BMC Pediatrics最新文献

{"title":"Dietary adherence and overnutrition among Kuwaiti adolescents: a school-based assessment of anthropometry and dietary intake.","authors":"Anwar H AlBaloul","doi":"10.1186/s12887-026-07489-9","DOIUrl":"10.1186/s12887-026-07489-9","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical period for the development of dietary behaviours that influence obesity and non-communicable disease risk later in life. In Kuwait, evidence on adolescent nutritional status integrating dietary intake with anthropometric indicators remains limited. This study aimed to assess adherence to dietary recommendations and examine the association between dietary intake and overnutrition, as measured by BMI and waist circumference (WC), among adolescents in Kuwait.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 375 adolescents aged 13-17 years recruited from public high schools in Kuwait. Dietary intake was assessed using a 24-h dietary recall and evaluated against UK Dietary Reference Values. Anthropometric measurements included BMI and WC. Associations between dietary adherence and anthropometric outcomes were examined using multivariable logistic regression adjusted for relevant sociodemographic and behavioural covariates.</p><p><strong>Results: </strong>Overall, 44.5% of participants were classified as overweight or obese based on BMI, and 34.7% had an elevated WC. Adherence to dietary recommendations was low, and almost all adolescents failed to meet recommendations for dietary fibre and fish intake. In contrast, excessive intake of free sugars (92.2%) and saturated fat (61.7%) was common. Protein intake was inversely associated with elevated WC, whereas excessive intake of total fat, carbohydrates, and red meat was positively associated with elevated WC.</p><p><strong>Conclusions: </strong>Kuwaiti adolescents exhibit a high prevalence of overnutrition alongside widespread non-adherence to dietary reference values. Dietary intake showed stronger associations with WC than with BMI, suggesting that WC may better capture diet-related differences in adiposity among adolescents. These findings underscore the need for culturally appropriate dietary reference standards and targeted public health strategies to address poor diet quality and rising metabolic risk among adolescents in Kuwait.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized trial of occlusive wrap for heat loss prevention in preterm infants: neurodevelopmental outcome.","authors":"Michael J Vincer, Maureen C Reilly, Sunita Vohra, Valeria E Rac, Zafira Bhaloo, Michael Dunn, Karla Ferrelli, Alex Kiss, John Wimmer, Denise Zayack, Roger Soll","doi":"10.1186/s12887-025-05678-6","DOIUrl":"https://doi.org/10.1186/s12887-025-05678-6","url":null,"abstract":"<p><strong>Background: </strong>Heat loss in the delivery room in very preterm infants is associated with increased mortality, hypothermia and other adverse outcomes. The Heat Loss Prevention (HeLP) trial resulted in a significant reduction of hypothermia but not a reduction in mortality. The HeLP follow-up trial was designed to determine whether application of occlusive wrap applied immediately after birth reduces adverse long-term neurodevelopmental outcomes at 18-24 months corrected gestational age in very preterm infants.</p><p><strong>Method: </strong>The original HeLP trial was a randomized controlled trial in infants < 28 weeks gestation placed at birth in occlusive wrap (wrap group) or not placed in occlusive wrap (control group). The HeLP follow-up trial was the later assessment of these infants enrolled in the HeLP trial to determine the composite outcome of death or neurodevelopmental disability at 18-24 month corrected gestational age.</p><p><strong>Results: </strong>This report constitutes a description of outcome for a subgroup of infants enrolled at centers with perinatal follow-up programs. 