Pediatrics

Multicomponent lifestyle programs can lower blood pressure in children

This systematic review included 27 school- or community-based lifestyle trials in children aged 3–18 years with at least 6 months’ duration. Thirteen studies reported beneficial blood pressure effects, most often when interventions combined physical activity, nutrition change, and education. Nine of 14 multicomponent programs improved blood pressure, suggesting integrated approaches outperform single-modality interventions. Family involvement occurred in many programs, but optimal physical activity dose, scalability, and long-term sustainability remain uncertain. 1

Universal newborn G6PD screening uncovers substantial risk missed by selective testing

Among 5470 screened newborns, G6PD deficiency and intermediate status prevalences were 1.7% and 2.4%, respectively, with 2.9% of males deficient. Deficient infants had higher bilirubin levels, greater phototherapy use during birth hospitalization, and more phototherapy readmissions than sufficient peers. Risk factor–based screening would have missed 44% of affected newborns before discharge, including many from traditionally lower-risk self-identified groups. Exchange transfusion and bilirubin-induced neurotoxicity were rare, likely reflecting protocolized bilirubin management alongside universal enzyme screening. 2

Thrombectomy improves outcomes for children with isolated M2 occlusion

This multicenter cohort included 40 children aged 28 days–17 years with isolated M2 occlusion presenting within 24 hours of last known well. Twenty underwent endovascular thrombectomy and 20 received best medical therapy, with similar baseline demographics. Thrombectomy patients had better 3–6 month functional outcomes (median ped-mRS 1 vs 2) and greater early PedNIHSS improvement. Benefits in ped-mRS and Pediatric Stroke Outcome Measure persisted to 24 months, with no deaths or access-site complications reported. One symptomatic intracranial hemorrhage occurred in the medical-therapy group, supporting an acceptable safety profile for thrombectomy here. 3

Congenital Zika syndrome greatly increases early-childhood epilepsy hospitalization risk

This Brazilian population-based cohort followed 10 828 887 singleton live births from 2015–2018 for epilepsy-related hospitalizations through age 4 years. Among these children, 2780 had congenital Zika syndrome and 8361 had in utero Zika exposure without congenital Zika syndrome. Congenital Zika syndrome was strongly associated with epilepsy-related admission, with an adjusted hazard ratio 34.22 versus unexposed children. Risk peaked at 7–18 months but remained elevated through 48 months, regardless of microcephaly status. Children exposed to Zika in utero without congenital Zika syndrome did not have increased epilepsy hospitalization risk compared with unexposed peers. 4