Pub Date : 2025-03-01DOI: 10.1016/j.lanepe.2025.101252
Francesco Di Gennaro, Annalisa Saracino
{"title":"Bridging gaps in migrant health competencies for infectious and tropical diseases specialists: the experience of the University of Bari from Lampedusa to Apulian Ghettos","authors":"Francesco Di Gennaro, Annalisa Saracino","doi":"10.1016/j.lanepe.2025.101252","DOIUrl":"10.1016/j.lanepe.2025.101252","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101252"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this short correspondence, we comment the recently published article “Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study” (The Lancet–Global Health Europe, https://doi.org/10.1016/j.lanepe.2024.101092). We commend the authors for generating real-world evidence that highlights the importance of rapid access to disease modifying therapy (DMT) for newly diagnosed patients. However, we caution that confirmatory studies are required to better understand the impact of treatment sequences, particularly in the presence of prior DMT exposure. Addressing these issues will ensure that clinical decision-making is based on the most rigorous evidence available.
{"title":"Real-world evidence in spinal muscular atrophy: addressing heterogeneity of populations and treatment comparisons","authors":"Juliette Ropars , Lamiae Grimaldi , Susana Quijano-Roy","doi":"10.1016/j.lanepe.2025.101248","DOIUrl":"10.1016/j.lanepe.2025.101248","url":null,"abstract":"<div><div>In this short correspondence, we comment the recently published article “Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study” (The Lancet–Global Health Europe, <span><span>https://doi.org/10.1016/j.lanepe.2024.101092</span><svg><path></path></svg></span>). We commend the authors for generating real-world evidence that highlights the importance of rapid access to disease modifying therapy (DMT) for newly diagnosed patients. However, we caution that confirmatory studies are required to better understand the impact of treatment sequences, particularly in the presence of prior DMT exposure. Addressing these issues will ensure that clinical decision-making is based on the most rigorous evidence available.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101248"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.lanepe.2025.101255
Alessandro Perrella , Massimo Bisogno
{"title":"The strength and resilience of Italy’s health data system","authors":"Alessandro Perrella , Massimo Bisogno","doi":"10.1016/j.lanepe.2025.101255","DOIUrl":"10.1016/j.lanepe.2025.101255","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101255"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.lanepe.2024.101188
Syed Ahmar Shah , Karen Jeffrey , Chris Robertson , Aziz Sheikh
Background
Prioritisation of COVID-19 care led to widespread cancellations of elective care, creating a substantial backlog for healthcare systems worldwide. While the pandemic's impacts on elective hospital waiting lists during the early phase of the pandemic have been described in multiple countries, there is limited research on longer-term impacts and recovery efforts.
Methods
We conducted a country-wide analysis of Scotland's healthcare system over an 11-year period (January 1, 2013–December 31, 2023) to assess the pandemic's impact on the elective care backlog, evaluate recovery efforts, and estimate the capacity increase required to clear the backlog. Our analysis involved assessments at national, elective type, regional, and specialty levels. We used descriptive statistics to compare trends and a statistical modelling approach (Vector Autoregressive model with exogenous variables) to estimate capacity increases needed.
Findings
Waiting lists gradually increased before the pandemic (2013: n = 285,149; 2019: n = 385,859; 35.3% increase over six years) and then rose rapidly during the pandemic (2023: n = 667,749; 73.1% increase over four years). Capacity for elective care dropped substantially during the initial lockdown period (April–June 2020) and had not fully recovered by the end of 2023. These patterns were broadly consistent across Scotland and similar trends were observed when stratified by elective type, region, and specialty. The number of referrals waiting over a year increased from 3056 on December 31, 2019, to 78,243 (>2400% increase) by December 31, 2023. To eliminate the backlog created during the pandemic, a gradual increase in capacity, accumulating to 20% over three years is required. This corresponds to an annual increase of approximately 6.67%, translating to an additional 32,302 cases per year.
Interpretation
Scotland's healthcare system struggled to meet elective care demand pre-pandemic, and the pandemic has worsened an already difficult situation. Pre-pandemic elective care capacity had not been restored by the end of 2023. While substantial additional capacity is necessary, it is crucial to adopt broader system-level strategies to effectively address waiting list backlogs.
Funding
University of Edinburgh’s Chancellor Fellowship; Health Data Research UK.
