Archives of Disease in Childhood最新文献

{"title":"Motor difficulties and associated risk factors at 12 years in children born extremely preterm: a population-based cohort study.","authors":"Maria Örtqvist, Nelly Padilla, Cecilia Montgomery, Karin Sävman, Thomas Abrahamsson, Aijaz Farooqi, Fredrik Serenius, Lisa B Thorell, Ulrika Ådén","doi":"10.1136/archdischild-2025-329687","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329687","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of significant motor difficulties at 12 years of age in children born extremely preterm (EPT, <28 weeks' gestational age) compared with term-born peers and to identify associated risk factors and comorbidities.</p><p><strong>Design: </strong>Population-based cohort study.</p><p><strong>Setting: </strong>National cohort from the Extremely Preterm Infants in Sweden Study, including children born from 2004 to 2007.</p><p><strong>Patients: </strong>Children born <27 weeks' gestational age without cerebral palsy and/or severe neurodevelopmental impairment and term-born controls.</p><p><strong>Interventions: </strong>Motor function was assessed at 12 years using the Movement Assessment Battery for Children, second edition (MABC-2). Logistic regression identified risk factors for motor difficulties.</p><p><strong>Main outcome measures: </strong>Prevalence of significant motor difficulties, defined as scores ≤fifth percentile on MABC-2.</p><p><strong>Results: </strong>A total of 268 EPT-born and 196 term-born children were assessed. Significant motor difficulties were found in 30% of EPT-born children compared with 3% of term-born peers (adjusted OR 16.99; 95% CI 6.64 to 43.47). Male sex and lower gestational age were independently associated with higher risk. Among EPT-born children with motor difficulties, comorbidities were common, including autism spectrum disorders and attention deficit hyperactivity disorders. Only 9.5% of affected children had received physiotherapy in the previous year.</p><p><strong>Conclusions: </strong>Children born EPT, even in the absence of cerebral palsy and/or severe neurodevelopmental impairment, have a markedly increased risk of motor difficulties and associated neurodevelopmental comorbidities by age 12. Structured follow-up into mid-school age is essential to enable timely interventions.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A small but welcome light on the child-adult transition in epilepsy.","authors":"Elizabeth I Harrison, Howard P Goodkin","doi":"10.1136/archdischild-2026-330663","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330663","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of fetal alcohol spectrum disorder and its relationship with levels and patterns of alcohol consumption: a scoping review.","authors":"Ana Cristina Castro-Avila, Veronica Mary Dale, Holly Essex, Susan Golder, Laura Jefferson, Trevor Andrew Sheldon, Kate Pickett, Karen Bloor","doi":"10.1136/archdischild-2025-329287","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329287","url":null,"abstract":"<p><strong>Objective: </strong>To explore prevalence estimates of fetal alcohol spectrum disorder (FASD) in high-income countries and the relationships between levels and patterns of alcohol consumption during pregnancy and FASD.</p><p><strong>Methods: </strong>Two scoping reviews of observational studies. We searched Medline, EMBASE, Maternity and Infant Care, and the Incidence and Prevalence Database until June 2024. Two reviewers screened studies independently using predefined criteria to address our two questions and extracted data on study design, diagnostic criteria, methods of collecting drinking history and details about levels and drinking patterns.</p><p><strong>Results: </strong>We identified 41 relevant studies. Most were conducted in the Americas region (n=15) and had a cross-sectional design (n=26). The US Institute for Medicine diagnostic criteria were most frequently used for case ascertainment (n=22). Prevalence ranged from 5.8 (95% CI 4.6 to 7.1) to 170 000 (95% CI 161 000 to 178 000) per 1 000 000 general population. Estimates of associations between drinking levels/patterns and having a child diagnosed with FASD varied substantially. The lowest OR (95% CI) was 1.8 (0.3 to 12.2) for women who drank 1-1.9 drinks per drinking day compared with no alcohol and the highest was 61 (18.9 to 195.5) for women who drank any amount of alcohol during pregnancy compared with women who did not drink at all.</p><p><strong>Conclusions: </strong>FASD prevalence estimates in high-income countries and the risk of different levels and drinking patterns varied widely due to the use of different diagnostic criteria, sampling and alcohol consumption collection methods. Improving alcohol consumption collection methods will help enhance diagnostic certainty and the identification of at-risk groups.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring transition success from paediatric to adult epilepsy services and its association with seizure outcomes: a UK retrospective cohort study.","authors":"Shivana Neeta Modi, Emmanouil Bagkeris, Catalina Suarez-Rivera, Maria-Christina Petropoulos, Dougal Hargreaves","doi":"10.1136/archdischild-2025-329776","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329776","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a working definition of successful transition from paediatric to adult epilepsy services, assess transition success, identify predictors and determine whether success is associated with improved seizure outcomes in early adulthood.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Paediatric and adult epilepsy services in London, UK.