Clinical and Experimental Pediatrics

Original Article

Neonatology (Perinatology)

Efficacy of body position on gastric residual in preterm infant: a systematic review and meta-analysis

Kurvatteppa Halemani, Alwin Issac, Sanjay Dhiraaj, Prabhaker Mishra

Clin Exp Pediatr. 2023;66(6):262-270. Published online November 30, 2022

Breastfeeding and it's tolerance are the positive indicators for preterm babies. Placing the preterm infant in the right lateral or prone position after feed had lesser gastric residual volume compared to placing them in left lateral or supine positions. The post-feed position is a vital element in enhancing feeding tolerance, mechanical functions of the gastrointestinal tract and the overall development of preterm infants.

DOI: https://doi.org/10.3345/cep.2021.01508

Developmental and Behavioral Medicine

Parenting stress and interactive engagement behaviors in children with developmental delay

Jung Sook Yeom, Rock Bum Kim, Jae Young Cho, Ji Sook Park, Eun Sil Park, Ji-Hyun Seo, Jae-Young Lim, Hyang-Ok Woo

Clin Exp Pediatr. 2023;66(6):252-261. Published online May 19, 2023

· Question: What level of parenting stress is experienced by parents of children with developmental delays (DDs) without autism spectrum disorder, and what factors contribute to it?
· Findings: Parents of children with DDs experienced high parenting stress that were significantly mediated by their children’s low interactive behaviors.
· Meaning: The interactive behaviors of children with DDs mediate parenting stress.

DOI: https://doi.org/10.3345/cep.2023.00101

Cardiology

Echocardiographic reference z scores of right ventricular dimension and systolic function of children aged 5–12 years

Alaba Busola Oladimeji, Moriam Omolola Lamina, Peter Odion Ubuane, Motunrayo Oluwabukola Adekunle, Omolara Adeolu Kehinde, Barakat Adeola Animasahun, Olisamedua FidelisNjokanma

Clin Exp Pediatr. 2023;66(5):215-222. Published online April 18, 2023

Question: Z score reference values for right ventricular size and systolic function in children using echocardiography are available in several countries. Despite the high burden of diseases involving the right ventricle in Nigeria, these reference values have limited applicability.
Finding: The right ventricular sizes of Nigerian children differed from those published elsewhere.
Meaning: These reference values will aid the treatment, monitoring, and pre- and postintervention for Nigerian children.

DOI: https://doi.org/10.3345/cep.2022.01410

Infection

Predicting COVID-19 transmission in a student population in Seoul, South Korea, 2020–2021

Young Hwa Lee, Han Ho Kim, Young June Choe

Clin Exp Pediatr. 2023;66(4):173-178. Published online December 22, 2022

Question: What is the spatial distribution and determinants of coronavirus disease 2019 (COVID-19) infection among students in Korea?
Finding: The community population was closely associated with the risk of COVID-19, and the number of students per school class were inversely associated with COVID-19 rates in students.
Meaning: Our finding suggests that controlling the community-level burden of COVID-19 can help prevent sudden acute respiratory syndrome coronavirus 2 infection in school-aged children.

DOI: https://doi.org/10.3345/cep.2022.00983

Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study

In Suk Sol, Eun Lee, Hyeon-Jong Yang, Yong Ju Lee, Hye Yung Yum, Mi-Hee Lee, Mi Ae Chu, Hui Jeong Moon, Hyo-Bin Kim, Ju Hee Seo, Jung Yeon Shim, Ji Young Ahn, Yoon Young Jang, Hai Lee Chung, Eun Hee Chung, Kyunghoon Kim, Bong-Seong Kim, Cheol Hong Kim, Yang Park, Meeyong Shin, Kyung Suk Lee, Man Yong Han, Soo-Jong Hong, Eun Kyeong Kang, Chang Keun Kim; on behalf of The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease

Clin Exp Pediatr. 2023;66(3):134-141. Published online December 22, 2022

Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown.
Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV.
Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic.

