Pediatric Research最新文献

{"title":"Smartphone use, wellbeing, and their association in children.","authors":"Tanja Poulain, Christof Meigen, Wieland Kiess, Mandy Vogel","doi":"10.1038/s41390-025-04108-8","DOIUrl":"https://doi.org/10.1038/s41390-025-04108-8","url":null,"abstract":"<p><strong>Background: </strong>This study assessed changes in the duration of smartphone use, problematic smartphone use (PSU), quality of life, and their association from 2018 to 2024 in children and adolescents.</p><p><strong>Methods: </strong>Data were collected between 2018 and 2024 within the LIFE Child cohort study (Germany). We used a repeated cross-sectional dataset containing 2576 data points of 1113 10- to 17-year-old children and adolescents (51% male) who had reported on their quality of life, PSU, and their smartphone use duration. Hierarchical regression analyses were applied to assess associations of PSU, smartphone use duration, and quality of life with the year of assessment and associations of PSU and smartphone use duration with quality of life.</p><p><strong>Results: </strong>From 2021 onwards, symptoms of PSU and smartphone use durations >3 h/day were significantly more frequent than in 2018. For PSU, these changes were significantly stronger in girls and younger children. Concurrently, quality of life was significantly poorer than in 2018. Both PSU and long smartphone usage durations were significantly associated with lower quality of life.</p><p><strong>Conclusions: </strong>This study shows the increasingly problematic use of smartphones and its negative association with the overall declining quality of life of children over the last seven years.</p><p><strong>Impact: </strong>Problematic smartphone use in children and adolescents has increased in the last seven years, while quality of life has decreased. Problematic smartphone use is associated with decreased quality of life, and this association was especially strong in 2022 and 2023. In contrast to previous studies, the present time trend analysis covers time periods before and within the Covid-19 pandemic and suggests that the pandemic has reinforced the observed changes in smartphone use and quality of life. Restricting children's smartphone use might help to improve or maintain a higher quality of life.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006604","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":"Circulating adipokines in girls with central precocious puberty: A systematic review and meta-analysis.","authors":"Mei Jiang, Ying Gao, Ling Huang","doi":"10.1038/s41390-025-03976-4","DOIUrl":"https://doi.org/10.1038/s41390-025-03976-4","url":null,"abstract":"<p><strong>Objectives: </strong>This meta-analysis aimed to assess circulating adipokine levels in girls with central precocious puberty (CPP) and compare them with those in healthy controls.</p><p><strong>Methods: </strong>An exhaustive literature search was conducted, using the Embase, PubMed, Web of Science, Cochrane Library, and Scopus databases, from the inception of the study to October 31, 2023, to identify relevant studies. Studies comparing the serum levels of adiponectin, leptin, irisin, apelin, omentin,chemerin, resistin, vaspin, and visfatin in girls with CPP and healthy girls of the same age were included. The findings were summarized in Grading of Recommendations Assessment, Development, and Evaluation evidence profiles and synthesized qualitatively.</p><p><strong>Results: </strong>Eleven studies that included 701 girls with CPP and 590 healthy girls were analyzed after the selection process. Leptin levels were significantly increased, whereas adiponectin levels were decreased in girls with CPP. Irisin levels did not change significantly. Subgroup and meta-regression analyses indicated that the heterogeneity in the association of leptin with CPP might be due to factors such as the number of cases, diagnostic criteria for CPP, and measurement methods.</p><p><strong>Conclusions: </strong>Adipokines levels were altered in girls with CPP compared with those in healthy controls. Preventing obesity in children and adolescents with CPP is crucial.</p><p><strong>Prospero registration number: </strong>CRD42022371490.