BMC Pediatrics最新文献

{"title":"Assessment of bone health and bone mineral density in patients with mucopolysaccharidosis receiving enzyme replacement therapy.","authors":"Nesreen Safwat Abdelrahman El Feil, Yasmine Abuzaid, Amira Mobarak","doi":"10.1186/s12887-026-06870-y","DOIUrl":"10.1186/s12887-026-06870-y","url":null,"abstract":"<p><strong>Background: </strong>Most patients with mucopolysaccharidosis (MPS) experience skeletal involvement due to impaired bone remodeling, glycosaminoglycan (GAG) accumulation, reduced mobility, and nutritional deficiencies. These factors may predispose to low bone mass and increased fracture risk. This study assessed bone mineral density (BMD) using height-adjusted dual-energy X-ray absorptiometry (DXA) in pediatric MPS patients receiving enzyme replacement therapy (ERT) and examined its associations with clinical, functional, and biochemical parameters.</p><p><strong>Methods: </strong>This cross-sectional study included 29 children with biochemically and/or genetically confirmed MPS receiving ERT at Tanta University Hospital. Children under 5 years and ERT-naïve patients were excluded. BMD was measured at the lumbar spine (L1-L4) and femoral neck using DXA and adjusted for height-for-age z-score (HAZ). Clinical data, Katz Activities of Daily Living (ADL) score, anthropometry, and biochemical markers of bone metabolism were recorded. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and two-tailed t-test (p < 0.05).</p><p><strong>Results: </strong>The cohort included 29 patients (19 males, 10 females; mean age 9.79 ± 3.85 years): 13 with MPS IVA, 11 with MPS I, 3 with MPS II, and 2 with MPS VI. Mean HAZ-adjusted BMD z-scores were - 1.84 ± 1.38 (right femur), - 2.07 ± 1.22 (left femur), and - 3.00 ± 1.49 (lumbar spine). Low bone mass for age (HAZ-adjusted z ≤ - 2) was present in 20/29 (68.9%) patients, predominantly affecting the spine. Vitamin D insufficiency/deficiency was observed in 75.9% of patients. Katz ADL score correlated strongly with BMD at all sites, particularly the lumbar spine (r = 0.88, p < 0.001). Total calcium and vitamin D levels showed positive correlations with BMD. Patients with cardiac involvement had significantly lower BMI than those without cardiac disease (p < 0.001).</p><p><strong>Conclusions: </strong>Pediatric patients with MPS receiving ERT show a high prevalence of low bone mass for age, driven by a multifactorial interaction between impaired mobility, nutritional deficiencies, and intrinsic skeletal pathology. Routine height-adjusted DXA monitoring, early physiotherapy, and proactive vitamin D and calcium supplementation should be integrated into comprehensive MPS care.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833547","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":"Using journey mapping to capture parents' experiences across phases of neonatal care: a qualitative study.","authors":"Josephine H L Wagenaar, Crystal Mah, Fredrik Bodell, Gerbrich E van den Bosch, Sylvia A Obermann-Borst, Irwin Km Reiss, Maaike S Kleinsmann, H Rob Taal, Saba Hinrichs-Krapels","doi":"10.1186/s12887-026-06842-2","DOIUrl":"https://doi.org/10.1186/s12887-026-06842-2","url":null,"abstract":"<p><strong>Background: </strong>Neonatal admissions are often lengthy and traumatic for parents, affecting parental and child outcomes. Parents' care experiences are shaped by emotional, informational, and practical factors. Understanding these factors is essential to improve support and outcome.</p><p><strong>Methods: </strong>We used a mixed-methods approach to develop a parental journey map, including: (1) conceptualizing a parental journey map (exploratory research), (2) developing the map (six interviews), (3) iteration (with eight parents), and (4) exploring transfer experiences (eight additional parents).</p><p><strong>Results: </strong>The journey map illustrated parents' transition from feeling powerless to confident caregivers at home. Early phases were dominated by emotional overload and limited cognitive capacity, highlighting the need for dosed, timely and consistent communication, practical information and acknowledgement of their parenting role. As the journey progressed, parents' needs shifted toward continuity of care, trust-building and individualized participation in caregiving, with inconsistencies emerging as key stressors. Transfers between units were a particularly vulnerable phase. Preparations, clear expectations and acknowledgement of prior experiences by all healthcare providers were essential. Parents' experiences varied widely, highlighting the importance of individualized care.</p><p><strong>Conclusions: </strong>This study demonstrates the value of journey mapping in capturing the diverse and evolving needs of parents during the different phases of their neonatal care journey. By highlighting when and how communication, psychosocial support, and parental role acknowledgement are most impactful, these findings provide a structured foundation for designing phase-specific, parent-centered interventions. Our results underline the need for future research across diverse parental backgrounds and time points to inform equitable improvements in neonatal care.