DOI: https://doi.org/10.3345/cep.2022.00703

Hematology

Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia

Fady Mohamed El-Gendy, Amira M.F. Shehata, Esam Awad Abd El-Kawy, Mahmoud Ahmed El-Hawy

Clin Exp Pediatr. 2023;66(3):127-133. Published online February 24, 2023

Question: What are the PD-1⁺ CD4⁺ T cells percentages and serum interferon gamma (IFN-γ) levels of pediatric patients with immune thrombocytopenia (ITP)?
Finding: Compared with healthy controls, the PD-1⁺ CD4⁺ T cells percentages and IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy.
Meaning: Our findings suggest that PD-1⁺ CD4⁺ T cells and IFN-γ are involved in the pathophysiological process of ITP.

DOI: https://doi.org/10.3345/cep.2022.00920

Gastroenterology

Association between maternal weight gain during pregnancy and child’s body mass index at preschool age

Jeewon Shin, Yoowon Kwon, Ju Hee Kim, Su Jin Jeong

Clin Exp Pediatr. 2023;66(2):76-81. Published online November 30, 2022

Question: What are the risk factors of newborn birth weight? Does gestational weight gain and prepregnancy body mass index affect childhood weight?
Finding: Excess maternal weight gain increases the risk of overweight/obesity, newborn birth weight, and child body mass index at 4–6 years.
Meaning: Maternal weight control before and during pregnancy should be well controlled.

DOI: https://doi.org/10.3345/cep.2022.01158

Neurobehavior

Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis

Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei

Clin Exp Pediatr. 2023;66(2):70-75. Published online August 17, 2022

Cited By 1

Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I²=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.

DOI: https://doi.org/10.3345/cep.2022.00108

Neurology

Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review

Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga

Clin Exp Pediatr. 2023;66(1):38-45. Published online November 30, 2022

Cited By 1

· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.

DOI: https://doi.org/10.3345/cep.2022.01102

Neonatology (Perinatology)

A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants

Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun

Clin Exp Pediatr. 2023;66(1):32-37. Published online December 15, 2022

Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.

DOI: https://doi.org/10.3345/cep.2022.00780

Nutrition

Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis

Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Salman Khazaei

Clin Exp Pediatr. 2023;66(1):28-31. Published online July 19, 2022

This study aimed to determine whether there is an association between not breastfeeding (versus breastfeeding) and the risk of autism spectrum disorders (ASD) among children. We found that the risk of ASD associated with not breastfeeding had an odds ratio of 1.81 (95% confidence interval, 1.35–2.27; I²=0 %). These findings suggest the importance of breastfeeding in decreasing the risk of ASD among children.

DOI: https://doi.org/10.3345/cep.2021.01872

Pulmonology

Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress

Kantara Saelim, Busawan Thirapaleka, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree

Clin Exp Pediatr. 2022;65(12):595-601. Published online November 1, 2022

SpO₂/FiO₂ ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients.

DOI: https://doi.org/10.3345/cep.2022.00241

Gastroenterology

Ability of polymicrobial probiotic and mono-strain probiotic to reduce functional abdominal pain in children: a randomized clinical trial

Seyed Sajad Jafari, Seyed Mojtaba Hashemi, Bahman Sadeghi, Amir Almasi-Hashiani

Clin Exp Pediatr. 2022;65(12):589-594. Published online October 31, 2022

· This study compared the ability of 2 probiotics to reduce and improve functional abdominal pain (FAP) in children.
· In the polymicrobial probiotic (PMP) group, 10.34% of children reported no pain; in the mono-strain probiotic (MSP) group, all patients reported low-degree pain. The mean pain score decreased significantly over time in both groups.
· The use of both PMP and MSP is recommended to reduce pain in patients with FAP.

DOI: https://doi.org/10.3345/cep.2022.00339

Probiotics added to maternal nutrition affect ınfantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study

Aysu Yıldız Karaahmet, Gülümser Dolgun, Metehan Özen

Clin Exp Pediatr. 2022;65(11):547-554. Published online September 23, 2022

Cited By 1

Question: Do probiotics added to maternal nutrition affect infantile colic symptoms and intestinal microbiota?
Finding: Infants whose mothers ingested probiotics demonstrated decreased crying frequency and intensity and significantly increased bacterial diversity in the stools. The bacterial variety was substantially affected by the added probiotic product.
Meaning: The addition of probiotics to maternal nutrition in early infancy could play an important role in preventing infantile colic.

