Early human development最新文献_第10页

Parental Five-to-Fifteen questionnaire in identifying motor difficulties at 5 years in children with later motor impairment: A longitudinal follow-up study of very preterm infants 父母5 - 15问卷在识别5岁后运动障碍儿童中的运动困难：一项对极早产儿的纵向随访研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-08-05 DOI: 10.1016/j.earlhumdev.2025.106348

Eeva Mäkilä , Mikael O. Ekblad , Päivi Rautava , Anna Nyman , Annika Lind , Helena Lapinleimu , Leena Haataja , Sirkku Setänen , on behalf of the PIPARI Study Group

Children born very preterm have an increased risk for motor impairments. We aimed to evaluate motor performance at 5 years in children born very preterm with and without motor impairment using the parental questionnaire Five-to-Fifteen (FTF).

This prospective follow-up study included 132 children born very preterm (gestational age < 32 weeks and/or birth weight ≤ 1500 g) without neurodevelopmental impairment at 2 years. Parents filled out the FTF regarding the neurodevelopment of their 5-year-old children. Higher scores indicated more difficulties. The Movement Assessment Battery for Children — Second Edition (MABC-2) was performed to evaluate the motor outcome at 11 years. Total test scores ≤15th percentile denoted motor impairment.

There were 23 (17.4 %) children with motor impairment. A 1-point increase in the FTF motor skills mean scores increased the risk of motor impairment to 19-fold (OR 19.1, 95 % CI 3.5–104.5, p = 0.001). Children with motor impairment had higher mean scores in the FTF motor skills compared to children without motor impairment (mean 0.56 vs. 0.26, p < 0.001), but also in Executive functions (0.63 vs. 0.40, p = 0.001), Perception (0.35 vs. 0.18, p < 0.001), Memory (0.51 vs. 0.31 p = 0.01) and Language (0.45 vs. 0.25, p = 0.02), respectively.

Motor impairment was almost 20 times more likely when motor difficulties increased by 1 point in the FTF questionnaire. Moreover, children with motor impairment had more difficulties in all other developmental domains of the FTF. Based on these findings, the FTF parental questionnaire might be a useful tool in children's preventive health care to early identify motor impairment and its negative associations.

早产儿患运动障碍的风险更高。我们的目的是用父母问卷5 - 15 （FTF）来评估5岁时有或没有运动障碍的早产儿的运动表现。这项前瞻性随访研究包括132名早产儿(胎龄<；32周和/或出生体重≤1500克)2岁时无神经发育障碍。家长们填写了关于他们5岁孩子神经发育的FTF。分数越高，说明难度越大。采用儿童运动评估系列-第二版（MABC-2）来评估11岁时的运动结果。总分≤15百分位为运动障碍。运动障碍患儿23例（17.4%）。FTF运动技能每增加1分，意味着运动障碍的风险增加19倍（OR 19.1, 95% CI 3.5-104.5, p = 0.001）。运动障碍儿童的FTF运动技能平均得分高于无运动障碍儿童(平均0.56比0.26,p <；0.001)，而且执行功能（0.63 vs. 0.40, p = 0.001），感知(0.35 vs. 0.18, p <；0.001)，记忆（0.51 vs. 0.31 p = 0.01）和语言（0.45 vs. 0.25, p = 0.02）。当运动障碍在FTF问卷中增加1分时，运动障碍的可能性几乎增加了20倍。此外，运动障碍儿童在FTF的所有其他发展领域都有更多的困难。基于这些发现，FTF父母问卷可能是儿童预防性保健的有用工具，可以早期识别运动障碍及其负面关联。

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引用次数: 0

Pubertal growth spurt does not occur in some normally growing Polish girls, suggesting an evolutionary origin of adolescent growth polymorphism 在一些正常生长的波兰女孩中，青春期生长突飞猛进并不发生，这表明青春期生长多态性的进化起源

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-08-05 DOI: 10.1016/j.earlhumdev.2025.106358

Maciej Henneberg , Iwona Rosset , Elżbieta Żądzińska

Objective

Numerous child growth studies showed the adolescent growth spurt in body height to the extent that its presence became a dogma applied to humans as a species. However, observations of growth in the 19th c. and in small traditional societies showed for some children a steady growth without visible pubertal spurt. Recently, substantial variation in the age at puberty and the magnitude of growth acceleration during puberty have been observed.

