Infantile colic, characterized by severe abdominal pain and excessive crying, significantly impacts both infants and their parents. This study examined maternal awareness, knowledge, and attitudes towards colic, with a focus on socio-demographic factors. Conducted over eight months with a sample of 400 infants in Karachi, the research employed structured questionnaires and clinical evaluations. Statistical analysis revealed significant variations in colic occurrence based on age (p < 0.001), maternal age (p = 0.005), and educational background (p = 0.001). Gender differences in digestive issues (p = 0.02) and responses to crying based on gestational age were also notable. Additionally, educational status significantly affected perceptions of colic severity (p = 0.000) and its impact on parental mental health (p = 0.03). These findings highlight the necessity for tailored healthcare strategies that consider familial contexts and educational interventions to enhance understanding and management of infantile colic. Future research should explore the influence of gut microbiota and probiotics, aiming to develop empathetic and evidence-based approaches to improve outcomes for affected families.
{"title":"Infantile Colic in Karachi: Exploring Maternal Awareness, Attitude and Management Approaches","authors":"Syed Rohan Ali, Moosa Abdur Raqib, Kiran Mehtab, Munir Nafees, Malik Hamdan Tafheem","doi":"10.1101/2024.07.09.24310028","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310028","url":null,"abstract":"Infantile colic, characterized by severe abdominal pain and excessive crying, significantly impacts both infants and their parents. This study examined maternal awareness, knowledge, and attitudes towards colic, with a focus on socio-demographic factors. Conducted over eight months with a sample of 400 infants in Karachi, the research employed structured questionnaires and clinical evaluations. Statistical analysis revealed significant variations in colic occurrence based on age (p < 0.001), maternal age (p = 0.005), and educational background (p = 0.001). Gender differences in digestive issues (p = 0.02) and responses to crying based on gestational age were also notable. Additionally, educational status significantly affected perceptions of colic severity (p = 0.000) and its impact on parental mental health (p = 0.03). These findings highlight the necessity for tailored healthcare strategies that consider familial contexts and educational interventions to enhance understanding and management of infantile colic. Future research should explore the influence of gut microbiota and probiotics, aiming to develop empathetic and evidence-based approaches to improve outcomes for affected families.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.1101/2024.07.09.24310071
Joao G Alves, Tulio Revoredo, David Romeiro Victor, Lucas Victor Alves
The World Health Organization (WHO) and the United Nations Children s Fund (UNICEF) recommend zinc supplementation for children with diarrhea. However, most of the studies supporting this recommendation were conducted in countries with low- middle-income countries (LMICs). Although the mortality rate of acute diarrhea in developed countries is low, diarrhea leads to a high number of clinical care and hospital admissions, which represents a significant economic burden. This systematic review assessed the therapeutic benefits of zinc supplementation in the treatment of acute diarrhea in children living in high-income countries. A literature search was conducted on Medline, Embase, Cochrane, and Scielo databases for published randomized controlled trials of zinc supplementation, and acute diarrhea in children living in developed countries. The systematic literature search of the databases uncovered 609 titles, and 3 trials with a total of 620 treated children with acute diarrhea were included after a subsequent review of abstracts and full manuscripts for inclusion and exclusion criteria. Two studies showed that zinc did not interfere with the duration of diarrhea. Based on the Cochrane Risk of Bias RoB2, the risk was considered low in two studies and some concerns in another. There was no statistically significant reduction in the mean RR for diarrheal episodes after 7 days of administering zinc supplements (0.4% vs 0.6%; RR 0.73; 95% CI 0.28-1.92; p=0.53; I2=16%). Zinc supplementation did not reduce the duration of acute diarrhea among children living in developed countries.
世界卫生组织（WHO）和联合国儿童基金会（UNICEF）建议为腹泻儿童补锌。然而，支持这一建议的大多数研究都是在中低收入国家（LMICs）进行的。虽然在发达国家，急性腹泻的死亡率很低，但腹泻导致大量的临床护理和入院治疗，造成了巨大的经济负担。本系统性综述评估了补锌对治疗高收入国家儿童急性腹泻的疗效。我们在 Medline、Embase、Cochrane 和 Scielo 数据库中检索了有关发达国家儿童补锌和急性腹泻的已发表随机对照试验文献。在对数据库进行系统性文献检索后，发现了 609 个标题，在对摘要和完整手稿进行纳入和排除标准审查后，纳入了 3 项试验，共治疗了 620 名急性腹泻患儿。两项研究表明，锌不会影响腹泻的持续时间。根据科克伦偏倚风险RoB2，两项研究的风险被认为较低，另一项研究的风险值得关注。在服用锌补充剂 7 天后，腹泻发作的平均 RR 没有统计学意义上的显著降低（0.4% vs 0.6%；RR 0.73；95% CI 0.28-1.92；P=0.53；I2=16%）。补锌并未缩短发达国家儿童急性腹泻的持续时间。
{"title":"Zinc supplementation in the management of acute diarrhea in high-income countries a systematic review and meta-analysis","authors":"Joao G Alves, Tulio Revoredo, David Romeiro Victor, Lucas Victor Alves","doi":"10.1101/2024.07.09.24310071","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310071","url":null,"abstract":"The World Health Organization (WHO) and the United Nations Children s Fund (UNICEF) recommend zinc supplementation for children with diarrhea. However, most of the studies supporting this recommendation were conducted in countries with low- middle-income countries (LMICs). Although the mortality rate of acute diarrhea in developed countries is low, diarrhea leads to a high number of clinical care and hospital admissions, which represents a significant economic burden. This systematic review assessed the therapeutic benefits of zinc supplementation in the treatment of acute diarrhea in children living in high-income countries. A literature search was conducted on Medline, Embase, Cochrane, and Scielo databases for published randomized controlled trials of zinc supplementation, and acute diarrhea in children living in developed countries. The systematic literature search of the databases uncovered 609 titles, and 3 trials with a total of 620 treated children with acute diarrhea were included after a subsequent review of abstracts and full manuscripts for inclusion and exclusion criteria. Two studies showed that zinc did not interfere with the duration of diarrhea. Based on the Cochrane Risk of Bias RoB2, the risk was considered low in two studies and some concerns in another. There was no statistically significant reduction in the mean RR for diarrheal episodes after 7 days of administering zinc supplements (0.4% vs 0.6%; RR 0.73; 95% CI 0.28-1.92; p=0.53; I2=16%). Zinc supplementation did not reduce the duration of acute diarrhea among children living in developed countries.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.1101/2024.07.08.24309901