DOI: https://doi.org/10.3345/cep.2022.00766

Nutrition

Survey of Korean pediatrician’s perceptions of barriers to and improvements in breastfeeding

Seong Phil Bae, Woo Ryoung Lee, Won-Ho Hahn, Hye-Jung Shin, Young Min Ahn, Son Moon Shin, Yong Joo Kim, Ellen Ai-Rhan Kim, Youn Jeong Shin, Dae Yong Yi, Soon Min Lee, Juyoung Lee, Jin A Lee, Sung-Hoon Chung, Euiseok Jung, Eui Kyung Choi, Ju Sun Heo

Clin Exp Pediatr. 2022;65(11):540-546. Published online July 29, 2022

Question: What barriers to breastfeeding do Korean pediatricians perceive?
Finding: Regardless of medical institution, breastfeeding counseling for parents is currently limited, and breastfeeding is commonly discontinued due to various maternal and neonatal factors.
Meaning: To promote breastfeeding, increasing pediatrician participation in breastfeeding counseling with the establishment of appropriate breastfeeding counseling fees and the expansion of practical and high-quality breastfeeding education for medical staff should be considered.

DOI: https://doi.org/10.3345/cep.2022.00311

Neonatology (Perinatology)

Mediation effect of cord blood cortisol levels between maternal prepregnancy body mass index and birth weight: a hospital-based cross-sectional study

Nisanth Selvam, Jayashree K, Prasanna Mithra

Clin Exp Pediatr. 2022;65(10):500-506. Published online July 29, 2022

Cited By 1

Question: What is the association between cord blood cortisol and maternal weight, birth weight, and cord blood lipid profile?
Finding: Cord blood cortisol levels did not influence the relationship between maternal weight changes or birth weight. Maternal weight changes, birth weight, and cortisol levels altered the cord blood lipid profile.
Meaning: Our findings may aid United Nations Sustainable Development Goal 3 (Good Health and Well-Being) achievement by 2030.

DOI: https://doi.org/10.3345/cep.2022.00122

Other

Plastic bottle feeding produces changes in biochemical parameters in human infants – A pilot study

Mahendra K. Pant, Abul. H. Ahmad, Manisha Naithani, Jayanti Pant

Clin Exp Pediatr. 2022;65(9):459-465. Published online May 19, 2022

Cited By 1

Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants?
Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding.
Meaning: Plastic bottles feeding alters bodily functions in infants.

DOI: https://doi.org/10.3345/cep.2022.00234

Oncology

Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand

Kunanya Suwannaying, Piti Techavichit, Patcharee Komvilaisak, Napat Laoaroon, Nattee Narkbunnam, Kleebsabai Sanpakit, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Lalita Sathitsamitphong, Chalongpon Santong, Panya Seksarn, Suradej Hongeng, Surapon Wiangnon

Clin Exp Pediatr. 2022;65(9):453-458. Published online May 24, 2022

Question: This study aimed to elucidate the outcomes of high-risk neuroblastoma (HR-NB) patients treated with high-dose chemotherapy and stem cell rescue without immunotherapy.
Finding: The 5-year overall survival and event-free survival rates were 45.1% and 40.4%, respectively.
Meaning: High-dose chemotherapy plus stem cell rescue followed by cis-retinoic acid for 12 months is well tolerated and could improve survival in patients with HR-NB in limited resource settings.

DOI: https://doi.org/10.3345/cep.2022.00437

Cardiology

Early myocardial functional abnormalities in primary dyslipidemia: clinical and echocardiographic observations in young children from a highly consanguineous population

Nehal M. El-koofy, Aya M. Fattouh, Areef Ramadan, Mohamed A. Elmonem, Dina H. Hamed

Clin Exp Pediatr. 2022;65(8):410-416. Published online December 8, 2021

Cited By 1

In children with primary dyslipidemia, functional myocardial abnormalities can occur at young age, including diastolic functional impairment of both ventricles and narrowing of the aortic valve and the sinus of Valsalva. Echocardiographic evaluations of high-risk children may be as important as biochemical evaluations.

