Journal of neonatal-perinatal medicine最新文献

{"title":"Expanding the diagnostic lens: Whole exome sequencing in a neonate with arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome.","authors":"Gayathri Sreenivasan, Jane Hedrick, Anita Ware, Melanie Leong","doi":"10.1177/19345798261483255","DOIUrl":"https://doi.org/10.1177/19345798261483255","url":null,"abstract":"<p><p>We report a term neonate who presented with early-onset conjugated hyperbilirubinemia, acholic stools, and imaging findings concerning for biliary atresia, including a contracted gallbladder and triangular cord sign on abdominal ultrasound. However, intraoperative cholangiography demonstrated normal bile flow. Persistently normal gamma-glutamyl transpeptidase (GGT), cholestasis, and renal tubular dysfunction prompted expanded evaluation. Whole-exome sequencing identified a pathogenic <i>VPS33B</i> variant, confirming Arthrogryposis-Renal dysfunction-Cholestasis (ARC) syndrome. Despite supportive management, his condition progressively declined, and he died at approximately 2 years of age following worsening cholestasis, reduced oral intake, and cardiorespiratory arrest at home. In this infant, the absence of arthrogryposis represented an incomplete and atypical phenotype at birth of an already rare condition. This case report and review of the literature expands the recognized clinical spectrum of ARC syndrome and underscores the importance of considering genetic etiologies in neonates with low-normal GGT cholestasis when conventional evaluation is inconclusive. Early integration of genomic testing may improve diagnostic accuracy, inform family counseling, and refine clinical decision-making in neonatal cholestasis.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261483255"},"PeriodicalIF":1.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of structured antenatal breastfeeding counselling on early initiation of breastfeeding: A comparative study from Central India.","authors":"Priyanshi Panwar, Bharati P Choubey, Sharmila Ramteke, Anukrati Khare, Manjusha Goel","doi":"10.1177/19345798261483256","DOIUrl":"https://doi.org/10.1177/19345798261483256","url":null,"abstract":"<p><p>ObjectivesTo determine the effectiveness of structured antenatal breastfeeding counselling on early initiation of breastfeeding (EIBF) within 1 hour of birth and its determinants among mothers delivering at a tertiary-care hospital in central India.MethodsA prospective, non-randomized (quasi-experimental) study was conducted in the Department of Pediatrics, Bhopal, from June 2024 to September 2025. The intervention group included third-trimester antenatal women who received one to three structured counselling sessions on selected Anganwadi centre days, while the comparison group included postpartum mothers with no prior counselling. Counselling was based on the Facility-Based Newborn Care (FBNC) module. Data were collected using a pre-tested semi-structured questionnaire and analyzed using STATA v14.2. Differences between groups were assessed using the χ² test and t-test. Multivariable logistic regression was additionally used to identify independent predictors of EIBF after adjustment for measured sociodemographic and obstetric covariates. A <i>p</i>-value <0.05 was considered statistically significant.ResultsAmong 496 mothers analysed (246 intervention; 250 comparison), baseline characteristics were largely comparable. EIBF within 1 hour was achieved by 58.0% of counselled mothers compared with 42.0% of controls, demonstrating an absolute improvement of 16 percentage points (95% CI: 9.6-26.8; <i>p</i> < 0.001). Higher maternal education (<i>p</i> < 0.001), working status (<i>p</i> = 0.016), higher socioeconomic status (<i>p</i> < 0.001), urban residence (<i>p</i> < 0.001), multiparity (<i>p</i> < 0.001), absence of pregnancy-related complications (<i>p</i> = 0.010), receipt of ≥4 ANC visits (<i>p</i> < 0.001), vaginal delivery (<i>p</i> < 0.001), and absence of prelacteal feeding (<i>p</i> < 0.001) were significant facilitators of early initiation. After adjustment for these covariates in a multivariable logistic regression model, structured counselling remained an independent predictor of EIBF (adjusted OR 1.68, 95% CI 1.12-2.52; <i>p</i> = 0.012), as did graduate-level education, multiparity, ≥4 ANC visits, and vaginal delivery.ConclusionStructured antenatal breastfeeding counselling was independently associated with improved early initiation of breastfeeding in this non-randomized comparative study. These findings support incorporating structured counselling into antenatal care programmes, pending confirmation in larger, multi-centre, and ideally randomized trials.