Acta Paediatrica最新文献

{"title":"From Paracelsus to Precision Medicine: Paediatric Epilepsy as the Paradigm of Individualized Therapy.","authors":"Annamaria Sapuppo, Vincenzo Sortino, Raffaele Falsaperla","doi":"10.1111/apa.70802","DOIUrl":"https://doi.org/10.1111/apa.70802","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217379","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":"Decreasing Trends in Birth Prevalence and Severity of Cerebral Palsy in Sweden During 2000-2019: A Population-Based Registry Study.","authors":"Semhal Getachew Teka, Gunnar Hägglund, Ann I Alriksson-Schmidt","doi":"10.1111/apa.70800","DOIUrl":"https://doi.org/10.1111/apa.70800","url":null,"abstract":"<p><strong>Aim: </strong>To examine temporal trends in cerebral palsy (CP) birth prevalence and changes in functional severity in Sweden between 2000 and 2019.</p><p><strong>Methods: </strong>This population-based registry study included all children with CP born in Sweden between 2000 and 2019. Annual CP birth prevalence was calculated using Poisson regression. Changes in functional severity were assessed using the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels across birth cohorts, with ordinal logistic regression used to examine their association.</p><p><strong>Results: </strong>In total 4281 participants were included. CP birth prevalence decreased over the study period with a rate ratio per year of 0.985 (95% confidence interval 0.980-0.990) corresponding to a 1.5% annual reduction. The proportion of children with milder impairment increased over time. In crude analyses: children born in 2015-2019 had lower odds of higher MACS levels (OR 0.70, 95% CI 0.60-0.83, p ≤ 0.001), and GMFCS level (OR 0.77, 95% CI 0.65-0.92, p = 0.003) than those born in 2000-2004.</p><p><strong>Conclusion: </strong>CP birth prevalence in Sweden decreased significantly between 2000 and 2019. A shift toward milder functional impairment was observed in more recent birth cohorts and occurred alongside changes in CP subtype distribution.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197846","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":"Safeguarding in Emergency Care: Clarifying the Targeted 'Child-Check' Protocol.","authors":"Louise Laurell, Andreas Rantala, Pia Lundqvist","doi":"10.1111/apa.70803","DOIUrl":"https://doi.org/10.1111/apa.70803","url":null,"abstract":"","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208237","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":"Patterns of Delivery Following in Utero Transfer for Extremely Preterm Birth: A Retrospective Cohort Study From a London Tertiary Centre.","authors":"Sristi Ganguly, Caroline Payne, Caroline Nyawira, Sandeep Shetty","doi":"10.1111/apa.70796","DOIUrl":"https://doi.org/10.1111/apa.70796","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate delivery patterns following in utero transfer (IUT) to a London tertiary neonatal intensive care unit, examining gestational age, referral indication, transfer-to-delivery interval, and maternal length of stay.</p><p><strong>Methods: </strong>Retrospective cohort study of women accepted for IUT at St George's Hospital, London (2021-2025), between 22 + 0-27 + 6 weeks' gestation (or 28-29 weeks with multiples/expected birth weight < 800 g) for threatened extremely preterm birth. Data were extracted from BadgerNet, maternity records, and delivery suite databases; Fisher's exact test was used for categorical comparisons.</p><p><strong>Results: </strong>Of 126 IUT episodes, 53 (42%) delivered at the tertiary centre; median transfer-to-delivery interval was 1 day (mean 2.02). Delivery rates averaged ~10%/day over the first 5 days. Transfers from outside the local network delivered within 24 h more often (18%). Among 73 (58%) who did not deliver, median length of stay was 4 days. Delivery was less likely at 22-24 weeks (32% vs. 50% at ≥ 25 weeks) and significantly associated with sepsis (p = 0.01), chorioamnionitis (p < 0.001), pathological CTG (p = 0.006), and Doppler abnormalities (p = 0.02).</p><p><strong>Conclusion: </strong>Over half of women undergoing IUT did not deliver during admission. Infection and fetal compromise indications were most strongly associated with delivery, supporting liberalised IUT acceptance and capacity planning.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186461","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":"Thirty Years of Pneumococcal Conjugate Vaccines in Children: Achievements, Challenges and Lessons From a Moving Target","authors":"Robert Cohen,&nbsp;Corinne Levy,&nbsp;André Birgy,&nbsp;Emmanuelle Varon","doi":"10.1111/apa.70574","DOIUrl":"10.1111/apa.70574","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To review the long-term epidemiological and immunological impact of pneumococcal conjugate vaccines (PCVs) in the context of serotype replacement and the development of higher-valency formulations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Brief literature overview of current evidence on pneumococcal biology, natural and vaccine-induced immunity, population-level effects of PCVs and the epidemiological dynamics of serotype distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PCVs have profoundly reshaped the landscape of paediatric infectious diseases, leading to a dramatic decline in <i>Streptococcus pneumoniae</i> infections in children and, through herd protection, in adults. The decline in vaccine-type infections has been partially offset by the gradual emergence of non-vaccine serotypes. However, despite this serotype replacement, PCVs remain among the most powerful paediatric vaccines ever developed. The diversity of pneumococcal biology, the interplay between natural and vaccine-induced immunity and the dynamic process of serotype replacement create a constantly moving target. The introduction of higher-valency vaccines, now including up to 15 or 20 serotypes, seeks to address this adaptation but faces intrinsic immunological limits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Three decades after the first clinical trials, our understanding of their long-term epidemiological and immunological impact is still evolving. Future vaccine strategies must optimize the balance between expanded serotype coverage and durable immune protection at both the individual and population levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2478-2486"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846820","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":"Optimising Human Papillomavirus Vaccination Strategies for Faster Cervical Cancer Elimination","authors":"Joakim Dillner","doi":"10.1111/apa.70756","DOIUrl":"10.1111/apa.70756","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Cervical cancer elimination is a global public health goal, with vaccination against Human Papillomavirus (HPV) and HPV screening being two major prevention pillars. This review focuses on how vaccinations can be used in order to reach the timepoint of cervical cancer elimination faster.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The concepts in previously published reviews on ‘faster cervical cancer elimination’ are summarised and explained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Major concepts explained are: HPV vaccines prevent not only cancer precursors, but also the HPV infection itself resulting in public health gains that exceed the individual direct vaccine protection because of herd immunity. The effective population coverages of vaccine-induced immunity required to reach the critical extinction level for infection elimination are moderate, in particular when gender-neutral vaccination is used. Major suggested enabling strategies include catch-up vaccinations of adolescents, one-dose HPV vaccination and use of HPV prevalences to monitor and optimise HPV vaccination programs. Finally, cervical screening with HPV testing is predicted to be easier if there are no new HPV infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The major challenge for faster cervical cancer elimination is to design HPV vaccination strategies that achieve an effective population immunity against the HPV infection as fast as possible.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2456-2459"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70756","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898454","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}

