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

{"title":"Congenital diaphragmatic hernia and a hernia sac.","authors":"Anneka Patel, Mahesh Nanjundappa, Mark Davenport, Anne Greenough","doi":"10.1136/archdischild-2025-328914","DOIUrl":"10.1136/archdischild-2025-328914","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F482"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803287","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":"Role of ultrasonography in the management of necrotising enterocolitis: time for routine practice?","authors":"George S Bethell, Ian Jones, Nigel J Hall","doi":"10.1136/archdischild-2026-330521","DOIUrl":"10.1136/archdischild-2026-330521","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F411-F412"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925799","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 hypertriglyceridaemia management: a UK survey of practices and perspectives.","authors":"Rebekah May Clark, Sristi Ganguly, Anay M Kulkarni, Touqueer Fatima","doi":"10.1136/archdischild-2026-330519","DOIUrl":"10.1136/archdischild-2026-330519","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F476-F477"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148147900","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":"Idiopathic neonatal arterial ischaemic stroke: a trio-based whole-exome sequencing study.","authors":"Jonathan Olival, Janet Hoenicka, Gemma Arca, Juan Arnaez, Thais Agut, Joan Maynou, Christian Stephan-Otto, Christian Núñez, Isabel Benavente, Simón Lubián-López, Francesc Palau, Alfredo García-Alix","doi":"10.1136/archdischild-2025-329771","DOIUrl":"10.1136/archdischild-2025-329771","url":null,"abstract":"<p><strong>Objective: </strong>To assess the contribution of rare coding genetic variants to idiopathic neonatal arterial ischaemic stroke (NAIS).</p><p><strong>Design: </strong>Observational genetic study using trio-based whole-exome sequencing (WES).</p><p><strong>Setting: </strong>Multicentre study.</p><p><strong>Patients: </strong>23 newborns diagnosed with idiopathic NAIS and their biological parents.</p><p><strong>Interventions: </strong>WES-trio with a customised workflow for filtering and interpreting variants in <i>de novo</i> autosomal dominant and recessive inheritance models.</p><p><strong>Main outcome measures: </strong>Identification of pathogenic (P) or likely pathogenic (LP) variants potentially associated with NAIS.</p><p><strong>Results: </strong>We identified 28 unique rare <i>de novo</i> variants in 28 genes across 23 newborns with NAIS. Under the autosomal recessive model, no candidate genes were identified. No common P/LP variant across the 23 newborns was detected. <i>In-silico</i> predictors and comprehensive knowledge-driven analysis highlighted <i>PIK3CD</i> (p.Gln431Arg) as a candidate gene in one patient with perforant stroke. However, no more cases were identified with <i>PIK3CD</i> variants, and functional studies are warranted to assess its pathogenicity impact.</p><p><strong>Conclusions: </strong>Trio-based WES did not identify a monogenic cause for idiopathic NAIS. Coding variants therefore appear unlikely to explain the underlying genetic base of the disease. Furthermore, <i>PIK3CD</i> (p.Gln431Arg) may contribute to perforant stroke, although it requires further association evidence. As the potential role of non-coding or structural variants in NAIS remains possible, genome-wide long-read sequencing approaches may provide further insights into the genetic architecture of this condition.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F433-F440"},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779885","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":"Donor human milk for maternal milk shortfall in preterm infants: a feasibility randomised controlled trial.","authors":"Kristina Chmelova, Janet Berrington, Judith Rankin, Stefan Zalewski, Nicholas Embleton","doi":"10.1136/archdischild-2025-330178","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330178","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility of a randomised controlled trial (RCT) of donor human milk (DHM) use for preterm infants with mother's own milk (MOM) shortfall, assessing DHM impact on breastfeeding.</p><p><strong>Design: </strong>Feasibility, open-label RCT.</p><p><strong>Setting: </strong>Two tertiary neonatal intensive care units in the UK.</p><p><strong>Patients: </strong>135 infants born before 33 weeks' gestation or with birth weight <1500 g whose mothers intended to provide MOM admitted between June 2021 and March 2023.</p><p><strong>Interventions: </strong>Infants were randomly assigned to either DHM for MOM shortfall until full feeds (FFs) and preterm formula thereafter, control (DHM-FF group) or the intervention, DHM until 36 weeks corrected gestational age (CGA) or discharge if sooner (DHM-36w group).</p><p><strong>Main outcome measures: </strong>Feasibility outcomes included study recruitment, retention and intervention feasibility measures. The primary clinical outcome was breastfeeding or receipt of any MOM at 36 weeks CGA or discharge if sooner. Secondary clinical outcomes included growth and neonatal morbidities.</p><p><strong>Results: </strong>Of 325 screened infants, 247 were eligible, out of which 135 were recruited (54.7%). Parents of 36 infants declined DHM. Three infants discontinued DHM use during the study. 13 infants could not access the intervention due to transfer.38/66 (57.6%) infants from the DHM-FF group and 40/69 (58%) infants from the DHM-36w group received some MOM at 36 weeks' CGA. There were no significant differences between groups in growth and morbidity outcomes.