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261483256"},"PeriodicalIF":1.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteral feeding practices around neonatal packed red blood cell transfusion: A national survey of U.S. NICU providers.","authors":"Irfan Shehzad, Kelsey Coombs, Lesley Cottrell, Mahmoud Ali","doi":"10.1177/19345798261483251","DOIUrl":"https://doi.org/10.1177/19345798261483251","url":null,"abstract":"<p><p>IntroductionAnemia and packed red blood cell (PRBC) transfusion are common in preterm infants, and feeding management during transfusion remains uncertain.ObjectiveTo characterize current opinions and enteral feeding practices surrounding PRBC transfusion among U.S. NICU providers.MethodsWe conducted a voluntary, anonymous 10-item REDCap survey distributed through AAP SONPM and TECaN listservs; responses were analyzed descriptively.ResultsAmong 432 respondents, most were neonatologists in level III or IV NICUs. More than half reported a transfusion-related feeding guideline, yet practices varied widely. Most withheld or restricted feeds, with variation in interruption timing, refeeding, glucose monitoring, and diuretic use. NEC and transfusion-related acute gut injury were the main reasons for restriction.ConclusionFindings highlight substantial practice variation and persistent uncertainty, not a preferred feeding approach. Prospective multicenter studies are needed to guide safe, evidence-based peri-transfusion feeding practices.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261483251"},"PeriodicalIF":1.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-dose 40% buccal dextrose gel for treatment of neonatal hypoglycemia: A randomized controlled trial.","authors":"Nagwa Mohamed Sabry Mahmoud, Aya Rabie Mohamed, Madeha Abdalla Sayed","doi":"10.1177/19345798261483257","DOIUrl":"https://doi.org/10.1177/19345798261483257","url":null,"abstract":"<p><p>BackgroundNeonatal hypoglycemia is a common, potentially serious postnatal metabolic disorder. This study evaluated the efficacy and safety of a single dose of 40% buccal dextrose gel versus standard care for achieving early euglycemia in at-risk neonates with a documented low baseline blood glucose.MethodsThis prospective randomized controlled trial was conducted at the Neonatal Intensive Care Unit, Minia University Hospital, Egypt (March-November 2024). Clinically stable, asymptomatic at-risk neonates (gestational age ≥34 weeks) with a documented low baseline blood glucose (below the maturity-specific operational threshold: <45 mg/dL for asymptomatic late-preterm/term infants and <30 mg/dL for preterm infants in the first 48 h) were randomized 1:1 to standard care alone or standard care plus a single 40% dextrose gel dose (0.5 mL/kg, buccal). The primary outcome was euglycemia (blood glucose ≥45 mg/dL) at 120 min, analyzed by intention-to-treat; infants requiring rescue intravenous dextrose before 120 minutes were counted as treatment failures.ResultsOf 120 screened neonates, 100 were randomized (50/group). By intention-to-treat, euglycemia at 120 minutes occurred in 82.0% (41/50) of the dextrose gel group versus 64.0% (32/50) of controls (absolute risk difference 18.0%, 95% CI 1.0-35.0; relative risk 1.28, 95% CI 1.00-1.64; number needed to treat = 6), a difference of borderline statistical significance (Pearson χ² p = 0.043; Fisher's exact <i>p</i> = 0.070). A secondary complete-case analysis (<i>n</i> = 90) showed a larger effect (91.1% vs 71.1%) but is potentially biased by exclusion of early treatment failures. Intravenous dextrose use during the study was numerically lower with gel (22.0% [11/50] vs 36.0% [18/50]; relative risk 0.61, 95% CI 0.32-1.16) but was not statistically significant. No intervention-related adverse events were observed during the 120-min study period.ConclusionsA single dose of 40% buccal dextrose gel improved early euglycemia in at-risk neonates by intention-to-treat analysis, with no intervention-related adverse events observed during the 120-min study period. These single-center findings are consistent with existing evidence and support further evaluation of buccal dextrose gel as a non-invasive first-line therapy, rather than establishing broad implementation.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261483257"},"PeriodicalIF":1.