</p><p><strong>Impact: </strong>This meta-analysis is the first to explore the relationship between adipokines and central precocious puberty. The results of this systematic review provide evidence that adipokines levels are altered in girls with central precocious puberty (CPP) compared with those in healthy controls. CPP in girls increases the risk of cardiovascular disease in adulthood. Preventing obesity in children and adolescents, especially in those with precocious puberty, is crucial.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031488","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":"Cerebral oxygenation measurements during immediate neonatal transition in the delivery room: a systematic review.","authors":"Rania Selim, Arangan Kirubakaran, Jay Banerjee","doi":"10.1038/s41390-025-04084-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04084-z","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the use of NIRS measured cerebral oxygenation and analyse these parameters during the immediate postnatal period.</p><p><strong>Data sources: </strong>EMBASE, MEDLINE, and Maternity and Infant Care databases using keywords: \"Infants,\" \"NIRS,\" and \"Cerebral oxygenation.\"</p><p><strong>Study selection: </strong>Inclusion criteria were clinical trials and observational studies measuring cerebral oxygenation up to 15 min of life. Exclusion criteria were non-human studies, non-English articles and case reports.</p><p><strong>Data extraction: </strong>Two authors independently performed study selection, data extraction, and risk of bias assessment. Cerebral regional tissue Oxygenation (CrSO₂) and cerebral fractional tissue oxygenation extraction (cFTOE) values were extracted.</p><p><strong>Results: </strong>Fifty nine studies, out of 4067 were included in the qualitative analysis. Studies included aimed to establish oxygenation reference ranges, assess the impact of delivery mode, cord clamping, and delivery room interventions on cerebral oxygenation, and evaluated its role in predicting long-term neurodevelopmental outcomes. Most studies focused on term neonates experiencing normal neonatal transitions. Aggregate mean values for CrSO₂ and cFTOE in the first 15 min of life were calculated, showing that a steady state is achieved by 10-15 min of life. ANOVA demonstrated no significant differences between preterm and term infants in CrSO₂ (p = 0.54) and cFTOE (p = 0.50).</p><p><strong>Conclusions: </strong>NIRS measurement of CrSO₂ is feasible and can be used alongside other clinical tools to inform delivery room management. There were no significant differences in CrSO₂ or cFTOE between term and preterm infants although most studies focussed on late preterm infants. Future research is therefore required for extremely preterm infants, those requiring ventilatory management, or those with congenital anomalies.</p><p><strong>Impact: </strong>There is a knowledge gap regarding cerebral oxygenation patterns during immediate neonatal transition. NIRS can be used to monitor and guide clinical management in delivery room, helping to inform clinicians about cerebral oxygenation during the transition. This study provides a comprehensive review of NIRS applications in measuring neonatal CrSO₂ up to 15 min after birth, producing a collated reference range graph with no significant differences found between gestations. This study enhances the understanding and application of NIRS during the immediate transitional period, providing insights that can improve delivery room management practices and guide interventions for both term and preterm infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039672","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 laryngeal mask epinephrine in neonatal resuscitation; an ovine study.","authors":"Hamza Abbasi, Clariss Blanco, Arun Prasath, Mary Kasu, Sylvia Gugino, Justin Helman, Nicole Bradley, Lori Nielsen, Rocco A Paluch, Praveen Chandrasekharan, Munmun Rawat","doi":"10.1038/s41390-025-04070-5","DOIUrl":"https://doi.org/10.1038/s41390-025-04070-5","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of Laryngeal Mask Airway (LMA) epinephrine during neonatal resuscitation has not been studied. We hypothesize that LMA epinephrine is as effective as endotracheal tube (ETT) epinephrine.</p><p><strong>Methods: </strong>Sixteen fetal lambs were randomized in ETT or LMA group for ventilation and airway epinephrine administration after cord occlusion to induce complete cardiac arrest. Lambs were delivered and instrumented to continuously record pulmonary and systemic hemodynamics. After 5 min of cardiac arrest, lambs were resuscitated per NRP guidelines. Blood gases and plasma epinephrine levels were regularly measured during resuscitation.