Pediatric Research最新文献

{"title":"Assessing motor development with wearables in low-resource settings: feasibility in rural Malawi.","authors":"Elisa Taylor, Manu Airaksinen, Rikhard Ihamuotila, Milja Kivelä, Ulla Ashorn, Leena M Haataja, Charles Mangani, Sampsa Vanhatalo","doi":"10.1038/s41390-025-03818-3","DOIUrl":"10.1038/s41390-025-03818-3","url":null,"abstract":"<p><strong>Background: </strong>Tracking of early motor development is essential for all neurodevelopmental assessments. A multisensor wearable system, MAIJU (Motor Assessment of Infants with a JUmpsuit), was recently developed for an objective and scalable measurement of developing motor skills in out-of-hospital settings. Here, we assessed its feasibility in remote low-resource settings.</p><p><strong>Methods: </strong>We recruited 44 infants for repeated at-home measurements (total N = 121) with the MAIJU wearable in rural Malawi. We assessed (i) technical quality of the measured wearable data, (ii) reliability of the cloud-based analysis outputs, and (iii) maternal user experience. A dataset from 47 infants (total N = 111 measurements) in Finland served as a reference from a high-resource environment.</p><p><strong>Results: </strong>Altogether 94% of the measurements were technically successful. The analysis outputs from the automated cloud pipeline were all comparable to the reference cohort in Finland. The method was rapidly learned by the local study personnel, and it was well received by the mothers.</p><p><strong>Conclusion: </strong>Our results suggest that advanced multisensor wearables and cloud-based analytics can be readily used in remote and low-resource settings. Uptake of such objective methods holds promise for harmonizing and increasing equality in developmental assessments, as well as facilitating a wide range of global health studies on early life.</p><p><strong>Impact: </strong>Motor development is an effective measure of infants' overall neurodevelopment.^1-4 A multisensor wearable system was recently developed for an objective and scalable tracking of infants' developing gross motor skills.^5-7 Here, we assessed feasibility of using such wearable systems in low-resource settings in rural Malawi. Our findings show that the measurements are technically reliable, the outputs from the cloud-based analysis pipeline are comparable to those from our reference study in Finland, and the wearable recordings are well-received by the parents. The findings support the use of multisensor wearables in remote settings and highlight their potential for benchmarking early-life global health studies.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542965","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":"Leveraging oxygen saturation monitoring for improved detection of pulmonary hypertension in preterm infants.","authors":"Gergely Toldi","doi":"10.1038/s41390-025-03974-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03974-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542967","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":"Malaria in pregnancy and its potential impact on neurodevelopment in children: a systematic review.","authors":"Shrikant Nema, Richa Singhal, Praveen Kumar Bharti, Nitika Nitika","doi":"10.1038/s41390-025-03967-5","DOIUrl":"10.1038/s41390-025-03967-5","url":null,"abstract":"<p><strong>Background: </strong>Malaria during pregnancy can have adverse effects on fetal development, but its impact on neurodevelopment remains unclear. Although some studies have explored the consequences of prenatal malaria, gaps persist due to inconsistencies in exposure timing, assessment methods, and study designs.</p><p><strong>Methods: </strong>This systematic review highlighted the gaps in six studies selected from an initial pool of 2029 articles, offering clearer insights into the neurodevelopmental outcomes of prenatal malaria exposure.</p><p><strong>Results: </strong>Studies from Uganda, Benin, Ghana, and Malawi show that malaria during pregnancy adversely impacts cognitive, motor, and behavioral development. Cognitive deficits were observed at 12 and 24 months, with some studies indicating long-term effects at 36 months. Motor development and language outcomes were variable, with language impairments linked to malaria acquired late in pregnancy.</p><p><strong>Conclusions: </strong>The review identifies gaps in research, such as the role of asymptomatic infections, exposure timing, and malaria's interaction with maternal comorbidities like HIV. Potential mechanisms for neurodevelopmental deficits include placental dysfunction and inflammation impacting fetal brain development. However, methodological limitations, such as varying assessment tools and sample sizes, prevent conclusive evidence. The review calls for more longitudinal studies to understand the long-term effects of prenatal malaria better and guide interventions to improve child development in malaria-endemic regions.