Early human development最新文献_第5页

Investigation of endotracheal tube position changes due to neck rotation in newborns 新生儿颈部旋转引起气管内管位置改变的研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-02-01 Epub Date: 2025-11-09 DOI: 10.1016/j.earlhumdev.2025.106436

Hidehiko Maruyama, Shoichiro Amari, Tetsuya Isayama, Yushi Ito

Background

There are few reports describing endotracheal tube (ETT) position changes due to neck rotation. Modifying ultrasonographic measurements of ETT tip and aortic distance, we aim to clarify the ETT tip position changes due to neck rotation.

Methods

Eligibility criteria: (1) birth between October 2022 and September 2023, between 32 and 41 gestational weeks, (2) ventilatory management with ETT fixed at the left mouth corner, and (3) physician judgment that respiratory and circulatory status is relatively stable. We measured the distance between the brachiocephalic artery bifurcation and the ETT tip on one plane in a close parasagittal section from the left neck. We compared them with the neck in right, neutral, and left rotation positions as distances R, N, and L, respectively.

Results

There were 30 study subjects. The means ± standard deviations of distances R, N, and L were 10.4 ± 2.1, 12.9 ± 3.5, and 13.7 ± 3.3 mm, respectively. Repeated measures analysis of variance found significant differences between groups (P < 0.001). A significant difference was found between distances R and N (mean difference − 2.50 [95 % confidence interval, −3.58, −1.42]) and between R and L (−3.31 [−4.72, −1.91]).

Conclusion

The tip position of ETT secured at the left mouth corner was significantly deeper in the right rotation neck position. In addition to left-right neck rotation, flexion-extension neck movement greatly affects ETT position change. Therefore, we must take care of neck movement.

背景：由于颈部旋转导致气管内插管（ETT）位置改变的报道很少。修改超声测量的ETT尖端和主动脉距离，我们的目的是澄清ETT尖端的位置变化由于颈部旋转。方法入选标准：(1)2022年10月~ 2023年9月出生，孕周32 ~ 41周；(2)左嘴角固定ETT进行通气管理；(3)医师判断呼吸循环状况相对稳定。我们测量了头臂动脉分叉和ETT尖端在一个平面上的距离，从左颈部开始的近旁矢状面切片。我们将它们分别与右、中、左旋转位置的颈部进行距离R、N、L的比较。结果共纳入30例研究对象。距离R、N、L的均值±标准差分别为10.4±2.1、12.9±3.5、13.7±3.3 mm。重复测量方差分析发现组间存在显著差异（P < 0.001）。距离R和N之间存在显著差异（平均差异为- 2.50[95%置信区间，- 3.58,- 1.42]），距离R和L之间存在显著差异（- 3.31[- 4.72,- 1.91]）。结论右转颈位固定于左口角的ETT尖端位置较右转颈位深。除了左右颈部旋转外，颈部屈伸运动对ETT位置变化影响很大。因此，我们一定要注意颈部的运动。

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引用次数: 0

Reference curves of first-trimester novel measurements of the fetal urinary tract using three-dimensional ultrasound and Virtual Reality 使用三维超声和虚拟现实技术对胎儿尿路进行新颖测量的妊娠早期参考曲线

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-02-01 Epub Date: 2025-11-21 DOI: 10.1016/j.earlhumdev.2025.106441

K. Zandbergen , A.G.M.G.J. Mulders , L. van der Bas , A.H.J. Koning , S. Galjaard , J. Mulder , E.A.P. Steegers , M. Rousian

