Pediatric Research最新文献

{"title":"ECI biocommentary.","authors":"Alexander Mark Weber","doi":"10.1038/s41390-025-04167-x","DOIUrl":"https://doi.org/10.1038/s41390-025-04167-x","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161213","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":"Sex differences in the risk of bronchopulmonary dysplasia and pulmonary hypertension: a Bayesian meta-analysis.","authors":"Elke van Westering-Kroon, Tamara M Hundscheid, Karen Van Mechelen, František Bartoš, Steven H Abman, Eduardo Villamor","doi":"10.1038/s41390-025-04145-3","DOIUrl":"https://doi.org/10.1038/s41390-025-04145-3","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD) is generally considered to be more frequent in males than in females. We conducted a Bayesian model-averaged (BMA) meta-analysis of studies addressing sex differences in the risk of developing different severities of BPD and BPD-associated pulmonary hypertension (BPD-PH).</p><p><strong>Methods: </strong>We used BMA to calculate Bayes factors (BFs). The BF₁₀ is the ratio of the probability of the data under the alternative hypothesis (presence of sex differences) over the probability of the data under the null hypothesis (absence of sex differences). BPD was classified as BPD28 (Supplementary oxygen at or during 28 days), BPD36 (moderate-to-severe BPD; oxygen at 36 weeks postmenstrual age), mild, moderate, and severe BPD.</p><p><strong>Results: </strong>We included 222 studies (541,826 infants). The BMA analysis showed evidence in favor of a male disadvantage in BPD28 (BF₁₀ > 10⁵), BPD36 (BF₁₀ > 10²¹), and severe BPD (BF₁₀ = 87.55), but not in mild BPD (BF₁₀ = 0.28), or BPD-PH (BF₁₀ = 0.54). The evidence for a male disadvantage in BPD decreased as the gestational age of the cohort decreased.</p><p><strong>Conclusions: </strong>We confirmed the presence of a male disadvantage in moderate-to-severe BPD, but not in less severe forms of BPD or in BPD-PH. The male disadvantage in BPD is much less apparent in the more immature infants.</p><p><strong>Impact: </strong>This Bayesian meta-analysis confirms that the risk of developing moderate to severe bronchopulmonary dysplasia (BPD) is approximately 20% higher in males than in females. Sex differences in BPD decrease with decreasing gestational age, are heterogeneous across geographic and sociodemographic settings, and have remained persistently stable over time. There is no evidence supporting sex differences in pulmonary hypertension associated with BPD. An important step in the process of individualizing the approach to BPD may be to consider the sex of the infant, as this information can be used to personalize care and potentially improve outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161214","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":"The association analysis between Glucose-6-Phosphate dehydrogenase deficiency and susceptibility to common diseases in children.","authors":"De-Feng Liang, Xue Li, Wen-Lin Guo, Shu-Han Tang, Xiao-Ying Ye, Song Zhang, Li-Ye Yang","doi":"10.1038/s41390-025-04148-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04148-0","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the relationship between G6PD deficiency and susceptibility to common pediatric diseases.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on hospitalized children who underwent G6PD screening at the Guangzhou Women and Children's Medical Center from January 2019 to March 2024.</p><p><strong>Results: </strong>Among 36,619 children, 20,662 were male. The prevalence of G6PD deficiency in males was significantly higher in conditions such as nephritis (OR 2.43,95%CI 1.45-4.21), allergic purpura (OR 2.24, 95%CI 1.24-4.09), patent ductus arteriosus (OR 2.04, 95%CI 1.32-3.33), atrial septal defect (OR 2.14, 95%CI 1.41-3.45), ventricular septal defect (OR 1.73, 95%CI 1.12-2.80), and type 1 diabetes (OR 2.04, 95%CI 1.16-3.66). Among 15,957 female patients, the prevalence of G6PD deficiency was significantly elevated in systemic lupus erythematosus (SLE) (OR 1.87, 95%CI 1.27-2.70), juvenile arthritis (OR 1.79, 95%CI 1.16-2.68), nephritis (OR 1.72, 95%CI 1.16-2.49), patent ductus arteriosus (OR 1.27, 95%CI 1.00-1.61), atrial septal defect (OR 1.33, 95%CI 1.10-1.61), and ventricular septal defect (OR 1.55, 95%CI 1.26-1.91).