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Nirsevimab Prophylaxis Reduced Bronchiolitis, Hospitalizations and Intensive Care Admissions in Children up to 2 Years of Age 尼瑟维单抗预防可减少2岁以下儿童的毛细支气管炎、住院和重症监护入院。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-12-02 DOI: 10.1111/apa.70395
Silvia Bertolo, Michele Patui, Silvia Zoletto, Giulia Monteleone, Lisa Sant, Sokhna Diarra Dieng, Alessia Natalizi, Giulia Paviotti, Paola Cogo, Ilaria Liguoro
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引用次数: 0
High-Flow Oxygen Therapy vs. Continuous Positive Airway Pressure in Hospitalised Bronchiolitis: A Meta-Analysis 住院细支气管炎患者高流量氧疗vs持续气道正压治疗:meta分析
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-12-02 DOI: 10.1111/apa.70396
Patrik Laiho, Sauli Palmu, Eero Lauhkonen, Matti Korppi, Paula Heikkilä

Aim

To compare high-flow oxygen therapy (HFOT) with continuous positive airway pressure (CPAP) in children with bronchiolitis aged < 24 months, using treatment failure, length of stay (LOS) in the paediatric intensive care unit (PICU), and adverse events as outcomes.

Methods

Systematic literature search was conducted using PubMed and Scopus until March 13, 2024. Data from prospective and retrospective studies comparing HFOT to CPAP were incorporated in the random-effects meta-analysis model. The results for treatment failure were presented as risk ratios (RRs) with 95% confidence intervals (95% CIs), and those for LOS in the PICU as mean differences (MD) with 95% CIs.

Results

Eight studies fulfilled the inclusion criteria, and one study was found by manual search. Treatment failure was less often associated with CPAP than with HFOT (RR: 0.65; 95% CI: 0.51–0.81). Instead, LOS in the PICU did not differ (standardised MD: −0.10; 95% CI: −0.27 to 0.06). Adverse events were minor being associated more often with CPAP.

Conclusion

Both HFOT and CPAP were safe for treating bronchiolitis, but CPAP showed a lower risk of treatment failure. Our results can be generalized to those treated in the PICU.

目的:比较高流量氧疗(HFOT)与持续气道正压通气(CPAP)治疗老年毛细支气管炎儿童的疗效。方法:系统检索PubMed和Scopus的文献,截止到2024年3月13日。比较HFOT和CPAP的前瞻性和回顾性研究的数据被纳入随机效应荟萃分析模型。治疗失败的结果以95%置信区间(95% ci)的风险比(rr)表示,PICU内LOS的结果以95% ci的平均差异(MD)表示。结果:8项研究符合纳入标准,人工检索到1项研究。治疗失败与CPAP的相关性低于与HFOT的相关性(RR: 0.65; 95% CI: 0.51-0.81)。相反,PICU的LOS没有差异(标准化MD: -0.10; 95% CI: -0.27至0.06)。不良事件较少,与CPAP相关的发生率更高。结论:HFOT和CPAP治疗毛细支气管炎均安全,但CPAP治疗失败的风险较低。我们的结果可以推广到PICU的治疗。
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引用次数: 0
EBNEO Commentary: Association Between Early Fortification and Body Composition in Very Preterm Infants EBNEO评论:早期强化与极早产儿身体成分之间的关系。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1111/apa.70389
Kaitlin Hannan, Kera McNelis

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引用次数: 0
Parents Who Accepted the Meningococcal Conjugate Vaccine Were More Aware of the Severity of the Disease and Risks. 接种脑膜炎球菌结合疫苗的家长对疾病的严重性和风险的认识更高。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1111/apa.70398
Ozge Yendur, Zuhal Gundogdu

Aim: Bacterial meningitis, including meningococcal meningitis, poses a significant global health threat for children. This study aimed to identify the key reasons why parents accepted meningococcal vaccines. It also wanted to promote wider meningococcal vaccination efforts.

Methods: A cross-sectional study was conducted with the parents of children who visited a university hospital's paediatric outpatient clinic in Turkey between 20 August 2015 and 30 May 2016. The parents provided sociodemographic information and responded to a questionnaire about the meningococcal conjugate vaccination (MCV), based on the Health Belief Model.