The aim of this research was to assess the feasibility and reproducibility of first-trimester biometric and volumetric measurements of the fetal urinary tract (FUT) using three-dimensional (3D) ultrasound (US) and Virtual Reality (VR), and to establish reference curves. In a prospective cohort, 2D- and 3D-US datasets of pregnancies (gestational age (GA) 11⁺⁰–14⁺⁶ weeks) were obtained. Novel biometric and volumetric FUT measurements were performed using 3D VR and compared with 2D US measurements. Reproducibility was evaluated through intra-, interobserver and intersystem agreement (ICC, Bland-Altman). All measurements were plotted against GA to create reference curves. A total of 108 3D-US datasets (mean GA 12⁺⁶ weeks (SD 5 days) mean CRL 67 mm (SD 9.0 mm)) were selected randomly. Using 3D VR, intra- and interobserver analyses showed moderate-good agreement for all FUT measurements (ICCs >0.77) and renal calyces (ICCs 0.51–0.83). Volumetric measurements showed the highest agreement (ICC >0.96). Comparison of 2D-US and 3D VR demonstrated good agreement (ICC 0.81). Mean relative differences were <10 % for all measurements except coronal renal calyx measurements. All FUT dimensions increased with GA and reference curve were constructed. First-trimester FUT measurements using 3D VR are feasible and reproducible, except for renal calyces. These measurements provide an in-vivo description of early FUT growth with potential diagnostic value for anomalies.

本研究的目的是评估使用三维（3D）超声（US）和虚拟现实（VR）技术对妊娠早期胎儿尿路（FUT）进行生物测量和体积测量的可行性和可重复性，并建立参考曲线。在前瞻性队列中，获得妊娠（胎龄（GA） 11+ 0-14 +6周）的2D和3D-US数据集。使用3D VR进行新的生物识别和体积FUT测量，并与2D US测量进行比较。通过内部、观察者间和系统间协议（ICC, Bland-Altman）评估再现性。所有的测量结果都是根据GA绘制的，以创建参考曲线。随机选择108个3D-US数据集（平均GA 12+6周（SD 5天），平均CRL 67 mm (SD 9.0 mm)）。使用3D VR，观察者内部和观察者之间的分析显示，所有FUT测量值（ICCs >0.77）和肾盂（ICCs 0.51-0.83）的一致性中等。体积测量结果的一致性最高（ICC >0.96）。2D-US和3D VR的比较显示出良好的一致性（ICC 0.81）。除冠状肾花萼测量外，所有测量值的平均相对差异为10%。所有FUT维度都随着遗传算法的增加而增加，并构建了参考曲线。除了肾盂外，使用3D VR测量妊娠早期FUT是可行且可重复的。这些测量提供了早期FUT生长的体内描述，对异常具有潜在的诊断价值。

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引用次数: 0

Five-year outcomes after cooling for hypoxic-ischemic encephalopathy and predictive value of aEEG 缺氧缺血性脑病降温后的5年预后及aEEG的预测价值

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-02-01 Epub Date: 2025-11-24 DOI: 10.1016/j.earlhumdev.2025.106455

Dorian Blommaert , Arend F. Bos , Anne E. den Heijer , Hendrik J. ter Horst

Background

Therapeutic hypothermia (TH) is standard practice for neonatal hypoxic-ischemic encephalopathy (HIE). Persistently abnormal amplitude-integrated electroencephalography (aEEG) background patterns are associated with adverse outcomes. We aimed to determine neurodevelopmental outcomes at age five and the predictive value of aEEG.

Study design

We studied infants with HIE treated with TH between 2013 and 2018. At age five, we assessed motor (neurological examination, movement-ABC) and cognitive outcomes. We classified children as developing typically (IQ ≥ 85 and M-ABC > p16), mildly abnormal (IQ 70–84 and/or cerebral palsy with GMFCS 1–2 and/or M-ABC ≤ p16), and severely abnormal (IQ < 70 and/or cerebral palsy GMFCS >2). During the first 96 h after birth, we assessed aEEG background patterns and presence of seizures.

Results

Out of 95 infants 14 (15 %) died and we lost 18 (22 %) survivors to follow-up. At age five, 33 (52 %) were developing typically, 21 (33 %) mildly abnormal, and 9 (14 %) severely abnormal. A severely abnormal aEEG at 48 h was the best predictor for death/severely abnormal outcome with a PPV of 88 %, and a PPV of 71 % for severe disability in survivors. Children with death/severely abnormal outcomes had electrographic seizures more frequently and a higher seizure burden than children developing typically/mildly abnormal (61 % vs 11 %, P < .001, median 40 vs 0 min, P < .001. Absence of electrographic seizures was highly predictive (NPV 92 %) of typical/mildly abnormal outcome in survivors.

