BMC Pediatrics最新文献

{"title":"Time series analysis for forecasting neonatal intensive care unit census and neonatal mortality.","authors":"Hosein Dalili, Mamak Shariat, Leyla Sahebi","doi":"10.1186/s12887-025-05685-7","DOIUrl":"https://doi.org/10.1186/s12887-025-05685-7","url":null,"abstract":"<p><strong>Background: </strong>This study analyzes time series data related to NICU (Neonatal Intensive Care Unit) census numbers, hospitalization days, and mortality rates.</p><p><strong>Methods: </strong>We utilized seven years of retrospective daily NICU census data for model development, covering the period from March 2016 to December 2022, encompassing a total of 7,227 infants. We applied the best-fitting models of ARIMA (Auto Regressive Integrated Moving Average) and SARIMA (Seasonal ARIMA) to forecast census numbers, lengths of hospital stays, and mortality proportions. Additionally, we conducted regression time series analysis to explore the relationships among these variables.</p><p><strong>Results: </strong>The mortality proportion peaked in 2017 at 9.94%. The average duration of hospitalization was 12.42 days, with significant variability observed between deceased and surviving neonates. Multiple regression analysis indicated an inverse relationship between the number of hospitalizations and the duration of hospital stays, with a coefficient of -2.58 days (P-value < 0.001). There was also a notable correlation between longer hospital stays and increased mortality, with a regression coefficient (B) of 0.339 (P-value = 0.018). Time series analysis revealed a decreasing trend in mortality proportion in the NICU, alongside seasonal patterns in census numbers, which peaked during the winter months.</p><p><strong>Conclusion: </strong>Seasonal variations were observed, with the highest admissions occurring in the winter months and the shortest hospital stays during this period. Additionally, longer hospital stays were associated with higher mortality. Forecasting using ARIMA and SARIMA models demonstrated strong predictive capabilities, highlighting the importance of effective resource planning to optimize outcomes in the NICU.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"339"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953789","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":"Complicated appendicitis and associated risk factors among children.","authors":"Molla Azmeraw, Biruk Beletew Abate, Dessie Temesgen, Sefineh Fenta Feleke, Ribka Nigatu Haile, Melsew Dagne Abate, Tegene Atamenta Kitaw","doi":"10.1186/s12887-025-05447-5","DOIUrl":"https://doi.org/10.1186/s12887-025-05447-5","url":null,"abstract":"<p><strong>Background: </strong>Complicated appendicitis is one of significant pediatric surgical care challenges and its burden varied from 5 to 75%. However, there is limited study about prevalence of complicated appendicitis among children in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of complicated appendicitis among children in Amhara region, Ethiopia.</p><p><strong>Methodology: </strong>A cross-sectional study design was employed. The data extraction tool was used to collect data from 423 sampled participants. Simple random sampling technique was used. The data was presented using table, and text forms. The data was also summarized by proportion and frequency depends on the data type. The logistic model was fitted. Any statistical test considered significant at P-value < 0.05.</p><p><strong>Result: </strong>A total of 406 study participants were included for analysis. The prevalence of complicated appendicitis was 32.02%, 95%CI(27.64%, 36.74%). Duration of symptom greater than 24 h, aOR = 1.64, 95% CI (1.01,2.66)), and white blood cell count greater than 12,000 cells/µl aOR = 2.08, 95% CI (1.15,3.77) were statistically significant predictors of complicated appendicitis in children.</p><p><strong>Conclusion and recommendation: </strong>The prevalence of complicated appendicitis was high as compared to the previous studies. Patient presentation after 24 h of symptom and white blood cell greater than 12000 cells/µl were significantly associated with complicated appendicitis. The surgical teams need to be aware that those children with greater white blood cell count and a chief compliant duration of greater than one day were present with complicated appendicitis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"336"},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971894","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":"Characteristics of children with ataxic cerebral palsy.","authors":"Katina Pettersson, Mette Johansen, Reidun Jahnsen, Elisabet Rodby-Bousquet","doi":"10.1186/s12887-025-05681-x","DOIUrl":"https://doi.org/10.1186/s12887-025-05681-x","url":null,"abstract":"<p><strong>Background: </strong>To compare the characteristics, functional levels, and comorbidities of children with ataxic cerebral palsy (CP), with those of children with other CP subtypes.