World Journal of Pediatrics最新文献

{"title":"Clinical and molecular prognostic factors in newly diagnosed pediatric T-cell lymphoblastic lymphoma: a prospective, multicenter, single-arm phase 2 clinical trial.","authors":"Xia Guo, Chao-Ban Wang, Yue-Jia Tang, Yong-Jun Fang, Jie Yan, Xiu-Li Ju, Ai-Guo Liu, Liang-Chun Yang, Ju Gao, Yi-Jin Gao","doi":"10.1007/s12519-026-01058-x","DOIUrl":"10.1007/s12519-026-01058-x","url":null,"abstract":"<p><strong>Background: </strong>Poor early treatment response in T-cell lymphoblastic lymphoma (T-LBL) is associated with an unfavorable prognosis. This multicenter prospective study evaluated the efficacy of the response-adjusted Chinese Children's Cancer Group (CCCG-LBL-2016) protocol for pediatric T-LBL and examined clinical and molecular prognostic factors.</p><p><strong>Methods: </strong>Clinical and laboratory data from seven pediatric oncology centers were analyzed. A sub-cohort of 23 patients underwent exploratory integrated genomic analysis, including targeted next-generation sequencing, RNA sequencing, and copy-number array analysis. Survival was evaluated using the Kaplan-Meier method, and prognostic factors were analyzed using multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>A total of 163 patients (median age: 108 months; 116 males, 47 females) were enrolled, most with advanced disease (stage III: 81.0%; stage IV: 17.8%). Patients were stratified into the low-risk (R1, n = 2) and intermediate-risk groups (R2, n = 161); thirty one patients in the R2 group were escalated to the high-risk intensified regimen (R3) due to poor early response. The 3-year overall survival (OS) was 78.6% ± 3.3% and event-free survival (EFS) was 73.9% ± 3.5%. Outcomes differed by risk group (P < 0.05), with 3-year OS and EFS of 100% and 100% in R1, 82.6% ± 3.4% and 79.5% ± 3.4% in R2, and 58.6% ± 9.1% and 48.3% ± 9.1% in R3. Progression or recurrence occurred in 42 patients (median: 7 months; 3-year OS: 17.1% ± 6.3%). Clinical risk factors included R3 assignment and elevated lactate dehydrogenase. In the exploratory molecular sub-cohort, recurrent alterations included CDKN2A (39.1%), NOTCH1 (26.1%), FBXW7 (21.7%), and MTAP/PIK3R1/NRAS (13.0%). Exploratory multivariable Cox regression analysis identified that CDKN2A alteration was associated with an increased risk of progression or recurrence (hazard ratio = 35.89, 95% confidence interval: 3.07-419, P = 0.004).</p><p><strong>Conclusions: </strong>Adjusting the risk stratification based on treatment response significantly improved the overall prognosis of T-LBL. However, survival rates remain very low among patients who experience disease progression or recurrence. The preliminarily explored molecular genetic risk factors might contribute to further risk stratification and provide potential therapeutic targets.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"741-754"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798536","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":"Gene expression patterns associated with influenza A and type I hypersensitivity in childhood appendicitis.","authors":"Marc Reismann, Natalie Kiss, Moritz Markel, Kathrin Hauptmann, Jan F Svensson, Tomas Wester, Steven W Warmann","doi":"10.1007/s12519-026-01067-w","DOIUrl":"10.1007/s12519-026-01067-w","url":null,"abstract":"<p><strong>Background: </strong>Both influenza A infection (IAV) and type I hypersensitivity mechanisms have been independently linked to acute appendicitis. Particularly the expression of type I hypersensitivity associated with cytokine interleukin (IL) 13 has been shown to be of significance in both, appendicitis and influenza infection. The aim of the current study was to analyze possible associations of respective gene expressions at the level of mathematical correlations.</p><p><strong>Methods: </strong>We analyzed messenger RNA (mRNA) gene expressions of IAV-associated markers, hypersensitivity type I-related cytokines and inflammatory markers IL-17A and c-reactive protein (CRP) in peripheral blood mononuclear cells from 29 children aged 7-17 years, who were operated for histologically confirmed appendicitis at Charité-Universitätsmedizin Berlin between April and August 2019. Statistical relationships between gene expressions were investigated using Spearman's correlation analysis, with a correlation coefficient r ≥ 0.5 or r ≤ - 0.5 representing high, and r ≥ 0.7 or r ≤ - 0.7 very high correlations. Statistical significance was assumed at P < 0.01.</p><p><strong>Results: </strong>A total of 29 patients were involved in this study. Particularly the expression of IL-13 showed highly significant negative correlations with that of IAV-specific antiviral response genes, ranging from - 0.89 (P < 0.0001) to - 0.49 (P = 0.006). A strong inflammatory background was demonstrated by very high correlations of IL-13 with CRP (r = 0.91, P < 0.0001) and IL-17A (r = 0.82, P < 0.0001).