Background: Extremely low birth weight (ELBW, <1,000 g) infants have a high risk of metabolic bone disease (MBD). Because of the late appearance of radiological signs, diagnosis of MBD in ELBW infants might be delayed, and its prevalence underestimated in this group of patients. This study adopted serial screening of serum alkaline phosphatase (ALP) and phosphate (P) of ELBW infants to determine whether such screening is helpful for the early detection of MBD.Materials and Methods: We performed a retrospective study of preterm infants with a gestational age ≤ 31 weeks and birth weight 500 IU/L, P ≥4.5 mg/dL), and severe (ALP >500 IU/L, P 4 weeks after birth) according to the time of onset.Results: A total of 142 ELBW infants were included, with a median gestational age of 28.1 (26.5–29.7) weeks and a median birth weight of 875 (818–950) g. Seventy-three cases of MBD were diagnosed, and the total prevalence was 51.4% (mild MBD, 10.6%; and severe MBD, 40.8%). Male sex, breastfeeding, and sepsis would increase the risk of severe MBD. Most MBD in ELBW infants occurred at 3–4 weeks after birth. Sixty-two percent (45/73) of infants were diagnosed as having early MBD, which are diagnosed earlier than late MBD [24 (21–26) vs. 39 (36–41), t = −7.161; P < 0.001]. Male sex [odds ratio (OR), 2.86; 95% confidence interval (CI), 1.07–7.64; P = 0.036], initial high ALP levels (OR, 1.02; 95% CI, 1.01–1.03; P < 0.001), and breastfeeding (OR, 5.97; 95% CI, 1.01–25.12; P = 0.049) are independent risk factors for the development of early MBD.Conclusion: The risk of MBD among ELBW infants is very high. Most cases occurred early and were severe. Male sex, initial high ALP levels, and breastfeeding are closely related to the increased risk of early MBD. Serial screening of serum ALP and P helps early detection of MBD; it is recommended to start biochemical screening for ELBW infants 2 weeks after birth and monitor their biochemical markers weekly.

Non-contact, rapid and accurate measurement of respiratory rates (RR) and heart rates (HR) in neonates has significant clinical importance. Existing methods predominantly focus on thoracic respiratory signal measurement. This thoracic-focused approach, when applied to neonates who exhibit predominantly abdominal breathing, leads to a low signal-to-interference ratio (SIR) that compromises the accuracy of RR measurement compared with using abdominal signal. Moreover, neonatal and staff motion in clinical environments pose challenges for the robustness of monitoring systems. In this paper, a method for the separation of thoracic and abdominal measurements based on MIMO radar is proposed to make use of the RR information contained within the abdominal signal, while extracting HR information from thoracic signal, in which case RR can be extracted more precisely from abdominal signal with a high SIR. In order to ensure proper separation of radar beams under the interference from neonatal and staff motion, this paper presents an integrated measurement system that combines a monocular camera and MIMO radar to achieve precise and real-time guidance for the radar beams. Experimental results demonstrate significant improvements in RR measurement accuracy and system robustness. We report maximum root mean square errors of 2.16 Beats Per Minute(BPM) for RR measurements and 3.54 BPM for HR measurements.

Background: Cough is the most common respiratory symptom in children with mild coronavirus disease 2019 (COVID-19); however, evidence regarding the duration and severity of COVID-19-related cough is sparse. Herein, we investigated the correlation between cough severity/duration and disease duration in children with allergic diseases following COVID-19.Methods: This single-center, retrospective case-control study was conducted at the Department of Pediatrics, Peking University Third Hospital, from February 6–13, 2023. Children aged 0–16 completed a questionnaire survey collecting basic information and weekly cough scores for 8 consecutive weeks after COVID-19 in December 2022. The Kaplan–Meier method was used to draw event curves, and the log-rank method was used to compare inter-group differences. Stepwise regression was applied for multivariate analysis of correlations between age, sex, allergic diseases, and the degree and duration of cough following COVID-19.Results: Overall, 686 children were included, of whom 183 (26.7%) had allergic diseases and 503 (73.3%) did not. Kaplan–Meier analysis identified significant differences between patients with and without allergic disease (log-rank test, P = 0.002) and between patients with no allergic disease and those with one and more than one allergic disease (log-rank test, P = 0.003). Multivariate regression identified a link between the presence of more than one allergic disease and coughing for >4 weeks after infection (P < 0.001). Allergic disease was the primary factor linked to cough symptoms lasting 8 weeks and cough severity (P < 0.001).Conclusions: Allergic disease contributes to the prolonged duration and severity of coughing in children with mild COVID-19.