Methods

Longitudinal height growth data of 110 girls aged 6–18 years (1314 height measurements in total) from a homogenous socio-economic situation were analysed by fitting polynomial regressions on age and assessing their first and second derivatives (growth velocity and acceleration).

Results

Among 110 girls, 18 (16 %) showed a steady growth with no spurts, while others' accelerations were highly variable. Girls who experienced a growth spurt had a mean age at peak height velocity of 11.2 years and a mean peak height velocity of 69.3 mm, comparable to many other studies. There was a negative correlation between adult height and variation in individual accelerations (r-0.24, p = 0.01) – girls whose accelerations differed less yearly (lower spurt) achieved greater adult heights.

Conclusions

Human growth at adolescence is highly variable, polymorphic, to the extent that the growth in height without the distinct pubertal spurt is also a normal polymorphic variant. Girls who had no significant growth spurt attained the same adult height at exactly the same age as their “spurting” peers.

客观：大量的儿童生长研究表明，青少年身高的快速增长，以至于它的存在成为一种教条，适用于人类这个物种。然而，对19世纪和小型传统社会的成长观察表明，一些儿童的成长稳定，没有明显的青春期爆发。最近，已经观察到青春期年龄和青春期生长加速幅度的实质性变化。方法对同质社会经济条件下的110名6 ~ 18岁女孩（共1314个身高测量值）的纵向身高增长数据进行年龄拟合多项式回归分析，并评估其一阶导数和二阶导数（生长速度和加速度）。结果在110名女生中，18名（16%）表现出稳定增长，没有突发性增长，而其他女生的加速变化很大。经历生长突增的女孩的平均年龄峰值高度速度为11.2岁，平均峰值高度速度为69.3毫米，与许多其他研究相媲美。成人身高与个体加速度变化呈负相关（r-0.24, p = 0.01），加速度差异较小的女孩成年身高较高。结论人的青春期生长具有高度的多变性和多态性，在一定程度上身高的生长没有明显的青春期发育突增也是一种正常的多态变异。没有显著生长突增的女孩在与“突增”的同龄人完全相同的年龄达到了相同的成年身高。

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引用次数: 0

“From birth to puberty: the main physio-pathological changes of the mammary gland during childhood and adolescence, described and illustrated” 《从出生到青春期：童年和青春期乳腺的主要生理病理变化，描述和说明》

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-08-04 DOI: 10.1016/j.earlhumdev.2025.106356

Cristiana Boldrini , Roberta Dattoli , Angelica Marra , Micol Bottalico , Alessandro Cina , Paolo Belli

Under hormonal stimulation, from birth to puberty, various normal and abnormal changes in the mammary gland occur, and pediatric patients may sometimes present with significant breast changes. Many conditions are physiological and transient; however, they can cause anxiety and concern. Some of them, although less common, may involve a non-physiological process or a latent disease, therefore, timely diagnosis is essential to prevent complications that can lead to permanent consequences. The objective of this review is to provide a systematic description of the clinical and radiological characteristics of the most common breast disorders during childhood and puberty, in order to help formulate a correct differential diagnosis and promptly intervene if necessary. A set of illustrations relating to the conditions described is supplied to complete the document, mainly ultrasound images but not only, which can support the professional in clinical practice. The main literature on pediatric breast (reviews and case reports) published over the past twenty-five years was examined, using as keywords “breast development,” “pediatric breast,” “breast enlargement”; “neonatal mastitis”; “infantile breast/mammary ductal ectasia”; “gynecomastia”; “isolated premature thelarche”; “central precocious puberty”; “breast asymmetry”; “breast ductal ectasia”; “juvenile breast hypertrophy”; “fibrocystic changes”; “fibroadenoma”. A careful physical examination, combined with a targeted ultrasound evaluation, in most cases allows for a correct diagnosis of the breast pathology in childhood and adolescence; appropriate laboratory tests may be necessary. Furthermore, ultrasound examination may help avoid unnecessary worry, and set aside unnecessary invasive diagnostic and therapeutic strategies.

