Pediatric Research最新文献

{"title":"Association between endogenous sex hormones and adiposity in youth across a weight status spectrum","authors":"Subin Jang, Justin R. Ryder, Aaron S. Kelly, Eric M. Bomberg","doi":"10.1038/s41390-024-03578-6","DOIUrl":"https://doi.org/10.1038/s41390-024-03578-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>While endogenous sex hormones (e.g., testosterone, estradiol) are important factors regulating adipose tissue distribution, studies evaluating such relationships in youth across a wide weight status spectrum are limited.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We performed a cross-sectional analysis of 8–21-year-old youth. Multiple linear regression models were used to evaluate associations between sex hormones and adiposity measures (android/gynoid ratio (A/G), total fat mass (FM), visceral adipose tissue (VAT), waist circumference (WC)) and total lean mass (LM), adjusting for pubertal stage and race/ethnicity, and stratified by sex and weight status.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 342 youth, the mean age was 13.0 ± 2.8 years old (52.6% female; 38.9% normal weight [NW]; 27.8% overweight/obesity [OW/OB]; 33.3% severe obesity [SO]). Testosterone was positively associated with LM among males with NW (1462 g, 95% CI: 255–2668 g) and OW/OB (3792 g, 95% CI: 1244–6340 g), with A/G and WC among males with NW (0.01, 95% CI: 0–0.2 and 10 mm, 95% CI: 4–16 mm, respectively), and negatively associated with WC among males with SO (−43 mm, −81 to −5 mm). Estradiol was positively associated with A/G, FM, and WC among males with SO, and VAT in females with NW.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our findings showed that sex hormones were associated with adipose tissue deposition in youth across the weight spectrum.</p><h3 data-test=\"abstract-sub-heading\">Impact statement</h3><ul>\u0000<li>\u0000<p>Sex hormones (e.g., testosterone, estradiol) are associated with various adiposity measures among male and female children and adolescents across a weight status spectrum.</p>\u0000</li>\u0000<li>\u0000<p>We evaluated associations between sex hormones and various adiposity measures among 8–21-year-olds across a weight status spectrum (normal weight, overweight/class 1 obesity, class 2–3 obesity). We found that estradiol was positively associated with total fat mass, android/gynoid ratio, and waist circumference in males with class 2–3 obesity, and testosterone was positively associated with lean mass in males with normal weight and overweight/class 1 obesity.</p>\u0000</li>\u0000<li>\u0000<p>Sex hormones may influence, or may be influenced by, adiposity in youth.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252230","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":"Global trends in type 1 diabetes in adolescents and young adults (1990-2019).","authors":"Jessy Louisa Silfer,Ksenia N Tonyushkina","doi":"10.1038/s41390-024-03554-0","DOIUrl":"https://doi.org/10.1038/s41390-024-03554-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268613","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 epigenetics and childhood outcomes: a scoping review","authors":"Srirupa Hari Gopal, Theresa Alenghat, Mohan Pammi","doi":"10.1038/s41390-024-03585-7","DOIUrl":"https://doi.org/10.1038/s41390-024-03585-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Abstract</h3><p>Epigenetics is the study of changes in gene expression, without a change in the DNA sequence that are potentially heritable. Epigenetic mechanisms such as DNA methylation, histone modifications, and small non-coding RNA (sncRNA) changes have been studied in various childhood disorders. Causal links to maternal health and toxin exposures can introduce epigenetic modifications to the fetal DNA, which can be detected in the cord blood. Cord blood epigenetic modifications provide evidence of in-utero stressors and immediate postnatal changes, which can impact both short and long-term outcomes in children. The mechanisms of these epigenetic changes can be leveraged for prevention, early detection, and intervention, and to discover novel therapeutic modalities in childhood diseases. We report a scoping review of early life epigenetics, the influence of maternal health, maternal toxin, and drug exposures on the fetus, and its impact on perinatal, neonatal, and childhood outcomes.</p><h3 data-test=\"abstract-sub-heading\">Impact statement:</h3><ul>\u0000<li>\u0000<p>Epigenetic changes such as DNA methylation, histone modification, and non-coding RNA have been implicated in the pathophysiology of various disease processes.</p>\u0000</li>\u0000<li>\u0000<p>The fundamental changes to an offspring’s epigenome can begin in utero, impacting the immediate postnatal period, childhood, adolescence, and adulthood.