Bubble Wrap PLUS – September 2024

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). 

This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

This month’s Bubble Wrap Plus provides answers to intriguing questions.

In JAMA Pediatrics, Chinese investigators studied the association between paternal preconception hepatitis B virus (HBV) infection and congenital heart diseases (CHDs) in offspring.

Using data from a cohort of over 6.6 million couples, investigators found that prior paternal HBV infection was independently associated with a higher risk of CHDs in offspring compared to no infection. The degree of risk was consistent regardless of maternal HBV immunity. However, there was a higher CHD risk in the offspring of newly infected fathers with immune wives (but not with susceptible wives). There was no significant interaction between maternal immune status and paternal HBV infection.

In the Journal of Pediatrics, Dr Rice et al. explore the impact of indoor air pollution on respiratory health in children under three years old with bronchopulmonary dysplasia.

Over 40% of the 1,011 children were exposed to at least one source of indoor air pollution, such as second-hand smoke (SHS), gas stoves, or wood stoves. Second-hand smoke exposure was associated with higher odds of emergency department visits, antibiotic use, and systemic steroid courses. Other forms of indoor air pollution (excluding SHS) were also linked to increased antibiotic use. However, there was no significant association between indoor air pollution and chronic respiratory symptoms or rescue medication use.

The Unity study group (NEJM) examined the use of nipocalimab, an anti-neonatal Fc receptor blocker, in preventing severe hemolytic disease of the fetus and newborn (HDFN) by inhibiting the transplacental transfer of maternal IgG alloantibodies in a phase 2 study.

Pregnant participants at high risk for early-onset severe HDFN received weekly intravenous doses of nipocalimab from 14 to 35 weeks’ gestation. 54% of the pregnancies resulted in live births at 32 weeks gestation or later without requiring intrauterine transfusions, a significant improvement over the historical benchmark. There were no cases of fetal hydrops, and 46% of participants did not require transfusion before or after birth. Treatment was associated with reduced maternal alloantibody titer and IgG levels, with no unusual infections reported in mothers or infants. 

The Avenir study group (NEJM) examined the impact of twice-yearly azithromycin distribution on childhood mortality in Niger by comparing three groups: children aged 1 to 59 months receiving azithromycin, infants aged 1 to 11 months receiving azithromycin with older children receiving a placebo, and a ‘full’ placebo group.

Distributing azithromycin to children aged 1 to 59 months significantly reduced mortality by 14%. However, giving azithromycin to only infants aged 1 to 11 months did not significantly reduce it. This study involved over 382,000 children and recorded 5,503 deaths over 419,440 person-years. Serious adverse events were rare and occurred across all groups. Bbroader azithromycin distribution to children 1 to 59 months may reduce mortality, though the potential for antimicrobial resistance requires monitoring.

You will find our list is broken down into four sections:

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!