Clinical and Experimental Pediatrics

Review Article

Neonatology (Perinatology)

Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea

In Gyu Song, Trisha M. Prentice, Lynn Gillam

Clin Exp Pediatr. 2026;69(4):282-292. Published online March 13, 2026

Shared decision-making (SDM) offers an ethically grounded, relational approach to making difficult decisions in neonatal care. Its effective use depends on recognizing when its use is appropriate and enacted in clinical conversations. In Korea, while parents are often involved in decision-making, SDM is not yet consistently articulated or evaluated as a structured practice. Culturally grounded research, education, and institutional support are needed to strengthen family-centered neonatal care.

DOI: https://doi.org/10.3345/cep.2025.02929

Optimal postnatal corticosteroid regimens to prevent bronchopulmonary dysplasia with minimal adverse effects

Ga Won Jeon

Clin Exp Pediatr. 2026;69(4):293-300. Published online March 27, 2026

Postnatal corticosteroids facilitate ventilator weaning and reduce the risk of bronchopulmonary dysplasia (BPD). Despite being commonly used in high-risk infants, administration guidelines have not been established. Early dexamethasone may cause neurodevelopmental harm, and the optimal dosing remains uncertain. Inhaled corticosteroids show inconclusive benefits, whereas intratracheal administration with surfactant appears promising. Thus, corticosteroids should be used cautiously in high-risk, ventilator-dependent infants with severe BPD, and further high-quality trials are needed.

DOI: https://doi.org/10.3345/cep.2026.00108

Editorial

General Pediatrics

Adiposity rebound in early childhood: understanding body mass index percentiles and monitoring on growth charts to be healthy

Sochung Chung

Clin Exp Pediatr. 2026;69(4):301-303. Published online April 1, 2026

Height, weight, and body mass index percentiles should be tracked in routine childhood health checkups to address the age of adiposity rebound in early childhood. Comprehensive interventional lifestyle counselling in primary practice after growth and nutritional status assessments might be an early, effective strategy for preventing obesity and decreasing the double burden of disease in later life. Therefore, there is an urgent need for a cooperative and supportive health care system.

DOI: https://doi.org/10.3345/cep.2026.00668

Original Article

Neonatology (Perinatology)

Prolonged cerebral oxygenation surveillance with algorithm-based management: a neurocritical care bundle for extremely preterm infants

Kai-Hsiang Hsu, Wei-Hung Wu, Shu-Yu Lin, Chih-Chen Chang, Mei-Yin Lai, I-Hsyuan Wu, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien

Clin Exp Pediatr. 2026;69(4):304-312. Published online December 22, 2025

Web of Science 1

Question: Is prolonged monitoring of regional cerebral oxygen saturation (rcSO₂) and hemodynamic parameters a feasible approach? Can these measures predict the neurological outcomes in extremely preterm infants?
Finding: We used a neurocritical care bundle from birth to discharge or term-equivalent age. Infants with poor outcomes had significantly lower rcSO₂ values.
Meaning: Understanding rcSO₂ and hemodynamic parameters may help manage cerebral hypoxia and reduce neurological complications in extremely preterm infants.

DOI: https://doi.org/10.3345/cep.2025.02117

Perinatal risk factors for hemodynamically significant patent ductus arteriosus in very low birth weight infants

Jie Hee Jue, So Young Shin, Jae Hyun Park, Chun Soo Kim, Hee Joung Choi

Clin Exp Pediatr. 2026;69(4):313-321. Published online December 22, 2025

Question: What perinatal factors influence patent ductus arteriosus (PDA) in and improve outcomes of preterm infants?
Finding: Lower birth weight, frequent surfactant treatment, and maternal hypertension increased hemodynamically significant PDA risk in very low birth weight infants, whereas chorioamnionitis and premature rupture of membranes protected against it. A lower birth weight and incomplete antenatal steroid use increased the risk of surgical ligation, whereas small for gestational age reduced it.
Meaning: Recognizing these factors may enable early, targeted intervention and reduce the need for surgical management.

