BMC Pediatrics最新文献

{"title":"Dental anxiety in cooperative preschool children during their first dental visit to the pediatric dentistry department: a cross-sectional study.","authors":"Alaa Snobar, Chaza Kouchaji, Jamila Bchara","doi":"10.1186/s12887-026-07393-2","DOIUrl":"10.1186/s12887-026-07393-2","url":null,"abstract":"<p><strong>Background: </strong>Dental fear and anxiety (DFA) is a psychological response ranging from mild apprehension to severe phobia of dental procedures, affecting children and adolescents. Its prevalence is highly variable globally, influenced by culture, family conditions, personality traits, and assessment tools.This study aimed to assess dental anxiety levels in cooperative children aged 4-6 during their first dental visit using both self-reported and physiological measures.</p><p><strong>Methods: </strong>A cross-sectional study included 100 children attending a pediatric dental clinic for the first time. The sample was collected from patients visiting the pediatric dentistry department in the faculty of dentistry. Self-reported anxiety was assessed using the Facial Image Scale (FIS), and pulse rate was recorded as a physiological indicator.</p><p><strong>Results: </strong>The sample comprised 44% males and 56% females. No significant differences were found among age and gender groups for FIS scores (p = 0.162, p = 0.811) or pulse rate in age groups (p = 0.552), but females exhibited significantly higher pulse rates than (mean 106.93vs. 95.52 bpm, p = 0.007).</p><p><strong>Conclusion: </strong>Dental anxiety is similar across ages 4-6 during the first visit, with girls showing higher physiological indicators. Monitoring both self-reported and physiological measures is essential, Future studies should include non-cooperative children and assess pulse rate at multiple time points to better distinguish situational arousal from dental anxiety.</p><p><strong>Clinical trial registration number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morquio A syndrome associated with bilateral hydroureteronephrosis and neurogenic bladder: a rare case report and review of the literature.","authors":"Bablu Kumar Gaur, Shreya Gupta, Ishfaq Ahmad Pir, Shreyashi Jain","doi":"10.1186/s12887-026-07330-3","DOIUrl":"10.1186/s12887-026-07330-3","url":null,"abstract":"<p><strong>Background: </strong>Morquio syndrome is a lysosomal storage disorder that damages several organs due to mucopolysaccharide accumulation in cells and tissues. Here, we highlight a case of Morquiosyndrome associated with hydroureteronephrosis and neurogenic bladder.</p><p><strong>Case presentation: </strong>An 8-year-old girl presented with a 5-year history of skeletal deformities, followed by urinary dribbling, nocturnal enuresis, and intermittent fever for the past 6 months. Physical examination revealed classical features of mucopolysaccharidosis, a suprapubic bulge, and lower limb weakness. Urine microscopy demonstrated pyuria. Abdominal ultrasonography showed bilateral gross hydroureteronephrosis with an overdistended bladder. Magnetic resonance urography confirmed bilateral gross hydroureteronephrosis with dilated, tortuous ureters. MRI of the whole spine revealed severe spinal canal stenosis at C2-3 and D10-11, along with platyspondyly. Enzyme assay demonstrated a markedly reduced level of N-acetylgalactosamine-6-sulfatase. Due to financial constraints, the parents declined spinal surgery. The patient was managed with clean intermittent self-catheterization (CISC) for neurogenic bladder.</p><p><strong>Conclusion: </strong>Hydroureteronephrosis and neurogenic bladder are rarely associated with Morquio syndrome. Clinicians should be aware of this rare association with mucopolysaccharidosis. Given that early identification can greatly lower morbidity and death in these individuals. Spinal imaging is necessary in all the case of Morquio syndrome A.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An MRI-based comparative study of pediatric medial epicondyle fractures with and without concomitant elbow dislocation.","authors":"Yi Mei, Qizhi Yao, Jingxian Qiao, Bin Xi","doi":"10.1186/s12887-026-07401-5","DOIUrl":"10.1186/s12887-026-07401-5","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate and compare the Magnetic Resonance Imaging (MRI) characteristics of pediatric medial humeral epicondyle fractures (MHEFs) with and without concomitant elbow dislocation, delineating the extent and complexity of associated injuries to inform clinical management and prognostic assessment.