Archives of Disease in Childhood - Fetal and Neonatal Edition最新文献

{"title":"Exclude or include? Monochorionicity as a part of benchmarking standards in deferred cord clamping.","authors":"Adam King, Olie Chowdhury","doi":"10.1136/archdischild-2026-330720","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330720","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855740","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":"Management of muscular hypertonia in infants: survey of current UK practice.","authors":"Nandhika Rabindranathnambi, Rajesh Karuvattil, Brigitte Vollmer, Anthony R Hart","doi":"10.1136/archdischild-2026-330549","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330549","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832893","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":"Ethical considerations for using alternative methods of consent in neonatal clinical trials: recommendations from a modified Delphi consensus process.","authors":"Elliott Mark Weiss, Abigail Brickler, Abril Beretta, Kaashif A Ahmad, Neal W Dickert, Rebecca A Dorner, Elizabeth Field, Katherine Guttmann, Anup C Katheria, Stephanie K Kukora, Diana Montoya-Williams, Benjamin A Mooso, Stephanie A Kraft","doi":"10.1136/archdischild-2025-330059","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330059","url":null,"abstract":"<p><strong>Importance: </strong>Neonatal clinical trials frequently encounter low enrolment rates, challenges obtaining consent and biased research populations. Alternative approaches to consent have been proposed to address these concerns but introduce complex ethical trade-offs.</p><p><strong>Objective: </strong>Using a modified Delphi approach with diverse stakeholders, we aimed to create recommendations for the use of alternative methods of consent in neonatal clinical trials.</p><p><strong>Findings: </strong>Our process resulted in 21 recommendations within three categories. In 'deciding whether to use alternative methods of consent', we present five statements to guide whether alternative methods are appropriate. For example, heightened justification may be required for early phase research or allocation arms that are highly preference-sensitive for families. In 'preallocation information and ability to opt-out', we present 11 statements related to information sharing with families of potential participants. These include guidance on researcher communication and guidance for passive information sharing such as via flyers. In 'postallocation information and decision to continue participation', we present five statements to guide later information sharing. These focus on best practices for researcher communication postallocation. For two items, our Working Group could not reach consensus. These items were not included in our recommendations.</p><p><strong>Conclusions and relevance: </strong>Our recommendations may guide researchers, clinicians, regulators and funders in the consideration and conduct of alternative methods of consent for neonatal clinical trials. Future work must evaluate these recommendations within neonatal clinical trials and the areas of lack of consensus among our Working Group.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809943","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":"Developmental follow-up, surveillance and support at the age of 4 years: a best practice guide from the British Association for Neonatal Neurodevelopmental Follow-Up.","authors":"Katie Mckinnon, Anusha Arasu, Joanne Beckmann, Jenny Bosworth, Philippa Chisholm, Alison Crawford, Laurence Galland, Samantha Johnson, Lexi Johnston, Anthony Kaiser, Elaine McMahon, Audrienne Sammut, Francesca Seregni, Louise Leven, Monica Negoita","doi":"10.1136/archdischild-2026-330533","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330533","url":null,"abstract":"<p><p>Developmental follow-up is a necessary part of neonatal care to identify additional support needs but also to allow national surveillance and research. Follow-up at 4 years of age enables assessment before school entry, allowing schools to be ready for and support children and their families. This is not currently routine across the UK despite the National Institute for Health and Care Excellence recommendations in 2017. This best practice guide was developed by the British Association for Neonatal Neurodevelopmental Follow-Up, a special interest group of the British Association of Perinatal Medicine.This framework supports clinicians developing and delivering a 4-year developmental follow-up service for children whose neonatal experiences put them at risk of developmental conditions or additional learning needs. This should include as a minimum those born before 28 weeks' gestation and