</p><p><strong>Conclusion: </strong>These findings suggest a connection between IAV infection and acute appendicitis in children, implicating sequential immune responses, including hypersensitivity type I mechanisms, in appendicitis pathophysiology.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"819-827"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure, left ventricular structure and cognitive development in young children: a cross-sectional study.","authors":"Hua-Lin Wang, Bo-Wen Du, Yue Zhou, Zhuo-Yan Li, Qian-Chuo Wang, Cai-Fang Xu, Zhi-Kang Xu, Xi Zhang, Sun Chen, Qian Chen, Kun Sun, Jian Wang","doi":"10.1007/s12519-026-01078-7","DOIUrl":"10.1007/s12519-026-01078-7","url":null,"abstract":"<p><strong>Background: </strong>As a consequence of hypertension, left ventricular (LV) structural alterations are associated with cognitive decline in the elderly. However, its role in early childhood remains unclear. We examined the relationship between blood pressure (BP), LV structure, and cognitive function in preschool-aged children. This population is free from aging-related comorbidities.</p><p><strong>Methods: </strong>We recruited 1279 4-year-old children from the Shanghai Birth Cohort (2018-2021), excluding those with birth defects or developmental delays. BP and echocardiographic assessment were conducted at follow-up. Cognitive function was evaluated using the Wechsler preschool and primary scales of intelligence-fourth edition.</p><p><strong>Results: </strong>Elevated BP (107.4 ± 6.2 mmHg) compared to normal BP (96.0 ± 5.9 mmHg) tended towards lower full scale intelligence quotient (IQ) [adjusted mean difference (β) = - 2.95, 95% confidence interval (CI) = - 4.65, - 1.25], processing speed index (β = - 1.77, 95% CI = - 3.41, - 0.14), working memory index (β = - 2.79, 95% CI = - 4.70, - 0.88) and visual spatial index (β = - 2.64, 95% CI = - 4.74, - 0.55). These associations persisted after adjusting for LV mass index (LVMI). Higher systolic BP, analyzed as a continuous variable, was associated with lower full scale IQ (β = - 0.12, 95% CI = - 0.21, - 0.03) and visual spatial index (β = - 0.23, 95% CI = - 0.35, - 0.10); diastolic BP showed the same trend. There was no significant association between cognitive function and LV structure or the mediating effect of LVMI.</p><p><strong>Conclusions: </strong>Higher BP was associated with poorer cognitive development as early as age four; LV structural alterations were not. This suggests that the relationship between BP and cognitive function was independent of LVMI in early childhood.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"782-792"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening adaptive functioning and participation in the contemporary spinal muscular atrophy paradigm: clinical perspectives and future directions.","authors":"Emily E Farah, Michelle A Farrar, Didu S Kariyawasam, Sarah-Grace Paguinto","doi":"10.1007/s12519-026-01063-0","DOIUrl":"10.1007/s12519-026-01063-0","url":null,"abstract":"<p><strong>Background: </strong>The developmental trajectory for children with spinal muscular atrophy (SMA) has been significantly altered following the availability of survival motor neuron (SMN) augmenting therapies. In the treatment era, a holistic patient-centred approach that looks beyond outcomes of survival and motor function is critical and must incorporate everyday functioning (\"adaptive functioning\") and participation.</p><p><strong>Methods: </strong>A literature review was conducted using PubMed, drawing on articles published until 2025. Keywords included: \"spinal muscular atrophy\", \"adaptive function\", \"adaptive behaviour\", \"the International Classification of Functioning, Disability and Health\", \"function\", \"participation\" and \"patient-reported outcome measures\". Articles were screened and included on the basis of their contextual relevance to the current SMA care paradigm, with preference given to studies providing insights into the application of the International Classification of Functioning, Disability and Health (ICF), and adaptive functioning.