首页 > 最新文献

Journal of Pediatrics最新文献

英文 中文
Predicting Failure of Ventricular Shunts in the Emergency Department: The SMaRT (Shunt Malfunction and Revision Triage) Score 在急诊科预测心室分流失败:SMaRT评分
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-20 DOI: 10.1016/j.jpeds.2025.114969
Kurt R. Lehner MD , Anita L. Kalluri BA , Kelly Jiang MS , Rama J. Alawneh MD , Ryan P. Lee MD , Foad Kazemi MD , Joan Yea MHS , Sai Chandan Reddy BS , Jacob Shaw BS , Ann Kane MD , Eric M. Jackson MD

Objective

To create a simple scoring system to stratify likelihood of shunt failure in the emergency department.

Study design

We conducted a retrospective cohort study of all children presenting to the pediatric emergency department with concern for ventricular shunt failure from 2017 to 2022. A separate dataset from 2022 to 2023 was used for validation. The main predictors of shunt revision were determined using univariate and multivariable regression models, and a scoring system utilizing the top predictors of ventricular shunt malfunction was created.

Results

There were 1167 neurosurgical consultations for shunt malfunction during the study period which resulted in 285 shunt revisions. Utilizing the 10 variables most associated with revision (increased ventricle size, abnormal shunt series, bradycardia, lethargy, altered mental status, vomiting, headache, shorter time interval from last shunt surgery, seizure, and the presence of upper respiratory symptoms), a SMaRT score was developed. For Shunt Malfunction and Revision Triage (SMaRT) score <4, we achieved a receiver-operating characteristic area under the curve of 0.87 with sensitivity of 0.93, specificity of 0.58, positive predictive value of 0.42, and negative predictive value of 0.96. This was confirmed in a separate validation set of 119 patients. A similar analysis excluding imaging data yielded a significant decrease in the discrimination of the scoring system, dropping the receiver-operating characteristic area under the curve to 0.71.

Conclusions

The SMaRT score provides a data-driven tool to determine the utility of a neurosurgical consult for shunt malfunction with a high negative predictive value for shunt malfunction in its lowest tier. Use of this tool has the potential to improve triage and resource utilization in the emergency department.
目的:建立一个简单的评分系统,对急诊科分流失败的可能性进行分层。研究设计:我们进行了一项回顾性队列研究,纳入了2017-2022年期间因心室分流衰竭就诊的所有儿童。使用2022-2023年的单独数据集进行验证。利用单变量和多变量回归模型确定分流管修复的主要预测因子,并利用心室分流管功能障碍的主要预测因子建立评分系统。结果:在研究期间,有1167例神经外科患者因分流管功能障碍就诊,其中285例进行了分流管修复。利用与改版最相关的10个变量(心室增大、分流术系列异常、心动过缓、嗜睡、精神状态改变、呕吐、头痛、离上次分流术时间间隔较短、癫痫发作和上呼吸道症状的存在),制定了SMaRT评分。结论:SMaRT评分提供了一个数据驱动的工具,以确定神经外科咨询对分流功能障碍的效用,其最低层次的分流功能障碍具有很高的负预测值。使用该工具有可能改善急诊科的分诊和资源利用。
{"title":"Predicting Failure of Ventricular Shunts in the Emergency Department: The SMaRT (Shunt Malfunction and Revision Triage) Score","authors":"Kurt R. Lehner MD ,&nbsp;Anita L. Kalluri BA ,&nbsp;Kelly Jiang MS ,&nbsp;Rama J. Alawneh MD ,&nbsp;Ryan P. Lee MD ,&nbsp;Foad Kazemi MD ,&nbsp;Joan Yea MHS ,&nbsp;Sai Chandan Reddy BS ,&nbsp;Jacob Shaw BS ,&nbsp;Ann Kane MD ,&nbsp;Eric M. Jackson MD","doi":"10.1016/j.jpeds.2025.114969","DOIUrl":"10.1016/j.jpeds.2025.114969","url":null,"abstract":"<div><h3>Objective</h3><div>To create a simple scoring system to stratify likelihood of shunt failure in the emergency department.</div></div><div><h3>Study design</h3><div>We conducted a retrospective cohort study of all children presenting to the pediatric emergency department with concern for ventricular shunt failure from 2017 to 2022. A separate dataset from 2022 to 2023 was used for validation. The main predictors of shunt revision were determined using univariate and multivariable regression models, and a scoring system utilizing the top predictors of ventricular shunt malfunction was created.</div></div><div><h3>Results</h3><div>There were 1167 neurosurgical consultations for shunt malfunction during the study period which resulted in 285 shunt revisions. Utilizing the 10 variables most associated with revision (increased ventricle size, abnormal shunt series, bradycardia, lethargy, altered mental status, vomiting, headache, shorter time interval from last shunt surgery, seizure, and the presence of upper respiratory symptoms), a SMaRT score was developed. For Shunt Malfunction and Revision Triage (SMaRT) score &lt;4, we achieved a receiver-operating characteristic area under the curve of 0.87 with sensitivity of 0.93, specificity of 0.58, positive predictive value of 0.42, and negative predictive value of 0.96. This was confirmed in a separate validation set of 119 patients. A similar analysis excluding imaging data yielded a significant decrease in the discrimination of the scoring system, dropping the receiver-operating characteristic area under the curve to 0.71.</div></div><div><h3>Conclusions</h3><div>The SMaRT score provides a data-driven tool to determine the utility of a neurosurgical consult for shunt malfunction with a high negative predictive value for shunt malfunction in its lowest tier. Use of this tool has the potential to improve triage and resource utilization in the emergency department.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"290 ","pages":"Article 114969"},"PeriodicalIF":3.5,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812319","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}
引用次数: 0
Acral Peeling Skin Syndrome 肢端脱皮综合征。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-19 DOI: 10.1016/j.jpeds.2025.114963
Marta Szepietowska MD, Andrzej K. Jaworek MD, PhD, Jacek C. Szepietowski MD, PhD, FRCP
{"title":"Acral Peeling Skin Syndrome","authors":"Marta Szepietowska MD,&nbsp;Andrzej K. Jaworek MD, PhD,&nbsp;Jacek C. Szepietowski MD, PhD, FRCP","doi":"10.1016/j.jpeds.2025.114963","DOIUrl":"10.1016/j.jpeds.2025.114963","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"290 ","pages":"Article 114963"},"PeriodicalIF":3.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806274","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}
引用次数: 0
Increase in Necrotizing Enterocolitis with Cessation of Bifidobacterium longum ssp. infantis Administration in Very Low Birthweight Infants: A Single Center Retrospective Cohort Study 随着长双歧杆菌亚种的停止,坏死性小肠结肠炎的增加。极低出生体重儿给药:一项单中心回顾性队列研究。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-17 DOI: 10.1016/j.jpeds.2025.114961
Leigh Selesner MD , Madeline Hedges BS , Rachel Pung BS , Cortnie Vaughn MD , Adam Burns PhD , Molly Aloia MS , Justin Henson BS , Joseph Tobias MD, MPH , Amy Olyaei BS , Samantha Nizich BS , Kevin Swift PhD , Amirali Veshagh BS , Sarah F. Andres PhD , Elizabeth Fialkowski MD , Brian K. Jordan MD, PhD , Brian Scottoline MD, PhD