在激素的刺激下，从出生到青春期，乳腺会发生各种正常和异常的变化，儿科患者有时会出现明显的乳腺变化。许多情况是生理的和短暂的；然而，它们会引起焦虑和担忧。其中一些虽然不太常见，但可能涉及非生理过程或潜伏性疾病，因此，及时诊断对于预防可能导致永久性后果的并发症至关重要。本综述的目的是对儿童期和青春期最常见的乳腺疾病的临床和放射学特征进行系统描述，以帮助制定正确的鉴别诊断并在必要时及时干预。提供了一组与所描述的条件有关的插图来完成文档，主要是超声图像，但不仅如此，这可以支持临床实践中的专业人员。以“乳房发育”、“儿童乳房”、“乳房增大”为关键词，对过去25年来发表的关于儿童乳房的主要文献（综述和病例报告）进行了研究；“新生儿乳腺炎”;“婴儿乳房/乳腺导管扩张”；“男性女乳症”;“孤立过早的古弓”；“中心性早熟”；“乳房不对称”;“乳腺导管扩张”；“幼年性乳房肥大”；“乳腺纤维囊性改变”;“纤维腺瘤”。在大多数情况下，仔细的身体检查，结合有针对性的超声评估，可以正确诊断儿童和青少年的乳房病理；可能需要进行适当的实验室检查。此外，超声检查可以帮助避免不必要的担忧，并搁置不必要的侵入性诊断和治疗策略。

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引用次数: 0

Prenatal and postnatal outcomes in fetuses with ventriculomegaly: Prognostic factors insights from a single-center study 脑室肥大胎儿的产前和产后结局：来自单中心研究的预后因素见解

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-08-01 DOI: 10.1016/j.earlhumdev.2025.106355

Murad Gezer , Abdullah Tabakçı , Ümit Taşdemir , Mucize Eriç Özdemir , Zeycan Aytaş , Oya Demirci

Objective

Fetal ventriculomegaly (VM) is a common prenatal ultrasound finding with a wide range of etiologies and variable prognostic outcomes. This study aimed to evaluate the prenatal characteristics, genetic findings, and postnatal neurodevelopmental outcomes of fetuses diagnosed with VM, according to the severity of VM and associated abnormalities.

Methods

This retrospective single-center study includes 357 fetuses diagnosed with VM between 2020 and 2024. Cases were classified according to VM severity, laterality, and the presence of associated anomalies. Prenatal genetic tests, neurosonography, and prenatal and postnatal MRI findings were analyzed. Outcomes included the termination of pregnancy, intrauterine and postnatal death, and long-term neurodevelopmental status.

Results

Among 357 fetuses, 193 (54.1 %) had mild VM, 85 (23.8 %) had moderate VM, and 79 (22.1 %) had severe VM. 25.2 % of the cases were isolated. Additional CNS abnormalities were present in 43.1 % of the fetuses. Genetic or chromosomal abnormalities were detected in 35.7 % of the fetuses who underwent genetic testing (55 out of 154 cases). The survival rate was highest in mild (75.6 %) and isolated VM (95.6 %). A higher gestational age at diagnosis, smaller ventricular diameter, and the absence of CNS/extracranial CNS abnormalities were associated with normal neurodevelopmental outcomes. In the logistic regression analysis, the presence of CNS abnormalities, ventricular width, and gestational age at diagnosis were found to be independent predictors of neurodevelopmental status. ROC analysis in our study showed that the cut-off value of 13 mm had good discrimination to predict normal neurodevelopmental status in all cases but limited accuracy in isolated cases of VM.

Conclusion

The severity and etiology of fetal VM significantly affect both survival and neurodevelopmental outcomes. Isolated mild VM correlated with positive outcomes, but moderate-to-severe VM and non-isolated cases had markedly poor survival rates and neurodevelopmental status. Key prognostic factors for normal neurodevelopmental status included higher gestational age at diagnosis, smaller ventricular diameters <13 mm, and the absence of CNS and non-CNS anomalies.

