International Journal of Pediatrics最新文献

{"title":"Chronic Kidney Disease in Pediatric Recipients of Hematopoietic Stem Cell Transplantation in a 5-Year Observation-A Single Center Experience.","authors":"Katarzyna Gąsowska, Katarzyna Zachwieja, Monika Miklaszewska, Aleksandra Krasowska-Kwiecień, Jolanta Goździk, Dorota Drożdż","doi":"10.1155/ijpe/5335429","DOIUrl":"https://doi.org/10.1155/ijpe/5335429","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a common complication of hematopoietic stem cell transplantation (HSCT). However, the data on its risk factors in the pediatric population is conflicting.</p><p><strong>Methods: </strong>We retrospectively analyzed data from HSCT patients treated between 2005 and 2019, including indications for HSCT, conditioning regimens, and complications observed during a 5-year follow-up period, and calculated estimated glomerular filtration rate (eGFR) values. We used repeated measures ANOVA to model the time course of eGFR as a function of CKD. We built unadjusted and multiple adjusted logistic regression models. We did Kaplan-Meier plots and Cox regression with CKD as a potential risk factor for mortality.</p><p><strong>Results: </strong>At HSCT, the median age (q5-q95) of the 200 (33.5% female) patients was 8.3 (0.64-17.4) years, median creatinine was 33.8 (17.0-65.5) <i>μ</i>mol/L, 49 (24.5%) developed CKD, and 42 (21.0%) died during follow-up. In the unadjusted logistic regression model, CKD was negatively related to baseline eGFR (unadjusted OR per 10 mL/min/1.73 m² greater eGFR: 0.87, 95% CI 0.78-0.95; <i>p</i> = 0.004). In the stepwise selection model, greater AKI severity (OR 2.92, 95% CI 1.89-4.15; <i>p</i> < 0.0001), presence of hypertension (OR 2.68, 95% CI 1.02-7.05; <i>p</i> = 0.05), malnutrition (OR 5.42, 95% CI 1.98-14.82; <i>p</i> = 0.001), and iron overload (OR 3.88, 95% CI 1.31-11.51; <i>p</i> = 0.01) were related to CKD during follow-up. Female sex was protective (OR 0.19, 95% CI 0.06-0.61; <i>p</i> = 0.005). CKD status during follow-up was not related to the risk of mortality.</p><p><strong>Conclusion: </strong>Our results underline the need for better nutrition, prevention of iron overload, and adequate blood pressure control to prevent CKD in pediatric patients after HSCT.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"5335429"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bubble CPAP Therapy in Newborns With Respiratory Distress With Its Outcome-A Prospective Observational Study From a Neonatal Intensive Care Unit of Tertiary Care Hospital in Western Nepal.","authors":"Hanshmani Prasad Chaudhary, Binod Kumar Gupta, Dinesh Chaudhary, Raju Kafle, Nagendra Chaudhary","doi":"10.1155/ijpe/2200049","DOIUrl":"https://doi.org/10.1155/ijpe/2200049","url":null,"abstract":"<p><strong>Background: </strong>Respiratory distress is one of the most common reasons for the admission of neonates to the NICU in low and middle-income countries (LMICs) like Nepal, where bubble CPAP therapy is one of the most emerging and first-line treatments.</p><p><strong>Aims: </strong>The aim is to study the various indications of bubble CPAP therapy in neonates with respiratory distress in different clinical conditions, success and failure rates, and outcomes.</p><p><strong>Methods: </strong>A prospective observational study was conducted for 17 months (Oct 2021-Feb 2023) at Universal College of Medical Sciences, Bhairahawa, Nepal, where 90 neonates with respiratory distress were enrolled and kept on bubble CPAP therapy. Various clinical conditions of CPAP use were observed along with success and failure rates. The final outcome was documented as discharge or death occurred.</p><p><strong>Results: </strong>A total of 90 babies with respiratory distress required CPAP therapy, where 53.3% were preterm, 44.4% term, and the rest postterm. About 32.2% of neonates had birth asphyxia, 16.7% had respiratory distress syndrome (RDS), 14.4% of cases had prematurity, and 12.2% had meconium aspiration syndrome. The study found a significant mean difference in Silverman score (in preterms) and Downe's score (in terms) before and after 6 h of CPAP (<i>p</i> < 0.001 in each) and 12 h of life (<i>p</i> < 0.001 in each). Out of the total enrolled babies, 67 (74.4%) neonates survived whereas 25.6% had mortality. The present study showed CPAP success and failure rates of 68.9% and 31.1%, respectively. Out of total CPAP failure rate (<i>n</i> = 28) babies, 67.9% had mortality and 32.1% were successfully discharged. No significant association of CPAP failure was seen when compared to gender, religion, gestational age, mode of delivery, resuscitation received, various indications of CPAP use, use of antenatal steroid, and duration of initiation of CPAP.</p><p><strong>Conclusion: </strong>Birth asphyxia, respiratory distress, and prematurity were three leading causes of respiratory distress for the initiation of CPAP in the present study.