Clinical and Experimental Pediatrics

Original Article

Hematology

Hematological alterations in adolescent girls with restrictive anorexia nervosa and secondary amenorrhea at the time of diagnosis

Katarína Šebeková, Alexandra Gaál Kovalčíková, Ľubica Tichá, Ľudmila Podracká

Clin Exp Pediatr. 2026;69(11):891-901. Published online October 19, 2026

Question: Do adolescent girls with restrictive anorexia nervosa and secondary amenorrhea have low blood counts at diagnosis?
Finding: Patients, even those with bone mineral density z scores similar to those of controls and adequate micronutrient levels, exhibited lower blood counts and suppressed bone formation and endocrine parameters compared with healthy age-matched controls.
Meaning: Hematological alterations may occur early in the disease course and complement routine clinical assessments.

DOI: https://doi.org/10.3345/cep.2026.00808

Developmental and Behavioral Medicine

Association between maternal traumatic stress related to Great East Japan Earthquake and behavioral problems in offspring

Shun Tanabe, Masatsugu Orui, Chikana Kawaguchi, Genki Shinoda, Aoi Noda, Mami Ishikuro, Taku Obara, Shinichi Kuriyama

Clin Exp Pediatr. 2026;69(11):878-890. Published online October 22, 2026

Association between maternal traumatic stress related to Great East Japan Earthquake and behavioral problems in offspringQuestion: Does prepregnancy maternal traumatic stress influence behavioral outcomes in early childhood?
Finding: Children born to mothers who reported greater disaster-related traumatic stress showed higher risks of internalizing, externalizing, and total behavioral problems at ages 2 and 3 years consistent with a dose-response relationship.
Meaning: Long-term maternal mental health support covering the broader reproductive period may play a role in addressing intergenerational behavioral problems after large-scale disasters.

DOI: https://doi.org/10.3345/cep.2026.00843

General Pediatrics

Effect of varicella vaccine introduction on chickenpox incidence in Kingdom of Bahrain

Afaf Merza Mohamed, Hasan M. Isa, Malak Husain Hasan, Maram Husain Hasan, Ali K. Moosa, Janan Husain Radhi, Basma Al Saffar, Adel Al Sayyad

Clin Exp Pediatr. 2026;69(11):868-877. Published online September 14, 2026

Question: What was the effect of varicella vaccine introduction on chickenpox incidence in Bahrain?
Finding: Postvaccine introduction in May 2015, new varicella cases declined substantially, particularly among children aged 0–9 years. Most cases are managed in primary healthcare settings, with rare hospitalizations and no reported deaths.
Meaning: Routine varicella vaccination is associated with reduced disease burden, demonstrating sustained high coverage, continued surveillance, and protection of susceptible groups.

DOI: https://doi.org/10.3345/cep.2026.01326

Neurology

Prenatal stress via chronic immobilization amplifies N-methyl-D-aspartate-induced spasm-like seizure susceptibility and neuroinflammation in neonatal rats

Hyeok Hee Kwon, Seungyeon Bin, Seung Gyu Choi, Hyo Jung Shin, Joon Won Kang

Clin Exp Pediatr. 2026;69(11):858-867. Published online September 8, 2026

Question: Does chronic prenatal immobilization stress increase an offspring's susceptibility to spasms, and is this associated with altered glial activation and gamma-aminobutyric acid (GABA)ergic signaling in the developing brain?
Finding: Prolonged prenatal stress increases susceptibility to N-methyl-D-aspartate-induced spasms, enhanced glial activation, and impaired GABAergic signaling.
Meaning: Long-term prenatal stress may promote early life epileptogenesis associated with neuroinflammation as well as disrupted inhibitory neurotransmission, although a causal role remains to be established.

