World Journal of Peri & Neonatology

AI in Maternal and Neonatal Medicine: Tool, Not Replacement

Mahta Mazaheri — Mon, 15 Dec 2025 08:31:45 +0000

The Article Abstract is not available.

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

Maryam Vajihinejad, Monireh Sadri, Saadat Eslami — Mon, 15 Dec 2025 08:31:49 +0000

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

Mon, 15 Dec 2025 00:00:00 +0000

Background: Transient tachypnea of the newborn (TTN), the most common cause of transient respiratory distress in neonates, occurs due to insufficient or delayed absorption of fetal alveolar fluid immediately after birth. Given the limited number of studies evaluating the effectiveness of inhaled salbutamol in TTN patients, this study aimed to assess the therapeutic effects of inhaled salbutamol and to investigate its potential side effects.

Methods: This study was a double-blind randomized clinical trial involving 100 infants with a gestational age of at least 35 weeks, who were diagnosed with TTN. The infants were randomly assigned into two groups. Within the first 6 hours after birth, the intervention group received inhaled salbutamol, while the control group received normal saline, both administered nebulization. The effectiveness of salbutamol on clinical and laboratory parameters, as well as its potential side effects, was examined in infants with TTN.

Results: The TTN score decreased significantly in the salbutamol group at 1 and 6 hours after the intervention compared with the control group. Additionally, the time required to initiate oral feeding was longer in the group receiving salbutamol. However, regarding the length of hospitalization, duration of oxygen therapy, and other clinical parameters, no significant difference was observed between the two groups.

Conclusion: Since no significant differences were observed in major clinical outcomes between the groups, inhaled salbutamol may be considered a safe and potentially effective therapeutic option for infants with TTN

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

Mon, 15 Dec 2025 08:31:57 +0000

Background: With the growing frequency of CT scans in children and the importance of limiting radiation exposure in early life, this study investigated the prevalence of normal CT scans among CT examinations in children aged ≤ 10. The research conducted a two-year period (2020-2022) aimed to describe on the distribution of normal and abnormal CT scan results in pediatric patients, emphasizing the need for prudent use of CT imaging.

Methods: A descriptive cross-sectional study was carried out, examining the medical records of children aged ≤10 years who underwent CT scans at Shahid Sadoughi Hospital in Yazd from 2020 to 2022. Organ-specific distributions of CT scans by anatomical region were analyzed, and the relationship between CT results, gender, age, and type of CT scan was assessed.

Results: From a total of 945 CT scans conducted on children, 30.3% were normal, while 69.7% showed abnormalities. Organ-specific distributions varied across anatomical regions, with lung (55.6%) being the most examined organ. There was no statistically significant association between CT results and gender or type of CT scan. The findings emphasize the necessity for judicious use of CT imaging in pediatric patients to minimize potential health risks associated with excessive radiation exposure.

Conclusion: The study showed that 30.3% of CT scans in children were normal, underscoring the importance of appropriate CT scan utilization. While CT scans are beneficial when medically necessary, overuse could pose potential public health challenges. Public awareness and education are essential to ensure the judicious and justified use of CT scans in pediatric healthcare.

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

Mon, 15 Dec 2025 08:32:03 +0000

Background: Poor ovarian response (POR) during in vitro fertilization (IVF) remains a major challenge, adversely affecting both the emotional wellbeing 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 analytical case-control study, 232 women under 45 years with poor ovarian response according to the POSEIDON criteria and 56 women with normal ovarian response (controls) were included. Demographic, hormonal, and ovarian reserve parameters, including age, BMI, FSH, AMH, and AFC, were recorded. Genotyping of the AMH rs10407022 (G/T) polymorphism was performed using ARMS-PCR, and associations were assessed using logistic regression adjusted for age and BMI.

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

Faezeh Sadat Azad, Elham Zare, Hanieh Shafienia — Mon, 15 Dec 2025 08:32:06 +0000

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

Seyede Maryam Lotfipur, Mahshid Bokaie — Mon, 15 Dec 2025 08:32:10 +0000

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

Somayeh Talaeipour, Seyedeh Zalfa Modarresi, Elham Shafighii — Mon, 15 Dec 2025 08:32:14 +0000

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.