BMJ Paediatrics Open最新文献

{"title":"Feasibility and clinical utility of daytime polysomnography performed in NICU to diagnose sleep disordered breathing in infants.","authors":"Dimple Goel, Andrew Wilson, Anne O'Donnell, Chloe Lappin, Rhiannon Plavsic, Tracey Verstandig, Shripada Rao, Max K Bulsara, Kellie Francis, Catherine Dunstan, Gareth Baynam, Karen Waters","doi":"10.1136/bmjpo-2025-003641","DOIUrl":"10.1136/bmjpo-2025-003641","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and clinical utility of daytime polysomnography (PSG) in infants <3 months of age.</p><p><strong>Methods: </strong>A prospective observational study of a convenience cohort analysing PSGs that were conducted for clinical purposes in infants less <3 months of age, between 1 May 2021 and 31 May 2024. A comparison was made between results for daytime PSG in the neonatal intensive care unit (NICU) and overnight PSG in the sleep laboratory. The type of PSG performed (daytime vs overnight) was based on the workflow of the sleep laboratory. Primary outcomes were successfully completed PSGs (feasibility) and per cent sleep efficiency (clinical utility). Secondary outcomes compared other sleep parameters between groups. Patient and public feedback directly informed the development of the research question and outcome measures.</p><p><strong>Results: </strong>Of 60 PSGs, 28 were daytime and 32 were overnight. Daytime studies had a younger age (median 18 vs 55 days, p<0.001) and shorter median recording time (8.2 vs 10.4 hours, p<0.001). All daytime PSGs were successful, indicating feasibility. After adjusting for age at PSG and total recording time, per cent sleep efficiency was equivalent in the two groups (95% CI -12.4 to 5.7; p 0.456), indicating their clinical utility. For secondary outcomes, daytime PSGs had a higher % rapid eye movement (REM) sleep by 9.9% points (95% CI 1.1 to 18.8; p 0.028) compared with overnight PSG. Parameters that were not different included: frequency of spontaneous arousals, REM latency, sleep latency, Apnoea-Hypopnoea Index and Obstructive Apnoea-Hypopnoea Index. A decline in requests for overnight PSGs and a corresponding increase in daytime PSGs over the course of the study were observed.</p><p><strong>Conclusion: </strong>Daytime PSGs performed in NICU were feasible and provided clinically useful results in infants <3 months of age. Availability of daytime PSGs performed at the infant's bedside expands resource capacity and has the potential for cost savings.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854460","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":"Efficacy of zinc supplementation for young infants with clinical severe infection in Tanzania: study protocol for a randomised controlled trial.","authors":"Karim P Manji, Sarah Somji, Mohamed Bakari, Wafaie W Fawzi, Upendo Kibwana, Rodrick Kisenge, Abuu S Kisumuni, Enju Liu, Neema Mafie, Fredrick A Maleko, Nahya Salim, Christopher P Duggan, Christopher R Sudfeld","doi":"10.1136/bmjpo-2025-003804","DOIUrl":"10.1136/bmjpo-2025-003804","url":null,"abstract":"<p><strong>Introduction: </strong>Innovative interventions will be essential for countries in sub-Saharan Africa to achieve the 2030 Sustainable Development Goal for child mortality. Infections among young infants, including sepsis, meningitis and pneumonia, continue to cause a large burden of morbidity and mortality in low-income and middle-income countries. Zinc is an essential micronutrient with a well-established role in human health and immune system function, and supplementation may improve survival and treatment outcomes for infants with bacterial infections.</p><p><strong>Methods and analysis: </strong>We will conduct an individually randomised, quadruple-blind trial of zinc supplementation among 3250 infants 0-59 days old with clinical severe infection (CSI) in Dar es Salaam, Tanzania. Infants with CSI will be randomised to receive either (1) zinc citrate supplementation consisting of 5 mg elemental zinc taken two times per day for 14 days or (2) a matching placebo supplementation taken two times per day for 14 days. Infants will be followed for 90 days postrandomisation. The coprimary outcomes are (1) infant death (all-cause mortality to 90 days) and (2) treatment failure (composite outcome of death during initial hospitalisation, need for additional respiratory support, use of vasoactive medicines or change of antibiotics). Secondary outcomes include important infant health and nutritional outcomes.