Archives De Pediatrie最新文献

{"title":"Mechanical ventilation in pediatric hospitals in Senegal","authors":"Amadou Sow ,&nbsp;Aliou Thiongane ,&nbsp;Abou Ba ,&nbsp;Younoussa Kéita ,&nbsp;Papa M. Faye ,&nbsp;Amadou L. Fall ,&nbsp;Djibril Boiro ,&nbsp;Ndeye Fatou Sow ,&nbsp;Aliou A. Ndongo ,&nbsp;Assane Sylla ,&nbsp;Ousmane Ndiaye","doi":"10.1016/j.arcped.2025.01.007","DOIUrl":"10.1016/j.arcped.2025.01.007","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Mechanical ventilation (MV) requires an efficient technical platform and experienced staff. The objective of this study was to evaluate the practice of MV in a pediatric intensive care unit in Senegal.</div></div><div><h3>Methods</h3><div>A total of 102 patients were included. The indications for intubation were respiratory failure in 51% of cases, circulatory failure in 29%, septic shock in 13%, and other indications in 5%. The average delay to intubation after admission was 1.86 days (1 h to 5 days). The mortality rate was 43%.</div></div><div><h3>Conclusion</h3><div>The construction of new and dedicated infrastructures, the training of personnel, and the improvement of the technical platform can lead to a reduction in the infant and child morbidity and mortality associated with MV.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 278-280"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing an antibiotic stewardship program to reduce the duration of antibiotics in community-acquired pneumonia: Experience in a French pediatric hospital","authors":"Lise Martin Perceval ,&nbsp;Matthieu Wargny ,&nbsp;Myriam Benhamida ,&nbsp;Morgane Dumortier ,&nbsp;Christèle Gras-Le Guen ,&nbsp;Dominique Navas ,&nbsp;Elise Launay","doi":"10.1016/j.arcped.2025.02.002","DOIUrl":"10.1016/j.arcped.2025.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>This work used a before–after study to evaluate the impact of a multifaceted stewardship intervention on the recommended duration of antibiotic treatment (5 vs 10 days) for non-severe community-acquired pneumonia (CAP) in pediatrics.</div></div><div><h3>Methods</h3><div>Children under age 15 years and 3 months who consulted for CAP in the emergency care unit of Nantes University Hospital from November 2019 to January 2020 and from December 2020 to April 2021 were included. Before the second period, the updated protocol was presented at a local meeting, sent by e-mail, and added to the internal network; physicians’ knowledge was tested through clinical situations and answers to the questionnaire as well as pocket cards were distributed. The main outcome was the absolute and relative difference in prescription adequacy according to the recommended duration of antibiotic therapy (5 days) before and after the intervention.</div></div><div><h3>Results</h3><div>We included 134 children: 71 and 63 before and after the intervention respectively. The proportion of adequate duration of antibiotic therapy prescribed was increased: 27 (38.0 %) children in the “before” group versus 50 (79.4 %) in the “after” group (<em>p</em> &lt; 0.0001). The prescription adequacy ratio (after/before) was 2.09 (95 %CI, 1.51–2.88). The mean treatment duration was significantly higher in the “before” than “after” group: 7.3 versus 5.7 days (<em>p</em> &lt; 0.0001). A total of 155 days of treatment per 100 treated children was avoided. The proportion of correctly prescribed dosages was higher in the “after” than the “before” group: + 18 % (<em>p</em> = 0.03). The proportion of nasopharyngeal PCR tests performed was significantly higher after than before the intervention (<em>p</em> &lt; 0.0001). Chest X-rays were performed in almost all children in both groups.</div></div><div><h3>Conclusion</h3><div>This multifaceted stewardship intervention demonstrated clinically and statistically significant results concerning the prescribed antibiotic therapy duration at individual and population levels and could be extended to other care centers and other situations.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 217-222"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth response to medical intervention in an observational real-life cohort of children with growth delay: A causal inference methods study","authors":"Mathea Gjoertz ,&nbsp;Alexis Rybak ,&nbsp;Alessio Picco ,&nbsp;Michael Hauschild ,&nbsp;Julien Sauser ,&nbsp;Kanetee Busiah","doi":"10.1016/j.arcped.2024.12.004","DOIUrl":"10.1016/j.arcped.