The Journal of Pediatrics

This descriptive cohort study documented continuity between family-delivered skin-to-skin care rates for preterm infants in the NICU and amount of child-directed speech at child age 9 months. Involvement in skin-to-skin care may be an early marker of caregiver engagement and a target for early interventions that support positive caregiver-infant interactions.

ObjectiveTo examine differences in infant-directed talk activities (e.g., reading) before and after introduction of a NICU book cart. Study DesignWe retrospectively analyzed medical record data of infants born <32 weeks gestational age (n = 147) whose NICU stay occurred in the year before or after book cart implementation (6/1/2022). Talk rates and frequencies were calculated from clinically charted family and staff talk data; talk amounts were compared across pre- and post-book cart cohorts, a...

BackgroundChildren born very preterm (< 32 weeks gestational age), are at risk for poor growth and adverse neurodevelopmental outcomes. Poor outcomes in preterm children have been attributed to the aversive sounds and relative speech paucity of the neonatal intensive care unit (NICU). Experimental studies that directly expose preterm infants to speech sounds in the NICU find significant improvements in health factors relevant for neurodevelopment. Few studies have examined whether natural variat...

IMPORTANCEObesity increases the severe COVID-19 risk. Whether obesity is associated with an increased risk of post-acute sequelae of SARS-Cov-2 infection (PASC) among pediatrics, independent of its impacts on acute infection severity, is unclear. OBJECTIVETo quantify the association between body mass index (BMI) status before SARS-CoV-2 infection and pediatric PASC risk, controlling for acute infection severity. DESIGNRetrospective cohort study occurred from March 2020 to May 2023, with a mini...

ObjectivesTo investigate the impact of early life experiences and gut microbiota on neurobehavioral development among preterm infants during neonatal intensive care unit (NICU) hospitalization. MethodsPreterm infants were followed from the NICU admission until their 28th postnatal day or until discharge. Daily stool samples, painful/stressful experiences, feeding patterns, and other clinical and demographic data were collected. Gut microbiota was profiled using 16S rRNA sequencing, and operatio...

Preterm infants are at high risk for systemic inflammatory disorders, including sepsis, meningitis, bronchopulmonary dysplasia, and necrotizing enterocolitis (NEC). The developing brain of the premature newborn is especially susceptible to the cascade of inflammatory mediators elaborated in these conditions that cross the blood-brain barrier. NEC, a severe and potentially fatal condition of the gut that occurs in premature newborns, is a prime example of how an inflammatory reaction, perhaps ini...

BACKGROUNDThere is growing evidence that environmental enteric dysfunction (EED) is a driver of poor growth and neurodevelopment (ND) in early childhood. To further investigate this, we measured the associations between biomarkers reflecting various domains of EED and growth and ND in Guatemalan infants. METHODS. A subset of 114 cohort infants were randomly selected for inclusion from a 2017-2019 population-based cohort study of 499 young infants in rural southwest Guatemala. Growth and neurodev...

Objective(s)To determine the causal relationship between exposure to early hyperoxaemia and death/disability in infants with hypoxic-ischemic encephalopathy (HIE). Study designWe analyzed data from the Infant Cooling Evaluation (ICE) trial that enrolled newborns [&ge;]35 weeks gestation with moderate-severe HIE, randomly allocated to hypothermia or normothermia. The primary outcome was death or major sensorineural disability at 2 years. We included infants with arterial pO2 measured within 2 h ...

IntroductionGastroschisis is a congenital birth defect with a rising incidence. The herniation of intestines into the amniotic cavity leads to prenatal bowel injury, which contributes to significant postnatal morbidity and mortality. Current management focuses on postnatal interventions, though bowel injury begins in utero. Emerging interest in prenatal therapies aims to mitigate this injury and improve outcomes. However, none of these interventions have been widely adopted in clinical practice,...

BackgroundPediatric myocarditis is caused by myocardial inflammation that can manifest a wide range of clinical courses, from mild symptoms to death, in the pediatric emergency department. This study aimed to identify risk factors or parameters to predict the clinical course of pediatric myocarditis. MethodsThis retrospective study included 46 patients who visited the pediatric emergency room at Severance Hospital. The patients were classified into spontaneous recovery (n=42) and extracorporeal...

