Clinical and Experimental Pediatrics

Original Article

Gastroenterology

Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study

Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw

Clin Exp Pediatr. 2025;68(3):247-256. Published online November 13, 2024

Web of Science 1 Crossref 1

Question: Short-term (1-year) follow-up data in pediatric patients with inflammatory bowel disease (IBD), especially in Southeast Asian countries, are limited.
Finding/Meaning: Abdominal pain and pallor rates remained high at 1 year after IBD diagnosis. Three independent factors of 1-year clinical remission for Crohn disease were oral prednisolone, antibiotic, and immunomodulator use at 1-year follow-up. A history of weight loss at diagnosis was the only independent risk factor of IBD flare.

DOI: https://doi.org/10.3345/cep.2024.01144

Endocrinology

Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency

Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul

Clin Exp Pediatr. 2025;68(3):238-246. Published online November 13, 2024

Crossref 1

Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population?
Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change.
Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development.

DOI: https://doi.org/10.3345/cep.2024.01060

General Pediatrics

Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia

Abdul Wahab, Ida Safitri Laksanawati, Retna Siwi Padmawati, Asal Wahyuni Erlin Mulyadi, Wahyu Triadmajani, Jarir At Thobari

Clin Exp Pediatr. 2025;68(3):228-237. Published online November 13, 2024

Web of Science 1 Crossref 1

Question: Do community members and health providers show different level of knowledge, attitude, and practice towards dengue vaccine?
Finding: These 2 groups only differed in practice component, while the knowledge and attitude constituents were relatively low for both.
Meaning: There is an urgent need to deliver educational interventions to raise awareness of community members and health providers regarding dengue vaccination.

DOI: https://doi.org/10.3345/cep.2024.00962

Editorial

Neonatology (Perinatology)

The predetermined future: tackling South Korea’s total fertility rate crisis

Jin Kyu Kim

Clin Exp Pediatr. 2025;68(3):225-227. Published online November 6, 2024

· South Korea faces a severe demographic crisis with the lowest global fertility rate. Despite significant investments, the total fertility rate continues to decline.
· It is necessary to fully mobilize national capabilities and execute comprehensive strategies that focus on both intangible and tangible values.
· Immediate and decisive action is essential to addressing these challenges effectively.

DOI: https://doi.org/10.3345/cep.2024.00871

Nutrition

Zinc as a treatment modality for acute infectious diarrhea in children

Ji Sook Park

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

· 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

Review Article

Endocrinology

Hidden link between endocrine-disrupting chemicals and pediatric obesity

Min Won Shin, Shin-Hye Kim

Clin Exp Pediatr. 2025;68(3):199-222. Published online November 28, 2024

Studies indicate potential connections between exposure to endocrine-disrupting chemicals (EDCs) and childhood obesity. Variations in the impact of EDCs in epidemiological studies may result from differences in exposure concentrations and timing, measurement methods, and interactive effects of multiple EDCs. Longitudinal studies on exposure to multiple EDCs are crucial to elucidating their contribution to pediatric obesity and minimize the adverse health consequences of EDC exposure.

DOI: https://doi.org/10.3345/cep.2024.00556

Gastroenterology

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

Byung-Ho Choe

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

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

Neonatology (Perinatology)

Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates

Kulthida Baingam, Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate

Clin Exp Pediatr. 2025;68(2):178-184. Published online November 13, 2024

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.

DOI: https://doi.org/10.3345/cep.2024.01011

Developmental and Behavioral Medicine

Characteristics of temper tantrums in 1–6-year-old children and impact on caregivers

Warangkana Prutipaisan, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho

Clin Exp Pediatr. 2025;68(2):170-177. Published online November 13, 2024

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.

DOI: https://doi.org/10.3345/cep.2024.00766

Neurology

Evaluation of pediatric migraine triggers: a single-center study

Hey-Joon Son, Joo-Ok Jin, Kon-Hee Lee

Clin Exp Pediatr. 2025;68(2):163-169. Published online November 11, 2024

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.