</p><p><strong>Conclusion: </strong>G6PD deficiency may increase the risk of autoimmune diseases, congenital heart defects, and type 1 diabetes in children. Further studies are required to elucidate its role in pediatric disease susceptibility and inform clinical management.</p><p><strong>Impact: </strong>1. This study found that G6PD deficiency is significantly associated with increased susceptibility to several common pediatric diseases, including autoimmune diseases, congenital heart defects, and type 1 diabetes. Notably, in both male and female patients, G6PD deficiency was significantly linked to specific conditions, such as SLE, juvenile arthritis, and congenital heart disease. 2. Our findings indicate that G6PD deficiency is not merely an enzymatic defect but may also impact the immune and cardiovascular systems. Specifically, an increased incidence of congenital heart disease has been observed in children with G6PD deficiency for the first time.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161215","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":"The association between four neighborhood disadvantage indices and child chronic health classifications.","authors":"Kahir Jawad, Yana B Feygin, Michelle Stevenson, Bethany A Wattles, Jennifer Porter, V Faye Jones, Deborah Winders Davis","doi":"10.1038/s41390-025-04143-5","DOIUrl":"https://doi.org/10.1038/s41390-025-04143-5","url":null,"abstract":"<p><strong>Background: </strong>Neighborhood advantage/disadvantage is a social determinant of health. We aimed to examine the distribution and associations between child chronic health conditions and four commonly used indices.</p><p><strong>Methods: </strong>Children with outpatient visits and valid addresses (n = 115,738) were included and outcomes were categorized as having no chronic disease (N-CD), non-complex chronic disease (NC-CD), and complex chronic disease (C-CD). Four measures of neighborhood characteristics (Child Opportunity Index, Area Deprivation Index, Neighborhood Disadvantage Index, Social Vulnerability Index were calculated from census data. Separate multinomial logistic regression models were used.</p><p><strong>Results: </strong>The indices' scores were correlated (r = 0.80-0.92). Children in low opportunity or high disadvantage/deprivation/vulnerability neighborhoods were more likely to be diagnosed with C-CD than those in high opportunity or low disadvantage/deprivation/vulnerability neighborhoods. The increased odds ranged from 5% to 39%. The adjusted odds of NC-CD were found to increase by 8-31% as the neighborhood opportunity declined or the disadvantage/deprivation/vulnerability increased, across all indices. The association grew stronger as neighborhood opportunity decreased, or disadvantage/deprivation/vulnerability increased for all four indicators.</p><p><strong>Conclusions: </strong>Each instrument was associated with medical complexity classifications, but the magnitude of the associations differed slightly. The rationale for choosing a measure of neighborhood characteristics should be based on the study's aims and population.</p><p><strong>Impact: </strong>This study evaluates the associations of four commonly used neighborhood indices with medical complexity classifications. All indices were associated with study outcomes. The Area Disadvantage Index (ADI) and Child Opportunity Index (COI) demonstrated incremental increases in the odds of receiving a classification of complex chronic disease (C-CD) compared to no chronic disease (N-CD) as neighborhood opportunity decreased or the disadvantage/deprivation/vulnerability increased. Being classified with a non-complex chronic disease (NC-CD) compared to N-CD, only the association with the COI increased incrementally at each level of opportunity. Study outcomes and index characteristics must be considered when designing studies.