Pediatric Research最新文献

{"title":"Systematic review of Apgar scores & cyanosis in Black, Asian, and ethnic minority infants","authors":"Frankie J. Fair, Amy Furness, Gina Higginbottom, Sam J. Oddie, Hora Soltani","doi":"10.1038/s41390-024-03543-3","DOIUrl":"https://doi.org/10.1038/s41390-024-03543-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Apgar score and cyanosis assessment may disadvantage darker-skinned babies. This review explored cyanosis and Apgar score assessments in Black, Asian, or minority ethnic neonates compared to White neonates.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>Four databases were searched. Studies of any methodology were included. A narrative synthesis was undertaken.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Ten studies were included. Three studies involving over 39 million neonates showed Apgar score ≤3 was predictive of neonatal mortality across all ethnicities. Black babies with Apgar score ≤3 had lower mortality rates before 28 days, however, variations in scoring practices were also observed. Three further studies (<i>n</i> = 39,290,014) associated low Apgar scores with poorer mental development up to 22 months, especially in mixed ethnicity and Black infants. One study reported inadequate training in assessing ethnic minority neonates. Cyanosis was the focus of three included studies (<i>n</i> = 455) revealing poor visual assessment of cyanosis across ethnicities. With pulse oximetry occult hypoxemia occurred slightly more frequently in Black neonates. Tongue color indicated oxygen requirement at birth, regardless of ethnicity.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Apgar scores correlate well with neonatal mortality in all ethnicities, however scoring variations exist. Cyanosis assessment is challenging, with tongue and lips the best places to observe in the absence of pulse oximetry.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>Assessment of the color component of the Apgar score and of cyanosis visually are not accurate in babies with darker skin. Small racial differences may exist for pulse oximetry in neonates, but it is more reliable than visual assessment.</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":"142252380","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":"Fostering a healthier generation of children with sickle cell disease through advancements in care","authors":"Emily Franco, Clare Nimura, Patrick T. McGann","doi":"10.1038/s41390-024-03566-w","DOIUrl":"https://doi.org/10.1038/s41390-024-03566-w","url":null,"abstract":"<p>Sickle cell disease (SCD) is an inherited disorder of hemoglobin that affects tens of millions of individuals worldwide. Without preventive and disease-modifying therapy, SCD results in many acute and chronic complications impacting both quality and length of life. We are currently in a new generation of SCD care in high resource settings due to recent advancements in care. Universal newborn screening (NBS) for SCD with associated parental education and preventive care significantly improved mortality rates. Beginning in the 1990s, hydroxyurea emerged as a promising pharmacologic treatment for SCD due to its ability to increase the amount of fetal hemoglobin. It is now the mainstay of treatment, with strong recommendations to begin as early as the first year of life with the goal of reducing most short- and long-term complications and allowing for a normalized quality of life. More recently, gene therapy has come to the forefront in SCD and brings the hope of a cure for many patients. In 2023, the FDA approved two cell-based gene therapies for patients with SCD. The future is bright for patients with SCD, and the current generation of affected children will expectantly be able to grow up free of suffering and severe, frequent pain.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185629","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: Examining the association between autism spectrum disorder and atopic eczema: meta-analysis of current evidence.","authors":"Anas Elgenidy, Eman F Gad, Islam Shabaan, Hasnaa Abdelrhem, Paula Gamal Wassef, Taher Elmozugi, Mohanad Abdelfattah, Hisham Mousa, Mohamed Nasr, Mostafa Salah-Eldin, Ahmed Altaweel, Abdelrahman Hussein, Mohammad Bazzazeh, Mohamed Atef Elganainy, Ahmed M Ali, Mohamed Ezzat, Amira Elhoufey, Abdulrahman A Alatram, Ahmed Hammour, Khaled Saad","doi":"10.1038/s41390-024-03570-0","DOIUrl":"https://doi.org/10.1038/s41390-024-03570-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292946","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":"Omic-signature of bronchopulmonary dysplasia associated pulmonary hypertension in <1500g-birth-weight-infants with hemodynamically significant intracardiac shunt","authors":"Lucy Emery, Alexa Hughes, Christiana Oji-Mmuo, Patricia Silveyra, Vincent P R Aluquin, Ann Donnelly, Roopa Siddaiah","doi":"10.1038/s41390-024-03541-5","DOIUrl":"https://doi.org/10.1038/s41390-024-03541-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>PDA and ASD are common intracardiac shunts noted in prematurely born infants. While there is evidence of persistent PDA and ASD associated with a higher risk for developing bronchopulmonary dysplasia (ICS-BPD) and pulmonary hypertension (ICS-BPD-PH), the underlying pathogenesis is poorly understood and hence challenging to identify at-risk infants. Our study goal was to evaluate transcriptomic expression and associated pathways in tracheal aspirates (TAs) of low-birth-weight infants with hemodynamically significant cardiac shunt (ICS) that develop bronchopulmonary dysplasia (ICS-BPD) and pulmonary hypertension (ICS-BPD-PH).