Pediatric Research最新文献

{"title":"Fetal intracerebral hemorrhage: review of the literature and practice considerations.","authors":"Mary Dunbar, Sonika Agarwal, Charu Venkatesan, Brigitte Vollmer, Barbara Scelsa, Andrea C Pardo, Tomo Tarui, Anthony R Hart, Sarah B Mulkey, Monica E Lemmon, Dawn Gano","doi":"10.1038/s41390-025-04000-5","DOIUrl":"10.1038/s41390-025-04000-5","url":null,"abstract":"<p><p>Fetal intracerebral hemorrhage is increasingly recognized on prenatal imaging. In this review, we discuss clinically relevant aspects of fetal intracerebral hemorrhage, including germinal matrix-intraventricular hemorrhage, as well as intraparenchymal hemorrhage. We discuss current clinical practice for prenatal counseling and postnatal management of fetal intracerebral hemorrhage, and offer practical recommendations for clinicians. We propose standardized terminology for classification of fetal intracerebral hemorrhage to be used in future research. We also highlight gaps in the literature and priorities for future research, namely the need for prospective large-scale studies to better understand underlying etiologies and neurodevelopmental outcomes in fetal intracerebral hemorrhage. IMPACT STATEMENT: We discuss the diverse etiologies and outcomes of fetal intracerebral hemorrhage, and propose standardized terminology for classification. We outline current practice and offer practical recommendations for management and counseling of fetal intracerebral hemorrhage, recognizing the need for capacity-building in the newly emerging subspecialty of fetal neurology. We highlight gaps in the literature and research priorities in fetal intracerebral hemorrhage to promote collaborative research, and the development of interventions to improve pregnancy and child outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649953","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 between early-phase opioid use and outcomes in extremely preterm infants: A nationwide study.","authors":"Hiroki Kitaoka, Takaaki Konishi, Yoshihiko Shitara, Atsushi Ito, Kohei Kashima, Yuya Kimura, Hiroki Matsui, Motohiro Kato, Naoto Takahashi, Hideo Yasunaga","doi":"10.1038/s41390-025-03998-y","DOIUrl":"10.1038/s41390-025-03998-y","url":null,"abstract":"<p><strong>Background: </strong>Opioids are often administered for extremely preterm infants to prevent morbidities (e.g., intraventricular hemorrhage); however, their short-term outcome remains unclear. We aimed to assess the association between early-phase opioid use and in-hospital outcomes in extremely preterm infants.</p><p><strong>Methods: </strong>This retrospective nationwide cohort study analyzed data from the Diagnosis Procedure Combination database in Japan. A total of 18,794 extremely preterm infants hospitalized between July 2010 and March 2021 were included. The patients were divided into those who received early-phase opioids (n = 4806) and those who did not (n = 13,988). We performed a 1:2 propensity score-matched analysis adjusting for patient backgrounds.</p><p><strong>Results: </strong>In-hospital mortality, intraventricular hemorrhage, and periventricular leukomalacia occurred in 8.5%, 13%, and 2.1% of the patients, respectively. The incidences of in-hospital mortality (12% vs. 12%) and intraventricular hemorrhage (14% vs. 15%) did not differ between the two groups after 1:2 propensity score matching. The patients who received early-phase opioids had a lower incidence of periventricular leukomalacia than those who did not (1.7% vs. 2.2%). However, bronchopulmonary dysplasia occurrence (65% vs. 58%), home assistive technology use (19% vs. 15%), and length of hospital stay (125 vs. 122 days) were increased for patients who received early-phase opioids.</p><p><strong>Conclusion: </strong>In this large retrospective study, early-phase opioid use in extremely preterm infants was not associated with increased mortality or intraventricular hemorrhage. Periventricular leukomalacia slightly decreased.