Shubaya Kasule Naggayi, Paul Bangirana, Robert O. Opoka, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Anne Jacqueline Nakitende, Dennis Kalibbala, Deogratias Munube, Phillip Kasirye, Ezekiel Mupere, John M. Ssenkusu, Nancy S. Green, Richard Idro
ABSTRACT Objective: Academic achievement in school-age children is crucial for advancing learning goals. Children with sickle cell anaemia (SCA) in Sub-Saharan Africa may be at risk of disease-associated school difficulties. Limited data exist on the academic achievement of children with SCA in the region. This study aimed to assess academic achievement of children with SCA in Uganda compared to siblings without SCA. Design and setting: A cross-sectional study conducted at Mulago Hospital SCA Clinic in Uganda. Participants: School-going children (6-12 years) with SCA and age-matched sibling controls without SCA. Outcome measures: Academic achievement was tested using the Wide Range Achievement Test, Fourth Edition (WRAT4). Outcome measures were spelling, mathematical computation, word reading, and sentence comprehension by age-normalized Z-scores on the WRAT4 test. Results: Among 68 SCA and 69 control, the mean age (standard deviation) was 9.44 (2.04) and 9.42 (2.02) years and males were 55.9% and 46.4% respectively. Mean haemoglobin was 7.9 (SD 0.89)g/dL in the SCA group versus 12.8 (SD 0.89)g/dL in the controls, (p<0.001). Children with SCA scored lower in spelling, (mean difference [95% confidence interval] -0.36 [-0.02 to -0.69], p=0.04) and mathematical computation, (mean difference [95% confidence interval] -0.51 [-0.17 to -0.85], p=0.003) than the controls. In the SCA group, lower scores in spelling correlated with age, while males performed better than females in mathematical computation. Conclusion: School-aged children with SCA are at risk of poor performance in spelling and mathematical computation. Our findings support the need for educational evaluation and possible support, especially in these two areas.
{"title":"Academic achievement in Ugandan children with sickle cell anaemia: A cross-sectional study.","authors":"Shubaya Kasule Naggayi, Paul Bangirana, Robert O. Opoka, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Anne Jacqueline Nakitende, Dennis Kalibbala, Deogratias Munube, Phillip Kasirye, Ezekiel Mupere, John M. Ssenkusu, Nancy S. Green, Richard Idro","doi":"10.1101/2024.07.08.24309901","DOIUrl":"https://doi.org/10.1101/2024.07.08.24309901","url":null,"abstract":"ABSTRACT\u0000Objective: Academic achievement in school-age children is crucial for advancing learning goals. Children with sickle cell anaemia (SCA) in Sub-Saharan Africa may be at risk of disease-associated school difficulties. Limited data exist on the academic achievement of children with SCA in the region. This study aimed to assess academic achievement of children with SCA in Uganda compared to siblings without SCA.\u0000Design and setting: A cross-sectional study conducted at Mulago Hospital SCA Clinic in Uganda.\u0000Participants: School-going children (6-12 years) with SCA and age-matched sibling controls without SCA. Outcome measures: Academic achievement was tested using the Wide Range Achievement Test, Fourth Edition (WRAT4). Outcome measures were spelling, mathematical computation, word reading, and sentence comprehension by age-normalized Z-scores on the WRAT4 test.\u0000Results: Among 68 SCA and 69 control, the mean age (standard deviation) was 9.44 (2.04) and 9.42 (2.02) years and males were 55.9% and 46.4% respectively. Mean haemoglobin was 7.9 (SD 0.89)g/dL in the SCA group versus 12.8 (SD 0.89)g/dL in the controls, (p<0.001). Children with SCA scored lower in spelling, (mean difference [95% confidence interval] -0.36 [-0.02 to -0.69], p=0.04) and mathematical computation, (mean difference [95% confidence interval] -0.51 [-0.17 to -0.85], p=0.003) than the controls. In the SCA group, lower scores in spelling correlated with age, while males performed better than females in mathematical computation.\u0000Conclusion: School-aged children with SCA are at risk of poor performance in spelling and mathematical computation. Our findings support the need for educational evaluation and possible support, especially in these two areas.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.1101/2024.07.07.24310050
Elizabeth G Salazar, Molly Passarella, Brielle Formanowski, Jeannette Rogowski, Erika Edwards, Ciaran Phibbs, Scott A Lorch
Objective To examine the association of admission NICU strain with neonatal mortality and morbidity. Study Design 2008 to 2021 South Carolina cohort using linked vital statistics and discharge data of 22 to 44 weeks GA infants, born at hospitals with a level 2 or greater unit and 5 or more births of infants <34 weeks GA/year. The exposure was tertiles of admission NICU strain, defined as the sum of infants <44 weeks GA with a congenital anomaly plus all infants born <33 weeks GA at midnight on the day of birth. We used Poisson generalized linear mixed models to examine the association of exposure to strain with the primary outcome of a composite of mortality and term and preterm morbidities adjusting for patient and hospital characteristics. Results We studied 64,647 infants from 30 hospitals. High strain was associated with increased risk of mortality and morbidity adjusting for patient/hospital factors (aIRR 1.07, 95% CI 1.01 to 1.12). Conclusion: NICU strain is associated with increased adverse outcomes.
