BMJ Paediatrics Open最新文献

{"title":"Neonatal unit admission and offspring mental health trajectories across childhood and adolescence: a nationally representative UK cohort study.","authors":"Madura Nandakumar, Gemma Lewis, Glyn Lewis, Francesca Solmi, Ramya Srinivasan","doi":"10.1136/bmjpo-2024-003092","DOIUrl":"10.1136/bmjpo-2024-003092","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the associations between neonatal unit admission (NNU) and subsequent emotional and behavioural difficulties during childhood and adolescence.</p><p><strong>Design: </strong>Longitudinal general population cohort study.</p><p><strong>Setting: </strong>The Millennium Cohort Study: nationally representative UK-based cohort.</p><p><strong>Participants: </strong>All children with exposure, outcome and confounding data.</p><p><strong>Exposure: </strong>NNU admission was identified at 9 months by asking parents whether their baby was 'taken to special care or neonatal or intensive care unit after birth'.</p><p><strong>Main outcome measures: </strong>Emotional and behavioural problems were assessed using the Strengths and Difficulties Questionnaire when children were 3, 5, 7, 11, 14 and 17 years. We explored the association between NNU admission and trajectories of emotional and behavioural problems using multilevel models with growth curves for outcome data between 3-17 years and adjusted for a broad range of confounders.</p><p><strong>Results: </strong>14 013 participants (48.9% female, 13.7% ethnic minority) were included in the analytical sample. In the sample, mean gestational age was 275.81 (SD): 13.80) days, and mean birth weight was 3.36 kg (SD=0.58). 1273 (9.1%) participants had an NNU admission. The latter was associated with increased emotional difficulties (mean difference (MD) 0.13, 95% CI 0.045 to 0.22, p=0.003) and peer problems (MD 0.11, 95% CI 0.026 to 0.19, p=0.010) during childhood in fully adjusted models. There was no evidence that NNU admission was associated with conduct problems (MD 0.013, 95% CI -0.062 to 0.088, p=0.732) or hyperactivity symptoms (MD 0.042, 95% CI -0.070 to 0.15, p=0.452).</p><p><strong>Conclusions: </strong>Children admitted to NNUs at birth are more likely to experience emotional difficulties and peer problems during childhood. These differences are apparent from early childhood continuing into adolescence and strengthen the case for a calm NNU environment with parental visits and mental health support, and early interventions for children admitted to NNUs.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058023","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":"Randomised feasibility study of an intestinal adsorbent in acute diarrhoea in The Gambia.","authors":"Paul Rahden, Abdoulie Fatty, Momodou Lamin Jobarteh, Abdoulwahab Sallah, Ebrahim Jaiteh, Angela Allen, Doreen Umoh, Fanta Bass, Matthew Dodd, Carol Howell, Elena Markaryan, Radovan Hnatič, Stephen Allen","doi":"10.1136/bmjpo-2024-003133","DOIUrl":"10.1136/bmjpo-2024-003133","url":null,"abstract":"<p><strong>Background: </strong>Diarrhoea remains a leading cause of death in children. An intestinal adsorbent may reduce diarrhoea duration and severity.</p><p><strong>Methods: </strong>Randomised controlled feasibility trial with two phases: phase 1 (0-4 hours and double-blind) and phase 2 (up to 5 days and open-label). 50 children aged 6-59 months with acute diarrhoea presenting with no or some dehydration to the emergency paediatric unit and outpatient clinic at Edward Francis Small Teaching Hospital, Banjul, The Gambia were randomised to either standard treatment (oral rehydration fluid and zinc) or standard treatment with polymethylsiloxane polyhydrate for up to 5 days.</p><p><strong>Results: </strong>Recruitment was completed in 7 months. All but one child completed the study. There were no major protocol deviations although patient-held diaries did not collect reliable information. Time from randomisation to the last watery stool (primary outcome) was shorter in the intervention than control arm (mean difference -19.3 hours, 95% CI -30.9 to -7.8). Stool frequency was lower in the intervention arm on days 2 (95% CI -0.8 to -1.3 to -0.3) and 3 (95% CI -0.8; -1.3 to -0.3). One serious event (death) occurred in the control arm.</p><p><strong>Conclusions: </strong>A randomised, controlled trial is feasible. Further clinical trials are warranted to confirm the efficacy of polymethylsiloxane polyhydrate in acute diarrhoea and inform management guidelines.</p><p><strong>Trial registration number: </strong>PACTR202302683128875.