Pediatric Research最新文献

{"title":"Associations of behavioral, motivational, and socioeconomic factors with BMI among children and adolescents.","authors":"Charlotte Jungehuelsing, Christof Meigen, Sarah Krause, Wieland Kiess, Tanja Poulain","doi":"10.1038/s41390-025-03860-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03860-1","url":null,"abstract":"<p><strong>Background: </strong>Higher weight represents a significant health concern in youth and may be influenced by socioeconomic and behavioral factors. We investigated the relationship between BMI and parental education, nutritional health, eating culture, organized and non-organized physical activity (PA), motives for PA (weight loss/maintenance, enjoyment), and screen-time in children and adolescents.</p><p><strong>Methods: </strong>677 2- to 11-year-olds (young-age-group) and 464 12- to 20-year-olds (old-age-group) from Leipzig, a city in Germany, participated. We applied multivariate linear regression analyses to assess associations.</p><p><strong>Results: </strong>BMI-SDS was negatively associated with parental education (young-age-group: b = -0.25, p < 0.001, old-age-group: b = -0.27, p = 0.02), non-organized PA (young-age-group: b = -0.23, p = 0.029), and PA enjoyment (young-age-group: b = -0.05, p = 0.01, old-age-group: b = -0.05, p = 0.038), but negatively with media use during dinner (old-age-group: b = 0.53, p < 0.001), PA for weight loss/maintenance (young-age-group: b = 0.15, p < 0.001, old-age-group: b = 0.12, p < 0.001), and screen-time (young-age-group: b = 0.11, p = 0.009, old-age-group: b = 0.09, p = 0.001). Significant interactions with age, sex and parental education were observed.</p><p><strong>Conclusion: </strong>A lower BMI in children is associated with high parental education, screen-free eating, higher participation in non-organized PA and lower screen-time. While measures of motivation were limited and thus findings should be interpreted with caution, intrinsic motivation for PA is associated with lower BMI whereas extrinsic motivation for PA is associated with higher BMI.</p><p><strong>Impact: </strong>In a German cohort of children and adolescents, lower BMI is associated with high parental education, less screen time, more participation in non-organized physical activity and less media use during dinner. Intrinsic and extrinsic motives for physical activity are directly linked to the weight status of children and adolescents. These associations are particularly strong in families with low/medium formal education.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression in children with abdominal pain in the emergency department.","authors":"Sarah R Martin, Theodore W Heyming, Michelle A Fortier, Luis H Salas, Heather C Huszti, Meredith L Dennis, Zeev N Kain","doi":"10.1038/s41390-025-03871-y","DOIUrl":"https://doi.org/10.1038/s41390-025-03871-y","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study examined depression and associated impairment in youth presenting to a pediatric emergency department (PED) with abdominal pain.</p><p><strong>Methods: </strong>Participants were 11-17 years old, presenting to a PED with idiopathic abdominal pain. Participants completed demographics, pain, pain-related impairment, and depression surveys. Depression was assessed using the Patient Health Questionnaire (PHQ-9A). Scores ≥10 met depression threshold and ≥1 on item 9 indicated self-harm ideation. Mean difference and logistic regression analyses were conducted.</p><p><strong>Results: </strong>Among 169 participants, 29.6% reported depression and 9.4% endorsed self-harm ideation. Depression was associated with Latinx ethnicity (X² = 4.02, p = 0.045), higher pain intensity (Z = -3.09, p = 0.002), and higher pain-related impairment (Z = -4.86, p < 0.001). In regression analyses, pain-related impairment and Latinx ethnicity were independently associated with depression (OR = 3.89 [95%CI, 1.22-12.40]; OR = 1.13 [95%CI, 1.06-1.21]). Self-harm ideation was not associated with study variables.</p><p><strong>Conclusions: </strong>Results highlight the need for enhanced mental health screening for youth presenting with idiopathic abdominal pain in the ED, particularly for Latinx youth. Early identification of depression and high pain-related impairment may inform interventions and improve outcomes.