</p><p><strong>Impact: </strong>This large retrospective nationwide study of 13,988 extremely preterm infants revealed that using early-phase opioids was not significantly associated with in-hospital mortality or intraventricular hemorrhage but was significantly associated with a decrease in periventricular leukomalacia. Early-phase opioids may not increase mortality or intraventricular hemorrhage, in contrast to the results of previous studies. Thus, these results could help clinicians select opioids as sedative agents for extremely preterm infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649922","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":"Can we really predict the respiratory morbidity of preterm birth?","authors":"Avinash Kondiboyina, Samuel B Axford, David G Tingay","doi":"10.1038/s41390-025-04012-1","DOIUrl":"https://doi.org/10.1038/s41390-025-04012-1","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658120","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":"Are we ready for volume targeting during high-frequency oscillatory ventilation in neonates?","authors":"David G Tingay, Sophia I Dahm, Arun Sett","doi":"10.1038/s41390-025-04015-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04015-y","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649920","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":"Ethanol metabolites increase over time in preterm infants receiving ethanol containing medications: a concern.","authors":"Arushi Mahajan, Juliann M DiFiore, Nageswara Pilli, Cansu Tokat, Maureen A Kane, Cynthia F Bearer","doi":"10.1038/s41390-025-03993-3","DOIUrl":"https://doi.org/10.1038/s41390-025-03993-3","url":null,"abstract":"<p><strong>Impact: </strong>That extremely premature infants may be exposed to ethanol to a greater degree than expected.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649923","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":"Unraveling the promise and challenges of biomarkers in pediatric sepsis: a commentary on risk estimation of organ dysfunction and immune dysregulation.","authors":"Kenneth E Remy, Niranjan Kissoon","doi":"10.1038/s41390-025-03983-5","DOIUrl":"https://doi.org/10.1038/s41390-025-03983-5","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649956","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":"Invited Commentary: \"Is physical fitness associated with leukocyte telomere length in youth with type 1 diabetes?\"","authors":"George Paltoglou","doi":"10.1038/s41390-025-03988-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03988-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649954","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":"Evaluating 3D-printed models for congenital heart disease: impact on parental anxiety and procedural understanding.","authors":"Linda Grefen, Felix Rudolf, Christopher Herz, Nikolaus A Haas, André Jakob, Christian Hagl, Paul Philipp Heinisch, Jürgen Hörer, Nikolaus Thierfelder, Maximilian Grab","doi":"10.1038/s41390-025-03999-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03999-x","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of the impact of 3D-printed models on parental education and anxiety in parents of children with congenital heart disease (CHD) who are undergoing interventions or surgeries.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was conducted at LMU University Hospital and the German Heart Center Munich. Parents (n = 57) of pediatric CHD patients were randomized into two groups: a control group using standardized paper-based methods and an intervention group using additional 3D-printed models. Parental anxiety was assessed using the Visual Analog Scale (VAS) and the State-Trait Anxiety Inventory, while procedural understanding and satisfaction with the education were evaluated using custom-developed questionnaires.</p><p><strong>Results: </strong>Both educational methods significantly increased procedural understanding (control 77.5% to 92.3%; 3D model: 77% to 89.4%, p < 0.0001, respectively). Significant reduction of anxiety was observed in both groups, (VAS reduction control: -0.9, p = 0.0342; 3D model: -1.1, p = 0.0116). Parents with medical background or those informed by pediatricians had lower anxiety whereas those seeking information online exhibited higher anxiety levels.</p><p><strong>Conclusion: </strong>Both educational methods significantly reduced parental anxiety and improved procedural understanding. 3D-printed models were well-received and will be integrated into routine practice to enhance education on CHD procedures and optimize physician-parent communication.</p><p><strong>Impact statement: </strong>Using additional 3D-printed models of congenital heart defects significantly reduces parental anxiety and increases procedural understanding of complex interventions or surgeries. Physicians are in desperate need of new visualization methods for an efficient patient education. This study underscores the need for tailored educational and psychological support for parents based on their previous experiences.