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161216","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":"Biliary atresia: Rotavirus amplification of lipopolysaccharide/toll-like receptor 4 by mediating MMP7 upregulation through NF-κB.","authors":"Shuiqing Chi, Liying Rong, Mengxin Zhang, Yibo Li, Yun Zhou, Xiangyang Li, Xi Zhang, Zhibin Luo, Shuai Li, Guoqing Cao, Shao-Tao Tang","doi":"10.1038/s41390-025-04128-4","DOIUrl":"https://doi.org/10.1038/s41390-025-04128-4","url":null,"abstract":"<p><strong>Background: </strong>Matrix metalloproteinase-7 (MMP7), which is expressed primarily by biliary epithelial cells (BECs), has been shown to promote biliary atresia (BA). However, the mechanism by which elevated MMP7 expression is induced in BA remains unclear.</p><p><strong>Methods: </strong>Mouse extrahepatic BECs were used to investigate MMP7 overexpression induced by rhesus rotavirus (RRV) and lipopolysaccharide (LPS). The cellular localization of TLR4 and related proteins in the liver specimens from model mice was analyzed by immunohistochemistry. In vivo experiments were performed in BA models with TLR4 inhibition or antibiotic treatment and their corresponding control groups.</p><p><strong>Results: </strong>RRV infection alone is insufficient to induce MMP7 expression in mouse extrahepatic BECs, whereas sequential RRV infection and low-dose LPS treatment could cause robust MMP7 overexpression. RRV disrupted BEC endotoxin tolerance via HMGB1-mediated TLR4 upregulation, which subsequently promoted NF-κB and MMP7 overexpression. BECs from experimental BA model mice presented significantly increased TLR4 expression and NF-κB activation. In vivo, treatment with TLR4 antibodies, inhibitors, or antibiotics reduced MMP7 production, alleviated disease severity, and improved survival rates in BA models.</p><p><strong>Conclusion: </strong>RRV infection disrupts BEC tolerance to low-dose LPS, triggering TLR4/NF-κB-mediated MMP7 overexpression and hepatobiliary inflammation, advancing our understanding of the role of LPS/TLR4 signaling in BA pathogenesis.</p><p><strong>Impact statement: </strong>Rhesus rotavirus infection induces the upregulation of TLR4 expression in BECs, disrupting their tolerance to physiological levels of LPS and resulting in robust activation of the NF-κB pathway and subsequent abundant expression of MMP7. In vivo inhibition of TLR4 or a reduction in LPS levels alleviates symptoms in newborn mice injected with RRV. This study underscores the crucial role of LPS/TLR4 pathway activation in the pathogenesis of biliary atresia, which may be a key potential therapeutic target.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143268","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":"Association of maternal dietary diversity during pregnancy and infant lower respiratory tract infections.","authors":"Qian Liang, Weiming Wang, Jin Liu, Xi Chen, Na Li, Longyu Zhang, Guoping Xiong, Guoqiang Sun, Hongying Yang, Xuefeng Yang, Liping Hao, Nianhong Yang","doi":"10.1038/s41390-025-04125-7","DOIUrl":"https://doi.org/10.1038/s41390-025-04125-7","url":null,"abstract":"<p><strong>Background: </strong>A varied diet during pregnancy benefits development of the fetus, but its impact on the infant respiratory health is less well-known. This study prospectively examines the association between the maternal Minimum Dietary Diversity for Women (MDD-W) score and the risk of lower respiratory tract infections (LRTIs) in infants.</p><p><strong>Methods: </strong>This study included 2588 women in Wuhan, China. Dietary intake was assessed using validated food frequency questionnaires. All food items were categorized into 10 groups based on guidance from the Food and Agriculture Organization to construct the MDD-W score. Infant LRTIs were recorded at 3-, 6-, and 12-months postpartum follow-ups.</p><p><strong>Results: </strong>In the study, 347 (13.4%) infants with LRTIs during the first year. Maternal MDD-W score ≤5 was associated with the higher risk of infant LRTIs (RR: 1.51; 95% CI: 1.11, 2.06) and hospitalization due to LRTIs (RR: 1.93; 95% CI: 1.23, 3.05) compared score ≥9. When the outcome was further subdivided into LRTIs at 0-6 months and 6-12 months of age, this association was only present at 0-6 months of age (RR: 2.02; 95% CI: 1.31, 3.10).</p><p><strong>Conclusions: </strong>Our results suggest that low maternal dietary diversity is associated with a higher risk of infant LRTIs.