Hamre Svendsen R, Andersen JKN, Kälvemark Sporrong S
… +2 more, Andersson Y, Tho I
Acta Paediatr
· 2026 Jul · PMID 41919793
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AIM: The aim was to observe the methods used for off-label manipulation of medication on Norwegian paediatric wards. METHODS: This prospective observational study used a digital form to collect information on how medicin...AIM: The aim was to observe the methods used for off-label manipulation of medication on Norwegian paediatric wards. METHODS: This prospective observational study used a digital form to collect information on how medicine was manipulated on five paediatric wards in four university and local hospitals, from October 2023 to May 2024. RESULTS: We observed 31 off-label manipulations over 41 days. Tablets were the most frequently manipulated dosage form (71%). All tablets were manipulated by dispersing them in water, either to ease administration or to extract a partial paediatric dose. The tablets were dispersed whole or after splitting or crushing them. Most partial doses from tablets were difficult to achieve by splitting alone, as they were outside of half or quarter doses. There did not appear to be a standard routine for how to manipulate tablets, even when they had the same active pharmaceutical ingredients and target doses. Manipulation methods used did not always follow the available guidelines. Potentially hazardous medication was sometimes manipulated without adequate safety measures. CONCLUSION: The way that medication was manipulated varied and did not always follow the available guidelines. Safety procedures were not always followed when manipulating tablets.
AIM: To determine the clinico-demographic profile and predictors of mortality in hospitalised children with diphtheria. METHODS: This retrospective cohort study included 202 children aged 5-16 years diagnosed with diphth...AIM: To determine the clinico-demographic profile and predictors of mortality in hospitalised children with diphtheria. METHODS: This retrospective cohort study included 202 children aged 5-16 years diagnosed with diphtheria per WHO criteria at Lady Reading Hospital, Peshawar, from January 2023 to December 2024. Data on demographics, vaccination status, clinical features, complications, antibiotic use and outcomes were collected from HMIS records and treatment charts. Multivariable logistic regression was used to identify independent predictors of in-hospital mortality. RESULTS: Mean age was 8.44 ± 2.69 years; 52.5% were male and 64.9% unvaccinated. Fever (96.0%), cough (93.1%) and throat pain (85.2%) were the most common presentations. Complications included airway obstruction (15.8%), respiratory failure (14.9%) and carditis (14.4%). Linezolid, alone or in combination, was the most frequently used antibiotic (59.4%). The case fatality rate was 15.8%. In multivariable analysis, carditis was the only independent predictor of mortality (adjusted OR 18.50; 95% CI 4.72-88.92; p < 0.001); antibiotic choice and vaccination status were not significantly associated with death. CONCLUSION: Mortality in children hospitalised with diphtheria remains substantial, with carditis as the strongest independent predictor of death. The high case fatality rate, predominantly among unvaccinated children, highlights the need for early cardiac evaluation and strengthened vaccination programmes.
Carlander A, Cassel S, Höök MJ
… +3 more, Lundgren O, Bagge AL, Löf M
Acta Paediatr
· 2026 Jul · PMID 41918285
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AIM: This study tested the associations between screen time and anxiety and depression, while accounting for physical activity, sleep and socioeconomic background. METHODS: We analysed repeated cross-sectional survey dat...AIM: This study tested the associations between screen time and anxiety and depression, while accounting for physical activity, sleep and socioeconomic background. METHODS: We analysed repeated cross-sectional survey data from the Swedish population-based Generation Pep Study, which was collected in 2021-2022 and comprised children aged 8-17 years. Screen time and symptoms of anxiety and depression were measured using the short 25-item child-reported Revised Children's Anxiety and Depression Scale, along with physical activity, sleep, sex and age. The parents provided some of the basic details and helped younger children under 12 complete the questionnaire, as required. RESULTS: The 4002 children (50.9% boys) had a mean age of 12.2 ± 2.7 years. The scores for anxiety and depression nearly doubled when the daily screen time increased from approximately two hours to seven hours or more. However, statistically significant marginal effects were only observed when screen time exceeded two hours per day. The results remained significant after adjusting for the plausible displacement effect of physical activity, sleep and socioeconomic status. CONCLUSION: Screen time that exceeded about two hours a day was associated with higher levels of anxiety and depression among Swedish children who took part in this population-based study.
