World Journal of Peri & Neonatology

AI in Maternal and Neonatal Medicine: Tool, Not Replacement

2025-12-30T12:09:42+00:00

The Article Abstract is not available.

Histopathological Spectrum of Duodenal Biopsies in Seropositive Pediatric Celiac Disease: A Retrospective Study from Yazd, Iran

2025-12-30T12:09:40+00:00

Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by gluten, with a global prevalence of approximately 1%. It is strongly associated with HLA-DQ2 and HLA-DQ8 haplotypes. Serological markers, particularly anti-tissue transglutaminase (tTG) immunoglobulin A (IgA), play a pivotal role in screening and diagnosis. This study aimed to evaluate the clinicopathological characteristics of duodenal biopsy specimens from patients with elevated serum tTG IgA levels.

Methods: This retrospective cross-sectional study analyzed 213 pediatric patients (age ≤16 years) with elevated anti-tTG IgA levels who underwent duodenal biopsy at Shahid Sadoughi Hospital, Iran (2016-2020). Demographic, clinical, and histopathological data were collected from medical records. Duodenal biopsies were classified using the Marsh-Oberhuber system. Statistical analysis was performed using SPSS version 22.

Results: The cohort Included 131 females (61.5%) and 82 males (38.5%), with a mean age of 5.9 years. Abdominal pain (58.7%) and failure to thrive (39%) were the most common clinical manifestations. Histopathological analysis revealed Marsh 3 lesions in 77% of cases (3a: 25.8%, 3b: 39.9%, 3c: 11.3%), while mild changes (Marsh 1-2) were observed in 23%. No significant association was found between Marsh classification and gender (P = 0.36).

Conclusion: Elevated anti-tTG IgA levels strongly predict severe mucosal damage in pediatric celiac disease, indicating that serology-based diagnosis could potentially reduce the need for invasive biopsies. Establishing validated antibody thresholds may allow for less invasive diagnostic approaches.

Evaluation of the effect of inhaled salbutamol in the treatment of neonates with a diagnosis of TTN

2025-12-30T12:09:43+00:00

Introduction: Transient tachypnea of the newborn (TTN) is the most common cause of transient respiratory distress in the newborn, which occurs as a result of insufficient or delayed absorption of fetal alveolar fluid immediately after birth. Considering that few studies have been conducted in the field of evaluating the effectiveness of inhaled salbutamol in TTN patients, therefore, the present study aimed to determine the effects of inhaled salbutamol in the treatment of TTN, as well as investigate the possible side effects of treatment with it.

Methods: This study was a double-blind randomized clinical trial in which 100 infants with a minimum gestational age of 35 weeks, with a diagnosis of TTN, participated. These infants were randomly divided into two groups receiving inhaled salbutamol and the control group, then in the first 6 hours of birth, the group receiving the therapeutic intervention received a dose of salbutamol, and the control one received a dose of normal saline both by nebulization. And then the effectiveness of salbutamol in changing the clinical and laboratory indicators of infants with TTN and the possible side effects of this treatment method was examined.

Results: It was seen that in the group receiving inhaled salbutamol, the TTN score decreased significantly in the first and sixth hours after receiving the intervention compared to the control group. Also, the results showed that the time required to start oral feeding was longer in the group receiving salbutamol than in the control group. This is while no significant difference was observed between the two groups in terms of indicators such as length of hospitalization, duration of need for oxygen therapy, and other clinical indicators of infants.

Conclusion: Considering that infants with TTN treated with inhaled salbutamol were not significantly different from the control group in terms of treatment complications and considering the other results mentioned, it can be said that the use of inhaled salbutamol can be an effective and less harmful option in the treatment of infants suffering from TTN.

Statistical Analysis of Normal CT Scans in Children Aged 10 and Below at Shahid Sadoughi Hospital, Yazd: A Two-Year Study

2025-12-30T12:09:39+00:00

Background: With the increasing use of CT scans in children and the need to minimize radiation exposure during early life, this study investigated the prevalence of normal CT findings among children aged ≤10 years at Shahid Sadoughi Hospital, Yazd, over two years (2020–2022). The objective was to determine the distribution of normal and abnormal CT results and emphasize the importance of prudent and evidence-based CT utilization in pediatric practice.

