To better assist primary healthcare providers in recognizing the importance of postnatal bilirubin monitoring, and in developing the ability to promptly identify neonatal jaundice that requires intervention and to provide appropriate evaluation and management, thereby reducing severe neonatal hyperbilirubinemia requiring exchange transfusion and bilirubin encephalopathy while avoiding overtreatment, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association and the Editorial Board of Chinese Journal of Contemporary Pediatrics organized experts who, based on the national expert consensus and guidelines on neonatal hyperbilirubinemia, integrated the latest clinical research evidence on neonatal jaundice and, after thorough discussion, formulated the "Guidelines for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal jaundice (2025)". The guideline addresses 10 common clinical questions on neonatal jaundice for primary healthcare providers and provides 16 recommendations.

In order to enhance the ability of primary healthcare providers to recognize and manage neonatal infectious pneumonia, and to reduce the incidence and mortality of severe neonatal pneumonia, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association convened a panel of experts to review and synthesize the latest clinical evidence on neonatal infectious pneumonia. After thorough discussion, this guideline was developed to address 10 common clinical issues faced by primary healthcare providers regarding neonatal infectious pneumonia, resulting in 18 recommendations.

The prevalence of depressive disorder among adolescents is rising, causing serious harm to families and society. Examining risk behaviors such as gaming addiction, non-suicidal self-injury, and suicidal behaviors resulting from adolescent depressive disorder in light of psychosocial and pathophysiological perspectives, along with in-depth exploration of diagnostic and therapeutic dilemmas—including insidious onset, high comorbidity, and difficulties in differential diagnosis—helps build a multidimensional intervention system encompassing psychological, pharmacological, and physical therapies. It also provides a theoretical basis for promoting multicenter cohort studies and establishing a comprehensive prevention and control model linking families, schools, and hospitals. This paper systematically outlines the current epidemiological status, comorbidity spectrum, and clinical pathways for early identification and comprehensive intervention in adolescent depressive disorder.

Objective To analyze the Bayesian network of harsh parenting, experiential avoidance, and adolescent short video addiction risk, identify key nodes, and provide precise recommendations for intervention. Methods In March 2025, the Harsh Parenting Scale, Experiential Avoidance Scale, and Short Video Addiction Scale were administered to 1 594 adolescents. Network analysis was performed using JASP 0.95.4, and key nodes were identified via centrality estimation. Results The core nodes of harsh parenting, experiential avoidance, and short video addiction risk were "I am hit with hands or kicked when I do something wrong or make my parents angry" (expected influence = 0.301), "Certain feelings make me feel scared" (expected influence = 0.684), and "Withdrawal" (expected influence = 1.222), respectively. Conclusions Interventions targeting these key nodes serve as an important reference for mitigating the impact of harsh parenting, experiential avoidance, and short video addiction risk on adolescents.

Neonatal respiratory distress syndrome (RDS) is a critical disease caused by pulmonary surfactant (PS) deficiency, leading to respiratory distress soon after birth. Comprehensive perinatal interventions can significantly improve outcomes. The core goal of RDS management is to maximize infant survival while minimizing lung injury. Based on the latest evidence, European neonatologists and obstetricians jointly developed the "European consensus guidelines on the management of respiratory distress syndrome: 2025". The guidelines provide evidence-based clinical recommendations for the management of RDS in preterm infants, covering the entire pathway from prenatal interventions, delivery room stabilization, surfactant administration, non-invasive and invasive respiratory support, to comprehensive supportive care. The aim is to reduce the incidence of lung injury through targeted interventions, increase survival rates, and improve long-term neurodevelopmental outcomes. This article interprets the 2025 guidelines in comparison with the 2022 version, aiming to improve the clinical competence of Chinese neonatologists in the diagnosis and treatment of RDS.

To help primary healthcare providers promptly identify and effectively treat neonatal hypoglycemia, thereby reducing the risk of hypoglycemic encephalopathy, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association led the development of this expert consensus. Through thorough discussion, experts integrated recent clinical advances to formulate the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal hypoglycemia (2025)". This consensus addresses 9 common clinical questions and provides 14 recommendations.

To effectively assist primary healthcare providers in timely identification, early diagnosis, and early treatment of neonatal urinary tract infections (UTIs), thereby reducing missed diagnoses and improving outcomes, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association and the Editorial Board of Chinese Journal of Contemporary Pediatrics organized experts to integrate the latest clinical research progress on neonatal UTIs. Following comprehensive discussions, the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal urinary tract infection (2025)" was developed. This consensus covers 10 common clinical issues faced by primary healthcare providers regarding neonatal UTIs and formulates 17 recommendations.

