Pediatric Research最新文献

{"title":"Sibling factors associated with gut microbiota and fecal short-chain fatty acids in preschoolers.","authors":"Yuichiro Tanaka, Ryohei Shibata, Yumiko Nakanishi, Tamotsu Kato, Bahrul Fikri, Tomoko Takahashi, Kenichi Sakurai, Midori Yamamoto, Masayuki Shima, Yasuhiro Takeshima, Narumi Tokuda, Taku Oishi, Narufumi Suganuma, Kahoko Yasumitsu-Lovell, Takahiro Arima, Hiroshi Kitazawa, Nobuo Yaegashi, Yuichi Adachi, Hidekuni Inadera, Shokei Murakami, Chisato Mori, Naoki Shimojo, Hiroshi Ohno","doi":"10.1038/s41390-026-05478-3","DOIUrl":"https://doi.org/10.1038/s41390-026-05478-3","url":null,"abstract":"<p><strong>Background: </strong>Sibling factors are linked not only to disease development but also to gut environmental factors (e.g., microbiota, short-chain fatty acids [SCFA]). However, these associations among preschoolers and their underlying mechanisms remain unclear.</p><p><strong>Methods: </strong>In a sub-cohort study of a nationwide birth-cohort study, using fecal microbiome and SCFA data from 903 children at age 2 or 4 years, we examined associations of sibling factors with gut environmental factors. We also determined enterotypes by clustering and sibling-enterotype associations with potential mediation pathways.</p><p><strong>Results: </strong>Among sibling factors, the number of older siblings showed the strongest associations with gut environmental factors. We identified 3 enterotypes: 1) Mediterraneibacter gnavus group, 2) Faecalibacterium, and 3) Ruminococcus. Compared to enterotype 2, having older siblings was associated with lower odds of enterotype 1, with the lowest Shannon index and propionate level, at age 2 (1 sibling: adjOR 0.49, 95%CI 0.34-0.69; ≥2: adjOR 0.32, 95%CI, 0.19-0.54) and 4 (1 sibling: adjOR 0.45, 95%CI 0.26-0.77; ≥2: adjOR 0.22, 95%CI 0.08-0.53) years. These associations were largely direct, with modest mediation by antibiotic use at age 4 years (1 sibling, adjOR 0.89; 95%CI, 0.79-1.00).</p><p><strong>Conclusion: </strong>Our data identified distinct enterotypes of preschoolers and sibling-enterotype association pathways.</p><p><strong>Impact: </strong>In this nationwide multicenter birth-cohort sub-cohort, older siblings were strongly associated with gut microbial composition in preschoolers. Having older siblings was associated with lower odds of a potentially less mature enterotype characterized by the lowest Shannon index and propionate level. The sibling-enterotype association was mainly direct, with modest mediation by recent antibiotic use. This study extends sibling-microbiota evidence beyond infancy/toddlerhood by identifying three enterotypes with distinct microbial and short-chain fatty acid profiles. These findings clarify pathways linking family structure to gut environmental development and may inform microbiota-targeted disease prevention strategies.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183804","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":"Gut microbiota are linked to gastrointestinal symptoms and behavioral changes but not inflammation in autism spectrum disorder: a cross-sectional analysis.","authors":"Vaishali Harne, Nicole Y Fatheree, Angela V Serrano, Beanna Okeugo, Ana Fadhel Alvarez, Manouchehr Hessabi, Amirali Tahanan, Rosleen Mansour, Fernando Navarro, Essam Imseis, Supriya Nair, Wallace A Gleason, Melissa R Van Arsdall, Tu Mai, Shabba A Armbrister, Salomea Giorgberidze, Mohammad H Rahbar, MinJae Lee, Deborah A Pearson, Ruth Ann Luna, Yuying Liu, J Marc Rhoads","doi":"10.1038/s41390-026-05548-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05548-6","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) symptoms are increased in children with autism spectrum disorder (ASD). We examined the relationship between ASD severity, intestinal inflammation, gut permeability, and dysbiosis.</p><p><strong>Methods: </strong>Our cross-sectional study examined baseline data from a clinical trial and included stools from typically developing (TD) controls and siblings. GI symptom severity was assessed using GI severity index (GSI) with Bristol stool scoring, while ASD symptoms were quantified using Social Responsiveness Scale (SRS-2). Biomarkers including plasma zonulin, occludin, and S100A9, and fecal calprotectin levels, were measured to assess intestinal permeability and inflammation. Fecal microbiota was analyzed using 16S rRNA sequencing.</p><p><strong>Results: </strong>Seventy-two children with ASD were included for biomarker analysis, and 135 children's stools for microbiome analysis. A statistically significant correlation was observed between GSI and SRS-2 scores (p = 0.02). GSI and SRS-2 scores did not correlate with measured biomarkers, none of which were elevated above published normal values. Children with ASD had reduced fecal richness and distinct clustering of organisms, with increased relative abundance of Fusicatenibacter, Blautia, Sarcina, and Eubacterium, compared to TD children.