356 infants were eligible for follow-up from the HeLP trial with a loss to follow-up of 116/356 (32.6%). The primary outcome occurred in 82/113 (72.6%) in the wrap group and 80/127 (63.0%) in the control group (p = 0.115). An unadjusted odds ratio was 1.55 (95% confidence interval = 0.90-2.69) and because of a large loss to follow-up, odds ratios adjusted for potential predictors of the outcome were determined and showed no differences in the primary outcome by group assignment. Secondary outcomes in the wrap versus control group were: cerebral palsy 9/70 (12.9%) versus 5/87 (5.7%) (p = 0.20), Mental Developmental Index < 85 (Bayley Scales) 30/53 (56.6%) versus 33/67 (49.3%) (p = 0.54), blindness at 0/68 (0.0%) versus 1/86 (1.2%) (p > 0.99) and deafness 5/70 (7.1%) versus 6/87 (6.9%) (p > 0.99). No difference was noted in prescription glasses, 7/70 (10.0%) in the wrap group versus 2/87 (2.2%) in the control group (p = 0.09).</p><p><strong>Conclusions: </strong>Use of polyethylene occlusive wrap after birth in very preterm infants was associated with similar death or long-term neurodevelopmental disability rate.</p><p><strong>Trials registion: </strong>This trial was registered with Clinicaltrials.gov NCT00607464 on 22 January 2008. Ethics approval was provided by each site and held Mount Sinai Hospital Research Ethics Board (15-0243-C; 7 October 2015).</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing health-related quality of life in children with leukemia in Saudi Arabia: a cross- sectional study.","authors":"Mohammed T A Omar, Hatem Mosa Maeshi, Amani A Alkofide, Zizi M Ibrahim, Mohamed Abdelaziz Emam, Maha F Algabbani, Tahani H Maashi, Olfat Ibrahim Ali, Mohammed A Zalah","doi":"10.1186/s12887-026-07466-2","DOIUrl":"10.1186/s12887-026-07466-2","url":null,"abstract":"<p><strong>Background/objective: </strong>Leukemia and its treatment can substantially impair children's health-related quality of life (HRQoL). This descriptive cross-sectional study aimed to evaluate HRQoL among Saudi children with leukemia and to identify the demographic, clinical, and functional factors associated with HRQoL.</p><p><strong>Methods: </strong>Eighty-six children aged 5-14 years with acute lymphoblastic or acute myeloid leukemia (AML) who were receiving active treatment at King Faisal Specialist Hospital and Research Center Riyadh, Saudi Arabia. All participants had been diagnosed at least three months before enrolment and were receiving active treatment. HRQoL was assessed using the Arabic version of the Pediatric Quality of Life Inventory™ (PedsQL™) 3.0 Cancer Module, while physical function was evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire and the Lower Extremity Functional Scale (LEFS). Correlations and theory-driven multiple linear regression analyses were performed to identify factors associated with HRQoL.</p><p><strong>Results: </strong>The mean overall HRQoL score was 62.7 ± 16.5, indicating a moderate level of HRQoL. The lowest scores were observed for procedural anxiety, whereas communication had the highest domain score. Girls demonstrated significantly higher HRQoL than boys.Multiple linear regression identified female gender (β = 0.270, 95% CI: 4.457-13.241, p < 0.001), older age (β = 0.229, 95% CI: 1.951-7.986, p = 0.002), higher educational level (β = 0.239, 95% CI: 1.933-7.437, p = 0.001), and better lower-extremity function measured by the LEFS (β = 0.307, 95% CI: 0.142-0.434, p < 0.001) as significant positive predictors of higher HRQoL, whereas more intensive cancer therapy was independently associated with lower HRQoL (β = -0.211, 95% CI: -8.808 to - 1.922, p = 0.003). The model explained 70.1% of the variance in HRQoL (R² = 0.701; adjusted R² = 0.665; F(9,76) = 19.753, p < 0.001).</p><p><strong>Conclusions: </strong>HRQoL in children with leukemia was independently associated with physical function, cancer treatment, and several sociodemographic characteristics. These findings highlight the importance of incorporating functional assessment and multidisciplinary supportive care into the management of children with leukemia to optimize HRQoL.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diurnal variations of fever in children: results from an app-based observational study.","authors":"Yvonne Beerenbrock, Ricarda Möhler, Larisa Rathjens, Ekkehart Jenetzky, David D Martin","doi":"10.1186/s12887-026-07432-y","DOIUrl":"10.1186/s12887-026-07432-y","url":null,"abstract":"<p><strong>Background: </strong>Fever is a frequent concern in early childhood. However, its management remains inconsistent, driven in part by persistent \"fever phobia\" and heterogeneous advice. Although body temperature follows a well-established circadian rhythm, the diurnal expression of fever in young children is insufficiently described. We aimed to characterise 24-hour patterns of febrile temperatures in children aged 0-7 years using real-world data from a participatory mobile health registry (FeverApp), with specific attention to age and antipyretic use.