Objectives

To evaluate the incidence of necrotizing enterocolitis before probiotic introduction, during probiotic administration, and after its cessation following the 2023 US Food and Drug Administration advisory discouraging probiotic use in preterm infants.

Study design

Retrospective non-concurrent cohort study of very low birthweight (VLBW) infants (birthweight <1500 g), admitted to a level IV neonatal intensive care unit (NICU) from 2014 through 2024. Infants were grouped into three epochs based on Bifidobacterium longum ssp. infantis (B. infantis) EVC001 use: pre-EVC001 (no probiotic), EVC001 (routine use), and post-EVC001 (post-discontinuation). The primary outcome was NEC incidence. Secondary outcomes included NEC-associated mortality, all-cause mortality, NEC severity and NEC incidence among extremely low birthweight (ELBW; <1000 g) infants. Multivariable log-binomial and ordinal logistic regression models were used.

Results

Among 733 VLBW infants, NEC incidence was 12% pre-EVC001, 2.6% EVC001, and 16% post-EVC001 (P < .001). NEC risk was higher both pre-EVC001 (adjusted relative risk [aRR] 4.4, 95% confidence interval [CI] 2.2-9.0) and post-EVC001 (aRR 4.5, 95% CI 2.0-9.9; both P < .001) compared to during EVC001 administration. ELBW infants showed similar trends. EVC001 use was associated with reduced odds of severe NEC compared to epochs without EVC001 use (VLBW odds ratio 5.3, 95% CI 2.5-11.0; ELBW odds ratio 5.0, 95% CI 2.2-11.7; both P < .001). NEC-related mortality was lowest during EVC001exposed infants (0.9%) compared to unexposed (2.8, P = .05).

Conclusions

NEC rates were higher before, lower during and rose after discontinuation of EVC001 in this single center retrospective study. There is a need for multicenter trials evaluating B. infantis for NEC prevention.
目的:评估在引入益生菌之前、给予益生菌期间以及在2023年FDA建议不鼓励早产儿使用益生菌后停用益生菌后坏死性小肠结肠炎(NEC)的发生率。研究设计:极低出生体重(VLBW)婴儿(出生体重)的回顾性队列研究结果:733名VLBW婴儿中,EVC001前NEC发病率为12%,EVC001后为2.6%,EVC001后为16%(结论:在本单中心回顾性研究中,EVC001治疗前NEC发病率较高,EVC001治疗期间NEC发病率较低,停药后NEC发病率升高。有必要开展多中心试验,评估婴儿b型结核菌对NEC的预防作用。
{"title":"Increase in Necrotizing Enterocolitis with Cessation of Bifidobacterium longum ssp. infantis Administration in Very Low Birthweight Infants: A Single Center Retrospective Cohort Study","authors":"Leigh Selesner MD ,&nbsp;Madeline Hedges BS ,&nbsp;Rachel Pung BS ,&nbsp;Cortnie Vaughn MD ,&nbsp;Adam Burns PhD ,&nbsp;Molly Aloia MS ,&nbsp;Justin Henson BS ,&nbsp;Joseph Tobias MD, MPH ,&nbsp;Amy Olyaei BS ,&nbsp;Samantha Nizich BS ,&nbsp;Kevin Swift PhD ,&nbsp;Amirali Veshagh BS ,&nbsp;Sarah F. Andres PhD ,&nbsp;Elizabeth Fialkowski MD ,&nbsp;Brian K. Jordan MD, PhD ,&nbsp;Brian Scottoline MD, PhD","doi":"10.1016/j.jpeds.2025.114961","DOIUrl":"10.1016/j.jpeds.2025.114961","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the incidence of necrotizing enterocolitis before probiotic introduction, during probiotic administration, and after its cessation following the 2023 US Food and Drug Administration advisory discouraging probiotic use in preterm infants.</div></div><div><h3>Study design</h3><div>Retrospective non-concurrent cohort study of very low birthweight (VLBW) infants (birthweight &lt;1500 g), admitted to a level IV neonatal intensive care unit (NICU) from 2014 through 2024. Infants were grouped into three epochs based on <em>Bifidobacterium longum</em> ssp. <em>infantis</em> (<em>B</em>. <em>infantis</em>) EVC001 use: pre-EVC001 (no probiotic), EVC001 (routine use), and post-EVC001 (post-discontinuation). The primary outcome was NEC incidence. Secondary outcomes included NEC-associated mortality, all-cause mortality, NEC severity and NEC incidence among extremely low birthweight (ELBW; &lt;1000 g) infants. Multivariable log-binomial and ordinal logistic regression models were used.</div></div><div><h3>Results</h3><div>Among 733 VLBW infants, NEC incidence was 12% pre-EVC001, 2.6% EVC001, and 16% post-EVC001 (<em>P</em> &lt; .001). NEC risk was higher both pre-EVC001 (adjusted relative risk [aRR] 4.4, 95% confidence interval [CI] 2.2-9.0) and post-EVC001 (aRR 4.5, 95% CI 2.0-9.9; both <em>P</em> &lt; .001) compared to during EVC001 administration. ELBW infants showed similar trends. EVC001 use was associated with reduced odds of severe NEC compared to epochs without EVC001 use (VLBW odds ratio 5.3, 95% CI 2.5-11.0; ELBW odds ratio 5.0, 95% CI 2.2-11.7; both <em>P</em> &lt; .001). NEC-related mortality was lowest during EVC001exposed infants (0.9%) compared to unexposed (2.8, <em>P</em> = .05).</div></div><div><h3>Conclusions</h3><div>NEC rates were higher before, lower during and rose after discontinuation of EVC001 in this single center retrospective study. There is a need for multicenter trials evaluating <em>B</em>. <em>infantis</em> for NEC prevention.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"291 ","pages":"Article 114961"},"PeriodicalIF":3.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795296","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}
引用次数: 0
General Movement Optimality Score-Revised (GMOS-R) with General Population-Based Percentile Ranks 一般运动最优性评分-修正(GMOS-R)与一般人群为基础的百分位排名。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-17 DOI: 10.1016/j.jpeds.2025.114962
Natasha Amery BSc , Caroline F. Alexander PhD , Alison T. Salt MSc , Sarah E. Hall PhD , Catherine Elliott PhD , Catherine Morgan PhD , Alicia J. Spittle PhD , Jane Valentine PhD