infants with moderate to severe neonatal encephalopathy. Infants with risk factors for developmental problems should also be considered.This framework recommends assessment of developmental domains including physical development and growth, cognitive development, emotional and behavioural development, sensory needs, speech, language and communication skills, social skills and relationships. A summary report should be shared with caregivers and key individuals in health, education and social care. This should describe the child's strengths and needs to support transition into and throughout education.Specific service arrangements will vary depending on local resources and existing services. This framework provides guidance for clinical teams to enhance follow-up for children whose early experiences put them at risk of challenges, facilitating lifelong learning, participation and well-being.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760441","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":"Probiotics for extremely preterm infants: a Norwegian population-based study.","authors":"Nina Clare Hapnes, Hans Jørgen Stensvold, Ingvild Dalen, Hans Jørgen Timm Guthe, Ragnhild Støen, Anne Lee Solevåg, Sissel J Moltu, Arild Rønnestad, Claus Klingenberg","doi":"10.1136/archdischild-2025-330176","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330176","url":null,"abstract":"<p><strong>Objective: </strong>To compare mortality and morbidity in extremely preterm (EPT) and/or extremely low birthweight (ELBW) infants receiving or not receiving probiotic supplementation.</p><p><strong>Design: </strong>Nationwide, population-based registry study.</p><p><strong>Setting: </strong>All neonatal intensive care units (NICUs) in Norway.</p><p><strong>Participants: </strong>All EPT (<28 weeks)/ELBW (<1000 g) infants born between 2014 and 2021, admitted to an NICU. Infants who within the first week of life died, underwent surgery for necrotising enterocolitis (NEC) or did not receive enteral feeds or started with probiotics after the first week of life were excluded from the main analyses. Logistic regression, propensity score matching, inverse probability of treatment weighting (IPTW) and clustering analyses were applied.</p><p><strong>Main outcome measures: </strong>The primary outcome was all-cause mortality after the first week of life. Secondary outcomes were surgical NEC and late-onset sepsis after the first week of life, growth and probiotic sepsis.</p><p><strong>Results: </strong>Among 1596 live-born EPT/ELBW infants, 1268 were included in the main analysis and 676 (53.5%) started probiotics in the first week of life. Probiotics were associated with lower all-cause mortality (IPTW analysis; adjusted OR (aOR) 0.65, 95% CI 0.43 to 0.97), but no reduction in surgical NEC (aOR 0.83, 95% CI 0.49 to 1.43). However, in an emulated intention-to-treat scenario, high (>80%) probiotic use versus low (< 30%) was associated with a reduction in surgical NEC (aOR 0.40, 95% CI 0.19 to 0.86). We found no association between probiotics and sepsis or growth. 5 out of 858 infants (0.58%) exposed to probiotics developed probiotic-associated sepsis, all survived.</p><p><strong>Conclusion: </strong>Probiotic supplementation to EPT/ELBW infants was associated with lower all-cause mortality and possibly reduced NEC.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760365","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":"Can targeting IL-1 mediated inflammation improve outcomes after neonatal hypoxic-ischaemic encephalopathy?","authors":"Diya Patel, Athimalaipet V Ramanan, Ela Chakkarapani","doi":"10.1136/archdischild-2025-329808","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329808","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760404","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":"Making sense of the evidence: designing randomised controlled trials for preterm infants with high-shunt volume patent ductus arteriosus.","authors":"Cheryl Battersby, Philip T Levy, Samir Gupta, Willem P de Boode, Souvik Mitra, Patrick J McNamara","doi":"10.1136/archdischild-2025-330266","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330266","url":null,"abstract":"<p><p>Management of the patent ductus arteriosus (PDA) in preterm infants remains controversial. Randomised controlled trials (RCTs) have shown that administering pharmacotherapy, predominantly ibuprofen, a cyclooxygenase (COX) inhibitor, to infants selected based on the standard echocardiography approach to diagnosis (eg, duct diameter and shunt direction), does not improve outcomes and may lead to harm. It remains uncertain, however, whether eliminating or reducing PDA shunt volume using an intervention with higher efficacy