</p>\u0000</li>\u0000<li>\u0000<p>This scoping review summarizes current literature on the impact of early life epigenetics, especially DNA methylation on childhood health outcomes</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252272","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":"Mild HIE and therapeutic hypothermia: gaps in knowledge with under-powered trials.","authors":"Lina F Chalak, Donna M Ferriero, Alistair J Gunn, Nicola J Robertson, Geraldine B Boylan, Eleanor J Molloy, Marianne Thoresen, Terrie E Inder","doi":"10.1038/s41390-024-03537-1","DOIUrl":"https://doi.org/10.1038/s41390-024-03537-1","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292950","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":"ECI biocommentary: Catherine Buck","authors":"Catherine O. Buck","doi":"10.1038/s41390-024-03591-9","DOIUrl":"https://doi.org/10.1038/s41390-024-03591-9","url":null,"abstract":"<p>I caught the research bug in high school, where one of my fantastic teachers developed a biotechnology course and was gifted an automated DNA sequencer (the first high school in the country to have such technology!) for use in class research projects. I remember taking a fieldtrip to MIT at the height of the National Human Genome Project to tour one of the labs. While in college I continued to explore the basic sciences but was ultimately drawn to clinical and translational research during medical school and beyond.</p><p>As a neonatologist, I am in awe of the developmental progress our sickest infants must make during their time in the NICU. I began to study how early life exposures, such as environmental chemicals, impact growth and development during my fellowship training under the mentorship of Dr. Joseph Braun at the School of Public Health at Brown. This early work inspired additional translational studies of how alterations in energy metabolism hormones may predict growth and adiposity development over time. My research program is now focused on understanding how early perinatal and newborn exposures, such as diabetes or obesity in pregnancy, influence growth and development in preterm infants. This includes adiposity development, which was the aim of our study in this issue of <i>Pediatric Research</i> in which my co-author, Dr. Kristin Santoro, and I have explored the use of point of care ultrasound to examine regional adiposity in a multicenter cohort of very preterm infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252276","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":"Antibiotic exposure for culture-negative early-onset sepsis in late-preterm and term newborns: an international study","authors":"Varvara Dimopoulou, Claus Klingenberg, Lars Navér, Viveka Nordberg, Alberto Berardi, Salhab el Helou, Gerhard Fusch, Joseph M. Bliss, Dirk Lehnick, Nicholas Guerina, Joanna Seliga-Siwecka, Pierre Maton, Donatienne Lagae, Judit Mari, Jan Janota, Philipp K. A. Agyeman, Riccardo Pfister, Giuseppe Latorre, Gianfranco Maffei, Nicola Laforgia, Enikő Mózes, Ketil Størdal, Tobias Strunk, Martin Stocker, Eric Giannoni","doi":"10.1038/s41390-024-03532-6","DOIUrl":"https://doi.org/10.1038/s41390-024-03532-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Early-life antibiotic exposure is disproportionately high compared to the burden of culture-proven early-onset sepsis (CP-EOS). We assessed the contribution of culture-negative cases to the overall antibiotic exposure in the first postnatal week.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a retrospective analysis across eleven countries in Europe, North America, and Australia. All late-preterm and term infants born between 2014 and 2018 who received intravenous antibiotics during the first postnatal week were classified as culture-negative cases treated for ≥5 days (CN ≥ 5d), culture-negative cases treated for &lt;5 days (CN &lt; 5d), or CP-EOS cases.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Out of 757,979 infants, 21,703 (2.9%) received intravenous antibiotics. The number of infants classified as CN ≥ 5d, CN &lt; 5d, and CP-EOS was 7996 (37%), 13,330 (61%), and 375 (1.7%). The incidence of CN ≥ 5d, CN &lt; 5d, and CP-EOS was 10.6 (95% CI 10.3–10.8), 17.6 (95% CI 17.3–17.9), and 0.49 (95% CI 0.44–0.54) cases per 1000 livebirths. The median (IQR) number of antibiotic days administered for CN ≥ 5d, CN &lt; 5d, and CP-EOS was 77 (77–78), 53 (52–53), and 5 (5-5) per 1000 livebirths.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>CN ≥ 5d substantially contributed to the overall antibiotic exposure, and was 21-fold more frequent than CP-EOS. Antimicrobial stewardship programs should focus on shortening antibiotic treatment for culture-negative cases.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>In a study of 757,979 infants born in high-income countries, we report a presumed culture-negative early-onset sepsis incidence of 10.6/1000 livebirths with an associated antibiotic exposure of 77 antibiotic days per 1000 livebirths.</p>\u0000</li>\u0000<li>\u0000<p>This study sheds light on the major contribution of presumed culture-negative early-onset sepsis to early-life antibiotic exposure.</p>\u0000</li>\u0000<li>\u0000<p>Given the diagnostic uncertainty surrounding culture-negative early-onset sepsis, the low mortality rate, and the disproportionate antibiotic exposure associated with this condition, our study emphasizes the importance of targeting culture-negative early-onset sepsis in antimicrobial stewardship programs.