{"title":"Impact of COVID-19 pandemic on elective care backlog trends, recovery efforts, and capacity needs to address backlogs in Scotland (2013–2023): a descriptive analysis and modelling study","authors":"Syed Ahmar Shah , Karen Jeffrey , Chris Robertson , Aziz Sheikh","doi":"10.1016/j.lanepe.2024.101188","DOIUrl":"10.1016/j.lanepe.2024.101188","url":null,"abstract":"<div><h3>Background</h3><div>Prioritisation of COVID-19 care led to widespread cancellations of elective care, creating a substantial backlog for healthcare systems worldwide. While the pandemic's impacts on elective hospital waiting lists during the early phase of the pandemic have been described in multiple countries, there is limited research on longer-term impacts and recovery efforts.</div></div><div><h3>Methods</h3><div>We conducted a country-wide analysis of Scotland's healthcare system over an 11-year period (January 1, 2013–December 31, 2023) to assess the pandemic's impact on the elective care backlog, evaluate recovery efforts, and estimate the capacity increase required to clear the backlog. Our analysis involved assessments at national, elective type, regional, and specialty levels. We used descriptive statistics to compare trends and a statistical modelling approach (Vector Autoregressive model with exogenous variables) to estimate capacity increases needed.</div></div><div><h3>Findings</h3><div>Waiting lists gradually increased before the pandemic (2013: n = 285,149; 2019: n = 385,859; 35.3% increase over six years) and then rose rapidly during the pandemic (2023: n = 667,749; 73.1% increase over four years). Capacity for elective care dropped substantially during the initial lockdown period (April–June 2020) and had not fully recovered by the end of 2023. These patterns were broadly consistent across Scotland and similar trends were observed when stratified by elective type, region, and specialty. The number of referrals waiting over a year increased from 3056 on December 31, 2019, to 78,243 (>2400% increase) by December 31, 2023. To eliminate the backlog created during the pandemic, a gradual increase in capacity, accumulating to 20% over three years is required. This corresponds to an annual increase of approximately 6.67%, translating to an additional 32,302 cases per year.</div></div><div><h3>Interpretation</h3><div>Scotland's healthcare system struggled to meet elective care demand pre-pandemic, and the pandemic has worsened an already difficult situation. Pre-pandemic elective care capacity had not been restored by the end of 2023. While substantial additional capacity is necessary, it is crucial to adopt broader system-level strategies to effectively address waiting list backlogs.</div></div><div><h3>Funding</h3><div><span>University of Edinburgh’s Chancellor Fellowship</span>; <span>Health Data Research UK</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101188"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.lanepe.2024.101171
Lorenza Rimassa , Shahid Khan , Bas Groot Koerkamp , Stephanie Roessler , Jesper B. Andersen , Chiara Raggi , Ana Lleo , Jean-Charles Nault , Julien Calderaro , Chiara Gabbi , Jakob N. Kather , Jesus M. Banales , Irene Bargellini , Helen Morement , Marcin Krawczyk , Paraskevi A. Farazi , Guido Carpino , Matias A. Avila , Anna Saborowski , Vincenzo Cardinale , Rocio I.R. Macias
Biliary tract cancer (BTC) is becoming more common worldwide, with geographic differences in incidence and risk factors. In Europe, BTC may be associated with primary sclerosing cholangitis, lithiasis, and liver cirrhosis, but is more frequently observed as a sporadic disease. BTC increasingly affects patients under 60 years, resulting in a significant social and economic burden. Early diagnosis remains challenging due to vague symptoms in 50% of patients with BTC, and lack of specific biomarkers, resulting in late presentation and poor prognosis. The identification of patients at increased risk and reliable biomarkers require collaborative efforts to make faster progress. This Series paper highlights the disparities in access to diagnostic tools and multidisciplinary care in Europe, particularly in economically disadvantaged regions, while identifying priority areas for improvement. Addressing these inequities requires harmonised guidelines, accelerated pathways to curative treatments, and improved awareness among healthcare professionals and the public. Multidisciplinary teams (MDTs) are crucial for the diagnosis of BTC and for improving patient outcomes, yet inconsistencies exist in their implementation not only between different countries, but also between different centres within a country. Collaboration and standardisation of diagnostic and treatment protocols across Europe are essential to effectively address the management of patients with BTC.