</p><p><strong>Methods: </strong>Preoperative MRI data from 58 pediatric patients undergoing surgery were retrospectively analyzed. Patients were classified into a dislocation group (n = 26) and a non-dislocation group (n = 32). Differences in age, sex, and side of injury were compared using independent t-tests and χ² tests, as appropriate. MRI findings of the medial collateral ligament (MCL), radial collateral ligament (RCL), common flexor tendon (CFT), common extensor tendon (CET), and ulnar nerve were systematically evaluated. Descriptive statistics (percentages and absolute numbers) are emphasized, with p-values reported for exploratory comparisons.</p><p><strong>Results: </strong>The mean age of the dislocation group was 10.0 ± 3.1 years and 11.5 ± 3.1 years of the non-dislocation group (P > 0.05). The incidence of MCL complete tear in the dislocation group (61.5%, 16/26) was significantly higher than in the non-dislocation group (9.4%, 3/32). RCL and CET injury were observed exclusively in the dislocation group (16 cases), with no such injury in the non-dislocation group. CFT injury were relatively common in both groups, occurring in 22 cases in the dislocation group and 30 cases in the non-dislocation group, with no significant difference. The incidence of ulnar nerve injury was higher in the dislocation group (11.5%, 3/26) compared to the non-dislocation group (3.1%, 1/32), but the difference was not statistically significant.</p><p><strong>Conclusions: </strong>In this cohort of surgically treated pediatric MHEFs, MRI demonstrates distinct soft tissue injury patterns between patients with and without elbow dislocation-specifically, a higher frequency of complete MCL tears and lateral-sided injuries in the dislocation group, which can potentially inform treatment planning. However, further research correlating these MRI patterns with clinical outcomes is needed before recommending MRI as a routine guide for management.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and imaging diagnostic challenges of fetus-in-fetu associated with abdominal cryptorchidism: a case report.","authors":"Xianlong Wu, Youqi Chen, Weiming Chen, Yongjuan Wei, Yangming Chen","doi":"10.1186/s12887-026-07405-1","DOIUrl":"10.1186/s12887-026-07405-1","url":null,"abstract":"<p><strong>Background: </strong>Fetus-in-fetu (FIF) is a rare congenital anomaly in which a malformed monozygotic twin is incorporated within its host twin. FIF is usually retroperitoneal, whereas association with an intra-abdominal undescended testis is exceptionally uncommon. Because imaging may show a heterogeneous mass containing soft tissue, fat and calcified elements, FIF can be difficult to distinguish preoperatively from mature teratoma, especially when cryptorchidism is also present.</p><p><strong>Case presentation: </strong>A 3-day-old male neonate was admitted because of jaundice and a palpable right abdominal mass. Physical examination revealed an underdeveloped right hemiscrotum without a palpable right testis; the left testis was palpable and a left hydrocele was suspected. Prenatal ultrasound demonstrated a mixed echogenic mass in the right lower abdomen and raised the possibility of FIF. Fetal magnetic resonance imaging (MRI) and postnatal contrast-enhanced computed tomography (CT) showed a well-circumscribed cystic-solid abdominal mass with fat-like signal/density and multiple calcified stripe-like components, leading to diagnostic uncertainty between FIF and teratoma. Serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) showed no abnormal elevation after interpretation according to neonatal age. Exploratory laparotomy revealed a 5.0 cm x 4.0 cm x 4.0 cm encapsulated cystic-solid mass arising from the right intra-abdominal undescended testis, without identifiable viable right testicular parenchyma. The mass and the atrophic right testicular/epididymal tissue were excised. Gross and histopathological examination demonstrated an organized axial skeleton/spinal structure and multiple differentiated tissues, including brain, intestine, liver, bone, skeletal muscle, skin, and epididymal duct tissue, fulfilling the Willis criterion for FIF.