{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:20:51Z","timestamp":1790389251235,"version":"4.1.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare diaphragm ultrasound findings and lung aeration between SGA and AGA newborns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, clinically stable term SGA and AGA newborns underwent diaphragm and lung ultrasound. Diaphragm parameters and 6-region lung ultrasound score (LUS) were assessed, with thickness and excursion normalized by birth weight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-four newborns were included (27 SGA and 27 AGA). SGA newborns had lower absolute inspiratory and expiratory diaphragmatic thicknesses; however, these between-group differences were no longer significant after normalization by birth weight. Regression analyses adjusting for body weight continued to demonstrate an association between SGA status and diaphragmatic thickness. No significant differences were observed in diaphragmatic functional indices or pulmonary aeration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SGA newborns had lower absolute diaphragmatic thickness than AGA newborns, while diaphragmatic function and pulmonary aeration were preserved. Differences in thickness were influenced by body size but were not fully explained by birth weight.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41372-026-02883-8","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:10:33Z","timestamp":1787299833000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diaphragm ultrasound and lung aeration in small-for-gestational-age versus appropriate-for-gestational-age newborns: a cross-sectional study"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5207-6543","authenticated-orcid":false,"given":"Ingrid Kelly Silva","family":"de Macedo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayson Laercio de Araujo","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara Bernardo Rinaldo da Silva","family":"Figueir\u00eado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Andr\u00e9 Freire","family":"Magalh\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"2883_CR1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.4103\/jrms.JRMS_771_16","volume":"22","author":"M Rezaei","year":"2017","unstructured":"Rezaei M, Jahangirimehr A, Karimi M, Hashemian AH, Mehraban B. Modeling birth weight neonates and associated factors. J Res Med Sci. 2017;22:60.","journal-title":"J Res Med Sci"},{"key":"2883_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1424-4","volume":"17","author":"JS Erkamp","year":"2019","unstructured":"Erkamp JS, Jaddoe VW, Mulders AG, Steegers EA, Reiss IK, Duijts L, et al. Customized versus population birth weight charts for identification of newborns at risk of long-term adverse cardio-metabolic and respiratory outcomes: a population-based prospective cohort study. BMC Med. 2019;17:186.","journal-title":"BMC Med"},{"key":"2883_CR3","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jpeds.2022.04.028","volume":"246","author":"JM Collaco","year":"2022","unstructured":"Collaco JM, McGrath-Morrow SA, Griffiths M, Chavez-Valdez R, Parkinson C, Zhu J, et al. Perinatal inflammatory biomarkers and respiratory disease in preterm infants. J Pediatr. 2022;246:34\u201339. e33.","journal-title":"J Pediatr"},{"key":"2883_CR4","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1002\/ppul.25169","volume":"56","author":"M Di Cicco","year":"2021","unstructured":"Di Cicco M, Kantar A, Masini B, Nuzzi G, Ragazzo V, Peroni D. Structural and functional development in airways throughout childhood: Children are not small adults. Pediatr Pulmonol. 2021;56:240\u201351.","journal-title":"Pediatr Pulmonol"},{"key":"2883_CR5","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.mce.2016.03.017","volume":"435","author":"LD Brown","year":"2016","unstructured":"Brown LD, Hay JrWW. Impact of placental insufficiency on fetal skeletal muscle growth. Mol Cell Endocrinol. 2016;435:69\u201377.","journal-title":"Mol Cell Endocrinol"},{"key":"2883_CR6","doi-asserted-by":"publisher","first-page":"5693","DOI":"10.1007\/s00431-023-05247-y","volume":"182","author":"S Fouzas","year":"2023","unstructured":"Fouzas S, Vervenioti A, Tsintoni A, Dassios T, Karatza AA, Dimitriou G. Diaphragmatic muscle function in term and preterm infants. Eur J Pediatr. 2023;182:5693\u20139.","journal-title":"Eur J Pediatr"},{"key":"2883_CR7","doi-asserted-by":"publisher","first-page":"3723","DOI":"10.1007\/s00431-023-05052-7","volume":"182","author":"A Alonso-Ojembarrena","year":"2023","unstructured":"Alonso-Ojembarrena A, Morales-Navarro A, Rodriguez-Medina J, Correro-Almagro A, Mart\u00ednez-Garc\u00eda R, L\u00f3pez-de-Francisco R, et al. The increase in diaphragm thickness in preterm infants is related to birth weight: a pilot study. Eur J Pediatr. 2023;182:3723\u201332.","journal-title":"Eur J Pediatr"},{"key":"2883_CR8","doi-asserted-by":"publisher","first-page":"2471","DOI":"10.1002\/ppul.25518","volume":"56","author":"MD Weber","year":"2021","unstructured":"Weber MD, Lim JK, Glau C, Conlon T, James R, Lee JH. A narrative review of diaphragmatic ultrasound in pediatric critical care. Pediatr Pulmonol. 2021;56:2471\u201383.","journal-title":"Pediatr Pulmonol"},{"key":"2883_CR9","doi-asserted-by":"publisher","first-page":"325","DOI":"10.11152\/mu-2485","volume":"22","author":"H Ma","year":"2020","unstructured":"Ma H, Yan W, Liu J. Diagnostic value of lung ultrasound for neonatal respiratory distress syndrome: a meta-analysis and systematic review. Med Ultrason. 2020;22:325\u201333.","journal-title":"Med Ultrason"},{"key":"2883_CR10","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1007\/s00431-021-04296-5","volume":"181","author":"UA Tandircioglu","year":"2022","unstructured":"Tandircioglu UA, Yigit S, Oguz B, Kayki G, Celik HT, Yurdakok M. Lung ultrasonography decreases radiation exposure in newborns with respiratory distress: a retrospective cohort study. Eur J Pediatr. 