DOI: https://doi.org/10.3345/cep.2024.00738

Infection

Clinical characteristics and associated factors of pediatric acute necrotizing encephalopathy: a retrospective study

Huiling Zhang, Yilong Wang, Qianyun Ding, Xuekun Li, Sheng Ye

Clin Exp Pediatr. 2025;68(2):153-162. Published online November 11, 2024

· The mortality rate of acute necrotizing encephalopathy was high.
· Laboratory tests revealed that the fatal group had higher creatinine, lactate, activated partial thromboplastin time, thrombin time, interleukin (IL)-6, IL-10, creatine kinase, and D-dimer than survivors.
· The fatal group displayed lower Glasgow Coma Scale scores and arterial pH.

DOI: https://doi.org/10.3345/cep.2024.00794

Gastroenterology

Differences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing

Dae Yong Yi, Hong-Jai Park, Min Sun Shin, Hyoungsu Kim, Sang Jin Lee, Insoo Kang

Clin Exp Pediatr. 2025;68(2):141-152. Published online January 10, 2025

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.

DOI: https://doi.org/10.3345/cep.2024.01585

Editorial

Hematology

Absolute versus functional iron deficiency

Hye Lim Jung

Clin Exp Pediatr. 2025;68(2):138-140. Published online November 13, 2024

Web of Science 1 Crossref 1

· Iron deficiency (ID), the most common cause of anemia, can be classified into absolute and functional types. Absolute ID is a state of low total body iron, while functional ID is a state of imbalance between iron demand and iron availability due to inflammation and/or infection.
· ID is diagnosed by serum ferritin and transferrin saturation levels.

DOI: https://doi.org/10.3345/cep.2023.01732

Allergy

Effect of metabolic syndrome on pulmonary dysfunction in children with asthma

Hyo-Bin Kim

Clin Exp Pediatr. 2025;68(2):136-137. Published online November 13, 2024

· The prevalence of metabolic syndrome increased in Korean children during the coronavirus disease 2019 pandemic owing to reduced physical activity resulting from social distancing.
· Metabolic syndrome impacts pulmonary dysfunction in childhood asthma.
· Further studies are needed to understand the mechanism linking asthma and metabolic syndrome and develop interventions.

DOI: https://doi.org/10.3345/cep.2024.00360

Review Article

Gastroenterology

Value of transabdominal ultrasonography for diagnosing functional constipation in children: a systematic review and meta-analysis

Duc Long Tran, Phu Nguyen Trong Tran, Paweena Susantitaphong, Phichayut Phinyo, Palittiya Sintusek

Clin Exp Pediatr. 2025;68(2):127-135. Published online November 13, 2024

Transabdominal ultrasonography is increasingly used as a novel modality for detecting pediatric functional constipation (FC). This systematic review and metaanalysis aimed to assess the diagnostic parameters of FC including rectal diameter (RD) and anterior rectal wall thickness. A systematic search was conducted of the Ovid MEDLINE, Embase, Scopus, and PubMed databases through September 29, 2023, to identify studies comparing RD...

DOI: https://doi.org/10.3345/cep.2024.00927

General Pediatrics

Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis

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

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

Hematology

Promising role of voxelotor in managing sickle cell disease in children: a narrative review

Amit Agrawal, Gaurav Jadon, Japna Singh, Dalwinder Janjua

Clin Exp Pediatr. 2025;68(2):106-114. Published online November 13, 2024

Voxelotor has promising ability to increase hemoglobin levels and reduce hemolysis markers in patients with sickle cell disease (SCD). Several preclinical and phase II/III trials have demonstrated its efficacy, dose-dependent responses, and tolerability in children. Ongoing trials are assessing its safety and effectiveness in various populations, including children younger than 12 years. These findings suggest its potential as a disease-modifying drug, warranting further exploration of its role in SCD management.