Conclusion

Among survivors, five-year outcomes after TH were favorable. aEEG background patterns at 48 h and seizure burden were reliable predictors of five-year outcomes.

背景：低温治疗（TH）是新生儿缺氧缺血性脑病（HIE）的标准做法。持续异常的波幅综合脑电图（aEEG）背景模式与不良结果相关。我们的目的是确定5岁时的神经发育结局和aEEG的预测价值。研究设计我们研究了2013年至2018年间接受TH治疗的HIE婴儿。在5岁时，我们评估了运动（神经学检查，运动- abc）和认知结果。我们将儿童分为发育典型（IQ≥85,M-ABC > p16）、轻度异常（IQ 70 - 84和/或脑瘫，GMFCS 1-2和/或M-ABC≤p16）和严重异常（IQ <； 70和/或脑瘫GMFCS >；2）。在出生后的前96小时，我们评估了aEEG背景模式和癫痫发作的存在。结果95例患儿中14例（15%）死亡，18例（22%）死亡。在5岁时，33例（52%）发育典型，21例（33%）轻度异常，9例（14%）严重异常。48小时严重异常aEEG是死亡/严重异常结局的最佳预测指标，PPV为88%，幸存者严重残疾的PPV为71%。死亡/严重异常的儿童比典型/轻度异常的儿童更频繁地发生电图癫痫发作，癫痫发作负担更高（61% vs 11%, P < 0.001，中位数40 vs 0分钟，P < 0.001）。无电性癫痫发作是幸存者典型/轻度异常结局的高度预测（NPV为92%）。在幸存者中，TH后的5年预后良好。48小时aEEG背景模式和癫痫发作负担是5年预后的可靠预测因子。

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引用次数: 0

Wireless monitoring directly after birth in term neonates: A feasibility study 足月新生儿出生后直接无线监护的可行性研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-02-01 Epub Date: 2025-11-23 DOI: 10.1016/j.earlhumdev.2025.106454

Marisse Meeus , Heleen Dingemanse , Corrie Jacobs , Maartje van Dalen , Anne Nieuwenhuis , Julie Lateur , Irma Pernot

Objective

To evaluate the suitability (feasibility and ease of use) of a novel, wireless, non-adhesive device for cardiorespiratory monitoring directly after birth.

Study design

Prospective observational study in which monitor data of healthy newborn infants were collected by applying and connecting a wireless belt directly after birth without skin preparation. Study duration was at least 30 min. Data were retrospectively analyzed. Primary endpoint was the success of displaying HR and RR within two minutes after device application. Secondary endpoints were the continuity and reliability of the monitor data throughout the monitored period, and the caregivers experience of ease of device application.

Results

As per sample size calculation, monitor data were collected in 39 infants. The measurement was successful in all 39 cases, with a median time to signal display of 4 s (IQR: 3.0–5.0), maximum 91 s. The time needed to obtain a signal did not depend on the degree of vernix. With regard to continuity of data registration, heart rate (HR) and respiratory rate (RR) signals were detectable for 94 % of the time (HR 94 %, RR 97 %).

Conclusion

A new wireless device was feasible for cardiorespiratory monitoring directly after birth without preparing the wet skin and without disturbing parent-infant skin to skin interaction.

目的评价一种新型无线、无粘连装置在新生儿出生后直接进行心肺监护的适用性（可行性和易用性）。研究设计前瞻性观察性研究，在健康新生儿出生后不做皮肤准备，直接应用并连接无线带收集监测数据。研究时间至少30分钟。回顾性分析资料。主要终点是在设备应用后两分钟内成功显示HR和RR。次要终点是整个监测期间监测数据的连续性和可靠性，以及护理人员对设备应用的易用性的体验。结果按样本量计算，收集监测数据39例。39例测量均成功，信号显示的中位时间为4 s (IQR: 3.0-5.0)，最长时间为91 s。获得信号所需的时间并不取决于黑化的程度。关于数据登记的连续性，心率（HR）和呼吸率（RR）信号在94%的时间内被检测到（HR 94%, RR 97%）。结论一种新型的无线监护装置可用于新生儿出生后直接进行心肺监护，无需准备湿皮肤，且不干扰母婴皮肤间的相互作用。

