Pediatric Research最新文献

{"title":"Functional brain connectivity in early adolescence after hypothermia-treated neonatal hypoxic-ischemic encephalopathy.","authors":"Gustaf Håkansson, Katarina Robertsson Grossmann, Ulrika Ådén, Mats Blennow, Peter Fransson","doi":"10.1038/s41390-025-03951-z","DOIUrl":"https://doi.org/10.1038/s41390-025-03951-z","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hypoxic-ischemic encephalopathy (HIE) injures the infant brain during the basic formation of the developing functional connectome. This study aimed to investigate long-term changes in the functional connectivity (FC) networks of the adolescent brain following neonatal HIE treated with therapeutic hypothermia (TH).</p><p><strong>Methods: </strong>This prospective, population-based cohort study included all infants (n = 66) with TH-treated neonatal HIE in Stockholm during 2007-2009 and a control group (n = 43) of children with normal neonatal course. Assessment with resting-state functional magnetic resonance imaging (fMRI) was performed at Karolinska Institutet, Stockholm at age 9-12 years.</p><p><strong>Results: </strong>fMRI data met quality criteria for 35 children in the HIE-cohort (mean [SD] age at MRI: 11.2 [0.74] years, 46% male) and 30 children in the control group (mean [SD] age at MRI: 10.1 [0.78] years, 53% male). Adverse outcome was present in 40% of children in the HIE-cohort. Non-parametric statistical analysis failed to detect any significant (p < 0.001) alterations of FC networks in the HIE-cohort, nor between children in the HIE-cohort with or without neurological symptoms.</p><p><strong>Conclusion: </strong>Findings of persistent alterations in specific functional networks did not remain significant after correction for multiple comparisons in this cohort of adolescent children exposed to TH-treated neonatal HIE.</p><p><strong>Impact: </strong>Neonatal hypoxic-ischemic encephalopathy (HIE) could not be associated with alterations in functional connectivity in this cohort of adolescent children. Findings of aberrant connectivity identified in two functional networks were no longer significant after correction for multiple comparisons. Larger, multi-center studies are needed to understand whether network abnormalities persist long term and are related to outcomes in neonatal HIE.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536932","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":"How accurate are labels of probiotic products marketed to infants?","authors":"Mohan Pammi, Geoffrey A Preidis","doi":"10.1038/s41390-025-03971-9","DOIUrl":"https://doi.org/10.1038/s41390-025-03971-9","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536856","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 structural cardiovascular changes on neonatal echocardiography after adverse intrauterine circumstances in identical twins.","authors":"Sophie G Groene, Erik W van Zwet, Arend D J Ten Harkel, Monique C Haak, Jeanine M M van Klink, Enrico Lopriore, Bastiaan T Heijmans, Arno A W Roest","doi":"10.1038/s41390-025-03916-2","DOIUrl":"10.1038/s41390-025-03916-2","url":null,"abstract":"<p><strong>Background: </strong>Studies on cardiovascular changes after fetal growth restriction (FGR) are limited by their design in which growth-restricted neonates are compared to appropriately-grown neonates. We aim to investigate early structural cardiovascular remodeling after FGR in identical twins, controlling for confounding of genetic and maternal factors.</p><p><strong>Methods: </strong>This study is part of a prospective cohort study including monochorionic twins from January 2019. Transthoracic echocardiography was performed within one week after birth. Z-scores for cardiac valve annuli diameters and left ventricle dimensions based on gestational age at birth were compared between smaller and larger twins. Z-score differences between birth weight and cardiac structure per twin were tested against the intercept.</p><p><strong>Results: </strong>Median gestational age at birth of the 100 included twin pairs was 33.8 (interquartile range (IQR) 30.8-36.1) weeks, with birth weights of 1729 (IQR 1200-2115) grams for smaller twins and 2058 (IQR 1643-2500) grams for larger twins. Smaller twins had a lower z-score for all structures. Z-score differences in birth weight and cardiac structure were higher than the intercept.</p><p><strong>Conclusion: </strong>While cardiac structures are generally smaller for the twin with the lower birth weight, the deviation in birth weight tends to be more pronounced than the deviation in cardiac structure.</p><p><strong>Impact: </strong>Our study shows that in identical twins, the smaller twin at birth has a structurally smaller heart on neonatal echocardiography when compared to the larger twin. Yet, cardiac structures per individual twin are less affected than body size for their given gestational age at birth. We have used a unique natural experiment by studying a population of identical twins with varying degrees of birth weight discordance, eliminating any confounding of genetic, maternal and obstetrical factors. Our results are suggestive of early cardiovascular remodeling after adverse intrauterine circumstances. This provides insight into the fetal programming of cardiovascular disease.