AIM: To investigate the association between mode of conception, that is, using fertility treatments versus spontaneously conception, and long-term infectious morbidity of the offspring while employing sibling matched ana...AIM: To investigate the association between mode of conception, that is, using fertility treatments versus spontaneously conception, and long-term infectious morbidity of the offspring while employing sibling matched analysis. METHODS: A retrospective population-based cohort study was performed, including all sibling deliveries between 1991 and 2021 at a tertiary medical center. Offspring were followed until the age of 18. A Kaplan-Meier survival curve was used to compare the cumulative incidence of infectious morbidity, and a multivariable Cox survival hazards regression model was used to control for confounders. RESULTS: During the study period, 14 336 siblings met the inclusion criteria, of which 7711 (53.8%) were conceived through fertility treatments and 6625 (46.2%) were conceived spontaneously. No differences in long term infectious morbidity were demonstrated between siblings conceived following fertility treatments and spontaneously conceived siblings using Kaplan Meier survival curve (Log-Rank p = 0.614). Likewise, the Cox proportional hazard model did not demonstrate an independent association between mode of conception and long-term infectious morbidity in the offspring (adjusted HR 0.92, 95% CI 0.85-1.00, p = 0.063) controlling for maternal age, gestational age and follow up time. CONCLUSION: Using a sibling analysis, fertility treatment does not appear to be an independent risk factor for long-term infectious morbidity of the offspring up to 18 years of age.
Weber S, Geser A, Unternaehrer E
… +2 more, Bolten M, Légeret C
Acta Paediatr
· 2026 Jul · PMID 41855387
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AIM: Functional gastrointestinal disorders (FGIDs) are common in childhood, but psychological correlates remain poorly understood. We compared emotional and behavioural functioning in children with FGIDs with somatic and...AIM: Functional gastrointestinal disorders (FGIDs) are common in childhood, but psychological correlates remain poorly understood. We compared emotional and behavioural functioning in children with FGIDs with somatic and healthy controls. METHODS: Parents of children aged 2-12 years were recruited at the University Children's Hospital Basel (February 2024-February 2025). Children meeting Rome IV criteria formed the Functional Group; those with somatic gastrointestinal diseases and healthy peers served as Somatic and Healthy Controls. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and Patient Health Questionnaire (PHQ-4). Group differences were tested using non-parametric models and adjusted negative binomial regression. RESULTS: Data from 218 children were analysed (Functional n = 66, Somatic n = 62, Healthy n = 90). SDQ total difficulties were markedly higher in FGIDs than in both control groups (p < 0.001). Differences were most pronounced for emotional and hyperactivity problems. Using age-adjusted SDQ total difficulties cut-offs, elevated scores occurred in 45.5% of children with FGIDs, compared with 8.1% in somatic and 10.0% in healthy peers. Parental psychological distress and separation predicted higher difficulties. CONCLUSION: Emotional and behavioural difficulties in FGIDs exceed those observed in somatic gastrointestinal diseases, indicating a particularly high psychosocial burden. These findings highlight the relevance of psychological aspects within integrated paediatric gastroenterology care.
Acta Paediatr
· 2026 Jun · PMID 41855134
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AIM: To examine the relationship between 'diagnoses of neurodevelopmental concern' before the age of 2 years and definite adverse outcomes before age 10. METHOD: Data from national registries were linked. Children born i...AIM: To examine the relationship between 'diagnoses of neurodevelopmental concern' before the age of 2 years and definite adverse outcomes before age 10. METHOD: Data from national registries were linked. Children born in Denmark from 1994 to 2017 were included. Eight diagnoses of neurodevelopmental concern recorded before age 2 were compared to four definite outcomes recorded before age 10. The association was also analysed in three subpopulations at risk of perinatal brain damage. RESULTS: A total of 1.5 million children were included. At least one diagnosis of neurodevelopmental concern was recorded in 34 392 (2.3%) of children before the age of 2 years, but numbers increased over the years. Definite outcomes were recorded in 35 300 (2.3%) children before age 10. Of these 7 757 (22.6%) had previously had an early diagnosis of neurodevelopmental concern OR (95% CI) = 12.0 (11.5; 12.5). In the three subpopulations, diagnoses of concern as well as the risk of a definite outcome were increased 3-to-4 fold. CONCLUSION: Early diagnosis of concern appeared valid indicators of adverse neurodevelopmental outcome. The use of diagnoses of concern increased gradually over the years and cannot serve as a simple monitor at the population level.
