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

{"title":"How deep is too deep and how long is too long? The effect of haemoglobin concentration on buffering capacity during desaturation in preterm infants.","authors":"Chad Andersen, Tara Marie Crawford, Michael Stark","doi":"10.1136/archdischild-2025-329029","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329029","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788113","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":"Extensive leukaemia cutis at birth.","authors":"Sota Iwatani, Yuto Ohnishi, Hiroki Goto, Atsuro Saito, Seiji Yoshimoto","doi":"10.1136/archdischild-2025-329262","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329262","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783331","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 transfusion practice: undesired variation or personalised medicine?","authors":"Amy K Keir, Ravi Mangal Patel","doi":"10.1136/archdischild-2024-327782","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327782","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697497","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 in 5-year-old children born very preterm: a European multicountry cohort.","authors":"Soodabeh Behboodi, Barbara Heude, Pauline Scherdel, Marina Cuttini, Rolf F Maier, Michael Zemlin, Heili Varendi, Ulrika Ådén, Adrien M Aubert, Jennifer Zeitlin","doi":"10.1136/archdischild-2025-328942","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328942","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to investigate the prevalence of underweight and overweight and obesity (OWOB) and associated risk factors among 5-year-old children born very preterm (VPT).</p><p><strong>Design: </strong>Multinational area-based cohort study of children born VPT.</p><p><strong>Setting: </strong>19 regions in 11 European countries.</p><p><strong>Patients: </strong>Children born before 32 weeks of gestational age in 2011-2012 and followed up at 5 years of age.</p><p><strong>Main outcome measures: </strong>Body mass index (BMI) at 5 years of age was classified into underweight and OWOB using International Obesity Task Force references, and associations with sociodemographic, perinatal and neonatal risk factors were assessed using multinomial logistic regression. Data came from medical records during the neonatal hospitalisation and parental questionnaires at 5 years of age. Models accounted for missing data and attrition by using multiple imputation by chained equations and inverse probability weighting.</p><p><strong>Results: </strong>27.6% of children were underweight and 10.8% were OWOB. Younger maternal age was associated with lower risks of underweight, while low maternal education, household unemployment and non-European maternal country of birth were associated with having OWOB. Fetal growth restriction, receiving postnatal steroids and bronchopulmonary dysplasia were associated with underweight, and fetal growth restriction, male sex and multiple birth were negatively associated with OWOB.</p><p><strong>Conclusions: </strong>38% of children born VPT had suboptimal BMI at 5 years, principally due to being underweight, with differing risk factors for underweight and OWOB. These results raise questions about underlying mechanisms and the growth trajectories and metabolic outcomes of underweight children, in light of high prevalence and association with clinical risk.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697509","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":"Transition off respiratory support for very preterm infants with bronchopulmonary dysplasia: an observational study of national audit data in England and Wales.","authors":"T'ng Chang Kwok, Amitava Sur, Humfrey Legge, Don Sharkey, Sam J Oddie","doi":"10.1136/archdischild-2025-328758","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328758","url":null,"abstract":"<p><strong>Objective: </strong>To compare the proportion of infants receiving different respiratory support types between 36 and 40 weeks postmenstrual age (PMA).</p><p><strong>Design: </strong>Retrospective cohort study using National Neonatal Audit Programme data.</p><p><strong>Setting: </strong>England and Wales.</p><p><strong>Patients: </strong>50 628 infants born <32 weeks of gestation admitted to neonatal units from 2017 to 2023.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Respiratory support received and mortality.</p><p><strong>Results: </strong>The proportion of infants who died increased at 36 weeks (8.1% to 8.6%, p=0.01) and 40 weeks (8.4% to 8.9%, p=0.01) PMA, respectively. This trend was driven by infants born <24 weeks of gestation. In survivors, those receiving any respiratory support or respiratory pressure support at 36 and 40 weeks PMA increased between 2017 and 2023 (p<0.0001). Over the study period, more infants received non-invasive ventilation at 36 weeks PMA (12.6% to 15.1%, p=0.0001) and supplemental oxygen at 40 weeks PMA (12.4% to 13.1%, p=0.002). Between 36 and 40 weeks PMA, there were absolute reductions of 11.8% and 10.6% in the proportion of surviving infants receiving any respiratory support and respiratory pressure support, respectively. This is especially so in infants born between 24 and 27 weeks of gestation, with absolute reductions of 21.3% and 24.2%, respectively.