Huda MH, Abdullah KL, Susanto H
… +11 more, Banda JK, Rustina Y, Putra HE, Angelia N, Novardian, Adawiyah R, Kardono RW, Saragih ID, Saptarini I, Santi NF, Hasan F
AIM: To compare complementary interventions for improving weight gain in preterm infants via network meta-analysis (NMA). METHODS: We conducted a systematic review and NMA across six databases, including randomized contr...AIM: To compare complementary interventions for improving weight gain in preterm infants via network meta-analysis (NMA). METHODS: We conducted a systematic review and NMA across six databases, including randomized controlled trials (RCTs). Two reviewers independently extracted data and assessed bias. Analyses used a Bayesian framework in GeMTC software, with effects reported as standardizes mean differences (SMDs). Confidence In Network Meta-Analysis evaluated inconsistency, ranking and evidence certainty. RESULTS: In total, 61 RCTs (n = 5858 infants) were analysed. Tactile kinesthetic stimulation showed greatest weight gain improvement (SMD 8.9, 95% CI 0.8-17). Multisensory stimulation (SMD 7.0, 6.2-7.9) and its combination with music therapy (SMD 7.9, 6.6-9.1) were also effective. Other beneficial interventions included kinesthetic stimulation (SMD 1.3, 0.091-2.5), massage (SMD 0.70, 0.39-1.0), and massage plus tactile stimulation (SMD 0.94, 0.044-1.9). Oral stimulation reduced hospitalization duration (SMD -0.49, -0.88 to -0.098). CONCLUSIONS: Tactile kinesthetic, multisensory stimulation and massage combinations significantly enhance preterm infant weight gain. These interventions should be considered in neonatal care protocols to optimize growth outcomes. TRIAL REGISTRATION: The PROSPERO registration number is CRD42024557428.
AIM: Extremely preterm birth is associated with high morbidity and long-term support needs. This study estimated long-term medical and non-medical costs throughout childhood among children born before 24 weeks of gestati...AIM: Extremely preterm birth is associated with high morbidity and long-term support needs. This study estimated long-term medical and non-medical costs throughout childhood among children born before 24 weeks of gestation in Sweden. METHODS: This nationwide register-based study included 344 infants born before 24 weeks of gestation in Sweden between 2007 and 2018 who survived at least one year. Individual-level data from national health registers and social insurance records were linked to estimate costs of hospital care, outpatient care, prescribed drugs and parental support until the end of 2022. Costs were analysed from a societal perspective and expressed in 2022 Swedish kronor. RESULTS: The mean follow up time was 7.8 years. Average total costs per child were 1.68 million Swedish kronor in the first year of life, with medical care accounting for more than 80% of expenditures. Non-medical costs increased during childhood and exceeded medical costs from approximately four years of age. Neonatal morbidities, including bronchopulmonary dysplasia, treated retinopathy of prematurity, and severe intraventricular haemorrhage, were associated with sustained long-term costs. CONCLUSION: Birth before 24 weeks of gestation was linked to high long-term costs. Early costs were related to hospital care, while long-term costs increasingly reflected social and welfare support.
MacKay LJ, Lagrisolal N, Chang U
… +4 more, Christoffersen M, Hayden KA, Birnie K, Dewan T
Acta Paediatr
· 2026 Jul · PMID 41910541
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AIM: The aim of this scoping review was to identify, examine, and summarize available evidence regarding psychosocial supports provided to children with a chronic disease when admitted to hospital and their parents. METH...AIM: The aim of this scoping review was to identify, examine, and summarize available evidence regarding psychosocial supports provided to children with a chronic disease when admitted to hospital and their parents. METHOD: The JBI methodology for conducting and reporting scoping reviews was followed. Seven databases were searched, 15 181 titles and abstracts were screened, and data from the included studies were extracted. The psychosocial supports were grouped into the following domains: emotional and psychological, informational, social, spiritual, and practical. Data describing ho the psychosocial support was offered within each domain were thematically analysed. RESULTS: A total of 59 studies met inclusion criteria. Emotional and psychological interventions were the most frequently utilized. Most interventions were multimodal, delivered in person, and healthcare professionals and researchers served as primary administrators of the interventions. A vast majority of the interventions yielded positive outcomes, and there were no reported harms. CONCLUSION: Comprehensive and multimodal psychosocial interventions should be developed and implemented among hospitalized children with a chronic disease and their parents. The predominance of emotional and psychological support interventions reflects the critical need to address the mental health impacts of chronic illness and hospitalization on children with a chronic disease and their families.
