Pediatric Research最新文献

{"title":"Rethinking healthcare's approach to ACEs treatment and the role of social health programming.","authors":"Rebecca A Drakowski, Ann L Anderson-Berry","doi":"10.1038/s41390-025-03970-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03970-w","url":null,"abstract":"<p><strong>Impact: </strong>This correspondence adds to the existing literature by highlighting the importance of community partnerships and social health programming as a necessary component of medical care for adverse childhood experiences.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531765","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":"Human Milk's Messengers from Mother to Infant.","authors":"Farha Ramzan, Gergely Toldi","doi":"10.1038/s41390-025-03973-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03973-7","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531745","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":"Renal dysplasia development and chronic kidney disease.","authors":"Li Zhang, Chunjiang Yang, Xing Liu, Dawei He, Tao Lin, Yuanyuan Zhang, Guanghui Wei, Deying Zhang","doi":"10.1038/s41390-025-03950-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03950-0","url":null,"abstract":"<p><p>Renal dysplasia is a common congenital birth defect in childhood, caused by fetal genetic defects, epigenetic modification disorders, or environmental factors. Maternal malnutrition, placental insufficiency, and exposure to harmful substances such as alcohol, angiotensin-converting enzyme inhibitors, and cocaine during pregnancy increase the risk of fetal renal dysplasia. The pathogenesis of this disease involves abnormal formation of renal units, leading to structural and functional abnormalities of the kidney. If left untreated, renal dysplasia can progress to chronic kidney disease (CKD) in children. This review explores the etiology and pathogenesis of renal dysplasia, emphasizing the intrinsic link between renal dysplasia and CKD through various pathological pathways. Additionally, we propose potential therapeutic agents targeting these mechanisms. We also highlight future research directions to further understand and address this issue. We hope this review will deepen clinicians' understanding of renal dysplasia and promote further laboratory research in this area. IMPACT: 1. This review comprehensively summarizes and elucidates the complex relationship between renal dysplasia and chronic kidney disease (CKD) based on previous research, offering new directions for related studies. 2. It expands upon conservative treatment approaches for renal dysplasia, providing more clinical options for therapeutic intervention.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502968","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":"Antenatal Vitamin C differentially affects lung development in normally grown and growth restricted sheep.","authors":"Erin V McGillick, Sandra Orgeig, Beth J Allison, Kirsty L Brain, Youguo Niu, Nozomi Itani, Katie L Skeffington, Andrew D Kane, Emilio A Herrera, Dino A Giussani, Janna L Morrison","doi":"10.1038/s41390-025-03828-1","DOIUrl":"10.1038/s41390-025-03828-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic hypoxemia is a common cause of fetal growth restriction and can have significant effects on the developing fetal lung. Maternal antioxidant treatment in hypoxic pregnancy protects against offspring cardiovascular dysfunction. The effects of antenatal antioxidants on lung development in the chronically hypoxic growth restricted fetus is unknown.</p><p><strong>Methods: </strong>We investigated the effect of maternal daily Vitamin C (200 mg/kg i.v. vs. Saline) for a month in late gestation on molecular markers regulating lung maturation between normoxic normally grown and hypoxic growth-restricted fetal sheep. Chronic fetal hypoxia and fetal growth restriction were induced by exposure to maternal chronic hypoxia (10% O₂ vs. Normoxia=21% O₂) from 105-138 d gestation (term=145 d).</p><p><strong>Results: </strong>The data show a differential effect of antenatal Vitamin C treatment on regulation of genes involved in surfactant maturation, sodium movement and hypoxia signaling. Limited responsiveness to antenatal Vitamin C exposure in the lung of the hypoxic fetus, compared to responsiveness to antenatal Vitamin C in the normoxic fetus, suggests a maximal upregulation of the molecular signaling pathways in response to the chronic hypoxic insult alone.</p><p><strong>Conclusion: </strong>We provide molecular insight into the heterogeneity of antenatal Vitamin C treatment on development of the normoxic and growth restricted hypoxic fetal lung.