Objectives

To describe writhing General Movements Assessment (GMA) classification and General Movement Optimality Score–Revised (GMOS-R) profiles in the general population; to explore relationships between GMOS-R scores and GMA classification, age of assessment and infant socio-demographic factors; and to establish the inter-rater reproducibility of writhing age GMA classification and GMOS-R.

Study design

A cross-sectional study of 1861 infants recruited from the general population in Perth, Western Australia, including 7.5% born preterm. Parent-recorded videos were collected between 41- and 45-weeks post-menstural age, when writhing movements are typically observed. General movements (GMs) classification and GMOS-R were assessed independently by at least 2 experienced advanced-trained clinicians.

Results

The majority of infants' GMs were classified as normal (66.8%) or poor repertoire (33.2%), with one infant's movements classified as cramped synchronized (0.1%). The median GMOS-R score was 33 (interquartile range 27-36). The GMOS-R differentiated GMA classifications. Lower gestational age, any nursery admission, minority ethnicity, and older age at video collection were each associated with a small but statistically significant reduction in GMOS-R scores. GMA classification had excellent inter-rater reliability and agreement. Total GMOS-R had excellent inter-rater reliability and moderate agreement.

Conclusions

Although most infants had normal GMs there was a high prevalence of poor repertoire GMs in the general population. GMOS-R scores effectively differentiated movement quality within the poor repertoire classification. This study provides population-based percentile ranks for interpreting individual post-term GM assessments and as a reference for future research.
目的:描述普通人群扭体一般运动评估(GMA)分类和一般运动优化评分-修订(GMOS-R)概况;探讨GMOS-R评分与GMA分类、评估年龄及婴幼儿社会人口因素的关系;并建立扭龄GMA分类和GMOS-R的等级间可重复性。研究设计:一项横断面研究,从西澳大利亚珀斯的普通人群中招募了1861名婴儿,其中包括7.5%的早产儿。父母录制的视频是在产后1到5周收集的,这段时间通常可以观察到扭动的动作。一般运动(GMs)分类和GMOS-R由至少两名经验丰富的高级培训临床医生独立评估。结果:绝大多数婴儿的GMs为正常(66.8%)或功能差(33.2%),1例婴儿的动作为局促同步(0.1%)。GMOS-R评分中位数为33(四分位数范围为27-36)。GMOS-R对GMA进行了分类。较低的胎龄、任何托儿所入学、少数民族和较年长的录像收集年龄都与GMOS-R评分的小幅但统计上显着降低有关。GMA分类具有良好的信度和一致性。总体GMOS-R具有良好的量表间信度和中等一致性。结论:虽然大多数婴儿有正常的gm,但在一般人群中,不良的全库gm的患病率很高。GMOS-R评分有效地区分了不良曲目分类中的动作质量。本研究提供了基于人群的百分位排名,用于解释个体的后期转基因评估,并提供了一个基于人群的大型扭动年龄GMA数据集,为未来的研究提供参考。
{"title":"General Movement Optimality Score-Revised (GMOS-R) with General Population-Based Percentile Ranks","authors":"Natasha Amery BSc ,&nbsp;Caroline F. Alexander PhD ,&nbsp;Alison T. Salt MSc ,&nbsp;Sarah E. Hall PhD ,&nbsp;Catherine Elliott PhD ,&nbsp;Catherine Morgan PhD ,&nbsp;Alicia J. Spittle PhD ,&nbsp;Jane Valentine PhD","doi":"10.1016/j.jpeds.2025.114962","DOIUrl":"10.1016/j.jpeds.2025.114962","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe writhing General Movements Assessment (GMA) classification and General Movement Optimality Score–Revised (GMOS-R) profiles in the general population; to explore relationships between GMOS-R scores and GMA classification, age of assessment and infant socio-demographic factors; and to establish the inter-rater reproducibility of writhing age GMA classification and GMOS-R.</div></div><div><h3>Study design</h3><div>A cross-sectional study of 1861 infants recruited from the general population in Perth, Western Australia, including 7.5% born preterm. Parent-recorded videos were collected between 41- and 45-weeks post-menstural age, when writhing movements are typically observed. General movements (GMs) classification and GMOS-R were assessed independently by at least 2 experienced advanced-trained clinicians.</div></div><div><h3>Results</h3><div>The majority of infants' GMs were classified as normal (66.8%) or poor repertoire (33.2%), with one infant's movements classified as cramped synchronized (0.1%). The median GMOS-R score was 33 (interquartile range 27-36). The GMOS-R differentiated GMA classifications. Lower gestational age, any nursery admission, minority ethnicity, and older age at video collection were each associated with a small but statistically significant reduction in GMOS-R scores. GMA classification had excellent inter-rater reliability and agreement. Total GMOS-R had excellent inter-rater reliability and moderate agreement.</div></div><div><h3>Conclusions</h3><div>Although most infants had normal GMs there was a high prevalence of poor repertoire GMs in the general population. GMOS-R scores effectively differentiated movement quality within the poor repertoire classification. This study provides population-based percentile ranks for interpreting individual post-term GM assessments and as a reference for future research.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"291 ","pages":"Article 114962"},"PeriodicalIF":3.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795327","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}
引用次数: 0
Prediction of Language Development in Neonates Born at Less than 32 Weeks of Gestation 妊娠32周以下新生儿语言发育的预测。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-17 DOI: 10.1016/j.jpeds.2025.114959
Nadine Pointner MSc , Daniel Savran MD , Johannes Mader MSc , Philipp Steinbauer MD , Angelika Berger MD , Renate Fuiko PhD , David Steyrl PhD , Vito Giordano PhD

Objective

To evaluate neonatal risk factors and the predictive value of prior assessments for language development at age 3 in toddlers born before 32 weeks of gestation.