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between patent ductus arteriosus and adverse outcomes in preterm infants.","authors":"Yaqi Tang, Xiuxiang Liu, Dongxu Wei, Zhixian Ji, Silin Pan","doi":"10.1186/s12887-026-06966-5","DOIUrl":"https://doi.org/10.1186/s12887-026-06966-5","url":null,"abstract":"<p><strong>Objective: </strong>The impact of patent ductus arteriosus (PDA) and its management on necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) risk in preterm infants remains debated.</p><p><strong>Methods: </strong>The present single-center study enrolled a total of 769 preterm infants with a gestational age of less than 37 weeks. The logistic regression was used to identify independent risk factors for PDA, NEC, and BPD based on maternal conditions during pregnancy, delivery details, and postnatal neonatal characteristics. Furthermore, the present study evaluated the effects of drug treatment for PDA on neonatal outcomes.</p><p><strong>Results: </strong>The incidence of NEC was not associated with the presence of PDA in preterm infants (P = 0.15). However, infants with PDA had a 2.12-fold higher likelihood of developing BPD compared to those without PDA (P < 0.01). Pharmacotherapy for PDA was associated with a 49% lower incidence of NEC and a 59% higher incidence of BPD (P < 0.01). Assisted reproductive technology and maternal diabetes were identified as factors independently associated with PDA in preterm infants. Additionally, infants delivered by cesarean section had a 42% lower incidence of BPD compared to those delivered vaginally (P < 0.01).</p><p><strong>Conclusion: </strong>Pharmacotherapy for PDA was independently associated with a lower risk of NEC but a higher risk of BPD in preterm infants. ART was an independent risk factor for PDA and served as a confounding factor for NEC. Cesarean delivery was independently associated with a lower risk of BPD.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in school-aged boys and girls: longitudinal associations with physical activity and sedentary behaviour in the HAPPY study.","authors":"Katherine L Downing, Borja Del Pozo Cruz, Lauren Arundell, Trina Hinkley, Jo Salmon, Anna Timperio, Kylie D Hesketh","doi":"10.1186/s12887-026-06961-w","DOIUrl":"https://doi.org/10.1186/s12887-026-06961-w","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is positively associated with physical activity (PA) and negatively associated with sedentary time (SED) assessed by self- and proxy-report in children. However, there is a dearth of longitudinal evidence using device-measured PA and SED in this population. This study aimed to examine longitudinal associations of device-measured PA and SED as well as parent-reported screen time with HRQoL in primary (elementary) school-aged boys and girls.</p><p><strong>Methods: </strong>Data from waves 2 and 3 (child ages 6-8 and 9-11y, respectively) of the Healthy Active Preschool and Primary Years (HAPPY) Study were analysed. At wave 2, children wore ActiGraph GT1M accelerometers to assess time in SED and light-, moderate- and vigorous-intensity PA (LPA, MPA and VPA). Parents reported their child's usual screen time (television viewing, computer/internet use, computer/electronic games, handheld electronic games). At wave 3, parents reported their child's HRQoL using the Pediatric Quality of Life Inventory. Mixed-effects linear models were used to assess longitudinal associations of different intensities of PA, SED, and screen time with HRQoL scores. Analyses were stratified by sex of the child and adjusted for child age, BMI z-score and maternal education, with child and preschool/childcare centre of recruitment as random-effects.</p><p><strong>Results: </strong>Boys had less SED and more MPA, VPA, TPA, electronic game use, handheld electronic game use and total screen time than girls (all p < 0.05); there were no sex differences in LPA, television viewing, computer/internet use, or HRQoL scores. For boys, VPA predicted better physical HRQoL (beta [β] = 0.18, 95%CI 0.02, 0.35). For girls, using electronic games predicted lower psychosocial HRQoL (β=-0.09, 95%CI -0.16, -0.01), while handheld electronic games and total screen time predicted lower physical HRQoL (β=-0.19, 95%CI -0.33, -0.06, and β=-0.04, 95%CI -0.07, -0.004, respectively) and total HRQoL (β=-0.12, 95%CI -0.23, -0.01, and β=-0.03, 95%CI -0.05, -0.001, respectively).</p><p><strong>Conclusions: </strong>Higher VPA predicted better physical HRQoL for boys; since boys were more active than girls, girls may not have engaged in sufficient VPA to benefit their HRQoL. Further research is needed to examine specific types of screen use, given the observed detrimental associations with HRQoL for girls.