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Studies on growth response to medical interventions in children with growth delay are mainly randomized controlled trials (RCTs) and observational studies. RCTs establish cause-effect relationships under controlled conditions but limited generalizability to real-life. Conversely, observational studies reflect real-life conditions but are subject to confounding factors and bias. Data regarding catch-up growth and associated factors in children who do not benefit from medical treatment are lacking.</div></div><div><h3>Objectives</h3><div>To evaluate the causal impact of etiological treatment (ET) versus a wait-and-see approach (WS) on one-year catch-up growth in children with growth delay of different etiologies and to identify factors associated with good catch-up growth independent of the intervention.</div></div><div><h3>Study design</h3><div>Retrospective cohort of children referred for growth delay, defined by height &lt; -2 SD, height &lt; -2 SD from target height, or growth velocity &lt; 0 SD.</div><div>Causal inference methods, including inverse probability treatment weighting (IPTW), and weighted Poisson regression with robust variance, were used to estimate the average treatment effect in the treated and relative risk, respectively. A variable selection procedure was applied using backward selection by Akaike Information Criterion.</div></div><div><h3>Results</h3><div>We included 198 children: 100 with ET and 98 with WS. Main diagnosis was secondary growth failure (42.4 %). Good catch-up growth was more frequent with ET versus WS (31.31% vs. 3.54 %, <em>p</em> &lt; 0.05). Patients in the ET group had a 10.3 times higher chance of achieving one-year good catch-up growth. Young age and low growth velocity at baseline were associated with better catch-up growth, independently of the intervention.</div></div><div><h3>Conclusion</h3><div>ET significantly improves growth catch-up in children with growth delay. Young age and low growth velocity are associated with good catch-up growth, regardless of intervention. The use of IPTW strengthen the validity of the findings in a real-world setting, despite the retrospective study design. This approach highlights the effectiveness of interventions and the robustness of findings through advanced statistical adjustments.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 238-243"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eating disorders in children under 4 years of age with autism spectrum disorder: Description and determinants","authors":"Clémentine Socie ,&nbsp;Alexandre Descamps ,&nbsp;Béatrice Thouvenin ,&nbsp;Catherine du Fraysseix Peigné ,&nbsp;Véronique Abadie ,&nbsp;Lisa Ouss","doi":"10.1016/j.arcped.2025.02.001","DOIUrl":"10.1016/j.arcped.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Eating disorders in children with autism spectrum disorder (ASD) are multifactorial and complex, and impair their quality of life. The link between eating difficulties and ASD is still controversial, and few studies have focused on very young children with ASD.</div></div><div><h3>Objectives</h3><div>Our objectives were: 1) to characterize the eating disorders of ASD children under 4 years; 2) to study the links between these eating disorders and the characteristics of the child (symptoms and severity of ASD, level of development).</div></div><div><h3>Methods</h3><div>33 ASD children (18 months to 4 years) were included. Their developmental level was assessed by the Brunet-Lézine Revised test (BL-R) and characteristics of ASD by the Autism Diagnosis Interview-Revised (ADI-R). We used a new questionnaire on eating disorders of children between 9 months and 6 years of age that covered 4 dimensions: eating behavior, oro-motor skills, oral and bodily sensory characteristics, and parental impacts and strategies.</div></div><div><h3>Results</h3><div>70 % of parents declared eating disorders in their child, with an early frequent onset beyond 12 months of age. These disorders caused significant parental suffering and worries about the future in two-thirds of parents, and more than half of the parents implemented strategies to handle them. We found two striking results: 1) No statistical link was observed between the severity of an eating disorder and the severity of ASD symptoms or the child's developmental level; 2) Children with better communication and socialization levels had more eating disorders.</div></div><div><h3>Conclusion</h3><div>These results show that eating disorders in our population are probably linked with the relational nature of the act of eating.