AIM: Improved survival after childhood cancer has led to a growing population at risk of second malignant neoplasms (SMNs). This study assessed SMN risk and time trends among childhood cancer survivors in Finland. METHOD...AIM: Improved survival after childhood cancer has led to a growing population at risk of second malignant neoplasms (SMNs). This study assessed SMN risk and time trends among childhood cancer survivors in Finland. METHODS: Data from the Finnish Cancer Registry included 10 941 patients diagnosed with cancer before age 20 between 1970 and 2020. Patients were followed until 2021 for SMN occurrence (mean follow-up 14.5 years). Standardised incidence ratios (SIRs) and absolute excess risks (AERs) were calculated. Trends were examined by comparing two diagnostic eras: 1970-1990 and 1991-2020. RESULTS: Among 10 941 patients, 498 (4.6%) developed an SMN. The overall SIR was 4.41 (95% CI 4.03-4.81). Patients diagnosed before age 10 had a significantly higher SMN risk (SIR 6.79, 95% CI 5.92-7.76) than those diagnosed at older ages (SIR 3.47, 95% CI 3.07-3.90; p < 0.001). Survivors of central nervous system (CNS) and solid tumours diagnosed in 1991-2020 had more than twice the SMN risk compared with those diagnosed in 1970-1990. CONCLUSIONS: SMN risk remains significant for childhood cancer survivors, particularly for CNS and solid tumour cases, highlighting the need for tailored surveillance and further research on the strategies to mitigate long-term adverse outcomes.
AIM: To describe the trend of indications and outcomes of Liver transplant (LT) for Inherited Metabolic Disorders (IMD) in a single centre over 30 years. METHODS: A retrospective review of LT undertaken for IMD between 1...AIM: To describe the trend of indications and outcomes of Liver transplant (LT) for Inherited Metabolic Disorders (IMD) in a single centre over 30 years. METHODS: A retrospective review of LT undertaken for IMD between 1989 to 2021 wasperformed. Demographic and clinical data, including LT indications, complications and outcomes, were collected. Categorical data were described as proportions; Kaplan-Meier analysis was used to determine patient/graft outcomes. RESULTS: 55 patients (29 females) underwent 62 transplants between 1989 to 2021. Postoperative complications were rejection (17/62; 27.4%), bile leak (5/62; 8%), primary non-function (4/62; 6.5%), hepatic artery thrombosis (6/62; 9.7%) and portal vein thrombosis (1/62; 1.6%). Mortality rate was highest in organic acidaemia (7/11 or 63.6%) in the 1st 2 decades of this period. Mortality was higher in the first decade of our LT program, which improved in subsequent decades. There was 53.3% mortality from 1989 to 2000; 18.8% from 2001 to 2010; and 8.3% from 2011 to 2021. Cumulative 1-, 5-, and 10-year patient survival rates since 1989 were 78.1%,76.3%, 74.5%; graft survival rates were 69.3%,67.7% and 66.1%, respectively. CONCLUSIONS: Although our overall patient and graft survival rates are lower than global reports, outcomes have improved in the last decade with careful patient and donor selection and changes in LT protocol.
AIM: To map evidence linking maternal exposure to ambient air pollution during pregnancy and around birth when reported, with perinatal outcomes. METHODS: We searched PubMed, Embase and Web of Science for studies evaluat...AIM: To map evidence linking maternal exposure to ambient air pollution during pregnancy and around birth when reported, with perinatal outcomes. METHODS: We searched PubMed, Embase and Web of Science for studies evaluating air quality index, fine particulate matter less than 2.5 μm, nitrogen dioxide or ozone in relation to birth weight, preterm birth, stillbirth, neonatal mortality, congenital anomalies or neonatal intensive care unit admission. Two reviewers screened and extracted data independently. We performed a narrative scoping synthesis; pooled odds ratios came from included meta-analyses. RESULTS: Twenty studies were included: 12 cohort studies, 3 case-control studies, 4 systematic reviews with meta-analyses and 1 cross-sectional study. Most assessed in utero exposure by trimester or pregnancy averages; a few assessed exposure around delivery, and none primarily evaluated preconception exposure. Fine particulate matter less than 2.5 μm showed the most consistent associations with lower birth weight and higher preterm birth risk. Nitrogen dioxide was also associated with preterm birth and reduced birth weight. CONCLUSION: Ambient air pollution, especially fine particulate matter less than 2.5 μm and nitrogen dioxide, is associated with adverse perinatal and neonatal outcomes and supports exposure reduction during pregnancy and better research on critical exposure windows.