</p><p><strong>Impact: </strong>The effect of maternal Vitamin C on molecular markers of lung maturation between normoxic normally grown and hypoxic growth restricted fetal sheep was unknown. We show a differential effect of Vitamin C with a greater increase in molecular markers of lung maturation in normoxic compared with hypoxic fetuses. Limited responsiveness in the hypoxic fetal lung is likely due to maximal upregulation by the hypoxic insult alone, thus added exposure to Vitamin C is unable to upregulate the system further. The work highlights the need to understand differential effects of antenatal interventions in healthy and complicated pregnancy, prior to clinical translation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502579","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":"Presumed etiology of preterm birth: brain injury and neurodevelopmental outcomes.","authors":"Amr El Shahed, Vann Chau, Jefferson Terry, Clare Whitehead, Anne Synnes, Ruth Grunau, Steven P Miller","doi":"10.1038/s41390-025-03945-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03945-x","url":null,"abstract":"<p><strong>Aim: </strong>To determine the relationship between presumed preterm birth (PTB) etiology and the incidence of brain injury, and neurodevelopmental outcomes at 3 and 4.5 years.</p><p><strong>Subjects and methods: </strong>Prospective cohort study including 222 neonates born at 24-32 weeks' gestation. The presumed PTB etiology was defined by placental histopathology and other clinical features. Outcome measures included brain injury defined on MRI, neurodevelopmental outcomes using the Bayley Scales of Infant and Toddler Development, the Movement Assessment Battery for Children, Wechsler Preschool and Primary Scale of Intelligence, Beery Buktenica Developmental Test of Visual-Motor Integration.</p><p><strong>Results: </strong>Presumed PTB etiology was inflammatory in 85 (38%), vascular in 57 (25%), multiple gestation in 56 (25%) and idiopathic in 24 (11%) neonates. Cognitive outcome at 3 years was marginally lower in the inflammatory group (Beta = -6.2, P = 0.05) relative to multiple gestation. At 4.5 years, white matter injury was associated with significantly lower motor scores (P = 0.004) and there were no significant associations between PTB etiology and WPPSI-III IQ scales or MABC-2 scores.</p><p><strong>Conclusions: </strong>The lack of association between presumed PTB etiology (using integrated clinical phenotype and placental pathology) and cognitive/motor outcomes suggests that postnatal morbidities and brain injury are pivotal in the neurodevelopmental trajectory of these infants.</p><p><strong>Impact: </strong>The presumed etiology of preterm birth (PTB), based on placental histopathology and clinical features, does not predict long-term neurodevelopmental outcomes, such as cognitive scores at 4.5 years. Postnatal factors, including neonatal morbidities (e.g., bronchopulmonary dysplasia, retinopathy of prematurity, brain injury), are more significant in determining neurodevelopmental outcomes than the initial PTB cause. Placental histopathology helps identify PTB causes but shows no direct link to brain injury or neurodevelopmental outcomes. Infants with \"idiopathic\" PTB (no clear cause) have the greatest white matter injury burden, suggesting genetic or unrecognized factors.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502850","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":"Congenital diaphragmatic hernia outcomes: navigating center-to-center variability in level 4 NICUs in the Children's Hospitals Neonatal Consortium.","authors":"Yigit S Guner, Isabella Zaniletti, Theresa R Grover, Sharada H Gowda, Nicolas F M Porta, Michael A Padula, Sarah Keene, Burhan Mahmood, Jacquelyn R Evans, Holly L Hedrick, Karna Murthy","doi":"10.1038/s41390-025-03829-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03829-0","url":null,"abstract":"<p><strong>Background: </strong>This study examined inter-center variation (ICV) in inpatient outcomes for infants with congenital diaphragmatic hernia (CDH), aiming to contribute to quality metrics and clinical benchmarks in neonatal care.</p><p><strong>Methods: </strong>We retrospectively analyzed CDH cases from the Children's Hospitals Neonatal Consortium (CHNC) database (2010-2022), focusing on infants without prior surgical repair or discharge. Our outcomes of interest included inpatient survival, survival without ECMO, and hospital length of stay (LOS). We incorporated centers with ≥30 cases into multivariable models to adjust for patient and clinical factors.