</p><p><strong>Conclusions: </strong>More surviving preterm infants are receiving respiratory support at 36 and 40 weeks PMA. However, a large proportion of infants born 24-27 weeks of gestation transition to no respiratory support during this period. Strategies to identify infants likely to wean off respiratory support could help safely transition them home at the right time or better plan respiratory support at discharge.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681907","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":"Variations in antibiotic use in late preterm and term newborns from 2012 to 2020: a nationwide population-based observational study.","authors":"Johan Gyllensvärd, Marie Studahl, Lars Gustavsson, Elisabet Hentz, Karin Åkesson, Huiqi Li, Mikael Norman, Anders Elfvin","doi":"10.1136/archdischild-2025-328944","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328944","url":null,"abstract":"<p><strong>Objective: </strong>To quantify regional and unit variations in antibiotic use during the first week of life, incidence of early-onset sepsis (EOS) and mortality in late-preterm and term newborns in Sweden.</p><p><strong>Design: </strong>A nationwide cohort study.</p><p><strong>Setting: </strong>The Swedish Neonatal Quality Register, a register of all newborns admitted for neonatal care in Sweden.</p><p><strong>Patients: </strong>All late-preterm and term newborns (≥34 weeks' gestation) admitted to a neonatal unit from 1 January 2012 to 31 December 2020.</p><p><strong>Main outcome measures: </strong>The proportion of antibiotic use, incidence of EOS and mortality in late-preterm and term newborns.</p><p><strong>Results: </strong>Out of 1 025 515 newborns, 19 286 neonates (1.9%) received antibiotics with a 2-fold to 5-fold variation across regions (1.3%-3.0%) and units (0.9%-4.3%). Duration of antibiotic therapy (median) varied across regions from 7-10 days for infants with EOS, and 4-7 days for infants with no sepsis. Incidence of EOS ranged from 0.33 to 0.93 per 1000 live births between regions. The number of infants treated per EOS case varied 2-fold to 15-fold across regions (22-39) and units (7-113). All-cause mortality and EOS-associated mortality ranged across regions from 0.21 to 0.54 per 1000 live births and 0.0 to 34.9 (3 of 86 newborns) per 1000 infants with EOS.</p><p><strong>Conclusions: </strong>This nationwide study revealed wide variations in antibiotic use and in the number of infants treated per EOS case. The results indicate a disproportionate antibiotic use in relation to the incidence of EOS. This emphasises the need for future efforts to minimise unwarranted antibiotic use.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666914","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":"Diffuse white matter abnormality is independently predictive of neurodevelopmental outcomes in preterm infants.","authors":"Abiot Y Derbie, Leanne Tamm, Beth Kline-Fath, Hailong Li, Karen Harpster, Stephanie L Merhar, Lili He, Mekibib Altaye, Nehal A Parikh","doi":"10.1136/archdischild-2025-328635","DOIUrl":"10.1136/archdischild-2025-328635","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate diffuse white matter abnormality (DWMA) volume at term-equivalent age as an independent predictor of neurodevelopmental outcomes in preterm infants.</p><p><strong>Study design: </strong>In this multicentre prospective cohort study, 392 preterm infants (≤32 weeks' gestation) underwent term-equivalent MRI with automated DWMA quantification. The primary outcome was cognitive function at 3 years corrected age using the Differential Ability Scales-II General Conceptual Ability (GCA) score. Secondary outcomes included motor function (Bayley-III) and cerebral palsy (CP) at 2 years. Multivariable regression analysed DWMA's prognostic value.</p><p><strong>Results: </strong>Follow-up was available for 89% (GCA) and 87% (Bayley-III/CP) of participants (mean gestational age 29 (SD: 2.5 weeks). Mean GCA was 94 (20.2); Bayley motor composite was 93 (14.5). CP was diagnosed in 12% of children (28 Gross Motor Function Classification System level I, six level II and III and five level IV and V). Higher DWMA volume independently predicted lower cognitive (β=-1.9; 95% CI -3.7 to -0.1), though only marginally over existing predictors (p=0.04), and motor scores (β=-2.0; 95% CI -3.3 to -0.7; p=0.003) and increased CP risk (adjusted OR=1.7; 95% CI 1.2 to 2.4; p=0.003) after controlling for clinical and socioeconomic factors. Socioeconomic disadvantages have amplified DWMA's adverse effects.</p><p><strong>Conclusions: </strong>This first external validation study demonstrates that objective DWMA quantification independently predicts multiple developmental outcomes through age 3 in preterm infants. The findings validate DWMA's pathological significance and support its utility as an early biomarker for risk stratification and targeted intervention.