BMC Pediatrics最新文献

{"title":"Effects of school-based nutrition education on self-efficacy, attitudes, food behaviors, and health in children.","authors":"Merve Terzi, Kübra Ergan, Hilal Demirkesen-Bicak","doi":"10.1186/s12887-026-07412-2","DOIUrl":"https://doi.org/10.1186/s12887-026-07412-2","url":null,"abstract":"<p><strong>Background and aim: </strong>School-based nutrition education programs are commonly used to promote healthy eating behaviors among children; however, their effectiveness may vary according to developmental stage. The present study aimed to evaluate the effects of a school-based nutrition education program on children's dietary self-efficacy (CDSS), dietary attitudes (DAS), food behaviors (FBS), and children self-rated health scale (CSHC).</p><p><strong>Materials and methods: </strong>This study employed a pre-post nutrition intervention design and including 1418 primary and secondary school students from different grade levels. CDSS, DAS, FBS, and CSHC were assessed before and after the nutrition education using validated self-report scales. Changes following the intervention were statistically examined and differences according to grade level and gender were analyzed.</p><p><strong>Results: </strong>Following the nutrition education program, a significant improvement was observed in child nutrition self-efficacy. In contrast, no significant overall changes were found in dietary attitudes, food behaviors, or self-rated health perception. Dietary attitudes and food behaviors differed significantly by grade level both before and after the intervention, with older children's dietary self-efficacy and food behaviors were more evident in certain lower grade levels. No significant differences were observed between girls and boys with respect to dietary attitudes or food behaviors.</p><p><strong>Conclusions: </strong>The findings suggest that while school-based nutrition education can enhance dietary self-efficacy, short-term educational interventions alone may be insufficient to produce measurable changes in children's eating behaviors. Developmentally tailored, multi-component interventions that incorporate family involvement and environmental factors may be necessary to support sustained improvements in dietary behaviors, particularly among older school-age children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285236","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":"Simulation-based neonatal resuscitation training in low- and middle-income countries: A scoping review.","authors":"Shalu Chaudhary, Medha Wadhwa, Kruti Gupta, Ankith Thomas","doi":"10.1186/s12887-026-07338-9","DOIUrl":"https://doi.org/10.1186/s12887-026-07338-9","url":null,"abstract":"<p><strong>Background: </strong>Neonatal mortality remains high in low- and middle-income countries (LMICs), where simulation-based training could enhance frontline providers' resuscitation skills. This scoping review maps evidence on simulation-based neonatal resuscitation training for nurses, midwives, and birth attendants in LMICs.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, three databases (Pubmed, Google scholar and Epistemonikos) were searched from 2015 to 2025 for studies on simulation training targeting nurses/midwives in LMICs. Two reviewers screened titles/abstracts and full texts, charting data on intervention design, outcomes, facilitators, and barriers.</p><p><strong>Results: </strong>Seventeen studies were included, mainly from Tanzania (n = 6), India (n = 4), Uganda, Kenya, Pakistan, Zambia, Liberia, and Latin America. Interventions included Helping Babies Breathe (HBB; n = 9), PRONTO (n = 3), and low-dose refreshers, varying in duration (1-6 days), fidelity (low-high), and follow-up (immediate to 12 months). Providers showed gains in knowledge, skills (bag-mask ventilation proficiency), and confidence, but retention waned without refreshers. Barriers encompassed equipment scarcity, staffing shortages, and integration challenges.</p><p><strong>Conclusions: </strong>Simulation training is feasible and effective short-term for LMIC providers, supporting scalable models like HBB with mentoring. Gaps in long-term neonatal outcomes and qualitative insights warrant randomized trials and policy focus on sustainability.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285198","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":"From 5Cs to ABC: operationalizing the AAP guidelines into the MEPA-ABC scale for parental mediation of children's digital media use.","authors":"Jaroslav Vacek, Michal Božík, Ondřej Hrabec, Roman Gabrhelík, Kateřina Lukavská","doi":"10.1186/s12887-026-07446-6","DOIUrl":"https://doi.org/10.1186/s12887-026-07446-6","url":null,"abstract":"<p><strong>Background: </strong>Parental regulation of children's digital media use is central to healthy development, yet existing instruments are often lengthy or only loosely aligned with contemporary clinical frameworks. The American Academy of Pediatrics (AAP) formulated the 5Cs of Media Use (Child, Content, Calm, Crowding Out, Communication), which, together with Family Media Plan (FMP), represent six theoretical domains relevant to modern digital parenting. A brief, psychometrically validated measure aligned with these concepts has been lacking. The aim of this study was to validate a theoretically derived measure covering the six AAP domains and to empirically establish a parsimonious three‑factor structure capturing key dimensions of parental digital media regulation.