{"title":"The Association of NICU Strain with Neonatal Mortality and Morbidity","authors":"Elizabeth G Salazar, Molly Passarella, Brielle Formanowski, Jeannette Rogowski, Erika Edwards, Ciaran Phibbs, Scott A Lorch","doi":"10.1101/2024.07.07.24310050","DOIUrl":"https://doi.org/10.1101/2024.07.07.24310050","url":null,"abstract":"Objective\u0000To examine the association of admission NICU strain with neonatal mortality and morbidity. Study Design\u00002008 to 2021 South Carolina cohort using linked vital statistics and discharge data of 22 to 44 weeks GA infants, born at hospitals with a level 2 or greater unit and 5 or more births of infants <34 weeks GA/year. The exposure was tertiles of admission NICU strain, defined as the sum of infants <44 weeks GA with a congenital anomaly plus all infants born <33 weeks GA at midnight on the day of birth. We used Poisson generalized linear mixed models to examine the association of exposure to strain with the primary outcome of a composite of mortality and term and preterm morbidities adjusting for patient and hospital characteristics. Results\u0000We studied 64,647 infants from 30 hospitals. High strain was associated with increased risk of mortality and morbidity adjusting for patient/hospital factors (aIRR 1.07, 95% CI 1.01 to 1.12). Conclusion:\u0000NICU strain is associated with increased adverse outcomes.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.1101/2024.07.05.24309972
Waverley Gee, Joseph Yuan-Mou Yang, Tom Gentles, Sonja Bastin, Ajay J Iyengar, Jian Chen, Dug Yeo Han, Rachael Cordina, Charlotte Verrall, Craig Jefferies, The Australian and New Zealand Fontan Registry
Objective: Short stature, central hypothyroidism and infertility are common in those with a Fontan circulation. Given that the Fontan circulation often results in hepatic portal venous congestion, we hypothesize that the hypothalamic-pituitary portal circulation is also affected, contributing to subsequent hypothalamic-pituitary axis dysfunction. Methods: MRI data from the Australian and New Zealand Fontan Registry (86 cases) was compared to 86 age- and sex- matched normal published controls. Total pituitary volumes (both anterior and posterior glands) were measured using a manual tracing segmentation method, and hypothalamic (and subunit) volumes using an automated segmentation tool. Measured gland volume was normalized to total brain volumes. A generalized linear model was used for statistical analysis. Results: Normalized total pituitary volumes (nTPV) were increased in Fontan patients compared to controls (p <0.0001), due to an increase in anterior pituitary volumes (nAPV) (p <0.0001), with no difference in normalized posterior pituitary volumes (p = 0.7). Furthermore, normalized anterior and tubular hypothalamic subunit groups) were increased in Fontan patients compared to the controls (p <0.01 and p <0.0001, respectively). The time between Fontan and MRI was positively related to nTPV, nAPV and bilateral hypothalamic volumes. nTPV increased with age, and the increase in nAPV was greater in Fontan patients. Conclusions: Segmental MRI Pituitary and Hypothalamus volumes post Fontan are increased and are related to the time since Fontan procedure. These findings are consistent with venous congestion of the anterior hypothalamic-pituitary portal venous system and may explain the high frequency of endocrine dysfunction in this patient group.
目的：身材矮小、中枢性甲状腺功能减退症和不育症在丰唐循环患者中很常见。鉴于 Fontan 循环常导致肝门静脉充血，我们推测下丘脑-垂体门静脉循环也会受到影响，进而导致下丘脑-垂体轴功能障碍。研究方法将澳大利亚和新西兰Fontan登记处的核磁共振成像数据（86例）与86例年龄和性别匹配的正常发表对照组进行比较。垂体总体积（包括前部和后部腺体）采用手动追踪分割法测量，下丘脑（和亚单位）体积采用自动分割工具测量。测量的腺体体积与大脑总体积进行了归一化处理。统计分析采用广义线性模型。结果与对照组相比，Fontan 患者的归一化垂体总体积（nTPV）增加（p <0.0001），这是因为垂体前叶体积（nAPV）增加（p <0.0001），而归一化垂体后叶体积没有差异（p = 0.7）。此外，与对照组相比，Fontan 患者的正常化垂体前叶和管状下丘脑亚单位组增加（分别为 p <0.01 和 p <0.0001）。Fontan和MRI之间的时间间隔与nTPV、nAPV和双侧下丘脑体积呈正相关。结论Fontan术后脑垂体和下丘脑的节段性磁共振成像体积增大，并与Fontan术后的时间有关。这些发现与下丘脑-垂体前部门静脉系统的静脉充血一致，并可解释该患者群为何频繁出现内分泌功能障碍。
{"title":"Segmental MRI Pituitary and Hypothalamus Volumes post Fontan: An analysis of the Australian and New Zealand Fontan Registry.","authors":"Waverley Gee, Joseph Yuan-Mou Yang, Tom Gentles, Sonja Bastin, Ajay J Iyengar, Jian Chen, Dug Yeo Han, Rachael Cordina, Charlotte Verrall, Craig Jefferies, The Australian and New Zealand Fontan Registry","doi":"10.1101/2024.07.05.24309972","DOIUrl":"https://doi.org/10.1101/2024.07.05.24309972","url":null,"abstract":"Objective: Short stature, central hypothyroidism and infertility are common in those with a Fontan circulation. Given that the Fontan circulation often results in hepatic portal venous congestion, we hypothesize that the hypothalamic-pituitary portal circulation is also affected, contributing to subsequent hypothalamic-pituitary axis dysfunction. Methods: MRI data from the Australian and New Zealand Fontan Registry (86 cases) was compared to 86 age- and sex- matched normal published controls. Total pituitary volumes (both anterior and posterior glands) were measured using a manual tracing segmentation method, and hypothalamic (and subunit) volumes using an automated segmentation tool. Measured gland volume was normalized to total brain volumes. A generalized linear model was used for statistical analysis. Results: Normalized total pituitary volumes (nTPV) were increased in Fontan patients compared to controls (p <0.0001), due to an increase in anterior pituitary volumes (nAPV) (p <0.0001), with no difference in normalized posterior pituitary volumes (p = 0.7). Furthermore, normalized anterior and tubular hypothalamic subunit groups) were increased in Fontan patients compared to the controls (p <0.01 and p <0.0001, respectively). The time between Fontan and MRI was positively related to nTPV, nAPV and bilateral hypothalamic volumes. nTPV increased with age, and the increase in nAPV was greater in Fontan patients. Conclusions: Segmental MRI Pituitary and Hypothalamus volumes post Fontan are increased and are related to the time since Fontan procedure. These findings are consistent with venous congestion of the anterior hypothalamic-pituitary portal venous system and may explain the high frequency of endocrine dysfunction in this patient group.