World Journal of Pediatrics最新文献

{"title":"Retinopathy of prematurity in the era of precision neonatology: from risk stratification to targeted therapies.","authors":"Luca Filippi, Silvia Gulden, Maurizio Cammalleri, Gabriella Araimo, Giacomo Cavallaro, Eduardo Villamor","doi":"10.1007/s12519-025-00919-1","DOIUrl":"https://doi.org/10.1007/s12519-025-00919-1","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant body composition in a randomised trial of a maternal nutritional supplement during preconception and pregnancy.","authors":"Jaz Lyons-Reid, José G B Derraik, Leigh C Ward, Timothy Kenealy, Benjamin B Albert, Jose M Ramos Nieves, Cathriona R Monnard, Mya Thway-Tint, Heidi Nield, Sheila J Barton, Sarah El-Heis, Elizabeth H Tham, Keith M Godfrey, Shiao-Yng Chan, Wayne S Cutfield","doi":"10.1007/s12519-025-00900-y","DOIUrl":"https://doi.org/10.1007/s12519-025-00900-y","url":null,"abstract":"<p><strong>Background: </strong>In a multinational randomized controlled trial, we previously showed that maternal supplementation with myo-inositol, probiotics, and micronutrients was associated with reduced incidence of rapid infant weight gain and high body mass index (BMI) at two years among offspring. It was unclear whether these differences in weight gain and body mass were due to reduced adiposity. Therefore, we aimed to determine whether there were any differences in body composition.</p><p><strong>Methods: </strong>Body composition was measured using bioelectrical impedance spectroscopy at six weeks, six months, one year, and two years among offspring born to mothers who received a nutritional intervention (n = 268) or control (n = 264) supplement preconception and during pregnancy.</p><p><strong>Results: </strong>There were no group-level differences in body composition, except at two years, when fat-free mass was greater among control offspring [adjusted mean difference (aMD) 0.14 kg, 95% confidence interval (CI) 0.03, 0.25, P = 0.012]. However, there were no differences in mean percentage fat mass (%FM) at any time. In both groups, rapid weight gain [Δ weight > 0.67 standard deviation (SD) from birth to one year] was associated with greater %FM (aMD 2.0% at six months, 2.0% at one year, 1.4% at two years) compared with those who did not have rapid weight gain. Likewise, high BMI (≥ 95 percentile) at two years was associated with greater %FM (aMD 2.5%).</p><p><strong>Conclusions: </strong>A maternal nutritional intervention did not lead to differences in average offspring body composition in the first two years of life. However, fewer offspring from the supplemented group experienced rapid weight gain and high BMI, characterized by greater %FM.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the contributions of risk factors to under-five mortality in low- and lower-middle-income countries (1997-2022): an analysis of Demographic and Health Survey data.","authors":"Bereket Kefale, Jonine Jancey, Amanuel T Gebremedhin, Gavin Pereira, Gizachew A Tessema","doi":"10.1007/s12519-025-00912-8","DOIUrl":"https://doi.org/10.1007/s12519-025-00912-8","url":null,"abstract":"<p><strong>Background: </strong>Under-five mortality (U5M) is a critical public health challenge in low- and lower-middle-income countries (LLMICs), where over 90% of global deaths occur. Despite progress, the changing contributions of risk factors to U5M in LLMICs remains unexplored.</p><p><strong>Methods: </strong>We analysed Demographic and Health Survey (DHS) data from 24 LLMICs across two periods: 1997-2005 and 2016-2022. We included 139,890 live births in 1997-2005 and 319,034 in 2016-2022. A mixed-effects robust Poisson regression model with a log link function was employed to identify risk factors of U5M in each period. Population-attributable fractions (PAFs) were calculated and compared to investigate changes in the contributions of risk factors over time.</p><p><strong>Results: </strong>U5M attributable to never having been breastfed increased by 15.5 percentage points (95% CI 8.6, 22.9), early maternal age at birth (< 20 years) by 5.4 percentage points (95% CI 3.1, 5.7), and plural births by 1.2 percentage points (95% CI 0.4, 1.8). U5M reductions attributable to maternal secondary education were increased by 5.5 percentage points (95% CI 0.4, 11.0) and tertiary education increased by 2.6 percentage points (95% CI 1.6, 4.2). However, U5M reductions associated with 1-3 antenatal care (ANC) visits decreased by 7.2 percentage points (95% CI 2.4, 11.7).</p><p><strong>Conclusions: </strong>The main contributors of U5M in LLMICs were never breastfeeding, short birth intervals (<33 months), ANC uptake, higher maternal education (secondary and tertiary), advanced maternal age at birth (≥35 years),  early maternal age at birth (<20 years), very small infants at birth, male sex, plurality, and single motherhood. The contributions of risk factors to U5M have changed over time. Interventions need to prioritize promoting breastfeeding, enhancing maternal education and increasing ANC uptake, and addressing other significant contributors to U5M.