DOI: https://doi.org/10.3345/cep.2026.01403

Neonatology (Perinatology)

Maternal metformin protects developing auditory brainstem function after neonatal hypoxia-ischemia in a neonatal rat model

Sei Eun Kim, Joo Young Kweon, Yong Joo Ahn, Jun Hee Kim

Clin Exp Pediatr. 2026;69(10):806-816. Published online September 17, 2026

Web of Science 1 Crossref 1

Question: Does maternal metformin administration during pregnancy protect offspring auditory brainstem function after neonatal hypoxia-ischemia (HI)?
Finding: Maternal metformin prevented HI-induced hearing threshold elevation, preserved auditory brainstem response amplitudes, and partially rescued neuronal and oligodendrocyte lineage cells in the medial nucleus of the trapezoid body.
Meaning: Maternal metformin during gestation may serve as a prenatal neuroprotective strategy against neonatal hypoxic-ischemic brain injury.

DOI: https://doi.org/10.3345/cep.2026.01368

Endocrinology

Gut microbiota profiles in Korean children with growth hormone deficiency: a case-control study

So Yoon Choi, Seom Gim Kong, Gyu Min Yeon, Yoo Rha Hong, Minyoung Jung, Jung Hyun Lee

Clin Exp Pediatr. 2026;69(10):797-805. Published online August 19, 2026

Question: Is gut microbiota composition altered in children with growth hormone deficiency (GHD)?
Finding: Children with GHD exhibited altered gut microbiota composition and predicted microbial functional pathways despite similar overall microbial diversity.
Meaning: These preliminary findings suggest a potential association between gut microbiota and pediatric GHD and warrant validation in larger prospective studies.

DOI: https://doi.org/10.3345/cep.2026.00493

Gastroenterology

Impact of bacterial infection on native liver survival in children with cirrhosis due to biliary atresia

Varissara Kaewchaivijit, Pornthep Tanpowpong, Songpon Getsuwan, Sophida Boonsathorn, Chatmanee Lertudomphonwanit, Suporn Treepongkaruna

Clin Exp Pediatr. 2026;69(10):788-796. Published online July 24, 2026

Question: Are bacterial infections associated with lower native liver survival in children with biliary atresia (BA)?
Finding: Children with BA and proven/suspected bacterial infections, including cholangitis, had significantly lower native liver survival and higher rates of liver transplantation or death.
Meaning: Early recognition, appropriate management, and prevention of bacterial infections may improve native liver survival in children with BA-related cirrhosis.

DOI: https://doi.org/10.3345/cep.2026.00388

Endocrinology

Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018–2024)

Pattara Wiromrat, Preamrudee Poomthavorn, Ratikorn Chaisiwamongkol, Chaiyawat Suppasilp, Ouyporn Panamonta, Ratchaneewan Sinitkul

Clin Exp Pediatr. 2026;69(9):733-742. Published online August 19, 2026

Web of Science 1 Crossref 1

Question: Did the incidence of central precocious puberty (CPP) and premature thelarche (PT) among Thai children change during 2018–2024?
Finding: CPP incidence in girls more than doubled during the COVID-19 pandemic and remained elevated thereafter, primarily at age 8 to <9 years. PT incidence increased progressively, particularly in girls aged 7 to <8 years.
Meaning: In peripubertal age groups, CPP and PT incidence increases may reflect pandemic-related factors, obesity, awareness, or earlier pubertal onset.

DOI: https://doi.org/10.3345/cep.2026.00983

Basic Research

Longitudinal changes in serum soluble C5b-9 levels following immunomodulatory therapy for multisystem inflammatory syndrome in children

Amrita Pattanaik, Prasad Varamballi, Srilatha Marate, Sushma Bhandarkar B., Shrikiran Aroor, Somashekar A.R., Suchetha S. Rao, Chiranjay Mukhopadhyay

Clin Exp Pediatr. 2026;69(9):726-732. Published online August 19, 2026

Question: Do serum soluble C5b-9 (sC5b-9) levels change following immunomodulatory therapy in children with multisystem inflammatory syndrome in children (MIS- C)?
Finding: In this longitudinal multicentric study of 100 children with MIS-C, serum sC5b-9 concentrations significantly decreased following treatment, although some patients showed persistently elevated levels at discharge.
Meaning: Serial sC5b-9 measurements may indicate treatment-associated immune activity and recovery in MIS-C.

