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

{"title":"Effect of interface dead space on the time taken to achieve changes in set FiO₂ during T-piece ventilation: is face mask the optimal interface for neonatal stabilisation?","authors":"Kolbrun Gunnarsdottir, Ben J Stenson, Elizabeth E Foglia, Vishal Kapadia, Thomas Drevhammar, Snorri Donaldsson","doi":"10.1136/archdischild-2024-327236","DOIUrl":"10.1136/archdischild-2024-327236","url":null,"abstract":"<p><strong>Background: </strong>T-piece is recommended for respiratory support during neonatal stabilisation. Bench studies have shown a delay >30 s in achieving changes in fraction of inspired oxygen (FiO₂) at the airway when using the T-piece. Using a face mask adds dead space (DS) to the patient airway. We hypothesised that adding face mask to T-piece systems adversely affects the time required for a change in FiO₂ to reach the patient.</p><p><strong>Methods: </strong>Neopuff (Fisher and Paykel, Auckland, New Zealand) and rPAP (Inspiration Healthcare, Croydon, UK) were used to ventilate a test lung. DS equivalent to neonatal face masks was added between the T-piece and test lung. Additionally, rPAP was tested with nasal prongs. Time course for change in FiO₂ to be achieved at the airway was measured for increase (0.3-0.6) and decrease (1.0-0.5) in FiO₂. Primary outcome was time to reach FiO₂+/-0.05 of the set target. One-way analysis of variance was used to compare mean time to reach the primary outcome between different DS volumes.</p><p><strong>Results: </strong>In all experiments, the mean time to reach the primary outcome was significantly shorter for rPAP with prongs compared with Neopuff and rPAP with face mask DS (p<0.001). The largest observed difference occurred when testing a decrease in FiO₂ with 10 mL tidal volume (TV) without leakage (18.3 s for rPAP with prongs vs 153.4 s for Neopuff with face mask DS). The shortest observed time was 13.3 s when increasing FiO₂ with 10 mL TV with prongs with leakage and the longest time was 172.7 s when decreasing FiO₂ with 4 mL TV and added face mask DS without leak.</p><p><strong>Conclusion: </strong>There was a delay in achieving changes in oxygen delivery at the airway during simulated ventilation attributable to the mask volume. This delay was greatly reduced when using nasal prongs as an interface. This should be examined in clinical trials.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"213-218"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144918","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":"Early hypophosphataemia and refeeding syndrome in extremely low birthweight babies and outcomes to 2 years of age: secondary cohort analysis from the ProVIDe trial.","authors":"Nadia Ford, Frank Harry Bloomfield, Yannan Jiang, Barbara Elizabeth Cormack","doi":"10.1136/archdischild-2024-327029","DOIUrl":"10.1136/archdischild-2024-327029","url":null,"abstract":"<p><strong>Objective: </strong>To investigate in extremely low birthweight (ELBW; <1000 g) babies the associations between refeeding syndrome (serum phosphate <1.4 mmol·L^-1 and serum total calcium>2.8 mmol·L^-1) and hypophosphataemia in the first week and death or neurodisability at 2 years' corrected age (CA).</p><p><strong>Design: </strong>Secondary cohort analysis of the ProVIDe trial participants with serum biochemistry within 7 days of birth. At 2 years' CA, neurodisability was assessed by Bayley Scales of Infant Development Edition III and neurological examination. Associations between neurodisability and other variables were analysed using t-tests and logistic regression adjusted for sex and smallness-for-gestational age.</p><p><strong>Setting: </strong>Six tertiary neonatal intensive care units (NICUs) in New Zealand.</p><p><strong>Participants: </strong>352 ELBW babies born between 29 April 2014 and 30 October 2018.</p><p><strong>Main outcome measure: </strong>Death or neurodisability at 2 years' CA.</p><p><strong>Results: </strong>Fifty-nine babies died, two after discharge from the NICU. Of the 336 babies who survived to 2 years' CA, 277 had neurodevelopmental assessment and 107 (39%) had a neurodisability. Death or neurodisability was more likely in babies who had refeeding syndrome (aOR 1.96 (95% CI 1.09 to 3.53), p=0.02) and in babies who had hypophosphataemia (aOR 1.74 (95% CI 1.09 to 2.79), p=0.02). Hypophosphataemia was associated with increased risk of death (aOR 2.07 (95% CI 1.09 to 3.95), p=0.03)) and severe hypophosphataemia (<0.9 mmol·L^-1) with increased risk of death (aOR 2.67 (95% CI 1.41 to 5.00), p=0.002) and neurodisability (aOR 2.31 (95% CI 1.22 to 4.35), p=0.01).