</p><p><strong>Participants: </strong>Patients aged 20-24 with epilepsy in the paediatric service database (2009-2023) who transitioned to adult care.</p><p><strong>Demographics: </strong>Date of birth, sex, ethnicity.</p><p><strong>Exposures: </strong>Age at first documented paediatric epilepsy clinical appointment (this is not age of epilepsy onset) and number of epilepsy-related comorbidities at age 17.</p><p><strong>Transition measure: </strong>Success was defined by four criteria: developmentally appropriate initiation, comprehensive preparation using National Institute for Health and Care Excellence guidance, attendance at joint paediatric/adult transition clinic and adult follow-up within 6 months of transition clinic.</p><p><strong>Main outcome measure: </strong>Change in seizure frequency between ages 17 and 20.</p><p><strong>Results: </strong>Of 59 eligible patients, 72.9% (43/59) achieved successful transition. Criteria were well-met: initiation (91.5%), preparation (91.5%), joint clinic (79.7%) and follow-up (88.1%). Successful transition increased the odds of seizure improvement/remaining seizure-free (adjusted OR 4.28, 95% CI 1.07 to 17.19) after adjusting for: age at first paediatric epilepsy clinical appointment, sex, ethnicity and comorbidities. Males had higher odds of seizure improvement/remaining seizure free than females (adjusted OR 4.29, 95% CI 1.26 to 14.67).No significant association was seen with ethnicity or age at first appointment.</p><p><strong>Conclusions: </strong>A novel transition success tool was developed. Larger, multicentre studies are needed to validate this tool and confirm associations with long-term outcomes.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of blood pressure for detecting serious illness in children attending acute care settings in low- and middle-income countries: a multicentre observational study.","authors":"Naomi Kemps, Nienke N Hagedoorn, Navin P Boeddha, Abdoulie Faal, Natanael Holband, Amadu E Juliana, Kristina Keitel, Kevin H Van't Kruys, Elizabeth V Ledger, Chacha D Mangu, Henriette A Moll, Andrew M Prentice, Rainer Tan, Effua Usuf, Stefan A Unger, Clementien L Vermont, Joany M Zachariasse","doi":"10.1136/archdischild-2025-329717","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329717","url":null,"abstract":"<p><strong>Background: </strong>In children, the value of routine blood pressure measurement in first assessment at the emergency department has been questioned. This has, however, not yet been evaluated in low- and middle-income countries (LMICs) where the incidence of serious illness is high. This study assessed the predictive value of low systolic blood pressure to detect serious illness in children attending acute care settings in LMICs.</p><p><strong>Methods: </strong>This observational study is based on data from children attending three acute care settings in The Gambia and Suriname. Hypotension was defined by age-adjusted reference values according to Advanced Paediatric Life Support (APLS) and Paediatric Advanced Life Support (PALS) cut-offs. The outcome measure was a composite marker of serious illness consisting of admission or referral to a higher level of care. A logistic regression analysis was used to evaluate the association between hypotension and serious illness for each setting separately.</p><p><strong>Results: </strong>20 185 visits from Gambia rural, 398 visits from Gambia urban and 1817 visits from Suriname were included. Hypotension was present in 8.3-17.3% of visits and serious illness in 3.9-15.7%. Hypotension was not significantly associated with serious illness in Gambia urban (OR_APLS 3.2 (0.7-10.9) and OR_PALS 1.4 (0.1-7.6)) and Suriname (OR_APLS 1.3 (0.9-1.9) and OR_PALS 1.7 (0.9-3.2)), and with an inverse association in Gambia rural (OR_APLS 0.6 (0.5-0.7) and OR_PALS 0.9 (0.5-1.4)).</p><p><strong>Conclusions: </strong>Our results do not show a significant association between hypotension and serious illness in LMICs. Our results suggest that routine blood pressure measurement does not aid in the evaluation of well-appearing children attending acute care settings in LMICs.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental finding of thoracic lesion detected on chest radiograph.","authors":"Ciaran Fergus O'Toole, Mark Tighe","doi":"10.1136/archdischild-2025-330131","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330131","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, causes and outcome of term infants presenting with hyponatraemia and hyperkalaemia: population surveillance study in Wales.","authors":"David Tuthill, Rebekah Pryce, Shivaram Hegde, Tim Cheetham, Yincent Tse","doi":"10.1136/archdischild-2025-329118","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329118","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equality, discrimination and gender.","authors":"Robert Wheeler","doi":"10.1136/archdischild-2025-330129","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330129","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pirandello and child health: why a 19th century Italian's writing is relevant today.","authors":"Amy Stevens","doi":"10.1136/archdischild-2026-330526","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330526","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doxycycline's stains.","authors":"Patrick M Meyer Sauteur, Beat M Greiter, Veronika Volkmann, Semjon Sidorov, Michelle Seiler, Agnes Schwieger-Briel","doi":"10.1136/archdischild-2025-330043","DOIUrl":"10.1136/archdischild-2025-330043","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"456"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}