Pediatric Research最新文献

{"title":"Evaluating bilicocoon phototherapy for neonatal hyperbilirubinemia.","authors":"Xin Li, Feifei Hu","doi":"10.1038/s41390-025-04457-4","DOIUrl":"https://doi.org/10.1038/s41390-025-04457-4","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258843","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":"Commentary on 'Early diagnosis of serious bacterial infection in febrile infants using type I interferon signature' by Fueri, Bellini and group.","authors":"Scott H Stansfield, Simon S Craig, Marcel F Nold","doi":"10.1038/s41390-025-04474-3","DOIUrl":"https://doi.org/10.1038/s41390-025-04474-3","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258875","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 neonatal SOFA score in very preterm neonates with early-onset sepsis.","authors":"Megan Tagerman, Rakesh Sahni, Richard Polin","doi":"10.1038/s41390-025-04068-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04068-z","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is associated with increased neonatal morbidity and mortality. The Neonatal Sequential Organ Failure Assessment (nSOFA) score was developed as a tool to assess neonates with late-onset sepsis (LOS). Absolute values and changes in nSOFA scores are associated with mortality in LOS. Few studies have investigated the nSOFA score in neonatal early-onset sepsis (EOS). This study assesses the relationship of the nSOFA score with morbidity in preterm neonates with EOS.</p><p><strong>Methods: </strong>Retrospective, single-center, cohort study. nSOFA scores were determined for very preterm neonates at seven time points within the first 36 hours of life. Peak and median nSOFA scores were compared between (i) survivors with versus without major morbidity (ii) survivors without major morbidity versus the combined outcome of mortality or major morbidity and (iii) survivors versus non-survivors.</p><p><strong>Results: </strong>Peak and median nSOFA scores were significantly higher in survivors with versus without major morbidity. That was also true for the combined outcome of mortality or major morbidity. Peak and median nSOFA scores trended higher in non-survivors versus survivors.</p><p><strong>Conclusions: </strong>The nSOFA score discriminates between very preterm neonates likely (versus unlikely) to develop major morbidity. The nSOFA score may have applicability as an assessment tool in neonatal EOS.</p><p><strong>Impact: </strong>The neonatal Sequential Organ Failure Assessment (nSOFA) score provides an operationalized assessment of organ dysfunction in late-onset neonatal sepsis. This study demonstrates the nSOFA score's utility in early-onset sepsis (EOS). This study provides data to support the nSOFA score's utility in discriminating major morbidity and mortality in neonates < 32 weeks gestational age with EOS. A higher nSOFA score was associated with increased morbidity in neonates < 32 weeks gestational age with EOS. A validated nSOFA score for EOS has the potential to improve prognostication and provide a basis for risk-stratifying neonates with EOS.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258818","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":"Maternal bioactive lipids during pregnancy and early childhood neurodevelopment and behavior.","authors":"Seonyoung Park, Megan L Woodbury, Sung Kyun Park, Bhramar Mukherjee, Wei Hao, Lixia Zeng, Subramaniam Pennathur, Gredia Huerta Montañez, Zaira Rosario-Pabón, Carmen M Vélez-Vega, José F Cordero, Akram Alshawabkeh, Deborah J Watkins, John D Meeker","doi":"10.1038/s41390-025-04465-4","DOIUrl":"https://doi.org/10.1038/s41390-025-04465-4","url":null,"abstract":"<p><strong>Background: </strong>Maternal immune activation, including inflammation and oxidative stress during pregnancy, has been linked to child neurodevelopmental problems (NDP) and emotional and behavioral problems (EBP). Polyunsaturated fatty acids (PUFAs) and their oxidized metabolites (oxylipins) are important bioactive lipids that modulate immune responses, inflammation, and oxidative stress. However, their roles in child NDP and EBP remain unclear.</p><p><strong>Methods: </strong>This study included 259 mother-child pairs from the PROTECT birth cohort in Puerto Rico. Maternal plasma samples collected around 26 weeks' gestation were analyzed for bioactive lipid levels using high-performance liquid chromatography-tandem mass spectrometry. Child NDP and EBP were assessed at ages 1-3 using the Battelle Developmental Index, 2nd edition (BDI-2) and the Child Behavioral Checklist for ages 1.5-5 (CBCL/1.5-5). We evaluated associations between maternal bioactive lipid levels and child NDP or EBP outcomes and conducted sex-stratified analyses to examine effect modification by child sex. As a sensitivity analysis, we restricted analyses to term births to evaluate the associations independent of potential effects of preterm birth.</p><p><strong>Results: </strong>Altered maternal bioactive lipid concentrations were associated with poorer neurodevelopmental and emotional/behavioral outcomes in children aged 1-3 years. The associations were modified by child sex and preterm birth status.</p><p><strong>Conclusion: </strong>These findings underscore the need for further research into bioactive-lipid-related maternal mechanisms that may influence early childhood neurodevelopment and behavior.</p><p><strong>Impact: </strong>Previous studies suggest potential roles of maternal PUFAs and oxylipins during pregnancy on child NDP and EBP, as these bioactive lipids play crucial roles in immune response, inflammation, and oxidative stress. In this cohort study, we found several associations between maternal bioactive lipid levels during pregnancy and child neurodevelopment and behavior from 1 to 3 years of age. The associations were attenuated after excluding preterm children, suggesting a potential mediating role of preterm birth. Additionally, distinct patterns emerged based on both the inflammatory properties of the bioactive lipids and child sex.