Most cited
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Most-cited articles are from the articles published during the last two years (2024 ~ ).
- Original Article
- Genetics and Metabolism
- Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis
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Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee
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Clin Exp Pediatr. 2025;68(3):257-265. Published online November 28, 2024
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Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function?
Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk.
Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal. |
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- Neurology
- Evaluation of pediatric migraine triggers: a single-center study
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Hey-Joon Son, Joo-Ok Jin, Kon-Hee Lee
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Clin Exp Pediatr. 2025;68(2):163-169. Published online November 11, 2024
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Question: What are the primary triggers for pediatric migraines, and how do they impact clinical management?
Finding: Common triggers for pediatric migraines include sleep disturbances, academic stress, and motion sickness, with academic stress identified as the most intense.
Meaning: Recognizing and addressing specific triggers like sleep disturbance and academic stress is crucial to effectively managing pediatric migraines with emphasis on personalized care to improve outcomes. |
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- Developmental and Behavioral Medicine
- Characteristics of temper tantrums in 1–6-year-old children and impact on caregivers
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Warangkana Prutipaisan, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho
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Clin Exp Pediatr. 2025;68(2):170-177. Published online November 13, 2024
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Question: What are common tantrum behaviors in preschool children, and how frequently are problematic behaviors observed? Do problematic tantrums have a different emotional impact on caregivers compared to typical tantrums?
Finding: Temper tantrums are common in preschool children, and verbal tantrums are the most common type.
Meaning: Problematic tantrums, defined as tantrums exhibiting aggressive physical behavior, long duration (>15 minutes), or frequent occurrence (>3 days/wk), significantly affected caregivers’ emotions. |
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- Neonatology (Perinatology)
- Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates
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Kulthida Baingam, Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate
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Clin Exp Pediatr. 2025;68(2):178-184. Published online November 13, 2024
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Question: Can sigh breaths (Sighs) application during high-frequency oscillatory ventilation (HFOV) decrease partial pressure of carbon dioxide (PaCO2) levels?
Finding: The mean PaCO2 level after Sighs during HFOV was significantly decreased compared to that after HFOV alone (mean difference, -3.6 mmHg).
Meaning: HFOV plus Sighs functionality can reduce PaCO2 levels. However, further studies are required to conclusively determine the effects of Sighs. |
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- Gastroenterology
- Differences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing
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Dae Yong Yi, Hong-Jai Park, Min Sun Shin, Hyoungsu Kim, Sang Jin Lee, Insoo Kang
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Clin Exp Pediatr. 2025;68(2):141-152. Published online January 10, 2025
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Question: Is there a difference in immune cells in human breast milk by parity?
Finding: There were higher proportions of monocytes and T/B cells in the primiparous and multiparous group, respectively. The expression of genes with a direct role in the infant immune system and immune response-related genes were highest in the primiparous group
Meaning: There were parity-dependent differences in the expression of genes between innate and adaptive immune cells. |
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- Oncology
- HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol
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Parisa Maneechai, Cholada Ratanatharathron, Jassada Buaboonam, Kleebsabai Sanpakit
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Clin Exp Pediatr. 2025;68(12):974-980. Published online October 2, 2025
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Question: Does human leukocyte antigen (HLA)–B*58:01 increase the risk of cutaneous reactions in pediatric patients with hematological and oncological diseases receiving allopurinol?
Finding: : Of 108 patients, 17.6% carried HLA–B*58:01 but none developed skin reactions. The only rash occurred in an HLA-B*58:01–negative patient.
Meaning: Short-duration allopurinol may mitigate severe cutaneous adverse reaction risk regardless of genotype. Routine HLA-B*58:01 screening may be unnecessary in pediatric patients with hematological and oncological diseases briefly receiving allopurinol. |
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- Endocrinology
- Long-term epidemiological insights into rickets: a nationwide population-based retrospective study
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Chun-Hao Chu, Ying-Chuan Chen, Pei-Yao Liu, Chun-Chieh Hu, Yu-Lung Lin, Feng-Chih Kuo, Chieh-Hua Lu, Tzu-Ju Hsu, Yu-Tung Hung, Fuu-Jen Tsai, Chien-Ming Lin
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Clin Exp Pediatr. 2025;68(11):879-891. Published online August 20, 2025
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Question: What are the nationwide trends and mortality risk factors of nutritional versus hereditary rickets among children in Asia?
Finding: In 2012–2018, the incidence of rickets steadily increased, whereas mortality rates declined. Mortality is associated with a low household income, anemia, chronic kidney disease, secondary hyperparathyroidism, and a prolonged hospital stay.