</p><p><strong>Methods: </strong>A nationally representative sample of parents (N = 2,040) was randomly split into Calibration (n = 1,020) and Validation (n = 1,020) subsamples. We first tested the theoretically specified 6‑factor/18‑item model using the Confirmatory Factor Analysis (CFA) and the whole sample. Due to poor fit and high inter‑factor correlations, an Exploratory Factor Analysis (EFA) was conducted using the Calibration sample to examine the empirical latent structure. EFA suggested a 3‑factor/7‑item solution, which was subsequently evaluated through CFA (WLSMV) in the independent (Validation) sample. Psychometric evaluation included factor loadings, McDonald's ω, AVE, and discriminant validity (Fornell-Larcker, HTMT). Measurement invariance was assessed across gender. K‑means clustering was used to identify empirical parenting profiles.</p><p><strong>Results: </strong>The theoretical 6‑factor model exhibited inadequate fit, and several domains showed near‑unity correlations. EFA identified a 3‑factor structure, Awareness, Balance, and Content, capturing parental monitoring and rules (3 items), lifestyle balancing (2 items), and active content curation (2 items). This 7‑item scale MEPA‑ABC demonstrated strong fit in CFA (CFI = 0.982, TLI = 0.965, RMSEA = 0.094, SRMR = 0.037). Factor loadings were high (0.677-0.950); AVE exceeded 0.50 for all factors, and internal consistency was acceptable (ω = 0.65-0.81). Metric and scalar invariance was established across gender and parental age. Cluster analysis revealed four distinct parenting profiles that varied systematically with child age.</p><p><strong>Conclusions: </strong>Empirical analyses supported a more parsimonious 3‑factor/7‑item structure rather than the theoretically proposed 6 domains. The MEPA‑ABC provides an ultra‑brief, psychometrically robust tool capturing key parental strategies in digital media regulation. It is suitable for research, screening, and clinical or preventive applications.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285153","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":"Factors associated with complications among children and adolescents with sickle cell disease in a tertiary hospital in southwestern Nigeria.","authors":"Yetunde Toyin Olasinde, Olayinka Rasheed Ibrahim, Abimbola Ololade Odeyemi, Adeola Olasinde, Ademola Toyosi Abolarin, Victor Oluwatomi Adeagbo, James Idowu Owolabi","doi":"10.1186/s12887-026-07383-4","DOIUrl":"https://doi.org/10.1186/s12887-026-07383-4","url":null,"abstract":"<p><strong>Background: </strong>Despite Nigeria having the largest burden of sickle cell disease (SCD) globally, the spectrum of complications and associated factors remains an understudied area, with most studies focused on acute complications of vaso-occlusive crisis. Hence, we determined the spectrum of complications (acute and chronic) of sickle cell disease and the associated factors among Nigerian children and adolescents residing in southwestern Nigeria.</p><p><strong>Methods: </strong>This cross-sectional descriptive study was conducted among children and adolescents with SCD in southwestern Nigeria from January 2021 to June 2022. We obtained relevant information from the caregivers and verified this using case record files and physical examinations to identify past or present evidence of complications.</p><p><strong>Results: </strong>Among the 100 children and adolescents recruited, 34 (34.0%) had at least one complication of SCD, 21 (61.8%) of whom were males. Osteomyelitis was the most common complication 20 (58.8%)] of 34 patients. The variables associated with complications were age, hospital admissions, total white blood cell count, and liver size. After adjusting for confounders, the variables associated with complications were adolescent age [adjusted odds ratio (AOR) of 7.8, 95% confidence interval (CI)] of 1.806-33.225, hepatomegaly of 2.0-5.0 cm with an AOR of 4.8 (95% CI of 1.199-18.782), and hepatomegaly greater than 5.0 cm with an AOR of 8.8 (95% CI of 1.989-38.676).</p><p><strong>Conclusion: </strong>This study revealed that one-third of SCD children and adolescents experienced at least one complication, and half experienced osteomyelitis. Being an adolescent and the presence of hepatomegaly increased the odds of complications of SCD.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285173","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":"Delayed methotrexate toxicity after initial clearance in a critically ill patient with severe fluid overload.","authors":"April Slamowitz, Rachel Kessel, Liron M Fedida, Reid LaPlante, Adam Beaton","doi":"10.1186/s12887-026-07441-x","DOIUrl":"10.1186/s12887-026-07441-x","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate (MTX) toxicity is a life-threatening complication in oncology patients.