Author’s conclusions: when intubating a newborn, videolaryngoscopy is successful in the first attempt more frequently than direct laryngoscopy.
Reviewers’ commentary: this trial offers results favouring videolaryngoscopy. However, it has some design limitations regarding blinding and control of some confounding variables and the difficulty to replicate some conditions in centers with less resources.
Gámez Belmonde A, Gimeno Díaz de Atauri Á. Evid Pediatr. 2025;21:14
Authors´ conclusions: maternal pertussis vaccination during pregnancy in Spain decreased disease severity in infants younger than two months compared to those between 3 and 11 months old. It is necessary to increase health professional education about the importance of maternal immunization.
Reviewers´ commentary: despite the weaknesses and the low level of evidence in this study, pertussis maternal immunization in the third trimester of pregnancy decreases hospitalizations and length of hospital stay in infants younger than two months old. These data reinforce the importance of educating healthcare professionals attending pregnant women to increase immunization coverage.
Ortega Páez E, Espínola Docio B. Evid Pediatr. 2025;21:15
Authors ́conclusions: treatment with crinecerfont in children with congenital adrenal hyperplasia (CAH) decreases androstenedione levels and allows a reduction in the replacement maintenance dose with glucocorticoids while maintaining good control of androstenedione levels.
Reviewers ́ commentary: this study, of adequate design and quality, concludes that crinecerfont helps improve androgen control in patients with classic CAH, with few side effects in the short term. Studies with long-term follow-up are needed to assess the effect on bone metabolism, final height and impact on quality of life.
Rivero Martín MJ, Blanco Rodríguez C. Evid Pediatr. 2025;21:16
Authors´ conclusions: horizontal transmission of vaccine-strain rotavirus was infrequent and without clinical consequences. Benefits of allowing vaccine-induced protection against rotavirus disease in infants through in-NICU rotavirus vaccination appear to have outweighed risks from vaccine-strain transmission.
Reviewers´ commentary: these findings suggest that the known benefits of pentavalent rotavirus vaccine (RV5) administration in the NICU outweigh the low transmission risks of the vaccine strains, thus supporting its use in these units, provided that an adequate hand hygiene and equipment cleaning policy is ensured in the unit.
Carvajal Encina F, Pérez Solís D. Evid Pediatr. 2025;21:17
Authors’ conclusions: the duration of breastfeeding of less than 6 months is associated with a higher percentage of overweight and obesity at 12 and 24 months of age, although maternal obesity influences this relationship at 24 months.
Reviewer comments: this prospective longitudinal study suggests an association between breastfeeding for less than 6 months and an increased risk of overweight and obesity in Spanish infants at 12 and 24 months of age. However, it has limitations within its design and the analysis of confounding factors that require caution when applying its results, considering the great number of factors that conditions obesity during childhood.
Gámez Belmonde A, Cuestas Montañés EJ. Evid Pediatr. 2025;21:18
Authors´ conclusions: switching to a one-dose HPV vaccination schedule could maintain population-level health benefits similar to the two-dose schedule while being more efficient in terms of vaccine use.
Reviewers´ commentary: switching from a two-dose to a one-dose schedule in the HPV vaccination program for adolescents may be effective, efficient, and applicable to our setting. However, some uncertainties remain, such as its long-term durability in high-income countries and whether the new regimen could shift HPV infection to adults over 40 years old with unknown consequences. Therefore, more long-term studies would be necessary to confirm the study's findings.
Ortega Páez E, Fraile Astorga G. Evid Pediatr. 2025;21:19
Authors´ conclusions: the bronchodilator effect of a single inhaled dose of short action beta agonists with a valve holding chamber is similar to the administration of successive doses in children with mild acute asthma exacerbation.
Reviewers’ commentary: this study in children with mild asthmatic exacerbations, after a first effective dose of salbutamol, finds no short-term functional benefit in administering successive doses. There is no evidence in the longer term impact or in other clinical variables. There is no data about the effect in more severe exacerbations neither in patients with partial response to a first dose of bronchodilator.
Gimeno Díaz de Atauri Á, Espínola Docio B. Evid Pediatr. 2025;21:20
Authors' conclusions: neonatal screening for vitamin B12 deficiency reduces the risk of developing symptoms in the first year of life by a factor of 4 compared to unscreened populations.
Reviewers' commentary: currently, there is insufficient evidence to recommend universal neonatal screening for vitamin B12 deficiency. While early detection is crucial to preventing permanent sequelae, precise data on false-positive and false-negative rates are lacking. Given the high efficacy of treatment, early case detection based on clinical suspicion may be a sufficient alternative. Furthermore, since vitamin B12 deficiency can cause symptoms and complications as early as pregnancy, prenatal screening could be a more appropriate strategy.
Suárez Cabezas S, Pérez-Moneo Agapito B. Evid Pediatr. 2025;21:21
Authors' conclusions: in febrile children of less than 36 months of age diagnosed with UTI by bladder catheterization, pyuria is not detected in the urine sediment in 20% of cases. Therefore, given the current sensitivity of available diagnostic tests, it is not necessary for diagnosis.
Reviewers' comments: in febrile infants and young children, the decision to initiate empirical treatment should not depend solely on the positive result of pyuria in the urine test.
Pérez González E, Esparza Olcina MJ. Evid Pediatr. 2025;21:22
Authors' conclusions: studies showed that there is no benefit in prolonging prednisone treatment beyond two to three months in the first episode of steroid-sensitive nephrotic syndrome and intercurrent disease, with no increased risk of relapse. Small studies in children with relapsing disease have not identified differences in efficacy using lower induction doses or shorter durations of prednisone, although further studies are required to confirm these findings.
Reviewers' commentary: this is a systematic review that suggests the usefulness of shorter steroid regimens in both first and subsequent relapses in SSNS. The usefulness of lower doses of corticosteroids in relapse remains to be confirmed, as well as the decrease in direct and indirect side effects derived from the shorter treatment time.
Pérez González E, Balado Insunza MN. Evid Pediatr. 2025;21:23
Authors´ conclusions: in children admitted to intensive care, acute kidney injury can progress to chronic kidney damage
Reviewers´ commentary: despite the methodological limitations of the study, acute kidney injury appears to be an important problem in critically ill children and a risk factor for developing chronic kidney disease.
Pérez González E, Molina Arias M. Evid Pediatr. 2025;21:24
Editorial