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141569709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background: Neonatal hypoglycemia is one of the most common metabolic abnormalities seen in newborns. It is a major contributing factor to neonatal morbidity and mortality. Globally, it affects around 5–15% of all babies and approximately 50% of at-risk babies.. In Ethiopia, neonatal hypoglycemia is frequently diagnosed and one of the commonest causes of admission to the neonatal intensive care unit. Nevertheless, documented records regarding its magnitude and factors associated with hypoglycemia are scarce in the study area. Therefore we aimed to assess the magnitude of neonatal hypoglycemia and its associated factors among neonates admitted to the neonatal intensive care unit at Hawassa City Public Hospitals, Ethiopia. Method: Institution-based cross-sectional study was conducted from April 20 – June 20, 2023among 293 neonates. A systematic random sampling technique was used to reach the study subjects. The data was collected through face-to-face interviews and card review by using structured pretested questionnaire and analyzed using SPSS software version 25. A multivariable logistic regression model was used to determine factors significantly associated with neonatal hypoglycemia with adjusted odds ratio, p-values <0.05 at 95% confidence interval (CI). Result: The magnitude of neonatal hypoglycemia was found 16.6%. Variables significantly associated with the occurrence of neonatal hypoglycemia were: Diabetes mellitus [AOR=9.8, 95%CI (3.08-31.37)], perinatal asphyxia [AOR=2.87, 95%CI (1.07-7.72)], delayed initiation of breastfeeding [AOR=2.63, 95%CI (1.04-6.6)] and hypothermia [AOR=3.8, 95%CI (1.6-9.1)]. Conclusion: In this study the magnitude of neonatal hypoglycemia among neonates was high. Neonates with hypothermia, perinatal asphyxia, and delayed initiation of breastfeeding and maternal history of diabetes mellitus have an increased risk of developing hypoglycemia. Hence, Health care providers who are working on delivery and neonatal care should focus on early identification and management of these identified factors.
{"title":"MAGNITUDE OF NEONATAL HYPOGLYCEMIA AND ITS ASSOCIATED FACTORS AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNIT AT HAWASSA CITY PUBLIC HOSPITALS, ETHIOPIA, 2023.","authors":"selam tadele, wegene jembere, Mastewal Aschale, Tewodros Mulugeta, Samuel Jigso, Mequanint Ayehu, Migbar Sibhat","doi":"10.1101/2024.07.01.24309773","DOIUrl":"https://doi.org/10.1101/2024.07.01.24309773","url":null,"abstract":"Abstract Background: Neonatal hypoglycemia is one of the most common metabolic abnormalities seen in newborns. It is a major contributing factor to neonatal morbidity and mortality. Globally, it affects around 5–15% of all babies and approximately 50% of at-risk babies.. In Ethiopia, neonatal hypoglycemia is frequently diagnosed and one of the commonest causes of admission to the neonatal intensive care unit. Nevertheless, documented records regarding its magnitude and factors associated with hypoglycemia are scarce in the study area. Therefore we aimed to assess the magnitude of neonatal hypoglycemia and its associated factors among neonates admitted to the neonatal intensive care unit at Hawassa City Public Hospitals, Ethiopia.\u0000Method: Institution-based cross-sectional study was conducted from April 20 – June 20, 2023among 293 neonates. A systematic random sampling technique was used to reach the study subjects. The data was collected through face-to-face interviews and card review by using structured pretested questionnaire and analyzed using SPSS software version 25. A multivariable logistic regression model was used to determine factors significantly associated with neonatal hypoglycemia with adjusted odds ratio, p-values <0.05 at 95% confidence interval (CI).\u0000Result: The magnitude of neonatal hypoglycemia was found 16.6%. Variables significantly associated with the occurrence of neonatal hypoglycemia were: Diabetes mellitus [AOR=9.8, 95%CI (3.08-31.37)], perinatal asphyxia [AOR=2.87, 95%CI (1.07-7.72)], delayed initiation of breastfeeding [AOR=2.63, 95%CI (1.04-6.6)] and hypothermia [AOR=3.8, 95%CI (1.6-9.1)].\u0000Conclusion: In this study the magnitude of neonatal hypoglycemia among neonates was high. Neonates with hypothermia, perinatal asphyxia, and delayed initiation of breastfeeding and maternal history of diabetes mellitus have an increased risk of developing hypoglycemia. Hence, Health care providers who are working on delivery and neonatal care should focus on early identification and management of these identified factors.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1101/2024.06.28.24309620
Shivanthan Shanthikumar, Liam Gubbels, Karen Davies, Hannah Walker, Anson Tsz Chun Wong, Eric Levi, Richard Saffery, Sarath C. Ranganathan, Melanie R. Neeland