DOI: https://doi.org/10.3345/cep.2024.00500

Letter to the Editor

Other

Adolescent hypertension and carotid intima-media thickness: significance of submillimetric differences

Christian Saleh

Clin Exp Pediatr. 2025;68(1):104-105. Published online November 28, 2024

DOI: https://doi.org/10.3345/cep.2024.01466

Original Article

Neurology

Instability of revised Korean Developmental Screening Test classification in first year of life

Ji Eun Jeong, You Min Kim, Na Won Lee, Gyeong Nam Kim, Jisuk Bae, Jin Kyung Kim

Clin Exp Pediatr. 2025;68(1):97-103. Published online November 11, 2024

Question: How stable are the revised Korean Developmental Screening Test score classifications in early infancy?
Finding: A significant number of infants improved into the peer and high-level group (≥-1 standard deviations), especially in the gross motor area.
Meaning: The early detection of developmental delay requires a comprehensive medical history, physical and neurological examinations, and repeated developmental screenings.

DOI: https://doi.org/10.3345/cep.2024.00619

Endocrinology

Efficacy of leuprolide acetate versus triptorelin pamoate administered every 3 months for treatment of central precocious puberty

Thanaporn Thaneetrakool, Suphab Aroonparkmongkol, Nattakarn Numsriskulrat, Vichit Supornsilchai, Suttipong Wacharasindhu, Khomsak Srilanchakon

Clin Exp Pediatr. 2025;68(1):91-96. Published online November 6, 2024

Question: What are the differences in efficacy between leuprolide acetate and triptorelin pamoate administered every 3 months for the treatment of central precocious puberty (CPP)?
Finding: There were no significant intergroup differences in luteinizing hormone suppression or predicted adult height at the end of treatment in girls with CPP.
Meaning: Leuprolide acetate and triptorelin pamoate have comparable efficacy for treating CPP.

DOI: https://doi.org/10.3345/cep.2024.00822

Pulmonology

Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?

Rungrat Sukharom, Prakarn Tovichien, Kanokporn Udomittipong, Pinyapach Tiamduangtawan, Wattanachai Chotinaiwattarakul

Clin Exp Pediatr. 2025;68(1):80-90. Published online November 6, 2024

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.

DOI: https://doi.org/10.3345/cep.2024.00066

Neonatology (Perinatology)

Short-term outcomes of oropharyngeal administration of colostrum in preterm neonates: a double-blind placebocontrolled randomized trial

Ameneh Lamsehchi, Maryam Shokouhi Solgi, Mohammad Kazem Sabzehei, Behnaz Basiri, Elahe Talebi Ghane, Kiana Kimiaei Asadi, Sina Azadnajafabad

Clin Exp Pediatr. 2025;68(1):73-79. Published online October 31, 2024

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.

DOI: https://doi.org/10.3345/cep.2024.00591

Infection

Carbapenem resistance in gram-negative pathogens in an Iranian hospital: high prevalence of OXA-type carbapenemase genes

Setareh Mamishi, Reihaneh Hosseinpour Sadeghi, Sadaf Sajedi Moghaddam, Babak Pourakbari, Shiva Poormohammadi, Maryam Sotoudeh Anvari, Shima Mahmoudi

Clin Exp Pediatr. 2025;68(1):65-72. Published online October 31, 2024

Question: What is the prevalence of carbapenem resistance in gram-negative bacteria and associated carbapenemase genes?
Findings: This study identified a notable prevalence of carbapenem-resistant gram-negative isolates, with Escherichia coli being the predominant contributor, follow ed by Klebsiella pneumoniae, Acinetobacter baumannii, while bla _OXA48 was the most prevalent carbapenemase gene.
Meaning: These findings highlight the urgent need for proactive measures including the rapid detection of carbapenemase- producing isolates and effective infection control.