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"2200049"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Nonpharmacological Approaches to Control Anxiety in Pediatric Dentistry.","authors":"Sepehr Siahvoshi, Sahar Hassantash, Katayoun Salem","doi":"10.1155/ijpe/6139102","DOIUrl":"10.1155/ijpe/6139102","url":null,"abstract":"<p><p><b>Objectives:</b> This review critically evaluates the literature on nonpharmacological interventions aimed at reducing anxiety in pediatric patients undergoing dental treatments. The aim is to analyze recent research findings on various behavior management techniques and their clinical implications. <b>Methods:</b> A thorough literature search was conducted using electronic databases, including PubMed, Web of Science, the Cochrane Library, and Scopus. Predefined terms were used to ensure a comprehensive and focused search for relevant studies. <b>Results:</b> The continuous stream of research has unveiled several methods, such as awards, Tell-Show-Do, exposure to positive images, and pictorial stories, that have demonstrated tangible effects on anxiety, behavior, and pain perception. These interventions have exhibited practical effectiveness in actual clinical settings. <b>Conclusions:</b> The findings underscore the importance of implementing nonpharmacological interventions in pediatric dentistry to establish a dependable, reassuring, and efficacious treatment environment for children. As more research adhering to designated guidelines and methodologies emerges, pediatric dentistry can further enhance its capacity to not only reduce dental fear and pain intensity but also promote positive dental hygiene practices, starting from early childhood.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"6139102"},"PeriodicalIF":1.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron Supplementation at 1 mg/kg/Day for Exclusively Breastfed Full-Term Infants: A Meta-Analysis.","authors":"Suyu Wang, Yayu Zhang, Dan Song, Hua Mei, Zhiying You, Xiaofang Xu, Yuqi Zhang","doi":"10.1155/ijpe/6662278","DOIUrl":"10.1155/ijpe/6662278","url":null,"abstract":"<p><p><b>Aim:</b> The aim for the study is to evaluate the effects of 1 mg/kg/day iron supplementation on hematologic and growth parameters in exclusively breastfed full-term infants. <b>Methods:</b> We conducted a meta-analysis of seven RCTs (<i>n</i> = 1114) comparing iron supplementation with placebo/no intervention. Primary outcomes included hemoglobin (Hb), serum ferritin (SF), mean corpuscular volume (MCV), height, and weight. Data were analyzed using RevMan 5.4. <b>Results:</b> Iron supplementation from 4 to 6 months significantly increased Hb (MD = 6.29 g/L, <i>p</i> = 0.01), but effects diminished with longer duration (MD = 2.00 g/L, <i>p</i> = 0.08). For SF, no significant difference was found at 6 months, but supplementation significantly increased SF at 12 months (MD = 5.95 <i>μ</i>g/L, <i>p</i> = 0.04). No significant differences were found in MCV, height, or weight. Subgroup variations were noted by formulation and region. <b>Conclusion:</b> While short-term iron supplementation improves iron status, the lack of sustained benefits suggests individualized approaches may be preferable to universal supplementation in well-nourished populations.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"6662278"},"PeriodicalIF":1.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Rate Variability Responses in Children With Medical Complexity Across Sensory Domains.","authors":"Cindy Dodds, Brooke Mulrenin, Carrie Cormack, Kimberly Kascak, Nia Mensah, Marianne Gellert-Jones, Keri Heilman, Mat Gregoski, Everette Keller, Jonathan Beall","doi":"10.1155/ijpe/5803653","DOIUrl":"10.1155/ijpe/5803653","url":null,"abstract":"<p><p><b>Purpose:</b> Heart rate variability (HRV) is a physiologic marker of autonomic nervous system (ANS) health. Because of multisystem impairments, children with medical complexity (CMC) can be challenging to evaluate and assess. They commonly display ANS dysfunction and subsequently reduced HRV. One purpose of this study was to report respiratory sinus arrhythmia (RSA) values derived from HRV, which may provide a reference and a future method to assess CMC and related treatments. <b>Methods:</b> Then, 36 CMC between the ages of 5-21 years were assessed within school-based settings. All children demonstrated severe brain impairment, functional limitations, participatory restrictions in life, and high healthcare needs and utilization. A subset of 20 children with cerebral palsy (CP) was identified within the study sample. Each child was assessed by the same assessor for 5 days within a 10-day period. Using Firstbeat Bodyguard 2 monitors, cardiac data were collected prior to and during the administration of the newly developed Pediatric