Despite the central role of cytokines in mediating inflammation that underlies a range of childhood diseases, cytokine testing remains primarily limited to research settings and surrogate markers of inflammation are often used to inform clinical diagnostic and treatment decisions. There are currently no reference ranges available for cytokines in healthy children, either systemically (in blood) or at sites of disease (such as the lung). In our study, we aimed to develop an openly accessible reference of cytokines in the airways and blood of healthy children spanning 1 to 16 years of age. We examined how cytokine concentration changes during childhood and assessed whether a core set of cytokine markers could be used to indirectly evaluate the response of a broad spectrum of inflammatory analytes. To develop our reference, a total of 78 unique analytes were measured in cell-free bronchoalveolar lavage (BAL) and plasma from 78 children. We showed that age profoundly impacts soluble immune analyte concentration in both sample types and identified a highly correlative core set of 10 analytes in BAL and 11 analytes in plasma capable of indirectly evaluating the response of up to 34 inflammatory mediators. This study addresses an urgent need to develop reference ranges for cytokines in healthy children to aid in diagnosis of disease, to determine eligibility for, and to monitor the effects of, cytokine-targeted monoclonal antibody therapy.
{"title":"Highly multiplexed cytokine analysis of bronchoalveolar lavage and plasma reveals age-related dynamics and correlates of inflammation in children.","authors":"Shivanthan Shanthikumar, Liam Gubbels, Karen Davies, Hannah Walker, Anson Tsz Chun Wong, Eric Levi, Richard Saffery, Sarath C. Ranganathan, Melanie R. Neeland","doi":"10.1101/2024.06.28.24309620","DOIUrl":"https://doi.org/10.1101/2024.06.28.24309620","url":null,"abstract":"Despite the central role of cytokines in mediating inflammation that underlies a range of childhood diseases, cytokine testing remains primarily limited to research settings and surrogate markers of inflammation are often used to inform clinical diagnostic and treatment decisions. There are currently no reference ranges available for cytokines in healthy children, either systemically (in blood) or at sites of disease (such as the lung). In our study, we aimed to develop an openly accessible reference of cytokines in the airways and blood of healthy children spanning 1 to 16 years of age. We examined how cytokine concentration changes during childhood and assessed whether a core set of cytokine markers could be used to indirectly evaluate the response of a broad spectrum of inflammatory analytes. To develop our reference, a total of 78 unique analytes were measured in cell-free bronchoalveolar lavage (BAL) and plasma from 78 children. We showed that age profoundly impacts soluble immune analyte concentration in both sample types and identified a highly correlative core set of 10 analytes in BAL and 11 analytes in plasma capable of indirectly evaluating the response of up to 34 inflammatory mediators. This study addresses an urgent need to develop reference ranges for cytokines in healthy children to aid in diagnosis of disease, to determine eligibility for, and to monitor the effects of, cytokine-targeted monoclonal antibody therapy.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141514853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1101/2024.07.01.24309377
Lorenz Manuel Leuenberger, Fabiën Naomi Belle, Rebeca Mozun, Ben Daniel Spycher, Maria Christina Mallet, Oskar Gian Jenni, Christoph Saner, Philipp Latzin, Alexander Moeller, Claudia Elisabeth Kuehni
INTRODUCTION: Switzerland has an ongoing debate about the appropriateness of national growth reference curves. The Swiss Society of Pediatrics currently recommends the growth references of the World Health Organization (WHO), while the Center for Pediatric Endocrinology Zurich has proposed alternative growth references based on local data. Specialists and researchers also use International Obesity Task Force (IOTF) references to define overweight and obesity. We investigated the fit of these three growth references to anthropometric measurements from schoolchildren in the canton of Zurich and assessed the prevalence of overweight, obesity, and short stature across the three references. METHODS: We analyzed data from 3755 children aged 6-17 years of the cross sectional LuftiBus in the school (LUIS) study, collected between 2013-2016 in the canton of Zurich. We calculated z-scores of height, weight, and body mass index (BMI) based on WHO, local, and IOTF references. We compared the mean and distribution of z-scores to the expected standard normal distribution using the Anderson-Darling test. We classified BMI based on cutoff values given by the three references: overweight (WHO: >90.0th percentile; local: >82.9[girls], >78.9[boys]; IOTF: >89.3[girls], >90.5[boys]), and obesity (WHO: >97.0; local: >96.8[girls], >95.5[boys]; IOTF: >98.6[girls], >98.9[boys]). We defined short stature as <3rd percentile of height-for-age. RESULTS: The mean z-scores in LUIS were 0.56 for height, 0.28 for weight, and 0.06 for BMI based on WHO references; 0.15 for height, 0.06 for weight, and -0.01 for BMI based on local references; and 0.19 for BMI based on IOTF references. WHO references provided a worse fit to the LUIS children than local references. Anderson-Darling goodness of fit A2 was 578.1 (WHO) vs. 48.1 (local) for height and 124.0 vs. 10.0 for weight, with lower values indicating better fit. WHO (A2: 24.3) and local references (A2: 0.8) fit the BMI of LUIS children better than IOTF (A2: 64.1). The WHO classified fewer children as overweight than the local and IOTF references (WHO: 9% vs. local: 15% vs. IOTF: 13%) but more children as obese (6% vs. 4% vs. 3%). The WHO defined fewer children as being of short stature than the local references (1% vs. 3%). CONCLUSIONS: Our findings suggest that anthropometric data of schoolchildren in Zurich differ notably from WHO and IOTF references potentially leading to misclassification of overweight, obesity, and short stature. Nationally representative and longitudinally collected data are needed to develop new Swiss growth references.