Study design

Data were acquired retrospectively from infants’ hospitalizations (level 3 perinatal center, Medical University of Vienna) and annual assessments (Bayley Scales of Infant and Toddler Development). We included children born in 2012-2020 at < 32 weeks of gestation, with annual follow-ups, at least one German-speaking parent, and unimpaired hearing. Predictors of 3-year language development were analyzed using Gradient Boost Decision Trees and interpreted through SHapely Additive exPlanations (SHAP) values.

Results

The cohort comprised 476 children (202 [42.4%] females; mean [standard deviation] gestational age, 27.4 [2.0] weeks). Risk factors were multilingualism (mean|SHAP| = 3.93, P ≤ .001), lower maternal education (mean|SHAP| = 2.51, P ≤ .001), reduced birth weight (mean|SHAP| = 1.92, P = .003), shorter gestational age (mean|SHAP| = 1.64, P = .009), grade of intraventricular hemorrhage in the left hemisphere (mean|SHAP| = 1.07, P = .005), severe intraventricular hemorrhage (mean|SHAP| = 0.80, P = .011, surgical necrotizing enterocolitis (mean|SHAP| = 0.80, P = .018), and surgical retinopathy of prematurity (mean|SHAP| = 0.59, P = .045).

Conclusions

The identification of SHAP values allowed us to evaluate the additive effect of neonatal and sociodemographic risk factors predicting language impairments in this cohort of children born preterm. Replication in other cohorts will be important, but SHAP-based analyses may be useful for tailored monitoring and implementation of early language support.
目的:评价孕前32周出生的3岁幼儿的新生儿危险因素及语言发育预估的预测价值。研究设计:回顾性数据来自婴儿住院(维也纳医科大学3级围产期中心)和年度评估(Bayley婴幼儿发育量表)。我们纳入了2012-2020年出生的儿童,结果:该队列包括476名儿童(202名[42.4%]女性;平均[SD]胎龄,27.4[2.0]周)。危险因素为多语(平均|SHAP| = 3.93, P≤0.001)、母亲受教育程度较低(平均|SHAP| = 2.51, P≤0.001)、出生体重降低(平均|SHAP| = 1.92, P = 0.003)、胎龄较短(平均|SHAP| = 1.64, P = 0.009)、左半球脑室内出血(平均|SHAP| = 1.07, P = 0.005)、重度IVH(平均|SHAP| = 0.80, P = 0.011)、外科坏血性小肠结肠炎(平均|SHAP| = 0.80, P = 0.009)、新生儿脑室内出血(平均|SHAP| = 0.80, P = 0.009)。P = 0.018)和手术性早产儿视网膜病变(ROP)(平均| = 0.59,P = 0.045)。结论:SHAP值的确定使我们能够评估新生儿和社会经济风险因素预测早产儿童语言障碍的叠加效应。在其他队列中的复制也很重要,但SHAP分析可能对量身定制的监测和早期语言支持的实施有用。
{"title":"Prediction of Language Development in Neonates Born at Less than 32 Weeks of Gestation","authors":"Nadine Pointner MSc ,&nbsp;Daniel Savran MD ,&nbsp;Johannes Mader MSc ,&nbsp;Philipp Steinbauer MD ,&nbsp;Angelika Berger MD ,&nbsp;Renate Fuiko PhD ,&nbsp;David Steyrl PhD ,&nbsp;Vito Giordano PhD","doi":"10.1016/j.jpeds.2025.114959","DOIUrl":"10.1016/j.jpeds.2025.114959","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate neonatal risk factors and the predictive value of prior assessments for language development at age 3 in toddlers born before 32 weeks of gestation.</div></div><div><h3>Study design</h3><div>Data were acquired retrospectively from infants’ hospitalizations (level 3 perinatal center, Medical University of Vienna) and annual assessments (Bayley Scales of Infant and Toddler Development). We included children born in 2012-2020 at &lt; 32 weeks of gestation, with annual follow-ups, at least one German-speaking parent, and unimpaired hearing. Predictors of 3-year language development were analyzed using Gradient Boost Decision Trees and interpreted through SHapely Additive exPlanations (SHAP) values.</div></div><div><h3>Results</h3><div>The cohort comprised 476 children (202 [42.4%] females; mean [standard deviation] gestational age, 27.4 [2.0] weeks). Risk factors were multilingualism (mean|SHAP| = 3.93, <em>P</em> ≤ .001), lower maternal education (mean|SHAP| = 2.51, <em>P</em> ≤ .001), reduced birth weight (mean|SHAP| = 1.92, <em>P</em> = .003), shorter gestational age (mean|SHAP| = 1.64, <em>P</em> = .009), grade of intraventricular hemorrhage in the left hemisphere (mean|SHAP| = 1.07, <em>P</em> = .005), severe intraventricular hemorrhage (mean|SHAP| = 0.80, <em>P</em> = .011, surgical necrotizing enterocolitis (mean|SHAP| = 0.80, <em>P</em> = .018), and surgical retinopathy of prematurity (mean|SHAP| = 0.59, <em>P</em> = .045).</div></div><div><h3>Conclusions</h3><div>The identification of SHAP values allowed us to evaluate the additive effect of neonatal and sociodemographic risk factors predicting language impairments in this cohort of children born preterm. Replication in other cohorts will be important, but SHAP-based analyses may be useful for tailored monitoring and implementation of early language support.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"290 ","pages":"Article 114959"},"PeriodicalIF":3.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795340","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}
引用次数: 0
The International Pediatric Stroke Study: Insight into Childhood Stroke from a Developmental Perspective. 国际儿童中风研究:从发展的角度观察儿童中风。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-16 DOI: 10.1016/j.jpeds.2025.114945
Michael J Rivkin, Alexandra Linds, Mahmoud Slim, Ann-Marie Surmava, Lauren A Beslow, Michael M Dowling, Mark Mackay, Adam Kirton, Lori C Jordan, Christine K Fox, Ryan Felling, Nomazulu Dlamini, Tim Bernard, Catherine Amlie-Lefond, Gabrielle deVeber