</p><p><strong>Case presentation: </strong>We report a 19-year-old male with newly diagnosed Burkitt lymphoma who received high-dose methotrexate as part of induction chemotherapy and initially met protocol-defined serum clearance criteria with suspected delayed MTX toxicity. This prolonged toxicity was due to possible redistribution from extravascular fluid compartments in the setting of severe fluid overload and renal dysfunction. Five weeks after methotrexate administration, a detectable serum methotrexate concentration (0.4 µmol/L) was identified despite no additional exposure. His course was complicated by tumor lysis syndrome, pleural effusions and anasarca, bowel perforations requiring multiple surgeries, acute respiratory distress syndrome, persistent pancytopenia, progressive renal and hepatic dysfunction, recurrent infections, and multiorgan failure. Despite treatment with leucovorin, urine alkalinization, continuous kidney replacement therapy, and high-flux hemodialysis, serum MTX concentrations demonstrated recurrent detectable elevations.</p><p><strong>Conclusions: </strong>This case highlights how altered pharmacokinetics in critical illness may render serum clearance thresholds unreliable and underscores the need for heightened clinical suspicion for delayed drug toxicity in critically ill patients with dynamic volume shifts or unexplained multiorgan dysfunction.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191261","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 hypocalcemia in neonates receiving phototherapy: a systematic review and meta-analysis.","authors":"Endashaw Belayhun, Mahider Shimelis Feyisa, Marye Wondimnew Tefera, Mihret Tilahun, Mikiyas Shemelis Achame, Rahel Birhanu Arage, Saleamlak Sebsibe, Sisay Desale, Sisay Kassa, Yabsira Asmare, Yonas Erkihun, Zewudu Mulatie, Bruktawit Eshetu, Afewerk Habtamu","doi":"10.1186/s12887-026-07442-w","DOIUrl":"https://doi.org/10.1186/s12887-026-07442-w","url":null,"abstract":"<p><strong>Background: </strong>Although phototherapy is the standard treatment for neonatal hyperbilirubinemia, its adverse effects cause electrolyte disturbances. Aggregated evidence regarding the prevalence of phototherapy-induced hypocalcemia remains inconsistent across studies. Therefore, this systematic review and meta-analysis aimed to determine the pooled incidence hypocalcemia in neonates receiving phototherapy.</p><p><strong>Methods: </strong>This systematic review and meta-analysis were conducted in compliance with the 2020 PRISMA guidelines. Relevant databases were searched to retrieve observational studies reporting hypocalcemia among neonates with hyperbilirubinemia through February 2026. The retrieved articles were cleaned for duplicates and selected based on the eligibility criteria. STATA 17.0 software was used to compute the pooled hypocalcemia with 95% confidence intervals via a random effects model. Heterogeneity was assessed via the I² statistic and Cochran's Q test, whereas robustness was evaluated via leave-one-out sensitivity analysis and subgroup analysis. Furthermore, publication bias was assessed by Egger's regression test, Begg's rank correlation test, and trim-and-fill correction.</p><p><strong>Results: </strong>In total, 25 studies involving 2673 neonates were included in the meta-analysis. The pooled prevalence of hypocalcemia in neonates undergoing phototherapy was estimated to be 20.68% (95% CI: 15.75-25.60%). There was significant heterogeneity (I² = 94.15%, p < 0.001). In the subgroup analysis, there was a greater hypocalcemia in studies with preterm (23.03%, 95% CI: 14.18% - 31.88%) and low birth weight (22.57%, 95% CI: 14.99% - 30.16%) neonates than in those with term (18.51%, 95% CI: 12.39% - 24.63%) and normal birth weights (13.97%, 95% CI: 8.72% - 19.17%). The hypocalcemia was higher in Africa (36.00%, 95% CI: 7.52% - 64.47%) than in Asia (18.89%, 95% CI: 14.02% - 23.76%). Egger's test revealed significant publication bias (p < 0.0001), with no significant change in the original effect size after trim-and-fill analysis.</p><p><strong>Conclusion: </strong>Hypocalcemia is a frequent electrolyte disorder in neonates under phototherapy with neonatal hyperbilirubinemia. Thus, regular monitoring is essential, particularly for those who are at high risk.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285166","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":"SLC10A1 variants causing NTCP deficiency in infants: clinical and functional characterization of a novel splice-site variant.","authors":"Wenzhuo Cheng, Fan Chen, Wen Pan, Biao Zou, Sainan Shu","doi":"10.1186/s12887-026-07411-3","DOIUrl":"https://doi.org/10.1186/s12887-026-07411-3","url":null,"abstract":"<p><strong>Background: </strong>Sodium taurocholate cotransporting polypeptide (NTCP), the product of the SLC10A1 gene, is essential for hepatic bile acid (BA) uptake. Biallelic SLC10A1 defects resulting in NTCP deficiency have recently been identified as a cause of familial hypercholanemia in children, but clinical and functional data are lacking.