Acta Paediatrica最新文献

Aim: Limited evidence exists on how different degrees of prematurity and foetal growth deviations impact anthropometric outcomes during childhood and adolescence.

Methods: The Gutenberg Prematurity Study Young (GPSY) is a retrospective cohort with prospective assessments of 4-17-year-olds born preterm or at term at the University Medical Center Mainz, Germany. Participants were classified by gestational age and birth weight into five categories: severely small for gestational age (SGA; < 3rd percentile), moderately SGA (3rd-< 10th percentile), appropriate for gestational age (AGA; 10th-90th percentile), moderately large for gestational age (LGA; > 90th-97th percentile) and severely LGA (> 97th percentile). Anthropometric parameters were analysed using multivariable regression models.

Results: Among 949 participants (median age 12.0 years; 52% female), lower gestational age was associated with reduced height and smaller head circumference across all ages, and lower weight in early childhood and adolescence. SGA birth was consistently linked to shorter height, lower weight, lower BMI in school-aged children, and smaller head circumference, especially at school age and adolescence. LGA birth was associated with increased height at school age and higher weight in early childhood and adolescence.

Conclusion: These findings underscore the need for targeted growth monitoring and early interventions to optimise long-term health trajectories.

Aim: This study explored the impact of very preterm (VPT; < 32 weeks' gestation) compared with full-term (FT; 37-41 weeks' gestation) birth on social functioning at age 20 years, and examined this within gender.

Methods: Three social functioning domains (social cognition, social interaction and social adjustment) were assessed by self-report questionnaires at age 20 years in the Victorian Infant Brain Study longitudinal cohort, comprising 123 individuals born VPT and 47 born FT. Differences in social functioning between groups were estimated using generalised linear models, adjusted for multiple birth and social risk (familial sociodemographic risk).

Results: VPT-born adults self-reported similar levels of social functioning compared with FT-born adults. VPT participants were more likely to be classified as exhibiting poor social information processing and low social activity participation than FT participants, but the level of certainty in findings is low given wide CIs. There was little evidence that the effect of birth group on social functioning varied within gender.

Conclusion: Social functioning was generally comparable between individuals born VPT and FT at 20 years, although this study may have lacked the statistical power to detect subtle deficits with confidence. Large-scale replication studies are needed, given the critical importance of social functioning for well-being.

Aim: The COVID-19 pandemic caused considerable organisational changes in maternity facilities. We investigated adherence to the Baby Friendly Hospital Initiative (BFHI) standards in Croatian maternity hospitals.

Methods: A cross-sectional online survey targeted participants of the only Croatian antenatal course available during the pandemic. Women aged 18+ years, resident in Croatia, who had given birth in a Croatian maternity facility between February 2020 and December 2021 were eligible. A 75-item questionnaire was created including BFHI adherence statements and open-ended items. Quantitative data were analysed descriptively and content analysis was used for qualitative data.

Results: Out of 3288 responses from across Croatia, 2130 were valid. Two-thirds (1473; 69%) had skin-to-skin contact (SSC) within 5 min of birth. Only 45% (795) held their baby for an hour, and 49% (1047) of babies latched during SSC. Just 29% (558) received breastfeeding help within 6 h, and 27% (582) exclusively breastfed in the first 2 days. Only 42% (886) were with their baby 24/7. Four qualitative themes are reported.

Conclusion: BFHI standards were not followed during the pandemic, leading to unnecessary separations and low exclusive breastfeeding rates. Prioritising breastfeeding is essential for the optimal health of mothers and newborns.

Aim: Prenatal maternal infections may impair infant brain development. This study investigated the effect of maternal infections with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy on infant neurodevelopment by assessing general movements (GMs).

Methods: Infants were recruited for this multicenter prospective cohort study from LMU University Hospital sites in Munich after birth or during routine visits. GMs were recorded and assessed between 1 July 2022 and 31 January 2023, using the Hadders-Algra method. Odds ratios for abnormal GMs were calculated for infants with parent-reported prenatal SARS-CoV-2 exposure compared to unexposed controls. Specific GM subgroups were analysed at preterm, writhing, and fidgety ages.

Results: The study comprised 114 exposed infants (55.3% male) and 92 controls (54.3% male). There were no significant differences between the groups at birth. Two of the mothers were infected twice and one of them required hospitalisation. GMs were assessed at a mean corrected age (CA) of 4 weeks. The odds ratios showed no significant differences in GM quality between exposed infants and controls in either the total group or the subgroups.

Conclusion: Prenatal exposure to SARS-CoV-2 did not affect early neurodevelopment, which was determined by GM quality. Further studies should include long-term outcomes.

Trial registration: The study was registered at the German Clinical Trial Register (ID: DRKS00029247; https://drks.de/search/de/trial/DRKS00029247).

Aim: To describe the intellectual level and changes during development in children with cerebral palsy (CP) and to investigate if there are factors associated with the pace of intellectual development.

Method: Population-based study of all 264 children (141 boys, 123 girls) with CP born 1999-2006 in the region of Västra Götaland. Information was retrieved from the CP Register of western Sweden and all medical records to the age of 18 years. For the 171 children assessed more than once, results from first and last assessments were further compared.

Results: Intellectual disability became more common with increasing age. Forty percent of the 264 children were diagnosed with intellectual disability at age 7, 50% at age 12% and 54% at age 18. Of the 171 children assessed more than once, 55% showed a lower intellectual level over time. Epilepsy, predominant grey matter brain injury, impaired communication and fine motor function were associated with increased risk of slower pace of intellectual development.

Conclusion: Intellectual disability as well as slower pace of intellectual development over time are common in children with CP, highlighting the importance of repeated intellectual assessments, especially in children with epilepsy, predominant grey matter brain injury, impaired communication or fine motor function.