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036407","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":"Exceeding the limits of paediatric heat stress tolerance: the risk of losing a generation to climate inaction.","authors":"Alexander Azan, Sulani Nyimbili, Oyinkansola O Babayode, Anna Bershteyn","doi":"10.1136/bmjpo-2024-002883","DOIUrl":"10.1136/bmjpo-2024-002883","url":null,"abstract":"<p><p>Greenhouse gas (GHG) emissions are creating unprecedented climate-driven extreme weather, with levels of heat and humidity surpassing human physiological tolerance for heat stress. These conditions create a risk of mass casualties, with some populations particularly vulnerable due to physiological, behavioural and socioeconomic conditions (eg, lack of adequate shelter, limited healthcare infrastructure, sparse air conditioning access and electrical grid vulnerabilities). Children, especially young children, are uniquely vulnerable to extreme heat-related morbidity and mortality due to factors including low body mass, high metabolism, suboptimal thermoregulatory mechanisms and behavioural vulnerabilities. Children are also uniquely vulnerable to non-fatal heat-related morbidities, including malnutrition due to agricultural disruptions and cardiometabolic, respiratory and mental illnesses from heat exposure and/or confinement during heat avoidance. Climate mitigation through GHG reductions is central to reducing harms to children and preventing the loss of a generation to climate change. In regions most predisposed to extreme heat-driven mass casualties under various GHG emission scenarios-particularly South Asian and Southwest Asian and North African regions-adaptation tools specific to children's needs are the most urgently needed. Existing public health interventions (eg, cooling infrastructure and preventative educational campaigns) to reduce acute heat mortality, and medical infrastructure capacity to treat heat-related illnesses are currently inadequate to meet children's growing heat resiliency needs. Paediatricians and other clinical and community child healthcare providers in these regions lack education about children's heat risks and adaptation tools. Paediatricians and other child healthcare providers have a crucial role in research, education, clinical practice and advocacy to protect children during extreme heat events. Paediatricians, other child healthcare providers and stakeholders of children's well-being are urged to act on young children's behalf and to elevate youth leadership in GHG mitigation and extreme heat adaptation policy-making.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021979","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":"Neurodevelopmental outcomes after infant heart surgery for congenital heart disease: a hospital-based multicentre prospective cohort study from India.","authors":"Manu Raj, Amitabha Chattopadhyay, Saurabh Kumar Gupta, Shreepal Jain, Usha M K Sastry, Remya Sudevan, Meenakshi Sharma, Pragati Pragya, Roopa Shivashankar, Abish Sudhakar, Anjana Radhakrishnan, Sana Parveen, Sakshi Patil, Shamika Naik, Shilpa Das, Raman Krishna Kumar","doi":"10.1136/bmjpo-2024-002943","DOIUrl":"10.1136/bmjpo-2024-002943","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disability is a common long-term concern following surgery for congenital heart disease (CHD). Little information is available from low-resource environments where the majority of children with CHD are born. Several challenges in the CHD care continuum exist in such environments.</p><p><strong>Methods: </strong>We followed 1346 infants who were operated for CHD using cardiopulmonary bypass from five paediatric cardiac programmes across India. The neurodevelopmental assessment was done using the Developmental Assessment Scale for Indian Infants (DASII) at 6 months after surgery.</p><p><strong>Results: </strong>A total of 1145 (94.8%) infants were alive at 6 months and 127 (11.1%) were lost to follow-up. The mean age of participants at baseline was 5.2 (3.6) months. The mean motor developmental quotient (DMoQ) and mental developmental quotient (DMeQ) of the remaining 1018 infants were 81.8 (69.5, 93.0) and 87.7 (77.1, 95.7), respectively. A total of 262 (25.7%) infants had motor developmental delay and 157 (15.4%) had mental developmental delay. Syndromic association, younger age at surgery, duration of mechanical ventilation and head circumference were significantly associated with DMoQ. The DMeQ was associated with syndromes, duration of hospital and intensive care unit stay and socioeconomic status. The preoperative condition did not impact mental and motor development. Motor clusters with maximum delay included body control and locomotion. Mental clusters with maximum delay included reaching and manipulation, social interaction-imitative behaviour and vocabulary comprehension.