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 255-260"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of the inpatient unit on referral for relevant examinations in child abuse","authors":"Florian Manoeuvrier ,&nbsp;Pierre Tourneux ,&nbsp;Anne-Gaelle Le Moing ,&nbsp;Richard Gouron ,&nbsp;Cécile Manaouil ,&nbsp;Céline Klein","doi":"10.1016/j.arcped.2025.02.003","DOIUrl":"10.1016/j.arcped.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Physical abuse affects 4–20 % of children per year. There is a lack of knowledge and skills about child abuse among doctors, which can lead to a failure to report the child abuse situation to the authorities.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate the influence of the inpatient unit on whether imaging examinations and social assessments are performed.</div></div><div><h3>Method</h3><div>A retrospective cohort study was carried out of children under 3 years old suspected of suffering child abuse. Demographic, clinical, and examination data were collected. In univariate analysis, we evaluated the relationship between the experience of the inpatient unit and the realization or not of imaging examinations and social assessments.</div></div><div><h3>Results</h3><div>Inpatient units not experienced in the management of child abuse situations were associated with a significantly increased risk of not performing cerebral magnetic resonance imaging (OR: 10.0; 95 % CI [3.8–26.3]), skeletal survey (OR: 19.0; 95 %CI [6.0–60.6]), bone scintigraphy (OR: 24.6; 95 % CI [8.5–70.8]), and fundus (OR: 13.6; 95 % CI [5.1–35.8]) examinations.</div></div><div><h3>Conclusion</h3><div>It is essential to improve medical and paramedical knowledge as well as skills in the recognition and management of suspected child abuse.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 272-277"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcome of diabetic ketoacidosis and its determinants among children admitted to hospitals in northwest Ethiopia in 2021: A retrospective cross-sectional study","authors":"Mequanint Ayehu Akele ,&nbsp;Rajalakshmi Murugan ,&nbsp;Feven Mulugeta ,&nbsp;Tamalew Alemie Tegegne","doi":"10.1016/j.arcped.2024.11.011","DOIUrl":"10.1016/j.arcped.2024.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic ketoacidosis (DKA) remains a leading cause of death among children in developing countries.</div></div><div><h3>Objectives</h3><div>To assess the treatment outcome of DKA and its determinants among children admitted to hospitals in northwest Ethiopia.</div></div><div><h3>Methods</h3><div>An institutional-based, retrospective cross-sectional study was conducted among 240 children with DKA. We collected 5-year data by reviewing patient charts using a checklist. Bivariate and multivariate models were used to determine the association of the independent variables with the outcome variable. After multivariate regression, a value of <em>p</em> &lt; 0.05 was considered statistically significant.</div></div><div><h3>Result</h3><div>Of the 240 children with DKA included in the study, 86.7 % recovered and 13.3 % died. Respiratory tract infections (adjusted odds ratio [AOR] = 3.5; 95 % confidence interval [CI]: 1.2–10), sepsis (AOR = 4.9; 95 % CI: 1.45–16.57), cerebral edema (AOR = 5.89; 95 % CI: 1.56–22.3), renal failure (AOR = 3.6; 95 % CI:1.06–12.45), hyponatremia (AOR = 4; 95 % CI:1.02–16.1), hypernatremia (AOR = 7.4; 95 % CI:1.29–42.08), dehydration (AOR = 4; 95 % CI: 1.15–14.03), and not receiving potassium replacement therapy (AOR = 7.4; 95 % CI: 1.29–42.08) were factors significantly associated with death.</div></div><div><h3>Conclusion</h3><div>In this study, the overall mortality of children with DKA was 13.3 %. The major factors associated with death were dehydration, hyponatremia or hypernatremia, respiratory tract infections, sepsis, renal failure, and cerebral edema. Thus, early diagnosis and treatment of these factors are necessary to decrease mortality in children with DKA.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 266-271"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal alcohol spectrum disorder and health professionals’ awareness of the syndrome: A comparison of practitioners’ knowledge in two french regions","authors":"S. Daoudi ,&nbsp;M. Spodenkiewicz ,&nbsp;S. Robin ,&nbsp;M. Rébola ,&nbsp;P. Castera ,&nbsp;Peter Von Theobald ,&nbsp;M. Husson ,&nbsp;B. Doray ,&nbsp;F. Villéga","doi":"10.1016/j.arcped.2024.11.008","DOIUrl":"10.1016/j.arcped.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Fetal alcohol spectrum disorder (FASD) is the leading cause of non-genetic intellectual disabilities. Many healthcare professionals in France have benefited from initial and continuing training programs on this public health theme. The objective of our study is to describe and compare knowledge of FASD among health professionals in two different french regions with a health prevention and information system (Indian Ocean (IO)) or without (Nouvelle-Aquitaine (NA)).