Pediatric Reports最新文献

{"title":"Impact of Maternal Microbiota Composition on Neonatal Immunity and Early Childhood Allergies: A Systematic Review.","authors":"Ayah Nabil Al Jehani, Manal Shuaib, Arwa Alsharif, Khlood Abdulaziz Alsubaie, Ayda Khraisat, Abdulaziz Alsharif, Manaf Altaf, Ruba H Almasry, Amal Mohamed Kayali, Shouq Abdin Abdallah","doi":"10.3390/pediatric17030067","DOIUrl":"10.3390/pediatric17030067","url":null,"abstract":"<p><p><i>Background</i>: The maternal microbiota serve as a key regulator of neonatal immune development and early-life health outcomes. This systematic review aims to find out how the makeup of the maternal microbiota affects newborn immunity and the risk of allergies, identify which microbes are linked to a higher or lower chance of allergies, and assess treatments that could improve newborn immune health. <i>Methods</i>: We conducted a systematic search in PubMed, MEDLINE, and Web of Science, adhering to the PRISMA guidelines. We included randomized controlled trials (RCTs), cohort studies, and observational studies that looked at how the makeup of the maternal microbiota affects newborn immune responses or allergic outcomes in early life. We conducted a systematic search, and the quality of the studies was evaluated using the GRADE system and tools to check for bias (RoB 2, Newcastle-Ottawa Scale, MINORS). <i>Results</i>: We included a total of 74 studies. The main findings showed that having a cesarean delivery and using certain antibiotics during pregnancy increased the risk of allergies, while breastfeeding, taking probiotics, and changing the mother's diet helped to protect against allergies. Maternal stress had a negative association with the microbiota composition (OR = 1.9-2.4) and neonatal immune regulation. Moreover, the study noted significant geographic variation in the microbiota's influence, underscoring the importance of contextualized interventions. <i>Conclusions</i>: The composition of the maternal microbiota has a major impact on neonatal immunity and the risk of early-life allergy. Adverse factors include cesarean birth, antibiotic exposure, and maternal stress, all of which have been associated with alterations in neonatal immunity. More studies are required to validate promising microbiota-targeted strategies and develop evidence-based guidelines to improve maternal and neonatal immune health.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Impact of Emotional Eating in Children: A Narrative Review.","authors":"Maria Mentzelou, Sousana K Papadopoulou, Evmorfia Psara, Olga Alexatou, Theodosis Koimtsidis, Constantinos Giaginis","doi":"10.3390/pediatric17030066","DOIUrl":"10.3390/pediatric17030066","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Emotional eating has been recognized as the tendency to eat in response to emotions, being recognized as a crucial risk factor for recurrent weight gain. Emotional eating has been interrelated with obesity/overweight, depression, anxiety, stress, and specific dietary habits at any stage of human life, negatively affecting human quality of life. The present study aims to summarize and explore the effects of emotional eating on children and how these effects may, in turn, influence their mental and physical health at the next stages of their lives. <b>Methods</b>: This is a narrative review of the presently existing clinical evidence concerning the impact of emotional eating in children. A comprehensive search of the most reliable online databases, e.g., PubMed, Scopus, Web of Science, and Google Scholar, was performed utilizing relevant keywords. Several inclusion and exclusion criteria were used to collect only cross-sectional, longitudinal, descriptive, and case-control surveys in children's populations. <b>Results:</b> The current clinical evidence suggests that parental behavior may increase the risk of emotional eating in children. Several pieces of evidence also implied potential associations of emotional eating with overweight/obesity and mental disorders in children. Children's dietary habits may also affect their risk of developing emotional eating. <b>Conclusions</b>: The prevalence of emotional eating is gradually increasing in the general population, and especially in children. Public strategies should be performed to educate parents to recognize potential emotional eating behaviors in their children and to adopt more healthy dietary habits for their children, even in the first months of their life. Educational programs should be organized in school communities to directly educate children on the benefits of healthy dietary patterns.