Results: The parents of 302 children (52.3% girls), with a mean age of 6.77 ± 4.77, participated in the study. Mothers accounted for 80.1%. Sociodemographic factors, including the parents' education and the mother's occupation, were significant factors in accepting the vaccine. So were recognizing the severity of the disease and the perceived susceptibility and risks. Vaccine uptake also increased if the parents received concise and timely information from doctors. However, some parents were uncomfortable with the number of injections their children would receive and larger families were also a barrier.

Conclusion: Factors that affected parents' acceptance of the MCV included sociodemographic factors, awareness of the severity of the disease and perceived susceptibility and risks.

目的:细菌性脑膜炎,包括脑膜炎球菌性脑膜炎,对全球儿童的健康构成重大威胁。本研究旨在确定家长接受脑膜炎球菌疫苗的关键原因。它还希望促进更广泛的脑膜炎球菌疫苗接种工作。方法:对2015年8月20日至2016年5月30日在土耳其某大学医院儿科门诊就诊的儿童家长进行横断面研究。父母提供了社会人口学信息,并根据健康信念模型回答了关于脑膜炎球菌结合疫苗接种(MCV)的问卷。结果:302例患儿家长参与研究,其中女孩占52.3%,平均年龄(6.77±4.77)岁。母亲占80.1%。社会人口因素,包括父母的教育程度和母亲的职业,是影响接受疫苗的重要因素。认识到疾病的严重程度以及感知到的易感性和风险也是如此。如果父母从医生那里得到简明及时的信息,疫苗接种率也会增加。然而,一些家长对孩子接受注射的次数感到不舒服,而大家庭也是一个障碍。结论:影响家长接受MCV的因素包括社会人口学因素、对疾病严重程度的认识以及对易感性和风险的认知。
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引用次数: 0
Increased Incidence of Type 1 Diabetes and Co-Existing Thyroid Autoimmunity During the COVID-19 Pandemic in Sweden 瑞典COVID-19大流行期间1型糖尿病和共存甲状腺自身免疫的发病率增加
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1111/apa.70388
J. Anderberg, P. Carlsson, M. Lundgren, H. Elding Larsson, A. Carlsson

Aim

We aimed to investigate if the incidence of type 1 diabetes increased in children during the SARS-CoV-2 pandemic and whether SARS-CoV-2 antibodies were more frequently present at diagnosis compared with healthy individuals. We also examined whether clinical characteristics and coexisting autoimmunity differed between SARS-CoV-2 antibody positive and negative individuals.

Methods

This retrospective, longitudinal observational study included children aged 0–17 years diagnosed with type 1 diabetes between 01 January 2018 and 31 December 2023 at Skåne University Hospital, Sweden. Blood samples were analysed for SARS-CoV-2 antibodies and islet autoantibodies and compared to analyses of healthy children from the same period. Clinical characteristics and thyroid autoimmunity at onset were collected from medical records.

Results

The incidence of type 1 diabetes increased from 40/100.000 (pre-pandemic) to 53/100.000 (pandemic). Children diagnosed with type 1 diabetes more likely tested positive for SARS-CoV-2 nucleocapsid protein (NCP) antibodies compared to healthy children. The SARS-CoV-2-NCP positive group had a higher prevalence of thyroid autoimmunity compared to the SARS-CoV-2-NCP negative group.

Conclusion

The incidence of type 1 diabetes increased during the SARS-CoV-2 pandemic, with a possible connection to COVID-19. Interestingly, children positive for SARS-CoV-2 antibodies at type 1 diabetes diagnosis had a higher likelihood of thyroid autoimmunity compared to children negative for SARS-CoV-2 antibodies.

目的:我们旨在调查在SARS-CoV-2大流行期间儿童中1型糖尿病的发病率是否增加,以及与健康个体相比,诊断时是否更频繁地出现SARS-CoV-2抗体。我们还研究了SARS-CoV-2抗体阳性和阴性个体的临床特征和共存的自身免疫是否存在差异。方法:这项回顾性、纵向观察研究纳入了2018年1月1日至2023年12月31日在瑞典sk大学医院诊断为1型糖尿病的0-17岁儿童。对血液样本进行SARS-CoV-2抗体和胰岛自身抗体分析,并与同期健康儿童的分析进行比较。从医疗记录中收集临床特征和发病时甲状腺自身免疫。结果:1型糖尿病发病率由流行前的40/10万上升至流行前的53/10万。与健康儿童相比,诊断为1型糖尿病的儿童更有可能检测出SARS-CoV-2核衣壳蛋白(NCP)抗体呈阳性。与SARS-CoV-2-NCP阴性组相比,阳性组甲状腺自身免疫患病率更高。结论:SARS-CoV-2大流行期间1型糖尿病发病率上升,可能与COVID-19有关。有趣的是,在1型糖尿病诊断中,SARS-CoV-2抗体阳性的儿童与SARS-CoV-2抗体阴性的儿童相比,甲状腺自身免疫的可能性更高。
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引用次数: 0
Oral Support Is Effective to Promote Exclusive Breastfeeding in Infants Born Small for Gestational Age 口服支持对促进小于胎龄婴儿纯母乳喂养有效。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-11-27 DOI: 10.1111/apa.70390
Ester Del Vescovo, Simonetta Costa, Simona Fattore, Chiara Piscitelli, Monica Fusco, Sara Rossin, Giovanni Vento, Giovanna Maragliano

