Frontiers in Pediatrics最新文献

{"title":"Case Report: Early surgical intervention for epilepsy with mild MOGHE: timing and clinical efficacy.","authors":"Yaning Sun, Liuyin Chen, Mei Jin, Fan Yang, Yakun Du, Jiangshun Fang, Baoguang Li, Zhixuan Sun, Lingyan Wang, Zhenghai Cheng, Zhiguo Yang, Yi Qu","doi":"10.3389/fped.2026.1790096","DOIUrl":"https://doi.org/10.3389/fped.2026.1790096","url":null,"abstract":"<p><strong>Background: </strong>Mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy (MOGHE) is a new histopathological entity identified in resected brain tissue from patients with drug-resistant epilepsy. Clinically, this epilepsy subtype most commonly presents as epileptic spasms in early childhood. Conventional anatomical-electro-clinical approaches struggle to accurately delineate the epileptogenic zone, posing substantial challenges to clinical management.</p><p><strong>Case description: </strong>This paper reports a 2-year-and-11-month-old male infant who developed significant intellectual and language regression merely 3 months after the onset of epileptic seizures. Scalp video-electroencephalography (VEEG) demonstrated generalized epileptiform discharges, cranial magnetic resonance imaging (MRI) revealed abnormal signals in the left frontal lobe, and fused cranial 18F-fluorodeoxyglucose positron emission tomography (PET)-MRI imaging showed no obvious hypometabolic foci. Following oral vigabatrin administration, clinical seizures were absent, yet neurodevelopmental regression progressed continuously. For children with early-onset developmental regression, a clinical decision-making dilemma exists: whether to continue medication adjustment and await fulfillment of traditional drug-resistant epilepsy criteria before surgery, or to implement active early surgical intervention.</p><p><strong>Conclusion: </strong>Through full-course follow-up of this child with MOGHE-associated epilepsy, this study integrated the evolution of clinical symptoms, electroencephalographic characteristics, imaging findings, and treatment responses to explore the rationale for surgical timing selection. The results suggest that for childhood epilepsy caused by definite cerebral structural abnormalities (particularly MOGHE) that has already led to obvious neurodevelopmental regression, active early surgical treatment should be considered to prevent disease progression and create favorable conditions for subsequent rehabilitation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1790096"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable two-stage deep learning for pediatric obstructive sleep apnea diagnosis using lateral cephalograms.","authors":"Jiayi Zhang, Jiao Tan, Xuesha Tong, Huiya Wang, Yue Zhao, Jinlin Song, Yang Liu","doi":"10.3389/fped.2026.1817094","DOIUrl":"https://doi.org/10.3389/fped.2026.1817094","url":null,"abstract":"<p><strong>Objective: </strong>Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a prevalent sleep-breathing disorder in pediatrics, yet early and accurate detection remains challenging due to the limited accessibility and efficiency of conventional diagnostic methods. This study aims to develop and validate an artificial intelligence framework that utilizes routine lateral cephalograms (LCs) to provide automated, accurate, and interpretable risk evaluations for pediatric OSAHS.</p><p><strong>Methods: </strong>We retrospectively enrolled 188 children from two hospitals between January 2021 and October 2025. A total of 150 LCs were used for cross- validation, and 38 LCs were reserved as an independent test dataset. Using LCs, we proposed and developed an interpretable two-stage framework for pediatric OSAHS diagnosis. The first stage segmented the upper airway, and the second stage performed classification using a modified fusion model that integrate information from both craniofacial structures and the upper airway. We compared different input strategies and used Grad-CAM for model interpretation. Clinical utility was evaluated in a reader study comparing dentists' performance across different experience levels.</p><p><strong>Results: </strong>The upper airway segmentation achieved a mean DSC of 0.931 and an IoU of 0.872. For OSAHS classification, the fusion model achieved an AUC of 0.945 (95% CI: 0.863-0.994) and an F1 score of 0.933 (95% CI: 0.818-0.995), outperforming the LCs model (AUC 0.797, 95% CI: 0.585-0.968) and the mask-based ROI model (AUC 0.882, 95% CI: 0.748-0.983). Grad-CAM consistently highlighted anatomically plausible regions related to craniofacial structure and the upper airway. In the reader study, AI assistance increased diagnostic accuracy by 0.165 for junior dentists and 0.237 for senior dentists.