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Implementation and Awareness of Children's Rights in Pediatric Hospital: A Comparative Study of Parents' and Children's Perspectives.","authors":"Vasiliki Georgousopoulou, Chrysoula Dafogianni, Pinelopi Vlotinou, Aspasia Serdari, Ioannis Koutelekos, Anna Tsiakiri, Dimitrios Cassimos, Maria Lavdaniti, Maria Amanatidou, Georgios Manomenidis","doi":"10.3390/pediatric17030064","DOIUrl":"10.3390/pediatric17030064","url":null,"abstract":"<p><p>To evaluate and compare the awareness and implementation of children's rights in pediatric hospital settings from the perspectives of parents and children, this study emphasizes ethical considerations in healthcare, focusing on communication practices, privacy, and participation rights. <b>Methods:</b> A cross-sectional study was conducted in the largest pediatric hospital in Greece between February and April 2023. A total of 250 parents and 150 children participated. Data were collected using a structured questionnaire assessing six domains of children's rights: access to information, participation, privacy, non-discrimination, play and recreation, and parental support. Statistical analysis included chi-square tests for categorical variables, with significance set at <i>p</i> < 0.05. <b>Results</b>: Significant discrepancies were identified between parents and children in their awareness of children's rights. Only 2.9% of children were aware of printed lists of rights, and 46.3% of parents reported not knowing of their existence (<i>p</i> = 0.005). Children evaluated communication practices, such as the use of child-friendly language, more positively than parents (<i>p</i> = 0.02). Parents reported higher satisfaction with explanations of health conditions, treatments, and medication side effects (<i>p</i> < 0.001). Regarding privacy, children rated room allocation and privacy practices during examinations less positively than parents (<i>p</i> = 0.02). <b>Conclusions:</b> The study highlights critical gaps in the communication and implementation of children's rights within pediatric hospitals. Tailored interventions, including staff training, development of child-friendly materials, and policy adjustments, are necessary to bridge these gaps and ensure an ethically sound healthcare environment that prioritizes the rights and well-being of both children and their families.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging and Emotional Development in the Pediatric Population: Understanding the Link Between the Brain, Emotions, and Behavior.","authors":"Giuseppe Marano, Maria Benedetta Anesini, Miriam Milintenda, Mariateresa Acanfora, Claudia Calderoni, Francesca Bardi, Francesco Maria Lisci, Caterina Brisi, Gianandrea Traversi, Osvaldo Mazza, Roberto Pola, Gabriele Sani, Eleonora Gaetani, Marianna Mazza","doi":"10.3390/pediatric17030065","DOIUrl":"10.3390/pediatric17030065","url":null,"abstract":"<p><p>Neuroimaging has emerged as an innovative and essential tool for understanding the intricate relationship between brain development, emotions, and behavior. Investigating the neurobiological mechanisms underlying this interaction during the critical phase of brain maturation is crucial for promoting individual psychological well-being and mitigating the profound impact of mood disorders during childhood. This narrative scoping review synthesizes current pediatric neuroimaging evidence, filling a gap in the literature by integrating structural, functional, and emerging modalities, to provide clear translational pathways for clinical and behavioral observations. The contribution of major neuroimaging techniques, including fMRI, PET, DTI, and sMRI, is analyzed, emphasizing their ability to detect structural and functional alterations associated with mood disorders, enabling early diagnosis and personalized therapeutic strategies. Furthermore, the potential of these technologies to monitor the effects of psychotherapy is explored, demonstrating how such interventions can modulate neural circuits and enhance emotional processing. Despite significant advancements and growing interest, challenges remain, including the complexity of data interpretation, technological limitations, and ethical considerations related to the use of these interventions in pediatric populations. This review synthesizes the most recent scientific evidence, underscoring the potential of neuroimaging to improve diagnostic accuracy and therapeutic outcomes, while outlining future research directions aimed at enhancing interventions for children and adolescents with mood disorders.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the Roots of Psychosis: The Role of Aberrant Salience.","authors":"Giuseppe Marano, Francesco Maria Lisci, Greta Sfratta, Ester Maria Marzo, Francesca Abate, Gianluca Boggio, Gianandrea Traversi, Osvaldo Mazza, Roberto Pola, Eleonora Gaetani, Marianna Mazza","doi":"10.3390/pediatric17030063","DOIUrl":"10.3390/pediatric17030063","url":null,"abstract":"<p><p>Aberrant salience, defined as the inappropriate attribution of significance to neutral stimuli, is increasingly recognized as a critical mechanism in the onset of psychotic disorders. In young individuals at ultra-high risk (UHR) for psychosis, abnormal salience processing may serve as a precursor to full-blown psychotic symptoms, contributing to distorted perceptions and the onset of psychotic ideation. This review examines current literature on aberrant salience among UHR youth, exploring its neurobiological, psychological, and behavioral dimensions. Through a comprehensive analysis of studies involving neuroimaging, cognitive assessments, and symptomatology, we assess the consistency of findings across diverse methodologies. Additionally, we evaluate factors contributing to aberrant salience, including neurochemical imbalances, dysregulation in dopamine pathways, and environmental stressors, which may jointly increase psychosis vulnerability. Identifying aberrant salience as a measurable trait in UHR populations could facilitate earlier identification and targeted interventions. Implications for clinical practice are discussed, highlighting the need for specialized therapeutic approaches that address cognitive and emotional dysregulation in salience attribution. Recent research underscores the importance of aberrant salience in early psychosis research and advocates for further studies on intervention strategies to mitigate progression to psychosis among UHR individuals.