Assessment of Sensory Motor Awareness. CardioEdit and CardioBatch software were used to edit cardiac data and calculate RSA values. Descriptive, repeated measures, and modeling statistics were used to analyze data. <b>Results:</b> Descriptive RSA values for baseline and across five sensory domains are reported for the total CMC group and its subsets of children with CP and non-CP. Significant differences in RSA values were noted for the gustatory domain as compared to baseline and other sensory domains. Significant differences from statistical modeling were demonstrated between the CP and non-CP groups. <b>Conclusions and Recommendations for Clinical Practice:</b> This study's HRV findings provide preliminary reference RSA values in CMC. Then, 20 children considered to be CMC with primary diagnoses of CP experienced less autonomic dysfunction than other CMC diagnostic groups at baseline and across the five sensory domains. The gustatory domain significantly reduced RSA. Modeling across days indicated that CMC experience a learning effect by Day 3 or 4. The measurement of HRV may provide a method to assess health and behavioral responses in CMC and associated treatments. Replication of these study findings will be necessary.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"5803653"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Umbilical Cord-Derived Cells Therapy for Hypoxic-Ischemic Encephalopathy: A Systematic Review and Meta-Analysis of Animal Models.","authors":"Yincong Chen, Yanling Lu, Yueqin Ding, Jianping Chen, Kuihuan Tan, Jian Ding, Linqi Huang, Peisi Chen, Zhifeng Chen","doi":"10.1155/ijpe/1111052","DOIUrl":"10.1155/ijpe/1111052","url":null,"abstract":"<p><p><b>Introduction:</b> Neonatal hypoxic-ischemic encephalopathy (HIE) is a severe neurological disorder associated with high mortality and long-lasting complications in survivors. Umbilical cord-derived cells have emerged as promising therapeutic candidates, demonstrating positive results in experimental HIE research. This review systematically evaluates the current preclinical evidence on the efficacy of umbilical cord-derived cells in animal models of HIE, focusing on their effects on neurological function and identifying research gaps and constraints that need to be addressed for future preclinical and clinical studies. <b>Methods:</b> The present systematic review and meta-analysis, conducted in accordance with the Systematic Review Protocol for Animal Intervention Studies, synthesized the available evidence on the efficacy of umbilical cord-derived cells. Relevant studies were searched for in Medline's PubMed, Web of Science, Embase, and Cochrane databases up to May 1, 2024. Papers that included the interventional use of UC-derived cells were considered, regardless of the source, dose, timing, and frequency. Nevertheless, studies involving modified UC-derived cells or combination therapies were excluded. Functional neurological outcomes were extracted for meta-analysis to calculate standardized mean difference (SMD) with 95% confidence interval (CI), using a random effects model. The risk of bias was evaluated using SYRCLE. Forest plots and funnel plots were utilized to evaluate potential publication bias. <b>Results:</b> Twelve studies were incorporated into the systematic review. The meta-analysis indicated a significant positive impact of umbilical cord-derived cells on neurobehavioral outcomes post-HIE injury. Sensorimotor function showed an improvement of 0.80 SMD (95% CI, 0.58-1.03) in the negative geotaxis test, while cognitive function demonstrated a 1.44 SMD (95% CI, 1.21-1.67) improvement in the water maze test. The subgroup analysis demonstrated heterogeneous effect sizes contingent on distinct study characteristics, including animal age, cell type, cell dosage, delivery method, and timing method. <b>Conclusions:</b> Overall, these findings suggest a promising role for umbilical cord-derived cells in preclinical HIE studies. The treatment with umbilical cord-derived cells exhibited enhanced functional outcomes, showing promise for future translational research. Despite limitations such as bias risk and heterogeneity affecting the meta-analysis robustness, our results align with existing literature in this research domain. <b>Trial Registration:</b> ClinicalTrials.gov identifier: CRD42024551469.