DOI: https://doi.org/10.3345/cep.2026.01179

Oncology

Pediatric patients with cancer exhibit increased neutrophil extracellular traps and reduced active deoxyribonuclease I: diagnostic, prognostic, and therapeutic opportunities

Nuria Benavent, Julia Oto, Patricia Verger, Alejandro Herreros-Pomares, Raquel Herranz, Bienvenida Argilés, Julia Balaguer, Antonio Juan-Ribelles, Santiago Bonanad, Pilar Medina, Adela Cañete

Clin Exp Pediatr. 2026;69(9):713-725. Published online August 19, 2026

· Circulating neutrophil extracellular trap (NET) markers are increased in pediatric cancer and correlate with disease risk and outcomes.
· Cell-free DNA and calprotectin levels show diagnostic and prognostic value, whereas impaired deoxyribonuclease I activity identifies a targetable mechanism.
· NETs are promising biomarkers and therapeutic targets for high-risk pediatric tumors.

DOI: https://doi.org/10.3345/cep.2026.01004

Cardiology

Red cell distribution width and reticulocyte hemoglobin content as predictors of iron depletion in children with cyanotic congenital heart disease

Hanyudh Prichayudh, Kanhatai Chiengthong, Khwaunrat Whaidee, Navaporn Phiphattanatikanunt, Vidhavas La-orkhun, Pornthep Lertsapcharoen

Clin Exp Pediatr. 2026;69(9):706-712. Published online July 29, 2026

Question: Are red cell distribution width (RDW) and reticulocyte hemoglobin content (CHr) reliable alternative markers for detecting iron depletion in children with cyanotic congenital heart disease, whose status is often masked by compensatory polycythemia?
Finding: Multivariate analysis demonstrated that RDW (≥18.8%) and CHr (<28 pg) are strong independent predictors of iron depletion in this vulnerable population.
Meaning: Combined use of these accessible markers facilitates earlier diagnosis and improves clinical management in resource-limited healthcare facilities.

DOI: https://doi.org/10.3345/cep.2026.00241

Neurology

Patient-independent automated pediatric seizure monitoring based on expert-labeled electrographic ictal data as core reference knowledge

Yoon Gi Chung, Jaeso Cho, Anna Cho, Hunmin Kim, Byung Chan Lim

Clin Exp Pediatr. 2026;69(8):665-675. Published online July 14, 2026

Question: Can deep learning models trained on expert-verified electroencephalography segments reliably detect seizures and be applied to single-channel wearable monitoring?
Finding: This technique demonstrated 80.1%–100% sensitivity and low false-alarm rates. On 1,604 expert-labeled segments, the model outperformed previous studies in terms of latency and accuracy across unseen datasets.
Meaning: Expert-labeled data are essential for achieving universal seizure detection. This channel-specific approach enabled efficient and continuous monitoring using wearable devices.

DOI: https://doi.org/10.3345/cep.2026.01011

Neonatology (Perinatology)

Efficacy and safety of home-based fiberoptic blanket versus hospital-based light-emitting diode phototherapy for neonatal jaundice: a retrospective cohort study from Thailand

Chayatat Ruangkit, Thanyathorn Thaninjeerawat, Saitarn Klaidangklum, Saowalak Prasopa, Pongsakorn Atiksawedparit, Sasivimon Soonsawad

Clin Exp Pediatr. 2026;69(8):655-664. Published online July 1, 2026

Question: Is a home-based fiberoptic phototherapy blanket as effective and safe as hospital-based overhead light-emitting diode phototherapy for the treatment of neonatal jaundice?
Finding: Home phototherapy (HPT) resulted in a slower bilirubin reduction rate than inpatient phototherapy (IPT); however, both modalities achieved the therapeutic targets without phototherapy-related complications.
Meaning: With careful patient selection, structured monitoring, and reliable follow-up, HPT is a safe and feasible alternative to IPT for neonatal jaundice.