</p><p><strong>Conclusions: </strong>In ELBW babies, refeeding syndrome and hypophosphataemia in the first week are associated with death or neurodisability. Until optimal phosphate requirements are determined through further research, monitoring for hypophosphataemia and mitigation strategies are indicated.</p><p><strong>Trial registration number: </strong>ACTRN12612001084875.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"157-164"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911523","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":"Should we use an 'accelerated' course of antenatal corticosteroids?","authors":"Abhijeet Anant Rakshasbhuvankar","doi":"10.1136/archdischild-2024-327476","DOIUrl":"10.1136/archdischild-2024-327476","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"228"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054760","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":"Most major bleeds in preterm infants occur in the absence of severe thrombocytopenia: an observational cohort study.","authors":"Hilde van der Staaij, Nadine M A Hooiveld, Camila Caram-Deelder, Suzanne F Fustolo-Gunnink, Karin Fijnvandraat, Sylke J Steggerda, Linda S de Vries, Johanna G van der Bom, Enrico Lopriore","doi":"10.1136/archdischild-2024-326959","DOIUrl":"10.1136/archdischild-2024-326959","url":null,"abstract":"<p><strong>Objective: </strong>To describe the incidence of major bleeds according to different platelet counts in very preterm infants, and to explore whether this association is influenced by other risk factors for bleeding.</p><p><strong>Design: </strong>Observational cohort study.</p><p><strong>Setting: </strong>A Dutch tertiary care neonatal intensive care unit.</p><p><strong>Patients: </strong>All consecutive infants with a gestational age at birth <32 weeks admitted between January 2004 and July 2022.</p><p><strong>Exposure: </strong>Infants were stratified into nine groups based on their nadir platelet count (×10⁹/L) during admission (<10, 10-24, 25-49, 50-99, 100-149, 150-199, 200-249, 250-299 and ≥300), measured before the diagnosis of a major bleed and before any platelet transfusion was administered.</p><p><strong>Main outcome measure: </strong>Incidence of major bleeds during admission. Logistic regression analysis was used to quantify the relationship between nadir platelet count and incidence of major bleeds.</p><p><strong>Results: </strong>Among 2772 included infants, 224 (8%) developed a major bleed. Of the infants with a major bleed, 92% (206/224) had a nadir platelet count ≥50×10⁹/L. The incidence of major bleeds was 8% among infants with and without severe thrombocytopenia (platelet count <50×10⁹/L), 18/231 (95% CI 5 to 12) and 206/2541 (95% CI 7 to 9), respectively. Similarly, after adjustment for measured confounders, there was no notable association between nadir platelet counts below versus above 50×10⁹/L and the occurrence of major bleeds (OR 1.09, 95% CI 0.61 to 1.94).</p><p><strong>Conclusion: </strong>In very preterm infants, the vast majority of major bleeds occur in infants without severe thrombocytopenia.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"122-127"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619187","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":"Intrapartum antibiotic prophylaxis for group B <i>Streptococcus</i>: what exactly is adequate?","authors":"Sarah A Coggins, Karen M Puopolo","doi":"10.1136/archdischild-2024-327481","DOIUrl":"10.1136/archdischild-2024-327481","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"116-117"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811864","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":"Voices of experience: insights from Dutch parents on periviability guidelines and personalisation.","authors":"Lien De Proost, Angret de Boer, Eduard Verhagen, Marije Hogeveen, Rosa Geurtzen, E J T Joanne Verweij","doi":"10.1136/archdischild-2024-327398","DOIUrl":"10.1136/archdischild-2024-327398","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the perspectives of experienced parents regarding guidelines and personalisation for managing imminent extremely premature births (22-26 weeks gestational age (GA)) . The study examined four scenarios: no guideline, a guideline based on GA, a guideline based on GA plus other factors and a guideline based on a calculated prognosis.