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between jaundice treatment and conventional electroencephalography (EEG) changes with spectral analysis in infants.","authors":"Hasan Boskhabadi, Fabrice Wallois, Azadeh Darabi, Javad Mohamadi Taze Abadi","doi":"10.1177/19345798261475686","DOIUrl":"https://doi.org/10.1177/19345798261475686","url":null,"abstract":"<p><p>ObjectiveNeonatal hyperbilirubinemia (NHB) is a common clinical condition that may lead to long-term neurodevelopmental impairment due to bilirubin-induced neurotoxicity. The development of reliable methods for neurological monitoring in affected newborns remains a major challenge in neonatal care. This study aimed to evaluate the association between treatment and EEG changes on cerebral activity in infants with hyperbilirubinemia using conventional EEG.Methods & MaterialsThis prospective before-and-after study was conducted on neonates aged over 35 weeks of gestation who were diagnosed with hyperbilirubinemia. Demographic and clinical data, including neonatal age, sex, birth weight, presence of ABO incompatibility, and treatment modalities, were collected. Maternal data, including parity, mode of delivery, and maternal and neonatal blood groups, were also recorded.Conventional EEG was performed for all neonates during the first eight hours of hospitalization and repeated after therapeutic interventions, including phototherapy and, when indicated, exchange transfusion.ResultsA total of 26 neonates with hyperbilirubinemia were included in this study. The mean total serum bilirubin level before treatment was 23.01 ± 2.99 mg/dL.A statistically significant change in the EEG spectral power was observed before and after treatment in the frontal regions Fp1, Fp2, and Fz, particularly within the delta and beta frequency bands.Furthermore, the findings demonstrated that delta activity was significantly dominant in the Fp1, Fp2, and Fz regions both before and after treatment. In contrast, no dominant frequency bands were observed in the C3, O1, T3, C4, T4, Cz, and O2 regions either before or after treatment.ConclusionHyperbilirubinemia in neonates may be associated with alterations in cortical electrical activity as assessed by conventional EEG. In our study, delta band activity was significantly predominant in the frontal regions (Fp1, Fp2, and Fz) both before and after treatment. Moreover, delta band activity remained the predominant frequency in the frontal regions (Fp1, Fp2, and Fz) before and after treatment, suggesting persistent frontal cortical involvement despite treatment.Further studies with larger samples are recommended to clarify whether these EEG changes reflect a transient bilirubin effect or age-related maturation patterns.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475686"},"PeriodicalIF":1.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium in a level IV NICU: Prevalence & modifiable risk factors.","authors":"Kathryn Martin, Mark F Weems, Divya Rana","doi":"10.1177/19345798261475317","DOIUrl":"https://doi.org/10.1177/19345798261475317","url":null,"abstract":"<p><p>ObjectiveWe aim to determine delirium prevalence in a Level IV NICU, identify demographic risk factors, controllable risk factors, and associated outcomes.Study DesignSelect NICU patients with at least one Cornell Assessment for Pediatric Delirium score, studied over 1 year period. Demographics and outcomes were compared in relation to delirium status. Medication exposure was analyzed prior to 40 weeks PMA and at significant CAPD score events.ResultPrevalence of delirium in the eligible study group was 64%. The delirium group had a lower median gestational age and birthweight, but higher median length of stay, and possible increased mortality rate. Exposure to benzodiazepines was strongly associated with the delirium group, though confounding may exist. Dexmedetomidine was not significantly associated with the delirium group.ConclusionsIt is possible that delirium is significantly prevalent and under-recognized among NICU patients, particularly those with lower gestational age and birthweight, and may be associated with poor outcomes. Benzodiazepine exposure may be significantly associated with neonatal delirium onset. Further investigation is needed in this area of study.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475317"},"PeriodicalIF":1.