</p><p><strong>Conclusions: </strong>The RCT design is feasible for future, larger-scale studies. Availability of MOM did not differ between groups at 36 weeks but was higher than historical cohorts.</p><p><strong>Trial registration number: </strong>57339063.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787560","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":"Impedance pneumography to explore bronchial obstruction in young infants born moderate-late preterm: a cohort study.","authors":"Inger C Van Duuren, Kishan D Tsang, Nicole Beydon, Saar C F Van Der Wurff, Lotte Kuiper, Geeske E Gijben, Mariëlle W Pijnenburg, Liesbeth Duijts, Gerdien Tramper-Stranders","doi":"10.1136/archdischild-2026-330485","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330485","url":null,"abstract":"<p><strong>Background: </strong>Wheezing, a symptom reflecting bronchial obstruction, is frequently reported in preterm-born infants. No objective and reliable tool is available to assert this diagnosis with minimal patient cooperation. Nocturnal tidal breathing measurements by impedance pneumography (IP) provide expiratory variability index (EVI) and the ratio of time to peak tidal expiratory flow to total expiration (tPTEF/tE) which are reduced in bronchial obstruction and may address this gap.</p><p><strong>Aims: </strong>To evaluate the application of IP measurements in a cohort of preterm-born infants.</p><p><strong>Methods: </strong>Home measurements were performed over two consecutive nights in infants (median (IQR) gestational age 34+4 weeks (33+1; 35+2)), around ages 3, 6 and 12 months. EVI and tPTEF/tE were derived from successful recordings (≥4 hours undisturbed). Measurements in term-born infants <14 months served as reference.</p><p><strong>Results: </strong>In total 372 night-recordings were obtained from 97 preterm infants. Success rates were 15%, 93% and 91% in infants aged <4 months, 4-9 months and >9 months, respectively. Explorative analyses showed EVI decreased during wheezing episodes from 14.4 (95% CI 13.2 to 15.7) to 9.6 (95% CI 5.6 to 13.5). Both EVI and tPTEF/tE tended to be lower in preterm than in term infants: EVI 14.6 (95% CI 13.5 to 15.8) versus 16.3 (95% CI 15.0 to 17.6) and tPTEF/tE 0.160 (95% CI 0.142 to 0.177) versus 0.187 (95% CI 0.158 to 0.216) CONCLUSIONS: Home IP measurement in preterm-born infants is moderately feasible, with improving success in older infants. Differences in EVI and tPTEF/tE by gestational maturity and during wheezing episodes indicate that IP provides clinically relevant information on airway obstruction, supporting its potential for research and future clinical use.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757417","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":"Complex mixed vascular malformation with overgrowth: PROS spectrum.","authors":"Rosa Perez Cuartero, Ana Mª Rivera Figueiras, Laura Berbegal de Gracia, Eva Garcia Canto","doi":"10.1136/archdischild-2026-330849","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330849","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705273","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":"Impact of changing open-label drug prescription policies on consent rates in a neonatal trial: a quasinatural experiment.","authors":"Kelly K Storm, Robert B Flint, Wes Onland, Sylvia A Obermann-Borst, Jarinda A Poppe, Debbie H Nuytemans, Willem P de Boode, Katherine Carkeek, Vincent Cassart, Luc Cornette, Peter H Dijk, Marieke Ac Hemels, Matthias C Hütten, Dorottya Kelen, Ellen Hm de Kort, André A Kroon, Julie Lefevere, Katleen Plaskie, Sarah Verbeeck, Michiel Voeten, Olivia Williams, Inge A Zonnenberg, Arjan B Te Pas, Irwin Km Reiss, Anton H van Kaam, Karel Allegaert, Anne Smits, G Jeroen Hutten, Sinno Hp Simons","doi":"10.1136/archdischild-2026-330821","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330821","url":null,"abstract":"<p><strong>Objective: </strong>To assess how restricting open-label access to an off-label drug influences consent and trial enrolment in neonatal medicine.</p><p><strong>Design: </strong>Multicentre, quasinatural experiment.</p><p><strong>Setting: </strong>Seventeen neonatal intensive care units in the Netherlands and Belgium participating in the DOXA-trial, a double-blind, randomised, placebo-controlled study of doxapram in extremely preterm infants.</p><p><strong>Patients: </strong>Infants born before 29 weeks' gestation whose parents were approached for DOXA-trial participation.</p><p><strong>Interventions: </strong>Ten centres discontinued open-label doxapram outside the DOXA-trial (intervention centres), while seven continued its use (control centres).</p><p><strong>Main outcome measures: </strong>Parental consent rates (proportion of parents who provided written informed consent among those approached) and patient enrolment rates (proportion of infants randomised among those whose parents were approached), compared 12 months before and after the policy change in intervention centres and before and after a corresponding reference point in control centres. The reference point in control centres was defined as the mean discontinuation date across intervention centres RESULTS: Overall consent rates increased from 27.8% to 37.1% after the intervention or reference point (+9.3, 95% CI 3.3 to 15.4, p=0.003). In intervention centres, the consent rates rose from 27.1% to 42.9% (+15.8, 95% CI 8.6 to 23.0, p<0.001) and enrolment rates rose proportionally from 9.9% to 16.6% (+6.7, 95% CI 1.5 to 11.9, p=0.011), whereas in control centres, consent and enrolment rates remained unchanged.