{"title":"Mapping the landscape of biliary tract cancer in Europe: challenges and controversies","authors":"Lorenza Rimassa , Shahid Khan , Bas Groot Koerkamp , Stephanie Roessler , Jesper B. Andersen , Chiara Raggi , Ana Lleo , Jean-Charles Nault , Julien Calderaro , Chiara Gabbi , Jakob N. Kather , Jesus M. Banales , Irene Bargellini , Helen Morement , Marcin Krawczyk , Paraskevi A. Farazi , Guido Carpino , Matias A. Avila , Anna Saborowski , Vincenzo Cardinale , Rocio I.R. Macias","doi":"10.1016/j.lanepe.2024.101171","DOIUrl":"10.1016/j.lanepe.2024.101171","url":null,"abstract":"<div><div>Biliary tract cancer (BTC) is becoming more common worldwide, with geographic differences in incidence and risk factors. In Europe, BTC may be associated with primary sclerosing cholangitis, lithiasis, and liver cirrhosis, but is more frequently observed as a sporadic disease. BTC increasingly affects patients under 60 years, resulting in a significant social and economic burden. Early diagnosis remains challenging due to vague symptoms in 50% of patients with BTC, and lack of specific biomarkers, resulting in late presentation and poor prognosis. The identification of patients at increased risk and reliable biomarkers require collaborative efforts to make faster progress. This Series paper highlights the disparities in access to diagnostic tools and multidisciplinary care in Europe, particularly in economically disadvantaged regions, while identifying priority areas for improvement. Addressing these inequities requires harmonised guidelines, accelerated pathways to curative treatments, and improved awareness among healthcare professionals and the public. Multidisciplinary teams (MDTs) are crucial for the diagnosis of BTC and for improving patient outcomes, yet inconsistencies exist in their implementation not only between different countries, but also between different centres within a country. Collaboration and standardisation of diagnostic and treatment protocols across Europe are essential to effectively address the management of patients with BTC.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101171"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.lanepe.2024.101170
Lorenza Rimassa , Angela Lamarca , Grainne M. O'Kane , Julien Edeline , Mairéad G. McNamara , Arndt Vogel , Matteo Fassan , Alejandro Forner , Timothy Kendall , Jorge Adeva , Andrea Casadei-Gardini , Lorenzo Fornaro , Antoine Hollebecque , Maeve A. Lowery , Teresa Macarulla , David Malka , Elene Mariamidze , Monica Niger , Anu Ustav , John Bridgewater , Chiara Braconi
In recent years, treatment options for patients with advanced biliary tract cancer (BTC) have increased significantly due to the positive results from phase 2/3 clinical trials of immune checkpoint inhibitors, combined with chemotherapy, and molecularly targeted agents. These advances have led to the need for molecular testing to identify actionable alterations and patients amenable to targeted therapies. However, these improvements have brought with them many questions and challenges, including the identification of resistance mechanisms and therapeutic sequences. In this Series paper we aim to provide an overview of the current systemic treatment options for patients with BTC, highlighting disparities in access to innovative treatments and molecular testing across European countries, which lead to inequalities in the possibilities of treating patients with advanced BTC. We also discuss how ongoing European collaborative projects, such as the COST Action Precision-BTC-Network CA22125, supported by COST (European Cooperation in Science and Technology), linked to the European Network for the Study of Cholangiocarcinoma (ENSCCA), can help overcome these disparities and improve the current scenario.