</p><p><strong>Conclusions: </strong>Children with ASD who had GI symptoms had increased Bacteroides and Ruminococci. Dysbiosis correlated with common GI symptoms, including flatulence, foul stools, and nighttime awakening.</p><p><strong>Impact: </strong>Children with ASD who have more disturbed social awareness are prone to more severe GI symptoms, reduced fecal microbial diversity and abnormal fecal microbial composition. Certain stool microbial taxa correlated with total GI symptom scores as well as with specific GI symptoms including flatulence, abdominal pain/irritability, and foul-smelling stools. However, we found no evidence of gastrointestinal or systemic inflammation, nor of increased gut permeability to explain the symptoms.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183802","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":"Trust but verify…the importance of multimethod and biomarker assessments of prenatal substance exposures.","authors":"Lynn T Singer","doi":"10.1038/s41390-026-05544-w","DOIUrl":"https://doi.org/10.1038/s41390-026-05544-w","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183065","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":"Strategies to increase participant diversity in pediatric research: a systematic review.","authors":"Ian J Litchfield, Olga Boiko, Rocco Sheldon, Veer Sheth, Thesanya Wijewickreme Perera, Sheila M Greenfield, Renuka P Dias","doi":"10.1038/s41390-026-05536-w","DOIUrl":"https://doi.org/10.1038/s41390-026-05536-w","url":null,"abstract":"<p><strong>Background: </strong>Multiple strategies have been introduced to improve research recruitment and retention of underserved children and young people (CYP) with long-term conditions. For the first time, this systematic review presents a structured description of CYP and caregiver preferences for these strategies and collates evidence of their impact on participation.</p><p><strong>Methods: </strong>The Embase, MEDLINE, CINAHL, PsycINFO, Scopus, and Cochrane CENTRAL databases were searched. Studies were included from the inception of the database to September 2025 if they were undertaken in a high-income country, with CYP under 19 years with a long-term condition.</p><p><strong>Results: </strong>We assessed 16,727 records and included 21 studies published between 1998 and 2024, all based in the USA, predominantly drawn from African American and Latino populations. We determined preferences for the positive impact of the use of familiar venues and culturally attuned community events for study activities; communication that was bilingual, used educational games or social media; reliable and equitable relationships with study facilitators; and the co-production of recruitment strategies and study interventions.</p><p><strong>Conclusions: </strong>There was a lack of comparative evidence across individual approaches. The time and resources needed to build awareness, trust, and facilitate research participation in underserved CYP need broader acknowledgement from funders and policymakers.</p><p><strong>Impact: </strong>The review highlights how building trust, maintaining contact, and using familiar language and venues for study activities can improve research recruitment and retention in under-researched children and young people. The additional time and resources required to increase the diversity of children and young people participating in research need to be understood by funding bodies. The review's structured description of recruitment and retention strategies and their comparative effectiveness provides valuable and practical insight for those wishing to diversify research participation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182741","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":"Motor-cognitive integrated training improves executive function and gross motor skills in children with developmental coordination disorder: a pilot RCT.","authors":"Ji-Wei Chen, Guan-Li Ma, Wen-Qian Du, Xu Zhang, Bo Sun, Bin Zhang, Kun Zhu","doi":"10.1038/s41390-026-05549-5","DOIUrl":"https://doi.org/10.1038/s41390-026-05549-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate a school-based pilot intervention combining fundamental movement skills (FMS) training and action observation and motor imagery (AOMI) for gross motor skills and executive function in developmental coordination disorder (DCD).</p><p><strong>Methods: </strong>In this pilot randomized controlled trial, 20 children with DCD were randomized to an experimental group (FMS plus AOMI, n = 10) or an active control group (FMS plus video-based physical activity education). Both groups completed sessions three times per week for 10 weeks. Gross motor skills were assessed using the Test of Gross Motor Development-3. Executive function was evaluated using the More-Odd Shifting, Stroop, and Spatial Working Memory tasks.