</p><p><strong>Conclusion: </strong>Our model represents a promising tool for automated pediatric OSAHS diagnosis based on routinely acquired LCs in dental settings. By enhancing diagnostic accuracy and interpretability, it has the potential to support early detection and individualized management.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1817094"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to mental health care experienced by youth involved in child welfare and their caregivers.","authors":"Christelle Tan, Courtney Dunn, Katie Fox, Houley Sall, Sarah Beal, Mary Greiner","doi":"10.3389/fped.2026.1763516","DOIUrl":"https://doi.org/10.3389/fped.2026.1763516","url":null,"abstract":"<p><strong>Introduction: </strong>Child welfare involved youth have high rates of behavioral health needs; however, many never receive needed mental health services. The specific barriers children and their caregivers face are not well described. The objective of this study was to describe the process and experience of initiating mental health care for youth entering out-of-home care.</p><p><strong>Methods: </strong>Youth-caregiver dyads were enrolled in a 12-month longitudinal study, after entering protective custody for the first time, during which dyads completed surveys every 3 months. Electronic health records data linked with administrative child welfare data were extracted. Subgroups of dyads were identified based on reported mental health needs and whether needs were met over time. Descriptive analyses of these subgroups were completed to compare sociodemographic and child welfare characteristics and mental health screening scores. Youth or caregivers of youth with reported unmet mental health needs were recruited to participate in semi-structured interviews regarding experiences seeking mental health services. Timeline recall was used to support enhanced reporting. Timelines created during interviews were analyzed to uncover additional patterns in the events described. Thematic content analysis was applied to all interviews using Dedoose.</p><p><strong>Results: </strong><i>N</i> = 201 youth-caregiver dyads were enrolled in the longitudinal study. The survey data showed that most youth entering out-of-home care have mental health needs, and these needs were inconsistently met over time. Descriptive analysis of subgroups showed that most characteristics were comparable across groups; however, some differences were noted. Nineteen dyads completed the interview. Timeline analysis revealed that adolescents rarely access mental health services prior to child welfare involvement, and caregivers who recognized service need and acted early accessed resources quicker than those who did not. Thematic analysis revealed both barriers and facilitators to mental health care which manifested in three primary categories: Caregiver, youth, and family-of-origin attributes, the mental health system, and other social service systems.</p><p><strong>Conclusion: </strong>Most youth access mental health services while in out-of-home placement; however, mental health needs are often not consistently met over time. Caregivers play an important role in both reporting mental health concerns and accessing mental health services. Integrated mental health services are an important resource for child welfare involved youth seeking mental health treatment.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1763516"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip instability and scoliosis in children with spinal muscular atrophy: a single center retrospective study in the United Arab Emirates.","authors":"Hagir Al-Dulaimi, Maryam Alabdullah, Salama AlGhanim, Haitham Elbashir, Ajay Dsouza, Ganga Rajapandian, Ibrar Majid, Sattar Alshryda, Mason Alnouri, Ali Nasreldien, Eurose Majadas, Noleen de Jager, Gail Alexander, Omer Al-Dulaimi, Abdulla AlGhanim, Zainab Al-Abdullah, Nidheesh Chencheri","doi":"10.3389/fped.2026.1732695","DOIUrl":"https://doi.org/10.3389/fped.2026.1732695","url":null,"abstract":"<p><strong>Introduction: </strong>Hip instability is an important complication of spinal muscular atrophy (SMA), which leads to various functional impairments, including mobility challenges and difficulties with daily care. The primary objective of this study is to determine the prevalence and severity of hip instability in a cohort of SMA patients managed at a tertiary care center. The prevalence of scoliosis and its association with hip instability in children with SMA were also assessed.</p><p><strong>Methods: </strong>This is a retrospective cross-sectional study including children with a genetic diagnosis of SMA and available hip x-rays, conducted between 2018 and 2023. Patients were grouped based on SMA type and motor status (non-sitters, sitters, or walkers). Relevant parameters were collected including hip subluxation/dislocation, presence of scoliosis, number of <i>SMN2</i> copies and disease modifying therapies (DMTs) received.