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252305","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":"Elevated cerebral perfusion in neonatal encephalopathy is associated with neurodevelopmental impairments","authors":"Ruth O’Gorman Tuura, Raimund Kottke, Barbara Brotschi, Carola Sabandal, Cornelia Hagmann, Beatrice Latal","doi":"10.1038/s41390-024-03553-1","DOIUrl":"https://doi.org/10.1038/s41390-024-03553-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Neonatal encephalopathy (NE) represents a primary cause of neonatal death and neurodevelopmental impairments. In newborns with NE, cerebral hyperperfusion is related to an increased risk of severe adverse outcomes, but less is known about the link between perfusion and mild to moderate developmental impairments or developmental delay.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Using arterial spin labelling perfusion MRI, we investigated the link between perfusion in 36 newborns with NE and developmental outcome at 2 years.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>53% of the infants demonstrated a normal outcome at 24 months, while two had cerebral palsy with impairments in cognitive, motor, and language domains, and three infants died. The remaining infants showed mild or moderate delays in development in one or two domains. Hyperperfusion across the whole brain was associated with more adverse outcome, including an increased risk of death or severe disability such as cerebral palsy. Among the surviving infants, higher perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum during the neonatal period was related to a poorer cognitive outcome at 2 years.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Hyperperfusion in infants with NE was associated with a more adverse outcome and lower cognitive outcome scores. In addition to severe adverse outcomes, altered perfusion is also related to mild to moderate impairment following HIE.</p><h3 data-test=\"abstract-sub-heading\">Impact statement</h3><ul>\u0000<li>\u0000<p>Neonates with neonatal encephalopathy (NE) show increased cerebral perfusion globally, which is linked to a more adverse outcome.</p>\u0000</li>\u0000<li>\u0000<p>Higher perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum during the neonatal period was related to a poorer cognitive outcome at 2 years.</p>\u0000</li>\u0000<li>\u0000<p>In addition to severe adverse outcomes altered perfusion is related to mild to moderate impairment following NE.</p>\u0000</li>\u0000<li>\u0000<p>To improve neurodevelopmental outcomes, it is important to improve our understanding of the factors influencing cerebral perfusion in infants with NE.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252277","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":"Body composition assessment of preterm infants: is it time to switch from research to bedside?","authors":"Carlo Agostoni, Maria L. Giannì","doi":"10.1038/s41390-024-03567-9","DOIUrl":"https://doi.org/10.1038/s41390-024-03567-9","url":null,"abstract":"<p>Postnatal growth is closely linked to health outcomes through the so-called <i>developmental programming</i>.¹ Longitudinal assessment of growth is critical to monitor the nutritional status and derive personalized dietary interventions in preterm and low birth weight infants. A comprehensive approach, however, should include not only the standard measurements of anthropometrics but also the assessment of changes in body composition that contribute to the modulation of long-term outcomes.² In light of this evidence, efforts have been made to implement growth and body composition assessments, aimed at tracking the quantity and quality of longitudinal growth patterns in premature infants.³</p><p>Growth is primarily supported by the supply of protein and energy (represented by fats and glucose), in adjusted amounts and ratio, through complex pathways that reflect adaptive changes during the deposition of fat tissue, muscle tissue, and other components. Fat mass deposition, physiologically increasing through the third trimester of pregnancy, peaks at 4th-6th months after birth in breastfed infants. After this period, the rate of fat mass accumulation slows down compared to lean mass, leading to a decrease in the percentage of fat mass.⁴ The trend in formula-fed infants is reversed, with an early higher deposition of fat free mass, possibly due to a greater protein intake in front of a higher resting energy expenditure, followed by a higher deposition of fats after the 6^th month of life.⁵ The pattern of fat deposition in healthy-term infants represents the reference curve.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252278","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":"Resuscitation arterial waveform quantification and outcomes in pediatric bidirectional Glenn and Fontan patients","authors":"Andrew R. Yates, David A. Hehir, Ron W. Reeder, John T. Berger, Richard Fernandez, Aisha H. Frazier, Kathryn Graham, Patrick S. McQuillen, Ryan W. Morgan, Vinay M. Nadkarni, Maryam Y. Naim, Chella A. Palmer, Heather A. Wolfe, Robert A. Berg, Robert M. Sutton","doi":"10.1038/s41390-024-03564-y","DOIUrl":"https://doi.org/10.1038/s41390-024-03564-y","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Background&lt;/h3&gt;&lt;p&gt;Resuscitation with chest compressions and positive pressure ventilation in Bidirectional Glenn (BDG) or Fontan physiology may compromise passive venous return and accentuate neurologic injury. We hypothesized that arterial pressure and survival would be better in BDG than Fontan patients.