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

{"title":"A novel human milk fortifier supports adequate growth in very low birth weight infants: a non-inferiority randomised controlled trial.","authors":"Jean-Charles Picaud, Peter Robert Reynolds, Paul Clarke, Edith van den Hooven, Mirjam M van Weissenbruch, Richard A van Lingen, Annemiek Goedhart, Akke Botma, Ralf Boettger, Elke van Westering-Kroon, Christoph Fusch, J M Hascoet","doi":"10.1136/archdischild-2024-327282","DOIUrl":"10.1136/archdischild-2024-327282","url":null,"abstract":"<p><strong>Objective: </strong>To compare growth, tolerance and safety parameters in very preterm infants receiving human milk (HM) fortified with a multicomponent cow's milk-based HM fortifier (HMF; control) versus a novel HMF-containing lipids (including docosahexaenoic acid and arachidonic acid), higher protein and lower carbohydrate levels (test). Our hypothesis was that weight growth velocity in the test group would be non-inferior to that in the control group.</p><p><strong>Design: </strong>Double-blind, randomised controlled trial.</p><p><strong>Setting: </strong>Nine European neonatal intensive care units.</p><p><strong>Patients: </strong>HM-fed infants born at <32-week gestational age.</p><p><strong>Interventions: </strong>Fortification of HM with Test or Control HMF for a minimum of 21 days.</p><p><strong>Primary outcome: </strong>Weight growth velocity between baseline and intervention day 21.</p><p><strong>Results: </strong>From March 2018 to July 2020, 102 and 103 infants were enrolled in the test and control groups, respectively. Weight growth velocity during the first 21 days in the test group (mean 18.4 g/kg/day) was non-inferior to that of controls (mean 18.5 g/kg/day), with a difference in estimated means of -0.175 g/kg/day (90% CI -1.34 to +0.99 g/kg/day; per-protocol population). No significant differences between groups were observed for gain in length, head circumference or anthropometric Z-scores. Rates of digestive intolerance, stool frequency and consistency were comparable. No significant differences were reported in common neonatal morbidities including necrotising enterocolitis (test: 2.9%, control: 6.9%, mean difference -4.0% (95% CI -11.1% to 2.2%); all subjects treated population).</p><p><strong>Conclusions: </strong>Use of the novel HMF containing lipids, higher protein and lower carbohydrate levels supports adequate postnatal growth and appears safe and well tolerated in very preterm infants.</p><p><strong>Trial registration number: </strong>NCT03315221.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"512-519"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video analysis of neonatal intubations using video laryngoscopy: a prospective comparison of clinical practice with resuscitation guidelines.","authors":"Caitríona M Ní Chathasaigh, Emma A Dunne, Lucy E Geraghty, Colm P F O'Donnell, Eoin O'Currain, Anna E Curley","doi":"10.1136/archdischild-2024-327723","DOIUrl":"10.1136/archdischild-2024-327723","url":null,"abstract":"<p><strong>Background: </strong>The Neonatal Resuscitation Program recommends direct laryngoscopy (DL) as the primary method for neonatal intubation. Video laryngoscopy (VL) is suggested as an option, particularly for training novice operators or for intubating infants with difficult airways. The programme outlines specific steps for intubation, including managing the external environment and techniques for visualising key anatomical landmarks. It is unclear whether the DL method can be effectively applied to VL.</p><p><strong>Objectives: </strong>To determine the degree of adherence to resuscitation guidelines during intubation using VL, and to examine the relationship between guideline adherence and intubation success.</p><p><strong>Methods: </strong>In a cohort of newborn infants who were intubated with VL, we simultaneously recorded the view obtained with the video laryngoscope and an external view of the procedure with a GoPro video camera, and synchronised the recordings for analysis. In each set of recordings, we assessed infant and operator positions, interventions during the procedure, and the anatomical landmarks visualised.