{"title":"The New Era of Respiratory Syncytial Virus Protection for Infants: A Mini Review of Current Tools for Immunoprophylaxis","authors":"Santtu Heinonen,&nbsp;Pekka Vartiainen","doi":"10.1111/apa.70725","DOIUrl":"10.1111/apa.70725","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This mini review describes the history of infant respiratory syncytial virus (RSV) immunoprophylaxis and the latest advances in this area. It also reviews the efficacy, safety and impact of the recently introduced prophylactic strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This narrative review is based on a targeted review of published literature, with emphasis on pivotal clinical trials, regulatory documents and recent real-world evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three immunisation products for preventing RSV in infants have been approved since 2022. These are two long-acting monoclonal antibodies, nirsevimab and clesrovimab, and a maternal RSV vaccine. The efficacy of these interventions has ranged from 49% to 76% against medically attended RSV-associated lower respiratory tract infections and from 55% to 91% against hospitalisation due to RSV-associated lower respiratory tract infection. The efficacy varied between the products and the duration of the follow-up. Similar or higher effectiveness has been reported in post-licensure, real-world evidence studies. Overall, these interventions have been well tolerated, with favourable safety profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The newly introduced long-acting monoclonal antibodies and the maternal RSV vaccine have proved highly effective and have demonstrated reassuring safety. They have already been implemented in a number of countries and have substantially reduced the RSV burden in infants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2466-2472"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761752","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}