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Methods&lt;/h3&gt;&lt;p&gt;Secondary analyses of the Pediatric Intensive Care Quality of CPR and Improving Outcomes from Pediatric Cardiac Arrest databases. &lt;i&gt;P&lt;/i&gt;-values were considered significant if &lt; 0.05.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;In total, 64 patients had either BDG (42/64, 66%) or Fontan (22/64, 34%) anatomy. Return of spontaneous circulation was achieved in 76% of BDG patients versus 59% of Fontan patients and survival with favorable neurologic outcome in 22/42 (52%) BDG versus 6/22 (27%) Fontan patients, &lt;i&gt;p&lt;/i&gt; = 0.067. Twelve of 24 (50%) BDG and 2/7 (29%) Fontan patients who survived to discharge suffered new morbidity as defined by worsening Functional Status Score. More BDG patients achieved adequate DBP (≥25 mmHg for neonates and infants; ≥ 30 mmHg for children) than Fontan patients (21/23 (91%) vs. 5/11 (46%), &lt;i&gt;p&lt;/i&gt; = 0.007).&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Only 27% of Fontan patients survived to hospital discharge with favorable neurologic outcome after CPR, likely driven by inadequate diastolic blood pressure during resuscitation. One half of the BDG patients who survived to hospital discharge had new neurologic morbidity.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Background&lt;/h3&gt;&lt;p&gt;Cardiac arrest in patients with congenital heart disease (CHD) may present challenges to resuscitation based on the unique cardiovascular physiology resulting from surgical palliation. Recent resuscitation guidelines for CHD patients highlight the lack of data surrounding these special patient populations.&lt;sup&gt;1&lt;/sup&gt; Univentricular heart disease is palliated by a series of cardiac surgeries that stepwise result in passive pulmonary perfusion from the systemic venous system directly to the pulmonary vascular bed. The bidirectional Glenn (BDG) palliation directly anastomoses the superior vena cava (SVC) to the pulmonary arterial system and leaves normal inferior vena cava (IVC) venous return to the heart.&lt;sup&gt;2&lt;/sup&gt; The Fontan palliation baffles IVC flow directly to the pulmonary vascular bed which relieves cyanosis due to right to left shunting, but requires systemic ventricular preload to be directly dependent upon pulmonary vascular resistance and intrathoracic pressures.&lt;sup&gt;3&lt;/sup&gt;&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Impact statement&lt;/h3&gt;&lt;ul&gt;\u0000&lt;li&gt;\u0000&lt;p&gt;Hemodynamic waveforms from 2 large prospective observational studies now allow for exploration of physiology during cardiopulmonary resuscitation for unique anatomy associated with single ventricle congenital heart disease.&lt;/p&gt;\u0000&lt;/li&gt;\u0000&lt;li&gt;\u0000&lt;p&gt;Fewer patients with Fontan p","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252279","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":"Development and child health in a world of synthetic chemicals","authors":"Jessica L. Wager, Jennifer A. Thompson","doi":"10.1038/s41390-024-03547-z","DOIUrl":"https://doi.org/10.1038/s41390-024-03547-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Abstract</h3><p>Chemical pollution is one of today’s most significant threats to the developmental potential of children worldwide. Maternal exposure to toxicants can perturb sensitive windows of fetal development, indirectly through promoting antenatal disorders, abnormal placental adaptation, or directly through maternal-fetal transport. Current evidence clearly shows that persistent organic chemicals promote hypertensive disorders of pregnancy, placental abnormalities, and fetal growth restriction, whereas findings are less consistent for phthalates and bisphenols. Prospective birth cohorts strongly support a link between adverse neurodevelopmental outcomes and prenatal exposure to flame retardants and organophosphate pesticides. Emerging evidence reveals a potential association between in utero exposure to bisphenols and childhood behavioral disorders, while childhood metabolic health is more consistently associated with postnatal exposure to phthalates and bisphenols.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>Synthesizes emerging evidence linking modern forms of chemical pollution to antenatal disorders, fetal growth restriction and childhood disorders.</p>\u0000</li>\u0000<li>\u0000<p>Highlights potential developmental impacts of emerging pollutants of concern now ubiquitous in our environment but without regulatory restrictions.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252306","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}