</p><p><strong>Conclusions: </strong>Survivors of infant heart surgery experience significant motor and mental neurodevelopmental delay. This delay is associated with similar factors reported by earlier studies. As more high-risk infants undergo cardiac surgery in low-resource settings, a growing population will require significant societal resources for neurodevelopmental assessment as well as neurodevelopmental rehabilitation. These resources include trained personnel for comprehensive developmental assessment of survivors of CHD surgery, as well as infrastructural requirements for dedicated assessment rooms in centres providing surgical care for CHD patients.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021982","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 of engaging parents attending an adult weight management programme with child weight management support: a mixed methods study.","authors":"Ruth Mears, Aidan Searle, Deborah Sharp, Russell Jago, Julian Ph Shield","doi":"10.1136/bmjpo-2024-002975","DOIUrl":"10.1136/bmjpo-2024-002975","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether parents' attendance at a commercial adult weight management programme (WMP) offers an opportunity to identify and signpost families to child weight management support, if appropriate to a child's weight status.</p><p><strong>Design: </strong>Mixed methods study including a cross-sectional online survey and semistructured telephone interviews.</p><p><strong>Setting and participants: </strong>Parents attending Slimming World (UK-based adult commercial WMP), with one or more children aged 5-11 years, were invited to take part. There were 396 survey and 18 telephone interview participants.</p><p><strong>Results: </strong>Most parents (78%) attending the adult WMP and worried about their child's weight were receptive to being offered support for their child. Nearly all (98%) of these parents were happy for the adult WMP to signpost to this support. Nearly half of parents (47%, n=122/262) not worried about their child's weight were still interested in a child height and weight check. The preferred intervention format and delivery possibilities differed among parents, with 'no-one size fits all', while recognising that change takes time, and weekly sessions may be too frequent. Parents were clear that the focus of support should be on healthy lifestyle not weight. Many parents felt a parent 'peer support' group would be helpful.</p><p><strong>Conclusions: </strong>Parents actively addressing their own weight, through an adult WMP, are receptive to being offered and signposted to support for their child, where they have concerns about their child's weight. These findings support a new referral pathway into child weight management services, through parents attending an adult WMP.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999358","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":"Study protocol for the development and pilot-testing of a Self-assessment tool for the implementation of the European Standards of Care for Newborn Health (ESCNH).","authors":"Julia Hoffmann, Sarah Lehmann, Gina Ancora, Helmut Hummler, Nicholas Lack, Dietmar Schlembach, Esther Schouten, Ilaria Simonelli, Ylva Thernström Blomqvist, Eleni Vavouraki, James Webbe, Luc J I Zimmermann, Silke Mader, Isabel Geiger","doi":"10.1136/bmjpo-2024-003008","DOIUrl":"10.1136/bmjpo-2024-003008","url":null,"abstract":"<p><strong>Introduction: </strong>In Europe, disparities exist in having access to optimal neonatal care. With the European Standards of Care for Newborn Health (ESCNH), evidence-based reference standards are available which provide guidance to improve the care for preterm and ill newborns. To support healthcare professionals (HCPs) and hospital/clinic management in identifying the extent of ESCNH implementation, a feasible assessment tool is required. Such a tool should help identify areas in need of improvement and provide clear recommendations for action. We aim to develop a digital self-assessment tool for HCPs to detect the local level of ESCNH fulfilment and identify areas in need of improvement, and thus provide recommendations for action.</p><p><strong>Methods and analysis: </strong>The self-assessment tool will have the form of a digital questionnaire with condensed ESCNH content. A Project Expert Group provides scientific input. With pretesting among HCPs, a template of a questionnaire section is evaluated and adapted accordingly. The subsequently developed full questionnaire will be appraised within a two-round eDelphi survey by at least 50 invited HCPs. Statements and formulations need to be accepted by at least 80% of participants. The remaining discrepancies will be solved in a final workshop. The resulting digital self-assessment tool (SAT) will be translated into several languages and evaluated in a pilot-testing among at least 20 hospitals/clinics across Europe.