DOI: https://doi.org/10.3345/cep.2021.00598

Hematology

Effect of cyclic pamidronate administration on osteoporosis in children with β-thalassemia major: a single-center study

Mahmoud A. El-Hawy, Nagwan Y. Saleh

Clin Exp Pediatr. 2022;65(8):405-409. Published online June 7, 2022

Cited By 1

Question: What is the effect of cyclic pamidronate administration on osteoporosis in children with β-thalassemia major?
Finding: The dual-energy x-ray absorptiometry scan findings of children with β-thalassemia major and osteoporosis were improved after pamidronate administration.
Meaning: Cyclic pamidronate effectively treated osteoporosis in children with β-thalassemia major.

DOI: https://doi.org/10.3345/cep.2019.00535

Infection

Role of lung ultrasound patterns in monitoring coronavirus disease 2019 pneumonia and acute respiratory distress syndrome in children

Satyabrata Roychowdhoury, Subhajit Bhakta, Manas Kumar Mahapatra, Saptarshi Ghosh, Sayantika Saha, Mithun Chandra Konar, Mihir Sarkar, Mousumi Nandi

Clin Exp Pediatr. 2022;65(7):358-366. Published online May 13, 2022

Cited By 1

Question: Potential role of patterns of lung ultrasonography (US) in monitoring changes in mechanically ventilated patients with coronavirus disease 2019 (COVID-19) pneumonia.
Finding: Interstitial syndrome, an irregular pleural line, and peripheral microconsolidation were the most prevalent findings. Changes in lung aeration after mechanical ventilation corelated with improved oxygenation. A fall in lung ultrasound reaeration score ≤ 5 may predict successful weaning.
Meaning: Lung US is gaining wider utility for monitoring COVID-19 pneumonia.

DOI: https://doi.org/10.3345/cep.2021.01655

Neonatology (Perinatology)

Neonatal sepsis-causing bacterial pathogens and outcome of trends of their antimicrobial susceptibility a 20-year period at a neonatal intensive care unit

Woo Sun Song, Hye Won Park, Moon Youn Oh, Jae Young Jo, Chae Young Kim, Jung Ju Lee, Euiseok Jung, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim

Clin Exp Pediatr. 2022;65(7):350-357. Published online December 9, 2021

Cited By 2

Question: What is prevalence of bacterial pathogens causing sepsis and their antimicrobial susceptibility over 20 years?
Finding: Coagulase-negative remains most common causative organism. The most common gram-negative organism was Klebsiella pneumonia. The susceptibility of staphylococcus aureus and K. pneumonia showed increased susceptability to oxacillin, cefotaxime and amikacin, gentamicin, respectively.
Meaning: Answers to the question asked is important in choosing antimicrobials and to monitor emergence of multidrug-resistant organisms.

DOI: https://doi.org/10.3345/cep.2021.00668

Neurology

Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the National Health Screening Program for Infants and Children database

Og Hyang Kim, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, Yun Hye Jo, Seongyeong Rhie, Man Yong Han, Kyu Young Chae

Clin Exp Pediatr. 2022;65(6):312-319. Published online December 9, 2021

Cited By 1

Question: What comorbidities are increased in children with congenital muscular torticollis (CMT)? Are there differences in the neurodevelopmental outcomes of children with CMT who received physical therapy versus those who did not?
Finding: The risk of congenital musculoskeletal deformities is increased in CMT. Children who did not receive physical therapy were at greater risk of neurodevelopmental delay.
Meaning: In CMT, musculoskeletal comorbidities should be identified and active early treatment provided.