</p><p><strong>Design: </strong>Nineteen semistructured qualitative interviews were conducted with Dutch parents who experienced (imminent) extremely premature births between 23+5 and 26+2 weeks of gestation. Diversity was aimed for through purposive sampling from a database created prior to this study. Four of the parents opted for palliative care. Among the parents who chose intensive care, in nine cases the infant(s) survived.</p><p><strong>Results: </strong>All participants acknowledged the necessity of having a periviability guideline because it would provide valuable decision-making support, and counterbalance decisions solely based on parental instincts to save their infant. Parents preferred guidelines that considered multiple prognostic factors beyond GA alone, without overwhelming parents with information, because more information would not necessarily make the decision easier for parents. Personalisation was defined by parents mainly as 'being seen and heard' and associated with building relationships with healthcare professionals and effective communication between them and professionals.</p><p><strong>Conclusions: </strong>The results underscore the importance of having a periviability guideline including multiple prognostic factors to assist parents in making decisions at the limit of viability, and the importance of a personalised care approach to meet parental needs in the context of imminent extremely preterm birth.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"165-170"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995132","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":"Evaluating the efficacy of endotracheal and intranasal epinephrine administration in severely asphyxic bradycardic newborn lambs: a randomised preclinical study.","authors":"Justine de Jager, Romy Pothof, Kelly J Crossley, Georg M Schmölzer, Arjan B Te Pas, Robert Galinsky, Nhi T Tran, Nils Thomas Songstad, Claus Klingenberg, Stuart B Hooper, Graeme R Polglase, Calum T Roberts","doi":"10.1136/archdischild-2024-327348","DOIUrl":"10.1136/archdischild-2024-327348","url":null,"abstract":"<p><strong>Objective: </strong>Intravenous epinephrine administration is preferred during neonatal resuscitation, but may not always be rapidly administered due to lack of equipment or trained staff. We aimed to compare the time to return of spontaneous circulation (ROSC) and post-ROSC haemodynamics between intravenous, endotracheal (ET) and intranasal (IN) epinephrine in severely asphyxic, bradycardic newborn lambs.</p><p><strong>Methods: </strong>After instrumentation, severe asphyxia (heart rate <60 bpm, blood pressure ~10 mm Hg) was induced by clamping the cord in near-term lambs. Resuscitation was initiated with ventilation followed by chest compressions. Lambs were randomly assigned to receive intravenous (0.02 mg/kg), ET (0.1 mg/kg) or IN (0.1 mg/kg) epinephrine. If ROSC was not achieved after three allocated treatment doses, rescue intravenous epinephrine was administered. After ROSC, lambs were ventilated for 60 min.</p><p><strong>Results: </strong>ROSC in response to allocated treatment occurred in 8/8 (100%) intravenous lambs, 4/7 (57%) ET lambs and 5/7 (71%) IN lambs. Mean (SD) time to ROSC was 173 (32) seconds in the intravenous group, 360 (211) seconds in the ET group and 401 (175) seconds in the IN group (p<0.05 intravenous vs IN). Blood pressure and cerebral oxygen delivery were highest in the intravenous group immediately post-ROSC (p<0.05), whereas the ET group sustained the highest blood pressure over the 60-min observation (p<0.05).</p><p><strong>Conclusion: </strong>Our study supports neonatal resuscitation guidelines, highlighting intravenous administration as the most effective route for epinephrine. ET and IN epinephrine should only be considered when intravenous access is delayed or not feasible.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"207-212"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139119","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":"Effects of a live versus heat-inactivated probiotic <i>Bifidobacterium</i> spp in preterm infants: a randomised clinical trial.","authors":"Gayatri Athalye-Jape, Meera Esvaran, Sanjay Patole, Elizabeth A Nathan, Dorota A Doherty, Edric Sim, Lakshmi Chandrasekaran, Chooi Kok, Stephan Schuster, Patricia Conway","doi":"10.1136/archdischild-2023-326667","DOIUrl":"10.1136/archdischild-2023-326667","url":null,"abstract":"<p><strong>Background: </strong>Heat-inactivated probiotics (HPs) may provide an effective alternative to live probiotics (P) by avoiding their risks (eg, probiotic sepsis) while retaining the benefits. We assessed the safety and efficacy of a HP in very preterm (VP: gestation <32 weeks) infants.