Meaning: Early diagnosis and targeted interventions addressing social and medical vulnerabilities are critical to reducing ricket-related mortality. |
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- General Pediatrics
- Trends and determinants in breastfeeding among Korean infants (2007–2021): a nationwide study using the National Health Screening Program for Infants and Children
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Minwoong Kang, Eui Kyung Choi, Jeung Min Lee, Hye-Jung Shin, Woo Ryoung Lee, Son Moon Shin; Korean Society of Breastfeeding Medicine
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Clin Exp Pediatr. 2025;68(10):772-780. Published online July 4, 2025
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Question: What are the recent trends and determinants of breastfeeding in South Korea?
Finding: Breastfeeding rates in South Korea declined significantly from 2007 to 2021, with lower rates observed in preterm, low-birthweight, and multiple-birth infants as well as rural or lower-income households.
Meaning: Targeted interventions, including prenatal education, postnatal support, and community-based programs, are required to address disparities and improve breastfeeding rates. |
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- Review Article
- General Pediatrics
- Impact of screen exposure during pediatric ages including multifaceted aggravating factors: a literature review
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Daniel González-Pérez, David Sebastián Huertas-Moreno, Manuela Granados-Pinilla, Sofía Hernandez-Rojas, Laura González-Rincon, Geraldine Hurtado-Garcia, Simón Grisales-Calle, María José González-Mariño, Luz Dary Gutierrez-Castañeda, Jhon Camacho-Cruz
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Clin Exp Pediatr. 2025;68(10):751-760. Published online September 24, 2025
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Excessive screen time in children is linked to obesity, overweight, sedentary behavior, depression and mood disorders, myopia, behavioral changes, sleep disturbances, attention deficit hyperactivity disorder, among others. Polymorphisms in genes like FTO, CACNA1D, and DRD2 could further increase these risks. Implementing strategies such as limiting screen use, creating screen-free zones, and monitoring content is essential to mitigate adverse physical and mental health effects in the pediatric population. |
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- Original Article
- Neonatology (Perinatology)
- Short-term outcomes of oropharyngeal administration of colostrum in preterm neonates: a double-blind placebocontrolled randomized trial
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Ameneh Lamsehchi, Maryam Shokouhi Solgi, Mohammad Kazem Sabzehei, Behnaz Basiri, Elahe Talebi Ghane, Kiana Kimiaei Asadi, Sina Azadnajafabad
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Clin Exp Pediatr. 2025;68(1):73-79. Published online October 31, 2024
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Question: What are the short-term outcomes of oropharyngeal administration of colostrum (OAC) in preterm neonates?
Finding: This study demonstrated the significantly lower rates of necrotizing enterocolitis, clinically suspected sepsis, shorter hospital stay, period to full enteral feeding, and antibiotic therapy period in the OAC group.
Meaning: This trial may further expand the clinical application of OAC in premature infants to reduce their length of hospital stay and complications. |
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- Pulmonology
- Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?
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Rungrat Sukharom, Prakarn Tovichien, Kanokporn Udomittipong, Pinyapach Tiamduangtawan, Wattanachai Chotinaiwattarakul
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Clin Exp Pediatr. 2025;68(1):80-90. Published online November 6, 2024
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Question: How Common is obstructive sleep apnea (OSA) in obese children? OSA is common in obese children, even without habitual snoring.
Finding: Among the subjects, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, 59.8% had desaturation, 20.5% had sleep-related hypoventilation, and 5.0% had obesity hypoventilation syndrome. Body mass index (BMI) and neck and waist circumferences were significantly associated with severe OSA.
Meaning: We recommend screening obese children (BMI > 29.2 kg/m2) for OSA. |
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- Review Article
- Neonatology (Perinatology)
- Need for national guidance regarding proactive care of infants born at 22–23 weeks' gestation
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Ga Won Jeon
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Clin Exp Pediatr. 2025;68(1):53-61. Published online November 13, 2024
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With advancements in neonatal intensive care, the limit of viability has shifted to 22–23 weeks' gestation, whose survival rates vary across countries and institutions. These rates are not static and can be improved through the proactive and centralized care guided by national protocols, including maternal transfer to high-activity regions with better neonatal intensive care practices before delivery. |
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- Infection
- Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
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Mohamad Shieb, Rand Hasanain, Zara Arshad, Faisal A. Nawaz, Rahul Kashyap, Eric J. Stern
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Clin Exp Pediatr. 2024;67(9):427-434. Published online April 5, 2024
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The overall incidence of bloodstream infections was 23.5%. Gram-negative organisms occur at a much higher rate in pediatric liver transplant recipients then that the general pediatric population. However, when comparing pediatric and adult liver transplant recipients Gram-positive organisms occur with a much higher rate in the pediatric population highlighting the importance of early and broad spectrum antimicrobial coverage when bloodstream infections are suspected. |
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- Allergy
- Recent advances in food allergen immunotherapy
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You Hoon Jeon, Edwin H. Kim
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Clin Exp Pediatr. 2024;67(8):386-394. Published online December 7, 2023
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· To enhance the safety of food allergen immunotherapy, alternative approaches such as sublingual immunotherapy, epicutaneous immunotherapy, low-dose oral immunotherapy (OIT), and omalizumab with OIT are being explored.