</p><p><strong>Results: </strong>Baseline characteristics were similar between the two groups. Incidence of return of spontaneous circulation (ROSC) was 5/8 (62.5%) in both groups; p = 1.00. Mean time to ROSC was similar in both groups; 6 minutes and 42 ± 65 s in the LMA group, and 6 min and 46 ± 51 s in the ETT group; p = 0.92. There was no difference in plasma epinephrine levels at baseline (LMA 0.7 ± 0.5 vs. ETT 0.8 ± 0.2 ng/mL; p = 0.88) and post-airway epinephrine administration (LMA 8.0 ± 3.1 vs. ETT 7.8 ± 4.6 ng/mL; p = 0.85).</p><p><strong>Conclusion: </strong>The use of LMA epinephrine for neonatal resuscitation is a suitable alternative to ETT epinephrine.</p><p><strong>Impact: </strong>The Neonatal Resuscitation Program (NRP) recommends a dose of airway epinephrine to be administered via the endotracheal tube (ETT) while intravenous access is being established. Endotracheal intubation is a highly skilled procedure. Laryngeal mask airway (LMA) is as effective in delivering positive pressure ventilation (PPV) and requires less training to achieve adequate competency to secure a stable airway. We show that LMA is a non-inferior method to deliver epinephrine during neonatal resuscitation in the ovine model.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037690","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":"Necrotizing enterocolitis: specific human milk oligosaccharides prevent enteric glia loss and hypomotility.","authors":"Chhinder P Sodhi, Daniel J Scheese, Cody Tragesser, William B Fulton, Johannes W Duess, Koichi Tsuboi, Maame Efua S Sampah, Rachael H Buck, David R Hill, Anice Sabag-Daigle, Thomas Prindle, Sanxia Wang, Menghan Wang, David J Hackam","doi":"10.1038/s41390-025-04077-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04077-y","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) is mediated by toll-like receptor 4 (TLR4)-induced inflammation and is preceded by reduced intestinal motility. Human milk oligosaccharides (HMOs) are non-digestible components of breast milk that prevent NEC in preclinical models. We now hypothesize that HMOs can reduce the risk of NEC through restoration of intestinal motility and reduced TLR4-mediated inflammation.</p><p><strong>Methods: </strong>NEC was induced in C57-BL/6 mice through the combination of formula gavage, hypoxia, and oral administration of NEC stool. Mice were administered either 2'-FL (5 g/L), 6'-SL (5 g/L), or a blend of 5 specific HMOs (5 g/L) containing 2'-FL (2.606 g/L), 3'-FL (0.652 g/L), LNT (1.304 g/L), 3'-SL (0.174 g/L), and 6'-SL (0.260 g/L). Gastrointestinal motility was assessed by 70 Kd FITC-dextran transit time. Enteric glia were quantified by immunohistochemistry and qRT-PCR expression.</p><p><strong>Results: </strong>Administration of either 2'-FL, 6'-SL, or HMO blend significantly attenuated NEC severity and reversed intestinal hypomotility. HMOs prevented enteric glia loss and regulated key genes critical for enteric glia maintenance, attenuated pro-apoptotic genes, and increased anti-apoptotic genes in vitro, resulting in a reduction in apoptosis. Strikingly, HMOs reduced LPS-TLR4-induced NFκB signaling and ROS generation in enteric glia.</p><p><strong>Conclusions: </strong>HMOs protect against NEC at least in part through protective effects on inflammation and the enteric nervous system.</p><p><strong>Impact: </strong>This study sheds light on the role of certain human milk oligosaccharides in a clinically relevant mouse model of NEC and adds additional insights into their underlying mechanism of action by revealing a protective effect on the enteric nervous system. These results reveal that HMOs prevent the loss of enteric glia in NEC and influence the expression of genes that regulate enteric glia maintenance. HMOs also limit TLR4-NFkB signaling, providing an additional mechanism of enteric glia maintenance.