</p><p><strong>Results: </strong>Analysis of 3639 infants revealed significant ICV. Unadjusted inpatient survival rate was 76.5%, with ICV ranging from 55.4% to 90.7%. The composite outcome of survival without ECMO was 63.3% (ICV: 38.6-87.9%). The median LOS for survivors was 50 days (ICV: 29-68 days). Multivariable analyses confirmed these trends, indicating an 18-fold variation in survival, a 35-fold variation in survival without ECMO, and a 3.3-fold variation in LOS across centers (p < 0.001 for all).</p><p><strong>Conclusion: </strong>The treating center was a significant predictor of risk-adjusted inpatient outcomes for infants with CDH. These findings highlight substantial disparities in care and support the integration of these metrics into future research and quality improvement efforts in level IV NICUs.</p><p><strong>Impact statement: </strong>This study reveals considerable inter-center differences in CDH outcomes, contributing extensive, multicenter data to the existing body of literature. It underscores how center-specific practices affect survival and ECMO use, suggesting that organized high-level care could enhance outcomes for CDH patients. These insights lay the groundwork for center-specific quality improvement initiatives to elevate the standard of care.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502896","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":"Associations between physical fitness, physical activity, sedentary behavior and executive function in preschoolers.","authors":"Yesenia García-Alonso, Robinson Ramírez-Vélez, Gaizka Legarra-Gorgoñon, Mikel Izquierdo, Alicia M Alonso-Martínez","doi":"10.1038/s41390-025-03946-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03946-w","url":null,"abstract":"<p><strong>Background: </strong>This study examined the association between individual physical fitness (PF) components, overall fitness scores, and executive function (EF) indicators in preschoolers. Additionally, it explored the relationship between objectively measured physical activity (PA), sedentary behavior (SB), and EF.</p><p><strong>Methods: </strong>This cross-sectional study included 241 preschoolers (121 males, 50%) aged 3-5 years from two different schools. Physical fitness was assessed using the PREFIT battery, which measures lower- and upper-body muscular strength (handgrip strength [HGS] and standing long jump [SLJ]), speed/agility (4 × 10 m), and cardiorespiratory fitness (CRF). The test scores for each student were standardized by age and sex. Individual z-scores were then calculated, and the sum of these z-scores constituted the overall PF. EF (including visual-spatial working memory, phonological working memory, inhibition, and cognitive shifting) was assessed using the one-on-one iPad-based Early Year Toolbox. Total PA, SB, and SB were objectively measured using a tri-axial GENEActiv Original accelerometer worn for six consecutive days.</p><p><strong>Results: </strong>Preschoolers with higher overall PF showed significantly better performance in visual-spatial working memory (β = 0.574, p < 0.001), phonological working memory (β = 0.317, p < 0.001), inhibition (β = 0.379, p < 0.001) and cognitive shifting (β = 0.395, p < 0.001). Similarly, greater engagement in total PA was associated with higher scores in visual-spatial working memory (β = 0.179, p = 0.016), phonological working memory (β = 0.237, p = 0.036), and inhibition (β = 0.148, p = 0.045), which had higher scores on inhibitory control and working memory tasks.</p><p><strong>Conclusion: </strong>These findings highlight the significant influence of PF and PA levels on cognitive performance. Therefore, educational and public health programs must implement strategies to encourage regular PA and improve PF. Such efforts could contribute to better cognitive development and overall health outcomes.</p><p><strong>Impact: </strong>This study emphasizes the importance of physical fitness, particularly muscular strength, speed agility, and cardiorespiratory fitness, in supporting executive function (EF) development in preschool-aged children. Early childhood education policies should prioritize structured physical activity programs to enhance cognitive functions such as working memory, inhibition, and cognitive flexibility. A direct inverse relationship between sedentary behavior and EF was observed. Limiting sedentary activities and encouraging movement in early childhood settings may yield significant cognitive benefits, suggesting that teachers and caregivers should promote more active environments for children. The findings indicate that overall physical fitness supports cognitive abilities rather than isolated fitness components.