Pediatrics — Weekly Evidence Brief

Early life experiences profoundly shape child health, with interventions showing promise for vulnerable populations. Early life stress impacts children's biology, behavior, and overall health, and targeted interventions can ameliorate negative effects 1. For premature infants, deferred cord clamping (DCC) during C-sections significantly reduces mortality and severe brain injury in extremely preterm infants (<29 weeks) 2. Additionally, effective discharge education for mothers of premature infants can improve maternal sensitivity and infant neurodevelopment, addressing long-term challenges associated with NICU stays 3. In low-resource settings, multimodal infection prevention programs in NICUs have dramatically cut healthcare-associated bloodstream infections and mortality 4.

Advances in pediatric oncology highlight the growing role of precision medicine, while chronic conditions like IBD and post-COVID require more refined approaches. Precision-guided therapies (PGT) offer meaningful responses and survival benefits for high-risk and relapsed/refractory pediatric cancer patients, showing potential to become a standard of care through comprehensive genomic profiling 5. However, parents providing complex home care for children with cancer face significant challenges, necessitating ongoing education on medication administration and emergency management 6. Pediatric inflammatory bowel disease (IBD) is increasingly prevalent and aggressive, requiring novel diagnostics and age-specific treatments, with research exploring precision medicine and microbiome therapy 7. Conversely, studies on pediatric post-COVID condition often have methodological weaknesses, hindering accurate disease definition and reliable epidemiological estimates, underscoring a need for rigorous study designs 8.

Vigilant monitoring and precise prognostication are crucial in pediatric critical care. Prearrest vital sign abnormalities are common (62.3%) in pediatric ICU cardiac arrest, with low SBP independently linked to the lowest odds of survival and a clear dose-response relationship between abnormality burden and worse outcomes 9. For predicting pediatric cardiac arrest outcomes, a parsimonious model integrating clinical, qualitative, and quantitative EEG features within 24 hours post-arrest achieved high accuracy for predicting 6-month neurological outcomes 10. Furthermore, over 1 in 8 children surviving out-of-hospital cardiac arrest (OHCA) are readmitted within 30 days, with readmission reasons varying by cardiac arrest etiology and being more likely in patients with comorbidities or longer initial hospitalizations 11.

Emerging research explores complex interactions between environment, genetics, and health, alongside critical mental health interventions. The gut microbiota plays a pivotal role in pediatric obesity, influencing metabolism and inflammation, with targeted interventions like probiotics showing promise but requiring more robust clinical data 12. Early life exposure to multiple metals impacts child growth, yet current research often overlooks mixture effects and the role of nutritional status 13. Genetic liability for autism spectrum disorder (ASD) combined with preterm birth may worsen phenotypic severity, with preterm-ASD individuals exhibiting increased de novo variants 14. For adolescents at risk of suicide, Dialectical Behavior Therapy (DBT) demonstrates moderate evidence for reducing suicidal ideation, though evidence for other psychosocial and pharmacologic interventions remains limited 15.