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neck circumference is associated with metabolic syndrome parameters in adolescents with obesity: a cross-sectional study.","authors":"Mehmet Cengiz","doi":"10.1186/s12887-026-06949-6","DOIUrl":"https://doi.org/10.1186/s12887-026-06949-6","url":null,"abstract":"<p><strong>Background: </strong>Neck circumference (NC) is a practical anthropometric measure for assessing obesity in youth, but its association with metabolic syndrome (MetS) components remains underexplored. This study evaluated the relationship between NC and MetS parameters in adolescents with obesity, using both standard International Diabetes Federation (IDF) criteria and expanded definitions incorporating insulin resistance.</p><p><strong>Methods: </strong>In this cross-sectional study, 48 adolescents with obesity and 41 age- and sex-matched controls were recruited from a tertiary pediatric clinic. Anthropometric data (BMI, waist circumference, NC) and fasting blood samples (glucose, insulin, HDL cholesterol, triglycerides) were collected. MetS was diagnosed using IDF criteria and an expanded definition including hyperinsulinemia or elevated HOMA-IR. The Pediatric siMS (PsiMS) score quantified metabolic risk.</p><p><strong>Results: </strong>NC was significantly greater in the obesity group than in controls (mean ± SD: 37.95 ± 3.03 cm vs. 31.86 ± 3.30 cm, p < .001). MetS prevalence was 14.6% by IDF criteria, rising to 43.8% with expanded criteria. In adolescents with obesity, NC positively correlated with fasting insulin, HOMA-IR, triglycerides, systolic blood pressure, and PsiMS score (p < .05 for all). NC was also associated with the total number of MetS criteria met under both diagnostic approaches.</p><p><strong>Conclusions: </strong>NC is a reliable, non-invasive marker correlated with key metabolic risk factors in adolescents with obesity. Its routine use could aid early detection of metabolic risk, particularly in resource-limited settings. Longitudinal research is needed to define NC thresholds and its predictive value for long-term outcomes.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time poverty of families of children with 22q11DS: a healthcare professional perspective.","authors":"Sophie Ayoub, Eva De Clercq, Sandra Meier, Ann Swillen, Cheryl Cytrynbaum, Luzius A Steiner, Holly Carbyn, Bernice S Elger","doi":"10.1186/s12887-026-06836-0","DOIUrl":"https://doi.org/10.1186/s12887-026-06836-0","url":null,"abstract":"<p><strong>Introduction: </strong>22q11 deletion syndrome (22q11DS) is the most common microdeletion in humans, leading to a wide range of variable clinical manifestations that can affect any part of the body. Most individuals with 22q11DS are diagnosed during childhood and the responsibility of care falls on their primary caregivers, usually their parents, who need to balance the needs of all family members including themselves. This affects parental wellbeing. This study investigates the perspective of healthcare professionals (HCPs), in Europe and Canada, on the parents' struggle with time invested in caring for their children, factors contributing, the impact of this responsibility and some strategies on how to support the families.</p><p><strong>Methods: </strong>This interview study was part of a larger research initiative aimed at improving the psychosocial well-being of individuals with 22q11DS and their families. The qualitative component concentrated on gathering insights from HCPs involved in patient care. We conducted qualitative content analysis after transcribing the semi-structured interviews. The research question focused on time poverty within families caring for a child with 22q11DS from the perspective of HCPs.</p><p><strong>Results: </strong>The 20 HCPs interviewed came from diverse professional backgrounds, but all had clinical experience with children with 22q11DS. Our analysis of the data identified three primary themes, centered on time poverty of families caring for a child with 22q11DS. Centralization of care and insufficient coordination were the main modifiable reasons for the time struggle, affecting the families, especially mothers and families living in rural areas. Strategies proposed to mitigate this issue included improved coordination and decentralization of care, and digitalization.</p><p><strong>Conclusions: </strong>Time poverty for families with a child with 22q11DS may result from fragmented and uncoordinated medical care, and centralized care disconnected from local care. Better communication between different HCPs, local and central, and a robust support system could enhance these families' well-being and assure an equal distribution of care services without gender bias or exclusion of rural underserved populations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and clinical features of food allergy in preschool children in Taizhou, China: a cross-sectional study.","authors":"Jiangyin Sheng, Yan Hong, Yandan Yin, Jingjing Jin, Yingying Xu","doi":"10.1186/s12887-026-06959-4","DOIUrl":"https://doi.org/10.1186/s12887-026-06959-4","url":null,"abstract":"<p><strong>Background: </strong>Food allergy (FA) is an increasing public health concern in children, but epidemiological data in Chinese preschoolers remain limited. We investigated the prevalence and clinical characteristics of FA among children aged 3-6 years in Taizhou, China.