</p><p><strong>Conclusions: </strong>This case highlights a very rare presentation of FIF associated with abdominal cryptorchidism. Recognition of calcified axial skeletal elements, fat components, organoid structures and the relationship to the spermatic cord/testicular structures may help pediatric surgeons and radiologists anticipate FIF rather than misdiagnosing the lesion as a testicular or abdominal teratoma. Complete surgical excision and long-term follow-up with ultrasonography and tumor markers are recommended.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very early onset inflammatory bowel disease in Jordan: a single-center case series of clinical, genetic, and therapeutic features.","authors":"Eyad Altamimi, Hala Almomani, Ayah Alsmadi, Nicole Issi, Maria Shurman","doi":"10.1186/s12887-026-07404-2","DOIUrl":"10.1186/s12887-026-07404-2","url":null,"abstract":"<p><strong>Background: </strong>Very early onset inflammatory bowel disease (VEOIBD), defined as onset before six years of age, is increasingly recognized as a distinct entity often linked to monogenic etiologies. Data from the Middle East remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective case series of ten pediatric patients diagnosed with VEOIBD at King Abdullah University Hospital, Jordan, between July 2017 and July 2024. Clinical, endoscopic, histopathologic, genetic, treatment, and outcome data were extracted and analyzed descriptively.</p><p><strong>Results: </strong>The cohort comprised ten patients (six males, four females). Median age at symptom onset was 12 months (range 3-60), with median diagnosis at 34 months (range 10-72). Diarrhea (100%), failure to thrive (60%), and recurrent infections (40%) were predominant presenting features. Endoscopy revealed mucosal ulceration in seven patients (70%), with non-caseating granulomas in three (30%) and focal active colitis in three (30%). Genetic testing (n = 8) identified pathogenic or likely pathogenic variants in six patients and variants of uncertain significance (VUS) in two; the genes implicated were MEFV (n = 3), CYBB (n = 2; both VUS), G6PC3, GUCY2C, NPC1, NOD2, RIPK1, and LRBA. Three patients carried variants in two genes. In one pair - a homozygous pathogenic NPC1 frameshift variant with a heterozygous NOD2 VUS - a composite digenic mechanism has been proposed as a candidate contributor to the unusually severe VEOIBD phenotype [21]. Therapies included infliximab (n = 4), mesalazine, azathioprine, budesonide, intravenous immunoglobulin, elemental diet, and colchicine. Three patients were referred for hematopoietic stem cell transplantation (HSCT); one died of infection-related multi-organ failure. The patient with a homozygous LRBA VUS lacked access to targeted therapy with abatacept or sirolimus.</p><p><strong>Conclusions: </strong>VEOIBD in Jordan is characterized by early presentation, genetic heterogeneity including co-occurring variants of uncertain significance, and poor response to conventional therapy. Limited access to targeted agents and HSCT significantly impacts outcomes. Early genomic testing, multidisciplinary management, and improved therapeutic access are essential for better prognosis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The course and remission of suicidality from ages 11 to 29: findings from a Dutch population-based longitudinal cohort study.","authors":"Mandy Gijzen, Bertus Jeronimus, Diana van Bergen, Albertine J Oldehinkel","doi":"10.1186/s12887-026-07322-3","DOIUrl":"10.1186/s12887-026-07322-3","url":null,"abstract":"<p><strong>Background: </strong>Suicide is a leading cause of death among adolescents and emerging adults. Suicidality is a multidimensional construct that includes suicidal ideation (SI), self-harm (SH), suicide attempts, and suicide completion, without a fixed or linear progression between these elements. We examined the course of suicidality (SI/SH) over adolescence and young adulthood (age 11-29) and correlates of natural remission and recovery over these 18 years, using the Dutch population-based longitudinal TRAcking Individuals Lives Survey (TRAILS). We examined whether perceived belongingness and social support are associated with recovery from suicidality, for example, as predicted by the Interpersonal Theory of Suicide.