{"title":"Tick-Borne Encephalitis (TBE) Vaccine in the National Immunisation Programme—For Whom, When and Where?","authors":"H. H. Askling,&nbsp;D. Zavadska","doi":"10.1111/apa.70280","DOIUrl":"10.1111/apa.70280","url":null,"abstract":"<p>The incidence of Tick-borne encephalitis (TBE) cases has increased. The presumed location of transmission of Tick-borne encephalitis virus (TBEV) has been expanding increasingly in the western parts of Europe during the past decade. There has also been an increased incidence of surveillance-reported TBE cases in southern Sweden and southern Norway. Additionally, the warmer climate has enabled ticks to be present to a greater extent in the northern part of Scandinavia. In several reports, pre-school children tend to have a lower TBE incidence rate compared to teenagers, whereas both younger children and teenagers may experience severe neurological symptoms such as meningitis and encephalitis. In addition to physical impairments, <b>long-term cognitive and mental impairments</b> have been observed in up to <b>70% of children</b> with TBEV infection. These may include <b>attention deficits, reduced concentration</b> and <b>impaired memory</b>, which can significantly affect daily life and <b>school performance</b>. Finland, Latvia and Slovenia have already included TBE vaccines in their National Immunisation Program (NIP). TBE vaccines are safe and effective for children from the age of 1, and we propose all countries with endemic areas include TBE vaccines in their future NIP. This is a cost-effective strategy and, even more important, a pivotal equity strategy for all European children.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2450-2455"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979698","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}

{"title":"Immune System Development—Pro Tips for Paediatricians","authors":"Petter Brodin","doi":"10.1111/apa.70627","DOIUrl":"10.1111/apa.70627","url":null,"abstract":"<p>There are many misconceptions about the immune system in children, its impact on infectious disease susceptibility and its role in the rapidly increasing rates of immune mediated diseases in industrialized societies. In this mini review, I will discuss common believes and the data supporting or countering such believes, with a focus on clinically relevant topics of relevance to trainees and practicing paediatricians. I will emphasize data from studies performed in humans rather than reductionist mouse models. I discuss open questions requiring further investigation and end with a discussion on clinical observations of particular concern which paediatricians should consider when caring for children in their practices. Immune development is increasingly recognized as an important determinant of health, not just early in life, but also long term and all of us caring for children should know more about it.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2398-2401"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058506","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}

{"title":"Update on Selected Adverse Events of Concern Following Immunization With Acellular Pertussis Vaccines, a Narrative Review","authors":"Lennart Nilsson,&nbsp;Jann Storsaeter","doi":"10.1111/apa.70676","DOIUrl":"10.1111/apa.70676","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To provide an update paper on evidence of adverse events of concern following immunization (AEFI) with pertussis vaccines, focusing primarily on acellular (aP) vaccines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Evidence was synthesised from epidemiological studies, systematic reviews over recent decades, expert interpretations in reviews from relevant research teams and well-conducted observational reports across different time periods. A more comprehensive review of the literature was conducted for certain specific AEFIs, including sterile abscesses, macrophagic myofasciitis, reactions to aluminium adjuvants, Guillain–Barré syndrome, acute disseminated encephalomyelitis (ADEM) and anaphylaxis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Acellular (aP) vaccines are generally associated with mild reactions such as local pain, redness, and transient fever. Moderate reactions, including prolonged crying, hypotonic-hyporesponsive episodes, extensive limb swelling, and aluminium-induced granuloma, occur infrequently and are self-limiting. Severe outcomes such as seizures or encephalopathy have been extensively investigated, with large studies showing no consistent increase above background incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Licensed acellular pertussis vaccine combinations demonstrate acceptable safety profiles, with serious adverse events being rare. Continuous pharmacovigilance and balanced, evidence-based communication remain essential to sustain trust in pertussis immunisation programmes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2370-2379"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431545","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}