Abhay Lodha

Objective Weight-for-length (WFL) is recommended for assessing weight status in infants under 2 years, although body mass index (BMI) may be an alternative. We compared weight classifications using WFL and BMI and assess their ability to predict later obesity. Study Design: This longitudinal study analysed public health data from Calgary, Canada (2000–2018). Growth measures from full-term infants under 2 years and children aged approximately 4.5 years were assessed using World Health Organization growth standards. Classification agreement and predictive performance were examined. Results Among 191,956 children, 51% were male. WFL and BMI showed moderate-to-strong agreement. Areas under the receiver operating characteristic curve for predicting later overweight and obesity ranged from 67.7%–79.2% for BMI and 65.7%–80.0% for WFL. Infant overweight/obesity classifications (> 2 z-scores) poorly predicted later status. Conclusion BMI and WFL showed comparable classification and predictive performance. Further research should evaluate BMI-based infant growth monitoring.

Severe pulmonary diseases, including atelectasis, pneumonia, and meconium aspiration syndrome, are major causes of neonatal respiratory distress, weaning difficulties, ventilator or oxygen dependence, prolonged oxygen requirements, extended hospitalization, and poor prognosis. The lack of simple and effective treatment strategies seriously endangers the survival and health of newborns, particularly premature infants. Recent advances in lung ultrasound (LUS) technology have made LUS-guided non-fiberobronchoscopic bronchoalveolar lavage (NFB-BAL) a promising solution. This approach addresses the limitations of conventional BAL in neonates by enabling accurate diagnosis, precise lesion localization, and dynamic procedural monitoring, hence reducing complications. Based on international expert consensus, these guidelines were developed to improve knowledge and promote the application of this technology and enhance operational standardization to ensure its effectiveness and safety. These guidelines contain 17 recommendations on 13 key clinical issues for reference and implementation in clinical practice. The wide application of these guidelines is expected to help significantly improve the prognosis of critically ill newborns with atelectatic pulmonary diseases.

Neonatal late-onset sepsis is associated with increased mortality and morbidity, adversely impacting long-term outcome. The objective of this study was to examine neurodevelopmental (ND) outcomes at 18 to 24 months' corrected age (CA) in infants with late-onset bacterial sepsis (LOS) and to categorize outcomes based on type of bacterial pathogen in a cohort of preterm infants born less than 29 weeks gestation in Canada. We conducted a retrospective cohort study of all non-anomalous infants born at ‡ Network details are available in the [Supplementary Material] (available in the online version only). Received: 01 April 2025 Accepted: 22 December 2025 Article published online: 29 January 2026 © 2026. Thieme. All rights reserved. Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

This study aimed to determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental outcomes at 5 years of age in infants born before 27 weeks of gestation. Infants born before 27 weeks of gestational age (GA) between 2005 to 2014 and 2017 to 2018 and evaluated at the neonatal follow-up clinic at age 5 years were included. Outcomes were assessed based on abnormal muscle tone, hearing and vision assessments, and cognitive assessment on standardized testing. Perinatal/neonatal characteristics and outcomes were compared between the PPROM (ruptured membranes >1 hour prior to onset of contractions) and No PPROM groups using univariate tests and multivariable regression models. The primary outcome was a composite of death or neurodevelopmental impairment (NDI) at 5 years of age. NDI was considered present if a child had any of cerebral palsy, full-scale intelligence quotient >1 standard deviation below the mean, sensorineural hearing loss, or corrected visual acuity < 20/60 in the better eye. A total of 566 eligible infants were followed up in our regional follow-up clinic at 5 years of age. A total of 226 (40%) were in the PPROM group and 340 (60%) were in the No PPROM group. Infants in the PPROM and No PPROM groups had mean birth weights of 758 (±141) and 740 (±159) grams, respectively, and a median GA of 25 (range: 22–26) weeks for both groups. After adjusting for confounders, the odds ratio of death or NDI in the PPROM group were 1.14 (95% confidence interval: 0.82–1.58). The study also provided comprehensive evaluations of the primary and secondary outcomes through propensity score–matched analyses. Our study suggests that PPROM may not be associated with an increased risk of a composite outcome of death or NDI at 5 years of age in preterm infants born before 27 weeks of GA.

Objective: To evaluate the effect of age correction up to 36 months of age for growth assessments of extremely preterm (<28 weeks) and very preterm (28 to <32 weeks) infants. Study Design: This longitudinal analysis used data from the Preterm Infant Multicenter Growth Study (2001–2014). Results: 1,416 children were included (Median gestational age = 27 weeks). Chronological age-based weight, height, and head circumference z-scores were consistently lower than those based on corrected age for all ages (0, 4, 8, 21 and 36 months) by up to −5.2 (95% confidence interval −5.4, −5.1) z-scores for length at term. Using chronological age, higher proportions of children were misclassified as having suboptimal growth (up to 72.9% misdiagnosed as stunted and 89.8% misdiagnosed as underweight at term). Conclusion: For extremely and very preterm children, age correction is required for all growth measures through 36 months of corrected age.

Introduction: Acid‐base management in neonates with hypoxic–ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH) can use either the “alpha‐stat” or the “pH‐stat” method, which adjusts values based on temperature. Objective: This study aimed to compare the efficacy of two blood gas analysis techniques in predicting the severity of brain injury in neonates with HIE. Method: A retrospective study was conducted on neonates over 35 weeks’ gestation who underwent TH between 2010 and 2015. Diagnostic, univariate, and multivariate analyses were performed to compare outcomes between the alpha‐sat and pH‐stat groups. Results: Adjusting for sex and age, the odds ratios for being classified as hypocapnic were 4.40 (95% CI: 1.19–16.27) using the alpha‐stat method and 2.94 (95% CI 1.15–26.48) using the pH‐stat method. The classification of patients as hypocapnic, normocapnic, or hypercapnic differed significantly between the two methods ( p < 0.0001), with 23% of patients reclassified from the alpha‐stat to the pH‐stat method. Conclusion: Both blood gas analysis methods were similarly effective in predicting brain injury extent. However, the alpha‐stat method significantly overestimated the lowest pCO ₂ values during therapeutic hypothermia.

Objective To determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental impairment (NDI) at 3 years corrected age (CA) in infants born before 29 weeks of gestational age (GA). Design/methods Infants born before 29 weeks GA between 2005 and 2017 were included. The primary outcome was a composite of death or NDI (full-scale intelligence quotient<85, cerebral palsy, vision or hearing impairment) at 3 years of CA. Infants were stratified by maternal PPROM status. Associations were explored using multivariate models. Results Of 1231 participants, 481 were in the PPROM group, and 750 were in the No PPROM group. After adjusting for factors, the odds ratio of death or NDI for PPROM vs. No PPROM was 1.22 (95% Confidence Interval 0.93–1.59). Conclusion Our study suggests that PPROM was not associated with an increased risk of a composite outcome of death or NDI at 3 years CA.