Clinical and Experimental Pediatrics

Review Article

Neonatology (Perinatology)

Demographic transition in South Korea: implications of falling birth rates (90 times)

Chae Young Kim, Sung-Hoon Chung

Clin Exp Pediatr. 2024;67(10):498-509. Published online June 27, 2024

· Since 1960, South Korea's TFR decreased from 6.33 to 0.78 in 2022, below the 2.1 replacement level since 1983, with women's average age at first marriage rising to 31.3 in 2022.
· Policies needed: financial incentives, longer parental leave, better childcare.
· The U.S. (15.3% immigrants) and Germany (18.8%) use immigration to maintain demographic stability, a strategy South Korea is considering.

DOI: https://doi.org/10.3345/cep.2023.01599

Original Article

General Pediatrics

Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial (90 times)

Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium

Clin Exp Pediatr. 2026;69(2):150-162. Published online October 30, 2025

Web of Science 2 Crossref 1

Question: Can probiotic BLa80 bring long-term benefits to the health of young children?
Finding: This trial demonstrated that the daily administration of s BLa80 at 5×109 colony-forming units for 3 months in children can reduce the risk of eczema, upper respiratory tract infections, and acute tracheitis/bronchitis as well as beneficially improve the gut microbiome without any adverse effect.
Meaning: Bla80 can bring definite health benefits to young children.

DOI: https://doi.org/10.3345/cep.2025.01256

Nonpharmacological interventions for managing postoperative pain and anxiety in children: a randomized controlled trial (89 times)

Edlin Glane Mathias, Mamatha Shivananda Pai, Vijay Kumar, Dinesh Narayanakurup, Malavika Kulkarni, Vasudeva Guddattu, Ann-Cathrine Bramhagen, Baby S Nayak, Anice George

Clin Exp Pediatr. 2024;67(12):677-685. Published online October 31, 2024

Web of Science 6 Crossref 4

Question: What is the effect of nonpharmacological interventions on postoperative pain and anxiety among children.
Finding: Nurse-provided distraction interventions reduce pain and anxiety among pediatric surgical patients.
Meaning: The findings suggest that nonpharmacological interventions provided postoperatively to children reduce their pain and anxiety levels.

DOI: https://doi.org/10.3345/cep.2023.01690

Review Article

General Pediatrics

Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis (89 times)

Ker Yang Chua, Ker Yung Chua, Karuthan Chinna, Chooi Ling Lim, Maheeka Seneviwickrama

Clin Exp Pediatr. 2025;68(2):115-126. Published online November 13, 2024

Web of Science 4 Crossref 4

The incidence of childhood obesity is increasing worldwide. National surveys in Malaysia have shown similar trends. This review aimed to increase our understanding of the prevalence and associated factors of childhood overweight, obesity, and excess weight in Malaysia. A systematic review and meta-analysis were conducted of studies reporting the prevalence of overweight and obesity in Malaysian children aged <18 years....

DOI: https://doi.org/10.3345/cep.2024.00899

Neonatology (Perinatology)

Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea (86 times)

In Gyu Song, Trisha M. Prentice, Lynn Gillam

Clin Exp Pediatr. 2026;69(4):282-292. Published online March 13, 2026

Web of Science 1 Crossref 1

Shared decision-making (SDM) offers an ethically grounded, relational approach to making difficult decisions in neonatal care. Its effective use depends on recognizing when its use is appropriate and enacted in clinical conversations. In Korea, while parents are often involved in decision-making, SDM is not yet consistently articulated or evaluated as a structured practice. Culturally grounded research, education, and institutional support are needed to strengthen family-centered neonatal care.

DOI: https://doi.org/10.3345/cep.2025.02929

Gastroenterology

Sarcopenia in pediatric gastroenterology and hepatology: an updated review (85 times)

Toshifumi Yodoshi

Clin Exp Pediatr. 2026;69(5):366-383. Published online April 27, 2026

Pediatric sarcopenia is common in chronic gastrointestinal and liver diseases, often hidden by normal body mass index or obesity, and predicts worse outcomes. Because growth and puberty alter body composition, assessment should use age- and sex-specific measures of muscle mass and, when feasible, function. Early multidisciplinary intervention—protein-adequate nutrition, resistance-based activity, and disease control—may improve prognosis.

DOI: https://doi.org/10.3345/cep.2026.00234

Original Article

Pulmonology

Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: a randomized controlled trial (83 times)

Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh

Clin Exp Pediatr. 2025;68(9):690-699. Published online April 1, 2025

This study assessed the effects of vitamin C on children with community-acquired pneumonia (CAP). Vitamin C supplementation improved clinical symptoms within 48–72 hours compared to placebo but did not reduce the length of hospital stay (LOS). These findings suggest that vitamin C is beneficial for managing CAP severity, but does not affect LOS.