Early screening, diagnosis, and intervention for congenital muscular torticollis (CMT) in infants are crucial for improving clinical outcomes. However, in China, limited awareness of CMT among child healthcare institutions and caregivers, as well as inconsistent professional standards among rehabilitation personnel, pose significant challenges to the effective diagnosis and management of CMT. The "Physical therapy management of congenital muscular torticollis: a 2024 evidence-based clinical practice guideline from the American Physical Therapy Association Academy of Pediatric Physical Therapy" includes 17 action statements, primarily addressing the prevention, identification, assessment, and intervention of CMT. This guideline is expected to facilitate early detection of CMT in infants, enhance the treatment capabilities of physical therapists, and improve clinical outcomes. This article provides an interpretation of the guideline in the context of the current status of CMT diagnosis and management in China, aiming to offer a reference for improving the ability of primary child healthcare providers and physical therapists to recognize and manage CMTropriately.

This article interprets the "Expert consensus on the management of neonatal parenteral nutrition (2025)", focusing on precise control of parenteral nutrition fluid volume, key considerations for the stability of compounded nutrient solutions, scientific determination of amino acid dosing, and rational recommendations for intravenous lipid emulsion. The aim is to offer authoritative and clear guidance for frontline clinicians, and facilitate the widespread dissemination and effective implementation of the consensus, thereby strengthening the standardization of neonatal parenteral nutrition management and improving short- and long-term outcomes in neonates.

Based on the current application status and existing challenges of artificial intelligence (AI) in the management of neonatal jaundice in primary medical institutions in China, a multidisciplinary expert panel was convened, including specialists from neonatology, pediatrics, child healthcare, obstetrics, public health, information management, and health administration, to develop the "Expert consensus on artificial intelligence-assisted monitoring and management of neonatal jaundice in primary medical institutions (2026)". This consensus focuses on how AI-assisted monitoring and management can empower early identification, risk assessment, and hierarchical referral of neonatal jaundice in primary medical institutions. It aims to improve the efficiency of early detection and dynamic management, prevent severe hyperbilirubinemia—especially bilirubin encephalopathy—and related adverse outcomes. The consensus addresses six clinical questions and proposes sixteen recommendations, providing standardized scientific guidance for primary healthcare providers in the implementation of AI-assisted monitoring and management of neonatal jaundice. Citation:Chinese Journal of Contemporary Pediatrics, 2026, 28(6): 643-651

In order to effectively assist primary healthcare providers in standardizing the screening of congenital heart disease (CHD), enabling early identification of critical CHD in neonates, and ensuring timely referral to reduce the risk of complications and mortality, the Subspecialty Group of Neonatology, Society of Pediatrics,Chinese Medical Association has led a team of experts to integrate the latest clinical research advances on CHD. Following comprehensive discussions, the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: congenital heart disease (2025)" was developed. The consensus covers eight common clinical questions faced by primary healthcare providers regarding CHD and provides 13 recommendations.

Vasovagal syncope (VVS) is the most common cause of neurally mediated syncope in children. Recurrent syncope severely affects physical and mental health and may lead to unintentional injury. Based on international and domestic guidelines and clinical practice experience, standardized recommendations for the diagnosis and treatment of pediatric VVS are proposed. Management of VVS should be individualized, and non-pharmacological interventions, including lifestyle modifications, are the cornerstone for both classic and malignant VVS. Pharmacological therapy is recommended for children with VVS who have recurrent syncopal episodes, are at risk of trauma, or respond poorly to non-pharmacological interventions. For children in whom the head-up tilt test induces asystole, pacemaker implantation is not recommended as first-line therapy. In malignant VVS with recurrent syncope despite conventional treatment, pacemaker implantation may be considered after specialist evaluation. Data on cardioneuroablation in children are limited, and long-term follow-up is required.

Ureaplasma urealyticum (UU) is a common pathogen colonizing or infecting the neonatal respiratory tract. It can be vertically transmitted from mother to infant, irrespective of the duration of premature rupture of membranes and the mode of delivery. UU infection is an important factor contributing to preterm birth and low birth weight and is closely associated with adverse outcomes such as bronchopulmonary dysplasia and neurodevelopmental impairment. Given the immaturity of neonatal immune and organ systems, pharmacologic treatment must balance efficacy and safety. Currently, no unified standard regimen has been established for the treatment of neonatal UU infection. This review summarizes pharmacotherapeutic options for neonatal UU infection to inform clinical practice.

Peripherally inserted central catheter (PICC) placement is an essential routine procedure in neonatal intensive care units and an important life-support technology. In recent years, point-of-care ultrasound-guided catheter insertion and ultrasound localization of catheter tips have been widely applied in neonatal practice and demonstrate clear advantages over traditional methods. This guideline was developed on the basis of currently available evidence and the practical experience of domestic experts, and it is tailored to the Chinese context. It provides clinical practice recommendations for ultrasound-monitored vascular selection, ultrasound-guided PICC cannulation, and ultrasound localization of the PICC tip. In total, 22 recommendations addressing 10 key clinical questions are presented, covering pre-insertion vascular selection, intra-procedural ultrasound-guided localization, post-insertion dynamic monitoring, and troubleshooting of difficult scenarios. The aim is to promote standardized application of this technology in neonatal intensive care units in China, reduce complications, and improve safety.