</p><p><strong>Methods: </strong>In this cross-sectional survey (February-March 2023), stratified cluster sampling was used to recruit children from 56 kindergartens across nine districts/counties in Taizhou. Parents/guardians completed a standardized questionnaire. Children with suspected FA underwent follow-up interviews and SPT and/or sIgE testing; FA was classified as clinically presumed based on compatible history plus SPT/sIgE, without oral food challenge (OFC).</p><p><strong>Results: </strong>Among 4,783 valid questionnaires, the prevalence of parent-reported FA was 9.28%, and the prevalence of clinically presumed FA was 6.10%. The most common manifestations were skin rash/pruritus (81.8%), followed by respiratory and gastrointestinal symptoms. The leading suspected allergens were eggs (29.8%), cow's milk (21.6%), seafood (20.5%), mango (9.3%), legumes (2.1%), and nuts (2.1%). Compared with non-FA children, those with clinically presumed FA had a lower BMI and higher rates of atopic dermatitis, allergic rhinitis, wheezing, and constipation (all P < 0.01). Parental history of atopic dermatitis or allergic rhinitis was associated with increased risk of clinically presumed FA in children (all P < 0.001).</p><p><strong>Conclusion: </strong>FA is common among preschool children in Taizhou; however, prevalence estimates reflect clinically presumed FA (history plus SPT/sIgE) rather than OFC-confirmed disease. Eggs, milk, and seafood were the predominant allergens, and affected children frequently had atopic comorbidities and a family history of allergic disease. These findings provide region-specific evidence to inform early identification and management strategies.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of oral motor interventions on feeding and orofacial motor outcomes in preterm infants: a systematic review and meta-analysis of randomized controlled trials.","authors":"Rina Febriani Puspitasari, Putri Kusuma Wardani Mahendra, Anrizandy Narwidina","doi":"10.1186/s12887-026-06905-4","DOIUrl":"https://doi.org/10.1186/s12887-026-06905-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Efficient oral feeding is a key functional milestone in neonatal and early childhood care, reflecting neuromuscular maturation, physiological stability, and readiness for hospital discharge. Infants and young children, particularly those born preterm, frequently experience feeding difficulties due to immature oral motor coordination. Structured oral motor interventions have been proposed to enhance feeding-related outcomes; however, their effectiveness remains variably reported. This systematic review and meta-analysis aimed to evaluate the effectiveness of oral motor interventions in improving feeding and oral motor outcomes in infants and young children compared with routine care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Randomized controlled trials published between 2014 and 2024 were identified through PubMed, Cochrane Library, and Google Scholar. Eligible studies involved infants and young children with feeding difficulties or underdeveloped oral motor function and evaluated structured oral motor interventions compared with routine care or standard feeding support. Study selection was performed using Rayyan. Risk of bias was assessed using the Cochrane Risk of Bias tool version 2.0. Where appropriate, random-effects meta-analyses were performed, and effect estimates were presented as mean differences or standardized mean differences with 95% confidence intervals. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ten randomized controlled trials were included. All included studies involved preterm infants receiving neonatal clinical care. Oral motor interventions were associated with improvements in feeding readiness, sucking-swallowing coordination, feeding efficiency, and earlier achievement of full oral feeding compared with routine care. Interventions incorporating Premature Infant Oral Motor Intervention demonstrated the most consistent benefits, particularly in reducing the time required to achieve independent oral feeding. The certainty of evidence ranged from low to moderate, with methodological heterogeneity and limited blinding representing the main sources of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Oral motor interventions were associated with clinically relevant improvements in feeding-related outcomes among preterm infants compared with routine care. Overall, the findings support oral motor interventions as a clinically relevant adjunct to routine care for preterm infants with feeding difficulties associated with underdeveloped oral motor function. However, the certainty of evidence ranged from low to moderate, highlighting the need for further well-designed randomized controlled trials to clarify long-term developmental implications and inform eviden","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors and survival of birth asphyxia-related neonatal mortality in rural Ghana: a five-year retrospective cohort study (2018-2023).","authors":"Samuel K Amponsah, James Duah, Peter Yeboah, William Dormechele, Desmond Kuupiel","doi":"10.1186/s12887-026-06938-9","DOIUrl":"https://doi.org/10.1186/s12887-026-06938-9","url":null,"abstract":"<p><strong>Background: </strong>Birth asphyxia remains a leading cause of neonatal mortality in low- and middle-income countries, particularly in rural settings with limited access to skilled intrapartum and neonatal care. Evidence on survival patterns and predictors of birth asphyxia-related neonatal mortality in rural Ghana is limited. This study assessed neonatal mortality among neonates admitted with birth asphyxia and predictors among neonates admitted with birth asphyxia in rural Ghana.