目的胎儿心室肿大（VM）是一种常见的产前超声发现，病因广泛，预后不一。本研究旨在根据VM的严重程度和相关异常，评估诊断为VM的胎儿的产前特征、遗传发现和出生后神经发育结局。方法回顾性单中心研究纳入357例诊断为VM的胎儿，时间为2020年至2024年。病例根据VM的严重程度，侧边性和相关异常的存在进行分类。分析了产前基因检测、神经超声检查以及产前和产后MRI检查结果。结果包括终止妊娠、宫内和产后死亡以及长期神经发育状况。结果357例胎儿中，轻度VM 193例（54.1%），中度VM 85例（23.8%），重度VM 79例（22.1%）。25.2%的病例被隔离。43.1%的胎儿存在额外的中枢神经系统异常。遗传或染色体异常在接受基因检测的胎儿中占35.7%（154例中有55例）。轻度和分离VM的存活率最高，分别为75.6%和95.6%。诊断时胎龄较高，心室直径较小，无中枢神经系统/颅外中枢神经系统异常与正常的神经发育结果相关。在logistic回归分析中，发现中枢神经系统异常、心室宽度和诊断时的胎龄是神经发育状态的独立预测因子。本研究的ROC分析显示，截断值13 mm对所有病例的正常神经发育状态都有很好的判别性，但在孤立的VM病例中准确性有限。结论胎儿VM的严重程度和病因对胎儿的生存和神经发育结局均有显著影响。孤立的轻度VM与阳性结果相关，但中度至重度VM和非孤立病例的存活率和神经发育状态明显较差。正常神经发育状态的关键预后因素包括诊断时胎龄较大，心室直径较小（约13 mm），无中枢神经系统和非中枢神经系统异常。

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引用次数: 0

The relationship between carpal tunnel syndrome and the 2D:4D digit ratio: A systematic review 腕管综合征与2D:4D指位比值的关系：系统综述

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-07-31 DOI: 10.1016/j.earlhumdev.2025.106349

Emine Kaplan Serin , Tuba Güner Emül

Carpal tunnel syndrome is a common peripheral neuropathy influenced by multiple biological and anthropometric factors. The 2D:4D digit ratio, a marker of prenatal androgen exposure, has recently been investigated for its association with carpal tunnel syndrome risk. This systematic review aimed to evaluate the relationship between 2D:4D ratio and carpal tunnel syndrome development, considering anthropometric variables. Four studies including a total of 672 participants were analyzed. Two of the studies were conducted on populations with the same ethnic background, while the other two involved individuals from different ethnic groups. The included studies assessed 2D:4D ratios alongside various anthropometric parameters such as body mass index. Across the four included studies, three consistently demonstrated that a lower 2D:4D ratio is associated with an increased risk of carpal tunnel syndrome, particularly in females. The findings suggest that 2D:4D may serve as a potential biomarker for carpal tunnel syndrome, especially in populations with higher susceptibility, such as women. Three of the four studies highlighted female gender as a common risk factor for carpal tunnel syndrome. Additionally, a lower 2D:4D ratio was associated with increased carpal tunnel syndrome risk in three studies, suggesting that this ratio reflecting prenatal androgen exposure may serve as a potential biomarker for carpal tunnel syndrome.

腕管综合征是一种常见的周围神经病变，受多种生物学和人体测量学因素的影响。2D:4D手指比例是产前雄激素暴露的标志，最近研究了其与腕管综合征风险的关系。本系统综述旨在评估2D:4D比值与腕管综合征发展之间的关系，并考虑人体测量变量。共分析了四项研究，包括672名参与者。其中两项研究是针对具有相同种族背景的人群进行的，而另外两项研究则涉及来自不同种族群体的个体。纳入的研究评估了2D:4D比率以及各种人体测量参数，如身体质量指数。在纳入的四项研究中，有三项研究一致表明，较低的2D:4D比例与腕管综合征的风险增加有关，尤其是在女性中。研究结果表明，2D:4D可能作为腕管综合征的潜在生物标志物，特别是在女性等易感性较高的人群中。四项研究中有三项强调女性是腕管综合征的常见风险因素。此外，在三项研究中，较低的2D:4D比值与腕管综合征风险增加相关，表明该比值反映了产前雄激素暴露可能作为腕管综合征的潜在生物标志物。

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引用次数: 0

Characterising non-pharmacological infant sleep interventions for theoretical underpinnings and behaviour change techniques: A scoping review 表征非药物婴儿睡眠干预的理论基础和行为改变技术：范围审查

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-07-26 DOI: 10.1016/j.earlhumdev.2025.106346