</p><p><strong>Ethics and dissemination: </strong>The trial protocol was approved by Harvard T. H. Chan School of Public Health Institutional Review Board, the Muhimbili University of Health and Allied Sciences Institutional Review Board, the National Health Research Ethics Sub-Committee and the Tanzania Medicine and Medical Device Authority. Findings will be disseminated locally, regionally and internationally at scientific conference presentations and as peer-reviewed publications.</p><p><strong>Trial registration number: </strong>NCT06102044; ClinicalTrials.gov identifier.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854443","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":"Leveraging large language models to inform paediatric chronic condition care: a cross-sectional study.","authors":"Syed Furrukh Jamil, Nada N Alshathri, Seham S Alsalamah, Nura A Almansour, Faris S Alsalamah, Tahir K Hameed, Jubran T Alqanatish","doi":"10.1136/bmjpo-2025-003742","DOIUrl":"10.1136/bmjpo-2025-003742","url":null,"abstract":"<p><p>This study assessed how ChatGPT 3.5, ChatGPT 4.0 and Google Gemini perform in providing educational content about coeliac disease and type 1 diabetes mellitus. We analysed 76 frequently asked questions for accuracy, comprehensiveness, readability and consistency. The models delivered highly accurate and comprehensive responses across the board. While ChatGPT 4.0 offered the most readable content, all models struggled with overall readability. Each model maintained consistent performance throughout testing. These results indicate that large language models show promise as supplementary tools for patient education in chronic paediatric conditions, though improvements in readability are needed to enhance accessibility.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854461","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":"Healthcare and productivity loss costs in young adults after bacterial meningitis: a cross-sectional follow-up study.","authors":"Omaima El Tahir, Sanne Vrijlandt, Jelle de Jongh, Rogier C J de Jonge, Sui Lin Goei, Jeroen Pronk, Anne Marceline van Furth","doi":"10.1136/bmjpo-2025-003536","DOIUrl":"10.1136/bmjpo-2025-003536","url":null,"abstract":"<p><strong>Objective: </strong>To determine healthcare and productivity loss costs among young adult survivors of childhood bacterial meningitis (BM).</p><p><strong>Methods: </strong>In this cross-sectional study, online versions of the Institute for Medical Technological Assessment (iMTA) Medical Consumption Questionnaire and the iMTA Productivity Costs Questionnaire were used to measure healthcare consumption and productivity loss costs in young adult survivors of childhood BM. Mean healthcare and productivity loss costs were calculated and the differences in costs across subgroups based on age at onset, sex and causative pathogens were investigated.</p><p><strong>Results: </strong>A total of 454 patients were included in the cost analysis of healthcare utilisation and a total of 471 patients were included in the cost analysis of productivity losses. The 3-month mean societal cost per patient amounted to €4985.32 (median €1363.71, IQR €576.04-€2948.67), of which €4790.84 (median €1125.90, IQR €271.20-€2489.54) was due to productivity losses. Productivity loss costs were significantly higher in survivors of childhood BM caused by <i>Streptococcus pneumoniae</i> compared with survivors of childhood BM caused by <i>Neisseria meningitidis</i>.</p><p><strong>Conclusions: </strong>This study highlights the potential significant economic burden in young survivors of childhood BM and emphasises the possible impact of very long-term sequelae. In particular, very long-term sequelae of BM contribute to indirect costs. To the best of our knowledge, this is the first study to investigate the societal costs of childhood BM over a two-decade follow-up period. Further research into societal costs in young adult survivors of neonatal meningitis is needed to provide additional insights into the economic burden of childhood BM.