DOI: https://doi.org/10.3345/cep.2025.01970

Review Article

Immunology

Multiomics approaches in Kawasaki disease: insights into pathogenesis and emerging directions for diagnosis and treatment (80 times)

Jong Gyun Ahn, Insoo Kang

Clin Exp Pediatr. 2026;69(3):197-210. Published online February 25, 2026

Web of Science 1 Crossref 2

Kawasaki disease (KD) is an acute febrile vasculitis and the leading cause of acquired heart disease in children. Despite decades of research, the etiology remains unknown and key mechanisms linking systemic inflammation to coronary artery lesions are incompletely defined. High-throughput technologies—including genomics, transcriptomics, proteomics, metabolomics, epigenomics, and immunomics—have enabled systems-level profiling of KD and highlighted reproducible inflammatory and vascular pathways....

DOI: https://doi.org/10.3345/cep.2025.02901

Critical Care Medicine

Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis (79 times)

Ambrus Szemere, Alíz Fazekas, Anna Réka Sebestyén, Rani Ezzeddine, Veronika Upor, Marie Anne Engh, Péter Hegyi, Zsolt Molnár, Klára Horváth

Clin Exp Pediatr. 2025;68(6):406-416. Published online February 19, 2025

Crossref 1

Protocolized sedation may reduce ventilation requirements, pediatric intensive care unit length of stay, and sedative exposure. However, it may increase the likelihood of unplanned extubation, highlighting the importance of incorporating preventive measures to mitigate this risk.

DOI: https://doi.org/10.3345/cep.2024.01711

Original Article

Endocrinology

Intramuscular and subcutaneous gonadotropin-releasing hormone agonist tests for central precocious puberty in girls: a randomized controlled trial (79 times)

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

Clinical Note

Gastroenterology

Ultrasonographic features of 5-aminosalicylic acid intolerance in pediatric ulcerative colitis (78 times)

Hirotoki Murashige, Yasufumi Sakata, Yoshihiro Azuma, Shunji Hasegawa

Clin Exp Pediatr. 2026;69(6):524-526. Published online May 28, 2026

Web of Science 1

DOI: https://doi.org/10.3345/cep.2025.02446

Review Article

Gastroenterology

High-resolution anorectal manometry in children (74 times)

Yogesh Waikar

Clin Exp Pediatr. 2024;67(2):57-63. Published online June 14, 2023

Web of Science 2 Crossref 5

· Anorectal manometry is safe in children.
· Defecation Dyssynergia is one of the commonest cause of chronic constipation.
· Positive Rectoanal inhibiory reflex rules out Hirschsprung's Disease

DOI: https://doi.org/10.3345/cep.2022.01242

Developmental and Behavioral Medicine

Screen time among preschoolers: exploring individual, familial, and environmental factors (74 times)

Sangha Lee, Donghee Kim, Yunmi Shin

Clin Exp Pediatr. 2024;67(12):641-650. Published online September 12, 2024

Web of Science 9 Crossref 13

This systematic review examined the correlation between screen time and various factors in preschoolers. Findings suggest that media parenting, including setting appropriate media limits, is crucial in protecting against excessive screen exposure. However, limited research has been done on the impact of family and personal factors, particularly with the increasing use of portable devices among young children.

DOI: https://doi.org/10.3345/cep.2023.01746

Original Article

Neurology

Clinical application of whole exome and genome sequencing in pediatric neurodevelopmental disorders (74 times)

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

Review Article

Endocrinology

Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis (74 times)

Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Ahmed, Khaled A. Siddiq, Mohammed Qusad, Mohamed AlKhalaf

Clin Exp Pediatr. 2026;69(7):531-541. Published online June 18, 2026

In boys with constitutional delay of growth and puberty, a short course of low-dose testosterone consistently accelerates linear growth and advances pubertal maturation. Long-term follow-up studies do not show a clinically meaningful effect of conservative regimens on near-adult height. As the pooled quantitative evidence represents only 46 boys in 2 controlled studies, treatment should remain individualized, while larger randomized trials using standardized patient-reported outcomes are needed.

DOI: https://doi.org/10.3345/cep.2026.00675

General Pediatrics

Metabolic complications of obesity in children and adolescents (73 times)

Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park

Clin Exp Pediatr. 2024;67(7):347-355. Published online November 16, 2023

Web of Science 36 Crossref 39

· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity.