Objective: To determine if children enrolled in the International Pediatric Stroke Study (IPSS) database (4,294 patients enrolled, 2003-2014, neonates through 18 years of age) demonstrate demographic, clinical, radiographic, and therapeutic characteristics that relate to age and development at the time of stroke .

Study design: Participants with arterial ischemic stroke or cerebral sinus venous thrombosis were enrolled using standardized consent and case report forms. Data were entered on-site and electronically transferred to a central data storage site in Toronto, Canada. Children were stratified into 4 age groups for analysis of developmental features: neonates (0-28 days of age); infants (29 days to <2 years of age); young children (2 years to <10 years old), and adolescents (> 10 years to <18 years old). Continuous and categorical variables were examined using appropriate statistical techniques in SAS.

Results: 3,809 children were analyzed: 1,112 (29.2%) neonates, 728 (19.1%) infants, 1,088 (28.6%) young children, and 881 (23.1%) adolescents. Arterial ischemic stroke alone occurred in 3,201 (916 neonates; 2,285 older children) and cerebral sinovenous thrombosis alone occurred in 608 (196 neonates; 412 older children). Age group specific clinical and neuroimaging features that segregate by ischemic stroke type were identified and are reported.

Conclusions: The IPSS database comprises the a very large, structured pediatric stroke database used by investigators to advance the understanding and treatment of pediatric stroke. Developmentally based analyses of IPSS data reveal features of childhood stroke that segregate by ischemic stroke type and age at stroke occurrence. These features should aid in understanding age-related pathophysiology and in clinical stroke recognition.

目的:确定纳入国际儿童卒中研究(IPSS)数据库的儿童(2003-2014年,4294例入组患者,新生儿至18岁)是否表现出与卒中时年龄和发育相关的人口统计学、临床、放射学和治疗特征。研究设计:采用标准化同意书和病例报告表纳入动脉缺血性卒中或脑窦静脉血栓形成的参与者。数据在现场输入,并以电子方式转移到加拿大多伦多的一个中央数据存储站点。将儿童分为4个年龄组进行发育特征分析:新生儿(0-28天);结果:共分析了3,809名儿童:新生儿1,112名(29.2%),婴儿728名(19.1%),幼儿1,088名(28.6%),青少年881名(23.1%)。单独发生动脉缺血性卒中3201例(新生儿916例,大龄儿童2285例),单独发生脑静脉血栓608例(新生儿196例,大龄儿童412例)。确定并报道了缺血性脑卒中类型的年龄组特异性临床和神经影像学特征。结论:IPSS数据库包括一个非常大的,结构化的儿童卒中数据库,研究者使用它来促进对儿童卒中的理解和治疗。基于IPSS数据的发育分析揭示了儿童中风的特征,这些特征是由缺血性中风类型和中风发生年龄分开的。这些特征有助于理解与年龄相关的病理生理学和临床卒中识别。
{"title":"The International Pediatric Stroke Study: Insight into Childhood Stroke from a Developmental Perspective.","authors":"Michael J Rivkin, Alexandra Linds, Mahmoud Slim, Ann-Marie Surmava, Lauren A Beslow, Michael M Dowling, Mark Mackay, Adam Kirton, Lori C Jordan, Christine K Fox, Ryan Felling, Nomazulu Dlamini, Tim Bernard, Catherine Amlie-Lefond, Gabrielle deVeber","doi":"10.1016/j.jpeds.2025.114945","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114945","url":null,"abstract":"<p><strong>Objective: </strong>To determine if children enrolled in the International Pediatric Stroke Study (IPSS) database (4,294 patients enrolled, 2003-2014, neonates through 18 years of age) demonstrate demographic, clinical, radiographic, and therapeutic characteristics that relate to age and development at the time of stroke .</p><p><strong>Study design: </strong>Participants with arterial ischemic stroke or cerebral sinus venous thrombosis were enrolled using standardized consent and case report forms. Data were entered on-site and electronically transferred to a central data storage site in Toronto, Canada. Children were stratified into 4 age groups for analysis of developmental features: neonates (0-28 days of age); infants (29 days to <2 years of age); young children (2 years to <10 years old), and adolescents (> 10 years to <18 years old). Continuous and categorical variables were examined using appropriate statistical techniques in SAS.</p><p><strong>Results: </strong>3,809 children were analyzed: 1,112 (29.2%) neonates, 728 (19.1%) infants, 1,088 (28.6%) young children, and 881 (23.1%) adolescents. Arterial ischemic stroke alone occurred in 3,201 (916 neonates; 2,285 older children) and cerebral sinovenous thrombosis alone occurred in 608 (196 neonates; 412 older children). Age group specific clinical and neuroimaging features that segregate by ischemic stroke type were identified and are reported.</p><p><strong>Conclusions: </strong>The IPSS database comprises the a very large, structured pediatric stroke database used by investigators to advance the understanding and treatment of pediatric stroke. Developmentally based analyses of IPSS data reveal features of childhood stroke that segregate by ischemic stroke type and age at stroke occurrence. These features should aid in understanding age-related pathophysiology and in clinical stroke recognition.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114945"},"PeriodicalIF":3.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783823","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}
引用次数: 0
The Association Between Neighborhood Factors and Early Organ Dysfunction in Children Who Are Critically Ill: A Retrospective Cohort Study 危重儿童邻居因素与早期器官功能障碍的关系:一项回顾性队列研究。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-15 DOI: 10.1016/j.jpeds.2025.114943
Paula M. Magee MD, MPH , Erin Paquette MD, JD, MBe , Latasha A. Daniels MA, MSW , L. Nelson Sanchez-Pinto MD, MBI, FAMIA , Nadir Yehya MD, MSCE

Objective

To explore potential associations between neighborhood-level factors and early organ dysfunction in children who are critically ill.

