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

{"title":"Neurodevelopmental impairment and morbidity patterns across two epochs among extremely preterm infant survivors in Australia and New Zealand.","authors":"Temesgen Getaneh, Nusrat Homaira, Abrar Chughtai, Trisha Parmar, Elizabeth Maria Hurrion, Georgina Chambers, Alice Rumbold, Kei Lui","doi":"10.1136/archdischild-2025-330101","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330101","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate neurodevelopmental outcomes at 2-3 years of age among survivors of extremely preterm infant (EPI).</p><p><strong>Design and setting: </strong>Analysis of prospectively collected Australian and New Zealand Neonatal Network data on infants born <28 weeks' gestation between 2010 and 2019.</p><p><strong>Main outcome: </strong>The prevalence of neurodevelopmental impairment (NDI), defined as any moderate to severe cerebral palsy (CP), sensory impairment or developmental delay (score <70) at 2-3 years of age was determined. Epoch comparisons (2010-204 vs 2015-2019) and the impact of major morbidity on NDI were examined, adjusting for maternal age, antenatal steroids, gestational age, Apgar score, admission temperature, sex and breast milk feeding.</p><p><strong>Results: </strong>Of 6617 EPIs, 15.5% had NDI. Developmental delay was most prevalent (14.5%), including language (11.1%), motor (5.9%), cognitive (5.7%) domains, followed by CP (3.2%), deafness (1.4%) and blindness (0.4%). Compared with infants without morbidity, adjusted odds of NDI increased with one (adjusted OR (aOR) 1.50, 95% CI 1.21 to 1.84), two (aOR 2.09, 95% CI 1.60 to 2.53) and three or more coexisting morbidities (aOR 3.56, 95% CI 2.73 to 4.65). Between epochs, bronchopulmonary dysplasia increased by 6.9% and retinopathy of prematurity by 3.8%, alongside a rise in developmental delay (10.3% to 17.8%), contributing to a 6.6% absolute increase in NDI. Survivors born at 22-23 weeks had the highest NDI rates, increasing from 23.0% to 26.4%.</p><p><strong>Conclusion: </strong>NDI rates among EPI increased over time and were associated with increasing multiple morbidities. Although changes in EPIs survival patterns may have contributed to these trends, reducing neonatal morbidities and strengthening neuroprotective care remain priorities.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890768","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":"Azithromycin for eradication of <i>Ureaplasma</i> and prevention of bronchopulmonary dysplasia in preterm infants: a meta-analysis.","authors":"Eduardo Villamor, Karen Van Mechelen","doi":"10.1136/archdischild-2026-331284","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331284","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890825","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":"Effect of brewers' yeast or beta-glucan derived from <i>Saccharomyces cerevisiae</i> on breast milk supply following preterm birth: the BLOOM randomised controlled trial.","authors":"Luke Grzeskowiak, Lauren Williams, Alice Rumbold, Bronni Simpson, Renee L Kam, Lisa Nicole Yelland, Kathryn Dansie, Wendy V Ingman, Amy Keir, Kathryn A Martinello, Lisa H Amir","doi":"10.1136/archdischild-2025-330214","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330214","url":null,"abstract":"<p><strong>Objective: </strong>Breast milk is the optimal source of nutrition for preterm infants; however, low breast milk production is common following a preterm birth. This study aimed to determine if taking brewers' yeast or beta-glucan improves daily expressed breast milk volume.</p><p><strong>Design: </strong>Randomised, blinded, parallel, placebo-controlled trial.</p><p><strong>Setting: </strong>Three Australian tertiary-level neonatal units.</p><p><strong>Patients: </strong>Mothers with a singleton or twin pregnancy who gave birth at <34 weeks' gestation.</p><p><strong>Interventions: </strong>Mothers were randomised within 72 hours of birth into three parallel groups in a 1:1:1 ratio to receive either brewers' yeast, beta-glucan or placebo capsules for 7 days.</p><p><strong>Main outcome measure: </strong>Total expressed breast milk volume over a 24-hour period on day 7 of intervention.</p><p><strong>Results: </strong>A total of 105 mothers underwent randomisation between August 2022 and April 2024 (36 brewers' yeast, 35 beta-glucan and 34 placebo). The adjusted mean difference in daily expressed breast milk volume was 94 mL/day (95% CI -51 mL/day to 239 mL/day) between the brewers' yeast and placebo groups and -25 mL/day (95% CI -173 mL/day to 123 mL/day) between the beta-glucan and placebo groups. Maternal side effects were similar across groups.</p><p><strong>Conclusion: </strong>We found no clear effect of short-term administration of brewers' yeast or beta-glucan on breast-milk production following preterm birth; both interventions were well tolerated. Given the small sample size, these findings do not rule out the possibility of a clinically meaningful benefit of brewers' yeast and suggest further research with a larger sample size may be warranted to clarify the potential clinical impact.</p><p><strong>Trial registration number: </strong>ACTRN12622000968774.