Pediatrics and Neonatology最新文献

{"title":"Unveiling neonatal mortality inequities in Ghana: A geospatial and temporal analysis of regional disparities, healthcare accessibility, and institutional gaps to drive targeted interventions.","authors":"Ahmed Farhan Abubakr, Chrysantus Kubio","doi":"10.1016/j.pedneo.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>Neonatal mortality remains a significant public health challenge in Ghana, with regional disparities and systemic inequities affecting progress toward achieving Sustainable Development Goal (SDG) 3. Previous studies show about three-fourths of these deaths occur in the early neonatal period (i.e., the first week of life). Despite national efforts to improve neonatal survival, limited data exist on spatial, motorized accessibility, and temporal trends. The aim of the study is to analyze neonatal mortality trends and burden across Ghana from 2019 to 2023, identify regional disparities, high risk regions and districts, and to examine the impact of healthcare accessibility on neonatal outcomes using geospatial and statistical modelling.</p><p><strong>Methods: </strong>Using a retrospective analysis of neonatal mortality data from the District Health Information Management System 2 (DHIMS-2), we conducted a cross-sectional descriptive survey assessing early, late, and institutional neonatal mortality rates at national and regional levels. Geospatial mapping and poisson regression models were employed to identify high-risk areas and associated factors. A p-value <0.05 was used to declare statistical significance.</p><p><strong>Results: </strong>Neonatal mortality in Ghana declined significantly between 2019 and 2023: early neonatal deaths decreased by 28.6% (4,645 to 3,317), and late neonatal deaths by 20.9% (912 to 721). Early and late neonatal mortality rates fell by 35.2% (6.51 to 4.22 per 1,000 live births) and 30.3% (1.32 to 0.92 per 1,000), respectively, with institutional neonatal mortality declining by 34.2% (7.79 to 5.13 per 1,000). However, stark regional disparities persisted. Greater Accra (5,626 deaths, 22.4%), Ashanti (4,234 deaths, 16.9%), and Northern (2,512 deaths, 10.0%) bore the highest burdens, while Savannah (259 deaths, 1.0%) and North-East (361 deaths, 1.4%) recorded the lowest. Poisson regression confirmed significant subnational heterogeneity: Oti (IRR = 0.24; CI = 0.13, 0.45), Western North (IRR = 0.28; CI = 0.15, 0.50), and North-East (IRR = 0.37; CI = 0.21, 0.62) exhibited mortality rates substantially lower than Greater Accra's baseline (IRR = 1). Conversely, Bono (IRR = 0.73; CI = 0.48, 1.12) and the Northern Region (IRR = 0.74; CI = 0.49, 1.13) showed no significant differences. Rural areas faced critical access barriers, with over 60% requiring >60 min to reach hospitals, likely exacerbating delays in care. These findings underscore progress in national mortality trends but highlight persistent inequities demanding region-specific interventions.</p><p><strong>Conclusion: </strong>Neonatal mortality in Ghana has declined over time, yet significant regional disparities and access inequities remain. Targeted interventions, such as improving rural healthcare infrastructure, expanding neonatal intensive care units, and strengthening ante/postnatal care, are crucial to address these gaps, and to","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of antenatal magnesium sulfate administration on parathyroid hormone secretion in preterm infants.","authors":"Satomi Inomata, Yuko Wada, Kyota Sasamoto, Riko Kato, Mitsuhide Nagaoka, Yukako Kawasaki, Kentaro Tamura, Taketoshi Yoshida","doi":"10.1016/j.pedneo.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Antenatal magnesium sulfate (MgSO₄) administration has raised concerns regarding its potential impact on calcium metabolism in preterm infants. However, its effects on parathyroid hormone (PTH) secretion in infants remain unclear. This study aimed to evaluate the influence of antenatal MgSO₄ on parathyroid function in preterm infants.