DOI: https://doi.org/10.3345/cep.2023.00892

Original Article

Neonatology (Perinatology)

Prolonged cerebral oxygenation surveillance with algorithm-based management: a neurocritical care bundle for extremely preterm infants (73 times)

Kai-Hsiang Hsu, Wei-Hung Wu, Shu-Yu Lin, Chih-Chen Chang, Mei-Yin Lai, I-Hsyuan Wu, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien

Clin Exp Pediatr. 2026;69(4):304-312. Published online December 22, 2025

Web of Science 1

Question: Is prolonged monitoring of regional cerebral oxygen saturation (rcSO₂) and hemodynamic parameters a feasible approach? Can these measures predict the neurological outcomes in extremely preterm infants?
Finding: We used a neurocritical care bundle from birth to discharge or term-equivalent age. Infants with poor outcomes had significantly lower rcSO₂ values.
Meaning: Understanding rcSO₂ and hemodynamic parameters may help manage cerebral hypoxia and reduce neurological complications in extremely preterm infants.

DOI: https://doi.org/10.3345/cep.2025.02117

Review Article

General Pediatrics

Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review (70 times)

Sandhya J. Kadam, Malika Goel

Clin Exp Pediatr. 2025;68(11):852-857. Published online October 2, 2025

Web of Science 1 Crossref 3

The prevalence of autism is increasing worldwide. The United States has the highest numbers, likely due to the availability of better treatment options. However, global disparities exist, especially in low-resource settings in which stigma, underdiagnosis, and limited services hinder care. A coordinated international approach emphasizing early screening, inclusive policies, and culturally sensitive support systems can bridge this gap and improve the outcomes for children with autism and their families worldwide.

DOI: https://doi.org/10.3345/cep.2025.00969

Original Article

Gastroenterology

Longitudinal analysis of gut microbiota dysbiosis and bacterial signatures predictive of postoperative enterocolitis in children with Hirschsprung disease (67 times)

Sireekarn Chantakhow, Chanon Kunasol, Jiraporn Khorana, Kanokkan Tepmalai, Nipon Chattipakorn, Siriporn C. Chattipakorn

Clin Exp Pediatr. 2026;69(3):214-227. Published online December 10, 2025

Question: Do gut microbiota differ between patients with Hirschsprung disease (HSCR) and healthy children, and can specific bacterial taxa predict postoperative HSCRassociated enterocolitis (HAEC)?
Finding: Patients with HSCR showed gut dysbiosis with reduced diversity. Postoperative microbial changes included increased alpha diversity. Certain taxa, such as Eubacterium and Collinsella, were associated with recovery or HAEC.
Meaning: Distinct microbial signatures may help identify HAEC risk and guide microbiota-based strategies to improve outcomes.

DOI: https://doi.org/10.3345/cep.2025.01886

Hematology

Granulocyte transfusion improves survival in pediatric febrile neutropenia: a 15-year cohort study (67 times)

Witsanu Phetsai, Kleebsabai Sanpakit, Jassada Buaboonnam, Kamon Phuakpet, Nassawee Vathana, Nattee Narkbunnam, Fon Kladed, Chayamon Takpradit

Clin Exp Pediatr. 2026;69(3):236-246. Published online January 12, 2026

Question: Does granulocyte transfusion improve survival and clinical recovery in pediatric febrile neutropenia?
Finding: In this 15-year real-world cohort, granulocyte transfusion significantly increased 30-day survival (92.3 % vs. 65.4%; adjusted odds ratio, 0.105; P=0.020) and accelerated fever and neutrophil recovery without serious adverse events.
Meaning: Granulocyte transfusion may be an effective adjunctive therapy for severe neutropenic infections in children, particularly in low- and middle-income settings.

DOI: https://doi.org/10.3345/cep.2025.01186

Endocrinology

Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort (67 times)

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

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

Editorial

Nutrition

Zinc as a treatment modality for acute infectious diarrhea in children (66 times)

Ji Sook Park

Clin Exp Pediatr. 2025;68(3):223-224. Published online October 31, 2024

Web of Science 1 Crossref 1

· Prevention and management of dehydration is the major goal of treatment in acute infectious diarrhea in children.
· Zinc could be effective as an adjuvant therapy in reducing the duration of acute infectious diarrhea in malnourished children.

DOI: https://doi.org/10.3345/cep.2024.00381

Original Article

Neonatology (Perinatology)

Perinatal risk factors for hemodynamically significant patent ductus arteriosus in very low birth weight infants (66 times)

Jie Hee Jue, So Young Shin, Jae Hyun Park, Chun Soo Kim, Hee Joung Choi

Clin Exp Pediatr. 2026;69(4):313-321. Published online December 22, 2025

Question: What perinatal factors influence patent ductus arteriosus (PDA) in and improve outcomes of preterm infants?
Finding: Lower birth weight, frequent surfactant treatment, and maternal hypertension increased hemodynamically significant PDA risk in very low birth weight infants, whereas chorioamnionitis and premature rupture of membranes protected against it. A lower birth weight and incomplete antenatal steroid use increased the risk of surgical ligation, whereas small for gestational age reduced it.
Meaning: Recognizing these factors may enable early, targeted intervention and reduce the need for surgical management.