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872815","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":"Neonatal outcomes following antenatal corticosteroid administration before planned caesarean birth at late preterm or early term (36-38 weeks' gestation): a retrospective cohort study.","authors":"Gizat Molla Kassie, Emily Frier, Amanda J Poprzeczny, Michael Stark, Luke Grzeskowiak","doi":"10.1136/archdischild-2025-329629","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329629","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the benefits and harms associated with antenatal corticosteroids (ACS) prior to planned caesarean birth at late preterm or early term.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>South Australia, Australia, 2005-2018.</p><p><strong>Patients: </strong>Women with singleton pregnancies undergoing planned caesarean birth between 36⁺⁰ and 38⁺⁶ weeks' gestation.</p><p><strong>Methods: </strong>We used routinely collected electronic maternity and neonatal data. Adjusted risk differences (aRD) with 95% CIs were calculated for neonatal and maternal outcomes.</p><p><strong>Outcome measures: </strong>Neonatal outcomes included respiratory distress requiring oxygen, hypoglycaemia requiring glucose, neonatal unit (NNU) admission and prolonged NNU admission (≥48 hours).</p><p><strong>Results: </strong>Among the cohort of 4049 women, the proportion receiving ACS was 54.8%, 48.4% and 5.6% at 36, 37 and 38 completed weeks' gestation, respectively. ACS administration was associated with a significant reduction in respiratory distress across all gestations, with the greatest reduction seen at 36 weeks' gestation (aRD -12.5%; 95% CI -21.4% to -3.6%). At 38 weeks' gestation, ACS administration was associated with an increased risk of neonatal hypoglycaemia (aRD 5.7%; 95% CI 1.1% to 10.2%), NNU admission (aRD 5.4%; 95% CI 0.1% to 10.7%) and prolonged NNU admission (aRD 4.6%; 95% CI 0.2% to 8.9%).</p><p><strong>Conclusions: </strong>ACS administration prior to late preterm and early term planned caesarean birth was associated with reduced risk of respiratory distress. The net benefit of ACS administration before planned caesarean birth remains unclear; however, there was evidence of potential neonatal harm when birth occurred after 37 weeks' gestation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872759","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":"Re: Umbilical cord milking for non-vigorous term and late preterm neonates - are we there yet?","authors":"Anup C Katheria, Georg M Schmölzer, Walid El-Naggar","doi":"10.1136/archdischild-2026-331086","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331086","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849770","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":"Comparison of two automated oxygen control algorithms in mechanically ventilated neonates: an open label, randomised, crossover trial.","authors":"Sumit Bhadu, Venkataseshan Sundaram, Jogender Kumar, Praveen Kumar","doi":"10.1136/archdischild-2026-330569","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330569","url":null,"abstract":"<p><strong>Objective: </strong>To compare rule-based non-fuzzy algorithm (Predictive Intelligent Control of Oxygenation (PRICO)) with adaptive algorithm (Closed-loop Inspired Oxygen (CLiO₂)) for automated oxygen control in mechanically ventilated neonates.</p><p><strong>Design: </strong>Open label, randomised, crossover trial.</p><p><strong>Setting: </strong>Level III neonatal intensive care unit.</p><p><strong>Patients: </strong>Neonates ≤44 weeks post-menstrual age receiving invasive or non-invasive ventilation and fraction of inspired oxygen (FiO_₂) ≥25%.</p><p><strong>Interventions: </strong>Participants randomised to one of two sequences of auto-FiO2 (CLiO₂ then PRICO or PRICO then CLiO₂). Each algorithm in the sequence was applied for 24 hours before crossing over to an alternate algorithm. Target saturation was 91-95%. Masimo pulse-oximeters were used for saturation measurement.</p><p><strong>Main outcome: </strong>Primary outcome was time-weighted proportion of time spent within target saturation range. Secondary outcomes were time spent below and above target saturation range.</p><p><strong>Results: </strong>32 neonates were enrolled; 29 completed both intervention periods and contributed to paired data. Mean time-weighted proportion within target range was 76% in the CLiO₂ group compared with 62% in PRICO (mean within-participant difference (PRICO-CLiO₂) -14 percentage points, 95% CI -24 to -4; paired t-test p=0.01). A mixed-effects model accounting for period gave an 18 percentage points difference (82% vs 64%; treatment effect -0.92 on the logit scale, 95% CI -1.51 to -0.33, p=0.004). Time-weighted proportion spent above target range was lower with CLiO₂ (15% vs 30%). Time spent below target range was comparable between groups. No significant period or carryover effect was observed.</p><p><strong>Conclusions: </strong>In mechanically ventilated neonates, adaptive CLiO₂ algorithm did maintain the oxygen saturation within target range for a greater proportion of time and reduced hyperoxic exposure compared with the rule-based PRICO algorithm.</p><p><strong>Trial registration number: </strong>CTRI/2025/05/087301.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838958","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":"Investigating variations and early-life temporal changes in oxygen saturation indices in healthy moderate-late preterm and term infants: a cohort study.","authors":"Thomas L Wilkinson, Jonathan James, Jemima Clarke, Zara Howarth, Imogen Joseph, Megan Lawley, Bethany McDermott, Molly Renton, Charlotte Wilson, Ho Ming Yuen, Mark John Johnson, Hazel J Evans","doi":"10.1136/archdischild-2025-329591","DOIUrl":"10.1136/archdischild-2025-329591","url":null,"abstract":"<p><strong>Background: </strong>Neonatal respiratory system immaturity causes unstable breathing patterns during sleep, resulting in respiratory events and intermittent hypoxaemia (IH). The recent literature correlates frequent respiratory events with adverse early neurodevelopmental outcomes.