</p><p><strong>Methods: </strong>We analysed 28,620 fever episodes recorded in the FeverApp registry between September 2019 and September 2023, comprising 12,454 children (median age 14 months) and 122,890 time-stamped temperature measurements. Mean hourly temperatures were calculated by pooling all eligible entries within hourly bins and were stratified descriptively by age group and recorded antipyretic use, without consideration of dependency. Between-group differences were summarised descriptively using mean differences.</p><p><strong>Results: </strong>Mean temperature demonstrated a clear diurnal pattern, reaching a nadir at 06:00 (38.25 °C) and a late-evening peak at 23:00 (38.93 °C), corresponding to an observed trough-to-peak difference of 0.68 °C. Infants (< 12 months) showed lower entry-level mean temperatures than older children (1-7 years), with differences smallest around the morning trough and more pronounced later in the day. Recordings close to documented antipyretic administration had higher mean temperatures throughout the day, consistent with confounding by indication, while the overall diurnal pattern remained preserved. High-fever measurements (≥ 39 °C) were least frequent in the early morning (05:00-08:59) and most frequent during late evening/night (21:00-00:59).</p><p><strong>Conclusions: </strong>Fever in young children should be interpreted as a dynamic 24-hour pattern rather than as a single static temperature value. In this app-based observational cohort, recorded febrile temperatures followed a clear aggregate time-of-day pattern, with lower values in the early morning and higher values later in the day. This temporal context may help clinicians and caregivers interpret fever more realistically: a low morning value should not be used as reassurance in isolation, while late-day increases may partly reflect expected circadian dynamics. Because the analysis is descriptive and entry-level, these findings should not be interpreted as individual fever trajectories, child-level risks, or inferential estimates.</p><p><strong>Trial registration: </strong>The FeverApp registry is registered in the German Clinical Trials Register (DRKS), number DRKS00016591, registered 07 February 2019 ( https://drks.de/search/en/trial/DRKS00016591 ), as a non-interventional observational study protocol.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From metabolic disorder to autoimmunity: lupus-like immune dysregulation in children with SLC7A7-associated lysinuric protein intolerance.","authors":"Xiaohua Tan, Li Li, Caifeng Li","doi":"10.1186/s12887-026-07467-1","DOIUrl":"10.1186/s12887-026-07467-1","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the clinical and immunological features of lupus-like immune dysregulation in children with lysinuric protein intolerance (LPI) through case analysis and literature review.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical records, genetic testing results, and immunological data of two LPI cases treated at Beijing Children's Hospital. A literature review was simultaneously performed to contextualize our findings.</p><p><strong>Results: </strong>The proband (Patient 1), a 1.5-year-old girl with homozygous SLC7A7 (c.625 + 1G > A) mutation, presented with growth retardation and multisystem involvement (hematologic, digestive, respiratory). Laboratory tests showed ANA positivity and hypocomplementemia. While initial therapy with glucocorticoids, immunosuppressants and dietary protein restriction showed benefit, treatment non-adherence resulted in disease progression culminating in fatal respiratory failure. Patient 2 (the proband's sister), carrying the same mutation, exhibited milder manifestations including growth retardation, interstitial lung disease, ANA positivity, hypocomplementemia, and proteinuria. With treatment, her condition stabilized, showing partial resolution of lung lesions and improved growth. Combining our two cases with 18 previously reported cases (total n = 20), common features included growth retardation (88.9%), renal involvement (72.2%), respiratory disease, and hematologic abnormalities. Rheumatologic markers included ANA positivity (90%), hypocomplementemia (85%), and anti-dsDNA antibodies (45%). Treatment primarily involved glucocorticoids and immunosuppressants, whereas plasma exchange and hematopoietic stem cell transplantation were used only rarely.