</p><p><strong>Methods: </strong>Preterm infants born at 28-33 weeks of gestation were divided into two groups: the Mg group (infants who received antenatal MgSO₄, n = 41) and the non-Mg group (infants who did not receive antenatal MgSO₄, n = 24). Neonatal blood samples, collected within 0.5-3 h after birth, were analyzed for serum calcium, phosphorus, magnesium, alkaline phosphatase, and whole PTH levels. Biochemical data were compared between the groups, and multivariate analysis was performed to assess antenatal MgSO₄ as an independent factor associated with lower whole PTH levels. The relationships between serum calcium and serum whole PTH levels were also analyzed in each group to evaluate MgSO₄'s suppressive effect on parathyroid function during hypocalcemia.</p><p><strong>Results: </strong>Serum whole PTH levels were significantly lower in the Mg group (24.7 ± 20.1 pg/mL) than in the non-Mg group (56.2 ± 47.1 pg/mL, p = 0.002). Serum phosphorus, magnesium, and alkaline phosphatase levels were significantly elevated in the Mg group (p < 0.001 for all). Multivariate analysis confirmed that antenatal MgSO₄ was an independent factor associated with lower whole PTH levels, even after adjusting for gestational age, sex, and serum calcium levels (β = -0.44, p < 0.001). A significant inverse correlation between serum whole PTH and serum calcium levels was observed in the non-Mg group (ρ = -0.77, p < 0.001), but not in the Mg group.</p><p><strong>Conclusion: </strong>Antenatal MgSO₄ administration reduces PTH levels and suppresses the parathyroid response to hypocalcemia in preterm infants. Postnatal calcium homeostasis should be closely monitored in these infants.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental transfer of rituximab in extremely low birth weight infants: KREC as a tool for neonatal immune assessment","authors":"Tsuguma Terukina,&nbsp;Shutaro Suga,&nbsp;Nao Ohama,&nbsp;Toshihiko Manabe,&nbsp;Hikaru Takahashi,&nbsp;Junpei Shibahara,&nbsp;Mayumi Kawase,&nbsp;Keisuke Taku,&nbsp;Reiji Fukano","doi":"10.1016/j.pedneo.2025.06.003","DOIUrl":"10.1016/j.pedneo.2025.06.003","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 5","pages":"Pages 511-512"},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing oxygen delivery for neonatal resuscitation through self-inflating bags in settings without air-oxygen blenders.","authors":"Tzu-Ching Sung, Hsiang-Chin Hsu, Yun-Ju Chen, Yuh-Jyh Lin, Chyi-Her Lin","doi":"10.1016/j.pedneo.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>Resuscitation guidelines recommend fractional inspired oxygen (FiO₂) of 0.21-0.30 for infants at <35 weeks gestation. However, without an air-oxygen blender, an FiO₂ < 0.3 is difficult to achieve with a self-inflating resuscitation bag (SIRB). This study investigated the effects of adjustments to the oxygen flow rate (FR), peak inspiratory pressure (PIP), and ventilation rate (VR) on FiO₂ levels with SIRBs.</p><p><strong>Methods: </strong>Two nondisposable SIRBs were used: a 280 mL bag (40 cm H₂O pop-off valve) and a 62 mL bag with a reservoir tube (25 and 40 cm H₂O pop-off valve). Both SIRBs were supplied with 100 % oxygen and connected to a flow meter, pressure gauge, oxygen analyzer, and test lung. FR (0.5, 1, 2, 5, or 10 L/min), PIP (20-29, 30-39, or ≥ 40 cm H₂O), and VR (40, 50, or 60/min) parameters were tested sequentially. FiO₂ was measured every 30 s for 150 s total, and each parameter combination was evaluated three times. Data were analyzed with a stepwise generalized linear model.</p><p><strong>Results: </strong>FiO₂ levels stabilized after 60-90 s of bagging across all settings, ranging from 0.27 to 0.82 and 0.40-1.0 for the 280 and 62 mL SIRBs, respectively. A higher FR increased FiO₂ levels, whereas a higher PIP decreased FiO₂ levels. VR increases did not affect FiO₂ except at an FR ≥ 5 L/min. An FiO₂ < 0.30 was achievable only with the 280 mL SIRB at 0.5 L/min FR and PIP >40 cm H₂O. FR had the greatest effect (R² = 0.4916) on FiO₂. SIRB, PIP, VR, and bagging duration further improved the model's predictive power (R² = 0.9578).</p><p><strong>Conclusions: </strong>A suitable SIRB, FR, PIP, and VR are crucial for FiO₂ titration in resuscitation. Further validation of these findings in clinical studies is warranted.