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>TAs were collected from preterm infants with ICS and a diagnosis of BPD or BPD-PH from a single center. 36 TA samples including 19 ICS-BPD and 17 ICS-BPD-PH were analyzed. MiRNA expression was determined via PCR arrays, and mRNA expression via RNA seq. Data were analyzed using <i>limma</i>.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>11 miRNAs and 10 mRNAs were differentially expressed (adjusted <i>p</i> &lt; 0.05) in ICS-BPD-PH group when compared to ICS-BPD. Ingenuity Pathway Analysis identified associations with cellular growth, proliferation, death, and cell function pathways.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>TAs from preterm infants show differentially expressed miRNAs and mRNAs in ICS-BPD-PH when compared to ICS-BPD, an in-silico model identified target molecules that could be playing a role in BPD-PH pathogenesis in low-birth-weight infants with ICS.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><p>Pulmonary hypertension associated with severe BPD (BPD-PH) is a distinct disease in preterm infants with severe BPD and the role of intracardiac shunt (ICS) in its development is controversial and often challenging for clinical management. Our pilot study, researching specific endotyping of infants with pulmonary hypertension associated with BPD using multiomics approach has identified molecular markers and potential underlying pathways associated with this condition. These markers could aid in stratifying high risk infants with ICS that are at risk for developing BPD-PH and aid clinical management.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185627","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: Early postnatal nutrition and renal consequences in preterm infants.","authors":"Silvia Iacobelli, Alexandre Lapillonne, Farid Boubred","doi":"10.1038/s41390-024-03156-w","DOIUrl":"https://doi.org/10.1038/s41390-024-03156-w","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292945","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 dietary patterns and offspring behavioral problems","authors":"Esther Cendra-Duarte, Josefa Canals, Nerea Becerra-Tomás, Cristina Jardí, Francisco Martín-Luján, Victoria Arija","doi":"10.1038/s41390-024-03462-3","DOIUrl":"https://doi.org/10.1038/s41390-024-03462-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Mental health problems often begin in early childhood and could predict psychiatric and behavioral outcomes. Prenatal factors such as maternal nutrition have an impact on neurodevelopment. This study aims to investigate the association between maternal dietary patterns and emotional and behavioral problems in 4-year-old children.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Within a cohort of 205 mother-child pairs, three maternal dietary patterns were identified: ‘Sweet and Superfluous’, ‘Fish and Vegetables’ and ‘Meat and Cereals’. Child behavior was evaluated by means of the Child Behavior Checklist 1.5-5 (CBCL 1.5-5), the Teacher’s Report Form 1.5-5 (TRF 1.5-5), and the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P). Multivariable analysis determined associations between maternal dietary patterns and their children’s behavior.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Maternal adherence to the ‘Sweet and Superfluous’ pattern was positively associated with externalizing and depressive problems in children. The ‘Meat and Cereals’ pattern was linked to a higher risk for attention, hyperactivity and depressive problems as somatic complaints. Conversely, the ‘Fish and Vegetables’ pattern was associated with a reduced risk of hyperactivity problems. All these associations were more pronounced in girls than in boys.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Maternal diet during pregnancy is associated with the emotional and behavioral development of children at 4 years of age.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>Previous research on prenatal dietary patterns and children’s behavior is inconclusive.</p>\u0000</li>\u0000<li>\u0000<p>In our study, children of mothers who had higher intakes of sugar and processed foods during pregnancy were more likely to have emotional and behavioral problems at age 4, especially girls.</p>\u0000</li>\u0000<li>\u0000<p>A high-quality diet characterized by fish and vegetable consumption during pregnancy was associated with reduced anxiety and hyperactivity problems in girls.</p>\u0000</li>\u0000<li>\u0000<p>Our findings highlight the importance of prenatal nutrition for child neurodevelopment.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185628","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":"Bifidobacterium regulates premature infant gut metabolites, reducing serum inflammatory factors: a randomised controlled trial","authors":"He Wang, Dongmei Chen, Huamei Li, Chunyan Fu, Lingyu Fang, Ruiquan Wang, Jinglin Xu","doi":"10.1038/s41390-024-03552-2","DOIUrl":"https://doi.org/10.1038/s41390-024-03552-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Analyse the effects of Bifidobacterium BB-12 on intestinal metabolites and serum inflammatory factors in premature infants.