DOI: https://doi.org/10.3345/cep.2025.01893

Cardiology

Influence of atrial septal defect on mitral valve growth after repair of coarctation of the aorta or an interrupted aortic arch in infants

Yi-Chia Wang, Heng-Wen Chou, Chi-Hsiang Huang, Hsing-Hao Huang, Yih-Sharng Chen, En-Ting Wu, Shyh-Jye Chen, Ming-Tai Lin, Shuenn-Nan Chiu, Shu-Chien Huang

Clin Exp Pediatr. 2026;69(4):322-329. Published online January 13, 2026

Question: Does atrial septal defect (ASD) physiology affect postrepair mitral valve growth in patients with coarctation of the aorta or an interrupted aortic arch?
Finding: Mitral valve growth occurred after biventricular repair but not single-ventricle palliation, particularly in patients with small valves and low ASD pressure gradients.
Meaning: The ASD pressure gradient determines mitral valve growth and should guide surgical strategies in patients with borderline hypoplastic left heart syndrome.

DOI: https://doi.org/10.3345/cep.2025.02110

Neonatology (Perinatology)

Hemodynamics and cerebral oxygenation in the neonatal transition: a prospective pilot study

Daniel Pfurtscheller, Christoph Schlatzer, Nina Höller, Bernhard Schwaberger, Lukas P. Mileder, Nariae Baik-Schneditz, Magdalena Holter, Gerhard Pichler

Clin Exp Pediatr. 2026;69(4):330-339. Published online January 13, 2026

Question: How is arterial blood pressure related to cerebral oxygenation during the immediate postnatal transition in neonates?
Finding: Among preterm infants requiring respiratory support, cerebral oxygenation was associated with diastolic and mean arterial pressures, indicating passive pressure perfusion.
Meaning: Compromised preterm infants are vulnerable to impaired autoregulation with cerebral oxygenation fluctuations, highlighting the need for hemodynamic and cerebral monitoring plus routine monitoring of arterial oxygen saturation and heart rate.

DOI: https://doi.org/10.3345/cep.2025.02572

Hematology

Outcomes of hematopoietic stem cell transplantation for pediatric patients with transfusion-dependent thalassemia in Thailand

Kleebsabai Sanpakit, Kamala Laohverapanich, Bunchoo Pongtanakul, Nattee Narkbunnam, Chayamon Takpradit, Usanarat Anurathapan, Samart Pakakasama, Supanun Lauhasurayotin, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Pornpun Sripornsawan, Piya Rujkijyanont, Duantida Songdej, Nongnuch Sirachainan, Suradej Hongeng

Clin Exp Pediatr. 2026;69(4):340-352. Published online March 13, 2026

Question: Can hematopoietic stem cell transplantation (HSCT) cure pediatric transfusion-dependent thalassemia in Thailand? What influences its outcomes?
Finding: Among 266 HSCT procedures, 5-year overall survival and event-free survival rates were 91.3% and 81.0%, respectively. Outcomes were comparable between related and unrelated donors. Pre-HSCT ferritin >2,500 ng/mL, low CD34+ cell dose, and oral busulfan conditioning were associated with unfavorable survival. Longterm complications affected 22.7% of survivors.
Meaning: Optimizing pre-HSCT care, ensuring adequate grafting, and long-term surveillance are crucial.

DOI: https://doi.org/10.3345/cep.2025.02173

Cardiology

Value of demographic factors in early identification of pediatric malignant vasovagal syncope in head-up tilt test

Shuo Wang, Yuwen Wang, Hong Cai, Ping Liu, Fang Li, Chuan Wen, Liqun Liu, Runmei Zou, Cheng Wang

Clin Exp Pediatr. 2026;69(4):353-361. Published online March 5, 2026

Question: Can demographic factors identify pediatric malignant vasovagal syncope pre-head-up tilt test (HUTT)?
Finding: Age/body mass index are independent protectors; <12.9 years age cuts risk 20%/yr.
Meaning: Enables early risk stratification to optimize HUTT safety for children.

DOI: https://doi.org/10.3345/cep.2025.02397

Correspondence

Nephrology (Genitourinary)

A commentary on “Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices”

Yanlan Ma, Yunyun Zhu

Clin Exp Pediatr. 2026;69(4):362-363. Published online March 6, 2026

DOI: https://doi.org/10.3345/cep.2025.02712

Correspondence and reply

Nephrology (Genitourinary)

Authors’ reply: a commentary on “Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices”

Pornpimol Rianthavorn

Clin Exp Pediatr. 2026;69(4):364-365. Published online March 6, 2026

DOI: https://doi.org/10.3345/cep.2026.00192

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