Abnormalities in growth and development in children with methylmalonic acidemia (MMA) have become a central challenge affecting prognosis. As a relatively common disorder of organic acid metabolism, MMA has a complex etiology and exhibits highly heterogeneous clinical manifestations. Among these, neurodevelopmental delay and impaired somatic growth are particularly prominent and are key determinants of poor long-term outcomes. Accordingly, early identification, refined assessment, and individualized intervention for these growth and developmental problems are focal points of current MMA clinical management. This review focuses on the occurrence status, potential mechanisms, and intervention strategies for growth and developmental abnormalities in MMA, aiming to provide a reference for optimizing patient management and improving long-term outcomes.

The "International consensus on early rehabilitation and nutritional management for infants at high risk of neurological impairment" was jointly developed by the Rehabilitation Group of the Pediatrics Branch of the Chinese Medical Association in collaboration with international experts. It aims to provide standardized guidance for early rehabilitation and nutritional management in infants at high risk of neurological impairments. Based on existing evidence and expert opinion, the consensus addresses 10 key clinical questions, including early identification, rehabilitation intervention, and nutritional management, and provides scientific and practical guidance for healthcare professionals in China to improve clinical management and outcomes. This article interprets the consensus to offer relevant guidance for the early rehabilitation and nutritional management of infants at high risk of neurological impairments.

This paper systematically explores the integration pathways, challenges, and future directions of artificial intelligence (AI) technology and narrative medicine in pediatric medical education. Due to the unique characteristics of the pediatric population, pediatric diagnosis and treatment place higher demands on physicians' empathy, communication skills, and humanistic qualities. Narrative medicine, as a key paradigm to address deficiencies in medical humanities, provides a theoretical framework and practical methods for cultivating these core humanistic qualities. However, its teaching promotion and practice face challenges such as insufficient scaling, lack of standardization, and limited depth of feedback. Advances in AI technology, particularly in natural language processing and generative AI, offer new opportunities to overcome these challenges. Based on a systematic literature review, relevant theories, research methods, and practical outcomes of the integration between AI and narrative medicine are synthesized, and a three-stage integration model of "independent development - skill empowerment - collaborative deepening" is constructed. The integration process faces significant challenges including technical ethics, educational integration, and value alienation. Finally, a new paradigm for future pediatric medical education centered on "human-machine collaboration" is proposed, aiming to cultivate the next generation of pediatricians who possess excellent technical skills, profound empathy, and resilient professional spirit, thereby opening new perspectives.

The number of women with gestational obesity has been increasing year by year and is a serious global challenge. Maternal obesity during pregnancy not only leads to gestational diabetes, hypertension, preterm birth, and miscarriage, but also adversely affects offspring growth and development after birth by increasing the risk of offspring obesity and other metabolic diseases. Changes in the maternal gut microbiota during pregnancy and delivery play important roles, and microbiota-derived metabolites are closely related to the metabolic regulation of obesity. This review summarizes the potential mechanisms by which the maternal gut microbiota in gestational obesity influences offspring, aiming to deepen understanding of how maternal gut microbiota affects offspring and to provide research targets and ideas for clinical intervention.

Objective To study the efficacy and safety of upadacitinib in children with refractory inflammatory bowel disease (IBD). Methods Clinical data of eight children with refractory IBD treated with upadacitinib at the Children's Hospital, Zhejiang University School of Medicine, from December 1, 2023 to May 20, 2025 were retrospectively collected to evaluate efficacy and safety. Results Eight children were included [Crohn's disease (CD), n=5; ulcerative colitis (UC), n=3]; seven were male and one was female. At baseline, six patients had mild disease activity (CD, n=4; UC, n=2) and two had severe activity (CD, n=1; UC, n=1). In UC, all three patients achieved clinical remission by week 2; the week-8 steroid-free clinical remission rate was 67% (2/3). In CD, after 4 weeks of upadacitinib, one patient achieved a clinical response and two switched to other drugs due to persistent activity; the week-12 clinical response rate was 20% (1/5). After 12 weeks, one additional patient switched therapy due to disease activity, and two received combination therapy with thalidomide and exclusive enteral nutrition, respectively. The median follow-up duration was 28 weeks. Overall, five patients achieved clinical remission; among CD, two achieved clinical remission at weeks 14 and 20, respectively. Among eight patients, one episode of norovirus infection occurred, complicated by hypovolemic shock. Conclusions Upadacitinib can induce a rapid response in children with refractory UC. In refractory CD, combining upadacitinib with agents of different mechanisms may increase the clinical remission rate. Multicenter studies with larger samples are required for confirmation, and vigilance for infection during treatment is warranted.

A comprehensive retrieval, evaluation, selection, and integration of literature on allogeneic hematopoietic stem cell transplantation (allo-HSCT) for transfusion-dependent thalassemia (TDT) published over the past decade was conducted. For 10 clinical questions related to allo-HSCT in TDT, 26 recommendations were developed. The guideline aims to guide and standardize clinical diagnosis and treatment practices of allo-HSCT for TDT in China.