</p><p><strong>Conclusion: </strong>LPI-associated lupus-like immune dysregulation is rare and clinically heterogeneous. Accurate diagnosis requires an integrated assessment of genetic, metabolic, and immunologic data. Immunomodulatory therapy may be effective, but vigilance is essential due to infection risk and disease flares. Early recognition, management, and long-term follow-up are critical to improving prognosis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of early-onset neonatal bacterial meningitis: a 20-year retrospective comparison of preterm and full-term infants.","authors":"Na Jiang, Minli Zhu, Xiuman Xiao, Haijing Li, Zhenlang Lin","doi":"10.1186/s12887-026-07350-z","DOIUrl":"10.1186/s12887-026-07350-z","url":null,"abstract":"<p><strong>Background: </strong>To compare the clinical characteristics and outcomes of early-onset neonatal bacterial meningitis (NBM) in preterm and full-term infants.</p><p><strong>Methods: </strong>This retrospective study analyzed neonates diagnosed with NBM within 7 days (based on symptom onset) of birth at authors' hospital (2005-2024). Participants were stratified into preterm (< 37 weeks) and full-term (37-42 weeks) groups. Data on perinatal factors, clinical presentation, laboratory results, and outcomes were compared.</p><p><strong>Results: </strong>A total of 74 infants (33 females, 41 males) were included, with 17 in the preterm group and 57 in the full-term group. Preterm infants had higher rates of premature rupture of membranes (PROM; 52.94% vs. 8.77%, p < 0.001), apnea (35.29% vs. 1.75%, p < 0.001), and respiratory support need (58.82% vs. 12.28%, p < 0.001), but lower fever incidence (41.18% vs. 80.70%, p = 0.004). Escherichia coli (37.10% of blood culture-positive cases) and Group B Streptococcus (GBS) (30.65% of blood culture-positive cases) were predominant pathogens. Overall cure and mortality rates (60.81% and 9%, respectively) did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Preterm infants with early-onset NBM had higher rates of apnea, respiratory support, and PROM, but lower incidence of fever compared to full-term infants. These differences highlight the need for early recognition and tailored management in preterm cases.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-session therapeutic plasma exchange as salvage therapy for pegaspargase-induced severe acute pancreatitis accompanied by multiple organ dysfunction in a pediatric patient with B-cell precursor acute lymphoblastic leukemia: a case report.","authors":"Jianhua Dai, Yingying Xiao, Yueqin Han, Haiyan Ye, Shaohua Xie","doi":"10.1186/s12887-026-07273-9","DOIUrl":"https://doi.org/10.1186/s12887-026-07273-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pegaspargase-related severe acute pancreatitis (SAP) combined with persistent multiple organ dysfunction syndrome (MODS) is a life-threatening adverse reaction in children receiving acute lymphoblastic leukemia (ALL) chemotherapy. Standard intensive supportive care often fails to halt progressive organ damage, while clinical data regarding therapeutic plasma exchange (TPE) as a rescue intervention in pediatric populations remain scarce. Guidelines released by the American Society for Apheresis (ASFA) do not recommend routine TPE administration for all patients diagnosed with acute pancreatitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective analysis describes a 7-year-old female patient newly diagnosed with B-cell precursor ALL, who developed SAP and refractory MODS 48 h after pegaspargase infusion. SAP diagnosis complied with the 2012 Revised Atlanta Classification, and MODS severity was quantified using the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) scoring system. After 24 h of maximum standardized supportive care failed to reverse clinical deterioration, a single standardized TPE session was implemented. A chronological care timeline and serial laboratory biomarker table were constructed to quantify the dynamic therapeutic response of the patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Non-invasive ventilation was applied to relieve intractable respiratory distress; invasive mechanical ventilation and vasopressor support were unnecessary throughout hospitalization. Severe epigastric pain disappeared within six hours after TPE, and respiratory support was successfully withdrawn 24 h post-intervention. Significant declines in pancreatic enzyme levels, extreme hypertriglyceridemia and systemic inflammatory mediators were observed, alongside full recovery of respiratory, renal and hematologic organ function. No adverse events linked to apheresis occurred during treatment. The patient recovered completely from pancreatitis, resumed scheduled maintenance chemotherapy, and maintained minimal residual disease (MRD)-negative hematologic remission at the 3-month outpatient follow-up. Clinical improvement was mainly attributed to extracorporeal clearance of triglycerides and pro-inflammatory cytokines; due to the pharmacokinetic characteristics of pegaspargase at 48 h post-administration, the removal of this chemotherapeutic agent via TPE was negligible.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Single-session TPE can rapidly reverse refractory MODS triggered by pegaspargase-induced SAP when conventional supportive treatments show no efficacy. Nevertheless, complete clinical recovery cannot be solely attributed to apheresis, as continuous multi-organ supportive management was provided throughout the treatment course. TPE can be regarded as a targeted rescue strategy for carefully selected critically ill pediatric patients, yet existing meta-analyses and ASFA consensus statements do not support its universal routine use. Large","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal outcomes of hypertensive pregnancy subtypes in very preterm infants: a multicenter cohort study.","authors":"Fernanda Gabriella Bezerra de Araujo, Rita C Silveira, Diego Gomes Teixeira, Fernanda Pegoraro de Godoi, Paulyne Stadler Venzon, Maria Eduarda Gurgel Cherpak, Maryne A Silva do Vale, Ligia Maria Suppo de Souza Rugolo, Fla Via Maria Batista da Costa, Humberto Fiori, Se Rgio Tadeu Martins Marba, Silvia Cwajg, Jose Luiz Muniz Bandeira Duarte, Walusa Assad Gonçalves-Ferri, Ma Rcia Gomes Penido Machado, Daniela Marques de Lima Mota Ferreira, Jose Mariano Sales Alves Junior, Juliana Paula Ferraz Dos Santos, Milton Harumi Miyoshi, Nathalia Moura de Mello E Silva, Renato Soibelmman Procianoy","doi":"10.1186/s12887-026-07455-5","DOIUrl":"10.1186/s12887-026-07455-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate whether distinct subtypes of hypertensive disorders of pregnancy (HDP), chronic hypertension (CH), pregnancy-specific hypertensive disorders (PSHD), and superimposed preeclampsia (CH + PE), are associated with differential neonatal outcomes in very preterm infants, independent of gestational age and perinatal confounders.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study using prospectively collected data from the Brazilian Neonatal Research Network, including infants with birthweights 401-1500 g and gestational age 22 + 0 to 32 + 6 weeks (2013-2020). Infants were classified according to maternal hypertensive status. Primary outcomes included major neonatal morbidities and in-hospital mortality. Associations were assessed using Poisson regression with robust variance, adjusting for gestational age, birthweight, sex, antenatal corticosteroids, and perinatal variables. Analyses were stratified by gestational age (≤ 28 and > 28 weeks).</p><p><strong>Results: </strong>Among 9,689 infants, 4,011 (41.4%) were exposed to HDP. PSHD and CH + PE were associated with higher risks of respiratory distress syndrome and surfactant use across models. CH + PE was additionally associated with higher mortality, particularly in infants ≤ 28 weeks. In contrast, CH was associated with lower observed risks of late-onset sepsis and, among infants > 28 weeks, severe intraventricular hemorrhage. Several crude associations were attenuated after adjustment, highlighting the confounding effect of gestational age.</p><p><strong>Conclusions: </strong>HDP subtypes were associated with distinct neonatal outcome profiles. PSHD and CH + PE were associated with higher risks of respiratory morbidity and mortality, whereas CH showed a more neutral profile and lower observed risks for selected outcomes. These findings support subtype-specific risk stratification in very preterm infants.