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引用次数: 0

Longitudinal changes in infant non-nutritive sucking across the first year of life 婴儿第一年非营养性吸吮的纵向变化。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-02-01 Epub Date: 2025-11-24 DOI: 10.1016/j.earlhumdev.2025.106440

Alaina Martens , Natalie Peterman , Kristen Allison , Katharine Radville , Hayden Kamiya , Emily Zimmerman

Non-nutritive suck (NNS; sucking without feeding) is among the earliest oromotor behaviors in infants and has been shown to be associated with future neurodevelopmental outcomes. Prior work has shown that by 12 months, NNS bursts become shorter and stronger compared to 3 months, but when this shift occurs within the first year remains unclear. Twenty-four full-term infants participated in this prospective, longitudinal study with repeated measures at 3, 6, 9, and 12 months. Infants sucked on a custom pacifier with a pressure transducer for ∼5 min. NNS outcomes included burst duration (s), frequency (Hz), amplitude (cmH₂O), bursts/min, cycles/burst, and cycles/min. As infants aged, their NNS patterns changed significantly. By nine months, the suck duration, bursts/min, cycles/burst, and cycles/min had decreased and by twelve months, these measures showed even further reduction, reflecting continued changes in sucking across the first year of life. The most pronounced NNS changes occurred between 6 and 9 months, coinciding with the introduction of solids and a decreased reliance on NNS. These findings highlight when NNS patterns shift during infancy, providing a reference for identifying age-appropriate targets for infants. This study emphasizes the dynamic nature of NNS during infancy and underscores the need for further assessment and exploration of its developmental trajectory.

非营养性吸吮（NNS；无喂养吸吮）是婴儿最早的运动行为之一，并已被证明与未来的神经发育结果有关。先前的研究表明，到12个月时，神经神经网络爆发比3个月时变得更短、更强，但这种转变何时发生在第一年内尚不清楚。24名足月婴儿参与了这项前瞻性、纵向研究，在3、6、9和12个月时重复测量。婴儿吮吸带有压力传感器的定制安抚奶嘴约5分钟。NNS结果包括突发持续时间(s)、频率（Hz）、幅度（cmH₂O）、突发次数/分钟、周期/突发次数和周期/分钟。随着婴儿年龄的增长，他们的神经网络模式发生了显著变化。到9个月时，吮吸持续时间、爆发/分钟、周期/爆发和周期/分钟减少了，到12个月时，这些测量显示进一步减少，反映了生命第一年吮吸的持续变化。最明显的NNS变化发生在6至9个月之间，与固体食物的引入和对NNS的依赖减少相一致。这些发现强调了婴儿期神经神经系统模式的变化，为确定婴儿年龄合适的目标提供了参考。本研究强调了婴儿期神经神经系统的动态性质，并强调了进一步评估和探索其发展轨迹的必要性。

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引用次数: 0

Early language delay among infants with hypoxic-ischaemic encephalopathy after therapeutic hypothermia: A prospective cohort study 低氧缺血性脑病患儿治疗性低温后的早期语言延迟：一项前瞻性队列研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.earlhumdev.2025.106444

Zsuzsanna Varga , Miklós Szabó , Tamás Kói , Bence Kas , Nóra Nyilas , Anna Dósa , Dóra Luca Bodócs , Ágnes Jermendy , Anett Ragó

Aim

To assess early language development in infants with hypoxic-ischaemic encephalopathy (HIE), treated with therapeutic hypothermia (TH) who survived without functional motor deficits, and to identify potential neonatal predictive markers for early language delay (ELD).

Methods

In a prospective cohort study, 77 infants with HIE treated with TH were recruited. Cognitive development was assessed using the Bayley Scales of Infant Development, Second Edition, and language development using the MacArthur-Bates Communicative Development Inventory in follow-up studies at a median age of 20 months.