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252306","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":"Prenatal vitamin D status and long-term neurocognitive outcomes: building on an emerging evidence base.","authors":"Carol L Wagner, Bruce W Hollis","doi":"10.1038/s41390-025-04476-1","DOIUrl":"https://doi.org/10.1038/s41390-025-04476-1","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252308","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":"Diagnostic performance of point-of-care bilirubin testing with Bilistick 2.0 device at a South Indian clinical site.","authors":"Mangalabharathi Sundaram, Arunkumar Muthusamy, Anitha Balachandran, Muthukumaran Natarajan","doi":"10.1038/s41390-025-04431-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04431-0","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hyperbilirubinemia is common in India, yet many public hospitals lack access to reliable and timely bilirubin testing. We evaluated the diagnostic performance of a point-of-care (POC) bilirubin device, Bilistick 2.0, in a high-volume neonatal setting.</p><p><strong>Methods: </strong>We conducted a prospective diagnostic accuracy study at Madras Medical College, Chennai. Neonates ≥28 weeks and ≤10 days old with jaundice or at high risk were enrolled. Paired TSB samples (Bilistick and reference lab) were collected from 153 neonates. Bland-Altman analysis, correlation, and subgroup comparisons were performed.</p><p><strong>Results: </strong>Of 153 paired samples, 137 non-hemolyzed pairs were analyzed. Mean TSB was 14.39 ± 4.03 mg/dL (Bilistick) vs. 14.27 ± 3.73 mg/dL (reference). Mean absolute difference was 1.35 mg/dL; 79% of values were within ±2 mg/dL. Mean bias was +0.13 mg/dL. Correlation was r = 0.88 overall, and r = 0.96 for TSB > 20 mg/dL. Test failure rate was 10.5%, mostly during the initial learning phase.</p><p><strong>Conclusion: </strong>Bilistick 2.0 showed strong diagnostic agreement with reference laboratory bilirubin testing. With training and basic laboratory coordination, it may support safe, rapid bilirubin management in resource-limited neonatal care.</p><p><strong>Impact: </strong>The Bilistick 2.0 point-of-care device showed strong diagnostic agreement with reference laboratory bilirubin testing. Performance remained reliable in neonates with clinically significant bilirubin levels, especially >20 mg/dL. Turnaround time was under 15 min, and user-related test failures decreased after brief training. The device has potential for decentralized bilirubin monitoring in public-sector neonatal care in India.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252318","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":"Heatstroke, dehydration, and missed voices: the hidden pediatric crisis in children with cerebral palsy amid Pakistan's climate emergency.","authors":"Muhammad Umar, Rayyan Nabi, Aftab Ahmed Dero, Muhammad Talha, Syed Moinnuddin, Yassar Sattar","doi":"10.1038/s41390-025-04433-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04433-y","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252315","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":"Neonatal resuscitation for bradycardia (HR < 60 bpm)-an alternate approach using an ovine model.","authors":"Mausma Bawa, Sylvia Gugino, Justin Helman, Nicole Bradley, Lori Nielsen, Arun Prasath, Clariss Blanco, Munmun Rawat, Praveen Chandrasekharan","doi":"10.1038/s41390-025-04444-9","DOIUrl":"https://doi.org/10.1038/s41390-025-04444-9","url":null,"abstract":"<p><strong>Background: </strong>The International Liaison Committee on Resuscitation recommends initiating chest compressions (CC) in newborns when heart rate (HR) is <60 beats per minute (bpm) after 30 s of effective positive pressure ventilation (PPV).</p><p><strong>Methods: </strong>Near-term lambs with asphyxia induced bradycardia (HR < 60 bpm) were randomized to: (i) control (n = 6)- Resuscitation per current Neonatal Resuscitation Program (NRP) (ii) study (n = 6)-PPV continued until HR = 0, only then CC with PPV were administered in a ratio of 3:1 until return of spontaneous circulation (ROSC). Outcomes included timing, incidence of ROSC, CC requirement, blood gases, and peak coronary, carotid, and pulmonary blood flow.</p><p><strong>Results: </strong>The time to achieve ROSC was not different between groups (3 ± 2 min vs. 1.6 ± 1 min in study (p = 0.17). Only 1/6 lambs in study group required CC versus 6/6 in control group (p = 0.015). At ROSC, the study group had significantly lower arterial PaCO2 (47 ± 5 mmHg vs. 94 ± 18 mmHg, p < 0.01) and higher arterial PaO₂ (148 ± 53 mmHg vs. 54 ± 12 mmHg, p < 0.01). The asynchronous external CC in the control group contributed to the loss of inherent cardiac activity.</p><p><strong>Conclusion: </strong>Prioritizing ventilation during bradycardia reduced need for CC, facilitated faster ROSC, and improved gas exchange in an ovine model.</p><p><strong>Impact: </strong>Prioritizing ventilation over chest compressions beyond 30 s for bradycardia during neonatal resuscitation improves outcomes, reducing the need for chest compressions and accelerating the time to return of spontaneous circulation. Pulseless electrical activity occurs before complete cardiac arrest. Focusing on initiating chest compressions at a specific heart rate will distract providers from prioritizing ventilation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244760","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":"Stop using \"former\": preterm birth and cardiometabolic risk to future health.","authors":"Michelle M Kelly","doi":"10.1038/s41390-025-04472-5","DOIUrl":"https://doi.org/10.1038/s41390-025-04472-5","url":null,"abstract":"<p><strong>Impact: </strong>Preterm birth conveys risk to future health across the life course particularly for non-communicable conditions associated with cardiometabolic risk. The intersection of social, economic, environmental, and biobehavioral risk and preterm birth complicate the timing and expression of cardiometabolic risk. A multifaceted approach to combating risk includes providing anticipatory guidance and support to families with children born preterm that mitigate risk and promote health.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244793","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":"Flat lines in survival from out-of-hospital pediatric cardiac arrest: making the case for bold reform in prehospital care and resuscitation.","authors":"Kendall J Donohue, Andrew M Fine","doi":"10.1038/s41390-025-04477-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04477-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239365","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}