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844387","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":"Short-term effects of air pollution on childhood respiratory symptoms in general practice: a time-series analysis.","authors":"Mata Sabine Fonderson, Evelien R van Meel, Saskia Willers, P J E Bindels, A Burdorf, A Bohnen, S van den Elshout","doi":"10.1136/bmjpo-2024-002892","DOIUrl":"10.1136/bmjpo-2024-002892","url":null,"abstract":"<p><strong>Objective: </strong>To study the association between air pollutant concentrations and daily general practitioner (GP) consultations for respiratory problems in children in Rotterdam, Netherlands.</p><p><strong>Design: </strong>A time-series study.</p><p><strong>Setting: </strong>General practices in greater Rotterdam.</p><p><strong>Patients: </strong>Children aged 0-17 years registered with participating GPs.</p><p><strong>Exposure: </strong>Daily nitrogen dioxide (NO₂), ozone (O₃), particulate matter ≤2.5 µg/m³ (PM_2.5) and particulate matter ≤10 µg/m³ (PM₁₀) concentrations at GP addresses.</p><p><strong>Main outcomes measured: </strong>Relative risk of respiratory consultations per 10 µg/m³ in pollutant concentration, adjusted for seasonality, pollen, day of the week and temperature.</p><p><strong>Results: </strong>Over 100 000 consultations were analysed between 2015 and 2019. The baseline daily consultation rate was 18.12 per 1000 person-years. Children consulted their GP most frequently for acute upper respiratory infections (AURIs) (4.69 consultations per 1000 person-years), followed by asthma (3.68 consultations per 1000 person-years) and cough (2.31 consultations per 1000 person-years). Our results indicated that exposure to NO₂ was predominantly associated with a decreased risk of GP consultations across most lag periods for all respiratory diseases (ARD), AURIs and asthma. In contrast, exposure to NO₂ was generally associated with increased risk of GP consultations for cough. Conversely, exposure to O₃ was associated with statistically significant increases in risk for ARD across all lag periods. Exposure to PM_2.5 and PM₁₀ showed opposite trends, with reduced risks in GP consultations for ARD and increased risks in consultations for AURI, asthma and cough.</p><p><strong>Conclusions: </strong>Our findings expose a critical paradox on the impact of air pollution. For clinicians counselling families, these results emphasise that 'good' overall air quality days may still pose risks, although effects are small. High O₃ increases total respiratory visits while particulate matter, though appearing protective overall, specifically exacerbates AURIs, asthma and cough. This divergence between total and specific respiratory effects indicates that comprehensive air quality policies must consider pollutant-specific impacts rather than assuming uniform effects.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844388","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":"Cross-cultural adaptation and validation of Neonatal Eating Assessment Tool (NeoEAT)-Paladai/cup feeding in Tamil: a caregiver-reported assessment tool.","authors":"Gopalakrishnan Jayapradha, Prakash Amboiram, Sanjanaa Anand, Deekshitha Akula, Britt Frisk Pados, Lakshmi Venkatesh","doi":"10.1136/bmjpo-2025-003403","DOIUrl":"10.1136/bmjpo-2025-003403","url":null,"abstract":"<p><strong>Background: </strong>Cup feeding is an alternative method to provide nutrition to infants exhibiting difficulties in breastfeeding. Paladai is a cup commonly used to feed milk to infants in several parts of India. Parental reports of infant feeding help address feeding concerns and establish successful oral feeding.</p><p><strong>Method: </strong>This cross-sectional study was conducted in a quaternary care hospital in South India. The NeoEAT-Paladai/cup in Tamil was developed through a systematic process of cross-cultural adaptation and included 64 items. A total of 325 Tamil-speaking mothers of children younger than 7 months who were fed through the paladai exclusively or partially, along with breastfeeding, completed the NeoEAT-Paladai (Tamil).</p><p><strong>Results: </strong>Factor analysis of the responses yielded five subscales with high internal consistency reliability across subscales (α=0.858 to 0.908) and the full scale (α=0.963). Test-retest reliability was high for the full scale (intraclass correlation=0.995). Infants with feeding concerns demonstrated significantly higher total and subscale scores than infants without feeding concerns (p<0.001).