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Landscape of Childhood Histiocytosis: A Decade of Discovery and Innovation.","authors":"Maurizio Aricò","doi":"10.3390/pediatric17030062","DOIUrl":"10.3390/pediatric17030062","url":null,"abstract":"<p><p>Over the past decade, the field of childhood histiocytosis, particularly Langerhans cell histiocytosis (LCH), has undergone transformative changes. The integration of molecular genetics, targeted therapies, and refined diagnostic methodologies has revolutionized patient management and redefined disease classification. This editorial provides a comprehensive overview of the pivotal developments from 2015 to 2025, highlights ongoing challenges, and explores future directions in research and clinical care.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychopathological Comorbidities in Children and Adolescents with Feeding and Eating Disorders: An Italian Clinical Study.","authors":"Maria Califano, Jacopo Pruccoli, Oliviero Cavallino, Alessandra Lenzi, Antonia Parmeggiani","doi":"10.3390/pediatric17030061","DOIUrl":"10.3390/pediatric17030061","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Feeding and eating disorders (FED) represent a major public health issue and are the second leading cause of death among psychiatric conditions in children and adolescents. Psychopathological comorbidities play a significant role in the onset and persistence of FED, yet research on their underlying structure remains limited. This study explores the psychiatric comorbidities associated with FED, focusing on common etiopathogenetic factors and their clinical implications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were retrospectively collected from the Italian Regional Center for FED in the Emilia-Romagna Region between June 2023 and April 2024. Diagnoses were assigned following DSM-5 criteria using the Italian version of the semi-structured K-SADS-PL diagnostic interview. Principal component analysis (PCA) was performed to identify latent psychological dimensions underlying FED psychopathology, retaining five components based on the scree plot. Additionally, an analysis of covariance (ANCOVA) was conducted to examine differences in factor scores across FED subtypes, while adjusting for potential confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-two participants were included (mean age: 14.6 years; mean BMI: 18.3 kg/m&lt;sup&gt;2&lt;/sup&gt;; male-to-female ratio: 1:8). Diagnoses were distributed as follows: 63.9% anorexia nervosa (AN), 13.9% other specified feeding and eating disorder (OSFED), 6.9% avoidant restrictive food intake disorder (ARFID), 4.2% binge eating disorder (BED), 4.2% unspecified feeding and eating disorder (UFED), and 2.7% bulimia nervosa (BN). All participants met the criteria for at least one psychiatric comorbidity. Identified psychopathological clusters include the following: (1) mood disorders (66.5%); (2) anxiety disorders (87.5%); (3) obsessive-compulsive and related disorders (47.2%); (4) neurodevelopmental disorders, i.e., attention-deficit/hyperactivity disorder (ADHD) (30.5%); (5) disruptive and impulse-control disorders (13.9%); and (6) psychotic symptoms (40.3%). No instances of tic or elimination disorders were detected. Conduct disorder was more prevalent among UFED, BED, and BN patients compared to other FED (&lt;i&gt;p&lt;/i&gt; = 0.005), and moderate/severe ADHD was associated with higher body mass index (BMI) (&lt;i&gt;p&lt;/i&gt; = 0.035). PCA revealed distinct psychological dimensions underlying FED, while ANCOVA indicated significant differences in factor scores across FED subtypes, supporting the presence of shared transdiagnostic mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study highlights the complex interplay between FED and psychiatric comorbidities, emphasizing the need for early intervention and personalized treatment approaches. The dimensional structure identified through PCA suggests that common psychopathological factors may drive FED development, and ANCOVA findings support their differential expression across FED types. Future research should further investigate these transdiagnostic mechan","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Care Becomes Abuse: A Forensic-Medical Perspective on Munchausen Syndrome by Proxy.","authors":"Emanuele Capasso, Carola Costanza, Michele Roccella, Beatrice Gallai, Michele Sorrentino, Marco Carotenuto","doi":"10.3390/pediatric17030060","DOIUrl":"10.3390/pediatric17030060","url":null,"abstract":"<p><p>Munchausen Syndrome by Proxy (MSBP) is recognized as a form of child abuse in which a caregiver induces or fabricates illnesses in their child to gain medical and social attention. MSBP represents one of the most complex and insidious forms of child abuse, characterized by an ambiguous clinical presentation that poses significant challenges for physicians, psychiatrists, and social workers. However, this condition raises critical questions regarding its diagnosis, management, and forensic implications. Traditionally, MSBP has been framed as an individual pathological manifestation of the mother, overlooking the role of the healthcare and legal systems in its identification and management. In this article, we propose a critical reflection on MSBP, emphasizing how the issue is not merely a \"parental failure\" but rather a systemic failure of healthcare, social, and judicial institutions in recognizing, preventing, and effectively managing such cases.