and fewer adverse effects, or in a more selective population, would show different results. It is possible that an imprecise approach to patient selection exposes low-risk infants to the adverse effects of pharmacotherapy without benefit and high-risk infants to the synergistic adverse effects of pharmacotherapy and persistent high volume pathological shunt when treatment fails. Whether targeted management of moderate-high volume PDA shunts, informed by comprehensive echocardiography adjudication, in the highest risk infants is beneficial remains untested in an RCT setting. Furthermore, both pharmacological and non-pharmacological interventions warrant further investigation. High quality practice changing research requires a collaborative approach between haemodynamic specialists, epidemiologists and trial methodologists to (1) define the study population based on phenotypic profiles of high-risk infants; (2) enhance the choice and timing of intervention; and (3) identify outcome measures that are relevant and clinically meaningful to families. In this review, we summarise evidence from RCTs and observational studies by discerning discrepancies and exploring potential explanations. Such an approach is essential to establish whether active PDA treatment confers any measurable benefit for high-risk preterm infants.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760427","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":"Prognostic value of haemodynamic and neurophysiological assessments in newborns with hypoxic-ischaemic encephalopathy undergoing whole-body therapeutic hypothermia: a systematic review and meta-analysis of short-term outcomes.","authors":"Mona Noureldein, Vincent So, Lamia Hayawi, Ayman Saker, Laurent Renesme, Anne Tsampalieros, Nadya Ben Fadel","doi":"10.1136/archdischild-2025-329322","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329322","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic value of amplitude-integrated electroencephalography (aEEG), cerebral near-infrared spectroscopy (cNIRS) and targeted neonatal echocardiography (TnECHO) for predicting short-term outcomes in neonates with hypoxic-ischaemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources: </strong>MEDLINE, Embase, CINAHL and the Cochrane Library were searched to 16 April 2025. The review was registered on PROSPERO (CRD42023387592).</p><p><strong>Eligibility criteria: </strong>Prognostic studies of neonates ≥35 weeks' gestation with HIE treated with TH, reporting short-term outcomes: death, abnormal brain MRI or a composite of both.</p><p><strong>Data extraction and synthesis: </strong>Data were extracted independently. Risk of bias was assessed using the Quality in Prognosis Studies tool. Pooled sensitivity, specificity, diagnostic OR (DOR) and area under the curve (AUC) were calculated using a random-effects model.</p><p><strong>Results: </strong>Thirty-seven studies (n=2836) were included; 26 (n=2268) contributed to meta-analyses. Abnormal aEEG background at 24 hours predicted abnormal MRI with sensitivity 0.76 (95% CI 0.38 to 0.94), specificity 0.70 (95% CI 0.43 to 0.87), DOR 5.91 (95% CI 2.00 to 17.49) and AUC 0.72. Abnormal cNIRS at 48 hours showed comparable prediction with sensitivity 0.77 (95% CI 0.57 to 0.89), specificity 0.61 (95% CI 0.19 to 0.91), DOR 8.38 (95% CI 2.02 to 34.66) and AUC 0.79. TnECHO-detected pulmonary hypertension had limited prognostic value with DOR 2.08 (95% CI 0.36 to 11.9) and AUC 0.62. Right ventricular function measures showed substantial heterogeneity in sensitivity and DOR.</p><p><strong>Conclusions: </strong>aEEG and cNIRS between 24 hours and 48 hours could offer reasonable prognostic value for detecting brain injury in HIE. TnECHO has limited predictive utility in isolation. Multimodal approaches may enhance early risk stratification and should be explored in future studies.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760429","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":"Variability in the use of therapeutic hypothermia in neonates across Europe.","authors":"Daniele De Luca, Tullio Ghi","doi":"10.1136/archdischild-2025-329513","DOIUrl":"10.1136/archdischild-2025-329513","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F283-F284"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231408","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":"Suboptimal BMI at 5 years after very preterm birth: too early to conclude?","authors":"Cornelia Wiechers","doi":"10.1136/archdischild-2025-329567","DOIUrl":"10.1136/archdischild-2025-329567","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F188-F189"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257228","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}