Pediatric Research最新文献

{"title":"Does skin pigmentation affect serum bilirubin estimation?","authors":"Richard P Wennberg, Jon Yngve Hardeberg","doi":"10.1038/s41390-025-04406-1","DOIUrl":"https://doi.org/10.1038/s41390-025-04406-1","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200524","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 and health professional perspectives of the CHD LIFE cardiac developmental long-term care pathway: a qualitative evaluation.","authors":"Bridget Abell, Thomasina Donovan, Karen J Eagleson, Robert Justo, Ben Auld, Sonia Riley, Steven M McPhail","doi":"10.1038/s41390-025-04380-8","DOIUrl":"https://doi.org/10.1038/s41390-025-04380-8","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the implementation and impact of the Congenital Heart Disease Long-term Improvements in Functional hEalth (CHD LIFE) decentralized care pathway in Australia. It explores perspectives of families and healthcare professionals, identifying key enablers, barriers, and opportunities for improvement.</p><p><strong>Methods: </strong>A qualitative evaluation was conducted using semi-structured interviews and reflexive thematic analysis. Purposeful and convenience sampling recruited (a) parents (n = 37) of children with CHD referred for developmental follow-up via the CHD LIFE pathway and (b) key service providers and organizational stakeholders (n = 23).</p><p><strong>Results: </strong>Findings were organized into implementation, perceived impact, and improvement summary domains. Families and providers generally found decentralization of the pathway acceptable and contextually appropriate, but not without challenges. Implementation was enabled by the pathway's co-design, centralized foundations, and system alignment, but challenged by variability in local capacity, provider engagement, and substantial reliance on families. Perceived impacts were noted for providers, parents, and children, including capacity building. Stakeholders identified a range of tangible improvements to enhance equity and sustainability.</p><p><strong>Conclusions: </strong>CHD LIFE presents a promising decentralized, family-centered follow-up model improving access and supporting local care. Strengthening support mechanisms for families and providers remains essential to promote equity, reduce burden, and ensure sustainable implementation across diverse settings.</p><p><strong>Impact: </strong>The CHD LIFE care pathway demonstrates the feasibility and acceptability of a decentralized neurodevelopmental follow-up model for children with congenital heart disease, reducing geographic and logistical barriers while promoting family-centered care. Findings contribute to the discourse around alternative care models, highlighting the barriers, enablers, and impacts of decentralized care implementation. The study also highlights the need for structured support systems, ongoing provider engagement, and more standardized processes to ensure equitable and sustainable care delivery. This work informs future policy and practice, offering a scalable model for cardiac neurodevelopmental follow-up, which may potentially be adaptable to other healthcare contexts.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200549","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, regional, and national burden of digestive congenital anomalies from 1990-2021.","authors":"Linghao Cai, Hongbo Gong, Qiuyu Geng, Dengming Lai, Jinfa Tou","doi":"10.1038/s41390-025-04442-x","DOIUrl":"https://doi.org/10.1038/s41390-025-04442-x","url":null,"abstract":"<p><strong>Background: </strong>Digestive congenital anomalies (DCAs) are a major cause of neonatal death and disability, but comprehensive data on their global burden and regional disparities are limited. This study aimed to evaluate the global trends and burden of DCAs from 1990 to 2021.</p><p><strong>Methods: </strong>Data from Global Burden of Disease Study 2021 were used to estimate annual prevalence, mortality, disability-adjusted life years (DALYs), age-standardized rates (ASPR, ASMR, ASDR) of DCAs. The average annual percent change (AAPC) was calculated and frontier analysis was conducted to evaluate the potential for burden reduction. Future trends were projected using statistical modeling.</p><p><strong>Results: </strong>Between 1990 and 2021, the global burden of DCAs decreased significantly, with reductions in mortality and DALYs. ASMRs declined from 1.19 (0.66, 1.85) to 0.77 (0.58, 0.96) per 100,000 (AAPC = -1.40), and ASDRs from 108.30 (60.88, 166.69) to 70.44 (53.14, 87.60) (AAPC = -1.38). The burden was highest in infants aged 0-6 days and in low-SDI regions, which have greater improvement potential. By 2036, prevalent cases will increase, but deaths and DALYs are expected to continue declining.</p><p><strong>Conclusions: </strong>Despite progress in reducing the burden of DCAs, disparities persist, particularly in low-SDI regions, emphasizing the need for improved healthcare and neonatal surgery access.</p><p><strong>Impact: </strong>We analyzed global trends in the prevalence, mortality, and DALYs of digestive congenital anomalies (DCAs) from 1990 to 2021 using data from the Global Burden of Disease Study 2021. Our findings reveal that although the global burden of DCAs has declined, significant disparities persist, particularly in low- and middle-SDI regions. Frontier analysis emphasized substantial improvement potential in these regions. These results underscore the urgent need for enhanced screening programs, healthcare resources, and targeted interventions in low-SDI regions to further reduce the burden of DCAs and achieve equitable healthcare outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200555","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":"Growth hormone treatment in cerebral palsy: long-term impact on growth, outcomes, and complications.","authors":"Juntaek Hong, Sujin Kim, Junghwan Suh, Dong-Wook Rha","doi":"10.1038/s41390-025-04440-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04440-z","url":null,"abstract":"<p><strong>Background: </strong>This study examined the effects of growth hormone (GH) treatment on growth and metabolic parameters, gross motor function, and musculoskeletal complications in children with cerebral palsy.