</p><p><strong>Results: </strong>This review highlights the growing importance of everyday functioning and participation within the contemporary SMA treatment paradigm. Current evidence suggests that adaptive functioning is affected across mobility, self-care, social, and neurodevelopmental domains. The ICF provides a practical and multidimensional framework that supports a holistic assessment approach, extending beyond traditional performance-based and motor-focused outcomes to better capture capabilities in everyday functioning, including outcomes that directly influence independence, participation, and quality of life for children with SMA and their families. Furthermore, the ICF may assist in identifying treatment goals, guiding personalised management, and facilitating multidisciplinary collaboration. A limitation of current evidence is that thus far studies have predominately been completed prior to the advent of SMN augmenting therapies, emphasising the necessity of assessing adaptive functioning, especially in the domain of patient-reported outcome measures, to support personalised care and meaningful long-term outcome assessment.</p><p><strong>Conclusions: </strong>The ICF is highly applicable for applying a holistic management approach for SMA in the treatment era, enabling SMA to be conceptualised through a multidimensional lens. Developing a minimum set of core SMA outcomes which incorporate the ICF framework and aim to understand and improve outcomes is a priority and of practical relevance to people with SMA, families and clinicians. This approach promotes an essential paradigm shift by emphasising functioning and participation as key focuses within clinical care and research.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"728-740"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus on the management of nocturnal enuresis in children.","authors":"Qian Shen, Hong Xu","doi":"10.1007/s12519-026-01051-4","DOIUrl":"10.1007/s12519-026-01051-4","url":null,"abstract":"<p><strong>Background: </strong>Nocturnal enuresis (NE) is a common condition in childhood that can adversely affect children's physical and psychological health. Since the publication of the \"Expert Consensus on the Management of Monosymptomatic Nocturnal Enuresis in Chinese Children\" in 2014, substantial clinical experience has been accumulated and international guidelines have been updated, necessitating a revision to standardize and improve clinical management.</p><p><strong>Methods: </strong>This consensus was developed by the Chinese Cooperative Group for the Management of Pediatric Nocturnal Enuresis, the Pediatric Nephrology Committee of the Chinese Medical Doctor Association using the Delphi method. A core writing group of nine experts drafted statements based on a synthesis of current evidence. These were subjected to iterative voting by 42 multidisciplinary panelists to achieve consensus, defined as ≥ 90% agreement.</p><p><strong>Results: </strong>The consensus provides 18 key recommendations. It updates the diagnostic criteria for children aged ≥ 5 years with at least one involuntary void per month for three months. It emphasizes classification into monosymptomatic (MNE) or nonmonosymptomatic (NMNE) NE based on daytime lower urinary tract symptoms. Recommendations cover comprehensive evaluation (history, physical exam, voiding diary), basic management (education, lifestyle), and first-line treatment (desmopressin for nocturnal polyuria, alarm therapy for reduced bladder capacity). Strategies for treatment-resistant cases, management of NMNE (prioritizing daytime symptoms), and the role of primary care and traditional Chinese medicine are outlined.</p><p><strong>Conclusions: </strong>This expert consensus provides an updated, evidence-based, and practical framework for the diagnosis and management of childhood NE. It aims to harmonize clinical practice, promote individualized care, and improve patient outcomes through standardized recommendations.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"709-727"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental understanding of restrictive bathroom policies in school-aged children.","authors":"Benjamin H Press, Corey S Weinstein, Jacob D Hansen, Christopher S Cooper, Andrew J Kirsch","doi":"10.1007/s12519-026-01054-1","DOIUrl":"10.1007/s12519-026-01054-1","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"828-832"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798699","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":"COSMIC: a core outcome set for intravenous maintenance fluid therapy trials in children.","authors":"David W Brossier, Frederic V Valla, George Briassoulis, Corinne Jotterand Chaparro, Fabrizio Chiusolo, Oguz Dursun, Els Lim Duval, Klara Horvath, Stavroula Ilia, Peter Kenderessy, Martin C J Kneyber, Jorge Lopez, Jesus López-Herce, Huw F Mayberry, Magdalena Mierzewska-Schmidt, Maria Miñambres Rodríguez, Claire Morice, Clémence Moullet, Megan Nallet-Amate, Joram Nyandat, Sevil Özkan, Leonor Reis Boto, John V Pappachan, Christoph Rohde, Luregn J Schlapbach, Hakan Tekguc, Konstantinos Tziouvas, Sascha C A T Verbruggen, Ann-Marie Brown, Wesley Hayes, Karl Reiter, Luis H Llano López, Alvin W F Hui, Guillaume Mortamet, Sainath Raman, Shira J Gertz, Claudio