DOI: https://doi.org/10.3345/cep.2021.01417

Endocrinology

Effects of probiotics combined with dietary and lifestyle modification on clinical, biochemical, and radiological parameters in obese children with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis: a randomized clinical trial

Thushara Rodrigo, Samaranayake Dulani, Sumudu Nimali Seneviratne, Arjuna P. De Silva, Jerad Fernando, H. Janaka De Silva, Jayasekera , V. Pujitha Wickramasinghe

Clin Exp Pediatr. 2022;65(6):304-311. Published online November 11, 2021

Cited By 6

Question: Could probiotics be used as a therapeutic modality in nonalcoholic fatty liver disease/nonalcoholic steatohepatitis?
Finding: There seem no added advantages over lifestyle modifications compared to Probiotics.
Meaning: There does not seem to be an advantage of probiotics over lifestyle modifications in improving obesity-associated metabolic derangement in children.

DOI: https://doi.org/10.3345/cep.2021.00787

Other

Risk factors and screening timing for developmental dysplasia of the hip in preterm infants

Ga Won Jeon, Hye Jung Choo, Yong Uk Kwon

Clin Exp Pediatr. 2022;65(5):262-268. Published online November 5, 2021

Cited By 4

Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants?
Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants.
Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants.

DOI: https://doi.org/10.3345/cep.2021.01074

General Pediatrics

Effect of 2–6 weeks of systemic steroids on bone mineral density in children

Athira Kuniyil, Somdipa Pal, Namrita Sachdev, Tribhuvan Pal Yadav

Clin Exp Pediatr. 2022;65(5):254-261. Published online November 18, 2021

Cited By 2

Question: Does steroid use for 2–6 weeks in children affect bone mineral content (BMC) or density (BMD)?
Finding: Steroid use for 2–6 weeks significantly decreased BMC and BMD of the whole body, total body less the head, lumbar spine, and distal radius. A significant negative correlation was observed among BMD, duration, and cumulative dose.
Meaning: Steroid use for 2–6 weeks in children negatively affected BMC and BMD.

DOI: https://doi.org/10.3345/cep.2021.00045

Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital

J. Jenifer Florence Mary, R. Sindhuri, A. Arul Kumaran, Amol R. Dongre

Clin Exp Pediatr. 2022;65(4):201-208. Published online October 18, 2021

Cited By 2

Background: According to the National Family Health Survey– 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.
Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among...

DOI: https://doi.org/10.3345/cep.2021.00129

Emergency Medicine

Nonfatal injuries in Korean children and adolescents, 2007–2018

Gyu Min Yeon, Yoo Rha Hong, Seom Gim Kong

Clin Exp Pediatr. 2022;65(4):194-200. Published online September 9, 2021

Question: How many children and adolescents have experienced nonfatal injuries in the previous year?
Finding: Among Korean children and adolescents, 8.1% experienced at least one injury per year. We found no significant change in the incidence of injuries over the previous 12 years.
Meaning: The incidence of injuries is higher than this estimation; therefore, more attention and effort are needed to prevent injuries among children and adolescents.

DOI: https://doi.org/10.3345/cep.2021.00563

Neonatology (Perinatology)

Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial

Mohammad Kazem Sabzehei, Behnaz Basiri, Maryam Shokouhi, Sajad Ghahremani, Ali Moradi

Clin Exp Pediatr. 2022;65(4):188-193. Published online July 28, 2021

Cited By 3

Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)?
Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects.
Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique.

DOI: https://doi.org/10.3345/cep.2021.00297

General Pediatrics

Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review

Preyal D. Jain, Akshatha Nayak, Shreekanth D. Karnad, Kaiorisa N. Doctor

Clin Exp Pediatr. 2022;65(3):142-149. Published online June 11, 2021

Cited By 8

Question: What are the primary motor and balance dysfunctions in children with Down syndrome?
Finding: These individuals have gross delays, altered balance, and inefficient compensatory mechanisms.
Meaning: Neuromuscular and musculoskeletal impairments due to the chromosomal abnormality lead to developmental delay. These children also exhibit poor balance with greater instability and inefficient compensatory mechanisms including altered center of pressure displacement and trunk stiffening that predisposes them to falls.

DOI: https://doi.org/10.3345/cep.2021.00479

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Original article