BMJ Paediatrics Open最新文献

{"title":"Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015.","authors":"Anna Dencker, Huiqi Li, Ida Lyckestam Thelin, Valerie Smith, Christina Nilsson, Ingela Lundgren, Lars Ladfors, Anders Elfvin","doi":"10.1136/bmjpo-2024-003026","DOIUrl":"10.1136/bmjpo-2024-003026","url":null,"abstract":"<p><strong>Objective: </strong>To explore health outcomes up to 5 years of age, according to mode of birth, in a large cohort of Swedish children who were born as a second child to women who had a caesarean section (CS) in their first pregnancy.</p><p><strong>Design: </strong>Retrospective population-based register study.</p><p><strong>Population: </strong>All children (n=94 498) who were born as a second child (or children in cases of twins or higher-order multiple births) during 1999-2015 in Sweden in women who had a CS first birth. The children were followed up to 5 years of age. For inclusion, both births must have occurred in Sweden.</p><p><strong>Methods: </strong>A nationwide cohort study using follow-up data up to 5 years of age. Maternal factors, including age, smoking, diabetes, obesity (body mass index ≥30), mental illness, pre-eclampsia, education, income, country of birth and the neonatal factors of being a singleton and prematurity (up to week 36+6) were adjusted for in regression models.</p><p><strong>Main outcome measures: </strong>Developmental problems, asthma, allergy, hospital care and death within 5 years of age.</p><p><strong>Results: </strong>A total of 94 498 children were included in the study. Risk for developmental problems, asthma and allergy was increased after repeat CS but not after vaginal birth. The need for hospital care was increased in all other birth modes compared with spontaneous vaginal birth. The risk of death within 5 years increased after instrumental vaginal birth and emergency repeat CS.</p><p><strong>Conclusions: </strong>All repeat CS compared with spontaneous vaginal birth was related to increased risks for developmental problems, asthma, allergy and hospital stay, and emergency repeat CS was associated with an increased risk of death within 5 years. The results of the present study support vaginal birth as the optimal mode of birth after previous CS for longer-term child health outcomes.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708401","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":"Assessment of dietary, genetic and metabolic factors in South Indian adolescents with metabolic dysfunction-associated steatotic liver disease: a case-control study protocol.","authors":"Swathilakshmi Venu, Rajesh Gopalakrishna, Bhanu Vikraman Pillai, Lalitha Biswas, Rashmi Poojara, Manu Raj","doi":"10.1136/bmjpo-2024-003138","DOIUrl":"10.1136/bmjpo-2024-003138","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of liver disease among adolescents. The objectives of this study are to investigate the associations of dietary, genetic and metabolic factors with MASLD in South Indian adolescents.</p><p><strong>Methods and analysis: </strong>The study will employ a case-control study design. We will recruit 280 adolescents (140 cases and 140 controls) from hospital and school settings. The hospital setting will be the paediatric gastroenterology outpatient department (OPD) at the study institution and the school setting will be selected urban schools from Ernakulam, Kerala. At the hospital, cases and controls will be selected from the patients who are attending the paediatric gastroenterology OPD with complaints of generalised abdominal pain or constipation with no other significant medical complaints or use of medications. A sensitisation programme on MASLD for parents of adolescents will be conducted in schools. All consenting parents along with their adolescent wards will be invited for study participation. Cases will be defined as adolescents having evidence of hepatic steatosis in ultrasound and meeting any one of the paediatric cardiometabolic criteria for MASLD. Those who fail to satisfy this criteria will be defined as controls. All participants will undergo nutritional and physical activity assessments using validated questionnaires along with blood sampling for biochemical analysis and genetic testing. We will examine the associations between MASLD and dietary parameters using Pearson's χ² tests after stratifying dietary variables into categorical groups. Logistic regression will be used to assess the impact of dietary parameters and single-nucleotide polymorphisms (SNPs) on the risk of MASLD.</p><p><strong>Ethics and dissemination: </strong>Ethics approval was obtained from the Ethics Committee of Amrita School of Medicine, Kochi. Informed consent will be obtained from participants and their legal guardians before enrolment. The study findings will provide valuable insights into the evolution of MASLD among adolescents in South India.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699599","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":"Prevalence and associated factors of admission hypothermia among neonates admitted to the premature baby unit of a secondary care hospital in Sri Lanka: a cross-sectional analytical study.","authors":"Savindi Kasturiarachchi, Inosha Alwis, Sanath Kumara, Buwanaka Rajapaksha","doi":"10.1136/bmjpo-2024-003233","DOIUrl":"10.1136/bmjpo-2024-003233","url":null,"abstract":"<p><strong>Background: </strong>Hypothermia is defined as core body temperature being below 36.5°C. This study aimed to identify the prevalence, associated factors and outcomes of hypothermia among neonates admitted to the premature baby unit (PBU) of a secondary care hospital in Nawalapitiya, Sri Lanka.