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"1111052"},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Collaborative Efforts in Craniosynostosis Surgery-A Rural Appalachian Institutional Experience in Patient Care and Outcomes.","authors":"Brittany McLay, Anushka Pathak, Erik Olness, Antonio Diaz Perez, Christopher Deskins, Andrew Criser, Hal Meltzer, Sebastian Brooke, Frank Casey, Candy M Mahle, Pavithra R Ellison","doi":"10.1155/ijpe/7477204","DOIUrl":"10.1155/ijpe/7477204","url":null,"abstract":"<p><p>Craniosynostosis surgery, addressing the premature fusion of cranial sutures, presents a unique challenge requiring standardized care, especially in rural settings, to optimize patient outcomes. This study evaluates surgical outcomes from 2012 to 2021, with a focus on 2020-2021, assessing intraoperative red cell-containing products, blood donor exposures, antifibrinolytic use, and ICU and hospital stays across various hospitals, with emphasis on our Rural Appalachian Institution (RAI). Primary outcomes include perioperative blood transfusion rates and hospital stay duration. Secondary outcomes include antifibrinolytic usage and blood donor exposures. Statistical analyses were performed using ANOVA and chi-square tests where applicable, with a significance threshold of <i>p</i> < 0.05. Results indicate that preoperative erythropoietin administration at RAI contributed to reduced perioperative blood transfusions. Increased antifibrinolytic use at RAI underscores efforts to minimize transfusions. Despite variations in ICU and hospital stays, RAI's standardized protocols address regional challenges and highlight the necessity for best practices in craniosynostosis care. Future research should explore the impact of erythropoietin on blood conservation, postoperative dexmedetomidine infusion on recovery, and tranexamic acid on perioperative blood management. This study, while acknowledging limitations, provides essential insights for refining surgical protocols in resource-limited settings.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"7477204"},"PeriodicalIF":1.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Knowledge, Attitude, and Practice of Kangaroo Mother Care Among Mothers in a Ghanaian Tertiary Care Center.","authors":"David Adedia, Felix Kwasi Nyande, Anthony Kuug, Agani Afaya, Martin Amogre Ayanore, Mildred Yibile, Evelyn Tangtie, Linda Cudjoe, Lillie Akanlie Baba Musah, Tackie-Ankrah Beatrice, Magdalene Kunje, Josephine Nana Ama Moreax, Rita Obeng, Francisca Gyan, Efua Essilfua Anaman, Kennedy Diema Konlan","doi":"10.1155/ijpe/9420090","DOIUrl":"10.1155/ijpe/9420090","url":null,"abstract":"<p><p><b>Introduction:</b> Kangaroo mother care (KMC) is one of the cost-effective interventions in low-resource settings for effective thermoregulation, supportive breastfeeding, and ensuring early hospital discharge of preterm and low birth weight babies. This study described the predictors of knowledge, attitude, and practice of KMC in a Tertiary Care Center in Ghana. <b>Methods:</b> A cross-sectional design using an online survey was conducted. The convenience sampling method was employed to select 385 mothers. Logistic regression models and path models were used to determine the factors influencing the knowledge, attitude, and practice of KMC. <b>Results:</b> The factors that predict a woman's knowledge of KMC are birthing a preterm or low birth weight baby, aged above 35 years, being a Christian, having health insurance, and giving birth at a health facility. The attitude of mothers toward KMC practice was significantly associated with education, ethnicity, health insurance, weight of newborn, and antenatal clinic (ANC) follow-up. Mothers who used the spontaneous vaginal delivery (SVD) type (aOR = 0.06, 95% CI: 0.01-0.28, <i>p</i> value = 0.001) are less likely to practice KMC than mothers who used the caesarean section (C/S) delivery type; however, mothers who used the SVD type and had health insurance (aOR = 16.02, 95% CI: 3.13-94.95, <i>p</i> value = 0.001) were more likely to practice KMC. Also, mothers who delivered at a private hospital (aOR = 0.42, 95% CI: 0.18-0.97, <i>p</i> value = 0.039) and newborns with weights 1000-1499 g (aOR = 0.32, 95% CI: 0.13-0.72, <i>p</i> value = 0.008) and 2000-2500 g (aOR = 0.31, 95% CI: 0.13-0.70, <i>p</i> value = 0.006) were less likely to practice KMC. In addition, mothers who are not married (aOR = 1.93, 95% CI: 1.10-3.49, <i>p</i> value = 0.025) are more likely to practice KMC. <b>Conclusion:</b> Given that numerous factors influence practice (SVD, having health insurance, not birthing in a private facility, and having a normal birth weight baby) of KMC, promoting health insurance registration, increasing pregnancy safety leading to SVD, and fostering normal birth weight births can limit the need to use KMC. However, given the positive benefits of KMC, ensuring a positive attitude among community members is crucial to its adoption, should it be needed.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"9420090"},"PeriodicalIF":1.