Heather Liebregts , Alexandra Metse , Andrea R. Steele , Justine DeMott , Kelli MacMillan , Rhonda Marriott , Renita A. Almeida

In Western settings where solitary, continuous infant sleep throughout the night is emphasised, parents might perceive their infant's nightwaking as a problem and seek solutions. Interventions typically aim to reduce nighttime parent-infant interactions to facilitate independent infant sleep. There are concerns regarding the acceptability of these interventions to parents, and their applicability for families with diverse parenting practices, such as co-sleeping. The specific theories and strategies applied by evidence-based infant sleep interventions have not been systematically explored. This scoping review aimed to characterise infant sleep interventions for their theoretical underpinnings and behaviour change techniques (BCTs). Where applicable, this review also aimed to explore associations between meaningful groupings of theory type and BCTs and outcomes including parent satisfaction and intervention adherence. Online databases were searched for Randomised Controlled and cluster Randomised Controlled Trials of non-pharmacological interventions delivered in non-acute primary care or community settings that targeted the prevention or treatment of sleep problems in infants (0–3 years). Twenty-eight of 34,898 retrieved articles were included, describing 34 unique interventions. Operant conditioning theory underpinned 50 % (13/26) of the theory-informed interventions. Interventions were found to be multicomponent and the application of BCTs was heterogeneous across interventions. Findings suggest a need for more diversity of theoretical underpinnings and a clear indication of BCTs included in interventions. Future research should identify theories that can be adapted to align with family cultural contexts and parenting practices, and BCTs that can be operationalised to facilitate acceptable and culturally sensitive approaches to infant sleep intervention.

在西方环境中，强调婴儿整夜单独、连续的睡眠，父母可能会将婴儿的夜醒视为一个问题，并寻求解决方案。干预措施通常旨在减少夜间亲子互动，以促进婴儿独立睡眠。这些干预措施对父母的可接受性以及它们对具有不同养育方式的家庭的适用性令人担忧，例如共睡。循证婴儿睡眠干预的具体理论和策略尚未得到系统的探讨。本综述旨在描述婴儿睡眠干预的理论基础和行为改变技术（bct）。在适用的情况下，本综述还旨在探讨理论类型和bct的有意义分组与包括父母满意度和干预依从性在内的结果之间的关联。在线数据库中检索了在非急性初级保健或社区环境中提供的针对0-3岁婴儿睡眠问题的预防或治疗的非药物干预措施的随机对照和聚类随机对照试验。在34,898篇检索文章中纳入了28篇，描述了34种独特的干预措施。操作条件反射理论支持了50%（13/26）的理论干预。研究发现，干预措施是多组分的，不同干预措施间bct的应用也存在异质性。研究结果表明，需要更多样化的理论基础和干预措施中包括的bct的明确指示。未来的研究应该确定可以适应家庭文化背景和育儿实践的理论，以及可以操作的bct，以促进可接受的和文化上敏感的婴儿睡眠干预方法。

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引用次数: 0

Simulation-based team training and changes in Apgar scores during neonatal transition: A multi-site controlled follow-up study 基于模拟的团队训练和新生儿过渡期间Apgar评分的变化：一项多地点对照随访研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-07-23 DOI: 10.1016/j.earlhumdev.2025.106345

Anders L. Schram , Nadja L. Bonne , Tine B. Henriksen , Niels T. Hertel , Lotte H. Hansen , Maja C. Bjerrum , Arlen Canenguez , Martin Hulgaard , Sofie Sommer , Camilla Hesselberg , Pernille K. Vandborg , Rikke Kaae , Signe B. Thim , Morten S. Lindhard

This multi-site, controlled follow-up study investigated the impact of intensified simulation-based pediatric team training on the evolution of Apgar scores within the first 10 min. No consistent improvement was observed. The results underscore the necessity for larger-scale studies and customized scenarios to fully evaluate the potential of simulation-based training in improving neonatal outcomes.