</p><p><strong>Methods: </strong>A cross-sectional study of children with CP born between 2000 and 2019 as reported in the Scandinavian national CP follow-up programmes and quality registries. Data for age, sex, levels of the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), the Communication Function Classification System (CFCS), epilepsy, intellectual disability, and pain were extracted.</p><p><strong>Results: </strong>There were 302 children (3.9%) with ataxic CP and 7336 children (96.1%) with other subtypes. Children with ataxic CP differed significantly from other subtypes, with a greater proportion classified in GMFCS II (37.7% vs. 15%), MACS II (41.4% vs. 24.8%), and CFCS II (24.7% vs. 10.5%), more girls (50.7% vs. 41.7%), school-aged (47% vs. 41.6%), adolescents (33.4% vs. 25.4%), or had an intellectual disability (51.2% vs. 38.4%), but the prevalence of pain and epilepsy was similar between the subtypes.</p><p><strong>Conclusions: </strong>Children with ataxic CP have different characteristics and functional levels than children with other subtypes. We recommend a thorough examination of motor performance, communication, and intellectual disability to meet the individual needs of children with ataxic CP.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"335"},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972572","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":"Gut microbiome dysbiosis as a potential biomarker for liver metabolic disorders in in neonatal hemolytic jaundice.","authors":"Jin Huang, Bi Zhou, Feng Zhu, Ying Li, Yingying Li, Rui Zhang, Jingling Zhang, Lili Wang","doi":"10.1186/s12887-025-05692-8","DOIUrl":"https://doi.org/10.1186/s12887-025-05692-8","url":null,"abstract":"<p><strong>Background: </strong>This study aims to reveal the composition and features of the gut microbiota in neonatal hemolytic jaundice, potentially identifying biomarkers for the diagnosis of this condition.</p><p><strong>Methods: </strong>A total of 62 neonates with hemolytic jaundice and 20 healthy neonates were ultimately enrolled in the study. Clinical data and fecal samples from these infants were collected separately. The composition and features of the gut microbiota were analyzed using 16S rRNA high-throughput sequencing technology. Alpha and Beta diversity analyses were conducted to elucidate the differences in gut microbiota composition. Additionally, LEfSe analysis was employed to identify differential microorganisms. Finally, PICRUSt2, metagenomeSeq, and BugBase software were utilized to investigate the phenotypic and functional differences in the gut microbiota.</p><p><strong>Results: </strong>Beta diversity analysis revealed significant differences in the composition of gut microbiota. LEfSe analysis demonstrated a significant increase in the relative abundance of Enterobacter in neonatal hemolytic jaundice. Furthermore, METACYC metabolic pathway analysis based on PICRUSt2 indicated a notable elevation in liver-related metabolic pathways in neonatal hemolytic jaundice. The metabolic analysis of differential bacterial genera revealed that Enterobacter secretes a wide array of enzymes, including oxidases, oxidoreductases, transferases, hydrolases, isomerases, and lyases. Notably, these enzymes are responsible for altering the liver metabolic pathways in neonates with hemolytic jaundice.</p><p><strong>Conclusions: </strong>Enterobacter is linked to multiple metabolic pathways in the liver via the secretion of numerous enzymes along the gut-liver axis metabolic pathway. This interaction indirectly reflects the metabolic status and disease progression in neonatal hemolytic jaundice. Consequently, Enterobacter may serve as a potential diagnostic marker of the gut microbiota for assessing liver metabolic disorders associated with hemolytic jaundice.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"337"},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976502","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":"A unique case of pulmonary minimally invasive mucinous adenocarcinoma arising from atypical goblet cell hyperplasia in the bronchial epithelium of a 9-year-old girl.","authors":"Ping Zhou, Cuomu Zhaxi, Lili Jiang","doi":"10.1186/s12887-025-05683-9","DOIUrl":"https://doi.org/10.1186/s12887-025-05683-9","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucinous adenocarcinoma without congenital pulmonary airway malformation (CPAM) is extremely rare in pediatric patients. Here, we report a unique case of minimally invasive mucinous adenocarcinoma without CPAM in a child and provide a comprehensive review of the clinical, radiographic, and histopathological characteristics of the published literature.</p><p><strong>Case presentation: </strong>A 9-year-old girl presented with persistent cough and sputum production, raising suspicion of respiratory infection. Chest computed tomography (CT) revealed a solid nodule measuring 1.9 cm × 1.6 cm in the right lower lobe. Prenatal ultrasonography revealed no congenital lung abnormality. The patient subsequently underwent video-assisted thoracoscopic surgery (VATS) without postoperative complications. Histologically, a focal area demonstrated marked atypical goblet cell hyperplasia in the bronchial epithelium, which abruptly transitioned to mucinous adenocarcinoma, predominantly characterized by a lepidic growth pattern and extensive extracellular mucin accumulation. Pathological examination confirmed pulmonary minimally invasive mucinous adenocarcinoma, staged as pT1miN0M0. Next-generation sequencing (NGS) identified the KRAS G12D mutation. The patient remained well 11 months after resection and did not require additional treatment.