Pediatrics and Neonatology最新文献

英文中文

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-10-10 DOI: 10.1016/j.pedneo.2025.09.001

Shau-Ru Ho , Hsin-Chung Huang , Po-Nien Tsao

引用次数: 0

Vitamin D status and the adequacy of its supplementation during the first year of life in preterm infants in northern Japan 日本北部早产儿第一年的维生素D状况及其补充是否充足。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-05-08 DOI: 10.1016/j.pedneo.2025.03.003

Fumikatsu Nohara , Toshio Okamoto , Kenta Takahashi , Tatsutoshi Sugiyama , Aiko Hashimoto , Mitsumaro Nii , Yukari Yamaki , Etsushi Tsuchida , Takashi Satou , Masaru Shirai , Ken Nagaya , Satoru Takahashi

Background

Vitamin D (VD) deficiency (VDD) is a major concern in preterm infants. The prevalence of VDD in mothers and infants varies between countries and is affected by a range of factors, such as geography and lifestyle. Thus, strategies aimed at preventing VDD must consider the status of each region. However, few reports have explored VDD in preterm infants in Japan and the safety and efficacy of VD supplementation in addressing VDD remain unclear.

Methods

This study was conducted between September 2019 and October 2022. The participants were 108 preterm infants who were divided into three groups based on their gestational age: <28 weeks (Group 1), 28–33 weeks (Group 2), and 34–36 weeks (Group 3). VD status at birth was assessed, and 25-hydroxyvitamin D (25OHD) levels and biochemical markers were monitored during supplementation with 400 IU/day of VD over the first year of life.

Results

Levels of 25OHD at birth were 10.0 (10.0–16.1), 10.5 (10.0–18.0), and 13.0 (10.0–19.0) nmol/L in Groups 1, 2, and 3, respectively. Infants in all three groups exhibited marked VDD. Their 25OHD levels gradually increased with VD supplementation before plateauing at 6 months. Nevertheless, VDD persisted in the majority of infants at 1 month of age. Serum intact parathyroid hormone levels peaked at 1 month of age and declined thereafter, negatively correlating with 25OHD levels. None of the infants exhibited symptoms of VD toxicity.

Conclusion

Preterm infants in northern Japan exhibited substantial VDD, regardless of gestational age. In our cohort, VD supplementation at 400 IU/day safely increased 25OHD levels. However, VD levels improved gradually over the months, and several of these infants developed secondary hyperparathyroidism. Further studies are warranted to determine the optimal VD supplementation dose for preterm infants in this region.

背景：维生素D （VD）缺乏症（VDD）是早产儿的一个主要问题。母亲和婴儿的VDD患病率因国家而异，并受到地理和生活方式等一系列因素的影响。因此，旨在预防VDD的战略必须考虑到每个区域的状况。然而，关于日本早产儿VDD的报道很少，补充VD治疗VDD的安全性和有效性仍不清楚。方法：本研究于2019年9月至2022年10月进行。参与者是108名早产儿，根据胎龄分为三组：结果：1、2和3组出生时25OHD水平分别为10.0（10.0-16.1）、10.5（10.0-18.0）和13.0 (10.0-19.0)nmol/L。三组婴儿均表现出明显的VDD。他们的25OHD水平随着VD的补充逐渐升高，在6个月时达到稳定。然而，大多数婴儿在1月龄时仍存在VDD。血清完整甲状旁腺激素水平在1月龄时达到峰值，随后下降，与25OHD水平呈负相关。没有婴儿表现出VD毒性症状。结论：无论胎龄大小，日本北部的早产儿都表现出大量的VDD。在我们的队列中，补充400 IU/天的VD可以安全地增加25OHD水平。然而，VD水平在几个月内逐渐改善，其中一些婴儿发展为继发性甲状旁腺功能亢进。需要进一步的研究来确定该地区早产儿的最佳VD补充剂量。