</p><p><strong>Methods: </strong>In a cross-sectional analytical study, medical records of neonates admitted to the PBU were selected retrospectively from 31 March 2022 to 1 April 2021 using consecutive sampling. The recorded axillary temperatures on admission, sociodemographic and clinical data were extracted. Following bivariate analysis, multivariable logistic regression was performed.</p><p><strong>Results: </strong>Among 407 neonates, the median admission age was 1 day. The majority were male (52.6%), were term (59%) and had a normal birth weight (52.5%). The number of babies with hypothermia was 157 with a prevalence of 38.6% (95% CI: 33.9 to 43.4). Maternal factors like teenage pregnancy, multiple pregnancy, hypertension during pregnancy, premature rupture of membranes and lower-segment caesarean sections; neonatal factors like age on admission being less than 24 hours, prematurity, corrected gestational age on admission being less than 37 weeks, low birth weight, weight on admission being less than 2.5 kg and having been resuscitated at birth had statistically significant associations with hypothermia on the bivariate analysis. Hypothermia showed no significant association with the month of admission. Following multivariable analysis, age on admission being less than 24 hours (adjusted OR (aOR): 3.3, 95% CI: 1.9 to 5.8), teenage pregnancy (aOR: 8.2, 95% CI: 1.8 to 37.2), multiple pregnancy (aOR: 2.8, 95% CI: 1.1 to 7.1) and hypertension in pregnancy (aOR: 2.3, 95% CI: 1.2 to 4.7) remained statistically significant. Neonates with hypothermia had 5.2 times (95% CI: 1.8 to 14.6) odds of mortality and 4.9 times (95% CI: 2.8 to 8.5) odds of receiving ventilatory support compared with normothermic neonates. Hypothermia also showed statistically significant associations with infant respiratory distress syndrome, metabolic acidosis and neonatal jaundice.</p><p><strong>Conclusions: </strong>Nearly two out of five neonates admitted to the PBU were hypothermic. There were significant maternal and neonatal associations to be addressed. Hypothermia on admission may indicate serious neonatal morbidity and mortality.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691054","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":"Mortality in children and adolescents in Western Democratic Republic of Congo: retrospective analysis of verbal autopsy and demographic data from the Kimpese Health and Demographic Surveillance System.","authors":"Joël Kiniati Fumwakwau, Mattias Schedwin, Mireille Amba Ngale, Helena Hildenwall, Tobias Alfven, Mala Ali Mapatano, Carina King, Delphin Mavinga Phanzu","doi":"10.1136/bmjpo-2024-003224","DOIUrl":"10.1136/bmjpo-2024-003224","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data on causes of death in children and adolescents that can be used for public health prioritisation in settings with the highest mortality burden. We aimed to estimate the causes and circumstances around deaths for the age group 1 month to 19 years in the Western Democratic Republic of Congo.</p><p><strong>Methods: </strong>Analysis of verbal autopsy and demographic data from the Kimpese Health and Demographic Surveillance System (rural setting 200 km west of Kinshasa) was collected between September 2018 and September 2021. About 66 000 individuals were surveyed yearly using structured questionnaires. Vital events were registered and identified deaths followed up with the World Health Organization 2012 or 2016 verbal autopsy questionnaire. Verbal autopsies were analysed using the InterVA-5 algorithm to generate cause of death and circumstances of mortality categories at the population level. Individual and household characteristics relevant to child survival were compared between deceased and surviving individuals using Fisher's exact test.</p><p><strong>Results: </strong>Overall, 166/273 (61%) of identified deaths had a complete verbal autopsy. 74% of deaths occurred in children 1-59 months of age, and 70% of all deaths were classified as due to infectious diseases. The top three causes were malaria (35%), lower respiratory infection (12%) and diarrhoeal disease (9%). 78% of deaths occurred at home, and <5% were considered inevitable. However, 70% of individuals sought healthcare in the days preceding death. Recognition (39%), emergencies (27%) and accessing care (20%) were the main contributing categories to fatal outcomes. Characteristics had low coverage (32-72% for the first dose of vaccinations and <10% for water, sanitation and hygiene).</p><p><strong>Conclusions: </strong>Results suggest a need to sensitise caregivers about care-seeking, home treatment and danger signs and improve access to health facilities, combined with improving the quality of care in facilities. Improvements in access to safe water, sanitation and vaccination coverage are also needed.