Chen T, Liu X, Kong X
… +4 more, Zhu W, Wang Y, Liu H, Xing L
Acta Paediatr
· 2026 Jun · PMID 41725074
·
Full text
AIM: Early skin-to-skin contact (SSC) is recommended after vaginal birth, but its implementation and evidence for Caesarean delivery remain limited. This study aimed to evaluate the impact of early SSC on neonatal adapta...AIM: Early skin-to-skin contact (SSC) is recommended after vaginal birth, but its implementation and evidence for Caesarean delivery remain limited. This study aimed to evaluate the impact of early SSC on neonatal adaptation and feeding behaviours in infants born via Caesarean section. METHODS: A randomised controlled trial was conducted at the Peking University People's Hospital in China from 1 January 2022 to 31 December 2023. We recruited 209 mother-infant dyads, assigning them to an intervention (early SSC) or control (routine care) group. Outcomes included timing of feeding-readiness behaviours, physiological metrics (e.g., body temperature), and breastfeeding frequency within 72 h. RESULTS: The cohort included 209 neonates (sex distribution: 52.7% male; mean gestational age: 34.15 ± 4.19 years old). The SSC group (n = 105) showed significantly shorter latencies to all feeding-readiness behaviours, maintained higher body temperatures postpartum, had a more favourable weight transition pattern, more frequent breastfeeding sessions, and a lower jaundice value on day 3 (all p < 0.05). CONCLUSION: Early SSC after Caesarean delivery enhanced neonatal behavioural organization, physiological stability, and early feeding efficacy. Its integration into routine post-Caesarean care is recommended to improve infant outcomes.
AIM: Tuberculosis (TB) among refugee minors in low-incidence countries remains underexplored. We estimated the incidence of TB disease among refugee minors compared to Danish-born minors. METHODS: This nationwide prospec...AIM: Tuberculosis (TB) among refugee minors in low-incidence countries remains underexplored. We estimated the incidence of TB disease among refugee minors compared to Danish-born minors. METHODS: This nationwide prospective historical cohort study included 31 172 refugee minors (< 18 years) granted residency in Denmark from 1993 to 2015. Each was matched 1:6 with a Danish-born control on age and sex. Follow-up extended from the date of residency until the earliest of: TB diagnosis, the age of 21 years, or study-end (31.12.2015). Data were obtained from Statistics Denmark and the International Reference Laboratory of Mycobacteriology. We conducted descriptive analyses and estimated incidence rates (IRs) using Poisson regression. RESULTS: Refugee minors had a 48 times higher TB IR compared to their Danish-born peers. Notably, refugee minors from sub-Saharan Africa had an IR of 203 per 100 000 person-years. For both refugee minors and their Danish-born peers, pulmonary TB was the most common form, but still more than a third had extrapulmonary manifestations. Among refugee minors, most TB cases were diagnosed more than 2 years after arrival. CONCLUSION: Our findings underscore the need for national policies and clinical guidelines for TB screening of all refugee minors upon arrival to reduce morbidity and advance TB elimination efforts.
Acta Paediatr
· 2026 Jun · PMID 41674295
·
Full text
AIM: This study investigated central autonomic network maturation deviations using a previously defined machine learning model set to estimate a functional maturation age (FMA) from heart rate variability (HRV) analysis....AIM: This study investigated central autonomic network maturation deviations using a previously defined machine learning model set to estimate a functional maturation age (FMA) from heart rate variability (HRV) analysis. We investigated whether these deviations were associated with maternal, fetal, perinatal, or postnatal complications and with neurodevelopment at 2 years of age. METHODS: Differences (ΔHRV) between post-menstrual age (PMA) and FMA were measured in a multicenter prospective cohort of 132 preterm infants born < 30 weeks gestational age (GA). The relationship between ΔHRV and clinical factors, occurrence of complications or alterations in neurodevelopment assessed by Ages and Stages Questionnaire (ASQ) at 2 years of age was studied. RESULTS: ΔHRV expressed in weeks delay at 34 weeks of PMA was greater when GA was lower (3 IQR 2.3-3.9) at 24-26 versus 1.3 (IQR 0.8-2.4) at 28-30 weeks GA (p < 0.0001), in cases of bronchopulmonary dysplasia (p < 0.0001) or patent ductus arteriosus (p < 0.0001). ΔHRV was also associated with altered social skills at 2 years of age (OR 2.05, 95% CI 1.02; 4.14 for each week, p < 0.05) but not with ASQ total score (p = 0.06). CONCLUSION: ΔHRV, early and non-invasively estimated, depends on GA, perinatal and postnatal complications. Its assessment could contribute to evaluation of neurodevelopmental risk.