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges and Outcome of Classical Phenylketonuria in a Resource-Constrained Middle Eastern Country.","authors":"Nadine Yazbeck, Rudy N Zalzal, Fadi El Oueichek, Jinane Samaha, Abir Barhoumi, Pascale E Karam","doi":"10.1155/ijpe/5246296","DOIUrl":"10.1155/ijpe/5246296","url":null,"abstract":"<p><p><b>Background:</b> Scarce data on classical phenylketonuria diagnosis and outcome in low-income Middle Eastern countries is available. The effect of phenylketonuria diet on growth parameters is still controversial. This 15-year retrospective study is aimed at examining the diagnosis, outcome, and growth of classical phenylketonuria patients following a phenylalanine-restricted Mediterranean diet in Lebanon. <b>Methods:</b> A retrospective review of the charts of patients diagnosed and followed between 2008 and 2023 at the American University of Beirut Medical Center, Lebanon, was conducted. Age at diagnosis, molecular profile, neurological status, anthropometric measurements, diet, and metabolic control were analyzed. <b>Results:</b> Out of 82 patients, 35 met the inclusion criteria. The majority were late-diagnosed (average age: 4 years) with poor neurological outcome. The Mediterranean variant IVS10-11G>A in a homozygous state was identified in 63%. There was no statistically significant difference between body mass index or height for age <i>z</i>-scores at first and last encounter for all patients on phenylalanine-restricted Mediterranean diet. <b>Conclusions:</b> Phenylalanine-restricted Mediterranean diet seems to preserve growth parameters in classical phenylketonuria patients. However, achieving a neurotypical outcome remains challenging in the absence of systematic newborn screening in Lebanon, a resource-constrained country with high rates of consanguinity.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"5246296"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Multicenter Stratified Study on Perinatal Factors Influencing Neonatal Mortality in Preterm Infants in Kazakhstan.","authors":"Nishankul Bozhbanbayeva, Olga An, Saltanat Sairankyzy, Indira Suleimenova, Aigul Bazarbayeva, Indira Adilbekova","doi":"10.1155/ijpe/8678975","DOIUrl":"10.1155/ijpe/8678975","url":null,"abstract":"<p><p><b>Aim:</b> This study is aimed at evaluating the cumulative effect of postnatal risk factors on the survival of preterm neonates by examining key clinical parameters and complications across various gestational ages. <b>Methods:</b> A retrospective cohort study was conducted using data from 1109 neonates admitted to neonatal intensive care units at two tertiary regional hospitals in Kazakhstan between 2021 and 2024. Patients were classified into three groups based on gestational age: extremely preterm (< 28 weeks, <i>n</i> = 223), very preterm (28-31 weeks, <i>n</i> = 384), and moderate to late preterm (32-36 weeks, <i>n</i> = 502). Initially, to identify significant risk factors, categorical variables were analyzed using the <i>χ</i> ² test or Fisher's exact test with the Bonferroni correction, depending on whether the expected counts were ≥ 5 or < 5, while continuous variables were examined with the Kruskal-Wallis and Mann-Whitney <i>U</i> tests. Subsequently, multivariate logistic regression was applied to develop a prognostic model for each study group based on previously identified statistically significant risk factors for neonatal mortality. The predictive performance of these factors was further evaluated through ROC curve analysis with AUC. Finally, the Kaplan-Meier method was used to reflect overall mortality outcomes, illustrating their association with gestational age and the distribution of fatal cases over time in days. <b>Results:</b> The results of this study reveal significant differences in survival rates among preterm neonates based on gestational age, with mortality being most pronounced in infants born at less than 28 weeks of gestation. As gestational age increased among preterm infants, there was a marked reduction in the number of statistically significant independent risk factors identified in logistic models that influence survival. Disseminated intravascular coagulation consistently emerged as a significant predictor across all three logistic models. Neonatal depression, hyperbilirubinemia, and necrotizing enterocolitis were significant in both extremely preterm infants (less than 28 weeks) and very preterm infants (28-31 weeks). However, patent ductus arteriosus and bronchopulmonary dysplasia were statistically significant only in the extremely preterm group (less than 28 weeks). <b>Conclusion:</b> In a cohort of preterm neonates in Kazakhstan, the cumulative impact of various risk factors plays a critical role in determining survival outcomes, with increasing gestational age significantly enhancing the likelihood of survival. Further research is required to refine prognostic models and identify factors specific to different sociogeographical populations.</p>","PeriodicalId":51591,"journal":{"name":"International Journal of Pediatrics","volume":"2025 ","pages":"8678975"},"PeriodicalIF":1.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}