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030769","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":"Longitudinal changes in human milk lactoferrin during the first year: a prospective cohort study.","authors":"Yang Zhou, Yifan Duan, Shan Jiang, Yuwen Zhang, Muxue Liu, Xuyang Gu, Ying Li, Ning Zhang, Rulan Jiang, Zhenyu Yang, Jianqiang Lai","doi":"10.1038/s41390-025-04109-7","DOIUrl":"https://doi.org/10.1038/s41390-025-04109-7","url":null,"abstract":"<p><strong>Background: </strong>Lactoferrin (Lf) is an important bioactive protein in human milk involved in diverse biological functions. Concentrations of milk Lf are tightly regulated during lactation. This study aims to investigate the longitudinal changes in human milk Lf concentrations during the first year postpartum and identify the factors associated with these changes.</p><p><strong>Methods: </strong>This prospective cohort study recruited 160 dyads of healthy mothers and their full-term newborns in Wuqiang, Hebei province, China. Maternal and infant characteristics were collected using a structured questionnaire. Milk Lf concentrations were measured using an ELISA. A linear mixed model was employed to examine the longitudinal changes in Lf concentrations and identify associated factors.</p><p><strong>Results: </strong>The mean milk Lf concentrations were 7.17 g/L, 4.02 g/L, 2.95 g/L, 2.19 g/L, and 2.43 g/L at 0-7 days, 30 days, 3 months, 6 months, and 12 months postpartum, respectively. The frequency of breastfeeding in the prior 24 h was negatively associated with Lf concentrations (P = 0.017). Prenatal mean corpuscular volume (MCV) status may influence the longitudinal changes in milk Lf (P_MCV*time = 0.011).</p><p><strong>Conclusions: </strong>Milk Lf concentrations decrease during the first 6 months and increase from 6 to 12 months, with these changes potentially associated with breastfeeding frequency and prenatal MCV status.</p><p><strong>Impact: </strong>This study represents one of the largest cohort investigations of the dynamic changes and influencing factors of human milk Lf concentration in China. The study investigated the relationship between maternal red blood cell indexes and milk Lf concentrations. Milk Lf concentrations dynamically change throughout lactation, decreasing during the first 6 months and potentially increasing from 6 to 12 months. The concentrations and longitudinal changes of milk Lf were impacted by the frequency of breastfeeding and maternal mean corpuscular volume.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039727","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":"Inspiration.","authors":"K Jost, E Williams","doi":"10.1038/s41390-025-04121-x","DOIUrl":"https://doi.org/10.1038/s41390-025-04121-x","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027070","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":"Skin reflectance changes in Kenyan neonates during the first month of life: an observational study.","authors":"Seth Bokser, Priscillah Koech, Hillary Bosuben, Anne Gaichiumia, Atsushi Miwa, Anthony Wanyoro","doi":"10.1038/s41390-025-04079-w","DOIUrl":"https://doi.org/10.1038/s41390-025-04079-w","url":null,"abstract":"<p><strong>Impact: </strong>The study documents significant changes in skin pigmentation among Kenyan newborns over their first month of life, with significant decreases in reflectance at wavelengths critical for transcutaneous diagnostic devices. This research provides the first quantitative documentation of optical-light characteristics in African newborn skin using Individual Typology Angle (ITA), demonstrating significant darkening as infant skin matures. By establishing baseline ITA values and developmental changes in African newborns, this study creates an evidence-based framework for designing future inclusive clinical trials for transcutaneous diagnostic devices that account for both skin tone diversity and age-related changes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019875","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":"Effect of phototherapy on cardiac function in full term neonates with unconjugated hyperbilirubinemia.","authors":"Doaa El Amrousy, Rowan Adel, Dalia Ayoub, Mohamed Rowisha","doi":"10.1038/s41390-025-04071-4","DOIUrl":"https://doi.org/10.1038/s41390-025-04071-4","url":null,"abstract":"<p><strong>Background: </strong>Phototherapy of jaundiced neonates has several cardiovascular effects. We investigated the effect of phototherapy on cardiac function in jaundiced full-term neonates using two-dimensional speckle tracking echocardiography (2D-STE).