Results

Thirty-two (41 %) infants had favorable cognitive and language development (FCLD group), 19 (25 %) exhibited ELD despite good cognitive skills, and 26 (34 %) showed concomitant adverse cognitive and language development (ACLD group). Despite differences in cognitive outcomes, the language profiles of the ELD and ACLD groups were comparable. No early clinical, socioeconomical, or MRI markers predicted language delay. However, maternal education was strongly associated with cognitive outcomes. Compared with maternal university education, infants of mothers with high school education had 3.9-fold higher odds (95 % CI 1.08–13.97) of adverse cognitive outcomes, and those with maternal elementary school education had 10.2-fold higher odds (95 % CI 2.56–40.31).

Conclusion

One-third of infants with HIE demonstrated favorable cognitive outcomes but concurrent early language delay, highlighting the need for linguistic screening to prevent later learning disorders. Longitudinal studies are warranted to determine whether ELD infants eventually catch up or remain at risk for persistent language deficits.

目的评估低氧缺血性脑病（HIE）患儿经治疗性低温（TH）治疗后无功能性运动缺陷存活的早期语言发育情况，并确定早期语言迟缓（ELD）的潜在新生儿预测标志物。方法在一项前瞻性队列研究中，招募77名接受TH治疗的HIE患儿。在中位年龄为20个月的随访研究中，使用Bayley婴儿发展量表（第二版）评估认知发展，使用麦克阿瑟-贝茨交际发展量表评估语言发展。结果fld组患儿认知和语言发育良好32例（41%），有良好认知能力的患儿19例（25%），有不良认知和语言发育的患儿26例（34%）。尽管认知结果存在差异，但ELD组和ACLD组的语言概况具有可比性。没有早期临床、社会经济或MRI标记预测语言延迟。然而，母亲教育与认知结果密切相关。与受过大学教育的母亲相比，受过高中教育的母亲的婴儿发生不良认知结局的几率高3.9倍（95% CI 1.08 ~ 13.97），受过小学教育的母亲的婴儿发生不良认知结局的几率高10.2倍（95% CI 2.56 ~ 40.31）。结论三分之一的HIE患儿表现出良好的认知结果，但同时存在早期语言迟缓，这突出了语言筛查预防后期学习障碍的必要性。有必要进行纵向研究，以确定ELD婴儿最终是否会赶上或仍有持续语言缺陷的风险。

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引用次数: 0

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.earlhumdev.2025.106411

Rafael Oliveira Fernandes , Simone Lanius dos Reis , Joana da Costa Eschiletti , Julia Jaekel , Renato Soibelmann Procianoy , Rita C. Silveira

Of 13.4 million children born preterm each year globally, 12 million are born in low- and middle-income countries (LMICs). Children born very preterm (<32 weeks gestation; VP) and/or with very low birth weight (<1500 g; VLBW) may grow up with low health-related quality of life (HRQoL); however, information on this topic remains scarce in LMICs. Therefore, the aim of this study was to compare HRQoL between children born VP/VLBW and their term-born peers in Brazil.

Methods

This observational study assessed children born VP and/or VLBW compared with term-born peers, aged 8 to 14 years. Clinical evaluations and the Pediatric Quality of Life Inventory (PedsQL 4.0) were administered.

Results

A total of 140 children were evaluated: 81 in the VP/VLBW group (11.4 ± 1.7 years; 42 girls and 39 boys) and 59 in the term-born group (mean age: 11.0 ± 1.2 years; 26 girls and 33 boys). Preterm children reported lower total HRQoL scores compared to the term-born group, after adjusting for biological and social confounders (mean difference − 5.6 [95 % CI: −10.0, –1.2]). Parents of VP/VLBW group rated their children's total HRQoL as lower (mean difference − 7.5 [95 % CI: −12.8, −2.1]), especially in the psychosocial scores (mean difference − 8.4 [95 % CI: −13.7, −3.2]) compared to parents of term-born children. VP/VLBW girls presented the lowest total HRQoL scores, especially in the emotional dimension. Neonatal morbidities did not impact HRQoL within the VP/VLBW group.