</p><p><strong>Methods: </strong>TRAILS followed 2229 adolescents aged 11 (SD = 0.6, 49% women) and we studied to age 29, with 7 waves 2-3 years apart. The prevalence of suicidality and changes therein were quantified using the Adolescent/Youth Self-report (Achenbach system), and we examined potential psychosocial and demographic correlates, such as self-esteem, self-efficacy, temperament/personality, and cognitive style, socioeconomic status, and gender.</p><p><strong>Results: </strong>The correlation between SI/SH increased from early adolescence (age 11 r = ~ .33) to stabilize over mid adolescence (ages 15-29, r = ~ .50). SI was somewhat more common in youth (4.4-8.3%) than SH was (1.9%-5.3%) and peaked earlier in time (SI, age 11) than SH (age 14), and suicidality declined gradually over adolescence and young adulthood. The low base-rate of SI/SH in our prospective general population sample proved a significant barrier to investigate the specific mechanisms of natural recovery in suicidality, as luckily > 90% of youth reported no suicidality.</p><p><strong>Conclusion: </strong>Protective and recovery factors for SI and SH remain difficult to identify, and apparently require general population studies of twenty thousand adolescents or more in the Western world. Complementary risk samples and time series or process approaches, interviews, and psychological autopsy studies can help identify prevention and protective factors to reduce suicidality among youth.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 risk factors for unplanned readmission following acute appendicitis surgery in children.","authors":"Yue Wang, Haiyan Lei, Hongxi Guo, Wu Wang, Huan Li, Hongqiang Bian, Xufei Duan, Qin Guo, Jun Yang","doi":"10.1186/s12887-026-07344-x","DOIUrl":"10.1186/s12887-026-07344-x","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis (AA) is the most common acute abdominal condition in children. The rate of unplanned readmission within 30 days after appendectomy ranges from 4% to 13%, significantly increasing the healthcare burden and affecting patient outcomes. Identifying independent risk factors for readmission is crucial for optimizing management of high-risk pediatric patients; however, relevant evidence in the Chinese pediatric population remains limited.</p><p><strong>Methods: </strong>This study employed a single-center retrospective cohort design, enrolling 5,016 pediatric patients who underwent appendectomy for AA at Wuhan Children's Hospital between July 2013 and February 2025. Perioperative variables were collected via the electronic medical record system, including demographic characteristics, inflammatory markers (WBC, CRP), surgical approach (laparoscopic/open), and appendicitis classification (complicated appendicitis /uncomplicated appendicitis). The primary outcome was unplanned readmission within 30 days after discharge following appendectomy. Multivariate logistic regression analysis was performed to identify independent risk factors (SPSS 27.0), with collinearity diagnostics to ensure model stability. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cutoff values for continuous variables.</p><p><strong>Results: </strong>The overall readmission rate was 2.4% (118/5,016), with 17.8% (21/118) requiring reoperation. Primary readmission causes included intra-abdominal infection (39.8%), intestinal obstruction (36.4%), and surgical site infection(SSI) (17.8%). 71.2% of readmissions occurred within ≤ 14 days post-discharge (median: 11 days). Independent risk factors included open surgery (aOR = 6.92, 95% CI: 3.65-13.13, P < 0.001), CRP ≥ 53.36 mg/L (aOR = 4.28, 95% CI: 2.62-6.98, P < 0.001), complicated appendicitis (aOR = 1.56, 95% CI: 1.03-2.37, P = 0.037), and operative time > 63.5 min (aOR = 1.82, 95% CI: 1.25-2.66, P = 0.002).</p><p><strong>Conclusion: </strong>Open surgery, elevated CRP (≥ 53.36 mg/L), complicated appendicitis, and prolonged operative time are independent risk factors for readmission following pediatric appendectomy. For children exhibiting these high-risk characteristics, individualized discharge follow-up strategies (e.g., early outpatient evaluation, enhanced complication monitoring) are recommended to reduce readmission risk. Future research should develop predictive risk models and validate the effectiveness of intervention measures.