</div></div><div><h3>Methods and Settings</h3><div>A free and anonymous electronic survey related to perinatality, childhood and adolescence was sent by email or social networks to various health professionals in the IO and NA regions. Responses were analyzed by comparing the function and affiliation of healthcare professionals to each region.</div></div><div><h3>Results</h3><div>We obtained 193 replies from the IO and 265 replies from NA. On the one hand, 79 % of healthcare professionals reported receiving training on FASD, and most of them were aware that there is no threshold of maternal alcohol intake without risk to the fetus. It appears that 91 % of them are aware of the cognitive-behavioral disorders associated with the diagnosis of FASD. On the other hand, barely 19 % were aware that maternal age is a risk factor, and only 39 % had knowledge of the three cardinal signs of FAS dysmorphia. Only 30 % described a neurological anomaly related to the diagnosis. Regarding alcohol-related neurodevelopmental disorders, 30 % wrongly believed that growth retardation and facial dysmorphia were necessary for diagnosis. Data analysis reveals more variability in inter-professional knowledge in the region without a platform. While there is no direct significant difference between regions regarding knowledge of the FASD, among the NA respondents, only 32 % reported that paternal alcohol consumption was a risk factor, whereas 51 % of the IO respondents were already aware of it.</div></div><div><h3>Conclusion</h3><div>This study points out the heterogeneity of healthcare professionals' knowledge of FASD within each region. It highlights the challenge of informing, training and orienting mothers and their children in an appropriate manner. The establishment of diagnostic platforms seems essential to provide early, optimised and adapted care in response to this particular public health problem.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 3","pages":"Pages 184-190"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low FODMAP diet in children with functional abdominal pain disorders. Is it always worth trying?","authors":"María Luisa Baranguán Castro ,&nbsp;Ignacio Ros Arnal ,&nbsp;Ruth García Romero ,&nbsp;Helena Lorenzo Garrido ,&nbsp;Lissette Delgado Sanzonetti ,&nbsp;Carlos Tutau Gómez ,&nbsp;Pablo Oliver Goicolea","doi":"10.1016/j.arcped.2024.12.008","DOIUrl":"10.1016/j.arcped.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>Our aim was to assess the use of a low FODMAP (<em>f</em>ermentable <em>o</em>ligosaccharides, <em>d</em>isaccharides, <em>m</em>onosaccharides <em>a</em>nd <em>p</em>olyols) diet in children with different types of functional abdominal pain disorders (FAPD) and to identify predictive factors of response to this diet.</div></div><div><h3>Methods</h3><div>This was a multicenter, experimental, uncontrolled, prospective trial. Patients with irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain followed a low FODMAP diet for 2 weeks. We collected data on abdominal pain before and after the diet. Patients who showed <em>a</em> ≥ 50 % reduction in abdominal pain frequency were considered responders.</div></div><div><h3>Results</h3><div>A total of 48 patients with FAPD participated in this trial. They all showed a significant decrease in the frequency (<em>p</em> &lt; 0.05) and intensity (<em>p</em> &lt; 0.05) of abdominal pain after the diet. We considered 41.7 % of patients to be responders. Among children with functional dyspepsia, 66.6 % responded to the diet, and so did 71.4 % of those with IBS. On the contrary, 71.8 % of children with functional abdominal pain were non-responders, and this diagnosis was considered a predictive factor of poor response to the diet (OR: 9.87, CI [1.52; 63.97], <em>p</em> = 0.016).</div></div><div><h3>Conclusion</h3><div>In children with FAPD, a diagnosis of functional abdominal pain is a predictive factor of poor response to a low FODMAP diet. Better results were achieved with this diet in children with IBS or functional dyspepsia.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 3","pages":"Pages 153-156"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of vitamin D supplementation for children under 16 years of age in France. A cross-sectional observational study","authors":"Nolwen Laurent ,&nbsp;Géraldine Favrais ,&nbsp;Claire Dupont ,&nbsp;Henri Ginies","doi":"10.1016/j.arcped.2024.11.009","DOIUrl":"10.1016/j.arcped.2024.11.