</p><p><strong>Results: </strong>We assessed 95 intubation attempts in 57 infants (median corrected gestational age: 28 weeks; median weight: 1160 g). Sixty-six of these attempts (69%) were successful. Operators spent more time attempting to insert the endotracheal tube through a visible glottis than locating it. Sixty-six (69%) attempts were performed with an appropriate lift manoeuvre. The vocal cords were visualised in only 58 (61%) attempts, while the glottis was seen in 85 (89%).</p><p><strong>Conclusions: </strong>Neonatal intubation using VL differed from the technique recommended in resuscitation guidelines. Revised guidelines considering the use of VL may be warranted.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"479-484"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma transfusions in neonatal intensive care units: a prospective observational study.","authors":"Nina A M Houben, Suzanne Fustolo-Gunnink, Karin Fijnvandraat, Camila Caram-Deelder, Marta Aguar Carrascosa, Alain Beuchée, Kristin Brække, Francesco Stefano Cardona, Anne Debeer, Sara Domingues, Stefano Ghirardello, Ruža Grizelj, Emina Hadžimuratović, Christian Heiring, Jana Lozar Krivec, Jan Maly, Katarina Matasova, Carmel Maria Moore, Tobias Muehlbacher, Miklos Szabo, Tomasz Szczapa, Gabriela Zaharie, Justine de Jager, Nora Johanna Reibel-Georgi, Helen V New, Simon J Stanworth, Emöke Deschmann, Charles C Roehr, Christof Dame, Saskia le Cessie, Johanna G van der Bom, Enrico Lopriore","doi":"10.1136/archdischild-2024-327926","DOIUrl":"10.1136/archdischild-2024-327926","url":null,"abstract":"<p><strong>Objective: </strong>Despite lack of evidence supporting efficacy, prophylactic fresh frozen plasma and Octaplas transfusions may be administered to very preterm infants to reduce bleeding risk. International variation in plasma transfusion practices in neonatal intensive care units (NICUs) is poorly understood, therefore, we aimed to describe neonatal plasma transfusion practice in Europe.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>64 NICUs in 22 European countries, with a 6-week study period per centre between September 2022 and August 2023.</p><p><strong>Patients: </strong>Preterm infants born below 32 weeks of gestational age.</p><p><strong>Interventions: </strong>Admission to the NICU.</p><p><strong>Main outcome measures: </strong>Plasma transfusion prevalence, cumulative incidence, indications, transfusion volumes and infusion rates and adverse effects.</p><p><strong>Results: </strong>A total of 92 of 1143 infants included (8.0%) received plasma during the study period, collectively receiving 177 transfusions. Overall prevalence was 0.3 plasma transfusion days per 100 admission days, and rates varied substantially across Europe. By day 28 of life, 13.5% (95% CI 10.0% to 16.9%) of infants received at least one plasma transfusion, accounted for competing risks of death or discharge. Transfusions were given for a broad range of indications, including active bleeding (29.4%), abnormal coagulation screen results (23.7%) and volume replacement/hypotension (21.5%). Transfusion volumes and infusion rates varied significantly; the most common volume was 15 mL/kg (range: 5-30 mL/kg) and the most common duration was 2 hours (range: 30 min to 6 hours).</p><p><strong>Conclusions: </strong>We found wide variation in plasma transfusion practices in Europe, highlighting the need for evidence to inform neonatologists in daily practice and guidelines, in particular for non-bleeding indications.</p><p><strong>Trial registration number: </strong>ISRCTN17267090.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"452-459"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success and safety of neonatal endotracheal tube exchanges: a NEAR4NEOS multicentre retrospective cohort study.","authors":"Kathleen Miller, Nicole Pouppirt, Paul Wildenhain, Ayman Abou Mehrem, Ivana Brajkovic, Cassandra DeMartino, Kristen Glass, Kate Alison Hodgson, Philipp Jung, Ahmed Moussa, Mihai Puia-Dumitrescu, Binhuey Quek, Jennifer Rumpel, Rebecca Shay, David Tingay, Michelle D Tyler, Jennifer Unrau, Michael Wagner, Justine Shults, Akira Nishisaki, Elizabeth E Foglia, Heidi M Herrick","doi":"10.1136/archdischild-2024-328287","DOIUrl":"10.1136/archdischild-2024-328287","url":null,"abstract":"<p><strong>Objectives: </strong>To compare success and safety of endotracheal tube (ETT) exchanges with primary intubations and identify factors associated with ETT exchange outcomes.