</p><p><strong>Conclusion: </strong>The NeoEAT-Paladai (Tamil) allows clinicians and caregivers of Tamil-speaking populations to monitor the feeding behaviours of infants when being fed by paladai.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844386","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":"Oxygenation indices and echocardiographic markers of pulmonary hypertension and ventricular dysfunction in congenital diaphragmatic hernia.","authors":"Talal Altamimi, Mohammed Almahdi, Saleh S Algarni, Saad Alshreedah, Naif Alotaibi, Mohammed Sufyani, Mohanned Alrahili, Abdulrahman Almehaid, Ibrahim Ali, Saif Alsaif, Kamal Ali","doi":"10.1136/bmjpo-2025-003637","DOIUrl":"10.1136/bmjpo-2025-003637","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between early oxygenation indices (oxygenation index (OI) and oxygen saturation index (OSI)) and echocardiographic markers of ventricular dysfunction and pulmonary hypertension in neonates with congenital diaphragmatic hernia (CDH).</p><p><strong>Design: </strong>Single-centre retrospective cohort study.</p><p><strong>Setting: </strong>Level III neonatal intensive care unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia.</p><p><strong>Patients: </strong>A total of 47 neonates with CDH admitted between 2016 and 2024 were included. Infants with major congenital heart disease or chromosomal anomalies were excluded.</p><p><strong>Main outcome measures: </strong>Correlation of OI and OSI within the first 48 hours with echocardiographic markers of ventricular function, pulmonary hypertension and Vasoactive-Inotropic Score (VIS).</p><p><strong>Results: </strong>Among 47 infants, survival was 70%. Survivors had higher left ventricular ejection fraction (M-mode: 61% vs 40%, p=0.010) and more preserved speckle-tracking strain (-17% vs -11%, p=0.006). Non-survivors had elevated right ventricular systolic pressure (RVSP) (68 vs 40 mm Hg, p=0.001), greater systolic eccentricity index (1.9 vs 1.4, p=0.002) and a higher percentage of right-to-left patent ductus arteriosus (PDA) shunting (50% vs 11%, p<0.001). Higher best, mean and highest OI and OSI values were significantly correlated with impaired ventricular function, elevated RVSP and greater right-to-left PDA flow. VIS was strongly correlated with all oxygenation indices, with the strongest correlations observed for mean OSI (r=0.851, p<0.001) and mean OI (r=0.812, p<0.001). Receiver operating characteristic analysis showed that RVSP had the strongest predictive accuracy for survival (area under the curve (AUC) 0.985, sensitivity 98% and specificity 97%), followed by the percentage of right-to-left PDA shunting (AUC 0.847) and left ventricular output (AUC 0.825).</p><p><strong>Conclusions: </strong>Elevated oxygenation indices within the first 48 hours are associated with biventricular dysfunction, pulmonary hypertension and higher inotropic support requirements in CDH. Integration of early oxygenation measures and echocardiographic assessment may enhance risk stratification and guide therapeutic decision-making.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820557","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":"Antibodies against SARS-CoV-2 in children and adolescents: a one-year longitudinal study.","authors":"Luciana de Freitas Velloso Monte, Ana Luiza Rosa Diniz, Cristiane Feitosa Salviano, Agenor de Castro Moreira Dos Santos Júnior, Ricardo Camargo, Isis Maria Quezado Magalhães, Elisa de Carvalho, Valdenize Tiziani","doi":"10.1136/bmjpo-2025-003392","DOIUrl":"10.1136/bmjpo-2025-003392","url":null,"abstract":"<p><strong>Background: </strong>The humoral response to SARS-CoV-2 is not fully understood, especially in children. This study provides valuable insights into the durability of adaptive immunity in paediatric patients who were unvaccinated and naturally infected with the prototype strain of SARS-CoV-2, including those who were asymptomatic or had pre-existing chronic and rare disorders. This study aimed to analyse the antibody response to SARS-CoV-2 during infection and over a 1-year follow-up period in patients aged 0-18 years who were admitted to a tertiary paediatric hospital at the onset of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This is a descriptive, prospective 1-year cohort study carried out in children and adolescents hospitalised for different reasons from July to October 2020 who presented with SARS-CoV-2 infection. Clinical and serological data (total antibody pool) were collected during SARS-CoV-2 infection and throughout the subsequent year.