Flauzino de Oliveira, Ben Gelbart, Siew Wah Lee, Jemma Woodgate, Jaime Fernández-Sarmiento, Sarah McNab, Michael L Moritz, Michael S D Agus, Lyvonne N Tume","doi":"10.1007/s12519-026-01066-x","DOIUrl":"10.1007/s12519-026-01066-x","url":null,"abstract":"<p><strong>Background: </strong>Intravenous maintenance fluid therapy is one of the most common therapies for hospitalized children, yet the field lacks standardized outcomes to evaluate its effectiveness. Although intravenous maintenance fluid therapy has been used for nearly two centuries, existing studies show wide heterogeneity in reported endpoints, limiting the ability to perform meta-analyses and generate robust evidence. No core outcome set specific to pediatric intravenous maintenance fluid therapy currently exists, and previous initiatives have focused narrowly on fluid accumulation rather than the five components of intravenous maintenance fluid therapy prescription. This study aimed to create a comprehensive core outcome set-COSMIC-to standardize outcome reporting across research involving indications, tonicity, balanced solutions, composition, and volume of intravenous maintenance fluid therapy in children.</p><p><strong>Methods: </strong>The study followed the core outcome measures in effectiveness trials and core outcome set-standards for development guidelines and was prospectively registered. Four phases were undertaken: a systematic literature review (1960-2023), the extraction and classification of all reported intravenous maintenance fluid therapy-related outcomes, a two-round modified Delphi process involving international experts and non-experts, and two online consensus meetings to finalize the cost. Eligible participants included authors of intravenous maintenance fluid therapy publications and healthcare professionals. Outcomes were rated on a 9-point Likert scale, and predefined consensus thresholds determined inclusion or exclusion. Items without consensus were discussed and voted on during the final meetings.</p><p><strong>Results: </strong>The literature review identified 259 outcomes, of which 104 unique items entered Delphi round 1. Ninety participants completed round 1 and 82 round 2. Participants represented all continents. Four outcomes were deemed essential for all five PICO-based intravenous maintenance fluid therapy questions: 28-day mortality, survival free of organ dysfunction, hospital length of stay, and natremia. Additional outcomes were defined specifically for each of the five intravenous maintenance fluid therapy components, resulting in a structured and globally applicable core outcome set.</p><p><strong>Conclusions: </strong>COSMIC is the first comprehensive core outcome set to address all core questions related to pediatric intravenous maintenance fluid therapy. It covers the full spectrum of prescription components and includes outcomes feasible across diverse healthcare settings. COSMIC adheres to the standards and provides a practical, internationally relevant framework. Its adoption will harmonize reporting, strengthen future trials, and support meta-analyses, ultimately improving evidence-based intravenous maintenance fluid therapy in children.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"755-768"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761610","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":"Efficacy and safety of tocilizumab in the chronic phase of febrile infection-related epilepsy syndrome: a retrospective cohort study.","authors":"Wei Liu, Jie Zhang, Jiong Deng, Xiao-Ling Yang, Hui Dong, Yuan Wu, Tian Sang, Tao-Yun Ji, Ying Zhu, Yu-Wu Jiang, Ye Wu","doi":"10.1007/s12519-026-01065-y","DOIUrl":"10.1007/s12519-026-01065-y","url":null,"abstract":"<p><strong>Background: </strong>Febrile infection-related epilepsy syndrome (FIRES) is a rare and severe epileptic encephalopathy characterized by refractory seizures following a febrile infection. FIRES is a subtype of new-onset refractory status epilepticus with an unknown etiology. Tocilizumab is an interleukin-6 receptor antagonist which has been recommended as an anti-inflammatory treatment for the acute phase of FIRES. However, the efficacy of tocilizumab for the chronic phase of FIRES remains unclear. This study aimed to analyze the efficacy and safety of tocilizumab in the treatment of pediatric patients with FIRES during the chronic phase.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in pediatric patients with FIRES during the chronic phase who received tocilizumab treatment. The primary outcome was the response rate at 16 weeks after tocilizumab initiation, defined as the proportion of pediatric patients who achieved a 50% or greater reduction in seizure frequency. Secondary outcomes included the response rate at 28 weeks, treatment-related adverse events, and changes in the modified Rankin Scale (mRS) scores. The response rate to tocilizumab treatment, incidence of adverse reactions and factors related with the efficacy of tocilizumab were analyzed.