</p><p><strong>Conclusions: </strong>We demonstrated a novel stepwise progression originating from atypical goblet cell hyperplasia in the bronchial epithelium, rather than from the CPAM, in a pediatric patient. KRAS mutations may play a critical role in the development of pulmonary mucinous adenocarcinoma in pediatric patients.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"333"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953739","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":"Prevalence of food and inhalant allergies in infants and children from the Nanhai area of Foshan city.","authors":"Xiao-Wen Yuan, De Bing Huang, Guang-Rong Feng, Hui-Ling Ye, Ping Chen, Jie Yao","doi":"10.1186/s12887-025-05664-y","DOIUrl":"https://doi.org/10.1186/s12887-025-05664-y","url":null,"abstract":"<p><strong>Background: </strong>The aim of our research was to explore the distribution characteristics of the most common food and inhalant allergens in children from Foshan city in Southwest China to provide evidence for the development of prevention and treatment strategies for allergic diseases in children.</p><p><strong>Methods: </strong>A total of 635 children who attended the Sixth Affiliated Hospital, South China University of Technology, were included in our retrospective study from February 2013 to October 2019. The sensitivity of immunoglobulin E (IgE) for 20 allergens (10 inhalant allergens and 10 food allergens) was determined. Statistical analysis was performed to analyze differences in the percentage of allergens among individuals according to sex, age and season.</p><p><strong>Results: </strong>Of the 635 patients, 200 tested positive for allergies. Dust mites were the most common inhalant allergens, followed by dog hair. The highest percentage of positive house dust mite sensitization was in the summer. Among the food allergens, individuals most frequently tested positive for wheat and milk allergies. The percentage of individuals with milk and egg allergies decreased with increasing age.</p><p><strong>Conclusion: </strong>The most common allergens found in children from Foshan were dust mites, dog hair, wheat, tree nuts (hazelnut and pistachio), milk and peanuts. The results obtained could be helpful in determining the etiology of allergic diseases.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"334"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978225","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":"Risk factors for invasive mechanical ventilation, extracorporeal membrane oxygenation, and mortality in children with severe adenovirus infection in the pediatric intensive care unit: a retrospective study.","authors":"Xiaofen Tao, Sheng Ye","doi":"10.1186/s12887-025-05461-7","DOIUrl":"https://doi.org/10.1186/s12887-025-05461-7","url":null,"abstract":"<p><strong>Background: </strong>Adenovirus infection causes considerable morbidity and mortality in pediatric patients, primarily those affected by severe respiratory system involvement. Although prevalent, it often presents vague indications, making accurate diagnosis and management challenging. This study aims to set some risk factors for invasive mechanical ventilation, ECMO, and mortality in children with severe adenovirus infection admitted to PICU.</p><p><strong>Methods: </strong>We evaluated 66 children with severe adenovirus infection admitted to the PICU of Children's Hospital, Zhejiang University School of Medicine, from 2018 to 2019. Data on general conditions, clinical manifestations, laboratory findings, pathogenetic and radiological discoveries, treatments, therapeutic efficacy, and outcomes were collected. Machine learning models were used to predict the need for invasive mechanical ventilation, ECMO, and mortality.</p><p><strong>Results: </strong>Of the 66 patients, 5 died, and 61 survived. Significant factors related to mortality included heart failure (p = 0.005), pericardial effusion (p = 0.032), septic shock (p = 0.009), hemoglobin levels (p = 0.013), lactate dehydrogenase (p = 0.022), albumin (p = 0.035), normal creatinine levels (p = 0.037), and pneumothorax (p = 0.002). Additional risk factors for invasive mechanical ventilation included acute respiratory distress syndrome and encephalopathy. Low breath sounds were identified as a risk factor for ECMO. For predicting poor outcomes, including invasive mechanical ventilation, ECMO, or mortality, the random forest model using these factors demonstrated high accuracy, with an area under the curve of 0.968.</p><p><strong>Conclusions: </strong>The study indicates poor prognosis in children with severe adenovirus infection is significantly related to comorbidities and clinical symptoms. Machine learning models can accurately predict adverse outcomes, providing valuable insights for management and treatment. Identifying high-risk patients using these models can improve clinical outcomes by guiding timely and appropriate interventions.