</p><p><strong>Methods: </strong>This retrospective single-center study included children who received GH treatment for over 1 year. Data on growth-related variables, metabolic indicators, and disease-specific factors were collected. Statistical analyses examined associations between GH treatment duration and outcomes, with pre- and post-treatment comparisons.</p><p><strong>Results: </strong>Twenty-two patients were enrolled in this study. GH treatment significantly improved height and weight Z-scores, along with insulin-like growth factor-1 Z-scores, regardless of GH deficiency or ambulatory status. Metabolic changes significantly included an increased bone age-to-chronological age ratio, decreased aspartate aminotransferase levels, and elevated uric acid levels. The gross motor function did not decline, and there was no significant worsening of hip subluxation or scoliosis.</p><p><strong>Conclusion: </strong>GH treatment led to significant improvements in growth and metabolic-related parameters without adverse effects on gross motor function or musculoskeletal complications. These findings suggest that GH treatment may be a safe and effective treatment option for children with cerebral palsy, providing potential benefits without increasing the risk of orthopedic complications.</p><p><strong>Impact: </strong>This study is the first to assess the long-term effects of GH treatment in children with CP. GH treatment improved height, weight, and insulin-like growth factor-1 Z-scores. Gross motor function did not decline during treatment, and no significant worsening of hip subluxation or scoliosis detected. There is a lack of longitudinal studies on the long-term effects of growth hormone administration in children with CP. It is anticipated that this study will lay the groundwork for large-scale multicenter prospective research.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lancet commission on the future of neonatology: a call to enhance interprofessional collaborations.","authors":"Steven H Abman, Neena Modi, Daniele De Luca","doi":"10.1038/s41390-025-04486-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04486-z","url":null,"abstract":"<p><strong>Impact: </strong>Advances in perinatal research and care have dramatically enhanced the survival of extremely preterm infants yet further advances to treat many morbidities have stalled. Major barriers limiting improvements in the health of sick preterm and term neonates are linked with the limited success in establishing strong pipelines for developing novel therapies and effective clinical management strategies. The Lancet Commission on the Future of Neonatology was launched to better define this urgent problem, to propose a \"call for action\" and provide a roadmap based on recommendations that will enhance the development of novel drugs and devices to improve outcomes world-wide.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200620","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":"Liposomal iron dramatic effect on chronic kidney disease pediatric anemia: a randomized clinical trial.","authors":"Sahar Kamal Hegazy, Mai Salah El-Din Koura, Mohamed Shokry Elharoun","doi":"10.1038/s41390-025-04418-x","DOIUrl":"https://doi.org/10.1038/s41390-025-04418-x","url":null,"abstract":"<p><strong>Background: </strong>Anemia affects pediatric quality of life. It can cause hypoxia and loss of concentration. There are a lot of iron supplements used in treating pediatric CKD-induced anemia our study aimed to evaluate the effectiveness of oral liposomal iron in treating pediatric CKD anemia compared tointravenous iron dextran.</p><p><strong>Methods: </strong>This randomized, parallel study was conducted on 60 CKD pediatric patients. The patients were categorized into two groups. Group 1 comprises 30 pediatric patients administered oral liposomal iron 30 mg/day for 3 months. Group 2 comprises 30 pediatric patients administered intravenous iron dextran 50 mg three times/ week for 3 months.</p><p><strong>Results: </strong>Both groups have no statistically significant difference in Hb, RBCS, MCV, PLTs, RDW-CV, Cr, Hepcidin, Ferritin, Iron, and Transferrin levels after 3 months of treatment. Liposomal iron has higher efficacy than IV dextran after 3 months of treatment since there is a significant difference within the group between before and after treatment period at Hb, RBCS, HCT, MCV, RDW-CV, Hepcidin, Ferritin, Iron, TIBC, and Transferrin levels with no reported side effects during the study period.</p><p><strong>Conclusion: </strong>Oral liposomal iron has higher efficacy than IV dextran, which is the traditional CKD anemia treatment in pediatric with no reported side effects.</p><p><strong>Impact: </strong>The key message of our article is to determine a safe, effective, easy to use, and less costly treatment of chronic kidney disease anemia in pediatrics. Our study will add to the existing literature a suggestion of an effective and safe treatment for pediatric chronic disorder, the traditional treatment has a lot of serious side effects. The impact of our study is to treat anemia resulted from chronic kidney disease in pediatrics with oral drug that has higher efficacy than the traditional injectable drug, this will lead to higher rate of anemia treatment due to higher rate of children compliance.