BMJ Paediatrics Open最新文献

{"title":"Whole blood lead concentrations in children undergoing autism assessment in a community paediatric clinic: a retrospective cross-sectional study.","authors":"Kirsty Brown, Caroline M Taylor, Richard Lee-Kelland","doi":"10.1136/bmjpo-2024-003268","DOIUrl":"10.1136/bmjpo-2024-003268","url":null,"abstract":"<p><strong>Objective: </strong>To investigate blood lead concentrations (BLCs) in children presenting with autistic spectrum disorder (ASD) and associations with clinical presentation (pica, motor delay, language delay and anaemia), age and social deprivation.</p><p><strong>Setting: </strong>Community-based autism assessment clinics, north Bristol, UK (single-centre, retrospective cross-sectional study).</p><p><strong>Patients: </strong>Children with autism who had BLC measured as part of an autism assessment during a 4-year period from November 2019 to November 2023.</p><p><strong>Main outcome measures: </strong>Data were collected from electronic case notes for children who underwent an assessment for ASD during this period, including diagnoses and investigations.</p><p><strong>Results: </strong>13/102 (13%) children with a diagnosis of autism had BLC ≥0.24 µmol/L, which is above the UK Health Security Agency threshold to trigger further investigation and identification of sources of exposure. Elevated BLC was not associated with the presence of pica or other clinical features including developmental delay.</p><p><strong>Conclusion: </strong>Pica and developmental delay were not useful indicators of children with elevated BLC. Their absence could lead to cases of elevated BLC being missed in children with autism. This lends weight to an argument that lead should be screened for routinely in the preschool autism population alongside other common causes of behavioural difficulties and developmental delay such as anaemia.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582985","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":"Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study.","authors":"Andrei Scott Morgan, Laetitia Marchand-Martin, Sabrina Twilhaar, Julie Blanc, Marie-Laure Charkaluk, Caroline Diguisto, Xavier Durrmeyer, Laurence Foix-L'Helias, Catherine Gire, François Goffinet, Monique Kaminski, Babak Khoshnood, Véronique Pierrat, Jennifer Zeitlin, Pierre-Yves Ancel","doi":"10.1136/bmjpo-2025-003531","DOIUrl":"10.1136/bmjpo-2025-003531","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of intensity of perinatal ('survival-focused') care on outcomes at 5½ years for two groups of survivors: those born at 24-26 and at 27-28 weeks of gestation.</p><p><strong>Design: </strong>Prospective, population-based national cohort.</p><p><strong>Setting: </strong>France, 2011.</p><p><strong>Patients: </strong>Children surviving to 5½ years who were born at <29 weeks gestation.</p><p><strong>Interventions: </strong>Intensity of perinatal care, defined at the hospital level, categorised into three based on the ratio of babies of 24-25 weeks of gestation admitted into neonatal intensive care to the number of fetuses alive at maternal admission to hospital subsequently delivered at 24-25 weeks gestation.</p><p><strong>Main outcome measures: </strong>Neurodevelopmental disability (NDD-none, mild, moderate or severe) comprising cognitive, behavioural, sensory and motor abilities.</p><p><strong>Results: </strong>Among 3217 births, 472 children born at 24-26 weeks and 633 born at 27-28 weeks survived. At 24-26 weeks, compared with children born in low-intensity hospitals, children born in high-intensity hospitals had the lowest levels of mild (33.9%) and moderate-severe (21.9%) NDD (ORs 0.42, 0.20-0.88 and 0.47, 0.20-1.12, respectively); no difference was found between hospitals of low and medium intensity. At 27-28 weeks of gestation, no differences were seen between hospitals of any intensity level (p=0.75).</p><p><strong>Conclusions: </strong>No evidence was found to support concerns that survival-focused perinatal care is associated with increased long-term NDDs in children born extremely preterm or at a higher gestational age.