Conclusion

School-aged children born VP/VLBW in an LMIC exhibit lower HRQoL than their term-born peers. Particular attention should be paid to HRQoL among girls born VP/VLBW and how it may affect their mental health needs.

在全球每年1340万早产儿童中，有1200万出生在低收入和中等收入国家。非常早产（妊娠32周；VP）和/或出生体重极低（1500 g； VLBW）的儿童长大后健康相关生活质量（HRQoL）可能较低；然而，关于这一主题的信息在中低收入国家仍然很少。因此，本研究的目的是比较巴西出生VP/VLBW的孩子和足月出生的同龄人的HRQoL。方法：本观察性研究评估了8 - 14岁的早产儿和/或重度新生儿。进行临床评估和儿童生活质量量表（PedsQL 4.0）。结果共对140例患儿进行评估：VP/VLBW组81例（11.4±1.7岁，女孩42例，男孩39例），足月组59例（平均年龄11.0±1.2岁，女孩26例，男孩33例）。在调整了生物和社会混杂因素后，早产儿报告的HRQoL总分低于足月出生组（平均差异为- 5.6 [95% CI: - 10.0, -1.2]）。与足月出生儿童的父母相比，VP/VLBW组的父母认为他们的孩子的总HRQoL较低（平均差值为- 7.5 [95% CI: - 12.8, - 2.1]），特别是在社会心理评分方面（平均差值为- 8.4 [95% CI: - 13.7, - 3.2]）。VP/VLBW女生的HRQoL总分最低，尤其是在情感维度上。新生儿发病率不影响VP/VLBW组的HRQoL。结论中低收入人群中出生VP/VLBW的学龄儿童的HRQoL低于足月出生的同龄人。应特别关注出生低体重/超低体重女孩的HRQoL及其如何影响她们的心理健康需求。

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引用次数: 0

Therapeutic hypothermia in mild hypoxic ischemic encephalopathy: A clinical dilemma with uncertain long-term outcomes 治疗性低温治疗轻度缺氧缺血性脑病：具有不确定长期结果的临床困境。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-01 Epub Date: 2025-10-26 DOI: 10.1016/j.earlhumdev.2025.106427

Ceyda Acun , Rakesh Lavu , Wei Liu , Nicholas Nicoletti , Jennifer Ramsey , Hany Aly

Objective

To evaluate short-term and neurodevelopmental outcomes at 18–24 months in infants with mild hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH), a population with limited long-term outcome data.

Study design

We conducted a retrospective cohort study of neonates ≥36 weeks gestational age (GA) diagnosed with mild HIE and treated with TH at a single center from March 2017 to February 2022. Neonates with severe congenital malformations or chromosomal anomalies were excluded. Data were extracted from medical charts of eligible neonates and their mothers. Outcomes assessed included short-term measures (neuroimaging findings, seizure incidence, length of hospital stay (LOS), and background electroencephalogram (EEG) abnormalities) and long-term neurodevelopmental outcomes (Bayley Scales of Infant and Toddler Development) at 18–24 months or pediatrician-documented developmental delays.

Results

Of the 64 infants meeting inclusion criteria, 17 (27 %) had MRI findings consistent with HIE, and 8 (13 %) experienced seizures. Long-term outcome data were available for 57 (89 %); of whom 9 (16 %) had abnormal outcomes. Among the 39 infants who underwent Bayley assessment at 22 ± 2 months, 6 (15 %) scored <85 in language, cognitive, or motor domains. Of the 17 infants without Bayley assessment but with pediatrician follow-up, 3 (18 %) had documented developmental delays.

Conclusion

Although TH is increasingly applied to mild HIE, evidence on long-term benefit remains scarce. In our cohort, infants with mild HIE treated with TH exhibited seizures, MRI abnormalities, and developmental impairments, underscoring the persistent risk of morbidity. These findings highlight the limited outcome data available and the urgent need for well designed prospective studies to clarify the role of TH in mild HIE.