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536723","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":"Kathryn Lemberg: ECI biocommentary.","authors":"Kathryn Lemberg","doi":"10.1038/s41390-025-03948-8","DOIUrl":"https://doi.org/10.1038/s41390-025-03948-8","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536974","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":"Neonatal microbiome in the multiomics era: development and its impact on long-term health.","authors":"Josef Neu, Christopher J Stewart","doi":"10.1038/s41390-025-03953-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03953-x","url":null,"abstract":"<p><p>The neonatal microbiome has been the focus of considerable research over the past two decades and studies have added fascinating information in terms of early microbial patterns and how these relate to various disease processes. One difficulty with the interpretation of these relationships is that such data is associative and provides little in terms of proof of causality or the underpinning mechanisms. Integrating microbiome data with other omics such as the proteome, inflammatory mediators, and the metabolome is an emerging approach to address this gap. Here we discuss these omics, their integration, and how they can be applied to improve our understanding, treatment, and prevention of disease. IMPACT: This review introduces the concept of multiomics in neonatology and how emerging technologies can be integrated improve understanding, treatment, and prevention of disease. We highlight considerations for performing multiomic research in neonates and the need for validation in separate cohorts and/or relevant model systems. We summarise how the use of multiomics is expanding and lay out steps to bring this to the clinic to enable precision medicine.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531762","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":"Rethinking healthcare's approach to ACEs treatment and the role of social health programming.","authors":"Rebecca A Drakowski, Ann L Anderson-Berry","doi":"10.1038/s41390-025-03970-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03970-w","url":null,"abstract":"<p><strong>Impact: </strong>This correspondence adds to the existing literature by highlighting the importance of community partnerships and social health programming as a necessary component of medical care for adverse childhood experiences.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531765","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":"Human Milk's Messengers from Mother to Infant.","authors":"Farha Ramzan, Gergely Toldi","doi":"10.1038/s41390-025-03973-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03973-7","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531745","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":"Renal dysplasia development and chronic kidney disease.","authors":"Li Zhang, Chunjiang Yang, Xing Liu, Dawei He, Tao Lin, Yuanyuan Zhang, Guanghui Wei, Deying Zhang","doi":"10.1038/s41390-025-03950-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03950-0","url":null,"abstract":"<p><p>Renal dysplasia is a common congenital birth defect in childhood, caused by fetal genetic defects, epigenetic modification disorders, or environmental factors. Maternal malnutrition, placental insufficiency, and exposure to harmful substances such as alcohol, angiotensin-converting enzyme inhibitors, and cocaine during pregnancy increase the risk of fetal renal dysplasia. The pathogenesis of this disease involves abnormal formation of renal units, leading to structural and functional abnormalities of the kidney. If left untreated, renal dysplasia can progress to chronic kidney disease (CKD) in children. This review explores the etiology and pathogenesis of renal dysplasia, emphasizing the intrinsic link between renal dysplasia and CKD through various pathological pathways. Additionally, we propose potential therapeutic agents targeting these mechanisms. We also highlight future research directions to further understand and address this issue. We hope this review will deepen clinicians' understanding of renal dysplasia and promote further laboratory research in this area. IMPACT: 1. This review comprehensively summarizes and elucidates the complex relationship between renal dysplasia and chronic kidney disease (CKD) based on previous research, offering new directions for related studies. 2. It expands upon conservative treatment approaches for renal dysplasia, providing more clinical options for therapeutic intervention.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502968","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":"Presumed etiology of preterm birth: brain injury and neurodevelopmental outcomes.","authors":"Amr El Shahed, Vann Chau, Jefferson Terry, Clare Whitehead, Anne Synnes, Ruth Grunau, Steven P Miller","doi":"10.1038/s41390-025-03945-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03945-x","url":null,"abstract":"<p><strong>Aim: </strong>To determine the relationship between presumed preterm birth (PTB) etiology and the incidence of brain injury, and neurodevelopmental outcomes at 3 and 4.5 years.