DOI: https://doi.org/10.3345/cep.2025.01893

Nutrition

Human milk macronutrient composition and intake in relation to preterm infant growth: a cohort study (66 times)

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

Endocrinology

Anthropometric trajectories of Korean children and adolescents with severe obesity (66 times)

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

Editorial

General Pediatrics

Adiposity rebound in early childhood: understanding body mass index percentiles and monitoring on growth charts to be healthy (65 times)

Sochung Chung

Clin Exp Pediatr. 2026;69(4):301-303. Published online April 1, 2026

Height, weight, and body mass index percentiles should be tracked in routine childhood health checkups to address the age of adiposity rebound in early childhood. Comprehensive interventional lifestyle counselling in primary practice after growth and nutritional status assessments might be an early, effective strategy for preventing obesity and decreasing the double burden of disease in later life. Therefore, there is an urgent need for a cooperative and supportive health care system.

DOI: https://doi.org/10.3345/cep.2026.00668

Review Article

Infection

Recommendation for use of a long-acting monoclonal antibody to prevent respiratory syncytial virus infection in infants and young children (63 times)

Soo-Han Choi, Dong Hyun Kim, Jong Gyun Ahn, Ki Wook Yun, Byung-Wook Eun, Jin Lee, Jina Lee, Taek-Jin Lee, Hyunju Lee, Dae Sun Jo, Eun Young Cho, Hye-Kyung Cho, Young June Choe, Ui Yoon Choi, Yun-Kyung Kim; The Committee on Infectious Diseases of the Korean Pediatric Society

Clin Exp Pediatr. 2025;68(10):742-750. Published online September 3, 2025

Crossref 1

To prevent respiratory syncytial virus (RSV)-associated lower respiratory tract infections, a single dose of nirsevimab, a long-acting monoclonal antibody, is recommended for all neonates born during the RSV season (October to March) and all infants younger than 6 months old at the start of the RSV season. Nirsevimab should be administered shortly after birth to neonates and just before or early in the season to infants entering their first RSV season.

DOI: https://doi.org/10.3345/cep.2025.01067

Allergy

Comparison and review of international guidelines for treating asthma in children (60 times)

Eui Jeong Roh

Clin Exp Pediatr. 2024;67(9):447-455. Published online August 20, 2024

Web of Science 6 Crossref 6

Asthma is the most common chronic disease among children. Although asthma in children may spontaneously improve, it continues into adulthood in many cases. Therefore, appropriate disease management and medication are essential. Consistent and objective guidelines are needed to manage pediatric asthma and related adverse reactions.

DOI: https://doi.org/10.3345/cep.2022.01466

Gastroenterology

Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children (60 times)

Byung-Ho Choe

Clin Exp Pediatr. 2025;68(3):185-198. Published online November 13, 2024

Web of Science 2 Crossref 2

Eosinophilic gastrointestinal disorders (EGIDs) often coexist with functional gastrointestinal disorders (FGIDs) and other IgE or non-IgE mediated GI diseases. Diagnosing EGIDs requires a high index of suspicion and a comprehensive approach to differentiate them from conditions like inflammatory bowel disease. Tests such as fecal calprotectin and biopsies aid in severe cases. Maintaining a food diary helps identify triggers for long-term elimination. Awareness and education are key to effective management.

DOI: https://doi.org/10.3345/cep.2024.01165

Original Article

Nutrition

Success rates of conservative treatment and optimal surgical timing for pediatric chylothorax (60 times)

Pakwan Kaewchusen, Narumon Densupsoontorn, Supaluck Kanjanauthai, Puthita Saengpanit

Clin Exp Pediatr. 2025;68(11):871-878. Published online August 6, 2025

Web of Science 2 Crossref 1

Question: What is the success rate of conservative treatment for pediatric chylothorax, and when should surgical intervention be employed?
Finding: Overall success rate of conservative treatment was 83.3%. Surgically related etiologies and lower peak pleural fluid drainage rates were significantly associated with successful conservative management of pediatric chylothorax.
Meaning: If chylous drainage persists at ≥10 mL/kg/day beyond 2 weeks of optimal conservative treatment, surgical intervention should be considered.

DOI: https://doi.org/10.3345/cep.2025.00598

Cited By 60	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
Cited By 39	Metabolic complications of obesity in children and adolescents
Cited By 37	Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment
Cited By 34	Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies
Cited By 34	Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study

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