Study design

This retrospective, ecological cohort study assessed the association between neighborhood factors and early organ dysfunction in 8289 encounters for children who were critically ill from January 2013 to December 2019 at a quaternary pediatric hospital in an urban setting. The exposures were neighborhood factors, which were measured using 3 composite indices: Child Opportunity Index (COI), Social Vulnerability Index (SVI), and Neighborhood Disorder Index (NDI). Peak Pediatric Logistic Organ Dysfunction [PELOD]-2 scores in the first 72 hours measured early organ dysfunction as the primary outcome. An adjusted Poisson regression with robust modeling was used to measure the association.

Results

Most encounters were for patients from very low opportunity (28%), very high vulnerability (29%), and very high physical disorder neighborhoods (27%). Median peak PELOD-2 score was 3 (interquartile range 2-5). No association was identified for COI or NDI with peak PELOD-2 scores; however, there was an association between a very high SVI and greater peak PELOD-2 scores (P = .004).

Conclusions

No association was found among COI or NDI with worse early organ dysfunction. Very high SVI was associated with worse early organ dysfunction. Further studies should assess whether specific aspects of neighborhoods drive critical illness in organ-specific diseases.
目的:探讨危重儿童早期脏器功能障碍与邻里因素的关系。研究设计:这项回顾性生态学队列研究评估了2013年1月至2019年12月在城市第四儿科医院就诊的8,289例危重儿童的社区因素与早期器官功能障碍之间的关系。暴露是邻里因素,采用儿童机会指数(COI)、社会脆弱性指数(SVI)和邻里障碍指数(NDI)三个综合指数来衡量。前72小时的峰值儿童后勤器官功能障碍[PELOD]-2评分衡量早期器官功能障碍作为主要结局。采用校正泊松回归与稳健建模来衡量相关性。结果:大多数遭遇的患者来自非常低的机会(28%),非常高的脆弱性(29%)和非常高的身体障碍社区(27%)。PELOD-2中位峰评分为3分(IQR 2-5)。未发现COI或NDI与PELOD-2评分峰值相关;然而,非常高的SVI与较高的PELOD-2评分之间存在关联(p=0.004)。结论:COI或NDI与早期较高的器官功能障碍无关联。非常高的SVI与较高的早期器官功能障碍相关。进一步的研究应该评估社区的特定方面是否驱动器官特异性疾病的危重疾病。
{"title":"The Association Between Neighborhood Factors and Early Organ Dysfunction in Children Who Are Critically Ill: A Retrospective Cohort Study","authors":"Paula M. Magee MD, MPH ,&nbsp;Erin Paquette MD, JD, MBe ,&nbsp;Latasha A. Daniels MA, MSW ,&nbsp;L. Nelson Sanchez-Pinto MD, MBI, FAMIA ,&nbsp;Nadir Yehya MD, MSCE","doi":"10.1016/j.jpeds.2025.114943","DOIUrl":"10.1016/j.jpeds.2025.114943","url":null,"abstract":"<div><h3>Objective</h3><div>To explore potential associations between neighborhood-level factors and early organ dysfunction in children who are critically ill.</div></div><div><h3>Study design</h3><div>This retrospective, ecological cohort study assessed the association between neighborhood factors and early organ dysfunction in 8289 encounters for children who were critically ill from January 2013 to December 2019 at a quaternary pediatric hospital in an urban setting. The exposures were neighborhood factors, which were measured using 3 composite indices: Child Opportunity Index (COI), Social Vulnerability Index (SVI), and Neighborhood Disorder Index (NDI). Peak Pediatric Logistic Organ Dysfunction [PELOD]-2 scores in the first 72 hours measured early organ dysfunction as the primary outcome. An adjusted Poisson regression with robust modeling was used to measure the association.</div></div><div><h3>Results</h3><div>Most encounters were for patients from very low opportunity (28%), very high vulnerability (29%), and very high physical disorder neighborhoods (27%). Median peak PELOD-2 score was 3 (interquartile range 2-5). No association was identified for COI or NDI with peak PELOD-2 scores; however, there was an association between a very high SVI and greater peak PELOD-2 scores (<em>P</em> = .004).</div></div><div><h3>Conclusions</h3><div>No association was found among COI or NDI with worse early organ dysfunction. Very high SVI was associated with worse early organ dysfunction. Further studies should assess whether specific aspects of neighborhoods drive critical illness in organ-specific diseases.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"290 ","pages":"Article 114943"},"PeriodicalIF":3.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776758","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}
引用次数: 0
Effect of Systemic Hydrocortisone in Ventilated Infants Born Preterm: Mortality and 5.5-Year Neurodevelopmental Outcomes of a Randomized Clinical Trial 全身性氢化可的松对通气早产儿的影响:一项随机临床试验的死亡率和5.5岁神经发育结局。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-13 DOI: 10.1016/j.jpeds.2025.114954
Tessa de Baat MD , Moniek van de Loo MD , Cornelieke S.H. Aarnoudse-Moens PhD , Nienke M. Halbmeijer MD, PhD , Wes Onland MD, PhD , Anton H. van Kaam MD, PhD , Corine Koopman MD, PhD , Renate M.C. Swarte MD, PhD , Susanne M. Mulder-de Tollenaer MD, PhD , Margriet van Stuijvenberg MD, PhD , Ratna N.G.B. Tan MD , Ellen de Kort MD, PhD , Els Bruneel MD, PhD , Filip Cools MD, PhD , Katerina Steiner MD , Anne Debeer MD, PhD , Karen Van Mechelen MD , Henry Blom MD , Yoann Maréchal MD, PhD , Katleen Plaskie MD , E. Cavatorta MD

Objective

To examine neurodevelopmental outcomes at 5.5 years of corrected age in children included in the Systemic hydrocortisone (HC) To Prevent Bronchopulmonary Dysplasia in preterm infants (SToP-BPD) study, and to investigate the neurodevelopmental outcomes and mortality with HC treatment started between 7 and 14 days after birth compared with placebo in infants born preterm who required mechanical ventilation.