AIM: Under Swedish law, a vaccination may be included in the National Immunisation Programme (NIP) if it effectively prevents transmission in the population, is cost-effective and aligns with ethical and humanitarian pri...AIM: Under Swedish law, a vaccination may be included in the National Immunisation Programme (NIP) if it effectively prevents transmission in the population, is cost-effective and aligns with ethical and humanitarian principles. The Public Health Agency of Sweden (PHAS) evaluated these criteria for introducing varicella vaccination. METHODS: The evaluation included a literature review, disease modelling to assess dose timing, a health economic analysis and an ethical review addressing vaccine acceptance and equitable access. RESULTS: Varicella vaccines are safe and highly effective, providing near-complete protection against severe disease requiring hospitalisation when two doses are given. Modelling indicates that virus circulation could be eliminated within 2-3 years with high coverage and catch-up vaccination, also protecting unvaccinated and immunocompromised individuals of all ages through population immunity. Two doses are recommended at 18 months and 7-8 years, both co-administered with MMR. This schedule ensures durable immunity and high acceptance. Health economic analyses show the programme would be cost saving. CONCLUSION: Following PHAS's evaluation, the Swedish government has decided to include varicella vaccination in the NIP from 2027, with catch-up vaccination for susceptible individuals up to 18 years, implemented primarily through the child and school health services to ensure equitable access.
Eggeling J, Meigen C, Ludwig J
… +2 more, Kiess W, Poulain T
Acta Paediatr
· 2026 Jul · PMID 41883306
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AIM: This study examined associations between children's use of electronic media and maternal education at age 3, and developmental outcomes and changes (cognitive, language, motor, socio-emotional) one year later. METHO...AIM: This study examined associations between children's use of electronic media and maternal education at age 3, and developmental outcomes and changes (cognitive, language, motor, socio-emotional) one year later. METHODS: Included were 109 participants of the LIFE Child cohort (Germany). Development was assessed at two time points (mean age = 3.3 years at t1, 4.3 at t2) using the standardised ET 6-6-R test. Electronic media use (modern media and TV) and maternal education were measured at t1 through parental questionnaires. Linear regression analyses were conducted, adjusting for age, sex and developmental scores at t1. RESULTS: High TV use (> 1 h/day) at t1 and lower maternal education were significantly associated with poorer cognitive skills at t2. Additionally, high TV use predicted poorer language skills, but this effect appeared only in children whose mothers had low or medium education; no such association was observed when maternal education was high. The use of modern media at t1 showed no significant association with developmental outcomes at t2. CONCLUSION: Early TV exposure may negatively affect cognitive and language development. Children from families with lower educational backgrounds appear particularly vulnerable, highlighting the need for targeted media education and guidance.
AIM: To assess the cost-effectiveness of including varicella vaccination in the Swedish national vaccination programme for children together with the added impact of catch-up vaccination of susceptible older children. ME...AIM: To assess the cost-effectiveness of including varicella vaccination in the Swedish national vaccination programme for children together with the added impact of catch-up vaccination of susceptible older children. METHODS: An epidemiological transmission model was used to assess the cost-effectiveness of a two-dose national varicella vaccination programme, with and without a catch-up strategy, compared to no varicella vaccination. Parameter estimates were based on scientific publications and data from Swedish national and regional registries. RESULTS: A national varicella vaccination programme would result in health gains and cost-savings from a societal perspective. Cost-savings were primarily due to a reduction in caregiver productivity loss. From a health system perspective, the cost per quality-adjusted life-year gained was estimated at around SEK 200 000 (EUR 18 000), both with and without catch-up vaccination. At a negotiated vaccine price reduction to 30% of the current list price, the cost per quality-adjusted life-year gained would come down to SEK 5 000 (EUR 450). CONCLUSION: Our analyses suggest that inclusion of varicella vaccination in the national vaccination programme for children would be a cost-saving strategy from a societal perspective, which together with a catch-up vaccination offer for susceptible older children would result in a fast decline of varicella in Sweden.