Aim

This study evaluated if oral support with techniques to support the infant's jaw to promote sucking could improve the exclusive breastfeeding rate in full-term infants born small-for-gestational-age (SGA).

Methods

This was an observational study with a prospective cohort and a historical control. SGA infants born in 2023–2024 who received oral support were compared to those born in 2020–2021 who did not. The primary outcome was the exclusive breastfeeding rate at 7–10 days of life. Secondary outcomes were the exclusive breastfeeding rate at discharge, the maximum weight loss, the time to regain birthweight, the occurrence of transient and/or persistent hypoglycaemia and the length of hospitalisation.

Results

We analysed 146 infants: 73 received oral support and 73 did not. Infants who received oral support had an exclusive breastfeeding rate when returning to the hospital at day 7–10 that was significantly higher than infants who did not (54.8% vs. 37.0%, p = 0.03). Exclusive breastfeeding at discharge, at a median (interquartile range) age of 3 (2–4) days, was similar between groups. No differences were found in the secondary outcomes.

Conclusion

Oral support appeared useful in promoting exclusive breastfeeding in full-term SGA infants. Further research could assess if the intervention maintained exclusive breastfeeding over time.

目的:本研究评估口腔支持技术支持婴儿颌部促进吸吮是否能提高小胎龄足月婴儿的纯母乳喂养率。方法:这是一项前瞻性队列和历史对照的观察性研究。将2023-2024年出生的接受口腔支持的SGA婴儿与2020-2021年出生的未接受口腔支持的婴儿进行比较。主要结果是出生后7-10天的纯母乳喂养率。次要结局是出院时的纯母乳喂养率、最大体重减轻、恢复出生体重的时间、一过性和/或持续性低血糖的发生以及住院时间。结果:我们分析了146名婴儿:73名接受了口头支持,73名没有。接受口服支持的婴儿在第7-10天返回医院时的纯母乳喂养率显著高于未接受口服支持的婴儿(54.8% vs. 37.0%, p = 0.03)。出院时纯母乳喂养,年龄中位数(四分位数范围)为3(2-4)天,各组之间相似。次要结果没有发现差异。结论:口腔支持有助于促进SGA足月儿纯母乳喂养。进一步的研究可以评估干预是否在一段时间内保持纯母乳喂养。
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引用次数: 0
Nutritional Strategies in Preterm Infants: The Role of Human Milk in Bronchopulmonary Dysplasia 早产儿的营养策略:母乳在支气管肺发育不良中的作用。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-11-27 DOI: 10.1111/apa.70385
Amaia Merino-Hernández, Elena Rodríguez-Corrales, Sylvia Caballero-Martín, Cristina Ramos-Navarro, Noelia González-Pacheco, María Carmen Sánchez-Gómez de Orgaz, Manuel Sánchez-Luna

Aim

Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and impaired growth in preterm infants. This study compared the incidence of grade 2–3 BPD in infants predominantly fed with mother's own milk (MOM) or pasteurised donor milk (PDM) and examined associations between nutrition and BPD severity.

Methods

Prospective single-centre study including infants < 32 weeks' gestation admitted between January 2023 and June 2024. Infants were classified by predominant feeding type (> 50% MOM or PDM) and BPD severity (no BPD/1 or BPD 2–3). Nutritional intake, feeding tolerance, fortification timing and growth were analysed.

Results

Of 158 infants, 88 (56%) received > 50% MOM and 70 (44%) > 50% PDM. BPD 2–3 occurred in 27 (17.1%) infants with no significant group difference (19% vs. 14%, p = 0.41). Feeding intolerance (44% vs. 11%, p < 0.01), delayed fortification (12.5 vs. 7.0 days, p < 0.01), and later enteral feeding (12.0 vs. 6.0 days, p < 0.01) were associated with BPD 2–3.