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567066","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":"Correction: '<i>Respiratory distress in late-preterm neonates: from controversy to consensus - a survey of regional advisory boards and neonatologists in France</i>'.","authors":"","doi":"10.1136/bmjpo-2025-003557corr1","DOIUrl":"10.1136/bmjpo-2025-003557corr1","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567065","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":"Analysis of characteristics of children with unintentional injuries admitted in Pediatric Intensive Care Unit from 2017 to 2022 in Shanghai, China.","authors":"Limin Wang, Xuemei Zhu, Miaomiao Chen, Weiming Chen, Ping Xue, Jicui Zheng, Xiaohong Li","doi":"10.1136/bmjpo-2025-003339","DOIUrl":"10.1136/bmjpo-2025-003339","url":null,"abstract":"<p><strong>Background: </strong>Understanding the patterns of unintentional injuries (UIs) among children admitted to the Pediatric Intensive Care Unit (PICU) is crucial for effective prevention and management. We aimed to explore the demographic, situational and clinical characteristics of children with UIs admitted to the PICU.</p><p><strong>Methods: </strong>We conducted a cross-sectional, retrospective study of patients under 18 with UIs admitted to the PICU of Children's Hospital of Fudan University from October 2017 to December 2022.</p><p><strong>Results: </strong>A total of 395 children were admitted, with a mean (SD) age of 5.6 (3.7) years. Road traffic injuries (RTI) (146 (37%)) and high falls (119 (30.1%)) were dominant. Patients with foreign body injuries had a lower median (Q1, Q3) age of 1.6 (1.1, 1.8) years (P＜0.001). Most UIs occurred when children were alone (318 (80.5%), P＜0.001), during recreation (61 (15.4%), P＜0.001) and indoors (212 (53.7%), P＜0.001). Injury types differed significantly in hospital stay length (P＜0.001) and prognosis (P＜0.001). Compared with RTIs, drowning and poisoning were more likely to result in poor prognosis (drowning OR=9.778 (3.515,28.537), P＜0.001; poisoning OR=3.556 (1.123,10.428), p=0.023).</p><p><strong>Conclusions: </strong>RTIs and high falls were the leading types of children with UIs admitted to the PICU. Injury patterns varied with age, situational characteristics and involved substantial medical costs. Tailored interventions based on injury patterns are essential to improve child safety and well-being.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526353","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":"Epidemiology of early-onset neonatal sepsis in Qatar, 2015-2022: a multicentre retrospective cohort study.","authors":"Anvar Paraparambil Vellamgot, Sajid Thyvilayil Salim, Khalil Salameh, Rajesh Pattu Valappil, Sudheer Babu Kurunthattil Thazhe, Abdurahiman Elikkottil","doi":"10.1136/bmjpo-2025-003534","DOIUrl":"10.1136/bmjpo-2025-003534","url":null,"abstract":"<p><strong>Background: </strong>Early-onset neonatal sepsis (EOS) is an important cause of neonatal morbidity and mortality. The incidence has declined due to intrapartum antibiotic use and improved perinatal care. This study aimed to analyse EOS incidence, pathogen profiles, resistance patterns and neonatal outcomes in Qatar.</p><p><strong>Objectives: </strong>The primary objective was to estimate the incidence and trend of EOS among neonates born in Qatar from July 2015 to December 2022. Secondary objectives included describing risk factors, clinical characteristics and outcomes associated with EOS.</p><p><strong>Methodology: </strong>The study reviewed medical records in three major public hospitals in Qatar to identify EOS cases among live-born infants.</p><p><strong>Results: </strong>The study analysed 179 147 live births (LBs) and identified 157 cases of EOS, with an overall EOS incidence of 0.88 per 1000 LBs. Group B <i>Streptococcus</i> was the most common pathogen (58.6%), followed by <i>Escherichia coli</i> (15.3%). A significant decline in EOS incidence was observed from 2015 to 2022. The overall mortality rate was 13.4%, with the significant predictors being decreasing gestational age, chorioamnionitis and thrombocytopenia. The combined outcome of death and neurodisability was observed in 21% of the cohort.</p><p><strong>Conclusion: </strong>This study highlights an EOS incidence of 0.88 per 1000 LB in Qatar, a rate comparable to high-income countries. The decline in incidence underscores the effectiveness of improved prenatal care and screening. Continued surveillance and enhanced preventive measures are essential to further reduce incidence and improve outcomes for vulnerable newborns.