</p><p><strong>Conclusion: </strong>With the self-reflection through the SAT, HCPs, hospital/clinic managers, policymakers and other stakeholders will receive feedback on the conformity with the ESCNH and guidance for improvement.</p><p><strong>Trial registration number: </strong>NCT06379828.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999724","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":"Neighbourhood socioeconomic conditions and emergency admissions for ambulatory care sensitive conditions in children: a longitudinal ecological analysis in England, 2012-2017.","authors":"Courtney Franklin, Kate Mason, Lateef Akanni, Konstantinos Daras, Tanith Rose, Bernie Carter, Enitan D Carrol, David Taylor-Robinson","doi":"10.1136/bmjpo-2024-002991","DOIUrl":"10.1136/bmjpo-2024-002991","url":null,"abstract":"<p><strong>Background: </strong>Ambulatory care sensitive conditions (ACSCs) are those for which hospital admission could be prevented by interventions in primary care. Children living in socioeconomic disadvantage have higher rates of emergency admissions for ACSCs than their more affluent counterparts. Emergency admissions for ACSCs have been increasing, but few studies have assessed how changing socioeconomic conditions (SECs) have impacted this. This study investigates the association between local SECs and emergency ACS hospital admissions in children in England.</p><p><strong>Methods: </strong>We examined longitudinal trends in emergency admission rates for ACSCs and investigate the association between local SECs and these admissions in children over time in England, using time-varying neighbourhood unemployment as a proxy for SECs. Fixed-effect regression models assessed the relationship between changes in neighbourhood unemployment and admission rates, controlling for unmeasured time-invariant confounding of each neighbourhood. We also explore the extent to which this relationship differs by acute and chronic ACSCs and is explained by access to primary and secondary care.</p><p><strong>Results: </strong>Between 2012 and 2017, paediatric emergency admissions for acute ACSCs increased, while admissions for chronic ACSCs decreased. At the neighbourhood level, each 1% point increase in unemployment was associated with a 3.9% and 2.7% increase in the rate of emergency admissions for acute ACSCs, for children aged 0-9 years and 10-19 years, respectively. A 2.6% increase in admission rates for chronic ACSCs was observed, driven by an association in 0-9 years old. Adjustment for primary and secondary care access did not meaningfully attenuate the magnitude of this association.</p><p><strong>Conclusions: </strong>Increasing trends in neighbourhood unemployment were associated with increases in paediatric emergency admission rates for ACSCs in England. This was not explained by available measures of differential access to care, suggesting policy interventions should address the causes of unemployment and poverty in addition to health system factors to reduce emergency admissions for ACSCs.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999419","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":"Management of infants presenting with fever: a review of pan-London hospital guidelines and national guidelines.","authors":"Stephanie Haberman, Basma Haroun, Alexia Prol Alvarez, Suchika Garg, Ruud Nijman","doi":"10.1136/bmjpo-2024-002970","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002970","url":null,"abstract":"<p><p>Febrile infants often have self-limiting conditions. Differentiating them from infants with serious bacterial infections can be challenging. We aimed to understand how febrile infants are managed across London, by analysing the management steps from local clinical practical guidelines (CPGs) and comparing them to the national guideline 143 (NG143). The ten hospitals using local CPGs recommended doing blood tests for febrile infants and often had more cautious advice about performing lumbar punctures and starting antibiotics. All CPGs scored lower on quality, as per AGREE-II tool, when compared with NG143. CPGs giving more cautious advice, exposes more infants to invasive investigations and treatments.