这项多地点、对照随访研究调查了基于模拟的强化儿科团队训练对前10分钟内Apgar评分演变的影响。没有观察到持续的改善。这些结果强调了进行大规模研究和定制方案的必要性，以充分评估基于模拟的培训在改善新生儿预后方面的潜力。

引用次数: 0

A systematic review of pre- and postnatal ultrasound measurements for assessing brain growth: Reliability and implications for clinical practice 产前和产后超声测量评估大脑发育的系统回顾：可靠性和临床实践的意义

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-07-22 DOI: 10.1016/j.earlhumdev.2025.106344

Mathies Rondagh , Bregje O. van Oldenmark , Phebe J. Adama van Scheltema , Enrico Lopriore , Jeanine M.M. van Klink , E.J.T. (Joanne) Verweij , Linda S. de Vries , Sophie G. Groene , Sylke J. Steggerda

Background and aim

The aim of this systematic review was to identify and assess the reliability of pre- and postnatal ultrasound measurements for evaluating early longitudinal brain growth. The secondary aim was to provide a reliable and feasible set of pre- and postnatal ultrasound measurements for clinical practice and future research.

Methods

This review was conducted according to PRISMA guidelines and used the validated QAREL scale to assess the risk of bias in the included studies. We included studies assessing the reliability of prenatal and/or postnatal ultrasound measurements. Articles were excluded if intraclass correlation coefficients for intra- or interobserver agreement were not provided. The primary outcome was the intraclass correlation coefficient (ICC) of the intra- and inter-observer agreement.

Results

A total of twenty-two studies were included, in which one study assessed both pre- and postnatal brain growth measurements, eleven studies focused on prenatal measurements, and ten on postnatal measurements. In these studies, twenty-seven prenatal and thirty-two postnatal ultrasound measurements were used to assess brain growth, showing predominantly good or excellent intra- and interobserver reliability.

Conclusions

This review highlighted a significant gap in studies assessing longitudinal brain growth from the pre- to the postnatal period. Therefore, collaboration between obstetricians, radiologists and neonatologists is important for assessing longitudinal brain growth, which could help identify infants at risk of abnormal brain growth and potential neurodevelopmental impairment. We propose a set of ultrasound measurements of total brain size, ventricles, cerebellum, and corpus callosum to monitor early brain growth.

背景和目的本系统综述的目的是确定和评估产前和产后超声测量评估早期纵向脑发育的可靠性。第二个目的是为临床实践和未来的研究提供一套可靠和可行的产前和产后超声测量。方法本综述按照PRISMA指南进行，并使用经过验证的QAREL量表评估纳入研究的偏倚风险。我们纳入了评估产前和/或产后超声测量可靠性的研究。如果没有提供类内或观察者间一致性的相关系数，则排除文献。主要结局是观察者之间和观察者之间一致性的类内相关系数（ICC）。结果共纳入22项研究，其中1项研究对产前和产后脑生长测量进行了评估，11项研究对产前测量进行了评估，10项研究对产后测量进行了评估。在这些研究中，27个产前和32个产后超声测量被用来评估大脑发育，显示出良好或优异的观察者内部和观察者之间的可靠性。结论：本综述强调了从产前到产后纵向脑发育评估研究的显著差距。因此，产科医生、放射科医生和新生儿医生之间的合作对于评估纵向脑发育非常重要，这可以帮助识别有脑发育异常和潜在神经发育障碍风险的婴儿。我们建议一套超声测量的总脑大小，脑室，小脑，和胼胝体监测早期大脑发育。

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引用次数: 0

The effectiveness of pulmonary hypertension screening in infants born preterm 早产儿肺动脉高压筛查的有效性

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-07-15 DOI: 10.1016/j.earlhumdev.2025.106342

Stephanie Vachon , Rajiv Devanagondi , Andrew Dylag , Hongyue Wang , Gloria Pryhuber

Objective

To determine if pulmonary hypertension (PH) screening in at-risk infants born preterm reduces morbidity and/or NICU length of stay.

Study design

This single-center retrospective cohort chart review compared infants born <32 weeks gestational age (GA) before and after the implementation of an updated PH screening guideline. Screening eligibility and PH diagnosis were determined by applying the standardized criteria to patients in both epochs. NICU and post-discharge outcomes were determined by chart review.