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>71 premature infants at gestational age of ≤32 weeks were randomly divided into the probiotic (<i>n</i> = 36) and control (<i>n</i> = 35) groups. Faecal and blood samples were collected from the two groups of premature infants at the 2nd and 4th week of life for intestinal metabolite detection and assessment of the level of the serum inflammatory markers TLR4, NF- κ B, IL-1β, and TNF- α.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Compared to the control group, the probiotic group contained more amino acids, these elements were enriched on multiple amino acid metabolic pathways, and the probiotic group showed significantly lower levels of the serum inflammatory markers TLR4, NF-κB, IL-1β, and TNF-α. Finally, the probiotic group showed a lower incidence of feeding intolerance.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The administration of Bifidobacterium BB-12 is associated with increasing the levels of glutamine, glutamic acid, and kynurenine in the gut of premature infants, and associated with reducing the levels of TLR4 and NF-κB in the serum, further decreasing the secretion of the pro-inflammatory factors IL-1β and TNF-α, and alleviating systemic inflammatory reactions, thereby reducing the incidence of feeding intolerance.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ol>\u0000<li>\u0000<span>1.</span>\u0000<p>The use of Bifidobacterium BB-12 in premature infants can increase the levels of amino acids in the intestine.</p>\u0000</li>\u0000<li>\u0000<span>2.</span>\u0000<p>Increases in Bifidobacterium BB-12 may decrease the serum levels of TLR4, NF-κB, IL-1β, and TNF-α.</p>\u0000</li>\u0000<li>\u0000<span>3.</span>\u0000<p>Kynurenine may improve the prognosis of preterm infants by reducing inflammation.</p>\u0000</li>\u0000<li>\u0000<span>4.</span>\u0000<p>Bifidobacterium BB-12 may improve the feeding tolerance of premature infants, thus reducing the incidence of feeding intolerance.</p>\u0000</li>\u0000</ol>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252307","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: premature birth: a parent’s perspective","authors":"Caroline Bishop","doi":"10.1038/s41390-024-03497-6","DOIUrl":"https://doi.org/10.1038/s41390-024-03497-6","url":null,"abstract":"<p>Our boys were all born prematurely. Sam, now ten, arrived at 34 weeks and four days. The twins, Finn and Zack, now five, were born at just 28 weeks and two days. The impact is ongoing for all three of them, and for us as a family.</p><p>Sam suffered from reflux and colic, both of which are more common in premature babies. He had frequent bouts of croup and is still susceptible to it.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185658","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":"Home is where the right ventricle lives: bronchopulmonary dysplasia-associated pulmonary hypertension and home ventilation.","authors":"Samuel J Gentle,Namasivayam Ambalavanan","doi":"10.1038/s41390-024-03550-4","DOIUrl":"https://doi.org/10.1038/s41390-024-03550-4","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252390","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":"Evaluation of a perinatal palliative care program by SWOT analysis","authors":"Francesca Catapano, Giuseppe Ramacieri, Giacomo Sperti, Luigi Tommaso Corvaglia, Chiara Locatelli","doi":"10.1038/s41390-024-03366-2","DOIUrl":"https://doi.org/10.1038/s41390-024-03366-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Perinatal Palliative Care (PPC) is individualized medical-nursing care aimed at improving the quality of life of newborns with life-limiting conditions and to support their families. This study draws on the analysis of the experience gained over ten years by a service of PPC called the “Percorso Giacomo” (PG).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We employed a SWOT analysis to identify the strengths, weaknesses, opportunities, and threats of the PG through a systematic retrospective review of 48 cases followed by the program over the course of 10 years, 21 unsolicited parents’ narrative and 27 experts’ point of view.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Main strengths of the program were communication and parents’ involvement in shared decision-making. Main weaknesses included lack of knowledge of the presence and the role of the PG and lack of resources. For opportunities, the PG proved to be an innovative choice for pregnancies with a fetal life-limiting diagnosis, however threats were identified such as lack of knowledge of PPC and delayed referrals.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The analysis by SWOT method of the 10-year experience of the PG allowed the identification of limitations and areas of improvement, however demonstrated that the PG provided beneficial services to women faced with fetal life-limiting diagnoses.</p><h3 data-test=\"abstract-sub-heading\">Impact</h3><ul>\u0000<li>\u0000<p>Perinatal Palliative Care (PPC) practice and literature on this subject is still limited.</p>\u0000</li>\u0000<li>\u0000<p>This study offers features of the 10-year experience of the Percorso Giacomo (PG), a service of PPC, through a SWOT analysis.</p>\u0000</li>\u0000<li>\u0000<p>By identifying strengths, weaknesses, opportunities and threats of the PG, the study shows limitations and areas of improvement but also benefits of a PPC service to women with fetal diagnosis of life-limiting condition and may allow replication in other institutions.</p>\u0000</li>\u0000</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185630","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}