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999399","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":"Exploring survival rates in HIV-infected Ethiopian children receiving HAART: a retrospective cohort study.","authors":"Yimam Getaneh, Yared Dejene, Birhanemeskel T Adankie, Siti Qamariyah Khairunisa, Dominicus Husada, Kuntaman Kuntaman, Maria Inge Lusida","doi":"10.1136/bmjpo-2024-003022","DOIUrl":"10.1136/bmjpo-2024-003022","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown a high rate of mortality among adults despite the introduction of highly active antiretroviral therapy (HAART). However, long-term outcomes of HAART among children remain poorly documented in Ethiopia. This study aimed to estimate the survival rate and identify associated factors among HIV-infected children on antiretroviral therapy.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted from August to December 2022 in 13 health facilities (HFs) using records of 554 children (<15 years old) initiating HAART from 2007 to 2019. HFs were selected using probability proportional to the size of patients. Survival rate and predictors of mortality were estimated using Kaplan-Meier and Cox-proportional hazards, respectively. The analysis was done using STATA V.16.0.</p><p><strong>Result: </strong>Overall mortality among HIV-positive children taking HAART in Ethiopia in 12-year follow-up was 25.5%. Moreover, the mortality rate was 24 per 100 child-year observation. Survival during the median 9.65 (95% CI=9.30 to 10.00) years of follow-up was 0.50. There was a significant drop in the survival rate from the 6th year of follow-up (0.96) to the 8th year (0.78) till the 12th year (0.18). By the end of the follow-up period, 172 (23.69%) were lost to follow-up. There was a high risk of mortality among female (adjusted HRs (AHRs) (95% CI) =1.35 (1.14 to 1.65)), those with poor adherence (AHR (95% CI) =1.29 (1.13 to 1.35)), CD4 count of ≤200 cells/mm³ (AHR (95% CI) =1.75 (1.33 to 2.30)) and baseline haemoglobin≤12 g/dL (AHR (95% CI) =1.8 (1.66 to 1.98)).</p><p><strong>Conclusion: </strong>The significant drop in the survival rate as of the 6th year follow-up and the high loss rate to follow-up call for programme attention. Close follow-up of children with low CD4 count, low haemoglobin and poor adherence could help improve survival.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999335","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":"Transition-to-home arrangements for very preterm infants and related parental needs at perinatal centres in Austria and Switzerland: a cross-sectional multicentred study.","authors":"Laura Ebner, Lea Buehrer, Simone Kistler, Ulla Jochumsen, Ulrike Held, Beatrice Latal, Ursula Kiechl-Kohlendorfer","doi":"10.1136/bmjpo-2024-003017","DOIUrl":"10.1136/bmjpo-2024-003017","url":null,"abstract":"<p><strong>Introduction: </strong>The current study aims to give an overview of transition-to-home services provided by perinatal centres in Austria and Switzerland and to evaluate parental satisfaction with the care provided.</p><p><strong>Methods: </strong>This cross-sectional multicentred study was conducted by performing two surveys between May 2022 and November 2023: one among all level III perinatal centres in Austria (n=7) and Switzerland (n=9) (institutional survey) and one among parents of very preterm infants treated at one selected perinatal centre in each of the two countries (parental survey). Both questionnaires consisted of matching questions focusing on current transition-to-home services.</p><p><strong>Results: </strong>All perinatal centres participated in the institutional survey and 61 out of 84 parents completed the parental questionnaire (response rate 72.6%). The discharge process to home was identified as a multidisciplinary effort involving various healthcare professionals with discrepancies in responses within and between institutional and parental questionnaires. Certain disparities were observed in the timing of discharge conversations between healthcare providers and parents. Most physicians mentioned initiating discharge discussions while the child was still in the intensive care unit, but only 14.8% of parents recalled these early conversations. One-fourth of perinatal centres actively contact patients after discharge. So far, video consultations or mobile applications have not been offered. While 95.1% of parents expressed satisfaction with the care received, there were concerns about contradictory medical information, particularly regarding breastfeeding.</p><p><strong>Conclusion: </strong>The transition-to-home process for very preterm infants presents several opportunities for improvement, especially concerning communication between healthcare providers and parents, lactation counselling services and the timely outreach to parents shortly after discharge. The findings of the current study may further improve this transition process and might aid in the development of a standardised programme that is tailored to parental needs.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999736","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}