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of EMA algorithm, 2022 ACR/EULAR criteria, and EMA-ACR/EULAR algorithm in classifying pediatric ANCA-associated vasculitis: a national cohort study in China.","authors":"Zhe Lu, Li-Wen Tan, Hong Xu, Zheng-Kun Xia, Xiao-Yun Jiang, Xiao-Chuan Wu, Fang Wang, Xiao-Rong Liu, Cheng-Guang Zhao, Xiao-Zhong Li, Jian-Hua Mao, Xiao-Wen Wang, Wen-Yan Huang, Xiao-Shan Shao, Jian-Jiang Zhang, Shi-Pin Feng, Jun Yang, Qiu Li, Ai-Hua Zhang, Mo Wang","doi":"10.1007/s12519-025-00899-2","DOIUrl":"https://doi.org/10.1007/s12519-025-00899-2","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a type of necrotizing vasculitis with poor prognosis, which is more severe in children. Classifying AAV patients may be helpful for diagnosis and management. However, present classification criteria for pediatric AAV are developed mainly based on adults, which have limitations in clinical practice. In this study, we introduced an updated algorithm based on the European Medicines Agency (EMA) algorithm in conjunction with the American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) criteria. This new approach aims to resolve the issue of duplicate classification present in the 2022 ACR/EULAR criteria and to refine the existing EMA algorithm.</p><p><strong>Methods: </strong>This study included 179 pediatric patients diagnosed with AAV across 17 centers in China. Patients were classified using the EMA algorithm, the ACR/EULAR criteria, and the EMA-ACR/EULAR algorithm. The Kappa value and Net Reclassification Index (NRI) were used to evaluate the classification performance of these criteria.</p><p><strong>Results: </strong>According to the EMA algorithm, 136 (76.0%) patients were classified with microscopic polyangiitis (MPA) and 14 (7.8%) with granulomatosis with polyangiitis (GPA), while 29 (16.2%) remained unclassifiable. According to the ACR/EULAR criteria, 145 (81.0%) patients were classified with MPA, 14 (7.8%) with GPA, 2 (1.1%) with eosinophilic granulomatosis with polyangiitis (EGPA), and 4 (2.2%) with both MPA and GPA, while 14 (7.8%) remained unclassifiable. The EMA-ACR/EULAR algorithm classified 124 patients (69.3%) as MPA, 26 (14.5%) as GPA, and 2 (1.1%) as EGPA, while 27 (15.1%) were unclassified. The Kappa values between the EMA algorithm and ACR/EULAR criteria for GPA and MPA were 0.225 [95% confidence interval (CI) 0.000-0.456, P = 0.003] and 0.357 (95% CI 0.196-0.518, P < 0.001). Compared to these two criteria, the EMA-ACR/EULAR algorithm demonstrated positive NRIs in the classification of both GPA (0.702, 95% CI 0.258-1.146, P = 0.002; 0.547 95% CI 0.150-0.944, P = 0.007) and MPA (0.425, 95% CI 0.209-0.642, P < 0.001; 0.519, 95% CI 0.305-0.733, P < 0.001).</p><p><strong>Conclusions: </strong>The EMA-ACR/EULAR algorithm addresses the limitations of the 1990 ACR criteria within the EMA framework and resolves the issue of duplicate classification in the 2022 ACR/EULAR criteria. However, further research is necessary to validate the superiority of the EMA-ACR/EULAR algorithm in the clinical classification of pediatric AAV patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovating pediatric epilepsy: transforming diagnosis and treatment with AI.","authors":"Giovanni Battista Dell'Isola, Antonella Fattorusso, Gianmichele Villano, Pietro Ferrara, Alberto Verrotti","doi":"10.1007/s12519-025-00904-8","DOIUrl":"https://doi.org/10.1007/s12519-025-00904-8","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin use in the pediatric population: an evolving global concern.","authors":"Judith Owens","doi":"10.1007/s12519-025-00896-5","DOIUrl":"https://doi.org/10.1007/s12519-025-00896-5","url":null,"abstract":"<p><strong>Background: </strong>The impact of melatonin on pediatric populations has not yet been widely researched. This narrative review is intended to summarize the current literature regarding the efficacy and safety of melatonin for children and potential pitfalls in its clinical use, in order to assist pediatric practitioners in making evidence-based recommendations that serve the best interests of their patients and families.</p><p><strong>Data sources: </strong>A literature review of melatonin in the pediatric population was conducted using PubMed search terms: melatonin, pediatrics, child/adolescent.</p><p><strong>Results: </strong>Melatonin use in the pediatric population world-wide has increased significantly over the past several decades. While a number of studies, largely in children with neurodevelopmental disorders with insomnia, have suggested that melatonin is generally safe and well-tolerated, a similar body of evidence is overall lacking for typically developing children and prospective studies regarding long-term adverse events are lacking. In addition, recent studies have raised concerns regarding the variable content of melatonin in over-the-counter products, as well as safety issues relating to accidental ingestions.</p><p><strong>Conclusions: </strong>Due to a number of concerns regarding inappropriate use, lack of efficacy and safety data across pediatric populations and variability in actual content, melatonin should be used with caution in children and only under medical supervision.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of lateral positioning on upper airway morphology in sedated children under five.","authors":"Hui Li, Xuan Jia, Hui Ye, Jia-Wei Liang, Wen-Li Zhao, Ping Cui, Yaqi Sun, Deng-Ming Lai, Qiang Shu, Yue Jin, Guo-Hao Xie, Xiang-Ming Fang","doi":"10.1007/s12519-025-00910-w","DOIUrl":"https://doi.org/10.1007/s12519-025-00910-w","url":null,"abstract":"<p><strong>Background: </strong>The upper airway morphology in children varies with age and body position. This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under five.