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluating cutoffs of serum 25-OH-D for vitamin D deficiency in early infancy","authors":"Chien-Ming Lin","doi":"10.1016/j.pedneo.2025.06.001","DOIUrl":"10.1016/j.pedneo.2025.06.001","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 5","pages":"Page 411"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of hematology parameters and symptoms in children with HCMV infection across different age groups.","authors":"Yingying Wang, Zhou Zheng, Lijuan Kan, Dan Xiong, Xiuming Zhang","doi":"10.1016/j.pedneo.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.02.003","url":null,"abstract":"<p><strong>Background: </strong>Children are vulnerable to Human Cytomegalovirus (HCMV) infection, the majority of infections of which are asymptomatic, which often leads to missed diagnoses. Missing early diagnosis and treatment may have adverse consequences for the child. Therefore, the purpose of this study was to evaluate the hematological parameters and clinical symptoms in HCMV-infected infants and children under 6 years old.</p><p><strong>Method: </strong>This study conducted a retrospective analysis of laboratory data from 223 children aged 0 day to 6 years who had undergone urine HCMV-DNA test at the Luohu People's Hospital. We categorized children into two groups based on the results of their urine HCMV-DNA test: the HCMV infected group and the HCMV non-infected group. Furthermore, we divided them into different age groups: 0-21 days, 22 days-<6 months, 6 months-<1 year, 1-<2 years, and 2-6 years.</p><p><strong>Results: </strong>The lymphocyte percentage (L%) and lymphocyte count (LYM) of HCMV-infected children aged 0-6y were significantly higher than those of the control group (P < 0.05). The alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) of HCMV-infected children aged 0-<1y and aspartate aminotransferase (AST) of HCMV-infected children aged 0d-<2y were significantly higher than those of the control group (P < 0.05), but this difference was not evident among older children. We found that GGT was highest in HCMV-infected children aged 0-21d and decreased with the increase of age. Furthermore, our data indicate that older children exhibit a reduced diversity of illnesses after infection.</p><p><strong>Conclusion: </strong>We conclude that HCMV infection can increase lymphocytes in the peripheral blood of children aged from 0 to 6 years and can cause more severe hepatobiliary injury in younger children.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of an adolescent with lupus nephritis and secondary thrombotic microangiopathy using eculizumab and belimumab","authors":"Yen-Wen Tseng ,&nbsp;Tzu-Ching Lin ,&nbsp;Hsin-Lin Tsai ,&nbsp;Lih-Ying Kuo ,&nbsp;Bih-Ru Wang ,&nbsp;Jei-Wen Chang","doi":"10.1016/j.pedneo.2025.03.009","DOIUrl":"10.1016/j.pedneo.2025.03.009","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 5","pages":"Pages 502-506"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive effects of Larazotide acetate (AT-1001) on non-alcoholic fatty liver diseases (NAFLD) in a mouse model.","authors":"Yu-Chen Huang, Jen-Shiu Chiang Chiau, Mei-Lein Cheng, Hung-Chang Lee, Wai-Tao Chan, Szu-Wen Chang, Yu-Cheng Chen, Chun-Yan Yeung, Chuen-Bin Jiang","doi":"10.1016/j.pedneo.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.01.016","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal risk factors and lung function at 8 years of age in extremely preterm infants: Insights from a new Japanese bronchopulmonary dysplasia classification.","authors":"Katsuya Hirata, Hidehiko Nakanishi, Fumihiko Namba, Narutaka Mochizuki, Shinya Hirano, Kazuko Wada, Masanori Fujimura","doi":"10.1016/j.pedneo.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.05.005","url":null,"abstract":"<p><strong>Background: </strong>Advances in neonatal care have considerably improved the survival rates of extremely preterm infants. However, long-term pulmonary sequelae remain a major concern. A revised classification of bronchopulmonary dysplasia (BPD) in Japan highlights histological chorioamnionitis, small for gestational age (SGA), and a bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as key risk factors. This study aimed to evaluate the effect of extremely preterm birth on lung function at school age.