DOI: https://doi.org/10.3345/cep.2026.00703

Gastroenterology

Prognosis of pediatric hepatic Wilson disease with ATP7B loss of function variants

Amresh Kumar Mishra, Moinak Sen Sarma, Anchal Dubey, Pratik Gadekar, Amita Moirangthem, Anshu Srivastava, Amrita Mathias

Clin Exp Pediatr. 2026;69(8):646-654. Published online July 13, 2026

Question: Do the loss of function (LOF) of ATP7B mutated variants affect the severity or outcomes of hepatic Wilson disease (WD)?
Finding: LOF is associated with advanced liver disease, portal hypertension, and extrahepatic involvement. LOF did not determine hepatic or overall outcomes. ATP7B: c.813C>A (truncation variant) has an aggressive course with higher predisposition to acute liver failure. Lower serum exchangeable copper levels and higher disappearance of Kayser-Fleischer ring were observed in ATP7B: c.3809A>G (nontruncation variant) suggesting a better effect of chelation and lesser systemic copper.
Meaning: Truncation of the ATP7B protein determines the severity of the phenotype in WD.

DOI: https://doi.org/10.3345/cep.2026.00689

Other

Association between sodium content of intravenous immunoglobulin and electrolyte changes and clinical course of Kawasaki disease

Yoshitaka Watanabe, Naomi Yagi, Toya Hattori, Chisato Oyake, Shota Endo, Maria Yoshimi, Takayoshi Kyoda, Hirokazu Ikeda

Clin Exp Pediatr. 2026;69(8):639-645. Published online July 1, 2026

Web of Science 1

Question: Hyponatremia in Kawasaki disease is associated with inflammation and disease severity. Intravenous immunoglobulin (IVIG) formulations feature various sodium contents. What is the clinical impact of such variations?
Finding: IVIG sodium content was associated with sodium, potassium, and protein level changes.
Meaning: Coronary outcomes were similar but electrolyte changes differed: high-sodium IVIG caused hypokalemia, whereas low-sodium IVIG caused hyponatremia. IVIG preparation requires consideration when interpreting laboratory values.

DOI: https://doi.org/10.3345/cep.2026.00619

Pulmonology

Telomere biology disorders associated with childhood interstitial lung disease

Maria Greiner-Mai, Christina Katharina Rapp, Katrin Knoflach, Daniel Gräfe, Franz Wolfgang Hirsch, Julia Ley-Zaporozhan, Simone Reu-Hofer, Julia Hentschel, Stefan Zielen, Monika Helena Tedy, Heymut Omran, Ernst Rietschel, Tuğba Sismanlar Eyuboglu, Ayse Tana-Aslan, Nagehan Emiralioglu, Nicola Ullmann, Samuele Naviglio, Massimo Maschio, Fabian Beier, Tuğba Ramaslı Gürsoy, Matthias Griese, Freerk Prenzel

Clin Exp Pediatr. 2026;69(7):593-603. Published online June 18, 2026

Web of Science 2 Crossref 2

Question: What are the pulmonary manifestations and clinical characteristics of telomere biology disorders in children with interstitial lung disease?
Finding: Telomere biology disorders are an important but often underrecognized cause of childhood interstitial lung disease and are associated with variable pulmonary, radiologic, and histopathologic findings, frequent multisystem involvement, and often severe disease progression.
Meaning: Early genetic testing and multidisciplinary evaluation are essential for timely diagnosis, optimized management, and improved outcomes in affected children.