</p><p><strong>Design: </strong>Retrospective observational study of prospectively collected National Emergency Airway Registry for Neonates data. ETT exchanges are the placement of a new ETT when one is already in place, whereas primary intubations do not have a pre-existing ETT. The primary outcome was first-attempt success. Secondary outcomes included number of attempts, adverse tracheal intubation-associated events (TIAEs), severe TIAEs, desaturation and bradycardia. Descriptive statistics compared characteristics for ETT exchanges and primary intubations. Univariable and multivariable analyses compared primary and secondary outcomes and identified factors independently associated with ETT exchange outcomes.</p><p><strong>Results: </strong>A total of 1572 ETT exchanges and 9999 primary intubations across 21 sites were included from October 2014 to September 2022. ETT exchanges represented 2.3%-31.2% (mean 13.6%) of intubations across sites. Patient, provider and practice characteristics varied significantly between ETT exchanges and primary intubations. In univariable analyses, ETT exchanges were associated with higher first-attempt success (70.5% vs 53.6%; p<0.001) and fewer safety events. In multivariable analyses, ETT exchanges were associated with an increased adjusted OR (aOR) of first-attempt success (1.71; 95% CI 1.57 to 1.86; p<0.001). ETT exchanges were associated with lower aOR of all safety outcomes except severe TIAEs. Factors independently associated with ETT exchange first-attempt success included video laryngoscopy and paralytic premedication.</p><p><strong>Conclusion: </strong>Compared with primary intubations, ETT exchanges were associated with higher first-attempt success and fewer safety events. Video laryngoscope and paralytic premedication were associated with improved ETT exchange outcomes.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"498-503"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fantoms.","authors":"Ben J Stenson","doi":"10.1136/archdischild-2025-329511","DOIUrl":"10.1136/archdischild-2025-329511","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":"110 5","pages":"433"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881945","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":"Nasal mask ventilator-delivered versus face maskT-piece resuscitator positive pressure ventilation during resuscitation of preterm neonates: a cohort study.","authors":"Nosheen Akhtar, Aman Hemani, Bonny Jasani, Brittany Lindsay, Brent Morgan, Amish Jain, Michelle Baczynski","doi":"10.1136/archdischild-2024-327966","DOIUrl":"10.1136/archdischild-2024-327966","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical impact of nasal mask ventilator-delivered positive pressure ventilation (PPV) versus face mask manual T-piece resuscitator PPV during resuscitation of preterm neonates.</p><p><strong>Design: </strong>We conducted a pre-post cohort study in a tertiary neonatal unit, comparing consecutive neonates born 25^0/7-28^6/7 weeks of gestational age (GA) who received PPV ≤10 min after birth, before and after changing the approach during resuscitation from face mask manual T-piece resuscitator PPV (epoch 1, April 2018-April 2020) to nasal mask ventilator-delivered PPV (epoch 2, May 2020-February 2022). The association between birth epoch and the primary outcome of emergent intubation (EI) during resuscitation was examined by multivariable logistic regression and inverse probability of treatment weighting models. Additional outcomes compared between epochs were rates of advanced resuscitation, and early (≤7 days) and late (>7 days) prematurity-related morbidities.</p><p><strong>Results: </strong>Of 545 eligible births, 336 (62%) received PPV; 176 (58%) in epoch 1 and 160 (66%) in epoch 2. Neonates in epoch 1 had lower GA (26.7 (25.9-27.9) vs 27.4 (26.0-28.1) weeks; p=0.02) but similar birth weight (900 (730-1060) vs 880 (740-1085) g; p=0.53). Neonates in epoch 2 had lower rates of EI (16% vs 44%; p<0.001) and less use of post-resuscitation invasive ventilation (22% vs 59%; p<0.001). After accounting for confounders, nasal mask ventilator-delivered PPV remained associated with lower odds of EI (adjusted OR 0.23 (95% CI 0.13 to 0.42)). Secondary outcomes were similar between groups.</p><p><strong>Conclusion: </strong>Nasal mask ventilator-delivered PPV may reduce EI during resuscitation of preterm neonates. Our observations support a large trial of nasal mask ventilator-delivered PPV in this context.