</p><p><strong>Impact: </strong>Prenatal malaria exposure is linked to cognitive deficits, with potential long-term effects on motor and language development. Late pregnancy malaria may have a stronger impact on language development, highlighting the importance of exposure timing. Mechanisms such as placental dysfunction and inflammation may disrupt fetal brain development and contribute to neurodevelopmental deficits. Future studies should prioritize longitudinal research using advanced methodologies to better understand the long-term effects of prenatal malaria exposure on neurodevelopment.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542970","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 association between fractalkine/CX3CR1 axis with IgA vasculitis and nephritis.","authors":"Rui Gu, Yuanzhao Zhi, Aoyu Wang, Daojing Ying, Huiqin Zeng, Peipei Shi, Lu Cao, Jianjiang Zhang, Qin Wang","doi":"10.1038/s41390-025-03957-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03957-7","url":null,"abstract":"<p><strong>Background: </strong>The study investigated whether the fractalkine/CX3CR1 axis is associated with the presence and severity of IgA vasculitis (IgAV) and IgA vasculitis nephritis (IgAVN) in children.</p><p><strong>Methods: </strong>We included 59 children with IgAV, 42 children with IgAVN (including 18 children with kidney biopsy), 26 plasma controls and 8 kidney controls. Clinical pathological data were collected, and the fractalkine/CX3CR1 axis and macrophage expression in the circulation and kidneys were detected.</p><p><strong>Results: </strong>Circulating fractalkine/CX3CR1 axis expression was significantly upregulated in children with IgAV and IgAVN compared to healthy controls. Plasma fractalkine levels and the proportion of CX3CR1⁺ monocytes were significantly higher in children with IgAVN than in those with IgAV, and the kidney expression of fractalkine/CX3CR1 axis and CD68 were significantly increased in the IgAVN group relative to normal controls, especially in children with IgAVN with more severe ISKDC pathological grading. Additionally, kidney levels of fractalkine, CX3CR1, and CD68 exhibited significant positive correlations with tubulointerstitial grading and serum creatinine levels.</p><p><strong>Conclusion: </strong>The expression of fractalkine/CX3CR1 axis is associated with the presence and severity of IgAV and IgAVN. Our findings support further investigation of fractalkine/CX3CR1 as a target for future therapies in IgAV and IgAN.</p><p><strong>Impact: </strong>The expression of plasma fractalkine/CX3CR1 axis is associated with the presence and severity of IgAV and IgAVN. The expression of kidney fractalkine/CX3CR1 axis and macrophage are upregulated in IgAVN, which is closely associated with poorer kidney function and more severe kidney pathology. Our findings support further investigation of fractalkine/CX3CR1 as a target for future therapies in IgAV and IgAVN.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542986","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":"Physical activity and screen time: prospective associations with child emotional and behavioral well-being during the COVID pandemic.","authors":"Simone A French, Alicia S Kunin-Batson, Anne A Eaton","doi":"10.1038/s41390-025-03954-w","DOIUrl":"https://doi.org/10.1038/s41390-025-03954-w","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) and screen time (ST) were examined longitudinally over 66 months to evaluate their association with child emotional and behavioral health during the early months of the COVID pandemic.</p><p><strong>Methods: </strong>Data are from 288 racially/ethnically diverse low-income children ages 2-4 years enrolled in the NET- Works studies (2012-2020). Baseline, 12-, 24-, 36- and 66-month measures of PA and ST were collected before the onset of the COVID pandemic. During the pandemic shutdown, parents completed a measure of their child's emotional and behavioral health (Strengths and Difficulties Questionnaire, SDQ). Longitudinal associations were examined between children's previous five-year PA and ST patterns and emotional and behavioral problems during the COVID shutdown.</p><p><strong>Results: </strong>Children whose objectively measured PA met recommendations at all five visits during the previous 66 months had poorer emotional and behavioral health, compared to less consistently active children (SDQ Emotions 0.91 points higher, 95% CI = 0.22, 1.6, p = 0.046; SDQ Conduct 1.1 points higher, 95% CI = 0.45, 1.8; p = 0.007). Child ST was not significantly associated with emotional or behavioral health.</p><p><strong>Conclusion: </strong>Future longitudinal research should examine the effects of changes in children's habitual PA on children's emotional and behavioral well-being.</p><p><strong>Impact: </strong>To prevent declines in psychological and behavioral well-being among children who are currently regularly physically active, it is important to support their continued engagement in PA during periods when external barriers to PA are high. Increases in physical activity among children who are currently more sedentary may help limit the negative effects of stressors on children's emotional and behavioral well-being, but further research is needed.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542983","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":"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}