</p><p><strong>Impact: </strong>Nearly 30% of youth, 11-17 years old, presenting to the ED with idiopathic abdominal pain screened positive for depression and 9.4% reported self-harm ideation. The higher likelihood of depression among Latinx youth experiencing pain emphasizes the importance of including diverse samples in future ED research to explore mechanisms contributing to poorer mental health in minoritized populations. Results highlight the need for enhanced mental health screening in youth presenting to the emergency department with idiopathic abdominal pain.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome prediction for late-onset sepsis after premature birth.","authors":"Francesca Miselli, Riccardo Cuoghi Costantini, Melissa Maugeri, Elisa Deonette, Sofia Mazzotti, Luca Bedetti, Licia Lugli, Katia Rossi, MariaFederica Roversi, Alberto Berardi","doi":"10.1038/s41390-025-03814-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03814-7","url":null,"abstract":"<p><strong>Background: </strong>Our aim was to develop a quantitative model for immediately estimating the risk of death and/or brain injury in late-onset sepsis (LOS) in preterm infants, based on objective and measurable data available at the time sepsis is first suspected (i.e., time of blood culture collection).</p><p><strong>Methods: </strong>Retrospective study on neonates ≤36 weeks' gestation with a positive blood and/or cerebrospinal fluid culture after 72 hours from birth.</p><p><strong>Results: </strong>Among 3217 preterm live births, 94 cases were included (median gestational age 26.5 weeks' IQR 25.0;28.0), of whom 26 (27.7%) had poor outcomes (17 death; 9 brain injuries). Infants with poor outcomes showed lower postnatal age (11.5 vs 12.5 days, p < 0.001), lower mean blood pressure (30.5 vs 43 mmHg, p < 0.001) and higher lactate levels (4.4 vs 1.5 mmol/l, p < 0.001). Our multivariable model showed good discrimination and calibration (c statistic=0.8618, Hosmer-Lemeshow p = 0.8532), stratifying the population into 3 groups: low-risk (sensitivity 97%, specificity 52%), middle-risk, and high-risk (sensitivity 77%, specificity 80%).</p><p><strong>Conclusion: </strong>This predictive model performs well as a practical and easy-to-use tool to help clinicians early identify the sickest neonates who may benefit from timely and aggressive support (e.g., central line, haemodynamic assessment) and close monitoring (e.g., 1:1 nursing assignment, frequent reassessments).</p><p><strong>Impact: </strong>We lack data to early identify the severity of neonatal late-onset sepsis in preterm infants. Delay in treatment contributes to poor prognosis. We developed a model for early prediction of poor outcomes (mortality and brain injuries). The model utilizes immediately available and measurable data at the time sepsis is first suspected. This can help clinicians in tailoring management based on individual risks.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in newborn metabolite patterns with preterm birth and diabetes in pregnancy.","authors":"Catherine O Buck, Sarah McCollum, Weiwei Wang, TuKiet T Lam, Sarah N Taylor, Veronika Shabanova","doi":"10.1038/s41390-025-03844-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03844-1","url":null,"abstract":"<p><strong>Background: </strong>This study examines the influence of prematurity and diabetes (DM) in pregnancy on metabolite patterns at birth, and associations with adiposity development in a prospective cohort.</p><p><strong>Methods: </strong>Term and preterm (30-36 weeks gestational age [GA]) infants were enrolled and body composition assessments completed through discharge. Targeted metabolomics was used to assess metabolites in cord or infant blood in the first 2 days.</p><p><strong>Results: </strong>Among 91 infants, 62 were preterm and 27 were exposed to DM. In factor analysis, variation in acylcarnitines' and non-essential amino acids differed by GA and DM exposure and were associated with adiposity at term age. DM-group had 1.95-fold increase in t4-OH-pro (p = 0.003) and 2.14-fold increase in taurine (p = 0.004) compared with non-DM group. Preterm infants had 1.77-fold increase in glycerophospholipid PC aa C32:2 versus term group (p < 0.001). Pathway analysis revealed differences across DM and GA groups in pathways associated with citrulline metabolism, amino acid transport/ synthesis, and fatty acid quantity/transport.</p><p><strong>Conclusion: </strong>In this cohort of infants, there are unique metabolite signatures associated with DM exposure, prematurity, and adiposity development after birth. These markers may reflect early metabolism changes in the developing infant which relate to known risks of adverse growth and cardiometabolic outcomes in this group.