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200645","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":"Probiotics in breast-fed healthy term infants: imperative or superfluous?","authors":"Muralidhar H Premkumar, Mohan Pammi","doi":"10.1038/s41390-025-04485-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04485-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192341","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":"Moving neonatal nephrology care and research forward: proceedings from the First International Neonatal Nephrology Symposium.","authors":"David Askenazi, Matt Harer, Dave Selewski, Namasivayam Ambalavanan, Jennifer Charlton, Michelle Starr","doi":"10.1038/s41390-025-04473-4","DOIUrl":"https://doi.org/10.1038/s41390-025-04473-4","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192359","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":"Implementation of an educational video about testicular torsion improves patient and caregiver awareness.","authors":"Benjamin Abelson, Viktor Flores, Cyrus Adams, Mark Adams, John Brock, John C Pope, John Thomas, Douglass B Clayton, Alice Rothman, Abby S Taylor","doi":"10.1038/s41390-025-04463-6","DOIUrl":"https://doi.org/10.1038/s41390-025-04463-6","url":null,"abstract":"<p><strong>Background: </strong>Testicular torsion is an emergency that can require orchiectomy if too much time passes between ischemia onset and surgery.</p><p><strong>Methods: </strong>This prospective, survey-based study demonstrates that there is poor understanding about torsion among boys, parents, and school nurses, and that a short, animated video could improve this knowledge gap and motivate early presentation to the hospital. After completing a survey about managing acute testicular pain, participants viewed a video ( https://youtu.be/d9GAt7et85Y ) and answered follow-up questions.</p><p><strong>Results: </strong>670 parents, 376 school nurses, 43 boys, and 47 pediatricians completed the study. 45% of parents have never heard of torsion. Over half of the boys report they would wait before telling a parent about testicular pain. Less than half of school nurses say they would recommend a child's parents take him to the emergency department.</p><p><strong>Conclusions: </strong>Viewing an educational video improves awareness among boys, parents and school nurses that acute testicular pain needs to be evaluated and treated emergently.</p><p><strong>Impact: </strong>Testicular torsion is the most common urologic emergency in children, but most boys and their caregivers are unaware of the diagnosis. This leads to delays in care and higher rates of testicular loss. Many hospital initiatives have sought to decrease delays for boys with testicular torsion after they interact with the healthcare system, however, most time delay occurs prior to arrival at the hospital. This is the first study to demonstrate that patient and parent education can be more effective in taking efficient care of boys with acute testicular torsion.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192293","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":"Blood flow assessment in echocardiography of hemodynamically significant patent ductus arteriosus in preterm infants.","authors":"Yu-Jen Wei, Yung-Chieh Lin, Yen-Ju Chen, Min-Ling Hsieh, Jieh-Neng Wang","doi":"10.1038/s41390-025-04449-4","DOIUrl":"https://doi.org/10.1038/s41390-025-04449-4","url":null,"abstract":"<p><strong>Background: </strong>In premature infants, patent ductus arteriosus (PDA) can lead to hemodynamic instability and prematurity-related complications. The conventional left atrial-to-aortic (LA/Ao) ratio for evaluating hemodynamically significant PDA (hsPDA) has demonstrated limited accuracy. We aimed to investigate the correlation between mitral inflow E-wave velocity, left pulmonary artery (LPA) end-diastolic velocity, and hsPDA in preterm infants.</p><p><strong>Methods: </strong>Single-center, retrospective cohort study included neonates born at a gestational age (GA) between 24 and 30 weeks. The echocardiographic parameters, including mitral E-wave velocity, LPA end-diastolic velocity and LA/Ao ratio were assessed with hsPDA requiring treatment.</p><p><strong>Results: </strong>Forty-nine infants were included, of whom 30 were diagnosed with hsPDA. The mitral E-wave (95% CI: 4.6-18.2, p = 0.0016) and LPA end-diastolic velocities (95% CI: 4.14-15.15, p = 0.0010) were significantly higher in infants with hsPDA, while the LA/Ao ratio exhibited no difference. Multivariate analysis revealed that lower GA, higher mitral E-wave, and LPA end-diastolic velocities were predictive of hsPDA. The receiver operating characteristic (ROC) analysis showed that these parameters offered better diagnostic accuracy than the LA/Ao ratio.</p><p><strong>Conclusion: </strong>Our findings suggest that mitral E wave and LPA end-diastolic velocities are more reliable echocardiographic markers for evaluating hsPDA in preterm infants than the conventional LA/Ao ratio.</p><p><strong>Impact: </strong>Assessment of dynamic blood flow is more reliable than the left atrium chamber size in evaluating the hemodynamic status of a PDA. Our result provides new criteria for assessing the hemodynamic significance of PDA. Utilizing this technique may yield evidence to assist clinical decision-making regarding PDA treatment. Multifactorial assessment, including birth gestational age and increased intracardiac or pulmonary blood flow velocity, provides more accurate prediction for a hsPDA.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192317","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}