Acta Paediatrica最新文献

Aim: Peanut and tree nut allergies are leading causes of food-induced anaphylaxis in children. We aimed to examine early introduction and allergic characteristics in children with suspected severe peanut and/or tree nut allergy.

Methods: Children aged 3-16 years with suspected severe peanut and/or tree nut allergy were recruited from Tampere University Hospital, Finland. Eligibility was based on a history of anaphylaxis and/or elevated specific immunoglobulin E (sIgE) to high-risk allergenic components. Data were collected through structured, physician-led interviews with participants and their caregivers.

Results: The study included 103 children (mean age 7.2 ± 3.0 years), of whom 47.6% had a history of anaphylaxis. Early nut introduction (< 6 months) did not occur at all among the participants. Additionally, nut introduction before 12 months was rare (< 2%). Peanut and cashew were the most introduced nuts and the most frequent anaphylaxis triggers. Parental food allergy was significantly more common among children without anaphylaxis compared to those with confirmed anaphylaxis (38.5% vs. 18.4%; p = 0.035).

Conclusion: Early nut introduction was absent among children with suspected severe nut allergy, regardless of anaphylaxis history. Parental food allergy was more prevalent in children without anaphylaxis, suggesting it is not a reliable predictor of severe allergic reactions.

Aim: The developmental profile underlying visual-motor difficulties in very preterm children (< 32 weeks gestation) remains unclear. The aim is to test whether visual perception and fine motor skills mediate effects of very preterm birth on visual-motor integration before school entry.

Methods: 60 very preterm and 60 term children were assessed at age 5-6 years with the Movement Assessment Battery for Children and the Developmental Test of Visual Perception. Direct and indirect effects of very preterm birth, visual perception and fine motor performance on visual-motor integration were tested using mediation analysis with SPSS.

Results: Mediation hypothesis was confirmed, specifically: (I) very preterm birth was associated with low visual-motor integration, fine motor skills and visual perception (β = -0.46, β = -0.44, β = -0.25, p < 0.01, respectively). (II) Fine motor skills and visual perception were positively associated with visual motor skills (β = 0.62, β = 0.43, p < 0.001). (III) In the full mediation model, the direct association of very preterm birth with visual motor integration was partially mediated by fine motor skills (β = -0.39, p < 0.001) and visual perception (β = -0.12, p < 0.001).

Conclusion: Effects of very preterm birth on visual-motor integration are partially mediated by fine motor skills and visual perception. This developmental profile should be considered in screening and follow-up assessments.

Trial registration: German clinical trial register number: DRKS00011503.

Aim: Neonatal supraventricular tachycardia lacks neonatal-specific evidence to guide therapy.

Methods: We retrospectively collected data of neonates with supraventricular tachycardia across two Italian centres between 2014 and 2024. Clinical features, mechanisms, echocardiography, biomarkers, acute and maintenance therapy were collected; outcomes included recurrences, intensive-care admission, electrophysiology and ablation.

Results: Thirty-two infants were included (59% male; median onset 14 days). Among the supraventricular tachycardia mechanisms, we identified atrioventricular reentrant tachycardia in 72%, AV-nodal reentrant tachycardia in 9%, permanent junctional reciprocating tachycardia in 9%, focal atrial tachycardia in 9%. Median ejection fraction was 60% overall and 39% in those with heart failure; tachycardia-induced cardiomyopathy occurred in 28%. First-episode termination was spontaneous in 13%, achieved with vagal manoeuvres in 28% and adenosine in 47%. Maintenance therapy was required in 97% for a median of 21 months. During a mean 3.75-year Follow-up, recurrence after withdrawal occurred in 3; electrophysiology was performed in 3 and ablation in 2. Elevated NT-pro-brain natriuretic peptide and focal atrial tachicardia/permanent junctional reciprocating tachycardia phenotypes correlated with greater therapy burden.

Conclusions: Atrioventricular reentrant tachycardia predominates in neonatal supraventricular tachycardia. While acute control is usually attainable, sustained control often requires prolonged combination therapy. Early mechanism assignment and biomarker-informed risk stratification may guide step-up treatment, and catheter ablation is a viable option for refractory cases beyond infancy.

Aim: This study aimed to determine whether infants' oromotor skills were related to the onset of babbling and their phonetic inventory at 6 months of age.

Methods: Parents of 50 6-month-old infants (41 full-term, 9 preterm) completed the Child Oral and Motor Proficiency Scale (ChOMPS), a valid and reliable caregiver-report measure of oromotor, feeding, and gross motor development. Caregivers additionally reported information about their infant's babbling and perceived phonetic inventory, or protophones, via an online questionnaire.

Results: Linear regression analysis revealed a statistically significant positive association between ChOMPS scores at 6 months and the number of different protophones parents reported that the infant produced. Logistic regression modelling showed that infants' ChOMPS scores significantly predicted their likelihood of babbling by 6 months of age. Preterm status and sex were not associated with babbling onset or phonetic inventory.

Conclusion: These findings suggest a possible link between early oromotor development and emerging speech abilities in infancy. Infants with stronger oromotor skills at 6 months tended to produce a larger variety of protophones and were more likely to be early babblers, per parent report. These results reveal the potential value of early oromotor behaviours as indicators of developing speech skills.

of Key Findings and Limitations of FEED1 trial.

Aim: To evaluate the feasibility and validity of the tablet-based application CogniTOT for remote assessment of cognitive function.

Methods: An ongoing follow-up study with children born < 32 weeks of gestational age uses Ages and Stages Questionnaire (ASQ). Parents were further invited to remote CogniTOT assessment and to fill in the Non-Verbal Cognitive Scale (NVC) of the parental questionnaire Parent Report of Children's Abilities Revised (PARCA-R) at 2 years of age. Factors influencing successful CogniTOT completion were examined. Construct validity was explored by comparing the preterm-born group with term-born controls. To ensure concurrent validity, CogniTOT scores were compared to NVC PARCA-R.

Results: Thirty-two out of 77 invited preterm children completed CogniTOT along with 12 term-born children. Median scores did not differ between groups (p = 0.51). Difficulties in completion were frequent and both technical and interpersonal. There was no correlation between NVC PARCA-R and CogniTOT scores (correlation coefficient 0.079, p = 0.65). The correlation between NVC PARCA-R and ASQ was moderate (correlation coefficient 0.535, p < 0.001).

Conclusion: Remote assessment using a tablet-based task is challenging and did not correlate with parental report. Technical advances may make this feasible for large-scale assessment.

Cry-fuss problems, breastfeeding difficulties and sleep issues commonly prompt parents to seek help for their infants. Many families turn to social media, where they encounter diverse service providers, conflicting advice and health misinformation. This may encourage medicalisation, treating normal developmental variation as a medical problem and paramedicalisation, the use of non-evidence-based therapies. Global search trends for non-evidence-based therapies and national registry data on diagnostic shifts (gastro-oesophageal reflux, allergic colitis, ankyloglossia) illustrate how paramedicalisation and medicalisation shape infant care. Addressing medicalisation and paramedicalisation requires understanding their drivers, recognising potential harms and focusing on how clinicians can better support families.