</p><p><strong>Results: </strong>During the study period, 122 patients with confirmed SARS-CoV-2 infection were included. Most patients (85%) had at least one serology assessed and reactive throughout 1-year follow-up, even those with asymptomatic infection or immunosuppressive conditions. The mean antibody titre levels reached their maximum value about 60 days after the initial SARS-CoV-2 infection. By the end of the 1-year follow-up, 72.46% of the 69 assessed individuals still had detectable serum antibodies. Patients with comorbidities and/or immunosuppression conditions had lower median titre levels over the year. Subjects with severe clinical presentation of COVID-19 had higher levels of antibody values at the 1-year time point assessment.</p><p><strong>Conclusions: </strong>This study demonstrated that most subjects presented antibody response against SARS-CoV-2 over 1 year of follow-up, even if they had asymptomatic infection or comorbidities, including patients with immunosuppression. There was a difference in the magnitude and duration of antibody response, lower in patients with comorbidities and longer and higher in subjects who had severe COVID-19 clinical presentation.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820556","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":"Viewpoint: taking a strengths-based approach to developmental disability: the F-words for child development.","authors":"Olaf Kraus de Camargo","doi":"10.1136/bmjpo-2025-003418","DOIUrl":"10.1136/bmjpo-2025-003418","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820558","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":"Mothering from the margins: lived experiences of incarcerated substance-abusing mothers and the developmental risks faced by their children in Sri Lanka.","authors":"Kavinda Dayasiri, Gihan Gunarathna","doi":"10.1136/bmjpo-2025-003750","DOIUrl":"10.1136/bmjpo-2025-003750","url":null,"abstract":"<p><strong>Background: </strong>Children of incarcerated substance-abusing mothers represent a profoundly vulnerable yet under-researched population in low- and middle-income countries (LMICs). In Sri Lanka, the intersection of maternal addiction, incarceration and poverty poses complex threats to child health and development. This study explores the lived experiences of such mothers and the perceived risks their children face.</p><p><strong>Methods: </strong>A qualitative, phenomenological study was conducted using 10 focus group discussions (FGDs) with 48 incarcerated mothers in Sri Lanka's largest female correctional facility. Participants were purposively sampled to ensure diversity in age, drug use history and caregiving experience. Data were collected through structured, audio-recorded FGDs conducted in Sinhala, transcribed, translated and thematically analysed using Braun and Clarke's framework. A second-order analysis was performed to interpret systemic drivers.</p><p><strong>Results: </strong>Five major themes emerged: (1) barriers to healthcare access, (2) intergenerational substance use, (3) social stigma and marginalisation, (4) maternal guilt and psychological burden and (5) coping strategies and resilience. Many mothers described how stigma, fear of withdrawal and trauma hindered timely healthcare for themselves and their children. Substance use was often normalised in their families and workplaces, particularly in contexts of poverty, exploitation and domestic violence. Despite adversity, many participants expressed hope for recovery, supported by kinship networks, particularly maternal figures.</p><p><strong>Conclusions: </strong>Substance use among incarcerated mothers in Sri Lanka is deeply entwined with structural violence, gendered labour exploitation and intergenerational trauma. Child health interventions must be trauma-informed, gender-responsive and family-centred, promoting rehabilitation while safeguarding child development.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798152","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}