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Vitamin D is essential for children's growth and for the prevention of rickets; moreover, it has an essential role in phosphocalcic homeostasis. In 2022, new recommendations for vitamin D supplementation were established in France. In this study, we sought to evaluate the modalities of supplementation in children up to the age of 16 years and to determine the factors that might be related to compliance with the recommendations.</div></div><div><h3>Materials and methods</h3><div>This was an observational descriptive study. Over two distinct periods, questionnaires were distributed at three pediatric emergency departments in <em>Basse-Normandie</em> (Lower Normandy) to children up to 16 years of age.</div></div><div><h3>Results</h3><div>Overall, 710 questionnaires were analyzed. Adherence to vitamin D supplementation among children aged 0–16 years was low, with only 17 % of children following the supplementation recommendations, but it increased to 38 % in children under 2 years old. The main factors associated with adherence to the recommendations were younger age (odds ratio [OR]: 0.35, 95 % confidence interval [CI] [0.19–0.62], <em>p</em> &lt; 0.001), medical follow-up by a pediatrician (OR: 0.34, 95 % CI [0.21–0.55], <em>p</em> &lt; 0.001), and a higher socioeconomic status of the parents (OR: 2.43, 95 % CI [1.23–5.16], <em>p</em> = 0.014).</div></div><div><h3>Conclusion</h3><div>Adherence to the 2022 vitamin D supplementation recommendations was low, with only 17 % of children complying. However, these data need to be verified by conducting further large-scale research to confirm the findings and identify the most effective strategies for improving long-term adherence to the recommendations.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 3","pages":"Pages 163-167"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early osteopathic manipulative treatment to prevent cranial positional deformities: A randomized controlled trial","authors":"Catherine Genelot ,&nbsp;Valérie Macioce ,&nbsp;Héléna Huguet ,&nbsp;Inge Harrewijn ,&nbsp;Gilles Cambonie ,&nbsp;David Dessauge ,&nbsp;Thibault Mura ,&nbsp;Lionel Moulis ,&nbsp;Guillaume Captier","doi":"10.1016/j.arcped.2024.11.003","DOIUrl":"10.1016/j.arcped.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Cranial positional deformities occur frequently in the first months of life.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of osteopathic manipulative treatment (OMT) in preventing the onset of positional plagiocephaly and brachycephaly at 4 months in at-risk newborns.</div></div><div><h3>Methods</h3><div>This single-center, randomized, controlled open-label study, with blinded assessment of the endpoints, was carried out at the maternity unit of Montpellier University Hospital (France) between 2019 and 2022. Newborns aged between 3 and 10 days with at least one risk factor for cranial deformity were included and randomized into a group receiving OMT in addition to advice for the prevention of cranial deformities or a group receiving advice alone (standard care). OMT included an osteopathic assessment, osteopathic treatment, and at least one follow-up session. The primary outcome was the occurrence of plagiocephaly (cranial asymmetry index ≥106 %) or brachycephaly (cranial index ≥93 %) at 4 months after birth.</div></div><div><h3>Results</h3><div>The trial terminated early due to enrolment issues (56.1 % of planned recruitment). Among the 101 patients included, 35 in the OMT group and 30 in the control group completed the study and were analyzed. At 4 months, no significant difference was observed in the rates of brachycephaly (relative risk [RR] of the control group vs. OMT: 1.55, 95 % confidence interval [CI]: [0.38, 6.39], <em>p</em> = 0.54), or plagiocephaly (RR=1.64, 95 % CI [0.34, 8.00], <em>p</em> = 0.54). A trend toward more frequent cases of severe brachycephaly or plagiocephaly was observed in the control group (<em>n</em> = 5) compared with the OMT group (<em>n</em> = 1; <em>p</em> = 0.09). No adverse effects were reported.</div></div><div><h3>Conclusions</h3><div>This study did not find any significant effect of OMT on the occurrence of cranial positional deformities. However, recruitment and follow-up difficulties, partly linked to the COVID-19 pandemic, resulted in an underpowered study that does not allow definitive conclusions to be drawn on potential benefits of OMT.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 3","pages":"Pages 203-209"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}