DOI: https://doi.org/10.3345/cep.2026.00290

Other

Did government subsidy program improve quality of care for children with complex chronic conditions in children’s hospitals? A quasi-experimental study in South Korea

Riyoung Na, Myoung-Hee Kim, Seok-Jun Yoon

Clin Exp Pediatr. 2026;69(7):582-592. Published online May 28, 2026

Question: Do government-funded Specialized Public Medical Centers for Children (SPMCCs) improve the quality of care for pediatric patients requiring complex and intensive medical care?
Finding: The SPMCC hospital designation reduced 30-day readmission rates among pediatric patients with severe conditions.
Meaning: Government investments are associated with improved quality of care for children with complex chronic conditions. Therefore, sustained government funding is essential to enhancing pediatric care quality.

DOI: https://doi.org/10.3345/cep.2026.00199

Hematology

Peripheral blood cell counts of prematurely born, small for gestational age neonates

Mara O. Zuiderwijk, Sophie Groene, Enrico Lopriore, Vincent Bekker, Michiel H.D. Schoenaker

Clin Exp Pediatr. 2026;69(7):572-581. Published online May 12, 2026

Question: As small for gestational age (SGA) neonates are more susceptible to infections, we hypothesized that their complete blood count and leukocyte differentiation might be affected.
Finding: The counts of multiple blood cells of extreme SGA neonates were affected as illustrated by multivariate analyses, which showed significant decreases in neutrophil, monocyte, lymphocyte, and thrombocyte counts.
Meaning: The mechanisms underlying this phenomenon and its clinical effects require further elucidation.

DOI: https://doi.org/10.3345/cep.2025.02978

Gastroenterology

Distinct age-dependent phenotypes of abnormal liver function tests derived from national Emergency Department data

Dong-Uk Kim, Shinjie Choi, Yeji Kim, Lia Kim, Jung Ok Shim, Jin Soo Moon, Jong Woo Hahn, Hye Ran Yang, Ju Young Chang, Jae Sung Ko

Clin Exp Pediatr. 2026;69(7):563-571. Published online May 14, 2026

Question: What are the clinical phenotypes and pathogen associations of pediatric and adult Emergency Department visits for abnormal liver function tests?
Finding: Pediatric visits showed fever-predominant profiles with temporal correlations with respiratory viruses, whereas adult visits revealed population-level temporal associations between enteric pathogens and infectious gastroenteritis, upper gastrointestinal disorders, and metabolic comorbidity clustering.
Meaning: These findings provide novel population-level evidence of age-specific pathogen associations and support distinct age-stratified clinical diagnostics.

DOI: https://doi.org/10.3345/cep.2026.00038

Neonatology (Perinatology)

Association between base excess levels and clinical outcomes among very low birth weight infants: a multicenter birth cohort study in South Korea

Ji Yoo Kim, Hyeon Jin Kim, Heeyoon Choi, Minji Kim, Jinseok Lee, Yong Sung Choi, Dong Keon Yon

Clin Exp Pediatr. 2026;69(7):555-562. Published online May 21, 2026

Question: Is metabolic acidosis at birth in very low birth weight infants (VLBWIs) associated with long-term clinical outcomes?
Finding: Metabolic acidosis at birth was associated with increased mortality, adverse respiratory outcomes, neurological morbidities, and infection-related and gastrointestinal outcomes.
Meaning: VLBWIs with metabolic acidosis are at high risk of systemic complications. This finding emphasizes the need for close monitoring and comprehensive care.

DOI: https://doi.org/10.3345/cep.2025.02817

Nephrology (Genitourinary)

Serum metabolomic profile in children with sepsis-associated acute kidney injury

Nisha Chaudhary, Praveen Singh, Abhijeet Saha, Shantanu Sengupta

Clin Exp Pediatr. 2026;69(7):545-554. Published online April 15, 2026

Web of Science 2 Crossref 2

Question: Can the potential metabolites/pathways involved in the pathogenesis of sepsis-associated acute kidney injury (SA-AKI) be identified using metabolomics?
Finding: We identified 18 novel metabolites involved in the pathogenesis of SA-AKI as well as 31 metabolites that were altered in severe AKI. Linoleic acid, linolenic acid, and phospholipid pathways were altered in SA-AKI.
Meaning: Once validated, these markers may be used to diagnose SA-AKI at an early stage before sufficient kidney injury occurs.