Study design

Data at 5.5 years of corrected age on cognitive, motor and neurosensory functioning, behavior, schooling, and general health outcomes were derived from regular follow-up visits. The primary outcome was death or moderate-severe neurodevelopmental impairment (NDI, complete case analysis), with NDI defined as a disability in at least 1 of the domains of cognition, motor development, vision, or hearing. Other outcomes included neurologic and behavioral assessments as well as parent reports of service use and school function.

Results

NDI was assessed in 213 of the 277 (77%) surviving children. Children attending follow-up were more likely to have highly educated or nonsmoking parents and had better neurodevelopmental outcomes at 2 years of corrected age than nonattending children. Baseline characteristics of assessed children were comparable between treatment arms. No significant difference was found on the primary outcome (OR 0.75; 95% CI 0.49-1.14; P = .18). All developmental outcomes were comparable between the HC and placebo group.

Conclusions

Treatment with HC started between 7 and 14 days after birth in infants born preterm at risk of BPD did not affect death or moderate-severe NDI nor any of the separate developmental outcome measures at 5.5 years of corrected age.

Trial registration

2010-023777-19; https://www.clinicaltrialsregister.eu
目的:研究在系统性氢化可的松(HC)预防早产儿支气管肺发育不良(SToP-BPD)研究中纳入的5.5岁矫正年龄(CA)儿童的神经发育结局,并调查在出生后7-14天开始使用HC治疗的早产儿与需要机械通气的安慰剂相比的神经发育结局和死亡率。研究设计:5.5岁时的认知、运动和神经感觉功能、行为、学校教育和一般健康结果的数据来自定期随访。主要结局为死亡或中重度神经发育障碍(NDI,完整病例分析),NDI定义为认知、运动发育、视觉或听力领域中至少一个领域的残疾。其他结果包括神经系统和行为评估,以及家长对服务利用和学校功能的报告。结果:277例存活儿童中有213例(77%)进行了NDI评估。参加随访的儿童更有可能有受过高等教育或不吸烟的父母,并且在两年的CA时比没有参加随访的儿童有更好的神经发育结果。被评估儿童的基线特征在治疗组之间具有可比性。在主要结局上没有发现显著差异(OR 0.75 [95% CI, 0.49-1.14]; P=0.18)。所有发育结果在HC组和安慰剂组之间具有可比性。结论:对于有BPD风险的早产婴儿,在出生后7-14天开始HC治疗不会影响死亡或中重度NDI,也不会影响5.5岁时的任何单独发育结局指标。
{"title":"Effect of Systemic Hydrocortisone in Ventilated Infants Born Preterm: Mortality and 5.5-Year Neurodevelopmental Outcomes of a Randomized Clinical Trial","authors":"Tessa de Baat MD ,&nbsp;Moniek van de Loo MD ,&nbsp;Cornelieke S.H. Aarnoudse-Moens PhD ,&nbsp;Nienke M. Halbmeijer MD, PhD ,&nbsp;Wes Onland MD, PhD ,&nbsp;Anton H. van Kaam MD, PhD ,&nbsp;Corine Koopman MD, PhD ,&nbsp;Renate M.C. Swarte MD, PhD ,&nbsp;Susanne M. Mulder-de Tollenaer MD, PhD ,&nbsp;Margriet van Stuijvenberg MD, PhD ,&nbsp;Ratna N.G.B. Tan MD ,&nbsp;Ellen de Kort MD, PhD ,&nbsp;Els Bruneel MD, PhD ,&nbsp;Filip Cools MD, PhD ,&nbsp;Katerina Steiner MD ,&nbsp;Anne Debeer MD, PhD ,&nbsp;Karen Van Mechelen MD ,&nbsp;Henry Blom MD ,&nbsp;Yoann Maréchal MD, PhD ,&nbsp;Katleen Plaskie MD ,&nbsp;E. Cavatorta MD","doi":"10.1016/j.jpeds.2025.114954","DOIUrl":"10.1016/j.jpeds.2025.114954","url":null,"abstract":"<div><h3>Objective</h3><div>To examine neurodevelopmental outcomes at 5.5 years of corrected age in children included in the Systemic hydrocortisone (HC) To Prevent Bronchopulmonary Dysplasia in preterm infants (SToP-BPD) study, and to investigate the neurodevelopmental outcomes and mortality with HC treatment started between 7 and 14 days after birth compared with placebo in infants born preterm who required mechanical ventilation.</div></div><div><h3>Study design</h3><div>Data at 5.5 years of corrected age on cognitive, motor and neurosensory functioning, behavior, schooling, and general health outcomes were derived from regular follow-up visits. The primary outcome was death or moderate-severe neurodevelopmental impairment (NDI, complete case analysis), with NDI defined as a disability in at least 1 of the domains of cognition, motor development, vision, or hearing. Other outcomes included neurologic and behavioral assessments as well as parent reports of service use and school function.</div></div><div><h3>Results</h3><div>NDI was assessed in 213 of the 277 (77%) surviving children. Children attending follow-up were more likely to have highly educated or nonsmoking parents and had better neurodevelopmental outcomes at 2 years of corrected age than nonattending children. Baseline characteristics of assessed children were comparable between treatment arms. No significant difference was found on the primary outcome (OR 0.75; 95% CI 0.49-1.14; <em>P</em> = .18). All developmental outcomes were comparable between the HC and placebo group.</div></div><div><h3>Conclusions</h3><div>Treatment with HC started between 7 and 14 days after birth in infants born preterm at risk of BPD did not affect death or moderate-severe NDI nor any of the separate developmental outcome measures at 5.5 years of corrected age.</div></div><div><h3>Trial registration</h3><div>2010-023777-19; <span><span>https://www.clinicaltrialsregister.eu</span><svg><path></path></svg></span></div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"290 ","pages":"Article 114954"},"PeriodicalIF":3.5,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758313","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}
引用次数: 0
The Impact of Prematurity on Self-Reported Quality of Life in Adulthood: A Prospective Swedish National Cohort Study of Infants Born with Extremely Low Birth Weight 早产对成年后自我报告的生活质量的影响:一项前瞻性瑞典国家极低出生体重婴儿队列研究。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-13 DOI: 10.1016/j.jpeds.2025.114956
Maria Heyman MD , Helena Grönqvist MSc, PhD , Lena Hellström-Westas MD, PhD , Fredrik Serenius MD, PhD , Ourania Vasileiadou MD , Fredrik Ahlsson MD, PhD , Ylva Fredriksson Kaul MSc, PhD , Barbro Diderholm MD, PhD

Objective

To investigate the physical and mental health of a national cohort of Swedish adults born with extremely low birth weight (ELBW, ≤1000 g) and its impact on self-reported health-related quality of life (HRQoL).