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed methotrexate toxicity after initial clearance in a critically ill patient with severe fluid overload.","authors":"April Slamowitz, Rachel Kessel, Liron M Fedida, Reid LaPlante, Adam Beaton","doi":"10.1186/s12887-026-07441-x","DOIUrl":"10.1186/s12887-026-07441-x","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate (MTX) toxicity is a life-threatening complication in oncology patients.</p><p><strong>Case presentation: </strong>We report a 19-year-old male with newly diagnosed Burkitt lymphoma who received high-dose methotrexate as part of induction chemotherapy and initially met protocol-defined serum clearance criteria with suspected delayed MTX toxicity. This prolonged toxicity was due to possible redistribution from extravascular fluid compartments in the setting of severe fluid overload and renal dysfunction. Five weeks after methotrexate administration, a detectable serum methotrexate concentration (0.4 µmol/L) was identified despite no additional exposure. His course was complicated by tumor lysis syndrome, pleural effusions and anasarca, bowel perforations requiring multiple surgeries, acute respiratory distress syndrome, persistent pancytopenia, progressive renal and hepatic dysfunction, recurrent infections, and multiorgan failure. Despite treatment with leucovorin, urine alkalinization, continuous kidney replacement therapy, and high-flux hemodialysis, serum MTX concentrations demonstrated recurrent detectable elevations.</p><p><strong>Conclusions: </strong>This case highlights how altered pharmacokinetics in critical illness may render serum clearance thresholds unreliable and underscores the need for heightened clinical suspicion for delayed drug toxicity in critically ill patients with dynamic volume shifts or unexplained multiorgan dysfunction.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SLC10A1 variants causing NTCP deficiency in infants: clinical and functional characterization of a novel splice-site variant.","authors":"Wenzhuo Cheng, Fan Chen, Wen Pan, Biao Zou, Sainan Shu","doi":"10.1186/s12887-026-07411-3","DOIUrl":"https://doi.org/10.1186/s12887-026-07411-3","url":null,"abstract":"<p><strong>Background: </strong>Sodium taurocholate cotransporting polypeptide (NTCP), the product of the SLC10A1 gene, is essential for hepatic bile acid (BA) uptake. Biallelic SLC10A1 defects resulting in NTCP deficiency have recently been identified as a cause of familial hypercholanemia in children, but clinical and functional data are lacking.</p><p><strong>Methods: </strong>Three unrelated infants with neonatal or infantile cholestasis were recruited. Clinical data, laboratory results, and follow-up details were reviewed. SLC10A1 variants were identified by whole-exome sequencing (WES) and confirmed by Sanger sequencing. An HEK293T minigene splicing assay was used to assess the functional consequences of the new splicing variant.</p><p><strong>Results: </strong>All three patients exhibited sustained hypercholanemia accompanied by varying degrees of elevated liver enzymes and decreased levels of fat-soluble vitamins. WES identified homozygous or compound heterozygous SLC10A1 variants in all three patients, including the frequent East Asian missense variant c.800 C > T (p.Ser267Phe), the rare frameshift variant c.722_723del (p.Ser241Cysfs*36), and a novel splice-site variant c.746 + 5G > T. The c.746 + 5G > T variant was predicted to affect splicing, and a minigene assay showed that this variant caused exon 3 skipping, which is predicted to result in a frameshift transcript. According to ACMG/AMP guidelines, c.722_723del variant was classified as \"Pathogenic\", and the c.746 + 5G > T variant was assessed as \"Pathogenic\" after incorporating functional evidence from the minigene assay.</p><p><strong>Conclusions: </strong>This study broadens the variant spectrum of SLC10A1-related NTCP deficiency and highlights the value of functional testing in the assessment of novel splicing-site variants. Early genetic diagnosis may facilitate appropriate clinical management and help prevent unnecessary interventions.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}