Särkkä E, Saarimäki L, Protudjer JLP
… +6 more, Ojaniemi I, Karjalainen J, Huhtala H, Ekström S, Kull I, Kivistö JE
Acta Paediatr
· 2026 Jun · PMID 41641791
·
Full text
AIM: Peanut and tree nut allergies are leading causes of food-induced anaphylaxis in children. We aimed to examine early introduction and allergic characteristics in children with suspected severe peanut and/or tree nut...AIM: Peanut and tree nut allergies are leading causes of food-induced anaphylaxis in children. We aimed to examine early introduction and allergic characteristics in children with suspected severe peanut and/or tree nut allergy. METHODS: Children aged 3-16 years with suspected severe peanut and/or tree nut allergy were recruited from Tampere University Hospital, Finland. Eligibility was based on a history of anaphylaxis and/or elevated specific immunoglobulin E (sIgE) to high-risk allergenic components. Data were collected through structured, physician-led interviews with participants and their caregivers. RESULTS: The study included 103 children (mean age 7.2 ± 3.0 years), of whom 47.6% had a history of anaphylaxis. Early nut introduction (< 6 months) did not occur at all among the participants. Additionally, nut introduction before 12 months was rare (< 2%). Peanut and cashew were the most introduced nuts and the most frequent anaphylaxis triggers. Parental food allergy was significantly more common among children without anaphylaxis compared to those with confirmed anaphylaxis (38.5% vs. 18.4%; p = 0.035). CONCLUSION: Early nut introduction was absent among children with suspected severe nut allergy, regardless of anaphylaxis history. Parental food allergy was more prevalent in children without anaphylaxis, suggesting it is not a reliable predictor of severe allergic reactions.
Dathe AK, Jaekel J, Hoehn T
… +2 more, Felderhoff-Mueser U, Huening BM
Acta Paediatr
· 2026 Jun · PMID 41636557
·
Full text
AIM: The developmental profile underlying visual-motor difficulties in very preterm children (< 32 weeks gestation) remains unclear. The aim is to test whether visual perception and fine motor skills mediate effects of v...AIM: The developmental profile underlying visual-motor difficulties in very preterm children (< 32 weeks gestation) remains unclear. The aim is to test whether visual perception and fine motor skills mediate effects of very preterm birth on visual-motor integration before school entry. METHODS: 60 very preterm and 60 term children were assessed at age 5-6 years with the Movement Assessment Battery for Children and the Developmental Test of Visual Perception. Direct and indirect effects of very preterm birth, visual perception and fine motor performance on visual-motor integration were tested using mediation analysis with SPSS. RESULTS: Mediation hypothesis was confirmed, specifically: (I) very preterm birth was associated with low visual-motor integration, fine motor skills and visual perception (β = -0.46, β = -0.44, β = -0.25, p < 0.01, respectively). (II) Fine motor skills and visual perception were positively associated with visual motor skills (β = 0.62, β = 0.43, p < 0.001). (III) In the full mediation model, the direct association of very preterm birth with visual motor integration was partially mediated by fine motor skills (β = -0.39, p < 0.001) and visual perception (β = -0.12, p < 0.001). CONCLUSION: Effects of very preterm birth on visual-motor integration are partially mediated by fine motor skills and visual perception. This developmental profile should be considered in screening and follow-up assessments. TRIAL REGISTRATION: German clinical trial register number: DRKS00011503.