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引用次数: 0

Motor skills as early indicators for cognitive development in preterm infants with very low birth weight 运动技能是极低出生体重早产儿认知发展的早期指标。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-03-10 DOI: 10.1016/j.pedneo.2025.01.010

Yen Ting Chen , Sot-Fu Lei , Chia-Hua Tang , Hsiu-Man Lin , Yueh-Tang Weng , Chen-Yu Yeh , Kai-Cheng Hsu , Ya-Lun Wu , Huang-Tsung Kuo

Background

Preterm babies born with very low birth weight (VLBW, birth weight <1500 g) have inferior long-term neurodevelopmental outcomes to term babies. This study aimed to identify early predictive neurodevelopmental factors for future cognitive outcomes that could serve as indicators for early intervention strategies.

Methods

This longitudinal cohort study enrolled 146 VLBW preterm infants, identified between 2011 and 2020. Each child underwent four neurodevelopmental assessments (at ages 6,12, 24, and 60 months) using the Bayley-III and Wechsler Preschool and Primary Scale of Intelligence-IV examinations. Correlation and linear regression analyses were performed to determine the correlation between early neurodevelopmental status and late cognitive outcomes. We concurrently considered neonatal medical complications and socioeconomic variables as risk factors to develop a prediction model of cognitive outcomes at five years old.

Results

A total of 146 VLBW children, born with a mean weight of 1090.4 ± 229.6 g and a mean gestational age of 28.2 ± 2.0 weeks, were evaluated. At 6 months of age, motor outcome was the only factor that exhibited a significant correlation with cognitive development at 5 years of age (p < 0.01, r = 0.242). The strength of the correlation between motor and cognitive function increased with age, reaching greater significance at 12 and 24 months (p < 0.001, r = 0.409 and 0.472, respectively). The linear regression model demonstrated that neonatal medical conditions and Bayley motor score at six months old predicted 26% of the variance in the Full-Scale Intelligence Quotient (FSIQ) at five years old.

Conclusion

The results of the present study show that motor function was the earliest and persistent predictor of FSIQ. This underscores the importance of prioritizing motor development in interventions as early as six months of age, which could substantially advance the timing of early intervention programs.

背景：出生体重极低的早产儿早产儿出生时体重极低（VLBW，出生体重方法）：这项纵向队列研究共招募了 146 名 VLBW 早产儿，这些婴儿是在 2011 年至 2020 年间确认的。每个孩子都接受了四次神经发育评估（6、12、24 和 60 个月大时），分别使用 Bayley-III 和 Wechsler Preschool and Primary Scale of Intelligence-IV 考试。我们进行了相关分析和线性回归分析，以确定早期神经发育状况与晚期认知结果之间的相关性。我们同时考虑了新生儿医疗并发症和社会经济变量等风险因素，从而建立了五岁时认知结果的预测模型：共评估了 146 名超低体重儿，他们出生时的平均体重为 1090.4 ± 229.6 克，平均胎龄为 28.2 ± 2.0 周。在 6 个月大时，运动结果是唯一与 5 岁时认知发展有显著相关性的因素（p 结论：在 6 个月大时，运动结果是唯一与 5 岁时认知发展有显著相关性的因素：本研究结果表明，运动功能是最早且持续预测 FSIQ 的因素。这凸显了早在 6 个月大时就在干预中优先考虑运动发育的重要性，这可大大提前早期干预计划的时间安排。

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引用次数: 0

Congenital neck mass – What approach? 先天性颈部肿块-什么方法？

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-08-05 DOI: 10.1016/j.pedneo.2023.12.015

Catarina Freitas , Liliana Teixeira , Ana Cristina Freitas , Luísa Neiva-Araújo

引用次数: 0

Non-invasive simple predictors of biliary atresia in cholestatic infants – A preliminary report 胆汁淤积症婴儿胆道闭锁的无创简单预测指标-初步报告。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-05-08 DOI: 10.1016/j.pedneo.2024.11.006

Yu-Hsueh Hsiao , Wei-Li Hung , Yao-Jong Yang , Fang-Ting Lu , Fang-Min Liao , Cheng-Yu Chen , Jia-Feng Wu

Background

Biliary atresia (BA) and other cholestatic liver diseases of early infancy share many similar clinical manifestations. We intended to investigate easy and popular non-invasive parameters to assist the differential diagnosis of BA among cholestatic infants.