目的：评估治疗性低温（TH）治疗的轻度缺氧缺血性脑病（HIE）婴儿在18-24个月时的短期和神经发育结局，该人群的长期结局数据有限。研究设计：我们对2017年3月至2022年2月在单一中心诊断为轻度HIE并接受TH治疗的≥36周胎龄（GA）新生儿进行了回顾性队列研究。排除有严重先天性畸形或染色体异常的新生儿。数据取自符合条件的新生儿及其母亲的医疗图表。评估的结果包括短期测量（神经影像学结果、癫痫发作发生率、住院时间（LOS）和背景脑电图（EEG）异常）和18-24个月或儿科医生记录的发育迟缓的长期神经发育结果（Bayley婴幼儿发育量表）。结果：在符合纳入标准的64名婴儿中，17名（27%）的MRI表现与HIE一致，8名（13%）经历过癫痫发作。57例（89%）有长期结局数据；其中9例（16%）预后异常。在39名22±2个月接受Bayley评估的婴儿中，6名（15%）得分。结论：尽管TH越来越多地应用于轻度HIE，但关于长期益处的证据仍然很少。在我们的队列中，接受TH治疗的轻度HIE婴儿表现出癫痫发作、MRI异常和发育障碍，强调了持续发病的风险。这些发现强调了现有的结果数据有限，迫切需要设计良好的前瞻性研究来阐明TH在轻度HIE中的作用。

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引用次数: 0

Sleep variability and learning outcomes in preterm and full-term children: An observational study 早产儿和足月儿童的睡眠变异性和学习结果：一项观察性研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-01 Epub Date: 2025-10-18 DOI: 10.1016/j.earlhumdev.2025.106413

Yusuke Mitani , Yuko Yoshimura , Shinichiro Mizutomi , Tetsujiro Shirahashi , Hidenori Iwasaki , Ikuko Hama , Takashi Ikeda , Sanae Tanaka , Chiaki Hasegawa , Hidenobu Ohta , Akiko Ando , Kazutoshi Cho , Mitsuru Kikuchi , Taizo Wada

Advances in perinatal care have improved survival rates of preterm infants; however, concerns regarding their neurodevelopmental outcomes persist. This study investigates the relationship between intraindividual variability (IIV) in sleep duration and crystallized intelligence in very low birth weight (VLBW) children at the preschool stage. This study had 38 participants, including 18 VLBW children and 20 full-term children aged 5 to 6 years. Sleep duration was assessed using actigraphy and sleep diaries, while crystallized intelligence was evaluated using the Achievement Scale (ACH) of the Kaufman Assessment Battery for Children (K-ABC). Statistical analyses, including correlation and multiple regression analyses, were conducted to examine the effect of preterm birth on the relationship between sleep variability and learning outcomes. The results revealed that sleep duration IIV adversely affected ACH scores of preterm children but had no impact on those of full-term children. In multiple regression analysis, the interaction term between sleep variability and preterm birth significantly predicted ACH scores (p = 0.032), suggesting that early childhood learning in preterm children is more vulnerable to the effects of sleep instability. Additionally, among VLBW children, older age was associated with lower ACH scores, implying that learning difficulties may become more pronounced with age. These results show the potential role of sleep regulatory mechanisms in cognitive development. The findings show the importance of monitoring and supporting healthy sleep habits in preterm children to mitigate potential learning difficulties. Early interventions targeting sleep stability may play a critical role in improving academic performance in this high-risk population.