导言：瑞士一直在争论国家生长参考曲线是否合适。瑞士儿科学会目前推荐使用世界卫生组织（WHO）的生长参考曲线，而苏黎世儿科内分泌中心则根据当地数据提出了其他生长参考曲线。专家和研究人员还使用国际肥胖问题工作组（IOTF）的参考标准来定义超重和肥胖。我们研究了这三种生长参照标准与苏黎世州学龄儿童人体测量数据的拟合情况，并评估了这三种参照标准中超重、肥胖和身材矮小的发生率。方法：我们分析了苏黎世州在 2013-2016 年间收集的 3755 名 6-17 岁儿童的数据，这些数据来自学校中的横截面 LuftiBus（LUIS）研究。我们根据世界卫生组织、当地和国际营养与食品协会（IOTF）的参考数据计算了身高、体重和体重指数（BMI）的 z 值。我们使用 Anderson-Darling 检验将 z 值的平均值和分布与预期的标准正态分布进行了比较。我们根据三个参考值给出的临界值对体重指数进行了分类：超重（世卫组织：90.0 百分位数；地方：82.9[女孩]，78.9[男孩]；国际营养与健康研究联合会：78.9[男孩]，82.9[女孩]）。9[男孩]；IOTF：>89.3[女孩]，>90.5[男孩]）和肥胖（WHO：>97.0；当地：>96.8[女孩]，>95.5[男孩]；IOTF：>98.6[女孩]，>98.9[男孩]）。结果：根据世界卫生组织的参考数据，LUIS 系统中身高的平均 z 值为 0.56，体重的平均 z 值为 0.28，BMI 的平均 z 值为 0.06；根据当地参考数据，身高的平均 z 值为 0.15，体重的平均 z 值为 0.06，BMI 的平均 z 值为-0.01；根据 IOTF 的参考数据，BMI 的平均 z 值为 0.19。世卫组织参考资料与 LUIS 儿童的拟合程度低于本地参考资料。身高的安德森-达林拟合度 A2 为 578.1（世卫组织）对 48.1（本地），体重的安德森-达林拟合度 A2 为 124.0 对 10.0，数值越低，拟合度越高。世卫组织（A2: 24.3）和本地参考值（A2: 0.8）比国际OTF（A2: 64.1）更适合 LUIS 儿童的体重指数。世卫组织将儿童划分为超重的比例低于本地参考值和 IOTF 参考值（世卫组织：9% 对本地：15% 对 IOTF：13%），但将更多儿童划分为肥胖（6% 对 4% 对 3%）。世卫组织定义为身材矮小的儿童少于当地参考值（1% vs. 3%）：我们的研究结果表明，苏黎世学龄儿童的人体测量数据与世界卫生组织和国际儿童发育组织的参考数据存在明显差异，这可能会导致超重、肥胖和身材矮小的错误分类。需要收集具有全国代表性的纵向数据，以制定新的瑞士生长参考标准。
{"title":"Evaluating Swiss growth reference curves: A comparative analysis in Zurich schoolchildren","authors":"Lorenz Manuel Leuenberger, Fabiën Naomi Belle, Rebeca Mozun, Ben Daniel Spycher, Maria Christina Mallet, Oskar Gian Jenni, Christoph Saner, Philipp Latzin, Alexander Moeller, Claudia Elisabeth Kuehni","doi":"10.1101/2024.07.01.24309377","DOIUrl":"https://doi.org/10.1101/2024.07.01.24309377","url":null,"abstract":"INTRODUCTION: Switzerland has an ongoing debate about the appropriateness of national growth reference curves. The Swiss Society of Pediatrics currently recommends the growth references of the World Health Organization (WHO), while the Center for Pediatric Endocrinology Zurich has proposed alternative growth references based on local data. Specialists and researchers also use International Obesity Task Force (IOTF) references to define overweight and obesity. We investigated the fit of these three growth references to anthropometric measurements from schoolchildren in the canton of Zurich and assessed the prevalence of overweight, obesity, and short stature across the three references.\u0000METHODS: We analyzed data from 3755 children aged 6-17 years of the cross sectional LuftiBus in the school (LUIS) study, collected between 2013-2016 in the canton of Zurich. We calculated z-scores of height, weight, and body mass index (BMI) based on WHO, local, and IOTF references. We compared the mean and distribution of z-scores to the expected standard normal distribution using the Anderson-Darling test. We classified BMI based on cutoff values given by the three references: overweight (WHO: >90.0<sup>th</sup> percentile; local: >82.9<sub>[girls]</sub>, >78.9<sub>[boys]</sub>; IOTF: >89.3<sub>[girls]</sub>, >90.5<sub>[boys]</sub>), and obesity (WHO: >97.0; local: >96.8<sub>[girls]</sub>, >95.5<sub>[boys]</sub>; IOTF: >98.6<sub>[girls]</sub>, >98.9<sub>[boys]</sub>). We defined short stature as <3<sup>rd</sup> percentile of height-for-age.\u0000RESULTS: The mean z-scores in LUIS were 0.56 for height, 0.28 for weight, and 0.06 for BMI based on WHO references; 0.15 for height, 0.06 for weight, and -0.01 for BMI based on local references; and 0.19 for BMI based on IOTF references. WHO references provided a worse fit to the LUIS children than local references. Anderson-Darling goodness of fit A<sup>2</sup> was 578.1 (WHO) vs. 48.1 (local) for height and 124.0 vs. 10.0 for weight, with lower values indicating better fit. WHO (A<sup>2</sup>: 24.3) and local references (A<sup>2</sup>: 0.8) fit the BMI of LUIS children better than IOTF (A<sup>2</sup>: 64.1). The WHO classified fewer children as overweight than the local and IOTF references (WHO: 9% vs. local: 15% vs. IOTF: 13%) but more children as obese (6% vs. 4% vs. 3%). The WHO defined fewer children as being of short stature than the local references (1% vs. 3%).\u0000CONCLUSIONS: Our findings suggest that anthropometric data of schoolchildren in Zurich differ notably from WHO and IOTF references potentially leading to misclassification of overweight, obesity, and short stature. Nationally representative and longitudinally collected data are needed to develop new Swiss growth references.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-28DOI: 10.1101/2024.06.28.24309651
yong Liu, Alan R . Barker, Anna-Lynne R Adlam, Minghui Li, Stephanie L. Duncombe, Andrew O. Agbaje, Yaodong Gu, Huiyu Zhou, Craig A. Williams