Methods

We enrolled 145 consecutive cholestatic infants (43.03 ± 2.00 days) who underwent cholestatic workups at our hospital as the study cohort, and another 27 cholestatic infants (47.78 ± 13.33 days) who received their initial cholestatic workups and laboratory tests at four other 4 hospitals as the validation cohort. The clinical data were surveyed retrospectively using a cross-sectional design.

Results

We demonstrated that the “GGT∗D-bil” was significantly higher in the BA group than in the non-BA group in the study cohort (p < 0.001). The Receiver operating characteristic curve analysis of the study cohort identified the “GGT∗D-bil” cutoff >510 mg U/dL.L for the best prediction of BA among cholestatic infants (92 % area under the curve, p < 0.001). The sensitivity and negative predictive value (NPV) for predicting BA among cholestatic infants are 100 % in the study cohort. In the validation cohort, the “GGT∗D-bil” > 510 mg U/dL.L also achieved good sensitivity and NPV (92.31 % and 90.91 %, respectively) for the prediction of BA.

Conclusions

We demonstrated that an easy parameter, “GGT∗D-bil” > 510 mg U/dL.L, may be used as part of the non-invasive cholestatic workups to assist in the diagnosis of BA among cholestatic infants in our study and validation cohorts. The application of this parameter is easy and not limited by the resources of the hospitals.

背景：小儿早期胆汁闭锁（BA）与其他胆汁淤积性肝病具有许多相似的临床表现。我们打算研究简单和流行的非侵入性参数，以协助鉴别诊断胆汁淤积婴儿BA。方法：选取145例（43.03±2.00天）在我院连续接受胆汁淤积检查的患儿作为研究队列，另选取27例（47.78±13.33天）在其他4家医院接受首次胆汁淤积检查和实验室检查的患儿作为验证队列。采用横断面设计对临床资料进行回顾性调查。结果：我们证明了在研究队列中，BA组的“GGT∗D-bil”显著高于非BA组（p 510 mg U/dL）。L为预测胆汁淤积婴儿BA的最佳方法（曲线下面积92%，p 510 mg U/dL）。L预测BA的灵敏度和净现值（NPV）均较好（分别为92.31%和90.91%）。结论：我们证明了一个简单的参数，“GGT * D-bil”> 510 mg U/dL。L，在我们的研究和验证队列中，可作为无创胆汁淤积检查的一部分，以协助胆汁淤积婴儿BA的诊断。该参数的应用简单，不受医院资源的限制。

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引用次数: 0

Hepatic tumors in Iranian children: Characteristics and survival predictors 伊朗儿童肝脏肿瘤：特征和生存预测因素。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-04-10 DOI: 10.1016/j.pedneo.2024.10.014

Fateme Ziyaee , Seyed Mohsen Dehghani , Mehdi Forooghi , Ali Bahador , Hamidreza Foroutan , Hamed Nikoupour , Bita Geramizadeh , Mahmood Haghighat , Mohammad Hadi Imanieh , Naser Honar , Iraj Shahramian , Maryam Ataollahi , Narges Ansary , Mehdi Ghasemian , Mahsa Rouhafshari , Zahra Radaei , Maryam Moradian Shahrebabaki , Mohammad Salehi Khatouni

Background

Hepatic tumors are rare in children. This study was conducted to determine the characteristics of liver masses in children and identify the independent predictors of their survival.