The prevalence of adolescent depressive symptoms has been rising, and maternal depression is a key predictor. This review synthesizes evidence on mechanisms of influence and on intervention research. The intergenerational transmission of risk from maternal depression appears more pronounced than that associated with paternal depression. At the biological level, genetic susceptibility and neurodevelopmental alterations underpin intergenerational transmission; at the social level, negative parenting practices and stressful family environments create a vicious cycle; at the psychological level, deficits in emotion regulation and insecure attachment amplify vulnerability to depression. Family-based interventions, including cognitive-behavioral therapy and family systems therapy, can mitigate intergenerational transmission. However, more longitudinal research is needed, and future work may integrate digital technologies to develop structured intervention protocols.

Objective To evaluate the clinical efficacy and safety of the 3-month formulation of triptorelin (triptorelin pamoate) in the treatment of idiopathic central precocious puberty (ICPP) in children. Methods A retrospective analysis was conducted of 49 children with ICPP treated with the 3-month formulation of triptorelin at Xiangya Hospital, Central South University, from May 2023 to September 2025. All patients received at least one injection and completed a 3-month follow-up. The numbers of patients who subsequently completed 6-, 9-, and 12-month follow-ups were 42, 26, and 11, respectively. Sex hormone levels, growth and development, and the differences between bone age and chronological age (ΔBA-CA) were assessed at 3, 6, 9, and 12 months after treatment initiation. Results At diagnosis, after the gonadotropin-releasing hormone agonist stimulation test, the peak luteinizing hormone (LH) level was (15.6±5.8) IU/L, the peak follicle-stimulating hormone (FSH) level was (8.5±3.9) IU/L, and the peak LH/FSH ratio was 1.9±0.9. After 3 months of treatment, 92% of the children achieved a peak LH <3 IU/L, all children had a peak LH/FSH ratio <0.6, and estradiol or testosterone decreased to prepubertal levels; this suppression was maintained through 12 months without rebound. In girls, uterine length was significantly reduced from baseline at 3, 6, 9, and 12 months (P<0.0125). In boys, testicular volume was significantly reduced from baseline at each follow-up (P<0.0125). At 3, 6, 9, and 12 months, ΔBA-CA was significantly decreased compared with baseline in all children (P<0.0125). The incidence of adverse reactions during treatment was low, no treatment discontinuations due to adverse events occurred, and overall tolerability was good. Conclusions The 3-month formulation of triptorelin effectively suppresses the hypothalamic-pituitary-gonadal axis and delays bone age progression in children with ICPP, providing the potential to improve adult height, with a favorable safety profile.

Children with autism spectrum disorder (ASD) frequently have comorbid gastrointestinal problems, with constipation being the most prevalent. The onset and severity of constipation are closely related to the core symptoms of ASD, and improving constipation can alleviate these core symptoms. However, the mechanisms underlying comorbid constipation in ASD remain unclear. Multidisciplinary assessment is the foundation of clinical management for comorbid constipation in ASD. Targeted pharmacological therapy, dietary interventions, gut microbiota modulation, and complementary and alternative medicine interventions can be chosen for personalized treatment. This review summarizes the mechanisms, assessment, and clinical management of comorbid constipation in ASD and aims to provide a reference for comprehensive interventions in ASD.

Objective To explore the manifestations of sensory hypersensitivity in children with autism spectrum disorder (ASD) and individuals with subclinical autistic traits. Methods From September 2021 to April 2023, interviews were conducted on 18 college students with high levels of autistic traits and sensory hypersensitivity selected using the Adolescent/Adult Sensory Profile and the Autism Spectrum Quotient (as subclinical group). Interviews were also conducted on the parents of 11 children with ASD aged 6-13 years selected using the intensity sampling method (as clinical group). Qualitative content analysis and thematic analysis were performed on the interview texts to investigate the scenarios and impact of sensory hypersensitivity and coping strategies in the two groups. Results The Autism Spectrum Quotient score was significantly positively correlated with sensory hypersensitivity (r=0.504, P<0.001; n=225). Sensory modalities that triggered sensitive reactions were similar in the subclinical and clinical groups, with auditory hypersensitivity being the most prominent. Sensory hypersensitivity had significant negative impact on emotional wellbeing, cognitive ability, physical health, interpersonal relationships, and general adaptive functioning. These dimensions were interconnected, culminating in a holistic experience. Avoidance was the most commonly used coping mechanism for both groups (16 subclinical participants mentioned it 44 times; 8 clinical participants mentioned it 40 times). The clinical group required more support and help from their caregivers (18 times), while the subclinical group used more proactive coping strategies (e.g., facing sensitive scenarios, distracting attention) to alleviate the negative impact (51 times). Conclusions Sensory hypersensitivity is a common manifestation across the broad ASD phenotype, posing negative effects on multiple aspects of their lives. There is an urgent need for social tolerance and acceptance as well as the development of effective intervention measures.