Study design

This prospective, follow-up study was conducted on a Swedish national cohort of individuals born between 1990 and 1992 with a birth weight of ≤1000 g (n = 201), along with a matched control group (n = 327) born appropriate for gestational age at term. All participants were between 26 and 29 years old at the time of the study. Data were collected through web-based questionnaires assessing physical and mental health, including the 36-item Short Form Health Survey version 2 to evaluate HRQoL. In addition, registered diagnoses were obtained from the Swedish National Board of Health and Welfare. Multivariable linear regressions were performed to investigate factors associated with HRQoL.

Results

Compared with the control group, adult individuals born ELBW had a significantly higher prevalence of physical morbidities. In terms of mental health, developmental and psychiatric conditions were also more prevalent, with the exception of mood disorders. However, there were no significant differences in self-reported HRQoL between ELBW and the control group.

Conclusions

Despite a higher prevalence of impairments, ELBW individuals may not perceive themselves as limited in their daily functioning.
目的:探讨瑞典一组极低出生体重(ELBW≤1000 g)成人的身心健康状况及其对自我报告的健康相关生活质量(HRQoL)的影响。研究设计:这项前瞻性的随访研究是在瑞典国家队列中进行的,这些个体出生在1990年至1992年之间,出生体重≤1000g (N=201),以及一个匹配的对照组(N=327),他们出生时足月胎龄合适。所有参与者在研究时的年龄都在26到29岁之间。通过基于网络的身心健康评估问卷收集数据,包括36项健康问卷第2版(SF-36v2)来评估HRQoL。此外,还从瑞典国家卫生和福利委员会获得了登记的诊断结果。采用多变量线性回归研究与HRQoL相关的因素。结果:与对照组相比,出生低体重的成年个体躯体疾病患病率显著增高。在心理健康方面,除了情绪障碍外,发育和精神状况也更为普遍。然而,在自我报告的HRQoL在ELBW组和对照组之间没有显著差异。结论:尽管损伤的患病率较高,但低脑损伤患者可能并不认为自己在日常功能上受到限制。
{"title":"The Impact of Prematurity on Self-Reported Quality of Life in Adulthood: A Prospective Swedish National Cohort Study of Infants Born with Extremely Low Birth Weight","authors":"Maria Heyman MD ,&nbsp;Helena Grönqvist MSc, PhD ,&nbsp;Lena Hellström-Westas MD, PhD ,&nbsp;Fredrik Serenius MD, PhD ,&nbsp;Ourania Vasileiadou MD ,&nbsp;Fredrik Ahlsson MD, PhD ,&nbsp;Ylva Fredriksson Kaul MSc, PhD ,&nbsp;Barbro Diderholm MD, PhD","doi":"10.1016/j.jpeds.2025.114956","DOIUrl":"10.1016/j.jpeds.2025.114956","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the physical and mental health of a national cohort of Swedish adults born with extremely low birth weight (ELBW, ≤1000 g) and its impact on self-reported health-related quality of life (HRQoL).</div></div><div><h3>Study design</h3><div>This prospective, follow-up study was conducted on a Swedish national cohort of individuals born between 1990 and 1992 with a birth weight of ≤1000 g (n = 201), along with a matched control group (n = 327) born appropriate for gestational age at term. All participants were between 26 and 29 years old at the time of the study. Data were collected through web-based questionnaires assessing physical and mental health, including the 36-item Short Form Health Survey version 2 to evaluate HRQoL. In addition, registered diagnoses were obtained from the Swedish National Board of Health and Welfare. Multivariable linear regressions were performed to investigate factors associated with HRQoL.</div></div><div><h3>Results</h3><div>Compared with the control group, adult individuals born ELBW had a significantly higher prevalence of physical morbidities. In terms of mental health, developmental and psychiatric conditions were also more prevalent, with the exception of mood disorders. However, there were no significant differences in self-reported HRQoL between ELBW and the control group.</div></div><div><h3>Conclusions</h3><div>Despite a higher prevalence of impairments, ELBW individuals may not perceive themselves as limited in their daily functioning.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"290 ","pages":"Article 114956"},"PeriodicalIF":3.5,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758335","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}
引用次数: 0
Application of the Target Trial Emulation Framework to Studies in the Pediatric Population 目标试验模拟框架在儿科人群研究中的应用。
IF 3.5 2区 医学 Q1 PEDIATRICS Pub Date : 2025-12-13 DOI: 10.1016/j.jpeds.2025.114941
Jenny W. Sun PhD , Daniel B. Horton MD, MSCE , Timothy J. Savage MD, MPH, MSc , Mehmet Burcu PhD , Sonia Hernandez-Diaz MD, DrPH
{"title":"Application of the Target Trial Emulation Framework to Studies in the Pediatric Population","authors":"Jenny W. Sun PhD ,&nbsp;Daniel B. Horton MD, MSCE ,&nbsp;Timothy J. Savage MD, MPH, MSc ,&nbsp;Mehmet Burcu PhD ,&nbsp;Sonia Hernandez-Diaz MD, DrPH","doi":"10.1016/j.jpeds.2025.114941","DOIUrl":"10.1016/j.jpeds.2025.114941","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"291 ","pages":"Article 114941"},"PeriodicalIF":3.5,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758328","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}
引用次数: 0
期刊
Journal of Pediatrics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1