Results

Pre- (N = 513) and post-screening (N = 544) epochs had similar gestational age and demographic characteristics. More echocardiograms were obtained in post-screening infants resulting in more PH diagnoses (11.5 % vs. 16.5 %, p = 0.02) at a younger median post-natal age [day of life 73 (28–193) vs. 55 (28–212), median and range, p = 0.01]. PH+ infants in the post-screen epoch were discharged at a younger median post-natal age [127 (49–407) vs 113.5 (46–433) days, p = 0.02] and corrected GA [43.6 (36.7–87.4) vs 41.7 (36.6–64.9) weeks, p = 0.03].

Conclusion

PH screening protocol with multidisciplinary team involvement may be associated with increased detection of PH in at risk infants yet a shorter NICU stay in infants with PH.

目的探讨肺动脉高压筛查是否能降低新生儿重症监护病房的发病率和/或住院时间。研究设计：本单中心回顾性队列图综述比较了实施更新的PH筛查指南前后出生的32周胎龄（GA）婴儿。通过对两个时期的患者应用标准化标准来确定筛查资格和PH诊断。新生儿重症监护病房和出院后的结果通过图表审查确定。结果孕产期（513例）和筛查后（544例）胎龄和人口学特征相似。筛查后获得更多超声心动图的婴儿，在较年轻的中位出生年龄[生命日73（28-193）对55(28-212)，中位和范围，p = 0.01]获得更多的PH诊断（11.5%对16.5%,p = 0.02）。筛查后PH+婴儿的中位出生年龄较低[127 (49-407)vs 113.5（46-433）天，p = 0.02]，校正后GA [43.6 (36.7-87.4) vs 41.7（36.6-64.9）周，p = 0.03]。结论多学科团队参与的PH筛查方案可能与高危婴儿PH检出率增加以及PH婴儿NICU住院时间缩短有关。

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引用次数: 0

Exploring congenital hypertrophic pyloric stenosis in preterm and low weight infants: A Western China perspective 探讨先天性肥厚性幽门狭窄在早产儿和低体重儿：中国西部的视角

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-07-14 DOI: 10.1016/j.earlhumdev.2025.106341

Jinfeng Hou (侯金凤), Mengying Cui (崔梦莺), Yi Wang (王佚), Zhenhua Guo (郭振华), Wei Feng (冯伟), Wei Liu (刘伟)

Purpose

To retrospectively analyze the clinical characteristics of congenital hypertrophic pyloric stenosis (CHPS) patients with different gestational ages and admission weights.

Materials and methods

The clinical records of CHPS patients between 2008 and 2022 were retrospectively reviewed. The patients were classified into two main groups: premature group and full-term group. Moreover, they were further divided into two subgroups based on their admission weight, namely the ≤3 kg group and the >3 kg group.

Results

The median age at the onset of the disease for premature infants was found to be later than that for full-term infants, with values of 29.00 days and 22.00 days respectively (P = 0.015). In terms of the proportion of patients with dehydration, it was significantly higher in the premature infants group compared to the full-term infants group, reaching 45.83 % and 25.30 % respectively (P = 0.026). Regarding the median pyloric muscle thickness, it was 0.45 (0.43–0.515) cm in the weight ≤3 kg group and 0.48 (0.43-0.53) cm in the weight >3 kg group, with a significant difference (P = 0.028).

Conclusion

There are distinct differences in the clinical characteristics of CHPS patients with different gestational ages at birth and admission weights. Premature infants show a later onset age and a higher proportion of dehydration. Additionally, the pyloric muscle thickness is also related to the admission weight of infants.

目的回顾性分析不同胎龄和入院体重的先天性肥厚性幽门狭窄（CHPS）患者的临床特点。材料与方法回顾性分析2008 ~ 2022年CHPS患者的临床资料。将患者分为两组：早产儿组和足月组。并根据入院体重进一步分为≤3kg组和>； 3kg组。结果早产儿发病年龄中位数晚于足月儿，分别为29.00 d和22.00 d （P = 0.015）。在脱水患者比例方面，早产儿组明显高于足月儿组，分别达到45.83%和25.30% （P = 0.026）。幽门正中肌厚度，体重≤3 kg组为0.45 (0.43-0.515)cm，体重≤3 kg组为0.48 (0.43-0.53)cm，差异有统计学意义（P = 0.028）。结论不同胎龄和出生体重的CHPS患者临床特征有明显差异。早产儿发病年龄较晚，脱水比例较高。此外，幽门肌厚度也与新生儿入院体重有关。

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