</p><p><strong>Results: </strong>Fifty-four children with types 1-3 SMA were included in this study. Hip dislocation/subluxation in both hips was most prevalent in type 1 SMA patients [Fisher's Exact Test (FET): <i>p</i> = 0.046]. There was no significant correlation between the presence of hip subluxation or dislocation and scoliosis, but patients with fewer <i>SMN2</i> copies were more likely to have scoliosis (<i>p</i> = 0.023). Several factors, including gender, age, motor status and presence of scoliosis were analysed, but none showed a statistically significant association with hip abnormalities.</p><p><strong>Discussion: </strong>To the best of our knowledge, this is the first study in the Middle East on hip instability and scoliosis in a cohort of children with SMA. Hip dislocation and/or subluxation is most common and most severe in type 1 SMA. The study's findings can aid the development of hip instability screening programs in SMA patients, enabling early intervention.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1732695"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abusive head trauma: a consensus statement on a shared workflow model within the Balkan network for quality improvement in forensic medicine.","authors":"Monica Concato, Maximo Leonardo Franzoni, Tijana Petrović, Anita Galic, Viktorija Belakaposka Srpanova, Emina Dervisevic, Chara Spiliopoulou, Stefano D'Errico","doi":"10.3389/fped.2026.1800421","DOIUrl":"https://doi.org/10.3389/fped.2026.1800421","url":null,"abstract":"<p><p>Abusive head trauma (AHT), is considered a leading cause of fatalities resulting from physical abuse in infants under 2 years of age, with a peak incidence between 1 and 2 months after birth. The incidence of AHT ranges from 14 to approximately 40 cases per 100,000 children in industrialized countries with a mortality rate ranging from 10 to 20%. The absence of internationally recognized best practices or guidelines especially in the field of forensic medicine has resulted in methodological variability in the management of these cases across different settings. In response to this gap, a comparative working group involving experts from Italy and the Balkan countries was established, leading to the creation of a shared discussion platform. The aim of this collaborative effort was to identify strengths and critical issues in the forensic handling of abusive head trauma, ultimately with the goal of developing a shared workflow chart for the management of these complex cases within the network.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1800421"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 10-year review of pediatric inguinal hernia management at a tertiary center.","authors":"Bingran Yu, Shuan Liu, Zai Song","doi":"10.3389/fped.2026.1802302","DOIUrl":"https://doi.org/10.3389/fped.2026.1802302","url":null,"abstract":"<p><strong>Aims: </strong>To analyze the epidemiology, clinical characteristics, surgical outcomes, and risk factors for incarceration and recurrence in a large cohort of children undergoing inguinal hernia repair, and to evaluate differences across sex, laterality, and surgical approaches.</p><p><strong>Methods: </strong>We retrospectively reviewed the children who underwent inguinal hernia repair at a tertiary pediatric center over ten years. Demographic characteristics, perioperative outcomes, and postoperative complications were analyzed. Subgroup comparisons were performed by sex, laterality, and surgical approach. Multivariate logistic regression models were used to identify independent predictors of incarceration and recurrence.</p><p><strong>Results: </strong>Of 9590 children, 72.2% were male, and the median age was 2 years and 10 months. Laparoscopic surgery was performed in 93.1% of cases. Incarceration occurred in 4.2% of children and recurrence in 1.4%. Females, children ≤1 year, and unilateral hernias were independently associated with higher risk of incarceration. Male sex and age >1 year predicted recurrence, while laparoscopic technique served as a protective factor. Laparoscopy identified synchronous contralateral hernias in 39.2% of children initially diagnosed with unilateral hernia, compared with only 0.9% detected during open repair. Laparoscopic approach was also associated with shorter operative time, fewer complications, and faster recovery.</p><p><strong>Conclusions: </strong>This large cohort study highlights the epidemiology and surgical outcomes of pediatric inguinal hernia. Age, sex, and hernia laterality were associated with clinical presentation and complication risk. Laparoscopic surgery showed favorable perioperative outcomes and facilitated detection of contralateral hernias. Because surgical approach selection was not randomized, comparisons between techniques should be interpreted cautiously. These findings emphasize the importance of individualized risk stratification and surgical decision-making.