Neonatal hydrocephalus is a serious neurological disease; however, advancements in neonatal care and the increasing survival rate of extremely preterm infants and its incidence, etiology, diagnosis and management have also undergone significant changes. In this study, we aimed to summarize the above clinical changes in neonatal hydrocephalus at our hospital over the past 12 years to provide a reference for clinical practice. This was a single-center retrospective study. To comprehensively collect data on neonatal hydrocephalus, we conducted a case search among hospitalized patients in both the obstetrics and pediatrics departments from January 1, 2010, to December 31, 2021. In the comparative analysis, the infants were divided according to the time of admission into a group for the first 6 years and one for the second 6 years. Between-group comparisons of gestational age, birth weight, etiology, treatment, and prognosis were performed. Sixty-two patients (28 in the first 6 years; 34 in the latter 6 years) were diagnosed with neonatal hydrocephalus. Their gestational ages ranged from 25 to 39+6 weeks (median, 30 weeks), and their birth weights ranged from 600 to 4046 g (median, 1255 g). The gestational age and birth weight were significantly lower in the second 6-year group than in the first 6-year group. Furthermore, there was a significant increase in severe germinal matrix-intraventricular hemorrhage (GMH-IVH) in infants and cerebral parenchymal hemorrhage in the latter 6-year group. In terms of surgical treatment, there are more applications of ventricular access devices (VADs) in the latter 6-year group. Among the 62 infants, 21 (33.9%) died, with the majority of deaths (19/21, 90.5%) attributed to treatment withdrawal. Of the surviving infants, 22 had normal development, and 19 had developmental delay. Gestational age and birth weight were significantly lower in the second 6-year group than in the first 6-year group, and there was a significant increase in severe intracranial hemorrhage and cerebral parenchymal hemorrhage in this group.

Introduction: We aimed to establish normative developmental patterns of cerebral microperfusion using ultra-micro angiography and evaluate regional microvascular differences in neonates across gestational ages. Methods: This prospective observational cohort study enrolled 115 neonates from a single-center neonatal intensive care unit or neonatal ward at Peking University Third Hospital (2023–2024). The patients were stratified by postmenstrual age into extremely/very preterm ( n = 30), moderate/late preterm ( n = 23), and term ( n = 62) groups, excluding those with major anomalies/hemodynamic instability. Ultra-micro angiography was performed via the anterior/sphenoid fontanelles during quiet sleep (3–14 days postnatal). Regional color pixel percentage (CPP) and large-vessel hemodynamics [peak systolic velocity [PSV]/end-diastolic velocity [EDV]/ resistance index [RI]] were measured. Results: Ultra-micro angiography revealed distinct postmenstrual age-dependent microvascular perfusion patterns, with cortical and white matter CPP demonstrating progressive increase across postmenstrual age groups (extremely preterm vs. term infants: frontal lobe CPP 22.97 [IQR 20.12–28.92] vs. 47.57 [40.07–55.93]; parietal lobe CPP 25.09 [20.96–29.94] vs. 47.69 [38.93–55.97]), while basal ganglia CPP remained stable [32.96 [30.64–35.02] vs. 33.77 [31.52–37.46]]. Midline regions consistently exhibited the highest perfusion across all ages [term infants: 66.26 (61.33–70.62)]. Concurrent macrovascular assessment showed that anterior/middle cerebral artery peak systolic and end-diastolic velocities increased with maturation, although resistance indices maintained stability. Conclusion: Ultra-micro angiography-derived CPP quantifies gestational age-dependent microvascular maturation, revealing distinct regional perfusion patterns. Differences in the progression of CPP in various brain regions may serve as a biomarker for risk stratification of neurodevelopment in premature infants.

Objective: To develop and internally evaluate a model that uses maternal blood markers obtained before delivery to differentiate neonatal acute respiratory distress syndrome (ARDS) from other causes of respiratory distress in late-preterm and term neonates requiring mechanical ventilation. Methods: This retrospective study enrolled 227 mother-infant pairs from two tertiary hospitals between June 2024 and January 2026. Neonates born at 34–40 weeks’ gestation with ventilation-dependent respiratory distress were divided into a training cohort and an internal test cohort. Predictors were screened using elastic-net regression with 1,000 bootstrap resamples. Four feature sets and six algorithms were then compared by 20 repeats of stratified five-fold cross-validation, and a six-predictor random forest (RF) was ultimately selected. Discrimination, calibration and net benefit were assessed, with 500-resample bootstrap optimism correction and Shapley additive explanation (SHAP) interpretation. Results: Maternal systemic immune-inflammation index (SII) and related inflammatory ratios were higher, and antenatal infection was more frequent, in the ARDS group, whereas recorded antenatal corticosteroid (ACS) use was less frequent (P < 0.001). Six predictors were retained in the final model: SII, antenatal infection, maternal age, gestational hypothyroidism, gestational diabetes mellitus and ACS use. The principal internal performance estimate, the mean training-set cross-validated area under the curve (AUC) was 0.729 ± 0.080, the fixed-pipeline optimism-corrected AUC was 0.793 and the internal test-set AUC was 0.827 (95% CI, 0.712–0.923), with an average precision of 0.828 and a Brier score of 0.175. These three values are not interchangeable and are reported as one principal and two secondary estimates, and none represents fully independent performance. At the training-derived threshold of 0.424, sensitivity was 78.8% and specificity 77.8%. SHAP identified SII as the largest contributor, without implying a causal effect for any predictor. Logistic regression using the same six predictors reached a numerically higher internal test-set AUC (0.838 versus 0.827, ΔAUC = −0.011, P = 0.744) and a cross-validated AUC of 0.706 ± 0.082 versus 0.729 ± 0.080, the RF therefore conferred no discriminative advantage. Conclusions: In mechanical ventilation needed neonates born at 34–40 weeks' gestation with respiratory distress, the six-predictor RF showed moderate discrimination, whereas evidence of adequate calibration was limited. The model remains preliminary and requires external validation, recalibration and prospective clinical-impact evaluation before clinical use.