</p><p><strong>Aims: </strong>This study investigated 5-week temporal changes in oxygen saturation indices in healthy moderate-late preterm (MLPT) (born between 32+0 weeks and 36+6 weeks of gestation) and term (born between 37+0 weeks and 41+6 weeks of gestation) infants.</p><p><strong>Methods: </strong>MLPT and term infants' sleeping postductal saturations were measured using nocturnal pulse oximetry at 7 days, 14 days, 21 days, 28 days and 35 days (±3 days) postnatal age. This recorded mean peripheral oxygen saturation (SpO₂), Oxygen Desaturation Indices (ODIs) 3, 4 and 10 (number of desaturations >3%, >4% and >10% per hour) and mean nadir SpO₂ >3%.</p><p><strong>Results: </strong>34 infants were studied (17 per group). The groups' median gestations were 35+0 weeks and 39+5 weeks, respectively. Generalised linear mixed modelling indicated increasing mean saturations from 94.98% in week 1 to 96.68% in week 5 (p<0.001) for both groups together, with no significant group differences. MLPT infants' average mean nadir SpO₂ >3% was 89.94% versus 91.55% for term infants (p=0.005), with both groups improving throughout the study (p=0.006). MLPT infants had 2.08 times more ODI3 dips/hour (p<0.001), 2.49 times more ODI4 dips/hour (p<0.001) and 6.66 times more ODI10 dips/hour (p=0.005) than term infants.</p><p><strong>Conclusion: </strong>This study demonstrated significant differences in IH prevalence and severity between groups. Further research is needed to evaluate IH's impact on neurodevelopmental outcomes in this population.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F466-F473"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687734","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":"Combining abdominal ultrasound and radiography for surgical risk stratification in necrotising enterocolitis: a prospective cohort pilot study.","authors":"Archana Priyadarshi, Rajeshwar Angiti, Shilpi Chabra, Ryan McAdams, Annabel Webb, Nadia Badawi, Murray Kenneth Hinder, Mark B Tracy","doi":"10.1136/archdischild-2025-329960","DOIUrl":"10.1136/archdischild-2025-329960","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether combining abdominal ultrasound with radiography improves diagnostic accuracy and surgical risk stratification in neonates with suspected necrotising enterocolitis (NEC) compared with radiography alone.</p><p><strong>Design, setting and patients: </strong>Prospective cohort pilot study conducted in two tertiary neonatal intensive care units. Sixty-seven neonates with suspected NEC underwent concurrent abdominal radiography and ultrasound assessments. Imaging studies were independently reviewed by masked investigators using pre-specified criteria to classify each study as reassuring or non-reassuring.</p><p><strong>Main outcome measures: </strong>The main outcome measure was the need for surgical intervention. Imaging data were analysed using unsupervised k-means clustering (k=2): logistic regression-testing associations with surgery and principal component analysis (PCA)-to identify imaging features most contributing to group separation.</p><p><strong>Results: </strong>Ultrasounds were reassuring in all cases subsequently diagnosed with non-NEC, that is, feeding intolerance, whereas most radiographs in this group were non-reassuring. Clustering based on radiographs alone did not significantly discriminate surgical risk (58.8% vs 39.4%; p=0.11). Combined model (radiograph+ultrasound) produced two distinct clusters with significantly different surgical rates (78.3% vs 34.1%; OR 6.96, 95% CI 2.29 to 24.58). PCA highlighted complex ascites, absent peristalsis and abnormal bowel perfusion as key discriminating features.</p><p><strong>Conclusion: </strong>Combining abdominal ultrasound with radiography improved the identification of neonates at high surgical risk from NEC, in our pilot study. A reassuring ultrasound reliably identified infants with feeding intolerance, suggesting potential to reduce unnecessary transfers and treatments. Larger multicentre studies are needed to validate these findings and inform development of a unified multimodal imaging score for NEC diagnosis.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F447-F452"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363934","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":"Moving beyond the binary of 'preterm' versus 'term' to address the continuum of risk.","authors":"Lauren Rossetti, Jeanie Ling Yoong Cheong","doi":"10.1136/archdischild-2025-329370","DOIUrl":"10.1136/archdischild-2025-329370","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F405-F406"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146059032","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":"Fantoms.","authors":"Ben J Stenson","doi":"10.1136/archdischild-2026-331431","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331431","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":"111 5","pages":"F401"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787553","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}