remains controversial. This study aims to evaluate the clinical utility and prognostic value of repeat CSF parameters within 3-5 days following initial antimicrobial therapy in neonates with BM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis of electronic medical records from January 2017 to December 2022 yielded 241 neonates of diagnosed with neonatal BM upon discharge in our neonatal intensive care unit. Of these, 85 met the stringent inclusion criteria for enrollment. Data on clinical characteristics, laboratory findings, cranial imaging results and other relevant information were collected. The criteria for an adequate response to the initial antimicrobial therapy, established for this study, included a 48-hour afebrile period, negative meningeal irritation signs, a C-reactive protein (CRP) level of ≤ 20 mg/L, and a neutrophil count of ≤ 10,000/mm³. Short-term adverse outcomes were defined as the occurrence of complications during hospitalization or sequelae at discharge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the analysis of 54 neonates demonstrating an adequate response to initial antimicrobial therapy, a comparison between 29 neonates with repeated CSF parameter measurements and 25 neonates without such measurements revealed no significant differences in antibiotic duration (p = 0.728), complications during hospitalization (p = 0.517), or sequelae at discharge (p = 1.000). A multiple logistic regression analysis of the group with repeated CSF measurements identified elevated CSF protein levels as the only potential risk factor for complications during hospitalization (p = 0.045; OR = 15.046; 95% CI: 1.062-213.089). However, none of the other repeated CSF measurements, such as total leukocyte count in CSF (CSF-TLC), the absolute neutrophil count to total leukocyte count ratio in CSF [CSF-Neutrophil (%)], and CSF glucose, were significant predictors of complications during hospitalizations (P &gt; 0.05 for all). Furthermore, except for CSF-Neutrophil (%), the other repeated CSF measurements were significantly positively correlated with their initial CSF parameters (P &lt; 0.05 for all). In the full cohort of 85 neonates, significant differences were observed between the 54 neonates with an adequate response and the 31 neonates with an inadequate response to therapy. Significant variables included admission weight (p = 0.047), peak blood CRP levels before antibiotic use (p &lt; 0.001), initial CSF protein levels (p = 0.007) and blood culture results (p = 0.037). Both the risk of complications during hospitalization and sequelae at discharge were also significantly different (p &lt; 0.001). In the cohort of 85 neonates, there were significant differences between the 52 neonates without short-ter","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"166"},"PeriodicalIF":3.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A predictive model for prognosis in infants with surgical necrotizing enterocolitis.","authors":"Jin Yu Chen, Qian Yang, Li Rong Dai, Wei Yue Wu, Wei Zuo, Li Li Wang","doi":"10.1186/s13052-025-02094-5","DOIUrl":"10.1186/s13052-025-02094-5","url":null,"abstract":"<p><strong>Background: </strong>Surgical intervention could improve the prognosis of infants with necrotizing enterocolitis (NEC), but it's also an independent risk factor for severe complications and death. This study aimed to establish a nomogram to predict the prognosis of infants with surgical NEC.</p><p><strong>Methods: </strong>A total of 189 infants with surgical NEC were enrolled from January 2013 to May 2024. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors. Then, a nomogram was constructed based on the risk factors.</p><p><strong>Results: </strong>This study demonstrated that gestational age, patent ductus arteriosus, mean corpuscular hemoglobin concentration and serum chlorine ion within 24 h before surgery, and pH within 24 h after surgery were independent risk factors to predict the prognosis of infants with surgical NEC. A nomogram was created utilizing the five predictors and showed excellent discriminative ability, with an area under the ROC curve of 0.842 [95% CI:0.772-0.912]. The concordance index for training and validation groups were 0.842 and 0.870, respectively.</p><p><strong>Conclusions: </strong>The present study identified five independent predictors of poor prognosis in infants with surgical NEC and used them to establish a nomogram model, helping pediatricians identify poor prognosis in surgical NEC infants early and providing important clinical reference information.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"245"},"PeriodicalIF":3.1,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis on the predictive role of CRP in NEC diagnosis and prognosis.","authors":"Huanhuan Cheng, Jing Yu, Liying Dai","doi":"10.1186/s13052-025-02081-w","DOIUrl":"10.1186/s13052-025-02081-w","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the role of C-reactive protein (CRP) in necrotizing enterocolitis (NEC) diagnosis and prognosis through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Cochrane Library, Embase, and Web of Science databases to identify relevant studies on CRP and NEC. Outcomes included correlations between CRP levels and NEC occurrence, surgical intervention, severity, and intestinal strictures.</p><p><strong>Results: </strong>A total of 30 studies were included in the analysis. Data from categorical variables indicated a significant positive association between CRP and the incidence of NEC (OR: 3.5, 95% CI: 2.23-5.49), while continuous variables revealed a significant difference in CRP levels between the NEC and non-NEC groups (SMD: 2.61, 95% CI: 1.72-3.5). Elevated CRP levels were significantly correlated with an increased risk of surgery, with a notable difference in CRP levels between the surgical and non-surgical groups. CRP levels were also positively associated with the risk of NEC progression, and a significant difference was observed between the progression and non-progression groups. Besides, a significant difference in CRP levels was observed between the stricture and non-stricture groups. Subgroup analysis indicated that CRP has a higher predictive value in infants with NEC who had a gestational age greater than 28 weeks and a birth weight exceeding 1500 g.</p><p><strong>Conclusion: </strong>CRP has significant clinical value in predicting the occurrence of NEC, disease progression, and the timing of surgical intervention.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"244"},"PeriodicalIF":3.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717943","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}