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild neonatal hypoxic-ischemic encephalopathy: current evidence and ongoing controversies.","authors":"Ceyda Acun, Julide Sisman, Mohamed El-Dib","doi":"10.1177/19345798261475683","DOIUrl":"https://doi.org/10.1177/19345798261475683","url":null,"abstract":"<p><p>Neonatal hypoxic-ischemic encephalopathy (HIE) remains a leading cause of neonatal morbidity and mortality worldwide. Therapeutic hypothermia (TH) is an established neuroprotective therapy for infants with moderate to severe HIE; however, its role in the management of mild HIE remains uncertain. This review summarizes current evidence regarding neurodevelopmental outcomes in infants with mild HIE and critically evaluates available data on the use of TH in this population. Although mild HIE was excluded from the original hypothermia trials, emerging observational studies suggest that a proportion of affected infants experience adverse short- and long-term neurodevelopmental outcomes. Interpretation of these findings is limited by challenges in the early clinical identification of mild HIE, evolving diagnostic criteria, heterogeneity in outcome definitions, and reliance on retrospective or underpowered cohorts. Consequently, evidence supporting the efficacy or safety of TH in mild HIE is inconclusive, and clinical practice varies widely across institutions and regions. Existing studies have not definitively demonstrated neurodevelopmental benefit and raise concern for potential overtreatment in some infants. Adequately powered, prospective trials are urgently needed to clarify the risk, benefit profile of TH in mild HIE, identify subgroups most likely to benefit from intervention, and establish standardized diagnostic and outcome measures. Until such evidence is available, management of infants with mild HIE should be individualized, balancing potential neuroprotective benefit against known and theoretical risks, while acknowledging persistent gaps in knowledge.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475683"},"PeriodicalIF":1.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic efficacy of intermittent versus continuous phototherapy in term neonates with hyperbilirubinemia: A randomized controlled trial.","authors":"D Kumar, D Kumar, R Chand, R Nivethaashree, S Singh, D Rastogi, D Sankhwar","doi":"10.1177/19345798261475688","DOIUrl":"https://doi.org/10.1177/19345798261475688","url":null,"abstract":"<p><p>BackgroundNeonatal jaundice affects most newborns due to immature bilirubin metabolism. Phototherapy continues to be the cornerstone of treatment, having significantly reduced bilirubin-induced neurotoxicity. This study compares continuous and intermittent phototherapy in term neonates with non-hemolytic indirect hyperbilirubinemia to evaluate their relative therapeutic efficacy in achieving effective bilirubin reduction.MethodsThis prospective randomized controlled trial was conducted in the Neonatal Intensive Care Unit of a tertiary care medical university in North India between August 2023 and July 2025. Term neonates (gestational age 37-42 weeks, birth weight ≥2500 g) with non-hemolytic indirect hyperbilirubinemia requiring phototherapy, as per American Academy of Pediatrics guidelines, were enrolled. A total of 150 eligible infants were randomized in equal numbers to receive either continuous phototherapy or intermittent phototherapy (3 h on/3 h off). All participants received standardized double-surface LED phototherapy with an irradiance of ≥30 μW/cm²/nm within a wavelength range of 460-490 nm. Infants were repositioned hourly, and exclusive breastfeeding was actively supported. Total serum bilirubin levels were monitored at 12-h intervals until the predefined discontinuation criteria were met.ResultsBaseline characteristics were comparable (all <i>p</i> > 0.05). Mean baseline TSB was similar (16.07 ± 2.67 vs 15.46 ± 3.04 mg/dL; <i>p</i> = 0.190). Unadjusted bilirubin reduction at 12 h and 24 h did not differ significantly. After adjustment, TSB at 12 h was comparable (<i>p</i> = 0.418), but higher in the continuous group at 24 h (mean difference 0.68 mg/dL; <i>p</i> < 0.001). The total phototherapy exposure time was shorter with intermittent therapy (13.75 ± 1.18 vs 18.15 ± 1.56 h; <i>p</i> = 0.001). Rebound hyperbilirubinemia and adverse events were similar between groups.ConclusionIntermittent phototherapy was as effective as continuous phototherapy in reducing bilirubin levels in term neonates with non-hemolytic indirect hyperbilirubinemia requiring treatment, while reducing total phototherapy exposure time and potentially facilitating feeding, mother-infant bonding, and more resource-efficient family-centered care.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475688"},"PeriodicalIF":1.