Conclusion

No significant difference in BPD 2–3 incidence was found between MOM and PDM groups. Feeding intolerance, delayed fortification, and slower enteral transition were independent risk factors for grade 2–3 BPD.

目的:支气管肺发育不良(BPD)是早产儿发病和生长受损的主要原因。本研究比较了主要以母乳喂养(MOM)或巴氏供体奶(PDM)喂养的婴儿2-3级BPD的发病率,并研究了营养与BPD严重程度之间的关系。方法:前瞻性单中心研究,包括50% MOM或PDM的婴儿和BPD严重程度(无BPD/1或BPD 2-3)。分析营养摄取量、摄食耐受性、强化时间和生长情况。结果:158例婴儿中,88例(56%)接受> 50% MOM治疗,70例(44%)接受> 50% PDM治疗。27例(17.1%)婴儿发生BPD 2-3,组间差异无统计学意义(19% vs. 14%, p = 0.41)。喂养不耐受(44% vs. 11%, p)结论:MOM组和PDM组BPD -3发生率无显著差异。喂养不耐受、延迟强化和较慢的肠内过渡是2-3级BPD的独立危险因素。
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引用次数: 0
Overall Good Quality of Life Reported by Survivors of Childhood Hodgkin Lymphoma in Sweden and Finland 瑞典和芬兰儿童霍奇金淋巴瘤幸存者报告的总体生活质量良好。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-11-27 DOI: 10.1111/apa.70386
Mia Giertz, Annika Englund, Fanny Fernsten, Sascha Michelsen Wilk, Riitta Niinimäki, Arja Harila, Henri Aarnivala

Aim

Most children with Hodgkin lymphoma (HL) survive today, yet about 50% experience long-term complications. This study evaluated health-related quality of life (HRQoL) in survivors of childhood HL.

Methods

Two different HRQoL-instruments, the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires, were sent to all individuals aged 0–18 and diagnosed with HL in Sweden and Finland from 2005 to 2019.

Results

A total of 135 of 377 survivors responded to the survey. The mean EQ-5D-5L index was 0.933 ± 0.11 and the EuroQoL Visual Analogue Scale (EQ-VAS) score averaged 75.1 ± 17.6. Females reported lower scores than males on the EQ-5D-5L index (p = 0.007) and EQ-VAS (p = 0.022), as well as more problems within the PROMIS-domains for physical function (p = 0.016), fatigue (p < 0.001), anxiety (p < 0.001), and depression (p = 0.002). Both EQ-5D-5L index and PROMIS T-scores for all assessed domains were comparable with the general population, including differences between sexes. Our analysis indicated that an EQ-VAS cut-off of ≤ 85 effectively identified 90%, or more, of the individuals reporting problems in the PROMIS domains for fatigue, anxiety and depression.

Conclusion

Survivors of childhood HL report a good HRQoL. The EQ-VAS may serve as a useful, simple screening tool for detecting survivors in need of psychosocial interventions.

目的:大多数儿童霍奇金淋巴瘤(HL)存活至今,但约50%经历长期并发症。本研究评估儿童HL幸存者的健康相关生活质量(HRQoL)。方法:2005年至2019年,向瑞典和芬兰所有年龄在0-18岁、诊断为HL的患者发放两种不同的hrqol工具,即EuroQoL 5维5级(EQ-5D-5L)和患者报告结果测量信息系统(PROMIS)问卷。结果:377名幸存者中有135人回答了调查。EQ-5D-5L指数平均值为0.933±0.11,EuroQoL视觉模拟量表(EQ-VAS)评分平均值为75.1±17.6。女性报告的EQ-5D-5L指数(p = 0.007)和EQ-VAS (p = 0.022)得分低于男性,并且在身体功能(p = 0.016)和疲劳(p)的承诺域中出现更多问题。结论:儿童HL幸存者报告的HRQoL良好。EQ-VAS可以作为一种有用的、简单的筛选工具,用于发现需要社会心理干预的幸存者。
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引用次数: 0
Parents of Premature Infants Value Early Skin-to-Skin Care: A 10-Year Survey in France 早产儿的父母重视早期皮肤到皮肤的护理:一项为期十年的调查在法国。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-11-26 DOI: 10.1111/apa.70387
Odile Dicky, Pierre Kuhn, Jacques Sizun, Madeleine Akrich, Charlotte Bouvard, Charlotte Tscherning, Laurence Caeymaex

Aim

Skin-to-skin contact (SSC) is a key aspect of infant- and family-centred developmental care and should be initiated as early as possible after birth. This study aimed to assess the effects of early SSC, within the first 3 days of life, compared to late SSC, from Day 4 onwards, in very preterm infants. It also explored parents' experiences of SSC.