</p><p><strong>Methods: </strong>VP infants were randomly allocated to receive a HP or P mixture (<i>Bifidobacterium breve</i> M-16V, <i>Bifidobacterium longum</i> subsp. <i>infantis</i> M-63, <i>Bifidobacterium longum</i> subsp. <i>longum</i> BB536, total 3×10⁹CFU/day) assuring blinding. Primary outcome was faecal calprotectin (FCP) levels were compared after 3 weeks of supplementation. Secondary outcomes included faecal microbiota and short chain fatty acid (SCFA) levels.</p><p><strong>Results: </strong>86 VP infants were randomised to HP or P group (n=43 each). Total FCP and SCFA were comparable between HP and P groups within 7 days (T1) and between day 21 and 28 (T2) after supplementation. At T2, median (range) FCP was 75 (8-563) in the HP group and 80 (21-277) in the P group (p=0.71). Propionate was significantly raised in both groups, while butyrate was significantly raised in the HP group (all p<0.01). Bacterial richness and diversity increased but was comparable between HP and P (p>0.05). Beta diversity showed similar community structures in both groups (all p>0.05). Changes in faecal Actinobacteria, Bacteroidetes and Bifidobacteriacae levels were comparable in both groups at T1 and T2. There was no probiotic sepsis.</p><p><strong>Conclusions: </strong>HP was safe and showed no significant difference in FCP as compared with a live probiotic. Adequately powered trials are needed to assess the effects of HP on clinically significant outcomes in preterm infants.</p><p><strong>Trial registration number: </strong>ACTRN12618000489291.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"177-184"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995131","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":"Evaluating decision regret after extremely preterm birth.","authors":"Laura Belden, Joseph Kaempf, Amy Mackley, Finley Kernan-Schloss, Chiayi Chen, Wendy Sturtz, Mark W Tomlinson, Ursula Guillen","doi":"10.1136/archdischild-2024-327287","DOIUrl":"10.1136/archdischild-2024-327287","url":null,"abstract":"<p><strong>Objectives: </strong>Little is known about decision regret following extremely premature birth. We assessed decision regret in women who delivered an extremely premature infant, comparing decision regret scores based on resuscitation decision.</p><p><strong>Methods: </strong>Electronic survey assessment of decision regret using a validated tool included women who delivered at 22-25 completed weeks of gestation at two hospitals 2004-2019. Comparison of 'active care', 'comfort care' and 'other' groups was quantified and comments reviewed.</p><p><strong>Results: </strong>442 of 787 (56%) eligible women were contacted, 242 of 442 (55%) completed surveys, response rate 242 of 787 (31%). Women not contacted were younger (p=0.0001) and/or delivered in an earlier year (p=0.002). There was a higher percentage of white women who completed the survey (p=0.004). Decision regret was elevated in all groups, varied widely, but was lower in 'active care' compared with 'comfort care' (Decision Regret Score 14 vs 39, p<0.0001). Lower decision regret occurred in women who recalled a prenatal consult (p=0.014) or identified as the primary decision-maker compared with women who perceived the doctor had a major role (p=0.02) or made the decision (p<0.0001). Lower decision regret occurred in women whose infant was alive at survey completion compared with women whose infant died in the hospital (p<0.0001) or after discharge (p=0.01).</p><p><strong>Conclusions: </strong>Decision regret was elevated in all groups. Women who recalled prenatal consultation, identified as the primary decision-maker, chose intensive care and/or whose infant survived had lower regret scores.</p><p><strong>Clinical trial registration: </strong>NCT04074525.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"191-199"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008108","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":"https://doi.org/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":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-16","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}