</p><p><strong>Subjects and methods: </strong>Prospective cohort study including 222 neonates born at 24-32 weeks' gestation. The presumed PTB etiology was defined by placental histopathology and other clinical features. Outcome measures included brain injury defined on MRI, neurodevelopmental outcomes using the Bayley Scales of Infant and Toddler Development, the Movement Assessment Battery for Children, Wechsler Preschool and Primary Scale of Intelligence, Beery Buktenica Developmental Test of Visual-Motor Integration.</p><p><strong>Results: </strong>Presumed PTB etiology was inflammatory in 85 (38%), vascular in 57 (25%), multiple gestation in 56 (25%) and idiopathic in 24 (11%) neonates. Cognitive outcome at 3 years was marginally lower in the inflammatory group (Beta = -6.2, P = 0.05) relative to multiple gestation. At 4.5 years, white matter injury was associated with significantly lower motor scores (P = 0.004) and there were no significant associations between PTB etiology and WPPSI-III IQ scales or MABC-2 scores.</p><p><strong>Conclusions: </strong>The lack of association between presumed PTB etiology (using integrated clinical phenotype and placental pathology) and cognitive/motor outcomes suggests that postnatal morbidities and brain injury are pivotal in the neurodevelopmental trajectory of these infants.</p><p><strong>Impact: </strong>The presumed etiology of preterm birth (PTB), based on placental histopathology and clinical features, does not predict long-term neurodevelopmental outcomes, such as cognitive scores at 4.5 years. Postnatal factors, including neonatal morbidities (e.g., bronchopulmonary dysplasia, retinopathy of prematurity, brain injury), are more significant in determining neurodevelopmental outcomes than the initial PTB cause. Placental histopathology helps identify PTB causes but shows no direct link to brain injury or neurodevelopmental outcomes. Infants with \"idiopathic\" PTB (no clear cause) have the greatest white matter injury burden, suggesting genetic or unrecognized factors.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502850","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":"Antenatal Vitamin C differentially affects lung development in normally grown and growth restricted sheep.","authors":"Erin V McGillick, Sandra Orgeig, Beth J Allison, Kirsty L Brain, Youguo Niu, Nozomi Itani, Katie L Skeffington, Andrew D Kane, Emilio A Herrera, Dino A Giussani, Janna L Morrison","doi":"10.1038/s41390-025-03828-1","DOIUrl":"10.1038/s41390-025-03828-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic hypoxemia is a common cause of fetal growth restriction and can have significant effects on the developing fetal lung. Maternal antioxidant treatment in hypoxic pregnancy protects against offspring cardiovascular dysfunction. The effects of antenatal antioxidants on lung development in the chronically hypoxic growth restricted fetus is unknown.</p><p><strong>Methods: </strong>We investigated the effect of maternal daily Vitamin C (200 mg/kg i.v. vs. Saline) for a month in late gestation on molecular markers regulating lung maturation between normoxic normally grown and hypoxic growth-restricted fetal sheep. Chronic fetal hypoxia and fetal growth restriction were induced by exposure to maternal chronic hypoxia (10% O₂ vs. Normoxia=21% O₂) from 105-138 d gestation (term=145 d).</p><p><strong>Results: </strong>The data show a differential effect of antenatal Vitamin C treatment on regulation of genes involved in surfactant maturation, sodium movement and hypoxia signaling. Limited responsiveness to antenatal Vitamin C exposure in the lung of the hypoxic fetus, compared to responsiveness to antenatal Vitamin C in the normoxic fetus, suggests a maximal upregulation of the molecular signaling pathways in response to the chronic hypoxic insult alone.</p><p><strong>Conclusion: </strong>We provide molecular insight into the heterogeneity of antenatal Vitamin C treatment on development of the normoxic and growth restricted hypoxic fetal lung.</p><p><strong>Impact: </strong>The effect of maternal Vitamin C on molecular markers of lung maturation between normoxic normally grown and hypoxic growth restricted fetal sheep was unknown. We show a differential effect of Vitamin C with a greater increase in molecular markers of lung maturation in normoxic compared with hypoxic fetuses. Limited responsiveness in the hypoxic fetal lung is likely due to maximal upregulation by the hypoxic insult alone, thus added exposure to Vitamin C is unable to upregulate the system further. The work highlights the need to understand differential effects of antenatal interventions in healthy and complicated pregnancy, prior to clinical translation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502579","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}