</p><p><strong>Impact: </strong>Diversified diet during pregnancy benefits the fetus's development, but few studies have demonstrated the effect of dietary diversity during pregnancy on the infant respiratory health. In this longitudinal cohort in China, we found that a varied diet during pregnancy was associated with a lower risk of infant lower respiratory tract infections, the association remained regardless of whether infants breastfed. An intervention to increase maternal dietary diversity should be carefully considered.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143262","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":"Fishing for a solution: exploring the impact of omega 3 supplement use in childhood obesity.","authors":"Matthew Campbell, Phillip Nehls, Jeanie B Tryggestad","doi":"10.1038/s41390-025-04165-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04165-z","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132714","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":"Machine learning for outcome prediction in preterm infants: opportunities and challenges.","authors":"Ashley N Nielsen, Christopher D Smyser","doi":"10.1038/s41390-025-04131-9","DOIUrl":"https://doi.org/10.1038/s41390-025-04131-9","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132722","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":"Efficacy of stochastic vibro-tactile stimulation for newborns at risk of neonatal opioid withdrawal syndrome.","authors":"Rachana Singh, Ludovic Trinquart, Benjamin Koethe, Mario Cordova, Lawrence Rhein, Shawana Bibi, Jamie Fey, Ariana Anderson, Jonathan M Davis","doi":"10.1038/s41390-025-04162-2","DOIUrl":"https://doi.org/10.1038/s41390-025-04162-2","url":null,"abstract":"<p><strong>Background: </strong>Neonatal Opioid Withdrawal Syndrome (NOWS) continues to be a major public health burden. Our objective was to assess the efficacy of a stochastic vibro-tactile stimulation (SVS) mattress in reducing initiation of pharmacotherapy in neonates at risk for NOWS.</p><p><strong>Methods: </strong>A multicenter, prospective, non-blinded, randomized clinical trial of neonates born ≥ 35 weeks gestation. Neonates randomized to either SVS mattress or standard crib mattress The outcomes examined were initiation of pharmacotherapy, readiness for discharge, NOWS monitoring scores, cry quality and mattress acceptability surveys.</p><p><strong>Results: </strong>Of 62 infants enrolled, 4 infants (10.0%) in the SVS group and 4 infants (18.2%) in the standard group were initiated on pharmacotherapy. Infants in SVS group demonstrated early readiness for discharge, with no differences between the two groups for NOWS scoring or cry quality. Overall, 60% of nurses and 80% of parents found the SVS mattress helped calm the neonate.</p><p><strong>Conclusion: </strong>Although the SVS mattress demonstrated a trend towards lower initiation of pharmacotherapy and earlier readiness for discharge, the results were not statistically significant due to fewer neonates being enrolled than expected. The mattress was highly acceptable to parents and nurses.</p><p><strong>Clinical trial: </strong>Registered at ClinicalTrials.gov ID # NCT04834297; https://clinicaltrials.gov/study/NCT04834297 IMPACT: Improving on current non-pharmacologic interventions for the prevention and treatment of Neonatal Opioid Withdrawal Syndrome (NOWS) is critically important. Our study focused on assessing the efficacy of a stochastic vibro-tactile stimulation (SVS) mattress in reducing the use of pharmacotherapy in neonates at risk for NOWS within the first 5 days after birth. In neonates at risk for NOWS, the SVS mattress may reduce the need for pharmacotherapy and improve readiness for discharge while being acceptable to parents and nurses.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132712","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":"Heat exposure impacts the incidence of intussusception in children.","authors":"Koichi Tsuboi, Chhinder P Sodhi","doi":"10.1038/s41390-025-04133-7","DOIUrl":"https://doi.org/10.1038/s41390-025-04133-7","url":null,"abstract":"<p><strong>Impact: </strong>This commentary provides an in-depth analysis of the research paper by Nawa et al. titled \"Association Between Heat Exposure and Intussusception in Children in Japan from 2011 to 2022.¹.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132716","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}