ObjectiveTo assess the effectiveness, cost-effectiveness and experiences of switching from intravenous antibiotics to oral antibiotics in neonates with suspected early onset sepsis (EOS). DesignSystematic review. PatientsClinically stable term and later preterm neonates with suspected EOS. InterventionsOral antibiotics. Main outcome measuresMortality and morbidity, cost and resource use, family related and process outcomes and experiences of families and health care professionals. Informati...

ObjectiveTo evaluate whether combining abdominal ultrasound with radiography improves diagnostic accuracy and surgical risk prediction in neonates with suspected necrotising enterocolitis (NEC) compared with radiography alone. Design, setting, patientsProspective cohort study conducted in two tertiary neonatal intensive care units. Sixty-seven neonates with suspected NEC underwent concurrent abdominal radiography and ultrasound assessments. Imaging studies were independently reviewed by masked ...

ImportanceIn randomized trials, early prophylactic low-dose hydrocortisone improved survival without bronchopulmonary dysplasia (BPD) and had few adverse effects in extremely preterm infants. Large scale implementation data are needed to estimate effect size and safety. ObjectiveTo examine the association between early prophylactic hydrocortisone and survival without BPD at 36 weeks postmenstrual age in extremely preterm infants in Sweden after implementation, and to assess the safety of this t...

BackgroundIn the absence of evidence-based therapies for Multisystem Inflammatory Syndrome in Children (MIS-C), we aimed to describe the similarities and differences in the evaluation and treatment of MIS-C at hospitals in the United States. MethodsWe conducted a cross-sectional survey from June 16 to July 16, 2020 of U.S. childrens hospitals regarding protocols for patients with MIS-C. Elements included hospital characteristics, clinical definition of MIS-C, evaluation, treatment, and follow-u...

Background and ObjectivesNeonatal hypothermia has been shown to be commonly detected among late preterm and term infants. In preterm and very low birth weight infants, hypothermia is associated with increased morbidity and mortality. Little is known about the clinical interventions and outcomes in hypothermic late preterm and term infants. This study fills this gap in the evidence. MethodsSingle-center retrospective cohort study using electronic health record data on infants [&ge;]35 weeks gest...

AbstractO_ST_ABSBackgroundC_ST_ABSThe increasing clinical use of combining structural MRI (sMRI) with General Movements Assessment (GMA) or Hammersmith Infant Neurological Exam (HINE) before five months corrected age (CA) for early diagnosis of cerebral palsy (CP) lacks sufficient prognostic data for children with CP, especially those with Gross Motor Function Classification System (GMFCS) I. ObjectiveEvaluate the predictive value of sMRI, GMA, and HINE individually and in combination for early...

BackgroundMulti-system inflammatory syndrome in children (MIS-C) represents one of the most severe post-acute sequelae of SARS-CoV-2 infection in children, and there is a critical need to characterize its disease patterns for improved recognition and management. Our objective was to characterize subphenotypes of MIS-C based on presentation, demographics and laboratory parameters. MethodsWe conducted a retrospective cohort study of children with MIS-C from March 1, 2020 - April 30, 2022 and care...

ObjectiveWe aim to assess the feasibility of a pragmatic randomized trial of antibiotics vs. no antibiotics in symptomatic premature infants after birth. Most premature infants are exposed to antibiotics after birth without evidence of benefit or harm for this practice. No study to date has attempted to randomize premature infants to antibiotics vs no antibiotics after birth. Study DesignInfants <33 weeks gestation admitted to the University of Florida Neonatal Intensive Care Unit were assigned...

ObjectivesTo describe (1) infant feeding practices during initial hospitalisation and up to 6 months corrected age (CA) in infants born late preterm with mothers intending to breastfeed, (2) the impact of early feeding practices on hospital length of stay and (3) maternal and infant factors associated with duration of breastfeeding. MethodsWe conducted a prospective cohort study of infants born at 34+0 to 36+6 weeks gestational age during 2018-2020. Families were followed up until the infant re...

Using electronic health record data combined with primary chart review, we identified 7 children across 8 pediatric medical centers with a diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C) who were managed as outpatients. These findings should prompt a discussion about modifying the case definition to allow for such a possibility.