Allison KM, Radville KM, Martens A
… +3 more, Manjourides J, Rajput N, Zimmerman E
Acta Paediatr
· 2026 Jun · PMID 41631893
·
Full text
AIM: This study aimed to determine whether infants' oromotor skills were related to the onset of babbling and their phonetic inventory at 6 months of age. METHODS: Parents of 50 6-month-old infants (41 full-term, 9 prete...AIM: This study aimed to determine whether infants' oromotor skills were related to the onset of babbling and their phonetic inventory at 6 months of age. METHODS: Parents of 50 6-month-old infants (41 full-term, 9 preterm) completed the Child Oral and Motor Proficiency Scale (ChOMPS), a valid and reliable caregiver-report measure of oromotor, feeding, and gross motor development. Caregivers additionally reported information about their infant's babbling and perceived phonetic inventory, or protophones, via an online questionnaire. RESULTS: Linear regression analysis revealed a statistically significant positive association between ChOMPS scores at 6 months and the number of different protophones parents reported that the infant produced. Logistic regression modelling showed that infants' ChOMPS scores significantly predicted their likelihood of babbling by 6 months of age. Preterm status and sex were not associated with babbling onset or phonetic inventory. CONCLUSION: These findings suggest a possible link between early oromotor development and emerging speech abilities in infancy. Infants with stronger oromotor skills at 6 months tended to produce a larger variety of protophones and were more likely to be early babblers, per parent report. These results reveal the potential value of early oromotor behaviours as indicators of developing speech skills.
AIM: Neonatal supraventricular tachycardia lacks neonatal-specific evidence to guide therapy. METHODS: We retrospectively collected data of neonates with supraventricular tachycardia across two Italian centres between 20...AIM: Neonatal supraventricular tachycardia lacks neonatal-specific evidence to guide therapy. METHODS: We retrospectively collected data of neonates with supraventricular tachycardia across two Italian centres between 2014 and 2024. Clinical features, mechanisms, echocardiography, biomarkers, acute and maintenance therapy were collected; outcomes included recurrences, intensive-care admission, electrophysiology and ablation. RESULTS: Thirty-two infants were included (59% male; median onset 14 days). Among the supraventricular tachycardia mechanisms, we identified atrioventricular reentrant tachycardia in 72%, AV-nodal reentrant tachycardia in 9%, permanent junctional reciprocating tachycardia in 9%, focal atrial tachycardia in 9%. Median ejection fraction was 60% overall and 39% in those with heart failure; tachycardia-induced cardiomyopathy occurred in 28%. First-episode termination was spontaneous in 13%, achieved with vagal manoeuvres in 28% and adenosine in 47%. Maintenance therapy was required in 97% for a median of 21 months. During a mean 3.75-year Follow-up, recurrence after withdrawal occurred in 3; electrophysiology was performed in 3 and ablation in 2. Elevated NT-pro-brain natriuretic peptide and focal atrial tachicardia/permanent junctional reciprocating tachycardia phenotypes correlated with greater therapy burden. CONCLUSIONS: Atrioventricular reentrant tachycardia predominates in neonatal supraventricular tachycardia. While acute control is usually attainable, sustained control often requires prolonged combination therapy. Early mechanism assignment and biomarker-informed risk stratification may guide step-up treatment, and catheter ablation is a viable option for refractory cases beyond infancy.
Acta Paediatr
· 2026 May · PMID 41615271
·
Full text
Cry-fuss problems, breastfeeding difficulties and sleep issues commonly prompt parents to seek help for their infants. Many families turn to social media, where they encounter diverse service providers, conflicting advic...Cry-fuss problems, breastfeeding difficulties and sleep issues commonly prompt parents to seek help for their infants. Many families turn to social media, where they encounter diverse service providers, conflicting advice and health misinformation. This may encourage medicalisation, treating normal developmental variation as a medical problem and paramedicalisation, the use of non-evidence-based therapies. Global search trends for non-evidence-based therapies and national registry data on diagnostic shifts (gastro-oesophageal reflux, allergic colitis, ankyloglossia) illustrate how paramedicalisation and medicalisation shape infant care. Addressing medicalisation and paramedicalisation requires understanding their drivers, recognising potential harms and focusing on how clinicians can better support families.