Method

Data were collected over 10 years, from 2014 to 2024, via an online parental survey created by parent associations and the French National Neonatal Society. We analysed only responses from parents of infants born before 32 weeks' gestation.

Results

A total of 2212 responses were analysed. Findings revealed that 98% of parents who began SSC early believed it occurred at the right time, while 30% of those who started later felt it was too late. Parents who practised early SSC were more likely to report comfortable SSC during the hospital stay, with an adjusted odds ratio of 1.64 (95% confidence interval: 1.14–2.37). Key factors contributing to a positive SSC experience included support from nursing staff, a secure setting, privacy and a comfortable chair.

Conclusion

Early SSC was highly valued by parents of very preterm infants.

目的:皮肤对皮肤接触(SSC)是婴儿和家庭为中心的发展护理的一个关键方面,应在出生后尽早开始。本研究旨在评估早期SSC的影响,在生命的前3天内,与晚期SSC相比,从第4天起,在早产儿中。并探讨了家长在南南合作中的体验。方法:通过父母协会和法国国家新生儿协会创建的在线父母调查,从2014年到2024年,收集了10多年的数据。我们只分析了孕32周前出生婴儿的父母的回答。结果:共分析了2212份回复。调查结果显示,98%的早期开始SSC的父母认为它发生在正确的时间,而30%的晚开始的父母认为为时已晚。早期实施SSC的家长更有可能在住院期间报告舒适的SSC,调整后的优势比为1.64(95%置信区间:1.14-2.37)。促进积极的SSC体验的关键因素包括护理人员的支持、安全的环境、隐私和舒适的椅子。结论:早期SSC受到极早产儿家长的高度重视。
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引用次数: 0
Clinic Versus Home: Nurses' and Social Workers' Perceptions of Extended Home Visits 诊所与家庭:护士和社会工作者对延长家访的看法。
IF 2.1 4区 医学 Q1 PEDIATRICS Pub Date : 2025-11-26 DOI: 10.1111/apa.70382
Mattias Wennergren, Ann Jansson, Julie Showich Lundgren

Aim

This study aimed to compare providers' ratings of delivery and fidelity of a post-natal extended home visiting programme within Child Health Services for visits conducted in families' homes versus the clinic setting.

Methods

A retrospective quantitative study based on questionnaires (n = 3028) from child health services nurses and social workers was conducted using non-parametric tests to determine if there were any differences in professionals' perceptions of programme delivery and/or quality.

Results

The results from this study indicate significant differences in professionals' perceptions of fidelity, confidence in abilities, content coverage, alliance-building, and emotional climate between home and clinic visits, with higher ratings given in all areas for visits conducted in the home.

Conclusion

While clinic visits may offer certain logistical advantages for professionals and primary care clinics, they may not provide the optimal environment for delivering the programme with fidelity, which is necessary for achieving the desired outcomes for child health and family well-being. The findings need to be taken into consideration when making decisions about resource allocation for early childhood programmes aimed at equitable health for a more sustainable society.

目的:本研究旨在比较儿童健康服务机构在家庭与诊所进行的产后延伸家访计划的提供者对分娩和保真度的评分。方法:采用非参数检验对来自儿童保健服务护士和社会工作者的问卷(n = 3028)进行回顾性定量研究,以确定专业人员对方案交付和/或质量的看法是否存在差异。结果:本研究结果显示,专业人员在家访视与诊所访视在保真度、能力信心、内容覆盖、联盟建立、情绪氛围等方面的认知均有显著差异,在家访视在所有领域的评分均较高。结论:虽然诊所访问可能为专业人员和初级保健诊所提供一定的后勤优势,但它们可能无法为忠实执行方案提供最佳环境,而忠实执行方案是实现儿童健康和家庭福祉的预期结果所必需的。在决定为旨在促进更可持续社会的公平保健的幼儿方案分配资源时,需要考虑到这些调查结果。
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引用次数: 0
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Acta Paediatrica
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