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511520","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":"Eco-anxiety, knowledge and action in primary school-aged children in East London.","authors":"Imogen I Hensler, Khushi Patel, Julia Michalek, Callum Ritchie, Francois van Loggerenberg, Dennis Ougrin, Jennifer Y F Lau","doi":"10.1136/bmjpo-2025-003324","DOIUrl":"10.1136/bmjpo-2025-003324","url":null,"abstract":"<p><p>Eco-anxiety refers to negative feelings around climate change, associated with distress and concern about the future. As there are minimal data on eco-anxiety in pre-adolescent children, here, we measured worries, knowledge and commitment to action in primary school-aged children in East London, an area characterised by high child poverty levels and ethnic diversity. Approximately half of the children worry about and are aware of global warming. We also found a correlation between worries and knowledge, and between worries and taking action. While these data are limited by a cross-sectional design and by the use of single-item self-reports of these constructs, nonetheless, greater engagement of pre-adolescent children in discussions around climate change is called for.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504778","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":"Analysis of parental beliefs and practices leading to excessive screen time in early childhood.","authors":"Priyank Bhutani, Litna A Varghese, Gagan Bajaj, Charul Bhutani, Firoz Khan, Geetha R Menon, Ramesh Chandra Deka, Suvendra Kumar Ray, Siddhartha Sankar Satapathy","doi":"10.1136/bmjpo-2025-003488","DOIUrl":"10.1136/bmjpo-2025-003488","url":null,"abstract":"<p><strong>Background: </strong>Excessive screen time in young children is a growing concern in the digital age. It is important to explore parental beliefs and practices that could shape children's screen time routines.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 3624 parents of children aged 2-5 years from five northern Indian states between July and October 2024. The participants completed a validated questionnaire assessing sociodemographic factors, children's screen time duration, parental beliefs and practices related to screen time regulation (guidelines and enforcement), screen use purposes (eg, feeding, chores) and perceived impacts on child development (eg, social skills, attention, speech/language). Data analysis included χ² tests and multinomial logistic regression to identify associations between variables.</p><p><strong>Results: </strong>Over 60% of the children spent 2-4 hours daily on screens, with no significant associations between weekday-weekend screen time patterns and sociodemographic factors. Multinomial logistic regression revealed that the odds of excessive screen use were greater among children whose parents were unsure of whether restrictions should be set (AOR=3.03 for 4-6 hours), those whose parents did not set screen time limits (AOR=1.64 for 4-6 hours and AOR=2.07 for >8 hours), those whose parents used screens during feeding (AOR=1.82 for 2-4 hours; AOR=2.66 for 4-6 hours, AOR=2.79 for 4-8 hours and 3.54 for >8 hours) and those whose parents did not believe that screen time hindered speech and language development (AOR=1.77 for 2-4 hours and AOR=2.11 for 4-6 hours).</p><p><strong>Conclusion: </strong>Parental factors, including the absence of screen time limits and the cultural use of screens during mealtimes, contribute to excessive screen time. Interventions in India should focus on practical programmes that support parents in managing screen time, tailored to regional and cultural contexts.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494548","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":"Accuracy and utility of newborn foot length screening tools to identify small babies by mothers in Sidama Region, Ethiopia.","authors":"Fitsum Weldegebriel Belay, Fanuel Belayneh Bekele, Rekiku Fikre, Akalewold Alemayehu, Hannah Richards, Andrew Clarke, Sarah Williams, Yohannes Chanyalew Kassa","doi":"10.1136/bmjpo-2025-003371","DOIUrl":"10.1136/bmjpo-2025-003371","url":null,"abstract":"<p><strong>Background: </strong>Simple, low-cost anthropometric screening tools like foot length (FL) can be used to screen for small babies (low birth weight (LBW) or preterm) delivered at home or in facilities where functional weighing scales are unavailable. This study aimed to evaluate the accuracy and utility of newborn FL screening tools to help identify small babies by mothers.</p><p><strong>Methods: </strong>A mixed-method study was conducted at selected health facilities from 15 May to 6 July 2024. The consecutive sample included 396 mother-newborn dyads. Mothers screened newborns using laminated cards and plastic tools with colour codes (green/red) based on a 73 mm FL cut-off. In-depth interviews were also conducted with purposively selected participating mothers. The screening tools' diagnostic accuracy was evaluated by receiver operating characteristic curve analyses.