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral motor intervention and weight gain in premature infants: A clinical randomized controlled study.","authors":"Sayyedeh Marziyeh Mir Masoumi, Seid Hooshyar Mojabi, Shabnam Jaliolghadr, Mohadeseh Bajalan, Azita Kakavand, Mohammad Reza Maleki, Alireza Razzaghi","doi":"10.1177/19345798261475691","DOIUrl":"https://doi.org/10.1177/19345798261475691","url":null,"abstract":"<p><p>BackgroundInterventions aimed at providing oral motor stimulation improve the preparedness for oral feeding and support the earlier attainment of full oral feeding in preterm infants. However, utilizing the Premature Infant Oral Motor Intervention (PIOMI) as a structured method may prolong the time needed to reach complete oral feeding and enhance feeding efficiency regarding weight gain and exclusive breastfeeding, compared to an unstructured approach.ObjectiveThe current study aimed to evaluate the impact of PIOMI on the progression of oral feeding and weight gain in premature infants.MethodsThis study represents a randomized controlled trial that took place in a neonatal intensive care unit in 2024. The intervention group received PIOMI, and the control group did not receive the intervention. The participants of the two groups were compared based on weight gain, mean height, head circumference, and length of hospitalization.ResultsThe findings of this study showed that the mean of studied parameters, such as weight, height, and head circumference of the infants in the intervention group, was higher than that of the control group, and this difference was statistically significant (<i>p</i> < 0.05). Moreover, the mean number of uninterrupted sucking of infants in the intervention group was higher, and it was statistically significant (<i>p</i> < 0.001).DiscussionThe PIOMI intervention enhances the sucking strength and consequently boosts the growth metrics of premature infants.ConclusionIt was concluded that the PIOMI intervention increases the sucking power and, as a result, improves the growth indicators of premature neonates, such as weight, height, and head circumference, which is clinically important. Additionally, it reduces the mean hospitalization time.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475691"},"PeriodicalIF":1.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal exposure to second-hand smoke during pregnancy and risk of autism spectrum disorder in offspring: A systematic review and meta-analysis.","authors":"Salman Khazaei, Ensiyeh Jenabi, Helen Behmanesh","doi":"10.1177/19345798261475335","DOIUrl":"https://doi.org/10.1177/19345798261475335","url":null,"abstract":"<p><p>BackgroundEmerging evidence suggests that environmental exposures during pregnancy may influence the risk of autism spectrum disorder (ASD) in offspring. Maternal exposure to second-hand smoke is a potentially modifiable risk factor, but previous studies have reported inconsistent findings. This is the first meta-analysis on the association between maternal second-hand smoke exposure during pregnancy and the risk of ASD in children.Materials and methodsA systematic search of the PubMed, Web of Science, and Scopus databases was conducted, covering articles published up to May 2, 2026, without language or publication date restrictions. Observational studies reporting odds ratios (ORs) for the association between maternal passive smoking during pregnancy and ASD diagnosis in offspring were included. Methodological quality was assessed using the Newcastle-Ottawa Scale. A random-effects model was used to calculate pooled ORs. Subgroup analysis was performed based on study design, and publication bias was evaluated using Begg's and Egger's tests.ResultsNine studies comprising 9,005 participants met the inclusion criteria. The pooled OR from adjusted studies demonstrated a statistically significant association between maternal second-hand smoke exposure during pregnancy and ASD risk (OR = 2.12; 95% CI: 1.59-2.66), indicating that exposed children had more than twice the risk of ASD compared to unexposed children.ConclusionsMaternal exposure to second-hand smoke during pregnancy was associated with increased odds of ASD in offspring. The findings highlight the importance of public health interventions aimed at reducing prenatal second-hand smoke exposure, including smoke-free legislation and smoking cessation counseling for pregnant women and their families.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475335"},"PeriodicalIF":1.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}