</p><p><strong>Methods: </strong>An institution-based multicentre retrospective cohort study was conducted using routinely collected clinical records from 22 Christian Health Association of Ghana (CHAG) district hospitals in rural Ghana. All neonates diagnosed with birth asphyxia and admitted to Neonatal Intensive Care Units (NICUs) of these facilities between January 2018 and October 2023 who met the eligibility criteria were included (n = 211). Survival time was defined as the number of days from NICU admission to death; neonates who survived to discharge were right-censored. Kaplan-Meier estimates were generated and log-rank tests used to assess survival differences across covariates. Multivariable analysis was conducted using Cox proportional hazards regression with cluster-robust standard errors at the hospital level to account for intra-facility correlation. Predictor selection was guided by a conceptual framework incorporating clinical relevance, prior evidence, and potential confounding.</p><p><strong>Results: </strong>Of the 211 neonates included, 76 (36.0%) died during follow-up and 135 (64.0%) survived to discharge and were right-censored. Deaths were concentrated predominantly in the early post-admission period. In the adjusted Cox proportional hazards model, significant independent predictors of neonatal mortality were: lack of maternal health insurance (HR = 3.56; 95% CI: 2.16-5.84; p < 0.001), non-utilisation of antenatal care (HR = 2.31; 95% CI: 1.49-3.57; p < 0.001), multiparity as a protective factor (HR = 0.52; 95% CI: 0.34-0.80; p = 0.003), absence of partograph-based labour monitoring (HR = 2.01; 95% CI: 1.21-3.34; p = 0.007), delivery at a CHPS compound or home versus hospital (HR = 1.70; 95% CI: 1.29-2.23; p < 0.001), poor foetal progress during labour (HR = 3.21; 95% CI: 1.49-6.94; p = 0.003), head circumference (HR = 0.98; 95% CI: 0.97-0.99; p = 0.005), and five-minute Apgar score (HR = 0.77; 95% CI: 0.68-0.86; p < 0.001).</p><p><strong>Conclusion: </strong>Birth asphyxia-related neonatal mortality in rural Ghana reflects maternal, intrapartum, neonatal, and health-system factors. Strengthening monitoring, resuscitation, referral, and insurance, particularly in peripheral facilities, is critical to reducing deaths and advancing progress toward SDG 3.2.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of childhood anemia in urban and rural areas of West Java, Indonesia: a cross-sectional study.","authors":"Rodman Tarigan Girsang, Muhammad Gilang Dwi Putra, Kusnandi Rusmil, Eddy Fadlyana, Riyadi Adrizain, Nur Melani Sari, Frizka Primadewi Fulendry, Alvira Dwilestarie Putri, Behesti Zahra Mardiah, Rona Kania Utami, Rizky Perdana Mulyadi, Arief Budiman, Dinda Tiaraningrum Nashsyah, Hadyana Sukandar","doi":"10.1186/s12887-026-06859-7","DOIUrl":"https://doi.org/10.1186/s12887-026-06859-7","url":null,"abstract":"<p><strong>Background: </strong>Anemia in children has become a serious global public health problem, which may lead to delayed growth and possibly have long term effects on neurodevelopmental and behavioral outcomes. Therefore, this study aimed to determine the prevalence and determinants of anemia among children in urban and rural areas of West Java, Indonesia.</p><p><strong>Methods: </strong>An observational analysis and cross-sectional study was conducted, with data was taken from secondary data of serosurvey of hand, foot, and mouth disease (HFMD) study of 560 healthy children aged 6-59 months in November 2022-January 2023 at the Garuda Primary Health Care in Bandung City as urban area and Padalarang Primary Health Care in West Bandung Region as rural area. The Chi-square test and logistic regression model were used to identify risk factors of anemia in urban and rural areas.</p><p><strong>Result: </strong>The results showed anemia was not significantly higher in urban areas (25.6%) than in rural areas (21.3%) with a p-value 0.220. In urban areas, anemia was significantly associated with children aged 6-23 months (AOR = 2.17 4; 95% CI: 1.44-3.26), stunting children (AOR = 1.71; 95% CI: 1.07-2.72) and children with parents income below regional minimum wage (AOR = 1.73 1.74; 95% CI: 1.14-2.63). In rural areas, no variables had a significant relationship with anemia.</p><p><strong>Conclusion: </strong>The current study showed that children in rural and urban areas can have anemia. Further research and evaluation are needed in the detection and monitoring of risk factors through a multisectoral approach.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}