AIM: To evaluate the feasibility and validity of the tablet-based application CogniTOT for remote assessment of cognitive function. METHODS: An ongoing follow-up study with children born < 32 weeks of gestational age use...AIM: To evaluate the feasibility and validity of the tablet-based application CogniTOT for remote assessment of cognitive function. METHODS: An ongoing follow-up study with children born < 32 weeks of gestational age uses Ages and Stages Questionnaire (ASQ). Parents were further invited to remote CogniTOT assessment and to fill in the Non-Verbal Cognitive Scale (NVC) of the parental questionnaire Parent Report of Children's Abilities Revised (PARCA-R) at 2 years of age. Factors influencing successful CogniTOT completion were examined. Construct validity was explored by comparing the preterm-born group with term-born controls. To ensure concurrent validity, CogniTOT scores were compared to NVC PARCA-R. RESULTS: Thirty-two out of 77 invited preterm children completed CogniTOT along with 12 term-born children. Median scores did not differ between groups (p = 0.51). Difficulties in completion were frequent and both technical and interpersonal. There was no correlation between NVC PARCA-R and CogniTOT scores (correlation coefficient 0.079, p = 0.65). The correlation between NVC PARCA-R and ASQ was moderate (correlation coefficient 0.535, p < 0.001). CONCLUSION: Remote assessment using a tablet-based task is challenging and did not correlate with parental report. Technical advances may make this feasible for large-scale assessment.
AIM: This study described the aetiological factors associated with neonatal seizures and the risks for adverse neurological outcomes. METHODS: We identified all infants born at ≥ 36 weeks of gestation between 2009 and 20...AIM: This study described the aetiological factors associated with neonatal seizures and the risks for adverse neurological outcomes. METHODS: We identified all infants born at ≥ 36 weeks of gestation between 2009 and 2015 who were diagnosed with or treated for neonatal seizures and registered in the Norwegian Neonatal Network. Data from four nationwide registries provided information on perinatal factors and neurological outcomes until 5 years of age. RESULTS: There were 892 infants with seizures, which was an incidence of 2.2 per 1000 live births. More than half (58.5%) underwent electroencephalography monitoring and examinations. Mortality before discharge was 8.4% and deaths occurred a median of 5 days after birth. The most frequent presumed aetiology for neonatal seizures was moderate to severe hypoxic-ischaemic encephalopathy (25.1%). Of the 817 survivors, 115 (14.1%) were diagnosed with post-neonatal epilepsy, 119 (14.6%) with cerebral palsy (CP), and 43 (5.3%) had both diagnoses. The epilepsy risk was greatest after neonatal encephalopathy with normal Apgar scores (40.9%) and the CP risk was greatest after an ischaemic stroke (29.9%). CONCLUSION: Neonatal seizures were associated with a high risk of mortality and about a quarter were later diagnosed with epilepsy and/or CP. Improved access to electroencephalography and higher usage could improve diagnostics.
Cholecystectomy is a relatively uncommon procedure in the paediatric population. Day-case cholecystectomy is the standard procedure for adults but is not yet established in children. This systematic review assesses the c...Cholecystectomy is a relatively uncommon procedure in the paediatric population. Day-case cholecystectomy is the standard procedure for adults but is not yet established in children. This systematic review assesses the current literature on day-case cholecystectomy in children under 18 years of age. Fourteen final papers were analysed which include 5690 individuals. This systematic review describes the population deemed suitable for day-case procedures, perioperative protocols and the associated outcomes in those who have undergone a day-case procedure. Paediatric day-case cholecystectomy can be safe and effective in certain populations within a defined protocol.