</p><p><strong>Trial registration: </strong>The article is a retrospective study without a clinical trial number, so it is not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"331"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972657","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":"Evaluation of timed dexamethasone eye drops to prevent proliferative retinopathy of prematurity: a study protocol for a randomized intervention, multi-centre, double-blinded trial (DROPROP).","authors":"Ann Hellström, Mariya Petrishka-Lozenska, Aldina Pivodic, Anders K Nilsson, Ulrika Sjöbom, Ingrid Hansen Pupp, David Ley, Lotta Gränse, Hanna Maria Öhnell, Gunnar Jakobsson, Karin Sävman, Lois E H Smith, Pia Lundgren","doi":"10.1186/s12887-025-05673-x","DOIUrl":"https://doi.org/10.1186/s12887-025-05673-x","url":null,"abstract":"<p><strong>Background: </strong>As the survival rate of preterm infants continues to rise worldwide, more infants are at risk of developing sight-threatening retinopathy of prematurity (ROP). Destructive retinal laser treatment and intravitreal injections of anti-vascular endothelial growth factor (VEGF), factor, which have potential systemic side effects, are necessary to prevent blindness in severe cases of ROP. Off-label use in clinical settings suggests that dexamethasone eye drops, 1 mg/ml, may prevent the progression of ROP to severe disease (Type 1 ROP) requiring treatment. Our current study aims to assess the efficacy and safety of timely administered dexamethasone eye drops to reduce the need for laser or anti-VEGF ROP treatment in preterm infants.</p><p><strong>Methods: </strong>In a randomized prospective interventional, multi-centre, double-blinded trial, we plan to include 100 infants with severe ROP born before gestational age 30 weeks in Sweden. Infants will be randomized to intervention with dexamethasone eye drops (1 mg/ml) (n = 50) or placebo, saline (n = 50) until either ROP is resolved or severe ROP (Type 1 ROP) development occurs, fulfilling ROP treatment criteria. Eye drops will be administered one drop per day or every other day, depending on the severity of ROP, with a maximum duration of 12 weeks. The primary objective is to evaluate whether dexamethasone intervention reduces the proportion of infants developing Type 1 ROP compared to infants receiving a placebo. Adverse events and potential side effects will be recorded, such as high intraocular pressure and growth restriction. Levels of cortisol in saliva and glucose in urine will be measured repeatedly. Secondary outcomes will include the timing of ROP progression, the recurrence rate after ROP treatment and retinal morphology. An ophthalmological follow-up will be initiated at 2 and 5.5 years of age, evaluating visual acuity, refractive errors, strabismus, retinal morphology and ophthalmological complications. All outcomes in the study will be compared between the infants receiving dexamethasone intervention and those receiving placebo.</p><p><strong>Discussion: </strong>Timely administration of dexamethasone eye drops may prevent severe ROP from progressing to Type 1 ROP, which requires treatment. This study aims to assess the efficacy and safety of dexamethasone intervention to support its clinical use and national guidelines.</p><p><strong>Trial registration: </strong>EudraCT, 2020-004933-19, registered in January 2021 and CTIS, 2023-505318-97-00, registered in August 2023.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"332"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062169","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":"Co-creation and evaluation of online care maps for children with medical complexity.","authors":"Sherri Adams, Madison Beatty, Blossom G Dharmaraj, Clara Moore, Arti D Desai, Leah Bartlett, Erin Culbert, Eyal Cohen, Jennifer N Stinson, Julia Orkin","doi":"10.1186/s12887-025-05679-5","DOIUrl":"https://doi.org/10.1186/s12887-025-05679-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Care maps are a caregiver-created diagrammatic tool to support the care of children with medical complexity (CMC). They provide a high-level overview of care, allowing the care team to appreciate the interrelatedness of medical and non-medical aspects of care. Limitations currently exist for the usability, shareability, and integration of care maps into clinical care as they are typically paper-based and caregiver-held. Therefore, the aims of the study were to (1) collaborate with caregivers and care team members (CTMs) of CMC to determine the design requirements and develop an online care map, (2) assess usability, and (3) explore its feasibility and utility from multiple perspectives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This mixed methods study utilized an exploratory sequential design. In Phase 1 (Design and Development), the design requirements and utility of an online care map were identified through semi-structured qualitative interviews with caregivers and CTMs. In Phase 2 (Usability Testing), caregivers were