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Article History

Received: 19 August 2024

Accepted: 8 September 2025

First Online: 6 October 2025

Declarations

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: This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). Ethical approval was obtained from the ethics review board of Children’s Hospital of Fudan University (2018–296), which was recognized by all participating hospitals. Waiver of informed consent were granted at all sites including 79 Chinese tertiary NICUs for de-identified data. Ethics committees that waived the consent included Ethics Committee of Children’s Hospital of Fudan University, Ethics Committee of Children's Hospital of Zhejiang University School of Medicine, Ethics Committee of The Third Affiliated Hospital of Zhengzhou University, Ethics Committee of Guangzhou Women and Children’s Medical Center, Ethics Committee of Tianjin Obstetrics & Gynecology Hospital, Ethics Committee of Gansu Provincial Maternity and Child Care Hospital, Ethics Committee of Northwest Women's and Children's Hospital, Ethics Committee of Shenzhen Maternity and Child Health Care Hospital, Ethics Committee of Guizhou Women and Children’s Hospital, Ethics Committee of Suzhou Municipal Hospital affiliated to Nanjing Medical University, Ethics Committee of Shengjing Hospital of China Medical University, Ethics Committee of Children’s Hospital of Shanxi, Ethics Committee of Quanzhou Women and Children’s Hospital, Ethics Committee of Fujian Women and Children’s Medical Center, Ethics Committee of Children’s Hospital of Nanjing Medical University, Ethics Committee of Hunan Children’s Hospital, Ethics Committee of Qingdao Women and Children’s Hospital, Ethics Committee of Nanjing Maternity and Child Health Care Hospital, Ethics Committee of The First Bethune Hospital of Jilin University, Ethics Committee of The First Affiliated Hospital of Anhui Medical University, Ethics Committee of Women and Children's Hospital of Guangxi Zhuang Autonomous Region, Ethics Committee of The First Affiliated Hospital of Xinjiang Medical University, Ethics Committee of Foshan Women and Children’s Hospital, Ethics Committee of The Affiliated Hospital of Qingdao University, Ethics Committee of Henan Children’s Hospital, Ethics Committee of Children’s Hospital of Shanghai, Ethics Committee of Chongqing Health Care Center for Women and Children, Ethics Committee of Children’s Hospital of Chongqing Medical University, Ethics Committee of Wuxi Maternity and Child Healthcare Hospital, Ethics Committee of Children's Hospital of Soochow University, Ethics Committee of People's Hospital of Xinjiang Uygur Autonomous Region, Ethics Committee of Yuying Children's Hospital Affiliated to Wenzhou Medical University, Ethics Committee of Shanghai First Maternity and Infant Hospital, Ethics Committee of Anhui Provincial Hospital, Ethics Committee of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Ethics Committee of Qilu Children’s Hospital of Shandong University, Ethics Committee of The First Affiliated Hospital of Zhengzhou University, Ethics Committee of General Hospital of Ningxia Medical University, Ethics Committee of Hebei Children’s Hospital, Ethics Committee of Hainan Women and Children’s Hospital, Ethics Committee of The second XiangYA hospital of Central South University, Ethics Committee of Ningbo Women&Children Hospital, Ethics Committee of Xiamen Children’s Hospital, Ethics Committee of Shaanxi Provincial People’s Hospital, Ethics Committee of The Affiliated Hospital of Southwest Medical University, Ethics Committee of Shanghai Children’s Medical Center affiliated to Shanghai Jiaotong University School of Medicine, Ethics Committee of First Affiliated Hospital of Kunming Medical University, Ethics Committee of Changzhou Maternal and Children Health Care Hospital, Ethics Committee of Shenzhen Children’s Hospital, Ethics Committee of Jiangxi Provincial Children’s Hospital, Ethics Committee of Xiamen Maternity and Child Health Care Hospital, Ethics Committee of Zhuhai Center for Maternal and Child Health Care, Ethics Committee of Guangdong Women and Children's Hospital, Ethics Committee of Wuhan Chidren's Hospital, Ethics Committee of Beijing Children's Hospital of Capital Medical University, Ethics Committee of Maternal and Children Hospital of Shaoxing, Ethics Committee of The First People's Hospital of Yunnan Province, Ethics Committee of Dehong people's Hospital of Yunnan Province, Ethics Committee of First Affiliated Hospital of Xian Jiaotong University, Ethics Committee of Inner Mongolia maternal and child health care hospital, Ethics Committee of Dalian Municipal Women and Children’s Medical Center, Ethics Committee of Lianyungang Maternal and Children Health Hospital, Ethics Committee of Children's Hospital Affiliated to Capital Institute of Pediatrics, Ethics Committee of Anhui Children's Hoospital, Ethics Committee of Fuzhou Children’s Hospital of Fujian Province, Ethics Committee of Kunming Children's Hospital, Ethics Committee of Shenzhen Hospital of Hongkong University, Ethics Committee of Peking Union Medical College Hospital, Ethics Committee of Obstetrics & Gynecology Hospital of Fudan University, Ethics Committee of The Affiliated Hospital of Guizhou Medical University, Ethics Committee of Qinghai Women and Children Hospital, Ethics Committee of The International Peace Maternity & Child Health Hospital of China welfare institute, Ethics Committee of Children's Hospital of Zhejiang University, Ethics Committee of Inner Mongolia People's Hospital, Ethics Committee of Xiamen Humanity Hospital, Ethics Committee of Shanghai General Hospital, Ethics Committee of The First People's Hospital of Yinchuan, Ethics Committee of The Third Hospital of Nanchang, Ethics Committee of University of Alberta.

: Not applicable.

: The authors declare no competing interests.