· Factors such as causative allergen type, natural outgrowth, symptom severity, and patient age should be considered.
· Individualized food allergen immunotherapy plans should be established to determine the most beneficial treatment for each patient. |
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- Original Article
- Infection
- Construction and validation of predictive models for intravenous immunoglobulin–resistant Kawasaki disease using an interpretable machine learning approach
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Linfan Deng, Jian Zhao, Ting Wang, Bin Liu, Jun Jiang, Peng Jia, Dong Liu, Gang Li
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Clin Exp Pediatr. 2024;67(8):405-414. Published online July 23, 2024
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Question: Is there a reliable model to predict intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD)?
Finding: We constructed 5 machine learning models to predict IVIG-resistant KD. Extreme gradient boosting (XGBoost) model was superior to logistic, support vector machine, light gradient boosting machine and multiple layers perception models. The SHAP (SHapley Additive exPlanations) value interpreted the contribution of each feature in XGBoost model.
Meaning: XGBoost model showed the excellent performance to predict IVIG-resistant KD with explainable and visualizable machine learning algorithm. |
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- Original Article
- Neonatology (Perinatology)
- Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial
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Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi
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Clin Exp Pediatr. 2024;67(5):249-256. Published online March 26, 2024
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Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia?
Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants.
Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay. |
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- Review Article
- Nutrition
- Macronutrients modified dietary intervention in the management of overweight/obese children and adolescents: a systematic review
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Jihyun Park, Oh Yoen Kim
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Clin Exp Pediatr. 2024;67(4):191-200. Published online July 11, 2023
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· Dietary macronutrient modifications affect the body composition of and metabolic markers in children and adolescents.
· Hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children.
· Future interventional studies with meta-analyses that include Korean children and adolescents are needed to provide basic information applicable to this population. |
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- Original Article
- Cardiology
- Comparative analysis of adolescent hypertension definitions for predicting early adulthood carotid artery intima-media thickness: Tehran lipid and glucose study
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Maryam Barzin, Shirin Yaghoobpoor, Maryam Mahdavi, Behnaz Abiri, Majid Valizadeh, Fereidoun Azizi, Pooneh Dehghan, Farhad Hosseinpanah
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Clin Exp Pediatr. 2024;67(12):694-703. Published online September 12, 2024
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Question: What is the prevalence of HTN among adolescents enrolled in the TLGS according to 3 different accepted definitions (4th report, ESH, and AAP-CPG). Also, what is the ability of each of these definitions in predicting early adulthood CIMT, as a surrogate for cardiovascular disease events?
Finding: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. The highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively.
Meaning: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG. |
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- General Pediatrics
- Role of proper postnatal care in continued exclusive breastfeeding among young Indonesian mothers
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Wahyu Triadmajani, Shinta Prawitasari, Abdul Wahab
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Clin Exp Pediatr. 2024;67(12):686-693. Published online September 12, 2024
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Question: Is proper postnatal care (PNC) associated with exclusive breastfeeding (EBF) practice among young Indonesian mothers?
Finding: Proper PNC elevates the likelihood of EBF among Indonesian adolescent mothers aged 15–19 years.
Meaning: Breastfeeding services should be provided during the early postnatal period to support EBF practice among adolescent mothers. High-quality PNC is a tailored intervention for vulnerable populations. |
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- Review Article
- Adolescence Medicine
- Diet-related behaviors affecting health and substance use among children and adolescents
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Ji-Hyun Seo, Sochung Chung
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Clin Exp Pediatr. 2024;67(12):664-671. Published online October 31, 2024
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· Diet behaviors in children and adolescents are influenced by environmental and sociocultural factors.
· Unhealthy diet behaviors and poor diet quality are the main contributing factors to noncommunicable diseases and mental health problems during childhood and adolescence.