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"485-491"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370333","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":"Histological chorioamnionitis and neurodevelopment at 5 years of age among infants born very preterm: EPIPAGE-2 cohort study.","authors":"Fanny Salmon, Mathilde Letouzey, Laetitia Marchand-Martin, Héloïse Torchin, Valérie Benhammou, Kaminski Monique, Véronique Pierrat, Laurence Foix-L'Helias, Pierre Yves Ancel, Elsa Lorthe, Gilles Kayem","doi":"10.1136/archdischild-2025-329023","DOIUrl":"10.1136/archdischild-2025-329023","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between histological chorioamnionitis without maternal clinical symptoms and neurodevelopmental disabilities at age 5 years in children born very preterm.</p><p><strong>Design: </strong>French national prospective population-based cohort study, EPIPAGE-2 (<i>Etude épidémiologique sur les petits âges gestationnels</i>).</p><p><strong>Setting: </strong>All births from 22 to 34 weeks of gestational age in France in 2011 were eligible.</p><p><strong>Population: </strong>Infants born alive between 24⁺⁰ and 31⁺⁶ weeks following preterm labour (PTL) or preterm premature rupture of membranes (PPROMs).</p><p><strong>Exposure: </strong>Histological chorioamnionitis without maternal clinical symptoms, also called isolated histological chorioamnionitis, was defined as the presence of neutrophils in the chorionic plate, excluding clinical chorioamnionitis.</p><p><strong>Main outcome measures: </strong>Neurodevelopmental disabilities, a composite outcome including cerebral palsy, developmental coordination disorders, sensory impairment, developmental cognitive deficiencies or behavioural difficulties. These assessments were comprehensive, standardised and conducted by trained neuropsychologists and paediatricians at age 5 years.</p><p><strong>Results: </strong>Among 1296 children alive at 5 years of age, 486 (36.3%) were born in a context of isolated histological chorioamnionitis. Overall, 47% vs 33.6% of children exposed and not exposed to isolated histological chorioamnionitis had mild neurodevelopmental disabilities, and 13.8% vs 13.3% had moderate-to-severe neurodevelopmental disabilities. After multiple imputation and multivariable analysis, isolated histological chorioamnionitis was found not to be associated with the occurrence of mild or moderate-to-severe neurodevelopmental disabilities (adjusted OR: 1.0, 95% CI: 0.7 to 1.4 and 0.9, 0.6 to 1.2).</p><p><strong>Conclusion: </strong>We did not find any association between isolated histological chorioamnionitis and neurodevelopmental disabilities at age 5 years in children born very preterm after PTL or PPROM.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881944","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 skin antisepsis with alcohol-based compared to aqueous 2% chlorhexidine, used in moderate preterm infants or extremely preterm infants after the first week of life, is safe and may be associated with a reduced incidence of catheter-related bloodstream infections.","authors":"Alejandro Pinilla-González, Lucía Pérez-Fiérrez, Alvaro Solaz-García, Laura Torrejón-Rodríguez, Anna Parra-Llorca, Teresa Pérez-Oliver, Ana Gimeno Navarro, María Dolores Lorena Mocholí Tomás, Rosario Ros Navarret, Maximo Vento, Marta Aguar, Maria Cernada","doi":"10.1136/archdischild-2024-327728","DOIUrl":"10.1136/archdischild-2024-327728","url":null,"abstract":"<p><strong>Background: </strong>Skin antisepsis is one of the most important bundle measures to decrease central line-related bloodstream infections (CRBSIs). However, in the neonatal population, the use of alcoholic chlorhexidine is limited by the risk of skin lesions.</p><p><strong>Objective: </strong>We hypothesised that skin antisepsis with alcohol-based 2% chlorhexidine instead of aqueous 2% chlorhexidine could reduce the incidence of CRBSI without increasing skin complications.</p><p><strong>Design: </strong>We conducted a double cohort study comparing two periods of 3 years, first using aqueous and second using alcohol-based chlorhexidine, leaving a 1-year washout interval between them. In extremely preterm infants, aqueous chlorhexidine was used during the first week of life in both periods.