</p><p><strong>Methods: </strong>Three unrelated infants with neonatal or infantile cholestasis were recruited. Clinical data, laboratory results, and follow-up details were reviewed. SLC10A1 variants were identified by whole-exome sequencing (WES) and confirmed by Sanger sequencing. An HEK293T minigene splicing assay was used to assess the functional consequences of the new splicing variant.</p><p><strong>Results: </strong>All three patients exhibited sustained hypercholanemia accompanied by varying degrees of elevated liver enzymes and decreased levels of fat-soluble vitamins. WES identified homozygous or compound heterozygous SLC10A1 variants in all three patients, including the frequent East Asian missense variant c.800 C > T (p.Ser267Phe), the rare frameshift variant c.722_723del (p.Ser241Cysfs*36), and a novel splice-site variant c.746 + 5G > T. The c.746 + 5G > T variant was predicted to affect splicing, and a minigene assay showed that this variant caused exon 3 skipping, which is predicted to result in a frameshift transcript. According to ACMG/AMP guidelines, c.722_723del variant was classified as \"Pathogenic\", and the c.746 + 5G > T variant was assessed as \"Pathogenic\" after incorporating functional evidence from the minigene assay.</p><p><strong>Conclusions: </strong>This study broadens the variant spectrum of SLC10A1-related NTCP deficiency and highlights the value of functional testing in the assessment of novel splicing-site variants. Early genetic diagnosis may facilitate appropriate clinical management and help prevent unnecessary interventions.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262821","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":"A comparison of dual vs. single diagnostic code approaches for neonatal opioid withdrawal syndrome surveillance in neonates ≥ 35 weeks gestational age.","authors":"Janine Y Khan, Hannah L Neuman, James M Groh, Marina G Feffer, Phoebe E Troeller, Chariya Christmon, Keith A Dookeran","doi":"10.1186/s12887-026-07015-x","DOIUrl":"10.1186/s12887-026-07015-x","url":null,"abstract":"<p><strong>Background: </strong>Using dual ICD-10-CM codes for exposure/withdrawal (P04.49 or P96.1, respectively) may be more sensitive for identifying Neonatal Opioid Withdrawal Syndrome (NOWS) than P96.1 alone. There are currently no studies that report on national prevalence using this dual code approach.</p><p><strong>Objectives: </strong>We examined U.S. national NOWS prevalence trends comparing the dual vs. single code approach for surveillance.</p><p><strong>Methods: </strong>2016-2022 cycles of cross-sectional data from the U.S. Healthcare Cost and Utilization Project, Kids' Inpatient Database were used to estimate weighted NOWS prevalence in newborns ≥ 35 weeks excluding iatrogenic cases. Generalized linear models with predictive margins were used to estimate prevalence differences for select sociodemographic factors stratified by race/ethnicity. Select measures of morbidity and mortality were evaluated as secondary outcome measures for NOWS.</p><p><strong>Results: </strong>The survey weighted population was 1,084,633 pediatric discharges and crude NOWS prevalence decreased across 2016-2022 cycles. Using dual codes, crude NOWS prevalence doubled overall at 19.05/1000 (95% CI: 18.33, 19.8) (vs. single: 9.48; 95% CI: 9.05, 9.93) and across most factors and was highest in White infants (dual: 25.15; 95% CI: 24.09, 26.26, single: 13.98; 95% CI: 13.27, 14.71). Crude prevalence for Black infants almost tripled (dual: 19.67; 95% CI: 18.46, 20.95, single: 6.19; 95% CI: 5.65, 6.78). Medicaid payer-type (dual: 35.93; 95% CI: 34.6, 37.3, single: 18.12; 95% CI: 17.29, 18.98), lowest ecologic income-quartile (dual: 29.43; 95% CI: 28.12, 30.79, single: 13.72; 95% CI: 12.92, 14.58), and rural hospital-location (dual: 33.22; 95% CI: 30.75, 35.88, single: 13.88; 95% CI: 12.31, 15.66) were factors with the highest crude prevalence. Trends for relative measures for within category comparison of crude prevalence were largely similar but showed greater magnitude of change for survey year and income quartile. In fully adjusted models, effect modification was evident by year, payer type, and income level, for all race/ethnicity comparisons with dual codes, and short-term morbidity risk appeared higher with dual codes (15.2% vs. single 6.2%) whereas length of stay was greater with single code (7.0 vs. 11.7 days).</p><p><strong>Conclusions: </strong>The dual code approach provides an alternative strategy for NOWS surveillance.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618455","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":"Biological and environmental correlates of infant neurodevelopment at six months: an exploratory regression analysis.","authors":"Tatyana Itova","doi":"10.1186/s12887-026-07384-3","DOIUrl":"https://doi.org/10.1186/s12887-026-07384-3","url":null,"abstract":"<p><strong>Background: </strong>Early neurodevelopment results from the interaction between biological conditions at birth and the postnatal caregiving environment. Understanding the relative contribution of these factors during early infancy may improve early identification of children at developmental risk.