2022;181:1029\u201335.","journal-title":"Eur J Pediatr"},{"key":"2883_CR11","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1007\/s12098-020-03575-7","volume":"88","author":"M Mandal","year":"2021","unstructured":"Mandal M, Bhattacharya D, Esquinas AM. Diaphragm and lung ultrasound indices in prediction of outcome of weaning from mechanical ventilation in pediatric intensive care unit: correspondence. Indian J Pediatr. 2021;88:627\u2013627.","journal-title":"Indian J Pediatr"},{"key":"2883_CR12","doi-asserted-by":"crossref","unstructured":"Malta M, Cardoso LO, Bastos FI, Magnanini MMF, da Silva CMFP. STROBE initiative: guidelines on reporting observational studies. Rev Saude Publica. 2010;44:559\u201365.","DOI":"10.1590\/S0034-89102010000300021"},{"key":"2883_CR13","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1016\/S0140-6736(14)60932-6","volume":"384","author":"J Villar","year":"2014","unstructured":"Villar J, Ismail LC, Victora CG, Ohuma EO, Bertino E, Altman DG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384:857\u201368.","journal-title":"Lancet"},{"key":"2883_CR14","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1007\/s00431-020-03805-2","volume":"180","author":"E Bahgat","year":"2021","unstructured":"Bahgat E, El-Halaby H, Abdelrahman A, Nasef N, Abdel-Hady H. Sonographic evaluation of diaphragmatic thickness and excursion as a predictor for successful extubation in mechanically ventilated preterm infants. Eur J Pediatr. 2021;180:899\u2013908.","journal-title":"Eur J Pediatr"},{"key":"2883_CR15","doi-asserted-by":"publisher","first-page":"167","DOI":"10.7863\/ultra.15.01082","volume":"35","author":"H El-Halaby","year":"2016","unstructured":"El-Halaby H, Abdel-Hady H, Alsawah G, Abdelrahman A, El-Tahan H. Sonographic evaluation of diaphragmatic excursion and thickness in healthy infants and children. J Ultrasound Med. 2016;35:167\u201375.","journal-title":"J Ultrasound Med"},{"key":"2883_CR16","doi-asserted-by":"publisher","first-page":"e151797","DOI":"10.1001\/jamapediatrics.2015.1797","volume":"169","author":"R Brat","year":"2015","unstructured":"Brat R, Yousef N, Klifa R, Reynaud S, Shankar Aguilera S, De Luca D. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr. 2015;169:e151797.","journal-title":"JAMA Pediatr"},{"key":"2883_CR17","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1530\/JOE-19-0273","volume":"244","author":"EI Chang","year":"2020","unstructured":"Chang EI, Rozance PJ, Wesolowski SR, Nguyen LM, Shaw SC, Sclafani RA, et al. Rates of myogenesis and myofiber numbers are reduced in late gestation IUGR fetal sheep. J Endocrinol. 2020;244:339\u201352.","journal-title":"J Endocrinol"},{"key":"2883_CR18","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s00431-025-06484-z","volume":"184","author":"MGS Carvalho","year":"2025","unstructured":"Carvalho MGS, Tomiyama JN, Terra MA, Lanza FC. Diaphragmatic ultrasonography: reference values and reliability for thickness, thickening fraction, and excursion in neonates. Eur J Pediatr. 2025;184:709.","journal-title":"Eur J Pediatr"},{"key":"2883_CR19","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.3390\/diagnostics13061095","volume":"13","author":"D Buonsenso","year":"2023","unstructured":"Buonsenso D, Mariani F, Morello R, Cammarota G, De Rose C, Valentini P, et al. Ultrasound imaging for diaphragm function in a population of healthy infants: a short observational report. Diagnostics. 2023;13:1095.","journal-title":"Diagnostics"},{"key":"2883_CR20","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.3390\/children10081307","volume":"10","author":"P-C Lin","year":"2023","unstructured":"Lin P-C, Chen C-H, Chang J-H, Peng C-C, Jim W-T, Lin C-Y, et al. Monitoring of the healthy neonatal transition period with serial lung ultrasound. Child. 2023;10:1307.","journal-title":"Child"},{"key":"2883_CR21","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1038\/s41390-025-04226-3","volume":"99","author":"F Vinci","year":"2026","unstructured":"Vinci F, Loi B, Ramenghi L, De Luca D. Lung water, aeration and function in late preterm\/term neonates: subgroup analysis of the ULTRAS study. Pediatr Res. 2026;99:734\u20139.","journal-title":"Pediatr Res"},{"key":"2883_CR22","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.chest.2022.08.003","volume":"163","author":"T Yeung","year":"2023","unstructured":"Yeung T, Mohsen N, Ghanem M, Ibrahim J, Shah J, Kajal D, et al. Diaphragmatic thickness and excursion in preterm infants with bronchopulmonary dysplasia compared with term or near term infants: a prospective observational study. Chest. 2023;163:324\u201331.","journal-title":"Chest"}],"container-title":["Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02883-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02883-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02883-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:10:34Z","timestamp":1787299834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02883-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":22,"alternative-id":["2883"],"URL":"https:\/\/doi.org\/10.1038\/s41372-026-02883-8","relation":{},"ISSN":["0743-8346","1476-5543"],"issn-type":[{"value":"0743-8346","type":"print"},{"value":"1476-5543","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"15 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"All methods were performed in accordance with the relevant guidelines and regulations, including the ethical standards established by the Research Ethics Committee of the University of Pernambuco. The study was approved by the Research Ethics Committee of the University of Pernambuco (CAAE No. 87835525.7.0000.5191). Written informed consent was obtained from the parents or legal guardians of all participants before their inclusion in the study.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Ethics"}}]}}