DOI: https://doi.org/10.3345/cep.2025.02439

Endocrinology

Intramuscular and subcutaneous gonadotropin-releasing hormone agonist tests for central precocious puberty in girls: a randomized controlled trial

Worapimon Lerdrassameethad, Suttipong Wacharasindhu, Vichit Supornsilchai, Khomsak Srilanchakon

Clin Exp Pediatr. 2026;69(6):518-523. Published online April 15, 2026

Question: Did the intramuscular (IM) and subcutaneous (SC) administration of gonadotropin-releasing hormone (GnRH) agonists have comparable timing and diagnostic utility for evaluating central precocious puberty in girls?
Finding: Both the IM and SC GnRH stimulation tests demonstrated comparable times to peak luteinizing hormone levels.
Meaning: Clinicians may consider the IM route as a time-efficient alternative, as it offers similar diagnostic utility for central precocious puberty without compromising the detection of hypothalamic-pituitary-gonadal axis activation.

DOI: https://doi.org/10.3345/cep.2026.00052

Anthropometric trajectories of Korean children and adolescents with severe obesity

Jeongho Han, Hakyung Lee, Dong Jun Ha, Jieun Lee, Yong Hee Hong, Hwa Young Kim, Jaehyun Kim

Clin Exp Pediatr. 2026;69(6):508-517. Published online April 10, 2026

Question: How do body mass index (BMI) and metabolic markers change over time in severely obese Korean children and adolescents receiving only lifestyle modifications?
Finding: Among 124 participants, BMI z scores decreased modestly over 2.6 years, primarily in younger prepubertal boys. However, most remained severely obese, with minimal improvement in body composition or metabolic markers.
Meaning: Lifestyle interventions alone have limited efficacy for severe pediatric obesity. Early and more intensive treatments are required.

DOI: https://doi.org/10.3345/cep.2025.02999

Pulmonology

High-Risk CCL14 lineage drives severe Mycoplasma pneumoniae pneumonia in children: a study in central China

Chunbo Hao, Zijie Li, Yanjuan Yu, Song Wang, Genhao Wang, Gaijing Jia, Tiantian Sun, Shouhang Chen, Yang Wu, Yu Tang, Fang Wang, Guangcai Duan, Yuefei Jin

Clin Exp Pediatr. 2026;69(6):497-507. Published online April 10, 2026

Web of Science 1 Crossref 1

Question: Are the predominant circulating strains of Mycoplasma pneumoniae associated with disease severity and clinical indicators?
Finding: The common cluster label 14 (CCL14) lineage was a high-risk clone circulating in central China that demonstrated a strong association between severe pediatric pneumonia and a distinct hyperinflammatory profile.
Meaning: Targeted molecular surveillance of the CCL14 lineage may facilitate early risk stratification and guide clinical management to reduce the burden of severe disease.

DOI: https://doi.org/10.3345/cep.2025.02796

Endocrinology

Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort

Hala M. Sakhr, Mohammed H. Hassan, Esraa Abbass Abdallah, Amira Mahmoud Ewis, Mohamed Hesham Mohamed, Shymaa Gaber Rizk

Clin Exp Pediatr. 2026;69(6):486-496. Published online March 26, 2026

Web of Science 1 Crossref 1

Question: Which factors influence pediatric thyroid disorder susceptibility and severity?
Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg³⁸⁶His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels.
Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg³⁸⁶His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management.