Methods

Medical records of children aged <18 years with a confirmed diagnosis of hepatic tumor diagnosed between January 2008 and December 2023 at two referral centers affiliated to Shiraz University of Medical Sciences, southern Iran, were reviewed.

Results

There were 153 children with hepatic tumors. The median age of the patients was 2 (IQR, 1–5) years. Abdominal pain and distension, and presence of a palpable mass and fever were the most common signs and symptoms at presentation. The most common tumor was hepatoblastoma (64.5 %) followed by hepatocellular carcinoma (HCC, 9.9 %). Right hepatectomy and hepatic segmentectomy were the most common surgical approach used. Children with hepatoblastoma were significantly (p < 0.001) younger than those with HCC. The risk of hepatoblastoma in males was twice that in females. Jaundice was not common in those with hepatoblastoma but it was in HCC. About a quarter of patients died. After adjusting for covariates, abdominal pain (adj OR = 4.90) and distension (adj OR = 3.17), and a diagnosis of HCC (adj OR = 13.63) were independent predictors of a poor prognosis.

Conclusions

The characteristics of pediatric hepatic tumors in our study were similar to those reported in most studies. Abdominal pain and distension and presence of HCC or jaundice were independent predictors of a poor prognosis.

背景：肝脏肿瘤在儿童中很少见。本研究旨在确定儿童肝脏肿块的特征，并确定其生存的独立预测因素。方法：查阅老年儿童病历。结果：153例肝肿瘤患儿。患者中位年龄为2岁（IQR， 1-5岁）。腹痛和腹胀，可触及肿块和发热是最常见的症状和体征。最常见的肿瘤是肝母细胞瘤（64.5%），其次是肝细胞癌（HCC, 9.9%）。右肝切除术和肝节段切除术是最常用的手术入路。结论：本研究中儿童肝脏肿瘤的特征与大多数研究报道的特征相似。腹痛和腹胀以及存在HCC或黄疸是预后不良的独立预测因素。

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引用次数: 0

Automatic assessment of fine motor development in children through hand-drawn shape images 通过手绘形状图像自动评估儿童精细运动的发展。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-05-08 DOI: 10.1016/j.pedneo.2025.04.001

Nai-Hsuan Hwang , Sheng-Shan Chen , Tun-Wen Pai , Mary Hsin-Ju Ko , Ya-Lan Yu , Hui-Ju Chen

Background

Fine motor skills are closely related to neurological maturity among children and serve as critical indicators of developmental status. However, clinical assessments require significant human and material resources. This study proposes an automated evaluation mechanism designed to assess the development of children's fine motor skills, offering a streamlined and resource-efficient approach to developmental assessment.

Methods

The designed system evaluated the fine motor skills of 82 children aged 36–72 months. The children were asked to replicate five geometric shapes designed by the system: circles, crosses, squares, triangles, and rhombuses. The system automatically assessed 23 distinct features across the geometric shapes using an artificial intelligence-based model. A tailored scoring system then assigned a score that reflected the child's level of fine motor skill maturity.

Results

A total of 81 replicated drawings from the children in the test group were collected and automatically assessed using the assessment mechanism developed in this study. The results demonstrated a strong positive correlation between fine motor skill maturity and practical age. Additionally, the scores identified children with delayed fine motor development. The macro F1-score and accuracy of the automatic classification models for the five different geometric shapes in the validation dataset were 0.9236 and 0.9268, respectively. These evaluation outcomes can effectively support early intervention and treatment efforts.

Conclusion

The system's structured drawing tasks for varying geometric shapes have substantial practical value for the automatic assessment of children's fine motor maturity. The scoring method developed in this study provides a clear distinction between the different developmental stages of children's fine motor skills. This system offers an effective online tool for assessing fine motor development among children, thereby providing essential preliminary reference information for physicians in subsequent clinical evaluations and significantly reducing the burden on healthcare professionals.