Duchenne muscular dystrophy (DMD) is an X-linked recessive neuromuscular disorder characterized primarily by progressive degeneration and necrosis of skeletal muscle, resulting from mutations in the Dystrophin gene. Patients with DMD typically present with progressive muscle weakness and atrophy during childhood. Currently, available treatment options for DMD remain limited and their efficacy is suboptimal. This review aims to provide a systematic overview of recent advances in therapeutic strategies for DMD, including an analysis of the mechanisms underlying various treatment approaches, outcomes from clinical trials, and their potential clinical applications, in order to inform and guide clinical decision-making.

Objective To investigate the correlation between induction therapy response and prognosis in children with high-risk neuroblastoma, and to analyze factors associated with the induction therapy response. Methods Data of 55 children with high-risk neuroblastoma diagnosed and treated at Shanghai Children's Hospital from January 2019 to December 2023 were retrospectively reviewed. Induction response was assessed according to the International Neuroblastoma Response Criteria and patients were categorized into a good-response group (complete response or very good partial response) and a poor-response group (partial response, progressive disease, mixed response, or no response). Clinical and biological characteristics, treatments, and prognostic factors were analyzed. Results Among the 55 children, 29 were male and 26 were female; the median age at onset was 39 months. Follow-up was performed until December 31, 2024. The 3-year overall survival (OS) and event-free survival (EFS) rates were (83.8±5.3)% and (47.0±10.3)%, respectively. Neuron-specific enolase level at initial diagnosis, induction therapy response, radiotherapy, and recurrence were prognostic factors for EFS and OS (P<0.05). The 3-year OS was (83.5±7.4)% in the good-response group and (66.7±13.6)% in the poor-response group (P=0.012), while the 3-year EFS was (62.8±10.4)% and (27.8±14.8)%, respectively (P<0.001). Intracranial metastasis at initial diagnosis was associated with a poor induction response (P=0.033). A platelet count ≥400×10⁹/L was associated with a better induction response (P=0.002). Conclusions Induction therapy response is a significant prognostic factor in high-risk neuroblastoma. Absence of intracranial metastasis and a platelet count ≥400×10⁹/L at initial diagnosis are associated with a favorable induction therapy response.

Objective To investigate the clinical features, treatment, and prognosis of pyruvate kinase deficiency (PKD) caused by PKLR gene variants. Methods Clinical data of six patients with PKD who received care at the Affiliated Hospital of Qingdao University from August 2014 to August 2025 were retrospectively analyzed. Results Of the six patients, five were children with onset in infancy, and one was an adult whose disease onset occurred at school age. All presented with jaundice and anemia, and PKD was confirmed by genetic testing. Two patients underwent splenectomy due to frequent transfusion. Three patients were mild, required no regular transfusion, and did not undergo splenectomy. One patient died. Conclusions PKD manifests chronic hemolysis with variable clinical severity. Genetic testing is recommended for diagnosis. Curative therapy remains lacking; management is mainly supportive. Splenectomy may reduce transfusion dependence and improve quality of life.

Objective To describe the current status of transition preparation among adolescents with thalassemia major (TM), identify its influencing factors, and provide a basis for transition-period interventions. Methods A convenience sampling approach was used to recruit 138 adolescent inpatients with TM from two tertiary Grade A hospitals in western Guangxi from April to December 2024. Data were collected using a general information questionnaire, a transition preparation questionnaire, the Pediatric Quality of Life Inventory Generic Core Scales, and the Family Caregiving Measurement Scale. Multivariable regression analysis was conducted to determine factors associated with transition preparation. Results Among the 138 adolescents with TM, the mean total transition preparation score was 59±9, the family caregiving score was 189±23, and the quality of life score was 57±14. Age, disease duration, monthly family income, exposure to transition-related information, caregiver education level, family caregiving level, and quality of life level were significantly associated with transition preparation (P<0.05). Conclusions Transition preparation among adolescents with TM is at a moderate level. Nursing staff should tailor family-focused interventions according to patient age and family caregiving capacity to promote transition preparation and improve quality of life.

Febrile infection-related epilepsy syndrome (FIRES) mainly affects previously healthy children and adolescents, often leading to severe neurological impairment and long-term sequelae such as drug-resistant epilepsy and cognitive dysfunction. Based on two pediatric FIRES cases, combined with international and domestic guidelines as well as clinical experience, this paper highlights therapeutic strategies and escalation pathways tailored to different inflammatory phases in the acute and chronic stages. Incorporating continuous electroencephalogram monitoring and cerebrospinal fluid inflammatory cytokine profile changes, a phase-specific treatment approach is systematically described, centered on the rapid termination of status epilepticus, targeted cytokine immunotherapy, and multidisciplinary collaborative support, and the active use of tocilizumab, anakinra, and the ketogenic diet is emphasized, to provide practical guidance for clinicians in managing FIRES.