DOI: https://doi.org/10.3345/cep.2023.01774

Editorial

Cardiology

What we should know about pediatric heart failure: children are not small adults

Ja-Kyoung Yoon

Clin Exp Pediatr. 2025;68(1):62-64. Published online November 6, 2024

· Pediatric heart failure (PHF) features high morbidity and mortality rates.
· Although adults and children can share a common diagnosis of heart failure, the underlying causes can differ significantly and require distinct therapeutic approaches.
· Treatments designed for adults are often applied to PHF despite the fundamental physiological and developmental differences between them.
· Child-specific data are vital for the development of tailored treatments to meet the unique needs of patients with PHF.

DOI: https://doi.org/10.3345/cep.2023.01130

Review Article

Neonatology (Perinatology)

Need for national guidance regarding proactive care of infants born at 22–23 weeks' gestation

Ga Won Jeon

Clin Exp Pediatr. 2025;68(1):53-61. Published online November 13, 2024

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2024.01277

Endocrinology

A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders

Nur Faten Hafizah Rosli, Noor Shafina Mohd Nor, Rose Adzrianee Adnan, Siti Hamimah Sheikh Abdul Kadir

Clin Exp Pediatr. 2025;68(1):30-52. Published online November 6, 2024

Crossref 1

· The prevalence of vitamin D deficiency is high among children and adolescents and mainly attributed to changes in environmental factors.
· Vitamin D hormone-like properties are associated with many endocrine-related disorders.
· The effect of vitamin D is modulated by the vitamin D receptor, polymorphisms of which are reportedly associated with an increased risk of disease development in children and adolescents.

DOI: https://doi.org/10.3345/cep.2024.00227

Other

Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea

Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S. Tremblay

Clin Exp Pediatr. 2025;68(1):16-29. Published online November 11, 2024

· The 24-hour movement behavior paradigm provides an important framework for future pediatric health promotion efforts.
· Policy priorities should include advancing surveillance and monitoring assessments related to 24-hour movement behaviors, evaluating their implementation in school and government policies, and building preparedness for future pandemics and natural disasters, including climate change, by promoting healthy 24-hour movement behaviors.
· Future research should advocate for the promotion of 24- hour movement behaviors.

DOI: https://doi.org/10.3345/cep.2024.00178

Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies

Rogers Wainkwa Chia, Ntegang Venant Atem, Jin-Yong Lee, Jihye Cha

Clin Exp Pediatr. 2025;68(1):1-15. Published online November 6, 2024

Web of Science 8 Crossref 9

· Milk and formula are common sources of microplastic in infants.
· Water and air are the most common sources of microplastic pollution from infancy to adolescence.
· Microplastic use by children of all ages can cause cell damage and affect their health.
· Microplastics present in children can be quantified using a stereomicroscope and characterized using micro- Fourier transform infrared spectroscopy.

DOI: https://doi.org/10.3345/cep.2023.01739

Clinical Note

Oncology

Right ventricular mass in a 10-year-old girl with osteosarcoma: an unusual case of asymptomatic cardiac metastasis

Jun Ah Lee, Hyun-Ju Lim, Jong Woong Park, Sang-Hoon Shin, Mi Hyang Kwak

Clin Exp Pediatr. 2024;67(12):725-727. Published online November 26, 2024

DOI: https://doi.org/10.3345/cep.2024.00857

Original Article

Other

Balance assessment with decreased base of support for children with disabilities

Guilherme M. Cesar, Madison Giebler, Thad W. Buster, Judith M. Burnfield

Clin Exp Pediatr. 2024;67(12):718-724. Published online November 11, 2024

Question: Can a balance task with narrowed base of support indicate overall functional balance control in children with disabilities?
Finding: While single-limb standing could explain overall balance control for children with disabilities, it was unrelated with balance control for typically developing children.
Meaning: One balance task with narrowed base of support can be used as practical assessment of balance abilities for children with disabilities when allocated session time is of concern.

DOI: https://doi.org/10.3345/cep.2024.00780

Cited By 25	Neurodevelopmental outcomes of preterm infants
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Cited By 19	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
Cited By 18	Nonalcoholic fatty liver disease and insulin resistance in children

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