monitored for errors and efficiency while completing a standardized task on the online care map. In Phase 3 (Feasibility Testing), caregivers created, updated, and shared online care maps that were housed within a patient-facing online platform accessible to CTMs. Caregivers and CTMs reported their usage of the care map and a descriptive visual content analysis of the care maps was completed. Semi-structured interviews with caregivers and CTMs were conducted to explore the use and feasibility of the online care maps. Qualitative interviews were analyzed using inductive content analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In Phase 1, interviews were conducted with caregivers (n = 16) and CTMs (n = 16). Four themes related to the utility and design were identified: (1) simplified snapshot, (2) envisioned use, (3) caregiver hesitancy, and (4) design modifications. The online care map prototype was modified accordingly. In Phase 2, half of the caregivers (n = 5) made one or more navigation error while using the care map. Nearly all caregivers (n = 9) completed the care map task successfully. In Phase 3, thirty-six caregivers registered on the online platform, with 70% (n = 25) creating a care map. Four themes were generated from interviews with caregivers (n = 15) and CTMs (n = 13): (1) care maps in clinical care, (2) enhanced understanding of the bigger picture, (3) uncertain value and redundancy, and (4) innovations for greater impact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;An online care map creation tool was co-developed with caregivers and CTMs for CMC. Caregivers and CTMs appreciated online care maps as an organizational, coordination, and communication tool, providing an enhanced understanding of the complexity of care, a holistic view of the child, and guiding care discussions. Some caregivers did not use the care map due to a perceived lack of value or redundancy. Future research should explore the integratio","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"329"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963452","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":"Guidance strategies for infantile asymmetry prevention: a systematic review.","authors":"Julie Ellwood, Kesava Kovanur Sampath, Iryna Rund, Loïc Treffel, Jerry Draper-Rodi","doi":"10.1186/s12887-025-05670-0","DOIUrl":"https://doi.org/10.1186/s12887-025-05670-0","url":null,"abstract":"<p><strong>Background: </strong>Infantile asymmetries of posture, movement and/or shape are common. Coincidence in the presentation of asymmetrical features can lead to a broad spectrum of descriptors. Published guidelines on prevention strategies are not currently available. The objective of this systematic review was to find, evaluate, and synthesise the available evidence regarding the effectiveness of prevention strategies for infantile asymmetries, specifically strategies involving paediatric screening and/or guidance to parents.</p><p><strong>Methods: </strong>This review has been reported based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the review protocol was prospectively registered on the Open Science Framework, ( https://osf.io/rgzev/ ). Searches were conducted on Ovid Medline, Ovid AMED, and PEDro. Inclusion criteria of articles were infants < 28 weeks old who had received either an early musculoskeletal screen and/or education to parents on home care guidance/exercises to prevent asymmetry development. Any primary research was included. There was no limit placed upon date of publication. Data were screened, extracted and appraised in duplicate by at least two blinded reviewers. The Cochrane Collaboration's tool for assessing risk of bias available as part of Covidence was used by two reviewers independently.</p><p><strong>Results: </strong>Of the 878 papers retrieved, 19 studies were included: 9 randomised controlled trials, 6 cohort studies and 4 non-randomised experimental studies. The presenting conditions included head shape asymmetry in 16/19 studies, cervical range of motion in 10 studies and positional preference in 3. Due to a lack of homogeneity between all the studies, it was not possible to pool the data and conduct meta-analysis. Guidance strategies show better outcomes in asymmetry prevention when provided early (< 3 months) and under supervision of a healthcare professional. The overall risk of bias for cohort and non-randomised experimental studies was considered to be 'low', and 'adequate' or 'low' for randomised controlled trials. The GRADE level of evidence was found to be 'very low'.</p><p><strong>Conclusion: </strong>Early parental guidance may prevent infantile asymmetry when supervised by a trained healthcare professional and with good adherence from parents. Further studies with a higher methodological rigour are needed to identify and perform comparative interventions.</p><p><strong>Clinical trial number: </strong>Not applicable. OSF NUMBER: https://doi.org/10.17605/OSF.IO/RGZEV .</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"328"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973800","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}