Mosquito-borne viruses, including dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV), pose major threats to public health in tropical and subtropical regions worldwide. Neonates are particularly vulnerable, and the associated disease burden has drawn increasing attention. Routes of neonatal infection include vertical mother-to-child transmission (transplacental and peripartum) and postnatal mosquito bites. Clinical manifestations are often nonspecific; a proportion of cases may progress to central nervous system infection, hemorrhagic disease, or long-term neurodevelopmental impairment, with serious consequences for survival and quality of life. Although China has issued prevention and control guidelines for adults and pregnant women, systematic clinical guidance tailored to neonates remains lacking. In response, the Perinatal Group of the Pediatric Branch of the Chinese Medical Doctor Association convened a multidisciplinary panel to develop this expert consensus, integrating the latest international evidence with China's practical prevention and control experience. The consensus addresses epidemiology; the effects of maternal infection on fetuses and neonates; clinical manifestations; diagnosis and differential diagnosis; early warning indicators of severe disease; therapeutic strategies and supportive care; and prevention and maternal-infant management. It aims to provide evidence-based, standardized, and practical guidance for frontline clinicians managing neonatal mosquito-borne viral infections.

Objective To investigate the effect of intraoperative hypothermia on short-term prognosis in neonates with necrotizing enterocolitis (NEC) undergoing surgery. Methods Clinical data of 150 neonates with NEC who underwent surgery at Children's Hospital of Chongqing Medical University from June 2017 to August 2023 were retrospectively collected. Based on the lowest intraoperative temperature, patients were classified into a normothermia group (≥36.0℃, n=49), a mild hypothermia group (35.0-35.9℃, n=73), a moderate hypothermia group (34.0-34.9℃, n=20), and a severe hypothermia group (<34.0℃, n=8). Postoperative outcomes were analyzed across groups. Results Intraoperative hypothermia occurred in 101/150 (67.3%) neonates. Mild hypothermia significantly increased the risk of postoperative coagulation disorders (OR=2.170, 95%CI: 1.035-4.552, P<0.05). Postoperative hospital stay was significantly prolonged in the mild (B=12.250, 95%CI: 1.176-23.324, P<0.05) and severe hypothermia groups (B=24.510, 95%CI: 1.645-47.376, P<0.05), while the duration of central venous catheterization was significantly increased in the moderate hypothermia group (B=11.388, 95%CI: 1.625-21.15, P<0.05). Conclusions Intraoperative hypothermia is common in neonates with NEC undergoing surgery, and different degrees of hypothermia are associated with distinct adverse effects on short-term prognosis. Intraoperative temperature management should be prioritized, and active warming measures should be implemented to improve outcomes.

Objective To investigate the clinical features and treatment of children with primary ciliary dyskinesia (PCD), aiming to improve early recognition of the disease among pediatricians and reduce misdiagnosis and missed diagnosis. Methods A retrospective analysis was conducted on the clinical data of 24 children with PCD admitted to the Children's Medical Center of People's Hospital of Hunan Province from January 2014 to December 2025. Results Among the 24 children, there were 12 boys and 12 girls, aged from 2 months to 15 years. The median age of onset was 6 months, and the median age at diagnosis was 98 months. All patients presented with recurrent respiratory tract infections and chronic productive cough; 21 had chronic sinusitis, 9 had neonatal pneumonia, and 3 had visceral inversion. The most frequently detected bacteria were Haemophilus influenzae and Streptococcus pneumoniae. Bronchiectasis was identified in 16 cases, atelectasis in 10 cases, and 19 cases showed fishbone-shaped changes in the bronchial lumen. Nasal nitric oxide testing was performed in 21 children, with all values markedly decreased (2.4-27 nL/min). Fourteen children underwent genetic testing, with 12 testing positive for autosomal recessive mutations involving 9 genes including HYDIN, DNAH11, and TUBB4B. Airway management and long-term low-dose macrolide therapy were key in treatment. Conclusions Primary ciliary dyskinesia is a rare genetic disorder with early onset, often before 6 months of age. Children presenting with chronic productive cough combined with chronic sinusitis, bronchiectasis, abundant airway secretions, and visceral inversion warrant high suspicion for this disease.

With continuous advancements in neonatal care in China, the survival rate of extremely preterm infants has markedly increased in recent years. However, the proportion of voluntary withdrawal of treatment for extremely preterm infants remains relatively high. To further improve the overall treatment success rate for extremely preterm infants in Hunan Province, the Hunan Neonatal Medical Quality Control Center, in collaboration with the Perinatal Committee of the Hunan Medical Association, organized experts to develop recommendations on antenatal counseling for extremely preterm infants. These recommendations aim to standardize antenatal counseling procedures, enhance the scientific rigor and consistency of clinical decision-making, and improve survival outcomes.

Osteogenesis imperfecta (OI) is a rare genetic skeletal disorder most commonly caused by variants in COL1A1 and COL1A2, which encode type I collagen. It is characterized by increased bone fragility, recurrent fractures, and skeletal deformities that adversely affect quality of life. With advances in genetic testing and molecular pathophysiology, diagnosis has evolved from traditional imaging-based assessment to comprehensive evaluation guided by genotype-phenotype correlations. Early diagnosis and standardized management are crucial for improving prognosis; however, the rarity of OI and rapid technological progress make it challenging to keep pace with evolving diagnostic and therapeutic strategies. This article discusses the genetic and pathophysiological mechanisms, recent advances in diagnosis and treatment, and key points in the management of OI, aiming to provide up-to-date reference information for OI care and clear, actionable guidance for clinicians.