</p><p><strong>Methods: </strong>This retrospective study included 283 extremely preterm infants (born at <28 weeks of gestation) admitted to our institution between 1994 and 2013. Perinatal data and spirometry results obtained at 8 years of age were analyzed. Logistic regression analysis was performed to assess the association of histological chorioamnionitis, SGA, and bubbly/cystic CXR with obstructive (FEV₁ [forced expiratory volume in 1 s]/FVC [forced vital capacity] < LLN [lower limit of normal]), restrictive (FEV₁/FVC ≥ LLN and FVC < LLN), and mixed (FEV₁/FVC < LLN and FVC < LLN) patterns, with adjustments for gestational age, sex, and birth year.</p><p><strong>Results: </strong>Extremely preterm infants exhibited lower z-scores for FEV₁/FVC, FEV₁, and FVC than the predicted values based on age, height, and sex. Bubbly/cystic CXR findings was associated with an increased risk of obstructive (adjusted odds ratio [aOR], 2.30; 95 % confidence interval [CI], 1.12-4.72) and mixed patterns (aOR, 3.51; 95 % CI, 1.19-10.4). SGA was a risk factor for a restrictive pattern (aOR, 2.81; 95 % CI, 1.37-5.74).</p><p><strong>Conclusion: </strong>Bubbly/cystic CXR findings and SGA status, key components of the revised Japanese BPD classification, were significantly associated with long-term pulmonary function abnormalities in extremely preterm infants, characterized predominantly by obstructive/mixed and restrictive patterns, respectively. These findings highlight the importance of targeted strategies to address specific perinatal risk factors and improve long-term pulmonary outcomes in this high-risk population.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide singleton birth weight percentiles for gestational age in Taiwan in 2008-2017.","authors":"Jia-Ling Wu, Chun-Heng Kuo, Chi-Nien Chen, Po-Nien Tsao, Chung-Yi Li, Hung-Yuan Li","doi":"10.1016/j.pedneo.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.010","url":null,"abstract":"<p><strong>Background: </strong>Establishing updated, population-based birth weight charts is essential for accurate classification of neonates as small for gestational age (SGA) or large for gestational age (LGA). The current birth weight charts in Taiwan have not been updated for over two decades, and the previous report has found an increasing trend in neonates with low birth weight (LBW) and preterm birth. This study aimed to develop updated birth weight charts and explore trends in LBW and preterm births using nationwide data.</p><p><strong>Methods: </strong>This study analyzed 1,913,124 singleton live births from the data set of Taiwan Birth Notifications between 2008 and 2017. Birth weight percentiles were calculated for each completed gestational week and gender. A nonlinear, resistant smoothing technique was applied to develop smoothed birth weight-for-gestational-age percentile curves.</p><p><strong>Results: </strong>The cohort included 994,175 male neonates and 918,949 female neonates. During the study period, the annual mean birth weight decreased significantly from 3098.10g to 3049.88g (p < 0.0001). A significant increase in the annual rate of LBW was observed, rising from 5.59 % in 2008 to 6.98 % in 2017 (p < 0.0001), coinciding with a slight and significant decrease in gestational age (p < 0.001) and a significantly declining proportion of foreign-born mothers (p < 0.0001) during the same period. In addition, birth weight percentiles by weeks of gestation in male and female singleton births were reported.</p><p><strong>Conclusion: </strong>This study developed an updated, nationwide birth weight chart for Taiwan. An increasing rate of LBW was observed from 2008 to 2017. Further investigation into maternal and environmental factors contributing to these trends is warranted.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}