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691050","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":"Funding the future: climate finance for youth.","authors":"Thomas Hardson Okinda","doi":"10.1136/bmjpo-2024-003164","DOIUrl":"10.1136/bmjpo-2024-003164","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691048","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":"Status epilepticus in the neonate.","authors":"Lakshmi Nagarajan, Soumya Ghosh","doi":"10.1136/bmjpo-2024-003202","DOIUrl":"10.1136/bmjpo-2024-003202","url":null,"abstract":"<p><p>Status epilepticus in the neonate (NSE) is a medical emergency that often results in dire consequences. Minimising injury from NSE is essential. The diagnosis of NSE can be challenging as neonates frequently have electrographic only seizures and an EEG is essential for recognition of seizures and seizure burden. The lack of a universally accepted definition of NSE, possible adverse effects from commonly used antiseizure medications, debate regarding the best treatment packages for NSE, limited access to EEG and investigations for aetiology of NSE add to the clinical conundrum. In this review, we aim to present what is known, highlight the importance of EEG monitoring for diagnosis and treatment, discuss what is not known and suggest a practical paradigm for the management of NSE.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690526","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":"Exploring the current usage of and attitudes towards transanastomotic tube (TAT) feeding in infants born with duodenal atresia: a survey of practice in the UK.","authors":"Alexandra Jager, Joanne Turnbull, Mark John Johnson, Nigel J Hall","doi":"10.1136/bmjpo-2024-003267","DOIUrl":"10.1136/bmjpo-2024-003267","url":null,"abstract":"<p><strong>Background: </strong>Despite evidence demonstrating clinical and cost benefits of transanastomotic tubes (TATs), following repair of congenital duodenal obstruction they are used in a minority of infants in the UK. Most infants are fed using parenteral nutrition (PN) (sometimes in combination with a TAT). This variation is unexplained by clinical or demographic factors. We aimed to understand why this is and the barriers to practice change.</p><p><strong>Methods: </strong>UK-based clinicians (surgeons, neonatologists, dietitians and specialist nurses) completed an online mixed methods survey. Open-ended replies were summarised thematically. Data were analysed using descriptive and inferential statistics.</p><p><strong>Results: </strong>109 clinicians (24 neonatologists, 7 nurses, 3 dietitians, 75 surgeons) from all 25 UK neonatal surgical units completed the survey. 88% (n=96/109) stated TAT use was decided solely by surgeons, driven primarily by considerations of providing appropriate nutrition and risks; 36% of surgeons felt TATs should always be used where possible. Decisions about central venous catheters (CVCs) were made by neonatologists (28%, n=31/109), surgeons (17%, n=18/109), jointly (48%, n=52/109) or 'other' (7%, n=8/109). Neonatologists and surgeons prioritised providing appropriate nutrition and risks when deciding whether to use CVCs/PN; surgeons rated a lack of supporting research and TATs' risks as key barriers to TAT usage. Costs and parents' preferences had limited influence on TAT and PN usage.</p><p><strong>Conclusions: </strong>Increased TAT usage requires surgeons to be persuaded of TATs' efficacy and safety, and neonatologist recognition that exclusive TAT feeding (ie, without CVCs/PN) can provide adequate nutrition. Further work is required to appreciate how best to achieve this.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655940","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":"Dexmedetomidine in neonates: utilisation trends and safety profile over time in a neonatal intensive care unit.","authors":"Gozdem Kayki, Nadir Yalcin, Hasan Tolga Celik, Sule Yigit","doi":"10.1136/bmjpo-2024-003004","DOIUrl":"10.1136/bmjpo-2024-003004","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine is an alpha-2 adrenergic agonist with sedative, anxiolytic and analgesic effects. Its use in neonatal intensive care units (NICUs) has been increasing in the last decade. The aim of this study was to assess the safety profile of dexmedetomidine and to identify specific trends in its use over time.</p><p><strong>Methods: </strong>In this retrospective observational study, data were collected on all patients who received continuous infusion of dexmedetomidine in a level IV NICU in Turkey between 2018 and 2023. Demographic characteristics were compared between preterm and term infants using the Mann-Whitney U test. Differences in adverse effects between term and preterm infants, as well as between lower and higher doses, were analysed using the χ² test. Regression analysis was conducted to identify factors influencing adverse effects.</p><p><strong>Results: </strong>A total of 383 patients were included. The participants had a median (IQR) gestational age of 37 (35-38) weeks with a median (IQR) birth weight of 2700 (2140-3270) grams and the median (IQR) postmenstrual age at the time of dexmedetomidine initiation was 38 (36-40) weeks. The most common indication for use was pain control following surgery and/or interventional procedures (81.5%). There was a statistically significant increase in initial doses (p<0.001) and treatment duration (p=0.009). Adverse drug reactions (ADRs) were observed in 5% of cases, mostly bradycardia (50%) and ADRs did not correlate with the dose (0.80), treatment duration (0.96) or gestational age (p=0.93).</p><p><strong>Conclusion: </strong>Our data and experiences demonstrated a significant increase in the dose and duration of dexmedetomidine use in the NICU over the years. Additionally, the findings have suggested that higher doses and treatment duration do not result in an increase in ADRs during the acute period.