Objective To investigate the dynamic changes in regional cerebral oxygen saturation (rScO₂) variability within the first week after birth in preterm infants and its relationship with different types of brain injury. Methods A retrospective study included 70 preterm infants with a gestational age of 28-32 weeks admitted to Cangzhou People's Hospital from August 2021 to June 2025. All infants underwent continuous near-infrared spectroscopy (NIRS) monitoring of rScO₂ within the first 7 days after birth. Based on cranial ultrasonography and magnetic resonance imaging findings, infants were divided into intraventricular hemorrhage (IVH) group (n=23), periventricular leukomalacia (PVL) group (n=18), hypoxic-ischemic encephalopathy (HIE) group (n=11), and control group (n=18). The coefficient of variation (CV), slope, peak, and trough values of rScO₂ were calculated across different time windows, and their correlations with brain injury type and severity were analyzed. Results Within the first 7 days after birth, rScO₂ CV showed a biphasic pattern characterized by an initial increase, followed by a decrease, then a second increase and decrease. The first high-variability period occurred at 0 to <24 hours, and the second at 72 to <120 hours. The CV at 6 hours after birth was positively correlated with brain injury severity (r_s =0.72, P<0.001). The area under the receiver operating characteristic curve (AUC) for diagnosing brain injury using 6-hour CV was 0.862 (P<0.05). A combined predictive model incorporating CV values at 6, 24, and 72 hours achieved an AUC of 0.924 (P<0.05). Conclusions The variability of rScO₂ within the first week after birth in preterm infants exhibits a biphasic fluctuation pattern. Different brain injury types show characteristic variability patterns, and early CV values can serve as sensitive indicators for early identification of brain injury.

Objective To investigate the antimicrobial resistance patterns of Escherichia coli isolates from infants younger than 90 days and analyze their relationships with age, infection site, and isolation time. Methods A retrospective study was performed by collecting Escherichia coli strains isolated from hospitalized infants aged ≤90 days in the neonatal ward of Capital Center for Children's Health, Capital Medical University from June 2020 to December 2023. Antimicrobial susceptibility testing was conducted. Relevant clinical information including age, infection site, and isolation time was collected to characterize the antimicrobial resistance of Escherichia coli from multiple perspectives. Results A total of 384 infants were included, among whom 253(65.9%) were in the neonatal group (age ≤28 days) and 131(34.1%) in the young infant group (29-90 days). The overall resistance rate of Escherichia coli was 72.4%, with a multidrug resistance rate of 21.0%. The neonatal group was more susceptible to invasive infections, whereas the young infant group exhibited higher antimicrobial resistance rates, with statistically significant differences observed in resistance rates to multiple antibiotics (P<0.05). Intestinal isolates showed higher resistance rates to β‑lactams, tetracyclines, and quinolones compared to the overall average, but lower resistance to sulfonamides. Blood isolates demonstrated higher resistance to β‑lactams. An increasing trend was observed in resistance to quinolones and tetracyclines over time. Among infants with multi-site infections, 72.9% had isolates with consistent antimicrobial susceptibility patterns, indicating clonal homology. Conclusions Escherichia coli isolates from infants aged 29-90 days exhibit relatively high antimicrobial resistance rates. In infants younger than 90 days, resistance patterns differ by age group and infection site, highlighting the need for rational antibiotic selection based on these factors.

Respiratory syncytial virus (RSV) is one of the main pathogens of acute lower respiratory tract infection in infants and young children and shows a year-round transmission pattern in tropical and subtropical regions, posing a serious health threat, especially to infants under one year of age. Current treatment is mainly symptomatic and supportive, and antiviral drugs have limited efficacy. In recent years, with advances in monoclonal antibody development, the long-acting RSV monoclonal antibody nirsevimab has been introduced into clinical practice worldwide, including in China, and has become a core intervention for immunoprophylaxis in infants and young children. Recommendations are proposed in this consensus based on the latest domestic and international evidence and the epidemiological characteristics of tropical and subtropical regions in China. They cover: epidemiological features of RSV; disease burden and clinical manifestations of RSV infection; dosage and administration of RSV monoclonal antibodies; efficacy and safety of RSV monoclonal antibodies; year-round immunoprophylaxis strategies for infants and young children; immunoprophylaxis strategies for infants and young children with special health conditions; coadministration of RSV monoclonal antibodies with vaccines in the national immunization program; and management measures for immunoprophylaxis with long-acting RSV monoclonal antibodies. The aim is to provide scientific and standardized guidance for frontline clinical and public health practice to reduce the incidence, severity, and public health burden of RSV infection in infants and young children.