</p><p><strong>Results: </strong>Twenty-seven pediatric patients with chronic-phase FIRES were included. The median duration of seizures at tocilizumab initiation was 16 months [interquartile range (IQR): 6-34 months]. All patients received a median of four (IQR: 3-6) doses of tocilizumab. Most patients (81.5%, 22/27) did not require additional anti-seizure medications during the entire treatment period. After 16 weeks of treatment, 63.0% (17/27) of patients achieved a 50% or greater reduction in seizure frequency, and 7.4% (2/27) were seizure free; 70.4% (19/27) of the patients showed improvements in mRS scores. After 28 weeks, the response rate was 48.1% (13/27). The most common adverse events were neutropenia (33.3%, 9/27) and infections (14.8%, 4/27).</p><p><strong>Conclusions: </strong>Tocilizumab is effective in the treatment of epilepsy in the chronic phase of FIRES. Tocilizumab can reduce the seizure frequency in pediatric patients with FIRES and is relatively safe.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"793-804"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892479","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":"Video bronchoscope-assisted tracheal intubation in pediatric difficult airways: a single-center retrospective case series.","authors":"Gui-Mei Zheng, Fei-Zhou Zhang, Fang Jin, Hu-Jun Wu, Xiao-Fen Tao, Yao-Jun Suo, Jiang-Mei Wang, Lei Wu, Lan-Fang Tang","doi":"10.1007/s12519-026-01090-x","DOIUrl":"10.1007/s12519-026-01090-x","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"833-838"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841097","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":"Clinical characteristics and epidemiology of pediatric cow's milk protein allergy: a multicenter cohort study in urban China.","authors":"Min Yang, Ying Wang, Dan-Dan Hu, Zai-Ling Li, Jie Wu, Hui-Qing Shen, Xun Jiang, Bao-Xi Wang, Xiao-Li Xie, Xiao-Qin Li, Ting Zhang, Ling-Fen Xu, Lan-Lan Geng, Mei-Zhen Tan, Wei Zhang, Zhuang Wei, Jin-Jin Chen, Yue-Sheng Wang, Shuan-Feng Fang, Li-Jing Xiong, Lan Zhang, Jiao-Li Lan, Jing Yang, You-Yi Peng, Hao-Tian Wu, Qing Zhao, Jin-Yan Jing, Yi Wen, Yu-Peng Li, Zheng-Zheng Luo, Zhi-Ling Li, Xiao-Yan Zhang, Hong-Li Wang, Li-Ping Ye, Huan Chen, Si-Tang Gong","doi":"10.1007/s12519-026-01062-1","DOIUrl":"10.1007/s12519-026-01062-1","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk protein allergy (CMPA) is the most common food allergy during infancy. Although the prevalence and natural history of allergic conditions have been well characterized in western populations, comprehensive data from rapidly urbanizing regions such as China remain scarce, limiting our understanding of how environmental transitions influence the developmental trajectories of allergic diseases.</p><p><strong>Methods: </strong>We conducted a multicenter, cross-sectional survey of infants across five major regions in China between November 2018 and June 2019. Infants diagnosed with CMPA using a standardized protocol were subsequently enrolled in a prospective longitudinal follow-up at 3 years and 5 years after diagnosis.</p><p><strong>Results: </strong>Among 10,754 infants, 327 were diagnosed with CMPA, yielding a prevalence of 3.04%. Independent associated factors included higher birth weight, winter birth, antibiotic exposure within the first 6 months of life, formula feeding, a family history of allergy, pet exposure during pregnancy, and maternal use of progesterone and vitamin A. Exclusive breastfeeding and higher parental education were inversely associated with CMPA. At the 3-year follow-up, 94.47% of the children had developed tolerance to cow's milk protein. Longitudinally, the prevalence of food allergy and eczema decreased, whereas that of allergic rhinitis increased significantly after 5 years, suggesting a dynamic evolution of atopic manifestations over time.</p><p><strong>Conclusions: </strong>CMPA affects approximately 3.04% of infants in urban China. Despite the high prevalence of early tolerance development, the progression to other atopic conditions-particularly respiratory allergies-is frequently observed. Our findings highlight the long-term consequences of early-life food allergies and emphasize the need for integrated surveillance and preventive strategies within child health programs in transitioning societies.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"769-781"},"PeriodicalIF":7.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798628","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}