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing healthcare anxiety in children with medical play: assessing effectiveness of the teddy bear bash.","authors":"Kayla Jane Joyce, Mackenzie Merrell Macza Heidel, Amanda Hall, Susan A Bobbitt, Wendi Stumborg","doi":"10.1186/s12887-026-07295-3","DOIUrl":"10.1186/s12887-026-07295-3","url":null,"abstract":"<p><strong>Background: </strong>Medical anxiety is common in the pediatric population. Anxiety may trigger persistent negative emotions regarding medical care, cause decreased cooperation during procedures, and lead to higher reports of post-procedure pain. Teddy Bear Hospital (TBH) events may reduce pediatric anxiety related to health care visits by providing exposure to medical professionals and simulating procedures in a play environment. Literature on the effectiveness of such events is currently limited. We aimed to assess the effectiveness of a TBH-modelled event, the Teddy Bear Bash, in reducing pediatric reports of medical anxiety.</p><p><strong>Methods: </strong>In a prospective cohort study, we surveyed 69 parents/guardians and 68 children during attendance at the Teddy Bear Bash in Saskatoon, Saskatchewan. Surveys were completed pre-event, immediately post-event, and 4 weeks after the event. Surveys assessed comfort level with medical care, reasons for medical anxiety, and improvements in either post-event.</p><p><strong>Results: </strong>74.4% of parents/guardians reported subjective improvement in their child's medical anxiety post-event, with 34.9% of these identifying a lasting change at 4-week follow-up. A statistically significant positive change in pediatric reports of feelings towards health care workers was demonstrated post-event (Z = -3.002, p = 0.003). Fears related to medical appointments in the pediatric population were decreased post-event, most markedly in concerns related to receiving an injection (a 31% decrease in percent responses). However, improvement of anxiety-related behaviours during medical appointments post-event was not clearly elicited.</p><p><strong>Conclusions: </strong>Our findings suggest the Teddy Bear Bash is beneficial in promoting subjective reports of decreased medical-related anxiety in children. Exposure to the Teddy Bear Bash encourages a positive change in feelings toward health care workers by pediatric participants. These findings can likely be extrapolated to other TBH-type events.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal risk factors associated with neonatal necrotizing enterocolitis: a meta-analysis and systematic review.","authors":"Lindsey Burnham, Will Lichstein, Alex Lyford","doi":"10.1186/s12887-026-07400-6","DOIUrl":"10.1186/s12887-026-07400-6","url":null,"abstract":"<p><strong>Background: </strong>Neonatal Necrotizing Enterocolitis (NEC) is a multifactorial intestinal disorder that affects 2-5% of premature infants and has a mortality rate of 20-30%. Maternal factors such as breastmilk feeding and antenatal corticosteroid therapy have been found to influence NEC development in infants, yet other maternal and perinatal contributors have not been analyzed in detail. A better understanding of the role of specific maternal factors in NEC development can help identify infants at risk. This meta-analysis aims to investigate the pooled association between Cesarean section delivery, smoking, preeclampsia, chorioamnionitis, diabetes mellitus, and maternal education on the development of NEC.</p><p><strong>Methods: </strong>We systematically searched for journal articles published before April 2025 in Springer Nature Link, Scopus, PubMed, and Google Scholar. Results were narrowed down using the Boolean search string (\"necrotizing enterocolitis\" OR \"neonatal necrotizing enterocolitis\") AND ((\"maternal risk\" OR \"maternal factors\") OR (\"smoking\" OR \"preeclampsia\" OR \"chorioamnionitis\" OR \"diabetes\")). Studies were included if they reported NEC incidence rates for any of the examined factors. Two evaluators independently screened and extracted literature, and disagreements were resolved through discussion. Interrater reliability was assessed using Cohen's Kappa.