Objective To evaluate the clinical utility and translational potential of a remote jaundice monitoring system for home-based screening of neonatal hyperbilirubinemia. Methods A prospective self-controlled study was conducted, enrolling 538 newborns with gestational age ≥35 weeks, birth weight ≥2 000 g, and postnatal age ≤14 days at the Women's Hospital of Nanjing Medical University from March to October 2023. Four screening protocols with different predictive indicators were developed based on the Chinese Neonatal Transcutaneous Hourly Bilirubin Nomogram. The effectiveness of the system was evaluated, and the feasibility of using the remote jaundice monitoring system in actual home settings was analyzed. Results A total of 538 paired transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) measurements showed a strong correlation (r=0.85, P<0.001), with 95.0% (511/538) of samples within the 95% limits of agreement. Using TcB ≥ the 95th percentile as the predictive indicator, the system achieved 100% sensitivity, 46.2% specificity, and an area under the receiver operating characteristic curve of 0.731 (95%CI: 0.682-0.780). This approach could reduce unnecessary hospital visits by 41.4% (221/538). Conclusions The system integrates the QBH-801 transcutaneous bilirubinometer, intelligent early warning, and remote guidance services, establishing a closed-loop "hospital-to-home" management model. It demonstrates high safety and feasibility, with significant clinical translational value.

Objective To understand the neuropsychological development status and catch-up characteristics of late preterm infants (LPI), and to explore the longitudinal association between parent-child interaction and neuropsychological development. Methods A retrospective cohort study was conducted on 888 children who completed regular follow-ups at corrected ages of 12 to 36 months at the Department of Child Healthcare of Guiyang Maternal and Child Health Hospital between January 2022 and August 2025. Participants were divided into LPI group (n=215) and full-term group (n=673) based on gestational age. Neuropsychological development and parent-child interaction were assessed at corrected ages of 12, 24, and 36 months using the Gesell Developmental Schedule and the Parent-Child Interaction Scale. Linear mixed-effects models were employed to examine the longitudinal effects of parent-child interaction on neuropsychological development. Results At corrected age 12 months, the LPI group showed the highest rate of developmental delay in the language domain (12.6%, 27/215), followed by gross motor delay (8.8%, 19/215). At corrected ages 12 and 24 months, the DQ scores of all developmental domains in the LPI group were significantly lower than those in the full-term group (P<0.05). By corrected age 36 months, except for language, no significant differences were found between groups in other domains (P>0.05). At corrected age 12 months, parent-child interaction was positively correlated with language DQ in the LPI group (B=0.172) and personal-social DQ in the full-term group (B=0.097) (P<0.05). At corrected age 24 months, parent-child interaction was positively correlated with all DQ domains in the LPI group (B_{adaptive behavior}=0.282, B_{gross motor}=0.309, B_{fine motor}=0.227, B_language=0.448, B_{personal-social}=0.271, B_{total DQ}=0.302). In the full-term group, correlations were found in gross motor (B=0.117), language (B=0.253), and total DQ (B=0.118) domains (P<0.05). At corrected age 36 months, parent-child interaction was positively correlated only with language DQ in the full-term group (B=0.216). Linear mixed-effects models showed significant positive predictive effects of parent-child interaction on language (β=0.09), personal-social (β=0.08), and total DQ (β=0.04) in both groups (P<0.05). Significant interaction effects of group × parent-child interaction were observed for gross motor (β=0.10), language (β=0.14), and total DQ (β=0.09) (P<0.05). Conclusions Neuropsychological development in late preterm infants lags behind that of full-term infants. Positive parent-child interaction effectively promotes neuropsychological development in late preterm infants.

Objective To analyze surveillance data on birth defects among perinatal infants in Guiyang City from 2016 to 2024, predict future trends, and provide a scientific basis for prevention and control strategies. Methods Perinatal birth defect data for Guiyang City during 2016-2024 were collected and statistically analyzed. An ARIMA model was established to predict monthly birth defect incidence for 2025-2026. Results The average annual incidence rate of birth defects in Guiyang City was 45.1‰, with an overall upward trend (P<0.001). The top five defects overall were congenital heart disease, external ear malformation, polydactyly, clubfoot, and hypospadias, with slight year-to-year variation in ranking; congenital heart disease consistently ranked first. The birth defect detection rate was higher in male infants (48.3‰) than in female infants (41.3‰) (P<0.001), and higher in rural areas (53.2‰) than in urban areas (44.3‰) (P<0.001). Among maternal age groups, the incidence was highest in infants of mothers aged ≥35 years (50.5‰). Most diagnoses were confirmed within 7 days postpartum, accounting for 82.71% of cases (10 489 cases). The ARIMA model predicted monthly mean incidence rates of 84.9‰ in 2025 and 91.2‰ in 2026, indicating a continued upward trend. Conclusions The incidence of birth defects in Guiyang shows an upward trajectory, with congenital heart disease as the leading defect. Targeted management for key populations such as rural residents and advanced-age pregnant women is recommended; the prenatal screening process should be standardized, and high-risk interventions strengthened via prenatal diagnosis centers to improve the quality of the newborn population.