</p><p><strong>Methods: </strong>This cohort study was conducted on 40 full term neonates with unconjugated hyperbilirubinemia who needed phototherapy as the patient group and 40 healthy neonates of matched gestational age, age, and sex served as the control group. Conventional echocardiography, tissue Doppler, and 2D-STE were performed before and 24 h after phototherapy. Serum troponin T, serum bilirubin levels, systolic and diastolic blood pressure, and heart rate (HR) were measured also before and after phototherapy.</p><p><strong>Results: </strong>Systolic and diastolic blood pressure significantly decreased in the patient group after phototherapy compared to their levels before phototherapy. On the contrary, HR significantly increased after phototherapy in the patient group. However, serum cardiac troponin showed non-significant change after phototherapy. After phototherapy, all conventional and tissue Doppler parameters showed non-significant change. While 2D- left ventricular global longtudinal strain (2D-LVGLS) obtained by STE significantly decreased after phototherapy. There was a significant negative correlation between 2D-LV GLS and both duration and number of phototherapy units and both are good predictors for 2D-LVGLS.</p><p><strong>Conclusion: </strong>Phototherapy may cause myocardial dysfunction that is correlated with the duration and number of phototherapy units.</p><p><strong>Impact: </strong>Phototherapy of jaundiced neonates has many cardiovascular effects such as decrease in blood pressure and stroke volume. However, the effect of phototherapy on cardiac function in neonates has not been fully investigated yet. We investigated, for the first time, the effect of phototherapy on cardiac function in jaundiced full term neonates using two-dimensional speckle tracking echocardiography (2D-STE). Phototherapy may cause myocardial dysfunction that is correlated with the duration and number of phototherapy unit. Cardiac shield may be needed during phototherapy.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034813","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 antibiotic exposure and necrotizing enterocolitis among preterm infants < 34 weeks' gestation.","authors":"Yue Zhu, Shujuan Li, Siyuan Jiang, Weiyin Yu, Yongfu Yu, Zhenlang Lin, Xiaoying Li, Huiqing Sun, Yan Mo, Yihuang Huang, Luyang Hong, Joseph Y Ting, Shoo K Lee, Zhiping Li, Weibing Wang, Yun Cao","doi":"10.1038/s41390-025-04076-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04076-z","url":null,"abstract":"<p><strong>Background: </strong>To investigate whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis (NEC) among preterm infants born at <34 weeks' gestation.</p><p><strong>Methods: </strong>This multicenter prospective cohort study included all infants with gestational age <34 weeks and admitted to neonatal intensive care units across China. Early antibiotic exposure was defined as the antibiotic treatment initiated within the first three postnatal days. The short-term outcomes included death, NEC, death and/or NEC. Propensity score matching was performed to generate matched cohorts. The impacts of early antibiotics exposure on the outcomes were evaluated by univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>Among 24,926 eligible infants, 20164 (80.9%) received early antibiotics. After matching, early antibiotics exposure was not significantly associated with the death and/or NEC (adjusted OR, 0.93; 95%CI, 0.72-1.21), NEC (adjusted OR, 0.81; 95% CI, 0.60 -1.10) or death (adjusted OR, 1.42; 95% CI, 0.90-2.25). However, prolonged antibiotic treatment (adjusted OR, 2.95; 95% CI, 1.67-5.22), especially broad-spectrum antibiotics exposure (adjusted OR, 5.09; 95% CI, 1.84-14.10), was independently associated with death.</p><p><strong>Conclusion: </strong>While early antibiotics exposure was not associated with the risks of NEC, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality.</p><p><strong>Impact: </strong>This multicenter cohort study sheds light on whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis among preterm infants <34 weeks of gestation. In preterm infants, early antibiotics exposure was not significantly associated with the risks of death and/or NEC. However, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality. Our study emphasizes the importance of neonatal antimicrobial stewardship in improving the prognosis of premature infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049650","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}