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599218","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":"Incorporating stressors during simulated neonatal endotracheal intubation creates a stress response but does not affect performance: a randomised pilot study.","authors":"Michael-Andrew Assaad, Thomas Pennaforte, Christian Lachance, Ilian Cruz Panesso, Ahmed Moussa","doi":"10.1136/archdischild-2025-328615","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328615","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the impact of high stress (HS) using four stressors (physiological, psychological/social, contextual and situational) versus low stress (LS) on stress response and performance during simulated neonatal endotracheal intubation (ETI).</p><p><strong>Design: </strong>Non-blinded crossover simulated randomised controlled trial. Subjects included paediatric and neonatology residents. Participants were exposed to HS and LS neonatal ETI scenarios. Primary outcomes were stress response measures: (1) physiologic: heart rate (HR) and HR variability (HRV), (2) psychologic: State-Trait Anxiety Questionnaire (STAI) responses and (3) endocrine: salivary cortisol. These were measured at baseline and pre/during/post each scenario. Secondary outcomes were intubation success rate, duration, and performance on a neonatal intubation checklist.</p><p><strong>Results: </strong>48 participants completed two scenarios. The HS scenario had a higher HR during (104±15 vs 100±15, mean difference 5 (1-9), p=0.03) and post (97±18 vs 93±15, mean difference 4 (0-9), p=0.04) compared with LS scenario. HRV was not different between groups. STAI trait scores did not differ, but STAI state scores were higher in the HS-post state compared with the LS-post state (38±8 vs 34±7, mean difference 4 (2-6), p=0.001). There was no significant difference in salivary cortisol between scenarios. Success rate, duration and checklist scores did not differ between scenarios.</p><p><strong>Conclusions: </strong>It is possible to generate a modest physiologic and psychologic stress response in simulated neonatal ETI using a combination of stressors, although without raising salivary cortisol or affecting performance.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582881","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":"Normative range of MRI-derived fetal brain volume throughout gestation: a prospective study.","authors":"Amine Bouachba, Raphael Bartin, Laurence Bussieres, David Grevent, Gwladys Gauchard, Laëtitia Bobet, Nathalie Roux, Laurent J Salomon, Guillaume Gorincour","doi":"10.1136/archdischild-2024-328310","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328310","url":null,"abstract":"<p><strong>Objective: </strong>To establish normative ranges for fetal brain volume (FBV) and investigate its relationship with gestational age, using MRI to improve the understanding of fetal brain development.</p><p><strong>Design: </strong>A prospective, cross-sectional study.</p><p><strong>Setting: </strong>A single-centre study conducted at a tertiary care hospital equipped with the world's only fetal-dedicated MRI system, located at Necker Hospital, Paris.</p><p><strong>Patients: </strong>A total of 260 healthy singleton pregnancies between 16 and 36 weeks' gestation were included. Inclusion criteria required confirmed gestational age by first-trimester ultrasound, absence of fetal or maternal anomalies and no high-risk conditions impacting fetal growth.</p><p><strong>Interventions: </strong>T2-weighted fetal MRI scans were acquired using standardised protocols. Brain and cerebellar volumes were manually segmented using dedicated three-dimensional post-processing software, with volume calculations. Manual segmentations were performed by experienced raters. Intra-rater and inter-rater reproducibility were assessed on randomly selected subsets of 50 cases each, demonstrating excellent agreement (intraclass correlation coefficient>0.96 for both comparisons).</p><p><strong>Main outcome measures: </strong>The primary outcome was the normative range of FBV by gestational age. Secondary outcomes included identifying variations in brain growth rates during gestation.</p><p><strong>Results: </strong>FBV increased significantly with gestational age, from a median of 20.1 cm³ at 16 weeks to 307.3 cm³ at 36 weeks. Growth rates showed the highest acceleration between 20 and 28 weeks' gestation, followed by a plateau. Linear regression demonstrated a strong correlation between FBV and gestational age (R²=0.95; p<0.001).</p><p><strong>Conclusions: </strong>This study provides normative data on FBV, demonstrating consistent growth patterns during mid-to-late gestation. These findings highlight the potential for MRI to serve as a reference tool for monitoring fetal brain development and detecting anomalies in early pregnancy.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511477","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 national guidance on survival for babies born at 22 weeks' gestation in England and Wales: implications for future research.","authors":"Hannah Farley, Charles C Roehr","doi":"10.1136/archdischild-2025-328935","DOIUrl":"10.1136/archdischild-2025-328935","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336279","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}