</p><p><strong>Impact: </strong>In this study of term and preterm infants, diabetes in pregnancy was associated with unique metabolic signatures at birth, including increased expression of metabolites related to protein synthesis and lipid metabolism. Metabolites related to lipid and protein metabolism were associated with adiposity development at term age, including estimated body fat percent, skin fold thickness measures, and arm circumference measures. Unique signatures of metabolites associated with prematurity and exposure to diabetes in pregnancy may reflect early metabolism changes in the developing infant which relate to known risks of adverse growth and cardiometabolic outcomes in this group.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early gross motor performance is associated with concurrent prelinguistic and social development.","authors":"Anastasia Gallen, Elisa Taylor, Juha Salmi, Leena Haataja, Sampsa Vanhatalo, Manu Airaksinen","doi":"10.1038/s41390-025-03832-5","DOIUrl":"https://doi.org/10.1038/s41390-025-03832-5","url":null,"abstract":"<p><strong>Background: </strong>To study how early gross motor development links to concurrent prelinguistic and social development.</p><p><strong>Methods: </strong>We recruited a population-based longitudinal sample of 107 infants between 6 and 21 months of age. Gross motor performance was quantified using novel wearable technology for at-home recordings of infants' spontaneous activity. The infants' prelinguistic and social development was assessed in parallel with a standardized parental questionnaire (Infant Toddler Checklist). The developmental trajectories of motor, prelinguistic, and social performance were inspected longitudinally at individual level, and correlated to each other to measure the relative, age-adjusted advance in performance (z-scores).</p><p><strong>Results: </strong>Advanced gross motor maturation (higher z-score) links to more advanced prelinguistic development (β = 0.033, p = 0.016, R² = 0.706) and social development (β = 0.038, p = 0.025, R² = 0.600). When looking at specific gross motor skills, an increased amount of independent movement (crawling, standing, walking) links to more advanced prelinguistic and social abilities.</p><p><strong>Conclusion: </strong>We introduce a novel approach that measures individual level gross motor development longitudinally at high resolution from child's spontaneous movements at home. This approach shows that age-adjusted relative advance in motor performance is linked to concurrent prelinguistic and social development, supporting the idea of developmental interaction across neurocognitive domains.</p><p><strong>Impact: </strong>Early gross motor, prelinguistic, and social developments show trackable idiosyncratic trajectories. Maturity in gross motor performance links to concurrent prelinguistic and social development. Gross motor performance can be assessed reliably and objectively from infants' spontaneous activity using unsupervised wearable recordings in their native environment, the homes. The present methodology with longitudinal quantitative assessments and age-adjusted modeling with z-scores introduce a potential paradigm shift to studying early neurodevelopment in the context of pediatric health, benchmarking of therapeutic interventions, and other developmental studies.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family reflections: a whole person: navigating aging and cerebral palsy.","authors":"Jocelyn Cohen","doi":"10.1038/s41390-025-03825-4","DOIUrl":"https://doi.org/10.1038/s41390-025-03825-4","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family reflections: our experience with thalassemia.","authors":"Maria Saradpon","doi":"10.1038/s41390-025-03823-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03823-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risky transportation-related behaviors among high school students, 2007 to 2023.","authors":"Guodong Ding, Jingxing Tang, Yan Chen, Angela Vinturache, Yongjun Zhang","doi":"10.1038/s41390-025-03875-8","DOIUrl":"https://doi.org/10.1038/s41390-025-03875-8","url":null,"abstract":"<p><strong>Impact: </strong>The study highlights significant declines in risky transportation-related behaviors among US high school students from 2007 to 2023.