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1802302"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare complication of internal jugular vein catheter ectopically placed into the dural sinus: a case report.","authors":"Lu Wang, Yan Jiang","doi":"10.3389/fped.2026.1796431","DOIUrl":"https://doi.org/10.3389/fped.2026.1796431","url":null,"abstract":"<p><strong>Background: </strong>Central venous catheterization is a procedure involving the percutaneous insertion of a catheter into a central vein, such as the internal jugular, subclavian, or femoral vein. It is frequently used for monitoring central venous pressure (CVP), assessing central venous oxygen saturation (ScvO₂), performing blood purification, providing nutritional support, and administering specialized medications. Among available sites, the internal jugular vein is commonly preferred. Catheter malposition is a recognized complication. Malpositioned catheters typically occur in larger veins, including the internal jugular, axillary, subclavian, and innominate veins. Rarely, ectopic catheter placements occur within smaller vessels associated with the venous trunk, venous sinuses, lymphatic vessels, or, exceptionally, within the arterial system. This article reports a rare case of an internal jugular vein catheter malpositioned intracranially, resulting in infiltration of intravenous nutrient fluid into the cerebrospinal fluid (CSF). The report aims to provide clinical guidance and raise awareness among medical personnel regarding this uncommon complication.</p><p><strong>Case summary: </strong>A 6-month-old boy was admitted to the pediatric surgery department for colostomy reversal. Before the operation, internal jugular vein catheterization was successfully performed under ultrasound guidance. However, on the second day after catheter placement, no blood return was obtained from the central venous catheter (CVC). Cervical vascular ultrasound initially suggested normal catheter positioning within the internal jugular vein. On the fourth day after catheterization, the patient developed poor oxygen saturation and seizures. Comprehensive evaluations, including CSF analysis, cervical vascular ultrasound, and radiographs of the skull and chest, strongly suggested that the CVC had inadvertently entered the intracranial dural sinus, causing intravenous nutrient fluid infiltration into the CSF. The patient was managed aggressively with endotracheal intubation, mechanical ventilation, antibiotic therapy, and measures to reduce intracranial pressure. Following treatment, he recovered fully and was discharged from the hospital.</p><p><strong>Conclusion: </strong>Precise technique and accurate catheter positioning are essential for successful internal jugular vein catheterization. Although ultrasound guidance improves catheterization success rates, it has significant limitations in preventing distal catheter-tip malposition. Therefore, imaging examinations remain critical to confirm catheter placement and trajectory, helping to prevent potential complications.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1796431"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive respiratory support attenuates lung damage in a murine model of bronchopulmonary dysplasia.","authors":"Jitendra K Tripathi, Anh Duong, Changgong Li, Parviz Minoo, Beiyun Zhou, Inderpal Randhawa, Nathan L Marsteller","doi":"10.3389/fped.2026.1755113","DOIUrl":"https://doi.org/10.3389/fped.2026.1755113","url":null,"abstract":"<p><p>Bronchopulmonary dysplasia (BPD) is a chronic lung disease primarily affecting preterm infants exposed to prolonged oxygen therapy and mechanical ventilation. This study investigates the potential effects of a non-invasive respiratory support strategy, Continuous Positive Airway Pressure (CPAP) on lung function and histopathological changes in a hyperoxia-induced murine model of BPD. The aim is to determine whether non-invasive respiratory support can attenuate lung damage caused by hyperoxia. In this study, mice were exposed to hyperoxia (60% O₂) and treated with non-invasive respiratory support. Histopathological analysis was conducted to evaluate alveolar simplification and septal thickening to assess structural injury and repair. Lung function was evaluated using key parameters including static lung compliance (Cst), airway resistance (Rrs), respiratory system elastance (Ers), and other parameters to assess mechanical properties. Additionally, the experimental findings indicate that non-invasive respiratory support treatment produced a robust preservation of lung function, with strong maintenance of compliance (Cst; <i>p</i> = 0.0416) and marked reductions in airway elastance (Ers; <i>p</i> = 0.0022) and resistance. Histological