</p><p><strong>Results: </strong>The mean maternal age was 26.9 years. There were 61 (15.4%) LBW and 48 (12.3%) preterm babies. Using the laminated card, mothers classified 39.4% of newborns as having a short foot, while 33.1% were classified as such using the plastic tool. The plastic tool showed LBW identification accuracy of 0.82 area under receiver operating characteristic curve (AUC): 0.82 (95% CI 0.77 to 0.87) compared with the laminated card AUC: 0.75 (95% CI 0.69 to 0.81). For preterm identification, both tools performed similarly (AUC: 0.73-0.74). Compared with the laminated card (81.9% sensitivity and 68.4% specificity), the plastic tool (86.9% sensitivity and 76.7% specificity) would miss fewer LBW babies and reduce unnecessary referrals. The qualitative findings also suggested that a smooth surface, footprint picture, colour codes and heel holder can increase acceptability and utilisation of the FL screening tools.</p><p><strong>Conclusion: </strong>FL screening tools made from plastic or card with colour codes can be used by mothers to help identify LBW and preterm babies. Area-specific cut-off points, a smooth surface with a footprint picture and a heel holder, should be considered while designing colour-coded FL screening tools.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494547","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":"Advancing early childhood development for children with disabilities and the Global Disability Summit 2025.","authors":"Bolajoko O Olusanya, Olaf Kraus de Camargo, Sheffali Gulati, Shanti Raman","doi":"10.1136/bmjpo-2025-003595","DOIUrl":"10.1136/bmjpo-2025-003595","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483123","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":"Systematic literature review and meta-analysis on therapeutic management of faecal impaction in the paediatric population.","authors":"Morris Gordon, Svetlana Lakunina, Anna de Geus, Aderonke Ajiboye, Ahmer Khan Amran, Merit Tabbers, Marc A Benninga, Amber Balda, Vassiliki Sinopoulou","doi":"10.1136/bmjpo-2025-003483","DOIUrl":"10.1136/bmjpo-2025-003483","url":null,"abstract":"<p><strong>Background: </strong>To date, there is no universally accepted or standardised protocol for management of faecal impaction (FI) in paediatric population. If left untreated, it can lead to serious consequences for the health and well-being of the child. We set out to determine the effectiveness and safety of existing therapeutic interventions for FI in children and identify any gaps occurring in current research.</p><p><strong>Methods: </strong>We have performed a systematic literature review on treatment of FI in paediatric population in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We have included randomised controlled trials (RCTs) on all interventions for children (0-18 years old) with FI on background of functional constipation and excluded children with organic causes of FI. Our primary outcomes were treatment success, defecation frequency and withdrawals due to adverse events. We have performed a meta-analysis of the data.</p><p><strong>Results: </strong>Out of 13 341 records identified, only eight RCTs met our inclusion criteria with a total of 513 participants randomised. The diagnosis of functional constipation was mainly made using ROME III criteria. The diagnosis of FI varied from study to study. We identified several intervention groups based on our search. Our analysis has shown that there is no difference probably between PEG (Polyethylene Glycol).and PEG with sodium picosulphate, and there may be no difference between PEG and rectal enema for treatment success, but enema may lead to greater stool frequency. No other studies produced anything other than very low certainty evidence.</p><p><strong>Conclusions: </strong>No therapeutic approach was superior to others, with evidence limited by significant clinical heterogeneity related to varying patient and clinical factors, different outcome measures and limited study numbers. More high-quality research is needed to determine effective strategies for FI. Moreover, a consensus should be reached regarding the definition and diagnosis of FI as based on that a standardised approach to patient's care can be determined.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367869","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}