Honkila M, Lindholm V, Ojala AK
… +5 more, Koskela U, Pokka T, Mäki-Koivisto V, Mattila S, Ruuska-Loewald T
Acta Paediatr
· 2026 Jul · PMID 41848346
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AIM: The aim of this study was to investigate the occurrence of M. pneumoniae detections in asymptomatic children during an outbreak. METHODS: We prospectively recruited symptomatic and asymptomatic children under 18 yea...AIM: The aim of this study was to investigate the occurrence of M. pneumoniae detections in asymptomatic children during an outbreak. METHODS: We prospectively recruited symptomatic and asymptomatic children under 18 years of age between 1 January and 1 November 2024. Picornavirus positivity was also assessed in both groups. A multiplex polymerase chain reaction (PCR) panel was used to detect respiratory pathogens in nasopharyngeal swab samples. RESULTS: A total of 183 children with respiratory symptoms (median age 11 years, IQR 7.4 to 14) and 61 asymptomatic children (median age 11 months, IQR 3.0 to 121) were included. In the symptomatic group, 46 children (25%, 95% CI 19%-32%) tested positive for M. pneumoniae, whereas none of the asymptomatic/mildly symptomatic children (0%, 95% CI 0%-6.3%) tested positive (p < 0.001). Forty-seven symptomatic children (26%, 95% CI 20%-33%) and eight asymptomatic/mildly symptomatic children (14%, 95% CI 6.3%-26%) tested positive for picornaviruses (p = 0.052). CONCLUSION: M. pneumoniae detections were rare in asymptomatic/mildly symptomatic children during an outbreak. These findings suggest that multiplex PCR of nasopharyngeal swabs may serve as a specific diagnostic test for acute mycoplasma infections. The generalizability of the study's findings to school-aged children is, however, limited.
Kuntz M, Raljevic L, Bergmann K
… +3 more, Matheisl D, Schneider H, Fuchs H
Acta Paediatr
· 2026 Jul · PMID 41830318
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AIM: Caffeine is the mainstay of treatment for apnea of prematurity, yet the optimal strategy and timing for discontinuation remain undefined. Marked inter-centre variation in the practise of discharging preterm infants...AIM: Caffeine is the mainstay of treatment for apnea of prematurity, yet the optimal strategy and timing for discontinuation remain undefined. Marked inter-centre variation in the practise of discharging preterm infants home on caffeine therapy has been reported. We aimed to map current practises in Europe concerning discharge of preterm infants on caffeine therapy, including home-monitoring and strategies for discontinuing ambulatory therapy. METHODS: A web-based three-part questionnaire was sent to 633 neonatal units in 36 European countries (July-October 2025). One response per unit was permitted. The survey collected data on policies and practises regarding discharge on caffeine, criteria for stopping therapy, and post-discharge monitoring. Responses were analysed descriptively. RESULTS: Complete responses were obtained from 125 units in 21, revealing wide variation in practise patterns. Fifty-eight per cent of participating centres reported discharging preterm infants on continued caffeine therapy at least occasionally. Among those units, 58% reported prescribing home-monitoring routinely for infants discharged on caffeine therapy. Overall, significant differences in practise existed between geographical regions but not between high- and low-volume centres. CONCLUSIONS: Discharging preterm infants on continued caffeine therapy is a widespread practise among neonatologists in Europe, with considerable variation among regions and differing strategies concerning home-monitoring and discontinuation of treatment.
Svedberg M, Lundqvist F, Östrand HA
… +3 more, Krantz C, Ekman P, Imberg H
Acta Paediatr
· 2026 Jun · PMID 41814527
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AIM: Children with cystic fibrosis (CF) face substantial daily treatment burdens and the effects of transmembrane conductance regulator modulators on these have not been sufficiently described. We evaluated changes in tr...AIM: Children with cystic fibrosis (CF) face substantial daily treatment burdens and the effects of transmembrane conductance regulator modulators on these have not been sufficiently described. We evaluated changes in treatment burden after elexacaftor tezacaftor ivacaftor (ETI) was initiated. METHODS: This prospective observational study comprised children aged six to 17 years from three Swedish paediatric CF centres. They were enrolled from 7 December 2022 to 30 June 2023, before ETI was initiated. Their health-related quality of life, treatment burden, and adherence were assessed at baseline and at six and 12 months. RESULTS: We studied 62 children who initiated ETI and were followed up to 12 months. The mean standard deviation (SD) treatment burden score improved by 4.9 points (95% confidence interval (CI) -0.7 to 10.6, p = 0.087), from 67.6 (±20.6) at baseline to 72.5 (±17.6) at 12 months. The mean daily time spent on inhalation therapy and airway clearance decreased from 91.9 (±37.3) to 70.4 (±23.6) minutes (p < 0.001). Mean inhalation time per session fell by 7 min (95% CI -10.5 to -3.3, p < 0.001) and airway clearance time by 4 min (95% CI -6.7 to -1.5, p = 0.003). CONCLUSION: Treatment burden, particularly daily inhalation and airway clearance time, decreased after ETI initiation.
