Objective To evaluate pancreatic stone protein (PSP) levels in extremely preterm neonates and their association with early-onset sepsis (EOS), late-onset sepsis (LOS), and necrotizing enterocolitis (NEC). Study design A prospective longitudinal study, evaluating serial PSP, C-reactive protein (CRP), and white blood cell (WBC) count during the first ten days after birth. Results Thirty extremely preterm neonates with a mean gestational age of 26.5 ± 1.8 weeks and a mean birth weight of 890 ± 304 g were enrolled. PSP increased significantly 48 h before LOS presentation, with a diagnostic accuracy higher than that of CRP and WBC (AUROC 0.711, 0.567, and 0.538, respectively). PSP levels also increased from 72 h before NEC onset, with a better discriminatory ability than CRP and WBC (AUROC 0.851, 0.648, and 0.616, respectively). Conclusion PSP may represent a promising early biomarker for LOS and NEC in extremely preterm neonates. Larger multicenter studies are required to validate these findings.
Introduction Early childhood developmental conditions play a key role in subsequent neuropsychological trajectories and may predict later emotional and behavioral problems. Objective To investigate the association between developmental delays in children aged 2–3 years and emotional and behavioral problems at 4–5 years. Methods This is a longitudinal study of mother-child dyads followed up within a cohort of pregnant adolescents attending the Public Health System in Southern Brazil. Child development was assessed at 2–3 years of age using the cognitive, language, and social-emotional domains of the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III). The outcomes at 4–5 years included depressive, anxiety, attention deficit/hyperactivity, autism spectrum, and oppositional defiant problems evaluated using the Child Behavior Checklist (CBCL). Results Two hundred and eighty-five children were evaluated for child development at age 2–3 and for emotional and behavioral problems at age 4–5. Children with language delay had a higher prevalence of depressive (PR = 1.88; 95% CI: 1.02–3.46) and anxiety problems (PR = 1.77; 95% CI: 1.10–2.85) at preschool age, compared to those without delay. No significant associations were observed between delays in the cognitive and social-emotional domains and the outcomes. Conclusion Language delays in early childhood are associated with a higher probability of emotional problems at preschool age. These findings suggest that early developmental changes may serve as relevant clinical markers for identifying children at risk and for providing early interventions.
Objective In females, unilateral renal agenesis is associated with genital tract abnormalities, which can cause complications in childhood and beyond. However, its prevalence and characteristics are not consistently integrated into antenatal counselling. Methods An original retrospective case series study (2005–2024) at Guy's and St Thomas' Hospital identified fetuses with isolated antenatally diagnosed unilateral renal agenesis from an Astraia database, with standardized 6-week postnatal imaging. Results 110 cases of renal agenesis were identified. Of these, fifteen cases (n = 15) were excluded due to bilateral renal agenesis and five due to additional extra-renal abnormalities (n = 5). Outcome data was unavailable for 13 cases. Of the remaining 77 cases, 44 were males and 33 females. Of female fetuses,7 were diagnosed as pelvic kidneys postnatally, with no additional abnormalities present. From the remaining 26 cases with true unilateral renal agenesis, 5 (19%) were found to have associated genital tract abnormalities, which included uterovaginal fistula (n = 2) and Herlyn-Werner-Wunderlich syndrome with a bicornuate uterus (n = 3) identified at the six-week postnatal scan. Conclusion Among female infants with isolated unilateral renal agenesis, 19% had associated genital tract malformations, underscoring the need for antenatal counselling and multidisciplinary approach beginning in the prenatal period.
Objective Breast milk contains lipid metabolites and is indispensable for the growth and development of neonates and infants. However, studies investigating interindividual variations in human breast milk composition and the longitudinal changes in its constituent lipid metabolites remain limited. The temporal and individual patterns of variations in these metabolites were characterized to provide a foundation for future research on precision nutrition in infants. Study design Samples of human breast milk were collected shortly after birth and at 1 and 6 months postpartum, from participants who delivered healthy, full-term infants. Lipidomic analysis involving liquid chromatography coupled with tandem-mass spectrometry was used to quantify the levels of host- and microbe-derived fatty acid metabolites in the samples. The population was classified into five groups and analyzed based on the distribution of fatty acid substrate at 0 months. Results Breast milk samples from 116 participants were analyzed. The group-specific metabolite profiles were classified into three distinct patterns. The concentrations of substrates and many metabolites increased from birth to 1 month, particularly among samples with lower baseline concentrations, whereas from 1 to 6 months, some metabolites remained stable, while others decreased. These patterns were associated with differences in the metabolic pathways. Conclusions Longitudinal lipid metabolites, including microbe-derived metabolites, in human breast milk and presented characteristic patterns. These findings provide foundational data for future research on precision nutrition for infants based on the metabolic profiles of breast milk.