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking barriers: fostering equitable access to pediatric genomics through innovative care models and technologies.","authors":"Sabrina Malone Jenkins, Rachel Palmquist, Brian J Shayota, Chelsea M Solorzano, Joshua L Bonkowsky, Paul Estabrooks, Martin Tristani-Firouzi","doi":"10.1038/s41390-025-03859-8","DOIUrl":"https://doi.org/10.1038/s41390-025-03859-8","url":null,"abstract":"<p><p>The integration of genomic medicine into pediatric clinical practice is a critical need that remains largely unmet, especially in socioeconomically challenged and rural areas where healthcare disparities are most pronounced. This review seeks to summarize the barriers responsible for delayed diagnosis and treatment, and examines diverse care models, technological innovations, and strategies for dissemination and implementation aimed at addressing the evolving genomic needs of pediatric populations. Through a comprehensive review of the literature, we explore proposed methodologies to bridge this gap in pediatric healthcare, with a specific emphasis on understanding and speeding implementation approaches and technologies to mitigate disparities in underserved populations, including rural and marginalized communities. There are both external and internal factors to consider in demographic and social determinants when evaluating patient access. To address these barriers, potential solutions include telegenetic services, alternative care delivery models, pediatric subspecialist expansion, and non-genetic provider education. By improving access to pediatric genomic services, therapeutic interventions will also be more available to all pediatric patients. IMPACT STATEMENT: Genomic testing has clinical utility in pediatric populations but access for people from diverse demographic and social-economic groups is problematic. Understanding barriers responsible for delayed genetic diagnosis and treatment in pediatric populations will improve reach, adoption, implementation, and maintenance of genomic medicine in pediatric healthcare context. Innovative care models, adaptation of appropriate technologies, and strategies aimed at addressing pediatric genomic needs are needed.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension at diagnosis of coarctation of the aorta as a risk factor for recoarctation.","authors":"Nofar Berman, Shani Pozailov, Hanna Krymko, Leonel Slanovic, Michael Murninkas, Michael Grunseid, Aviva Levitas","doi":"10.1038/s41390-025-03801-y","DOIUrl":"https://doi.org/10.1038/s41390-025-03801-y","url":null,"abstract":"<p><strong>Background: </strong>Coarctation of the aorta (CoA) is a narrowing of the aorta that affects 5-8% of congenital heart defects. Treatment options include surgical repair or transcatheter management with endovascular stenting or balloon dilatation. Late complications after operative repair include systemic hypertension, aortic valve abnormalities, aortic aneurysm, and recoarctation. This study examines the association between the presence of hypertension at the diagnosis of CoA and recoarctation.</p><p><strong>Methods: </strong>This retrospective study analyzed medical records of patients at Soroka University Medical Center who underwent treatment for CoA between 1978 and 2021. The study included 128 patients diagnosed with CoA and who underwent repair; 9 were excluded, leaving 119 patients for analysis.</p><p><strong>Results: </strong>Of the 119 patients, 28 developed recoarctation within 15 years of initial repair. Patients with hypertension at initial diagnosis were more likely to develop recoarctation, adjusted to sex and ethnicity. Other patient characteristics were not significantly associated with recoarctation.</p><p><strong>Conclusions: </strong>Hypertension at the time of initial CoA diagnosis is a risk factor for the development of recoarctation within 15 years of initial repair. Close monitoring and management of blood pressure may be important for patients with CoA. Future research should investigate whether hypertension control can reduce recoarctation risk in this population.</p><p><strong>Impact: </strong>Previous studies focus on post-repair hypertension in CoA. Limited research on hypertension during CoA diagnosis. Knowledge gap on its impact on recoarctation risk. Hypertension at CoA diagnosis may predict recoarctation. Enables tailored monitoring and timely intervention.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}