Acta Paediatr
· 2026 Jul · PMID 41814524
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The LAKANA trial: a randomized control trial evaluating the impact of mass administration of azithromycin to infants 1 to 11 months of age in Mali showed no reduction in mortality.The LAKANA trial: a randomized control trial evaluating the impact of mass administration of azithromycin to infants 1 to 11 months of age in Mali showed no reduction in mortality.
Andersen DB, Fog J, Vestergaard MV
… +6 more, Rasmussen IS, Wilson P, Overbeck G, Jørgensen LB, Kragstrup J, Jensen BH
Acta Paediatr
· 2026 Jun · PMID 41803938
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AIM: Despite being a self-limiting condition, infant colic is associated with negative consequences for caregivers and infants. Gut inflammation is hypothesised as a contributing factor. We collected and meta-analysed th...AIM: Despite being a self-limiting condition, infant colic is associated with negative consequences for caregivers and infants. Gut inflammation is hypothesised as a contributing factor. We collected and meta-analysed the most recent evidence on the association between infant colic and gut inflammation. METHODS: A systematic PubMed search was conducted to identify peer-reviewed English language studies about infants with colic regarding their immunological profile. The search spanned from inception to the 24th of February 2024, identifying 124 articles. After exclusions, eight articles were included for analysis. Statistics on faecal calprotectin were extracted from four studies (infant colic = 227, healthy controls = 166) and meta-analysed. RESULTS: Faecal calprotectin was significantly elevated in infant colic cases in five of six studies covering faecal calprotectin with two studies finding a mean difference exceeding 200 μg/g. The meta-analysis showed a 49.5 μg/g mean difference in faecal calprotectin levels (95% CI = 43-56, p < 0.0001). MCP-1, MIP-1β and IL-8 were elevated in one study with no differences for other biomarkers. CONCLUSION: We found evidence of an inflammatory response in infant colic supporting the hypothesis that gut inflammation is involved in the pathogenesis of infant colic. Faecal calprotectin may become a valuable diagnostic tool for infant colic.
AIM: To identify clinical and laboratory factors associated with egg allergy persistence beyond age 8 in children diagnosed within the first 2 years of life. METHODS: We retrospectively analysed 77 children with IgE-medi...AIM: To identify clinical and laboratory factors associated with egg allergy persistence beyond age 8 in children diagnosed within the first 2 years of life. METHODS: We retrospectively analysed 77 children with IgE-mediated egg allergy (2013-2024). Patients were classified into persistent (n = 12) and tolerance (n = 65) groups after at least 8 years of follow-up. Multivariable logistic regression was performed to identify independent predictors. RESULTS: Persistence beyond age 8 occurred in 12 patients (15.6%). Multivariable analysis identified diagnosis at ≤ 5 months (OR 21.37), multiple food allergies (OR 8.47), and higher baseline egg-white specific IgE (F1) levels (OR 1.09 per 1 kU/L rise) as independent risk factors. The area under the curve (AUC) for initial F1 levels was 0.896 (95% CI: 0.808-0.985). A combined multivariable model incorporating diagnosis age, multiple food allergies, and initial F1 levels demonstrated superior predictive performance with an AUC of 0.935 (95% CI: 0.861-0.999). CONCLUSION: Early diagnosis, multiple food allergies, and high baseline specific IgE levels are strong predictors of egg allergy persistence beyond age 8. These factors enable clinicians to stratify high-risk patients and tailor long-term management strategies.
Typpö L, Solasaari T, Korpela K
… +3 more, de Vos WM, Salonen A, Kolho KL
Acta Paediatr
· 2026 Jun · PMID 41784952
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AIM: To study the relationship between bowel function after birth and at 1-2 years of age in the prospective HELMi cohort of term infants. METHODS: We focused on infants with predominantly green stools (n = 152) for thre...AIM: To study the relationship between bowel function after birth and at 1-2 years of age in the prospective HELMi cohort of term infants. METHODS: We focused on infants with predominantly green stools (n = 152) for three consecutive weeks in early life and their sex, age, and delivery mode-matched controls (n = 300), and evaluated bowel function at 1-2 years. We also evaluated bowel function in babies who had cried the most (n = 179) and compared the findings with the rest of the cohort (n = 689). RESULTS: There were no alarming signs of gastrointestinal dysfunction in any of the infants. Infants with green stools in early life had 1.5-2 times more reports of abdominal symptoms at 1-2 years compared to controls (p < 0.005), and stool-mucus was twice as frequent at 1 year (p < 0.05). Compared to controls, 1-year-old infants who cried most as babies had a higher frequency of defecation (a median of 14 per week [IQR 8-17] vs. 12 [IQR 7-15]; p < 0.05) and showed twice as frequent stool-mucus at 1 year (p < 0.05). CONCLUSION: In healthy term babies, occasional abdominal pain or predominantly green stools were associated with benign gastrointestinal symptoms in later infancy. This functional variation may reflect altered microbiota, warranting further research.