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655809","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":"Feasibility and acceptability of the Alarm Distress Baby Scale (ADBB) in universal health visiting practice in England: a mixed-methods study using Normalisation Process Theory.","authors":"Sharin Baldwin, Michael Fanner, Hilda Beauchamp, Vicky Gilroy, Alison Morton, Carl May, Jane Barlow","doi":"10.1136/bmjpo-2024-002997","DOIUrl":"10.1136/bmjpo-2024-002997","url":null,"abstract":"<p><strong>Background: </strong>The Alarm Distress Baby Scale (ADBB) is a validated observation tool, designed for use by healthcare practitioners to identify infant social withdrawal. A modified version (m-ADBB) was later developed as a clinically useful behavioural tool. However, neither version has been tested in the UK context. This study aimed to test the feasibility and acceptability of using the ADBB and m-ADBB within universal health visiting practice in England.</p><p><strong>Methods: </strong>A mixed methods convergent parallel design was used. Five health visitors were trained in the ADBB and 20 in the m-ADBB, from two National Health Service (NHS) community sites in England. Quantitative data were collected from health visitors, while qualitative semistructured interviews were conducted with health visitors and service managers, guided by Normalisation Process Theory (NPT). Thematic analysis was used to analyse the qualitative data and descriptive analysis for the quantitative data. NPT provided a framework for analysing the implementation process in routine health visitor practice.</p><p><strong>Results: </strong>The m-ADBB was used with 225 babies and behaviour concerns were identified in 23 babies (10%). Eleven themes were identified, aligned with the four NPT constructs: (1) Coherence: perceived uniqueness of the scale, new vocabulary for articulating baby behaviour, enrichment of existing knowledge and skills; (2) Cognitive participation: commitment to the use of the ADBB/m-ADBB, consolidation of new practice; (3) Collective action: implementation of the m-ADBB scale in routine practice, organisation and management support, existing systems and pathways for children and families and (4) Reflexive monitoring: perceived benefits of integrating the scales in practice, quality assurance for embedding the scales in practice, appraisal of the training and scales in practice.</p><p><strong>Conclusions: </strong>The ADBB/m-ADBB was perceived to have enhanced the health visitors' skills and knowledge in infant observation. The m-ADBB required minimal additional time and was highly acceptable to health visitors. These findings have significant implications for health visiting practice and future research.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655977","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 impact of climate change on child nutrition in Indonesia: a conceptual framework and scoping review of the available evidence.","authors":"David Colozza, Isabella Guo, Sri Wahyuni Sukotjo, Astrid Citra Padmita, Rene Gerard Galera, Endang Sulastri, Inti Wikanestri, Mamadou Ndiaye","doi":"10.1136/bmjpo-2024-002980","DOIUrl":"10.1136/bmjpo-2024-002980","url":null,"abstract":"<p><strong>Background: </strong>Climate change is expected to significantly impact child nutrition, worsening global health inequities. Indonesia, a country highly vulnerable to climate change, also faces substantial child malnutrition challenges. However, comprehensive knowledge on climate change's impacts on child nutrition in Indonesia is limited. This study addresses this gap through a scoping review of the scientific evidence on the effects of climate change on child nutrition in Indonesia.</p><p><strong>Methods: </strong>We developed a conceptual framework based on global literature to guide our systematic search, linking climate change to child nutrition and its determinants in Indonesia. Systematic searches were conducted in English and Indonesian on Scopus, Web of Science and PubMed, supplemented by Google Scholar and citation screening. We included peer-reviewed, Scopus-indexed studies focused on Indonesia, examining either direct or indirect impacts of climate change on child nutrition. A narrative synthesis was performed, structured around outcomes identified in our framework: (1) nutrition-associated conditions, (2) diets and disease, (3) social dynamics and (4) food system shocks.</p><p><strong>Results: </strong>From 3025 records, 134 studies met the inclusion criteria. Studies were either multicountry including Indonesia (23%, n=31), Indonesia-specific across multiple regions (26%, n=35) or region-specific, mainly focused on Java (22%, n=29), Sumatra (11%, n=14), Kalimantan (7%, n=9) and Sulawesi (7%, n=9). Other regions were under-represented (5%, n=7). Most studies used quantitative methods (87%, n=116). Few studies assessed direct links between climate change and nutritional outcomes (n=5), food security or dietary quality (n=7); more focused on indirect pathways such as disease (n=49), social dynamics (n=18) and food system disruptions (n=55).</p><p><strong>Conclusions: </strong>Evidence suggests significant impacts of climate change on child nutrition in Indonesia, highlighting the need for urgent action. Further localised studies that consider contextual factors, and actions focused on strengthening health and nutrition systems, are critical, especially in regions most vulnerable to both climate change and child malnutrition.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655951","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}