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649952","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":"Predicting optimal endotracheal tube depth in children based on height and middle finger length.","authors":"Yang Zhang, Jiarong Wang, Hao Cheng, Wenjun Guo","doi":"10.1038/s41390-025-03987-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03987-1","url":null,"abstract":"<p><strong>Background: </strong>Current calculation formulas cannot accurately predict intubation depth in children due to variations in growth and development patterns and unique anatomical characteristics of the pediatric airway. This study aims to develop a method for determining the appropriate ETT insertion depth in pediatric patients.</p><p><strong>Methods: </strong>This study included 205 patients aged 4-12 years who underwent elective surgery under general anesthesia with tracheal intubation. The general condition of the enrolled children was recorded, and growth parameters were measured preoperatively. Multivariate linear regression analysis was employed to develop a new formula for predicting intubation depth.</p><p><strong>Results: </strong>The novel multivariate-based formula was derived using height and middle finger length [D (cm) = 0.06 × height (cm) + 0.89 × middle finger length (cm) + 3.4] as reference variables. Bland-Altman analysis demonstrated mean differences between the optimal depth and ETT depth was -0.05 cm (95% LOA, -1.38 to 1.28 cm) for the new formula and 1.24 cm (95% LOA, -0.74 to 3.23 cm) for the traditional formula, respectively. This study demonstrated significant individual variations in tracheal intubation depth in pediatric patients.</p><p><strong>Conclusion: </strong>The height- and middle finger length-referenced formulas predicted the depth of intubation more accurate than the traditional age-based formula in pediatric patients.</p><p><strong>Impact: </strong>The prediction formula is effective in reducing the misalignment rate in children undergoing tracheal intubation under general anesthesia. The new formula, which incorporates both height and middle finger length, was found to predict the optimal endotracheal intubation depth with greater accuracy than the traditional formula. This provides an accurate and easy way for clinicians to calculate the depth of intubation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649955","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 di(2-ethylhexyl) phthalate exposure increases the risk of congenital heart disease in mice offspring.","authors":"Haiqun Shi, Zehua Zhang, Anna Shen, Tong Ding, Rui Zhao, Yan Shi, Jianyuan Zhao, Ke Cai, Feng Wang","doi":"10.1038/s41390-025-03997-z","DOIUrl":"10.1038/s41390-025-03997-z","url":null,"abstract":"<p><strong>Abstrct: </strong>BACKGROUD: Epidemiological data suggest that maternal occupational exposure to mixed phthalates comprising di(2-ethylhexyl) phthalate (DEHP) increases the risk of congenital heart disease (CHD). In this study, we used mice as an animal model to validate impact of first-trimester DEHP exposure on the risk of CHD in offspring, to elucidate the possible mechanisms and to provide a potential feasible intervention.</p><p><strong>Methods and results: </strong>Eight-week-old C57BL/6J pregnant mice were randomly divided into standard and DEHP diet groups. The incidence of CHD in DEHP diet group offspring was up to 14.41% observed via Hematoxylin-eosin (HE) staining. Quantitative PCR analysis revealed that expression of key genes involved in cardiogenesis were suppressed at the transcriptional level, which may be due to decreased nuclear translocation of p65. The inhibition of DEHP on key genes was rescued to some extent by choline through driving p65 into nuclear. In the mice, supplementation of choline during DEHP exposure reduced the incidence of CHD in offspring from 14.41% to 4.63%.</p><p><strong>Conclusions: </strong>Our study demonstrates that mice first-trimester DEHP exposure significantly increases the risk of CHD in the offspring via inhibiting mRNA levels of key genes in cardiogenesis, and choline could protect against the pathogenesis.</p><p><strong>Impact: </strong>Our study provides key mechanistic insights into the risk of CHD by DEHP exposure during early pregnancy, and provides choline as a potentially effective intervention. DEHP suppressed the expression of key genes involved in embryonic cardiac septum development at the transcriptional level via inhibiting nuclear translocation of p65. Choline can play a role in rescuing the inhibition of DEHP on cardiogenesis genes via driving p65 translocate into the nuclear.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634337","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}