</p><p><strong>Results: </strong>Motor skills improved in both groups, with larger gains observed in the experimental group. For executive function, the experimental group showed greater improvements mainly in reaction time and inverse efficiency scores, whereas accuracy improvements were limited and significant only in selected conditions.</p><p><strong>Conclusion: </strong>Compared with FMS combined with video-based physical activity education, FMS combined with AOMI may be associated with additional improvements in motor skills and executive function-related behavioural performance in children with DCD. Given the small pilot sample, these findings should be interpreted as preliminary rather than definitive evidence of efficacy or superiority.</p><p><strong>Clinical trial registration: </strong>Trial registration: ClinicalTrials.gov, NCT07486856.</p><p><strong>Impact: </strong>Children with developmental coordination disorder (DCD) commonly present with both motor coordination deficits and executive function difficulties. Existing interventions mainly focus on motor skills, whereas motor-cognitive integrated approaches remain insufficiently tested in school settings. This pilot randomized controlled trial provides preliminary evidence that a school-based programme combining fundamental movement skills training with action observation and motor imagery may be associated with larger improvements than an attention-matched active control condition involving fundamental movement skills training and video-based physical activity education.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183735","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":"Sociodemographic differences in time-specific smartphone use among a national sample of adolescents.","authors":"Gina Marie Mathew, Isaac R Rodriguez, David A Reichenberger, Dimitri A Christakis, Lauren Hale","doi":"10.1038/s41390-026-05563-7","DOIUrl":"https://doi.org/10.1038/s41390-026-05563-7","url":null,"abstract":"<p><p>Screen use among U.S. adolescents is ubiquitous. There is a lack of information on sociodemographic differences in time-specific usage patterns using objective measures of screen use. We examined sociodemographic differences in objectively measured time-specific smartphone use among a national, diverse sample of 233 U.S. adolescents (13-18 y; M ± SD = 15.9 ± 1.3; 46% female, 6% other gender). Participants self-reported sociodemographic characteristics, then installed a passive sensing meter on their smartphones for ≥3 days to monitor smartphone activity, including application use, duration, and timing. Multiple linear regression examined differences in smartphone usage patterns by sociodemographic factors. In fully adjusted analyses, teens who were LGBTQIA+ versus non-LGBTQIA+ (24 hr use: +0.94 h/day; evening use, 20:00-22:59: +0.22 h/evening; nighttime use, 23:00-5:59: +0.39 h/night), with less parental education (nighttime use: +0.37 h/night), and with no parental screen use limits (24 hr use: +1.24 h/day; evening use: +0.24 h/evening; nighttime use: +0.34 h/night) had greater smartphone use. This national study demonstrated that LGBTQIA+ adolescents and those with lower parental education may be at heightened risk for excessive screen use with possible impacts on wellbeing. Parental restrictions on screen use are potentially modifiable markers of youth smartphone use. IMPACT: The present study examined levels of objectively measured smartphone use among a national, diverse sample of adolescents. Our findings have broad public health implications for American adolescents. We demonstrated that adolescents who were LGBTQIA+ and those with lower parental education had higher levels of smartphone use, with potential for both beneficial and harmful impacts on health and well-being. Moreover, parental restrictions on screen use are important potential targets to help reduce smartphone use among U.S. youth.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182415","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":"Ensemble model-based prediction of school-age asthma risk in children with food allergy.","authors":"Xiaoxiao Jia, Youcheng Ye, Chenxi Shi, Jiadi Wang, Zhanqing Fu, Yuxuan Wu, Qihong Tao, Hao Hu, Haoxiang Ye, Zhe Ouyang, Weixi Zhang, Lei Wang","doi":"10.1038/s41390-026-05553-9","DOIUrl":"https://doi.org/10.1038/s41390-026-05553-9","url":null,"abstract":"<p><strong>Background: </strong>Early-life food allergy (FA) is a major childhood asthma risk, but prospective screening tools for high-risk infants aged 0-2 are lacking, delaying early intervention.</p><p><strong>Objective: </strong>To develop an ensemble-learning model with cost-sensitive optimization for early asthma risk screening in FA infants (0-2 years) and provide quantitative clinical decision support.