Methods: A descriptive cross-sectional study was performed by reviewing the medical records of children aged ≤10 years who underwent CT imaging at Shahid Sadoughi Hospital between 2020 and 2022. Demographic variables and organ-specific CT data were collected and analyzed using SPSS version 22, with a significance threshold of P<0.05. Associations between CT results, gender, age group, and scan type were examined to identify possible correlations.

Results: Among all pediatric CT scans, 30.3% were normal, while 69.7% demonstrated abnormalities. The lungs (55.6%) were the most frequently examined organ, followed by the brain and abdomen. No statistically significant associations were found between CT results and gender or scan type. These findings highlight potential overuse of CT imaging in children.

Conclusion: Approximately one-third of pediatric CT scans yielded normal results, underscoring the importance of rational CT use in children. Increasing awareness among healthcare professionals and parents is essential to ensure justified imaging and to reduce unnecessary radiation exposure in pediatric populations.

Analysis of the AMH rs10407022 Polymorphism Reveals Monomorphism in an Iranian IVF Cohort Consistent with POSEIDON Stratification Criteria: A Case-Control Study

2025-12-30T12:09:38+00:00

Background: Poor ovarian response (POR) during in vitro fertilization (IVF) remains a major challenge, adversely affecting both the emotional well‑being of patients and clinical outcomes. Genetic polymorphisms, particularly in the anti‑Müllerian hormone (AMH) gene, such as rs10407022, have been suggested to contribute to POR. This study aimed to investigate the association between the rs10407022 polymorphism and POR, as defined by the POSEIDON criteria, among Iranian women.

Methods: In this case–control study, 232 women with poor ovarian response (cases) according to the POSEIDON criteria and 232 women with normal ovarian response (controls), all undergoing IVF, were enrolled. Demographic, hormonal, and ovarian reserve parameters, including age, body mass index (BMI), baseline follicle-stimulating hormone (FSH), AMH, and antral follicle count (AFC), were recorded. Genotyping for the AMH rs10407022 (G/T) polymorphism was performed using polymerase chain reaction (PCR). Logistic regression, adjusted for age and BMI, was employed to assess associations.

Results: Cases exhibited significantly lower AMH levels (0.9 ± 0.4 ng/mL vs. 2.6 ± 0.8 ng/mL, p < 0.001), lower AFC, and higher day‑3 FSH compared to controls. Notably, all participants in both groups had only the GT genotype for rs10407022, with no GG or TT genotypes observed. This finding indicates that the rs10407022 locus was monomorphic in this Iranian cohort, precluding any significant association with POR.

Conclusion: The AMH rs10407022 polymorphism was monomorphic in this Iranian population, exhibiting only the GT genotype. While significant differences in hormonal markers were observed between POR and normal responders, this single nucleotide polymorphism (SNP) did not account for the variability in ovarian response. Further large-scale, multiethnic studies are warranted to elucidate the genetic underpinnings of POR.

Therapeutic Potential of Mesenchymal Stem Cells and MSC-derived Extracellular Vesicles for Bronchopulmonary Dysplasia: From Preclinical Promise to Clinical Trials

2025-12-30T12:09:37+00:00

Background: Bronchopulmonary dysplasia (BPD) is the most common respiratory complication in infants born extremely preterm. Despite advances in neonatal care, including improved respiratory support, nutrition, and infection control, no definitive cure for BPD has been identified. This study aimed to synthesize contemporary evidence on mesenchymal stem cell (MSC)-based strategies and MSC-derived extracellular vesicles (MSC-EVs) for BPD, and to discuss their* therapeutic therapeutic potential and remaining challenges.

Methods: This study reviews clinical and preclinical data across multiple models to evaluate the therapeutic effects of MSCs and MSC-EVs for the treatment of BPD.