</p><p><strong>Conclusion: </strong>Restricting open-label access to an off-label investigational drug can substantially increase parental consent and patient enrolment in neonatal RCTs. To promote both ethical recruitment and optimal enrolment, future trials should explicitly discuss equipoise in each contributing unit and align local clinical practices with the trial design prior to initiation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705276","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":"Active pharmacotherapy versus expectant management of patent ductus arteriosus in extremely preterm infants: a meta-analysis with trial sequential analysis.","authors":"Shripada C Rao, Chandra Rath, Sanjay Patole","doi":"10.1136/archdischild-2026-331024","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331024","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness and safety of active pharmacotherapy for patent ductus arteriosus (PDA) initiated based on echocardiography-criteria versus expectant management in extremely preterm infants <29 w gestation in the first three weeks of life.</p><p><strong>Study design: </strong>Systematic review with meta-analysis and trial sequential analysis (TSA). We searched PubMed, Embase, CENTRAL and Emcare for randomised trials published between 2010 and May 2026. We synthesised results using random-effects meta-analysis and conducted a TSA.</p><p><strong>Patients: </strong>Extremely preterm infants with PDA considered as significant on echocardiography.</p><p><strong>Interventions: </strong>Pharmacotherapy versus expectant management.</p><p><strong>Main outcome measures: </strong>Mortality by 36 weeks postconceptional age or before discharge and chronic lung disease (CLD).</p><p><strong>Results: </strong>We included 12 trials involving 2344 extremely preterm infants. Meta-analysis found increased risk of mortality with active pharmacotherapy (RR 1.34, 95% CI 1.08 to 1.67; p=0.008, I²=0%; 12 randomised controlled trials (RCTs)). Number-needed-to-treat for an additional harmful outcome (i.e. mortality) was 25 (95% CI 17 to 100). On TSA conducted with the stringent alpha error 3.3% and beta 10%, the cumulative Z-score touched the O'Brien-Fleming monitoring boundary at the current sample size, supporting the meta-analysis findings under the specified TSA assumptions.For CLD, meta-analysis showed little or no difference (RR 0.99, 95% CI 0.92 to 1.06, p=0.74, I²=14%, 12 RCTs). The certainty of evidence was high for mortality and moderate for CLD.</p><p><strong>Conclusions: </strong>In extremely preterm infants, active pharmacotherapy for PDA based on current echocardiographic criteria in the first three weeks of life was associated with increased mortality with a clinically important number needed to harm. These findings should inform treatment decisions and discussions with parents while ongoing research seeks to identify infants who may benefit from treatment.</p><p><strong>Prospero registration number: </strong>CRD420261303992.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683246","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":"Impact of Kaiser permanente early-onset sepsis risk calculator implementation in hospitals, England: pre-post intervention cohort analysis.","authors":"Hannah E Barton, Hannah L Moore, Rebecca L Guy, Clarissa Oeser, Olisaeloka Nsonwu, Simon M Collin, Cheryl Battersby, Chinthika Piyasena, Alicia Demirjian, Theresa L Lamagni","doi":"10.1136/archdischild-2026-330444","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330444","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of transition from National Institute for Health and Care Excellence (NICE) guidelines to Kaiser Permanente Neonatal Sepsis Risk Calculator (KP-SRC) on early-onset sepsis (EOS) diagnosis and mortality.</p><p><strong>Study design: </strong>Pre-post intervention analysis across 16 NHS hospital Trusts in England (2015-2023) 18 months before and after NICE to KP-SRC transition. Liveborn infants of any gestational age (N=222 122) were extracted from Hospital Episode Statistics and linked to national microbiological data and birth and death registrations.</p><p><strong>Main outcomes: </strong>Cases were identified within first 3 days of life during birth admission or first 7 days if readmitted and defined microbiologically (positive microbiology from normally sterile site) or clinically (International Classification of Diseases, 10th Revision codes). Deaths occurring within the neonatal period attributable to EOS and proportion of EOS cases diagnosed during readmission were identified.</p><p><strong>Results: </strong>There was no evidence of an increase in late diagnosis of EOS after KP-SRC implementation across hospitals combined, with the proportion of microbiologically confirmed cases diagnosed on readmission similar to pre-implementation (9.6% vs 10.8%; p=0.67). Variation between hospitals was observed, with non-significant increases in readmission diagnosis (vs diagnosis in birth episode) post implementation in 9 of 15. There was no difference in mortality for microbiologically confirmed cases or deaths based on clinical diagnosis though the study was not powered for these outcomes.</p><p><strong>Conclusion: </strong>No overall increase in late diagnoses due to EOS was observed after switching to KP-SRC but variation between hospitals, including non-significant increases in readmission diagnoses in some, injects caution and underscores the importance of local monitoring post implementation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381457","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}