Introduction High-intensity interval training (HIIT) is an effective strategy for improving a variety of health and fitness outcomes within the school settings. Incorporating HIIT into existing physical activity opportunities appears practically feasible, yet the process evaluation and effectiveness of this strategy needs to be further evaluated. Therefore, a PRO-HIIT intervention will be conducted to evaluate the effectiveness of a 12-week school-based HIIT intervention on cardiorespiratory fitness, physical activity, body composition, muscular strength, bone health, cognitive function, wellbeing and academic performance among 12-13-year-olds. Methods and analysis Eight classes of year 7 students (12-13-year-olds) from a secondary school in Ningbo, China, will be recruited and randomly allocated into an intervention or control group. While the control group maintains their usual activities, a 6 to 10-minute HIIT session will be embedded in the physical education or physical activity lessons five days a week for 12 weeks for the intervention group. Training workshops will be conducted for participants, teachers, and research staff for facilitating the intervention. Outcome data will be collected at three time points: pre- and post-intervention, and two months (summer holiday) upon completion of the intervention. Linear mixed models will be used to analyse the impact of groups (intervention and control), timepoints (pre-, post- and two-month after intervention) and group by time interactions. The implementation process of the intervention will be evaluated with the guidance of MRC process evaluation framework. Ethics and dissemination Ethics approval is obtained from the Ningbo University Ethics Committee (TY2024002) and the Public Health and Sport Sciences ethics committee, University of Exeter (5713479). Results from PRO-HIIT study will be disseminated via peer-reviewed journals, scientific conferences as well as local education system. The study protocol has been retrospectively registered on ClinicalTrials.gov Protocol Registration and Results System (NCT06374732), https://clinicaltrials.gov/study/NCT06374732.
{"title":"Effectiveness of a school-based high-intensity interval training intervention in adolescents: study protocol of the PRO-HIIT cluster randomised controlled trial","authors":"yong Liu, Alan R . Barker, Anna-Lynne R Adlam, Minghui Li, Stephanie L. Duncombe, Andrew O. Agbaje, Yaodong Gu, Huiyu Zhou, Craig A. Williams","doi":"10.1101/2024.06.28.24309651","DOIUrl":"https://doi.org/10.1101/2024.06.28.24309651","url":null,"abstract":"Introduction High-intensity interval training (HIIT) is an effective strategy for improving a variety of health and fitness outcomes within the school settings. Incorporating HIIT into existing physical activity opportunities appears practically feasible, yet the process evaluation and effectiveness of this strategy needs to be further evaluated. Therefore, a PRO-HIIT intervention will be conducted to evaluate the effectiveness of a 12-week school-based HIIT intervention on cardiorespiratory fitness, physical activity, body composition, muscular strength, bone health, cognitive function, wellbeing and academic performance among 12-13-year-olds.\u0000Methods and analysis\u0000Eight classes of year 7 students (12-13-year-olds) from a secondary school in Ningbo, China, will be recruited and randomly allocated into an intervention or control group. While the control group maintains their usual activities, a 6 to 10-minute HIIT session will be embedded in the physical education or physical activity lessons five days a week for 12 weeks for the intervention group. Training workshops will be conducted for participants, teachers, and research staff for facilitating the intervention. Outcome data will be collected at three time points: pre- and post-intervention, and two months (summer holiday) upon completion of the intervention. Linear mixed models will be used to analyse the impact of groups (intervention and control), timepoints (pre-, post- and two-month after intervention) and group by time interactions. The implementation process of the intervention will be evaluated with the guidance of MRC process evaluation framework.\u0000Ethics and dissemination\u0000Ethics approval is obtained from the Ningbo University Ethics Committee (TY2024002) and the Public Health and Sport Sciences ethics committee, University of Exeter (5713479). Results from PRO-HIIT study will be disseminated via peer-reviewed journals, scientific conferences as well as local education system. The study protocol has been retrospectively registered on ClinicalTrials.gov Protocol Registration and Results System (NCT06374732), https://clinicaltrials.gov/study/NCT06374732.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27DOI: 10.1101/2024.06.26.24309514
Sophia M Blaauwendraad, Arwen SJ Kamphuis, Francisco Javier Ruiz-Ojeda, Marco Brandimonte-Hernandez, Eduard Flores-Ventura, Marieke Abrahamse-Berkeveld, Maria Carmen COLLADO, Janna A van Diepen, Patricia Iozzo, Karen Knipping, Carolien A van Loo-Bouwman, Angel Gil, Romy Gaillard