{"title":"New systemic treatment paradigms in advanced biliary tract cancer and variations in patient access across Europe","authors":"Lorenza Rimassa , Angela Lamarca , Grainne M. O'Kane , Julien Edeline , Mairéad G. McNamara , Arndt Vogel , Matteo Fassan , Alejandro Forner , Timothy Kendall , Jorge Adeva , Andrea Casadei-Gardini , Lorenzo Fornaro , Antoine Hollebecque , Maeve A. Lowery , Teresa Macarulla , David Malka , Elene Mariamidze , Monica Niger , Anu Ustav , John Bridgewater , Chiara Braconi","doi":"10.1016/j.lanepe.2024.101170","DOIUrl":"10.1016/j.lanepe.2024.101170","url":null,"abstract":"<div><div>In recent years, treatment options for patients with advanced biliary tract cancer (BTC) have increased significantly due to the positive results from phase 2/3 clinical trials of immune checkpoint inhibitors, combined with chemotherapy, and molecularly targeted agents. These advances have led to the need for molecular testing to identify actionable alterations and patients amenable to targeted therapies. However, these improvements have brought with them many questions and challenges, including the identification of resistance mechanisms and therapeutic sequences. In this Series paper we aim to provide an overview of the current systemic treatment options for patients with BTC, highlighting disparities in access to innovative treatments and molecular testing across European countries, which lead to inequalities in the possibilities of treating patients with advanced BTC. We also discuss how ongoing European collaborative projects, such as the COST Action Precision-BTC-Network CA22125, supported by COST (European Cooperation in Science and Technology), linked to the European Network for the Study of Cholangiocarcinoma (ENSCCA), can help overcome these disparities and improve the current scenario.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101170"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.lanepe.2025.101251
Antonello Maruotti
{"title":"Catastrophe and impoverishment in paying for health care: the Italian case","authors":"Antonello Maruotti","doi":"10.1016/j.lanepe.2025.101251","DOIUrl":"10.1016/j.lanepe.2025.101251","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101251"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-26DOI: 10.1016/j.lanepe.2025.101247
Romy Gonçalves , Sophia Blaauwendraad , Demetris Avraam , Andrea Beneíto , Marie-Aline Charles , Ahmed Elhakeem , Joaquin Escribano , Louise Etienne , Gonzalo García-Baquero Moneo , Ana Gonçalves Soares , Jasmin de Groot , Veit Grote , Dariusz Gruszfeld , Kathrin Guerlich , Monica Guxens , Barbara Heude , Berthold Koletzko , Aitana Lertxundi , Manuel Lozano , Hanan El Marroun , Vincent W.V. Jaddoe
<div><h3>Background</h3><div>Fetal and infant development might be critical for cognitive outcomes and psychopathology later in life. We assessed the associations of birth characteristics and early life growth with behavior and cognitive outcomes from childhood to adolescence.</div></div><div><h3>Methods</h3><div>We used harmonized data of 109,481 children from 8 European birth cohorts. Birth weight, gestational age, and body mass index (BMI) tertiles at the age of 2 years were used as the exposure variables. Outcomes included internalizing and externalizing problems and attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and non-verbal intelligence quotient (Non-verbal IQ) in childhood (4–10 years), early adolescence (11–16 years), and late adolescence (17–20 years). We used 1-stage individual participant data meta-analyses using generalized linear models.</div></div><div><h3>Findings</h3><div>A one-week older gestational age was associated with lower scores for internalizing problems (difference −0·48 (95% CI: −0·59, −0·37)), externalizing problems (difference −0·34 (95% CI: −0·44, −0·23)), and ADHD symptoms (difference −0·38 (95% CI: −0·49, −0·27)), and with higher scores for non-verbal IQ (difference 0·65 (95% CI: 0·41, 0·89)). As compared to term birth, preterm birth was associated with higher internalizing problems (difference 3·43 (95% CI: 2·52, 4·33)) and externalizing problems (difference 2·31 (95% CI: 1·16, 3·46)), ADHD symptoms (difference 4·15 (95% CI: 3·15, 5·16)), ASD symptoms (difference 3·23 (95% CI: 0·37, 6·08)), and lower non-verbal IQ (difference −5·44 (95% CI: −7·44, −3·44)). Small size for gestational age at birth (SGA) in comparison with appropriate size for gestational age (AGA) was associated with higher ADHD symptoms (difference 4·88 (95% CI: 3·87, 5·90)) and lower Non-verbal IQ (difference −7·02 (95% CI: −8·84, −5·21)). Large size for gestational age at birth was associated with lower ADHD symptoms (difference −1·09 (95% CI: −1·73, 0·45)) and higher non-verbal IQ (difference 2·47 (95% CI: 0·77, 4·18)). Explorative analyses showed that as compared to children with an appropriate size for gestational age at birth and a normal BMI at the age of 2 years, children born SGA who remained small at 2 years had the lowest non-verbal IQ score (difference −8·14 percentiles (95% CI: −11·89, −4·39)).</div></div><div><h3>Interpretation</h3><div>Both fetal and early childhood growth are associated with emotional, behavioral and cognitive outcomes throughout childhood and adolescence. Compensatory infant growth might partly attenuate the adverse effects of suboptimal fetal growth. Future studies are needed to identify the potential for optimizing mental health outcomes in new generations by improving early-life growth.</div></div><div><h3>Funding</h3><div>This project received funding from the <span>European Union's Horizon 2020 research and innovation programme</span> (<span>LIFECYCLE</span>, grant agreement
