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

{"title":"Effect of enteral arachidonic acid and docosahexaenoic acid supplementation on brain volumes at term in preterm infants: a secondary outcome analysis of a randomised controlled trial.","authors":"William Hellström, Pia Lundgren, Anders K Nilsson, Staffan Nilsson, Anna-Lena Hård, Ulrika Sjöbom, Chatarina Löfqvist, Isabella M Björkman-Burtscher, Dirk Wackernagel, Ingrid Hansen-Pupp, Lois Eh Smith, Boubou Hallberg, Karin Sävman, David Ley, Ann Hellström, Rolf A Heckemann","doi":"10.1136/archdischild-2024-328292","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328292","url":null,"abstract":"<p><strong>Objective: </strong>Investigate whether enteral supplementation with arachidonic acid (AA) and docosahexaenoic acid (DHA), from birth to term-equivalent age (TEA), promotes brain maturation as a prespecified secondary outcome of a multicentre randomised controlled trial.</p><p><strong>Participants: </strong>206 infants born at 22-28 weeks gestational age (GA) were randomised into intervention or control groups from three university hospitals in Sweden.</p><p><strong>Intervention: </strong>The intervention group received an oil with AA (100 mg/kg/d) and DHA (50 mg/kg/d) starting at birth until 40 weeks postmenstrual age (PMA) in addition to standard nutrition. Standard-of-care infants received standard nutrition according to national guidelines.</p><p><strong>Main outcome and measures: </strong>MRI volumetrics were defined <i>a priori</i> as a secondary outcome of the trial and included total brain, white and cortical grey matter, central structures and cerebellum. Univariable and multivariable linear regression models were used for comparisons.</p><p><strong>Results: </strong>MRI data in 117 infants had sufficient quality for inclusion (n=58 intervention). Birth weight, GA at birth, sex distribution, and PMA at MRI were similar in the groups. Infants receiving intervention had significantly larger white-matter volume at TEA, as compared with standard of care, in models adjusted for GA at birth, sex, study centre and PMA at MRI (β=6.8 cm³, 95% CI 0.7 to 12.9, p=0.028). The contribution of the intervention to white-matter volume corresponded to 10 days of prolonged gestation.</p><p><strong>Conclusion and relevance: </strong>Our findings in this hypothesis-generating study suggest that AA+DHA promotes white matter growth, which may protect the developing brain in this vulnerable population.</p><p><strong>Trial registration number: </strong>NCT03201588.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002874","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 different feeding approaches on growth, neonatal morbidities, mortality and neurodevelopmental outcome in preterm infants: a systematic review and network meta-analysis.","authors":"Naema Hamouda, Yosra AboEL-Azm, Kholoud Elsamman, Soha Nabil, Mohammed Tarek, Fatma Elzahraa Wasia, Ahmed Mostafa Amin, Ahmed Elshahat, Nourhan Hassan, Ammar Mektebi, Abdelazem Khaled, Hatim Nasruldin Shahin, Mohamed A Aldemerdash, Neveen Refaey, Mohamed Khalil, Nada Ibrahim Hendi, Somaya Hafez, Yasmeen Jamal Alabdallat, Mohammed Abdellatif","doi":"10.1136/archdischild-2024-327677","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327677","url":null,"abstract":"<p><strong>Objective: </strong>To compare feeding strategies on preterm infants' growth during hospitalisation, neonatal morbidities, mortality and neurodevelopmental outcome (NDO) at 18-26 months corrected age.</p><p><strong>Methods: </strong>We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension statement for network meta-analysis . We searched five medical databases for randomised controlled trials comparing different feeding approaches in preterm infants and their effects on growth, neonatal morbidities, mortality and NDO. The Cochrane Collaboration's tool was used to assess the risk of bias. We used a random-effects model. Pooled mean differences (MD) or risk ratios with 95% CIs were calculated.</p><p><strong>Results: </strong>Ninety-five studies (9663 infants) were included.Human milk (HM) with bovine milk fortifier (BMF) (adjusted according to blood urea nitrogen) achieved the best length increment (MD=0.56 cm/week; 95% CI 0.19 to 0.93). Notably, HM+BMF (3.5 gm/kg/d protein) showed the best head circumference growth (MD 0.46 cm/week; 95% CI 0.10 to 0.81) but no significant difference in weight gain. There were no significant differences in neonatal morbidities/mortality. While MOM|+PTF (supp) displayed significantly lower NDO delay in the domain of mild cognitive delay.</p><p><strong>Conclusion: </strong>Overall, there is a lack of strong evidence to support a specific enteral feeding strategy and further high-quality research is required. Targeted HM fortification appears to improve head growth, while adjusted fortification enhances length. Given the significant inconsistency detected, which may compromise the reliability of the network estimates, these results must be interpreted carefully.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002899","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 visual acuity and neurodevelopment at five years in children born very preterm: the EPIPAGE-2 cohort study.","authors":"Yaman Hendi, Véronique Pierrat, Amandine Barjol, Valérie Benhammou, Léa Conversy, Laetitia Marchand-Martin, Pierre Yves Ancel, Thibaut Chapron","doi":"10.1136/archdischild-2025-329163","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329163","url":null,"abstract":"<p><strong>Introduction: </strong>Children born preterm often have anatomical and functional visual abnormalities, even in the absence of retinopathy of prematurity. This includes suboptimal visual acuity (VA), defined as binocular VA between 5-6.3/10 and 8/10. We examine relationships between suboptimal VA and neurodevelopment in children born preterm.