AIM: Countries with varicella immunisation programmes have seen major reductions in disease burden. While two-dose schedules are now universally adopted, dosing ages vary, and some countries initially include catch-up va...AIM: Countries with varicella immunisation programmes have seen major reductions in disease burden. While two-dose schedules are now universally adopted, dosing ages vary, and some countries initially include catch-up vaccination of older children to speed impact. This modelling study assessed three two-dose schedules in the Swedish setting (1) 12 and 18 months, (2) 18 months and 5 years, and (3) 18 months and 7 years, with and without catch-up of susceptible children based on their medical history. METHODS: A deterministic, compartmental, age-structured, dynamic transmission model was used to evaluate the different strategies. RESULTS: With coverage similar to other childhood vaccinations in Sweden (≥ 95%) but no catch-up, varicella cases are projected to decrease significantly within four years of programme start for all schedules modelled. However, a temporary rebound may occur around years 4-7 due to accumulating susceptibles before subsiding. Adding catch-up vaccination in this high-coverage setting accelerates and sustains the decline, with varicella disease burden significantly reduced within 2-3 years. CONCLUSION: A national childhood varicella programme in Sweden could cut transmission and disease burden within 4 years, with catch-up vaccination speeding this to a few years and lowering rebound risk. The schedule should be guided by programmatic considerations.
Anniina K, Teemu H, Tea N
… +4 more, Karoliina K, Matti R, Harri S, Laura MH
Acta Paediatr
· 2026 Jul · PMID 41873796
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AIM: Little is known about how socio-economic factors influence severe childhood bacterial infections. We explored whether parental socio-economic status correlates with the risk of invasive bacterial infections in the o...AIM: Little is known about how socio-economic factors influence severe childhood bacterial infections. We explored whether parental socio-economic status correlates with the risk of invasive bacterial infections in the offspring. METHODS: Data on children < 16 years with community-acquired blood or cerebrospinal fluid culture-positive bacterial infections during 2002-2016 were collected from the National Infectious Diseases Register for the following pathogens: Streptococcus agalactiae, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Escherichia coli. Statistics Finland randomly selected five age-, sex- and region-matched controls for cases, including data on parental income and education. Odds ratios (ORs) with 95% confidence intervals (95% CIs) for invasive bacterial infections were estimated using logistic regression. RESULTS: The risk of severe bacterial infection was slightly, but not statistically increased with lowest parental income (OR 1.09, 95% CI 0.94-1.26). This risk was more evident with Escherichia coli. Lower maternal education showed a slight trend towards increased risk of severe bacterial infections (ORs: primary education 1.10, 95% Cl 0.97-1.24; secondary education 1.07, 95% Cl 0.98-1.17). CONCLUSION: Despite universal healthcare and a social welfare system, our data suggest that lower parental income and maternal education may be associated with a slightly increased risk of severe bacterial infections.
Chiara CD, Boracchini R, Trinh NTH
… +11 more, Giugni A, Sturniolo G, Visonà E, Judd A, Prevost ML, Thorne C, Hardelid P, Giaquinto C, Lupattelli A, Donà D, Cantarutti A
Acta Paediatr
· 2026 Jul · PMID 41869987
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AIM: Immunocompromised children (IC) were presumed to be at higher risk of SARS-COV-2 infection and severe COVID-19, but population-based evidence is limited. We assessed infection risk, COVID-19 hospitalisation, and sev...AIM: Immunocompromised children (IC) were presumed to be at higher risk of SARS-COV-2 infection and severe COVID-19, but population-based evidence is limited. We assessed infection risk, COVID-19 hospitalisation, and severe outcomes in IC compared with children with and without other high-risk conditions. METHODS: We conducted a retrospective population-based cohort study using electronic health registries from Italy and Norway, including children aged 1-14 years from February 2020-February 2022. Children were classified as IC, non-immunocompromised with high-risk conditions (non-IC), or reference children (RC). Adjusted models estimated infection hospitalisation risks. RESULTS: We included 29 520 children (IC = 201, non-IC = 5 144, RC = 24 175) in Italy and 851 517 (IC = 4 862, non-IC = 157 358, RC = 689 297) in Norway. Infection rates were similar across groups in both countries. Hospitalisations were rare in both datasets; however, in the Norwegian cohort, the aHR for hospitalisation was 5.29 (95% CI: 2.49-11.25) for IC vs. RC and 2.30 (95% CI: 1.10-4.82) for IC vs. non-IC. Zero and five severe cases occurred in Italy and Norway, respectively. CONCLUSIONS: IC did not have an increased risk of infection but experienced higher hospitalisation rates despite a low incidence of severe disease. This pattern may reflect precautionary clinical management rather than increased disease severity.