背景：精细运动技能与儿童神经系统发育密切相关，是儿童发育状况的重要指标。然而，临床评估需要大量的人力和物力资源。本研究提出了一种评估儿童精细运动技能发展的自动化评估机制，为发展评估提供了一种精简和资源高效的方法。方法：采用设计的系统对82例36 ~ 72月龄儿童的精细运动技能进行评估。孩子们被要求复制系统设计的五种几何形状：圆形、十字形、正方形、三角形和菱形。该系统使用基于人工智能的模型自动评估几何形状中的23个不同特征。然后，一个量身定制的评分系统给出了一个反映孩子精细运动技能成熟程度的分数。结果：共收集了81张试验组儿童的重复图画，并采用本研究开发的评估机制进行了自动评估。结果表明，精细运动技能成熟度与实际年龄呈正相关。此外，分数确定了精细运动发育迟缓的儿童。验证数据集中5种不同几何形状的自动分类模型的宏观f1得分和准确率分别为0.9236和0.9268。这些评估结果可以有效地支持早期干预和治疗工作。结论：该系统对不同几何形状的结构化绘制任务对儿童精细运动成熟度的自动评估具有重要的实用价值。本研究开发的评分方法对儿童精细运动技能的不同发展阶段提供了清晰的区分。该系统为评估儿童精细运动发育提供了一个有效的在线工具，从而为医生在随后的临床评估中提供了必要的初步参考信息，并显著减轻了医疗保健专业人员的负担。

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引用次数: 0

Enhancing neonatal care through NAVA: A case study on optimizing respiratory support for a very low birth weight infant 通过NAVA加强新生儿护理：优化极低出生体重婴儿呼吸支持的案例研究。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-09-13 DOI: 10.1016/j.pedneo.2025.06.006

Daijiro Takahashi , Koko Goto , Kei Goto

引用次数: 0

Critical appraisal on neural tube defects and their complexities 神经管缺陷及其复杂性的批判性评价。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-04-17 DOI: 10.1016/j.pedneo.2024.07.015

Fouziya Shaikh , Mallica Sanadhya , Safa Kaleem , Tiya Verma , Richard L. Jayaraj , Faizan Ahmad

Neural tube defects (NTDs), as a group of diseases, are congenital disabilities due to incomplete closure of the neural tube along its length, which otherwise forms the fully developed brain and spinal cord. An amalgamation of genetic, nutritional, and environmental factors plays a role in causing NTDs. They develop relatively early, within the first month of pregnancy-the time of neurulation, which could indicate that the pathogenesis of these diseases could stem from even pre-pregnancy causes like folic acid deficiency. This article provides an overview of the various etiology of NTDs and how they interact, as well as various preventive and curative measures like folic acid and inositol supplementation, stem cell transplant, and postnatal surgery. Identifying potential risk factors can help clinicians develop better management techniques beyond the limited scope of the presently used prophylactic and treatment methods.

神经管缺损（神经管缺损）是由于神经管沿其长度不完全闭合而形成的先天性残疾，是一类疾病。遗传、营养和环境因素的综合作用在造成被忽视热带病方面发挥了作用。它们发展相对较早，在怀孕的第一个月，也就是神经发育的时间，这可能表明这些疾病的发病机制甚至可能源于怀孕前的原因，比如叶酸缺乏。本文概述了NTDs的各种病因及其相互作用，以及各种预防和治疗措施，如补充叶酸和肌醇，干细胞移植和产后手术。识别潜在的风险因素可以帮助临床医生开发更好的管理技术，超越目前使用的预防和治疗方法的有限范围。

引用次数: 0

Exploring stickler syndrome through a familial case: Beyond Robin sequence 通过家族病例探索stickler综合征：超越Robin序列。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-11-01 Epub Date: 2025-08-11 DOI: 10.1016/j.pedneo.2025.03.011

Hsin-Ru Wu , Fuu-Jen Tsai

引用次数: 0

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