analyses revealed substantial attenuation of alveolar injury (MLI; <i>p</i> = 0.0028), clear reduction in septal thickening, and pronounced suppression of pathological structural remodeling (septal thickness; <i>p</i> < 0.0001) in treated mice compared with hyperoxia-exposed controls (60% O₂).These results indicate non-invasive respiratory support not only enhances pulmonary mechanics but also mitigates hyperoxia-induced structural damage, offering insights into its potential application in managing BPD in preterm infants. This study highlights the significance of non-invasive ventilation strategies in reducing the severity of BPD and potentially improving outcomes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1755113"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based automated detection of fetal corpus callosum abnormalities in prenatal ultrasound.","authors":"Min Li, Shizhen Liu, Zhonglu Zhang, Qiang Li, Xuan Xu","doi":"10.3389/fped.2026.1774586","DOIUrl":"https://doi.org/10.3389/fped.2026.1774586","url":null,"abstract":"<p><strong>Objective: </strong>Prenatal detection of corpus callosum (CC) abnormalities is essential for assessing fetal neurodevelopment, yet conventional ultrasound diagnosis faces challenges from operator variability and suboptimal fetal positioning.</p><p><strong>Methods: </strong>We developed a novel deep learning framework CC-FocusNet that integrates automated region localization with an anatomy-aware dual-stream architecture for multi-view analysis. The model was trained on 496 cases and validated on an independent external cohort of 93 cases. We assessed both diagnostic performance and clinical interpretability through attention visualization.</p><p><strong>Results: </strong>Our framework achieved 97.36% accuracy on the external test set. Grad-CAM++ heatmaps revealed that model attention consistently focused on clinically relevant anatomical landmarks, demonstrating strong interpretability. When integrated into clinical workflows, the AI system enhanced diagnostic accuracy and efficiency, particularly reducing misdiagnosis rates in challenging cases.</p><p><strong>Conclusions: </strong>This interpretable AI system provides accurate and efficient prenatal detection of CC abnormalities, offering substantial potential to support clinical decision-making and enable timely intervention for at-risk pregnancies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1774586"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive systemic corticosteroids in pediatric orbital cellulitis: a systematic review and meta-analysis.","authors":"Emily S Acker, Gabriela Martin Gonzalez, Dylan Davie, Ratna B Basak","doi":"10.3389/fped.2026.1794826","DOIUrl":"https://doi.org/10.3389/fped.2026.1794826","url":null,"abstract":"<p><strong>Background: </strong>Orbital cellulitis is a serious pediatric infection that can cause vision- and life-threatening complications. Adjunctive systemic corticosteroids are sometimes added to antibiotics to reduce inflammation, but their effectiveness and safety in children remain uncertain.</p><p><strong>Methods: </strong>We conducted a PRISMA-compliant systematic review and meta-analysis of studies evaluating adjunctive systemic corticosteroids in children (<21 years) hospitalized with orbital cellulitis. Eligible studies compared corticosteroid plus antibiotics vs. antibiotics alone and reported hospital length of stay (LOS), surgical intervention, pediatric intensive care unit (PICU) admission, or 30-day readmission. Randomized and observational studies were included. Data were pooled using random- or fixed-effects models depending on heterogeneity.</p><p><strong>Results: </strong>Six studies (<i>n</i> = 11,803; 1,811 corticosteroid, 9,992 control) met inclusion criteria. Corticosteroid use was not associated with a statistically or clinically meaningful reduction in LOS (mean difference -0.43 days, 95% CI: -2.34 to 1.49). Corticosteroid use was associated with higher risks of surgery (RR 2.08, 95% CI: 1.47-2.96), PICU admission (RR 1.82, 95% CI: 1.36-2.45), and 30-day readmission (RR 2.53, 95% CI: 1.94-3.29). Certainty of evidence was low to moderate, largely due to observational data.</p><p><strong>Conclusions: </strong>Adjunctive corticosteroids were not associated with shorter hospitalization and may be associated with increased risks of adverse outcomes. These findings should be interpreted with caution given the observational nature of most included studies and potential confounding. High-quality pediatric randomized controlled trials are needed to better define the role of corticosteroids in orbital cellulitis.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251102999, PROSPERO CRD420251102999.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1794826"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}