</p><p><strong>Methods: </strong>Secondary analysis of the French EPIPAGE-2 cohort with children born between 24+0 weeks and 31+6 weeks of gestation, eligible for follow-up at 5.5 years. Children were classified into three VA groups: 5-6.3/10, 8/10 and 10/10 as reference group. Neurodevelopment was assessed with the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, the Movement Assessment Battery for Children-II (MABC-2) and the Strengths and Difficulties Questionnaire (SDQ). Comparisons between groups were adjusted for neonatal and socioeconomic characteristics using generalised estimating equations models.</p><p><strong>Results: </strong>Among 1787 included children, 62% had suboptimal VA. Compared with the 10/10 VA group, the mean full-scale IQ decreased by -3.09 (95 % CI -4.75 to -1.42) and -4.97 (95 % CI -6.47 to -3.46) points, the mean MABC-2 total score by -0.66 (95 % CI -0.71 to -0.61) and -1.06 (95 % CI -1.09 to -1.00), and the mean total SDQ scores increased by 0.40 (95 % CI -0.16 to 0.94) and 0.60 (95 % CI 0.10 to 1.1) in groups with VA groups at 8/10 and 5-6.3/10, respectively.</p><p><strong>Discussion: </strong>In this French population-based cohort of children born preterm, suboptimal VA was frequent and associated with increased risk of neurodevelopmental difficulties. A comprehensive neurodevelopmental and neurovisual assessment is warranted in children born preterm with suboptimal VA.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910220","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":"Screening of at-risk ROP patients: use of a single small field image centred on the optic disc.","authors":"Yse Borella, Thibaut Chapron, Florence Metge, Youssef Abdelmassih, Lucile Senicourt, Amandine Barjol, Georges Caputo","doi":"10.1136/archdischild-2025-329403","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329403","url":null,"abstract":"<p><strong>Objective: </strong>Currently, retinopathy of prematurity (ROP) screening requires a full retinal examination. To reduce the screening burden, we assessed whether a single optic nerve-centred image could detect treatment-requiring ROP. The objective is to investigate the use of a single image centred around the optic disc to detect treatment-requiring ROP, to reduce the burden of ROP screening with the same security of a full retinal examination.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Tertiary referral centre.</p><p><strong>Population: </strong>Premature infants screened for ROP in a tertiary referral centre.</p><p><strong>Main outcome: </strong>Vascular dilation and tortuosity on a scale from 1 to 5 were blindly labelled by three independent ROP experts using a 8 by 8 mm optic nerve-centred images. Images were automatically generated from images of the routine screening examinations.</p><p><strong>Results: </strong>A total of 278 patients (556 eyes) with a mean gestational age of 28.4±2.0 weeks and a mean birth weight of 1059.7±324.0 g were included. Treatment was needed in 49 eyes (8.8%) of 25 patients. A total of 1510 image sets centred on the optic disc were obtained and analysed. When the cut-off of the vascular dilatation and tortuosity rating was fixed at 3 (equivalent to a severe preplus disease), sensitivity and specificity for the detection of prethreshold type 1 ROP were 100% and 88.9%, respectively.</p><p><strong>Conclusions: </strong>ROP screening using a single posterior pole image could reduce stress in premature infants without degrading the quality of screening, compare to iterative dilated complete fundus examination.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779853","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":"https://doi.org/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":""},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","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":"Reducing antibiotic exposure in early life: how low can we go?","authors":"Eric Giannoni","doi":"10.1136/archdischild-2025-329377","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329377","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773349","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":"The future of neonatology.","authors":"Neena Modi, Nicola J Robertson, Mark Hanson, Paolo De Coppi, Allyah Abbas-Hanif, Mark A Turner","doi":"10.1136/archdischild-2025-329683","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329683","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fantoms.","authors":"Ben J Stenson","doi":"10.1136/archdischild-2025-330140","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330140","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":"111 1","pages":"F1"},"PeriodicalIF":3.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762039","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":"Aicardi-Goutières syndrome as a rare cause of neonatal intracranial calcifications.","authors":"Adriel Kwok Huang Chen, Laura Daniela Valderrama Penagos, Khadidja Belkhatir","doi":"10.1136/archdischild-2025-328751","DOIUrl":"10.1136/archdischild-2025-328751","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F92"},"PeriodicalIF":3.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085679","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":"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":"F20-F26"},"PeriodicalIF":3.6,"publicationDate":"2025-12-15","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}