</p><p><strong>Results: </strong>A total of 1783 patients and 2493 episodes of central line catheter were analysed. There were no statistically significant differences in clinical and demographic data from infants in both periods. There was a significant reduction in the pooled incidence density of CRBSI in the second compared with the first period (4.03 vs 9.05 episodes/1000 central line days, OR 0.45 (95% CI 0.29 to 0.68)). The overall absolute risk reduction was 0.039 (95% CI 0.023 to 0.056) and the number needed to treat was 25. A similar but not significant reduction of the small number of CRBSI was observed in extremely preterm infants within the first week of life OR 0.43 (95% CI 0.134 to 1.379). No statistically significant differences in skin lesions were observed between periods, making erythema the most common injury(5.1% vs 4.2%).</p><p><strong>Relevance: </strong>Alcohol-based 2% chlorhexidine as a skin antiseptic could reduce the incidence of CRBSI in neonates without producing an increase in skin lesions.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"460-466"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187981","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":"Routine pulse oximetry testing for newborn babies: a framework for practice.","authors":"Vix Monnelly, Thomas McEwan, Kate Hannah Regan, Lambri Yianni, Suzie Hutchinson, Jon Arnold, Kate Dinwiddy, Nicola Brake, Jessica Case-Stevens, Katie Cullum, Kerry Louise Gaskin, Olivia Houlihan, Caroline B Jones, Beth McCleverty, Ayevbekpen Grace Okoye, Sam J Oddie, Ngozi Edi-Osagie, Eleri Adams, Andrew K Ewer","doi":"10.1136/archdischild-2024-328285","DOIUrl":"10.1136/archdischild-2024-328285","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"436-443"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742067","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":"Motor and functional characteristics in school-age survivors of congenital diaphragmatic hernia: a cross-sectional observational study.","authors":"Takamasa Mitsumatsu, Yuji Ito, Yukako Muramatsu, Yoshiaki Sato, Tadashi Ito, Sho Narahara, Ryosuke Miura, Hiroyuki Yamamoto, Miharu Ito, Anna Shiraki, Tomohiko Nakata, Tomomi Kotani, Jun Natsume, Masahiro Hayakawa, Yoshiyuki Takahashi, Hiroyuki Kidokoro","doi":"10.1136/archdischild-2024-327942","DOIUrl":"10.1136/archdischild-2024-327942","url":null,"abstract":"<p><strong>Background: </strong>Children born with congenital diaphragmatic hernia (CDH) are at risk of poor developmental outcomes. This study aimed to clarify the motor and functional characteristics of school-age CDH survivors and identify perinatal factors associated with motor function deficits.</p><p><strong>Methods: </strong>Motor function was comprehensively assessed in CDH survivors aged 6-10 years (CDH group, n=24) and in age- and sex-matched controls (n=72). Assessments included physical activity time, grip strength, the five times sit-to-stand test, one-leg standing time, 6 min walking distance and gait ability using a three-dimensional gait analysis. In the CDH group, correlations between perinatal factors and motor function outcomes were analysed.</p><p><strong>Results: </strong>In the CDH group, all children had isolated CDH. Three were extracorporeal membrane oxygenation (ECMO) treated and 21 were non-ECMO treated. The CDH group exhibited shorter stature, lower weight and reduced physical activity time than the controls. They also showed significantly lower grip strength, longer five times sit-to-stand test time, shorter one-leg standing time and decreased 6 min walking distance. No significant differences were found between the two groups regarding walking speed, step length or Gait Deviation Index. Within the CDH group, a higher observed-to-expected lung area-to-head circumference ratio (o/e LHR) was positively correlated with better grip strength.</p><p><strong>Conclusions: </strong>School-age survivors of CDH are at risk of impaired motor function. Particularly, grip strength measurement is crucial for those born with a low o/e LHR. Implementing follow-up and intervention programmes focused on improving limb muscle strength, balance, and endurance, and promoting adequate physical activity may enhance motor function.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"492-497"},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432289","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}