</p><p><strong>Objective: </strong>To examine associations between biological, maternal, and environmental factors and neurodevelopmental outcomes at six months of age.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 124 healthy term infants aged six months. Neurodevelopment was assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3) across five developmental domains: communication, gross motor, fine motor, problem solving, and personal-social development. Potential predictors were categorized as biological factors (sex, birth weight, gestational age, breastfeeding status, and prenatal alcohol exposure), maternal factors (maternal educational attainment and early postpartum return to employment), and environmental factors (primary language spoken in the home and daily parent-infant verbal interaction). Hierarchical multiple regression analyses were performed to evaluate the independent contribution of each predictor group to infant neurodevelopmental outcomes.</p><p><strong>Results: </strong>Biological variables showed the most consistent associations across models, although the proportion of explained variance was modest. Birth weight emerged as the most stable predictor, showing significant positive associations with communication, gross motor, problem-solving, and personal-social development. Prenatal alcohol exposure was associated with lower personal-social scores. Sex differences were observed in communication outcomes, with female infants demonstrating slightly higher scores. Maternal and environmental factors contributed only modestly to explained variance and were not retained as independent predictors in the final regression models.</p><p><strong>Conclusion: </strong>In this exploratory cross-sectional study of healthy term infants, biological variables, particularly birth weight, showed the most consistent associations with developmental scores at six months. Prenatal alcohol exposure was associated with lower personal-social scores. However, the explained variance was modest, and findings should be interpreted cautiously given the sample size, imbalance in some predictors, and the cross-sectional design.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262681","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":"Tracheobronchial pen cap and pen nib foreign body aspiration in 32 children: clinical features, CT findings, and bronchoscopic management.","authors":"Zhao Cheng, Qi Cheng, Ying Yang, Shuhua Wu","doi":"10.1186/s12887-026-07395-0","DOIUrl":"https://doi.org/10.1186/s12887-026-07395-0","url":null,"abstract":"<p><strong>Background: </strong>Tracheobronchial foreign body aspiration is a common pediatric emergency. In recent years, aspiration of stationery-related objects such as pen caps and pen nibs has been increasingly encountered in school-aged children. These objects possess unique structural characteristics that may influence clinical presentation and management.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 32 pediatric patients with tracheobronchial foreign body aspiration caused by pen caps or pen nibs treated between January 2017 and December 2025. Clinical features, imaging findings, foreign body characteristics, bronchoscopic management, and outcomes were analyzed. The relationship between provision of a foreign body history and disease duration was evaluated.</p><p><strong>Results: </strong>All 32 patients were school-aged boys (mean age, 8.6 years). The most common symptoms were cough and wheezing. Chest CT was performed in 31 patients (96.9%) and identified/localized the foreign body in all examined cases; however, this retrospective study did not evaluate whether CT independently changed management or outcomes. Foreign bodies were most frequently located in the right main bronchus. All cases were successfully managed using rigid bronchoscopy, with flexible bronchoscopy used as an adjunct in one case. Patients who did not provide a clear or timely history of foreign body aspiration had a significantly longer disease course compared with those with a definite history (P < 0.001). No life-threatening complications occurred; however, clinically relevant events such as transient hemoptysis, airway edema, and pneumothorax were observed in individual cases.</p><p><strong>Conclusions: </strong>Stationery-related tracheobronchial foreign body aspiration predominantly affects school-aged boys and presents unique diagnostic challenges. Delayed or absent reporting of aspiration history is associated with prolonged disease duration. CT may be considered as a selective adjunct for localization and procedural planning in clinically stable children, particularly when the history is unclear or presentation is atypical, while rigid bronchoscopy remains the primary diagnostic and therapeutic modality.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262839","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}