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness in Mental Health and Psychiatric Disorders of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Bruno Daniel Carneiro, Daniel Humberto Pozza, José Tiago Costa-Pereira, Isaura Tavares","doi":"10.3390/pediatric17030059","DOIUrl":"10.3390/pediatric17030059","url":null,"abstract":"<p><p>Mindfulness-Based Interventions (MBIs) are important tools to address mental health issues in children and adolescents. However, previous studies provided variable results that suggest that the effectiveness of those third-wave Cognitive Behavioral Therapies remains uncertain.</p><p><strong>Objectives: </strong>The main objective is to assess the impact of MBIs on anxiety, depression, and stress in children and adolescents. The secondary objective is to examine the modalities of MBIs used, the duration of interventions, and potential confounding factors, such as age.</p><p><strong>Methods: </strong>A comprehensive search of multiple databases was conducted to identify randomized clinical trials (RCTs) evaluating the effects of MBIs on mental health outcomes in children and adolescents. The research was registered in PROSPERO, adhered to PRISMA guidelines, employed the Cochrane Risk of Bias 2 tool, and calculated the effect sizes using mean differences.</p><p><strong>Results: </strong>Thirteen RCTs were included; ten were identified as having some concerns, while three were classified as having a low risk of bias. Mindfulness-Based Stress Reduction (MBSR) demonstrated a small positive effect on depression and anxiety, while non-specific MBIs showed a moderate positive effect both on depression and anxiety. Mindfulness-Based Cognitive Therapy (MBCT) was effective in reducing anxiety, depression (moderate positive effects on both), and stress symptoms. In one study, no significant improvements were seen on both anxiety and depression (for MBCT) and in another study on anxiety (for MBCT/MBSR). The meta-analysis did not identify a significant effect of mindfulness interventions on depression or anxiety. The high heterogeneity suggests varying outcomes, requiring further study of moderating factors.</p><p><strong>Conclusions: </strong>While some studies suggest benefits from MBIs, mainly MBCT's ability to improve mental health outcomes in children and adolescents, their overall efficacy remains uncertain due to the high heterogeneity. The findings underscore the importance of considering the intervention type, duration, and moderating factors, such as age, when implementing MBIs.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Respiratory Failure in US Pediatric Care: Evidence from a Nationally Representative Database.","authors":"Michael Samawi, Gulzar H Shah, Linda Kimsey","doi":"10.3390/pediatric17030058","DOIUrl":"10.3390/pediatric17030058","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Pediatric postoperative respiratory failure in the United States is increasingly considered a significant adverse event due to the increased risk of co-morbidities, suffering, and cost of healthcare. This study investigates associations between pediatric adverse events (PAEs) and hospital and patient characteristics within the inpatient hospital setting, focusing solely on the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ). Specifically, the study focuses on PDI 09-Postoperative Respiratory Failure (PORF). <b>Methods</b>: This quantitative research analyzed the inpatient discharge data from the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Databases (KID) for 2019. We performed multivariate logistic regression to analyze patient-level encounters with PORF. <b>Results</b>: The results indicate that smaller, rural, and non-teaching hospitals exhibit significantly lower odds of PDI 09 than large, urban, and urban teaching hospitals, reflecting a concentration of operative procedures. In comparison, the Western United States exhibits higher odds of PDI 09. Various individual factors such as gender, age, race, service lines, payment sources, and major operating room procedures demonstrate differing levels of significance concerning PDI 09, warranting further investigation into confounding factors. In contrast, hospital ownership consistently shows lower odds of PORF risk for private, investor-owned hospitals. <b>Conclusions</b>: This study provides contextual expansion on the findings and offers valuable insights into PAEs in the inpatient hospital setting. It highlights areas for developing evidence-based interventions and guidelines for clinicians and policymakers. Ultimately, the findings contribute to the growing understanding of factors influencing PORF and emphasize the importance of targeted strategies for improving pediatric patient safety.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"17 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}