</p><p><strong>Methods: </strong>This retrospective study included pediatric patients who underwent MRI in both the supine and lateral positions at Children's Hospital, Zhejiang University School of Medicine. Upper airway morphology was reconstructed using 3D Slicer software. Python was employed to estimate cross-sectional areas via pixel analysis. The narrowest cross-sectional area, minimal transverse and anteroposterior diameters, airway length, and airway volume were measured and stratified by age for subgroup analysis.</p><p><strong>Results: </strong>In sedated children under 5 years old and when compared to the supine position, lateral positioning increased minimal transverse diameter by 18.70% (P = 0.001), narrowest cross-sectional area by 49.21% (P < 0.001), anteroposterior diameter by 25.54% (P < 0.001), airway volume by 65.64% (P < 0.001), and airway length by 11.93% (P < 0.001). In all subgroups, lateral positioning significantly increased the narrowest cross-sectional area, airway length, and airway volume. However, minimal anteroposterior diameter in the 1-to 3-year age group and minimal transverse diameter in the 3 -to 5-year age group tended to increase in the lateral position but did not reach statistical significance.</p><p><strong>Conclusions: </strong>Lateral position significantly enlarges the upper airway in sedated children under five. These findings support using lateral position to enhance airway patency in younger patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent need for newborn targeted sequencing screening technology in Shandong Province, China.","authors":"Jia-Lin Mu, Meng Sun, Yu-Lin Li, Pan-Pan Li, Hui Zou","doi":"10.1007/s12519-025-00907-5","DOIUrl":"https://doi.org/10.1007/s12519-025-00907-5","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurturing healthy futures: social and familial influences on childhood obesity.","authors":"Tiago Santos Trindade, Helena Neta Duarte, Tiago Marçal Brito, Joana Vanessa Silva, Benedita Bianchi Aguiar, Miguel Costa","doi":"10.1007/s12519-025-00906-6","DOIUrl":"https://doi.org/10.1007/s12519-025-00906-6","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram and scoring models based on BMI z-score, serum chlorine and urine specific gravity levels for predicting oral rehydration solution efficacy in pediatric postural orthostatic tachycardia syndrome.","authors":"Yu-Meng Gao, Bo-Wen Xu, Ping Liu, Yu-Li Wang, Qing-You Zhang, Ying Liao, Jun-Bao Du, Hong-Fang Jin","doi":"10.1007/s12519-025-00898-3","DOIUrl":"https://doi.org/10.1007/s12519-025-00898-3","url":null,"abstract":"<p><strong>Background: </strong>Oral rehydration solution (ORS) is predominantly utilized in the management of hypovolemic postural orthostatic tachycardia syndrome (POTS). This study aimed to identify effective indicators and develop models to assess the impact of ORS on pediatric patients diagnosed with POTS.</p><p><strong>Methods: </strong>We utilized a retrospective analysis of totally 158 pediatric patients with POTS receiving a 3-month course of ORS treatment. All patients were classified into training set (n = 98) and validation set (n = 60). Within the training set, univariate analysis and binary logistic regression were employed to select candidate predictors. To predict the efficacy of ORS in pediatric patients with POTS, a nomogram model and a scoring model were constructed and demonstrated. Additionally, the predictive ability and calibration performance were evaluated using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow (H-L) goodness of fit test, and calibration plots. Decision curve analysis (DCA) was employed to assess the clinical applicability of the predictive models.</p><p><strong>Results: </strong>Body mass index (BMI) z-score, serum chlorine, and urine specific gravity (USG) before treatment were identified as significant and independent predictors of efficacy of ORS in pediatric patients with POTS. Consequently, these indicators were included in the predictive models. A nomogram model was constructed in the training set (AUC = 0.87, which yields a sensitivity of 84.5% and a specificity of 85.0%) and validated in the validation set (the sensitivity, specificity, and accuracy were 87.5%, 85%, and 86.7%, respectively). A scoring model was advanced in the training set (AUC = 0.88, which yields a sensitivity of 79.3% and a specificity of 82.5%) and validated in the validation set (the sensitivity, specificity, and accuracy were 77.5%, 80.0%, and 78.3%, respectively). The H-L test results indicated a good model fit. The calibration plots and DCA for both models exhibited excellent calibration and satisfactory net benefit.</p><p><strong>Conclusions: </strong>Based on pre-treatment BMI z-score, serum chlorine, and USG, a nomogram model and a scoring model were developed and validated. The models can effectively assess the efficacy of ORS in pediatric patients with POTS, offering an accurate and individualized therapeutic strategy.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}