围产期护理的进步提高了早产儿的存活率；然而，对他们神经发育结果的担忧仍然存在。本研究探讨了极低出生体重儿（VLBW）学龄前阶段睡眠时间的个体变异（IIV）与结晶智力的关系。本研究共有38名参与者，包括18名VLBW儿童和20名5至6岁的足月儿童。睡眠时间采用活动记录仪和睡眠日记进行评估，结晶智力采用儿童考夫曼评估量表（K-ABC）的成就量表（ACH）进行评估。统计分析包括相关分析和多元回归分析，以检验早产对睡眠变异性和学习成果之间关系的影响。结果显示，睡眠时长iv对早产儿ACH评分有不利影响，但对足月儿童ACH评分无影响。在多元回归分析中，睡眠变异性与早产之间的交互项显著预测ACH评分（p = 0.032），提示早产儿早期学习更容易受到睡眠不稳定性的影响。此外，在VLBW儿童中，年龄越大，ACH分数越低，这意味着学习困难可能随着年龄的增长而变得更加明显。这些结果显示了睡眠调节机制在认知发展中的潜在作用。研究结果表明，监测和支持早产儿健康的睡眠习惯对于减轻潜在的学习困难很重要。针对睡眠稳定的早期干预可能在提高这一高危人群的学习成绩方面发挥关键作用。

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引用次数: 0

Nutritional status of Egyptian children with cow's milk allergy: A case-control study 埃及牛奶过敏儿童的营养状况：一项病例对照研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-01 Epub Date: 2025-10-05 DOI: 10.1016/j.earlhumdev.2025.106400

Mohammed Gamal , Ahmed Adel Fathy Mohamed , Khaled Amin Nasef Ahmed , Zakaria Elkhayat

Objective

To evaluate Egyptian children's anthropometric measures, hematological parameters, and nutritional indicators with cow's milk allergy (CMA) compared to healthy controls and assessed if these variables had gender-specific relationships.

Study design

We included children with clinically evidenced CMA non-IgE-mediated histories of CM sensitivity and its protein fractions and positive CM results in the challenge test as the case group, while healthy children without any food allergies were controls. Patients' demographics, clinical characteristics, anthropometric measures, hematological parameters, and dietary intake were collected and assessed.

Results

This study involved 102 children with CMA and 100 controls, aged 4.62 to 8.5 years. While 72.5 % of CMA children had normal heights, 61.8 % had impaired weight, and 49 % had a low BMI. CMA children showed significant reductions in iron levels associated with decreases in hematological parameters. CMA children had significantly deficient calcium, magnesium, and vitamin D levels compared to controls, but there were non-significant differences regarding phosphate and zinc levels. The CMA group revealed significant anthropometric indicators differences between males and females and significant differences between genders in the deficient levels of Hb, mean corpuscular volume, calcium, zinc, and vitamin D, while no significant differences between the deficient levels of iron and mean corpuscular hemoglobin. The logistic regression demonstrated that none of the studied factors had predictive potential for distinguishing between CMA patients and control participants.

Conclusion

Children with CMA exhibited impaired growth and significantly reduced hematological parameters and nutrients, emphasizing the importance of individualized nutritional monitoring to ensure adequate nutrient intake and proper growth.

目的：评价埃及牛奶过敏（CMA）儿童的人体测量指标、血液学参数和营养指标，并评估这些变量是否具有性别特异性关系。研究设计：我们将临床证实CMA非ige介导的CM敏感史及其蛋白组分和CM攻毒试验阳性的儿童作为病例组，而没有任何食物过敏的健康儿童作为对照组。收集和评估患者的人口统计学、临床特征、人体测量、血液学参数和饮食摄入量。结果：本研究纳入102例CMA患儿和100例对照组，年龄4.62 ~ 8.5岁。而72.5%的CMA儿童身高正常，61.8%的体重受损，49%的BMI低。CMA儿童表现出与血液参数降低相关的铁水平显著降低。与对照组相比，CMA儿童的钙、镁和维生素D水平明显不足，但磷酸盐和锌水平没有显著差异。CMA组的人体测量指标男女差异显著，Hb、平均红细胞体积、钙、锌、维生素D缺乏水平男女差异显著，铁缺乏水平和平均红细胞血红蛋白缺乏水平男女差异不显著。逻辑回归表明，没有研究的因素具有预测潜力，以区分CMA患者和对照组的参与者。结论：CMA患儿表现为生长障碍，血液学指标和营养物质明显降低，强调个体化营养监测的重要性，以确保充足的营养摄入和正常生长。

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引用次数: 0