30-Second Takeaway
- Gestational diabetes substantially increases childhood obesity risk; prenatal depression adds only a modest increment.
- Prophylactic hydrocortisone improves survival without BPD in extremely preterm infants, while prophylactic acetaminophen for PDA lacks outcome benefit.
- Combined Apgar score and cord pH refine cerebral palsy risk prediction and follow-up planning.
Week ending February 21, 2026
Perinatal risks, NICU prophylaxis, chronic disease, and equity updates for pediatric practice
Gestational diabetes has a stronger impact on childhood obesity than prenatal depression
This Kaiser Permanente cohort followed 203,333 birthing parent–child pairs from birth through age 10 with universal prenatal screening and growth monitoring. Childhood obesity prevalence rose from 14.6% at ages 2–4.9 years to 21.8% at ages 8–10 years. Prenatal depression was only modestly associated with obesity, with adjusted risk ratios around 1.05–1.08 across age strata. Gestational diabetes showed a larger association, with obesity risk ratios from 1.29 to 1.45 across childhood.
Prophylactic hydrocortisone improves BPD-free survival in extremely preterm infants
This Swedish historical cohort included 1106 infants born at 22–27 weeks’ gestation after implementation of an early hydrocortisone prophylaxis guideline. Hydrocortisone was given at 1 mg/kg/d for 7 days, then 0.5 mg/kg/d for days 8–10 to 474 infants; 632 were unexposed. Survival without BPD at 36 weeks’ PMA was higher with hydrocortisone (32.5% vs 29.3%; adjusted OR 1.62; 95% CI 1.16–2.27). BPD rates were lower with prophylaxis (49.2% vs 54.6%; adjusted OR 0.65; 95% CI 0.49–0.86), without significant increases in other severe morbidities.
Prophylactic IV acetaminophen for PDA closure lacks global benefit and increases cholestasis
This double-blind RCT enrolled 778 infants born at 23–28+6 weeks’ gestation in 43 European NICUs. Prophylactic IV acetaminophen did not improve survival without severe morbidities at 36 weeks’ PMA versus placebo (66.2% vs 63.6%; RR 1.04; 95% CI 0.94–1.16). Ductus arteriosus closure by day 7 was more frequent with acetaminophen (71.2% vs 52.2%; RR 1.36; 95% CI 1.21–1.53). Cholestasis occurred more often with acetaminophen (6.4% vs 2.6%; absolute risk difference 3.8 percentage points).
Combining Apgar and cord pH refines cerebral palsy risk after perinatal hypoxia
This nationwide Danish cohort included 825,159 singleton births at ≥35 weeks without major malformations and at least one year of follow-up. Infants with 5-minute Apgar 0–3 and cord pH <7.00 had 15.2% CP incidence, with adjusted relative risk 159.0 (95% CI 104.0–243.0) versus normal values. Normal Apgar (7–10) with pH <7.00 still carried increased CP risk (0.6%; aRR 6.1; 95% CI 3.7–10.0). Apgar 0–3 with normal pH (≥7.20) was also high risk (2.1%; aRR 22.0; 95% CI 11.0–44.0).
References
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Additional Reads
Optional additional studies from this edition.