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502583","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 life growth is related to pubertal growth and adult height - a QEPS-model analysis.","authors":"Carin Skogastierna, Anton Holmgren, Aimon Niklasson, Andreas F M Nierop, Aldina Pivodic, Anders Elfvin, Diana Swolin-Eide, Kerstin Albertsson-Wikland","doi":"10.1038/s41390-025-03939-9","DOIUrl":"https://doi.org/10.1038/s41390-025-03939-9","url":null,"abstract":"<p><strong>Background: </strong>The early life growth period, from conception to ~2 years of age, has proven crucial for later health. We hypothesized that early life growth could explain variations in pubertal growth and timing, and adult height.</p><p><strong>Methods: </strong>This retrospective, population-based study was conducted in Sweden. A subgroup, including individuals of all gestational ages and birth sizes (n = 4700, 50% males), from the longitudinal GrowUp_1974&1990Gothenburg cohorts was used. QEPS variables were analyzed in univariate and multivariate linear regression models, separately per sex; Q-function throughout all growth periods, and specific E- and P-functions, for early life growth and pubertal growth, respectively.</p><p><strong>Results: </strong>In multivariate models, early life growth explained 37-38% of the variability in specific pubertal growth, but less so the variability in pubertal timing. Variability in adult height was explained by birth size (57-62%), early growth (66-67%), childhood growth (65-69%), and to a lesser degree by mid-parental height (35-39%). The change in height during puberty explained 8-9% of the variation in adult height.</p><p><strong>Conclusion: </strong>This study indicates that early life growth is strongly associated with the variability in pubertal growth, and adult height, but not with the timing of pubertal growth.</p><p><strong>Impact: </strong>Early life growth is important as it can serve as a marker for future growth, development, and health. The association between length growth during fetal life and infancy and pubertal growth and timing, and adult height, is only partly understood. Using the QEPS growth model, specific early life growth (E-function) and specific pubertal growth (P-function), including individual variations in tempo and amplitude, can be studied separately from ongoing basic growth (Q-function). This study showed that early life growth is strongly associated with and explains specific pubertal height gain and adult height but less so the timing of pubertal growth.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502839","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":"Correction: Improving UK data on avoidable perinatal brain injury: review of data dictionaries and consultation.","authors":"Jan W van der Scheer, Victoria Komolafe, Kirstin Webster, Stamatina Iliodromiti, Charles C Roehr, Asma Khalil, Tim Draycott, Louise Dewick, George Dunn, Rachel Walsh, Philip Steer, Alessandra Giusti, Mark L Cabling, Nick Fahy, Mary Dixon-Woods","doi":"10.1038/s41390-025-03949-7","DOIUrl":"10.1038/s41390-025-03949-7","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492791","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":"Dupilumab successfully controlled eczema in Wiskott-Aldrich Syndrome over 52 weeks.","authors":"Changhua Zhu, Yaxuan Zheng, Lianming Liao, Jincong Chen, Lihang Lin, Huichun Su","doi":"10.1038/s41390-025-03941-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03941-1","url":null,"abstract":"<p><strong>Impact statement: </strong>Wiskott-Aldrich syndrome (WAS) is a rare genetic disorder characterized by immunodeficiency, thrombocytopenia, and eczema. The Management of eczema remains still a major clinical challenge. We present a rare case of eczema associated with WAS in an 8-year-old boy whose lesions significantly improve after a 4-week treatment of dupilumab, a interleukin(IL)-4α receptor monoclonal antibody. Although eczema relapsed after stopping dupilumab, and alleviated after dupilumab was resumed. Finally, the Eczema Area and Severity Index (EASI) score decreased to less than 7 after the patient receive dupilumab 300 mg every 4 weeks over 52 weeks. This case suggests that dupilumab is a promising therapy alternative for patient with eczema in WAS.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492808","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}