</p><p><strong>Methods: </strong>This prospective cohort enrolled 447 FA-confirmed infants (0-2 years), collecting 135 baseline predictors across 7 categories. After median 4.5-year follow-up to school age (≥6 years), we generated 3 clinically interpretable features and built a two-stage weighted ensemble (Random Forest, XGBoost, LightGBM, Deep Residual Networks) with cost-sensitive learning (missed-to-false-alarm ratio = 5:1) to optimize thresholds.</p><p><strong>Results: </strong>On the independent test set, AUC = 0.886, recall = 1.00 (zero missed). Decision-curve analysis showed superior net benefit across broad thresholds, including optimal cutoff 0.09. Top predictors: RSV infection, wheeze frequency, nocturnal sleep, antibiotic exposure, and rhinitis duration. Sensitivity analysis confirmed stable zero missed at cost ratios ≥5:1, indicating 5:1 was not the key driver.</p><p><strong>Conclusion: </strong>The model preliminarily predicts school-age asthma risk in FA infants. Its high-recall design avoids missed diagnoses and offers quantitative references for early intervention and individualized follow-up before age 2.</p><p><strong>Impact: </strong>Core finding: A performance-weighted ensemble model predicts school-age asthma in food-allergic infants (0-2 years) with an AUC of 0.886 and recall 1.00 using only clinical data. Contribution: A cost-sensitive, feature-engineered model tailored to this high-risk population; identifies RSV, wheeze grading, and antibiotic load as top predictors.</p><p><strong>Significance: </strong>Enables early, non-invasive screening before age 2, avoids missed high-risk children, and supports targeted preventive interventions in primary care.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170263","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":"Impact on mortality of inhaled nitric oxide in newborns ≤34 weeks with early hypoxemic respiratory failure: systematic review and meta-analysis.","authors":"Jorge Luis Alvarado-Socarras, Delia E Theurel-Martín, Edgar Fabián Manrique-Hernández","doi":"10.1038/s41390-026-05564-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05564-6","url":null,"abstract":"<p><strong>Introduction: </strong>Inhaled nitric oxide (iNO) is approved for hypoxemic respiratory failure (HRF) associated with pulmonary hypertension (PH) in term and near-term neonates; however, its use in preterm infants ≤34 weeks' gestation remains controversial, with limited and inconsistent evidence of survival benefit.</p><p><strong>Objective: </strong>To evaluate the association between iNO use and mortality in preterm neonates ≤34 weeks' gestation.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Major databases were searched up to October 11, 2025. Observational studies and clinical trials reporting mortality in preterm infants with early HRF treated with iNO were included. A random-effects meta-analysis was performed.</p><p><strong>Results: </strong>Nineteen studies were included in the qualitative synthesis, and six (n = 556 infants) in the meta-analysis. Study quality ranged from poor to good, with limitations related to confounding and heterogeneity. No significant reduction in mortality was observed with iNO compared with standard care (RR 0.65; 95% CI 0.29-1.48; I² = 55.7%). Infants receiving iNO were more severely ill at baseline. A positive oxygenation response was associated with improved outcomes and varied by gestational age (GA), timing of PH onset, echocardiographic confirmation, and hypoxemia severity.</p><p><strong>Conclusions: </strong>Current evidence regarding the survival benefit of iNO in preterm infants ≤34 weeks remains inconclusive.</p><p><strong>Impact: </strong>This systematic review and meta-analysis show that inhaled nitric oxide (iNO) is not associated with a consistent reduction in mortality in preterm infants ≤34 weeks at the population level. It adds evidence that outcomes are strongly influenced by clinical context, particularly, illness severity, gestational age, timing of pulmonary hypertension onset, echocardiographic confirmation, and response to therapy. These findings support a selective, phenotype-driven approach rather than routine iNO use in all preterm infants with hypoxemic respiratory failure. The results may inform clinical decision-making and highlight the need for well-designed randomized trials in this high-risk population.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168650","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: Still in the dark? Cardiovascular risks of perinatal melatonin.","authors":"Beth Joyce Allison","doi":"10.1038/s41390-026-05539-7","DOIUrl":"10.1038/s41390-026-05539-7","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166907","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: the questions we learn to ask.","authors":"Alex Smith","doi":"10.1038/s41390-026-05533-z","DOIUrl":"https://doi.org/10.1038/s41390-026-05533-z","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171930","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}