Acta Paediatr
· 2026 Jun · PMID 41742346
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AIM: To predict changes in health-related quality of life (HRQoL) when sedentary behaviour was hypothetically replaced with other movement behaviours (sleep, standing, light physical activity and moderate-to-vigorous phy...AIM: To predict changes in health-related quality of life (HRQoL) when sedentary behaviour was hypothetically replaced with other movement behaviours (sleep, standing, light physical activity and moderate-to-vigorous physical activity) in adolescents. METHODS: Participants (N = 216; 12-17 years) provided measures of HRQoL and accelerometer-measured movement behaviours at two time-points, separated by 1 year. HRQoL was assessed with the KIDSCREEN-27 questionnaire. Compositional linear mixed models were used to estimate changes in HRQoL when time was reallocated from sedentary behaviour to other movement behaviours. RESULTS: Favourable changes in global HRQoL scores (Δ (95% CI)) were predicted when 30 min/day of sedentary behaviour was substituted with light physical activity in girls (2.0 (0.7, 3.3)), moderate-to-vigorous physical activity in boys [1.8 (0.5, 3.2)], or sleep in all participants [0.4 (0.0, 0.8)]. Reallocating time from sedentary behaviour to standing had no impact on HRQoL. CONCLUSION: Sitting less, moving more is associated with better HRQoL in adolescents whilst replacing sitting with standing has no impact on HRQoL. The optimal intensity of movement for HRQoL differs between girls (light) and boys (moderate-to-vigorous).
Bolin K, Strandell K, Palmborg A
… +2 more, Gustafsson S, Silfverdal SA
Acta Paediatr
· 2026 Jun · PMID 41735786
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AIM: Respiratory syncytial virus (RSV) infection is a leading cause of paediatric hospitalisations. This study describes annual RSV-hospitalisation burden of disease, by gestational week of delivery, age and sex among ch...AIM: Respiratory syncytial virus (RSV) infection is a leading cause of paediatric hospitalisations. This study describes annual RSV-hospitalisation burden of disease, by gestational week of delivery, age and sex among children aged 0-17 years of age in Sweden, for the period 2010/11-2021/22. METHODS: Employing total population Swedish register data pertaining to hospitalisations due to RSV for the period 2010-2022. RESULTS: Over the study period a total of 26 772 children were hospitalised due to RSV. Most of the patients, 63.2%, were aged < 6 months and 39.9% were aged < 3 months. Among patients aged < 3 months, 88.5% were born at full term. The average number of hospital days increased with lower gestational age at birth for all age groups, except for patients aged 5- ≤ 17 years of age. Estimated incident rate ratios (IRR) comparing patients born at full term to patients born extremely preterm ranged between 2.43 and 1.75, respectively, for patients aged 0 < 3 months and 1 < 2 years of age. CONCLUSIONS: Paediatric RSV hospitalisations mostly occur in the youngest infants, and most are born at term. Gestational age at birth and age at admission are both negatively related to length of stay.
The 2025 recommendations from the International Liaison Committee on Resuscitation are updated from the 2020 version. The algorithm is unchanged from 2015. Ten topics are addressed in the 2025 recommendations: Anticipati...The 2025 recommendations from the International Liaison Committee on Resuscitation are updated from the 2020 version. The algorithm is unchanged from 2015. Ten topics are addressed in the 2025 recommendations: Anticipation and preparation, Umbilical cord management, Initial steps, Assessment of heart rate at birth, Ventilation and oxygenation, Circulatory support, Drug and fluid administration, Post-resuscitation care, Prognostication during cardio-pulmonary resuscitation and Family presence. Among changes since 2020 are an update of umbilical cord handling. Assessment of heart rate is now including auscultation as well as pulse-oximetry. We identified 51 recommendations given for topics published between the 2020 and the 2025 versions. Of these, 19 were weak and only three were strong recommendations, 6 were conditional and 15 recommendations are classified as good practice. Seven had insufficient evidence to draw any conclusion, and one was not graded. The certainty of evidence was low or very low for 25 recommendations and moderate for four only. Conclusion: The present recommendations for newborn resuscitation are improved; however, they are still based on weak evidence with mostly low or very-low certainty. This indicates extensive research to establish truly evidence-based recommendations for newborn resuscitation is still needed.