Prophylactic dextrose gel did not protect neurodevelopment at school age — and may harm wellbeing

The edition in brief

School-age follow-up of the hPOD trial assessed 1,067 children who, as at-risk newborns, received buccal dextrose gel or placebo at one hour of age; neurocognitive impairment at 6–7 years was similar (59% vs 57%), while emotional-behavioural difficulty (24% vs 18%) and low psychosocial function (17% vs 12%) were more common after gel. The SMART trial randomised 997 palivizumab-eligible infants to a single dose of clesrovimab or monthly palivizumab; adverse events and RSV lower respiratory infection (3.2% vs 3.4%) were similar, and a 210 mg dose in the second season was well tolerated. An international Delphi process agreed a definition of neonatal encephalopathy as heterogeneous impaired brain function with altered consciousness, separating it from hypoxic-ischaemic encephalopathy. A meta-analysis of 46 trials found behavioural interventions in young people with type 1 diabetes gave a small HbA1c benefit (g = 0.12), larger for family-focused approaches (g = 0.29). A Cochrane review of six small trials in 229 newborns could not show any antifungal to be better than amphotericin B for invasive fungal infection.