{"title":"Early-life growth and emotional, behavior and cognitive outcomes in childhood and adolescence in the EU child cohort network: individual participant data meta-analysis of over 109,000 individuals","authors":"Romy Gonçalves , Sophia Blaauwendraad , Demetris Avraam , Andrea Beneíto , Marie-Aline Charles , Ahmed Elhakeem , Joaquin Escribano , Louise Etienne , Gonzalo García-Baquero Moneo , Ana Gonçalves Soares , Jasmin de Groot , Veit Grote , Dariusz Gruszfeld , Kathrin Guerlich , Monica Guxens , Barbara Heude , Berthold Koletzko , Aitana Lertxundi , Manuel Lozano , Hanan El Marroun , Vincent W.V. Jaddoe","doi":"10.1016/j.lanepe.2025.101247","DOIUrl":"10.1016/j.lanepe.2025.101247","url":null,"abstract":"<div><h3>Background</h3><div>Fetal and infant development might be critical for cognitive outcomes and psychopathology later in life. We assessed the associations of birth characteristics and early life growth with behavior and cognitive outcomes from childhood to adolescence.</div></div><div><h3>Methods</h3><div>We used harmonized data of 109,481 children from 8 European birth cohorts. Birth weight, gestational age, and body mass index (BMI) tertiles at the age of 2 years were used as the exposure variables. Outcomes included internalizing and externalizing problems and attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and non-verbal intelligence quotient (Non-verbal IQ) in childhood (4–10 years), early adolescence (11–16 years), and late adolescence (17–20 years). We used 1-stage individual participant data meta-analyses using generalized linear models.</div></div><div><h3>Findings</h3><div>A one-week older gestational age was associated with lower scores for internalizing problems (difference −0·48 (95% CI: −0·59, −0·37)), externalizing problems (difference −0·34 (95% CI: −0·44, −0·23)), and ADHD symptoms (difference −0·38 (95% CI: −0·49, −0·27)), and with higher scores for non-verbal IQ (difference 0·65 (95% CI: 0·41, 0·89)). As compared to term birth, preterm birth was associated with higher internalizing problems (difference 3·43 (95% CI: 2·52, 4·33)) and externalizing problems (difference 2·31 (95% CI: 1·16, 3·46)), ADHD symptoms (difference 4·15 (95% CI: 3·15, 5·16)), ASD symptoms (difference 3·23 (95% CI: 0·37, 6·08)), and lower non-verbal IQ (difference −5·44 (95% CI: −7·44, −3·44)). Small size for gestational age at birth (SGA) in comparison with appropriate size for gestational age (AGA) was associated with higher ADHD symptoms (difference 4·88 (95% CI: 3·87, 5·90)) and lower Non-verbal IQ (difference −7·02 (95% CI: −8·84, −5·21)). Large size for gestational age at birth was associated with lower ADHD symptoms (difference −1·09 (95% CI: −1·73, 0·45)) and higher non-verbal IQ (difference 2·47 (95% CI: 0·77, 4·18)). Explorative analyses showed that as compared to children with an appropriate size for gestational age at birth and a normal BMI at the age of 2 years, children born SGA who remained small at 2 years had the lowest non-verbal IQ score (difference −8·14 percentiles (95% CI: −11·89, −4·39)).</div></div><div><h3>Interpretation</h3><div>Both fetal and early childhood growth are associated with emotional, behavioral and cognitive outcomes throughout childhood and adolescence. Compensatory infant growth might partly attenuate the adverse effects of suboptimal fetal growth. Future studies are needed to identify the potential for optimizing mental health outcomes in new generations by improving early-life growth.</div></div><div><h3>Funding</h3><div>This project received funding from the <span>European Union's Horizon 2020 research and innovation programme</span> (<span>LIFECYCLE</span>, grant agreement","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101247"},"PeriodicalIF":13.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.lanepe.2025.101244
Tom H. Karlsen , Frank Murray , Filippos T. Filippidis , Marieke Meijer , Pooja Jha , Gunhild Waldemar , Elizabeth Macintyre
{"title":"Opportunities for European medical societies within the European Global Health strategy","authors":"Tom H. Karlsen , Frank Murray , Filippos T. Filippidis , Marieke Meijer , Pooja Jha , Gunhild Waldemar , Elizabeth Macintyre","doi":"10.1016/j.lanepe.2025.101244","DOIUrl":"10.1016/j.lanepe.2025.101244","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101244"},"PeriodicalIF":13.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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