Background Adverse early life exposures might negatively affect foetal and infant development, predisposing children to obesity. We aimed to systematically identify and evaluate risk factors for childhood obesity in preconception, pregnancy, and infancy, and assess their potential as targets for future prediction and prevention strategies. Methods This systematic review (PROSPERO, CRD42022355152) included longitudinal studies from selected electronic databases published between inception and August 17th, 2022, identifying maternal, paternal, or infant risk factors from preconception until infancy for childhood obesity between 2 and 18 years. Screening and data extraction was performed through standardized extraction forms. We assessed risk factor quality on modifiability and predictive power using a piloted criteria template from ILSI-Europe-Marker-Validation-Initiative. Findings We identified 172 observational and 5 intervention studies involving n=1.879.971 children from 37, predominantly high-income, countries. 59%, 25% and 16% of studies measured childhood obesity between 2- <6 years, 6-10 years, and >10 -18 years respectively. Average reported childhood obesity prevalence was 11.1%. Pregnancy and infancy risk factors were mostly studied. We identified 59 potential risk factors, 24 of which were consistently associated with childhood obesity risk. Higher maternal prepregnancy weight (n=28/31 positive associations from 31 studies, respectively), higher gestational weight gain (n=18/21), maternal smoking during pregnancy (n=23/29), higher birth weight (n=20/28), LGA (n=17/18), no breastfeeding (n=20/31), and higher infant weight gain (n=12/12) were the strongest risk factors, which may aid in prediction or be targets for prevention. Level of evidence was generally moderate due to unreliable exposure measurement, short follow-up/loss-to-follow up, and risk of confounding. Interpretation We identified 7 early life risk factors, which were strongly associated with a higher risk of childhood obesity, and can contribute to future prediction and prevention strategies. These findings support implementation of prevention strategies targeting these early-life risk factors from a clinical and population perspective, where possible integrated with implementation studies. Funding This work was conducted by an expert group of the European branch of the International Life Sciences Institute, ILSI Europe.
{"title":"Risk factors in the first 1000 days of life associated with childhood obesity: a systematic review and risk factor quality assessment.","authors":"Sophia M Blaauwendraad, Arwen SJ Kamphuis, Francisco Javier Ruiz-Ojeda, Marco Brandimonte-Hernandez, Eduard Flores-Ventura, Marieke Abrahamse-Berkeveld, Maria Carmen COLLADO, Janna A van Diepen, Patricia Iozzo, Karen Knipping, Carolien A van Loo-Bouwman, Angel Gil, Romy Gaillard","doi":"10.1101/2024.06.26.24309514","DOIUrl":"https://doi.org/10.1101/2024.06.26.24309514","url":null,"abstract":"Background Adverse early life exposures might negatively affect foetal and infant development, predisposing children to obesity. We aimed to systematically identify and evaluate risk factors for childhood obesity in preconception, pregnancy, and infancy, and assess their potential as targets for future prediction and prevention strategies.\u0000Methods This systematic review (PROSPERO, CRD42022355152) included longitudinal studies from selected electronic databases published between inception and August 17th, 2022, identifying maternal, paternal, or infant risk factors from preconception until infancy for childhood obesity between 2 and 18 years. Screening and data extraction was performed through standardized extraction forms. We assessed risk factor quality on modifiability and predictive power using a piloted criteria template from ILSI-Europe-Marker-Validation-Initiative. Findings We identified 172 observational and 5 intervention studies involving n=1.879.971 children from 37, predominantly high-income, countries. 59%, 25% and 16% of studies measured childhood obesity between 2- <6 years, 6-10 years, and >10 -18 years respectively. Average reported childhood obesity prevalence was 11.1%. Pregnancy and infancy risk factors were mostly studied. We identified 59 potential risk factors, 24 of which were consistently associated with childhood obesity risk. Higher maternal prepregnancy weight (n=28/31 positive associations from 31 studies, respectively), higher gestational weight gain (n=18/21), maternal smoking during pregnancy (n=23/29), higher birth weight (n=20/28), LGA (n=17/18), no breastfeeding (n=20/31), and higher infant weight gain (n=12/12) were the strongest risk factors, which may aid in prediction or be targets for prevention. Level of evidence was generally moderate due to unreliable exposure measurement, short follow-up/loss-to-follow up, and risk of confounding. Interpretation We identified 7 early life risk factors, which were strongly associated with a higher risk of childhood obesity, and can contribute to future prediction and prevention strategies. These findings support implementation of prevention strategies targeting these early-life risk factors from a clinical and population perspective, where possible integrated with implementation studies. Funding This work was conducted by an expert group of the European branch of the International Life Sciences Institute, ILSI Europe.","PeriodicalId":501549,"journal":{"name":"medRxiv - Pediatrics","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141514911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：