Results: The reviewed literature highlights that both MSCs and MSC-EVs improve alveolar and vascular development, reduce inflammation and fibrosis, and mitigate pulmonary hypertension. MSC-EVs offer cell-free advantages, including reduced immunogenicity, lower tumorigenic risk, enhanced stability, and tunable targeting. Although MSCs and MSC-EVs hold substantial promise, Phase 1 safety data for EV-based therapies in neonates are lacking, underscoring the necessity of early clinical trials to define tolerability and pharmacodynamics.

Conclusion: Transformative advances have been made in the treatment of well-recognized BPD. The field is moving toward standardized EV production, definitive trial design, and exploration of MSC-EV–based therapies as safer, scalable medical countermeasures, with biomarker-guided patient selection and multi-omics integration to refine precision therapy for BPD.

Nutrition and environmental factors in the first 1,000 days of life: a decisive role in long-term health

2025-12-30T12:09:36+00:00

Background: The first 1,000 days of life lay the foundation for health, well-being, learning, and productivity throughout an individual’s lifespan, and also influence the health and well-being of the next generation. This review aimed to examine the role of nutrition and environmental factors during the first 1,000 days of life and their impact on long-term health.

Methods: In this review article conducted in 2025, a targeted search was performed in scientific databases including PubMed, Scopus, Google Scholar, SID, and Iran Medix using keywords such as “first 1,000 days of life,” “early-life nutrition,” “environmental determinants,” and “long-term health outcomes.” Relevant studies published between 2000 and 2025 were identified. After an initial screening of 200 articles and assessment based on inclusion criteria (including originality, methodological rigor, direct relevance to the topic, and availability of full text), 13 key studies with the highest relevance and quality were selected for in-depth analysis and presentation of findings.

Results: The first 1,000 days of life are influenced by maternal nutrition during pregnancy, breastfeeding, complementary feeding, and environmental factors such as air pollution, chemical exposures, and socio-economic conditions. These factors influence long-term health into adulthood through epigenetic, metabolic, and neurological mechanisms.

Conclusion: The first 1,000 days represent a critical window of opportunity to positively influence a child’s health trajectory by ensuring optimal nutrition and a supportive environment. Emphasizing early investments in this area appears essential as a key strategy for promoting public health and reducing health inequalities.

First Report of Concurrent Homozygous LEP and PKHD1 Pathogenic Variants in a Child with Early-Onset Obesity and Renal Microlithiasis

2025-12-30T12:09:35+00:00

Background: Severe early-onset obesity with hyperphagia may be caused by a monogenic disorder involving the leptin–melanocortin pathway. Leptin (LEP) deficiency is a known cause of congenital obesity, whereas PKHD1 mutations are associated with autosomal recessive polycystic kidney disease (ARPKD).

Case Presentation: We report a 20-month-old boy born to consanguineous parents with rapid weight gain since birth (current body weight of 25 kg), extreme hyperphagia, truncal obesity, acanthosis nigricans, dyslipidemia, and renal microlithiasis or nephrocalcinosis Results of endocrine and thyroid function tests were unremarkable. Renal ultrasonography revealed multiple echogenic foci, with no cystic dilatation or sonographic evidence of impaired renal function. Whole exome sequencing identified homozygous pathogenic variants in both LEP and PKHD1, consistent with autosomal recessive inheritance.

Interpretation: The LEP variant explains the early-onset severe obesity, hyperphagia, and metabolic abnormalities observed in this patient, as seen in congenital leptin deficiency. The PKHD1 variant likely accounts for the atypical renal phenotype of nephrocalcinosis without overt cystic disease and may result in a truncating frameshift. To our knowledge, this is the first report of simultaneous pathogenic LEP and PKHD1 variants in an individual.

Conclusion: The case underscores the clinical and diagnostic value of whole-genome analysis in early-onset obesity, particularly in consanguineous families where two or more recessive conditions can co-occur by chance. More comprehensive genetic evaluation should be encouraged in atypical or multisystem obesity in children to uncover composite molecular etiologies.