</p><p><strong>Results: </strong>We identified 74 manuscripts that met the inclusion criteria, of which 26 were suitable for our meta-analysis. We calculated unadjusted ORs from extracted 2 × 2 data, as adjusted estimates were infrequently reported and were not pooled. The unadjusted pooled risk calculation showed a higher odds of NEC for both preeclampsia (OR: 2.11, 95% CI: 1.15-3.06, n = 4) and smoking during pregnancy (OR: 1.97, 95% CI: 1.66-2.28, n = 6). Funnel plots and Egger's regression tests indicated no evidence of publication bias for maternal factors with more than 10 studies.</p><p><strong>Conclusions: </strong>This study highlights a significant pooled unadjusted association between maternal smoking and preeclampsia during pregnancy and the development of NEC. Chorioamnionitis and Cesarean sections alone were not significantly associated with NEC in this pooled unadjusted analysis, despite conflicting claims from other studies. This meta-analysis underscores the need for more research to be conducted to analyze the association between maternal smoking, preeclampsia, Cesarean sections, chorioamnionitis, and maternal education on the development of NEC.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Full Speed Ahead: an intervention for improved activities in daily life through Frame Running and Goal directed training.","authors":"Ann-Christin Eliasson, Kristina Löwing, Emma Hjalmarsson, Cecilia Lidbeck, Agnes Adestedt, Julia Starck, Magnus Aspdahl, Josefin Löwing, Emelie Frisk, Johanna Strand, Annika Ericson, Kristina Andersson, Eva Broström, Ola Kvist, Jessica Norrbom, Ferdinand von Walden","doi":"10.1186/s12887-026-07318-z","DOIUrl":"10.1186/s12887-026-07318-z","url":null,"abstract":"<p><strong>Background: </strong>Early and intensive intervention is crucial for children with cerebral palsy (CP), particularly during the period when gross motor activities typically develop. Despite the prevalence of CP, robust evidence for effective early mobility interventions remains limited. Frame Running, which enables children with limited walking ability to engage in dynamic, high-intensity activities, has emerged as a promising approach, yet research on its effect in young children is currently lacking. The aim of this study is to implement and evaluate the effects of a mobility-focused training program combining Frame Running and goal-directed gross motor training, on mobility in every day life and cardiovascular health in children aged 2-5 years with CP.</p><p><strong>Method: </strong>The study uses a prospective repeated-measures intervention design with assessments conducted during baseline, intervention, and post-intervention follow-up phases. At least 18 children meeting the inclusion criteria (CP diagnosis, age 2-5 years, GMFCS II-IV) will participate. The design consists of three baseline measurements, a 12-week intervention phase and three post-intervention measurements, across approximately 5-6 months. The program combines home-based training and hospital-based group training, with parents as active trainers and therapists providing coaching. Frame Running and goal-directed training are tailored to individual goals, set collaboratively with families. Outcome measures include the Gross Motor Function Measure (GMFM-66), Functional Mobility Scale (FMS), Paediatric Evaluation of Disability Inventory Computerised Assessment Test (PEDI-CAT), time-based mobility tests: ultrasound assessment of muscle size and morphology, gait analysis, accelerometry (7-day activity monitoring), heart rate monitoring during training, and Goal Attainment Scaling (GAS). Feasibility and fidelity will be investigated by questionnaires.</p><p><strong>Discussion: </strong>By evaluating the Full Speed Ahead program, this study aims to improve understanding of how an early intensive family-centered mobility intervention may influence developmental trajectories and health in children with CP. If effective, the findings will have significant implications for planning both short- and long-term treatment and services for young children with CP. The prospective repeated-measures intervention design allows for both group-level and individual-level analysis of changes over time, thereby strengthening the evidence base for early, intensive, family-centered mobility interventions.</p><p><strong>Trial registration: </strong>ClinicalTrial.gov NCTO7374432, Registered November 18 2025.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}