· Smoking and alcohol drinking in children and adolescents may be associated with unhealthy diet behavior or poor diet quality. |
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- Neonatology (Perinatology)
- Strategies to support language development in neonatal intensive care unit: a narrative review
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Ju Sun Heo, Ee-Kyung Kim
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Clin Exp Pediatr. 2024;67(12):651-663. Published online November 6, 2024
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· Preterm infants often experience speech and language development delays during early childhood, impacting children's ultimate outcomes.
· Promoting breastfeeding, increasing parent-infant interactions in a single-family room, promoting a nurturing language environment by parental book reading and language interventions, and parent-integrated interventions in the neonatal intensive care unit could potentially enhance children's language development.
· Integrating these strategies through family-centered care is essential. |
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- Editorial
- Allergy
- Comorbidities of allergic rhinitis in children
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Yong Ju Lee
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Clin Exp Pediatr. 2024;67(12):675-676. Published online July 31, 2024
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· Allergic rhinitis in children often goes undiagnosed or untreated, with significant systemic complications like sleep disorders, growth issues, and gastrointestinal symptoms linked to nasal obstruction.
· A patient-centered action plan that considers symptom severity, preferences, and comprehensive management of associated complications is essential for effective treatment. |
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- Original Article
- Neonatology (Perinatology)
- Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status
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Sung-Hoon Chung, Chae Young Kim, Yong-Sung Choi, Myung Hee Lee, Jae Woo Lim, Byong Sop Lee, Ki-Soo Kim; the Korean Neonatal Network
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Clin Exp Pediatr. 2024;67(11):619-627. Published online September 12, 2024
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Question: How do structural and staffing characteristics of neonatal intensive care units (NICUs) influence the mortality rates of very low birth weight infants (VLBWIs)?
Findings: NICUs with higher staffing levels, particularly with more neonatologists, and those offering advanced care levels were associated with lower mortality rates. Additionally, regional disparities were observed, with some areas demon-strating significantly higher survival rates.
Meaning: Adequate staffing and equitable regional distribution of medical resources are crucial for improving survival outcomes in VLBWIs. Efforts to enhance NICU staffing and address regional healthcare disparities are essential for optimizing care quality and reducing mortality in this vulnerable population. |
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- Allergy
- Regional differences in diagnosis and management of cow's milk allergy
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Fabian Hendricx, Emma Robert, Jaime A. Ramirez-Mayans, Karen Rubi Ignorosa Arellano, Erick M. Toro Monjaraz, Yvan Vandenplas
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Clin Exp Pediatr. 2024;67(11):601-607. Published online October 28, 2024
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· Although there is broad consensus on many aspects regarding the symptoms, diagnosis, and treatment of cow's milk allergy, the impact of geographical, cultural, and socioeconomic factors remains unestablished.
· Availability and cost of formula for the management of cow's milk allergy have a major impact on the therapeutic choice.
· Region-specific guidelines for the treatment of cow's milk allergy are required. |
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- Review Article
- Developmental and Behavioral Medicine
- Effect of pesticide exposure on stunting incidence: a systematic review and meta-analysis
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Sani Rachman Soleman, Yaltafit Abror Jeem, Muhammad Fathi Banna Al Faruqi, Mahdea Kasyiva, Vita Widyasari, Kuswati Kuswati, Nur Aini Djunet, Muflihah Rizkawati, Ety Sari Handayani
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Clin Exp Pediatr. 2024;67(10):510-518. Published online September 24, 2024
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This review aimed to determine whether pesticide exposure is associated with stunting in children. The 13 included studies agree that pesticide exposure is not correlated with stunting incidence regardless of substance type (organophosphate and pyrethroid). Heterogeneity appeared with age covariate as potential confounding. The evidence of this study is challeng-ing, as the adverse effects of pesticides grossly occurred. The protection of children is warranted for preventing future neurodevelopment issues. |
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- Original Article
- Neonatology (Perinatology)
- Protective effect of recombinant interleukin-10 on newborn rat lungs exposed to short-term sublethal hyperoxia
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Hyeon-Soo Lee, Young-Joon Ryu, Min-Jae Lee
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Clin Exp Pediatr. 2024;67(10):540-549. Published online September 27, 2024
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Lung injury is generated from the early stage of hyperoxia through the biologic effects of cell death and inflammatory response, which eventually leads to evolution of bronchopul-monary dysplasia. Therefore, a protective measure against hyperoxia-induced lung injury is needed. The present study observed that anti-inflammatory cytokine, interleukin-10 had protective effects on newborn rat lungs from injury induced at the early stage of hyperoxia, by preventing cell death and down-regulating inflammatory response. |
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