Acta Paediatr
· 2026 Jun · PMID 41869981
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AIM: This mini-review examines research on fetal consciousness, focusing on whether it can be empirically assessed or remains primarily a philosophical construct. METHODS: A review of theoretical frameworks was conducted...AIM: This mini-review examines research on fetal consciousness, focusing on whether it can be empirically assessed or remains primarily a philosophical construct. METHODS: A review of theoretical frameworks was conducted. Behavioural evidence from studies of prenatal sensory responsiveness is evaluated, with particular attention to whether observed behaviours are reflexive or intentional actions. RESULTS: Research in this area is frequently inconsistent. Theoretical models differ in how they conceptualise consciousness and in pinpointing when it may first emerge. Some frameworks propose that consciousness requires the integration of three key components: awareness, meaning the capacity to register sensory input; cognition, defined as the ability to acquire, organise and utilise information; and volition, in terms of intentional, goal-directed behaviour. Empirical findings from studies of self-directed fetal movements, behavioural responses to external stimuli, and systematic changes in fetal facial expressions following specific sensory inputs all point towards the presence of elements of conscious states rather than the alternative explanation of reflexive activity. These early capacities appear to be observable during prenatal development. CONCLUSION: Uncertainty remains regarding the extent to which fetal behaviours evidence full conscious experience. Advancing the field requires controlled experimental research and advanced technology to understand consciousness as it first emerges.
Acta Paediatr
· 2026 Jul · PMID 41860115
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AIM: An infantile hemangioma (IH) affecting the airway is rare. Identifying infants at risk for an airway IH is crucial to avoid potential airway compromise. Our objective was to identify risk factors for an airway IH an...AIM: An infantile hemangioma (IH) affecting the airway is rare. Identifying infants at risk for an airway IH is crucial to avoid potential airway compromise. Our objective was to identify risk factors for an airway IH and to study its incidence and treatments. METHODS: This study included 798 children with an IH visiting our paediatric vascular anomaly unit between 1.1.2008 and 31.12.2017. Patient demographics and IH-related data were retrospectively reviewed to identify factors predisposing to an underlying airway IH. RESULTS: An airway IH was diagnosed in 1.6% of the cohort. When a segmental beard distribution hemangioma was present, the risk for an airway IH was 33.3%, and when a non-beard distribution segmental hemangioma on the face or neck was observed, the risk was 11.5%. Focal hemangiomas were seen in 38.5% of infants with an airway IH, mostly in the perioral or nasal area. Propranolol was sufficient treatment for 80.0% of infants with an airway IH. CONCLUSIONS: The presence of a segmental beard distribution hemangioma involved the highest risk for an underlying airway IH. Children with other types of segmental IHs on the face or neck, or those with focal perioral and nasal hemangiomas were also at risk for airway involvement.
Kallenberger M, Bartling A, Hüning B
… +6 more, Dewan MV, Bialas J, Middendorf L, Dathe AK, Felderhoff-Müser U, Stein A
Acta Paediatr
· 2026 Jul · PMID 41860109
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AIM: Optimal treatment strategies for patent ductus arteriosus (PDA) and their impact on neurodevelopmental outcomes remain controversial. This study investigates the influence of PDA duration on neurodevelopment under a...AIM: Optimal treatment strategies for patent ductus arteriosus (PDA) and their impact on neurodevelopmental outcomes remain controversial. This study investigates the influence of PDA duration on neurodevelopment under a restrictive treatment approach. METHODS: Retrospective single-center study of 171 preterm infants ≤ 32 weeks gestation with echocardiographically-identified PDA (treated hemodynamically significant PDA-hsPDA, untreated PDA-ntPDA) or no PDA. Assessments included cerebral MRI at term-equivalent age, General Movement Assessment at 8-16 weeks and Bayley Scales of Infant Development III at 22-26 months corrected age. Infants with severe IVH ≥ III° were excluded a priori to isolate PDA effects without major brain injury. RESULTS: The hsPDA group represented infants with lower gestational age and birth weight, higher rates of bronchopulmonary dysplasia and longer hospitalization (all p < 0.001). Transcerebellar diameter differed significantly between groups (p = 0.004). PDA duration showed a statistical association with MRI-detected IVH ≤ II° in the hsPDA subgroup (OR 1.01 per day, p = 0.05). Multivariate analysis did not confirm any significant impact of PDA group or duration on neurodevelopmental outcomes after adjusting for confounders. CONCLUSION: Gestational age and comorbidities, rather than longer PDA duration, determined neurodevelopmental outcomes in our cohort of very preterm infants without severe brain injury.