DOI: https://doi.org/10.3345/cep.2025.02957

Neurology

Classification of neurocognitive impairment in pediatric drug-resistant focal epilepsy by quantifying seizure-affected brain network abnormalities in clinical diffusion-weighted imaging connectome

Jeong-Won Jeong, Min-Hee Lee, Yoon Ho Hwang, Michael Behen, Aimee Luat, Csaba Juhász, Eishi Asano

Clin Exp Pediatr. 2026;69(5):443-454. Published online March 13, 2026

Web of Science 1 Crossref 1

Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy?
Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients.
Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects.

DOI: https://doi.org/10.3345/cep.2025.02936

Neonatology (Perinatology)

Association between impaired renal function based on decline in serum creatinine level and brain injury in neonates with hypoxic-ischemic encephalopathy

Mélaine Boget, William Rozalen, Jeanne Fayard, Mohamed Boucekine, Diane Gillot, Isabelle Grandvuillemin, Farid Boubred

Clin Exp Pediatr. 2026;69(5):437-442. Published online April 27, 2026

Question: The clinical relevance of impaired renal function (IRF), based on the rate of serum creatinine level decline during the week after birth, in neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy need further investigation.
Finding: In this study, neonates with IRF had 2-fold higher risk of early death or severe brain injury.
Meaning: IRF can be used as a marker of adverse neonatal outcomes.

DOI: https://doi.org/10.3345/cep.2025.02670

Nutrition

Human milk macronutrient composition and intake in relation to preterm infant growth: a cohort study

Eakkarin Mekangkul, Chonnikant Visuthranukul, Anongnart Sirisabya, Thaninee Chitsinchayakul, Santi Punnahitananda, Sirinuch Chomtho

Clin Exp Pediatr. 2026;69(5):428-436. Published online April 22, 2026

Question: Is macronutrient intake, particularly that from human milk, distinctly associated with the growth of preterm infants?
Finding: Total protein and fat intake derived from human milk and fortifiers showed distinct positive associations with weight gain velocity.
Meaning: Particular attention to protein and fat composition during individualized human milk fortification can optimize weight gain in preterm infants.

DOI: https://doi.org/10.3345/cep.2025.02509

Neurology

Clinical application of whole exome and genome sequencing in pediatric neurodevelopmental disorders

Keun Soo Lee, Seung Hwan Oh, Ja Young Lee, Go Hun Seo, Da Eun Roh, Ji Kyoung Park, Bo Lyun Lee

Clin Exp Pediatr. 2026;69(5):417-427. Published online April 22, 2026

Question: What is the diagnostic utility of whole exome sequencing (WES) and whole genome sequencing (WGS) in unexplained neurodevelopmental disorders (NDDs)?
Finding: WES and WGS achieved a combined diagnostic yield of 39.1% in children with NDDs. Novel variants accounted for over half the pathogenic findings, and trio-based or phenotype-driven testing improved the diagnostic rate.
Meaning: Comprehensive genomic sequencing integrated with clinical phenotyping enhances diagnostic yield among children with NDDs.

DOI: https://doi.org/10.3345/cep.2025.02775

Hematology

Effects of induction-phase acute kidney injury and age at diagnosis on chronic kidney disease in pediatric acute lymphoblastic leukemia: a time-to-event cohort study

Pongpak Phongphiew, Nuanpan Penboon, Kanhatai Chiengthong, Pornpimol Rianthavorn

Clin Exp Pediatr. 2026;69(5):407-416. Published online March 5, 2026

Question: In pediatric acute lymphoblastic leukemia (ALL), what are the incidence and causes of induction-phase acute kidney injury (AKI), and which factors predict chronic kidney disease (CKD)?
Finding: Induction AKI occurred in 43% of patients, while CKD developed in 1 of 8 patients. The 5-year CKD-free survival rate was 94%. Older age at diagnosis was a continuous independent determinant of CKD risk.
Meaning: Induction AKI is common and clinically relevant. Older children warrant closer kidney monitoring during and after therapy.

DOI: https://doi.org/10.3345/cep.2025.02327

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Original article