Archives of Disease in Childhood

BackgroundPreterm birth (PTB) is a leading cause of atypical brain development and cognitive impairment, however, there are sparse data on its impact on statutory educational assessments. We aimed to describe school readiness at 5 years and educational attainment at 6-7 years of children born preterm in England and identify the early life factors that associate with attainment. MethodsWe created a novel record linkage between the National Neonatal Research Database and the National Pupil Databa...

BackgroundMajor congenital anomalies (CAs) occur in 2.3% of livebirths and are associated with lower educational attainment in affected children. Understanding how attainment changes throughout primary school would inform parents, schools and organisations and help plan support. ObjectivesWe compared school enrolment and attainment at ages 5, 7 and 11 in children with different CAs and their peers in England using linked administrative hospital and education data in the ECHILD database. Method...

Maternal stress and viral illness during pregnancy are associated with neurodevelopmental conditions in offspring. Children born during the COVID-19 pandemic, including those exposed prenatally to maternal SARS-CoV-2 infections, are reaching the developmental age for the assessment of risk for neurodevelopmental conditions. We examined associations between birth during the COVID-19 pandemic, prenatal exposure to maternal SARS-CoV-2 infection, and rates of positive screenings on the Modified Chec...

BackgroundThe epidemiological transition and medical innovations have led to changes in causes of ill-health and disability by children and young people (CYP) in many wealthy countries over the past two decades. However this has not been systematically examined at a national level in the UK. Here we examined changes in disability-adjusted life-years (DALYs) by cause for 0-24 year olds by age-group. MethodsWe used data on DALYS by cause, sex and age-group for the UK from 1998 to 2017 from the 20...

ObjectiveTo examine the impact of in utero exposure to SARS-CoV-2 virus on childrens emergency and planned hospital admissions up to 40 months of age. Design, Setting, and ParticipantsNationwide, birth cohort study using multiple linked administrative datasets in England. Children with conception start dates between 1st February and 31st July 2020 and born alive to mothers residing in England, followed for 40 months. ExposureIn utero SARS-CoV-2 exposure (i.e., maternal infection in pregnancy) ...

BackgroundBronchiolitis (most frequently caused by Respiratory Syncytial Virus; RSV) is a common winter disease predominantly affecting children under one year of age. It is a common reason for presentations to an Emergency Department (ED) and frequently results in hospital admission, contributing to paediatric units approaching or exceeding capacity each winter. During the SARS-CoV-2 pandemic, the circulation of RSV was dramatically reduced in the United Kingdom and Ireland. Evidence from the S...

BackgroundLinked administrative data covering whole populations are fundamental resources for longitudinal studies of children with rare conditions (cases) and unaffected peers (comparators). Data minimisation regulations sometimes limit the number of comparators per case (sampled comparators, SC), with unknown impact on study findings. MethodsUsing Monte Carlo draws, we simulated 100 000 children with and without an exemplar condition, congenital hypothyroidism (CHT), with covariates (sex and ...

ImportanceInternationally, there are gaps in data to monitor both early childhood development (ECD) and progress in closing the inequality gap. The unequal impact of the COVID-19 pandemic, and any differential impact on ECD domains is also not poorly understood. ObjectiveTo examine time trends and area-level socioeconomic inequalities in ECD at 2 2.5 years in England between 2019 and 2024 DesignCross-sectional and longitudinal ecological analysis Setting149 local authorities in England Parti...

Childrens attendances in paediatric emergency departments have fallen precipitously in North East England and elsewhere in recent months. We analysed data from 3 hospitals to understand which children were not being brought during the COVID-19 lockdown. In our population there is no evidence of a disproportionate impact on children belonging to vulnerable sociodemographic groups and no obvious change in illness acuity among those children still attending. However we noted a marked reduction in ...

ObjectiveTo support integrated health and education approaches by assessing differences in educational attainment between primary school children with and without a range of neurodisabilities. DesignPopulation-based cohort study. MethodsWe derived a national birth cohort of 2,351,589 children born in England between 01/09/2003-31/08/2008 enrolled in state-funded primary schools in Reception (age 4-5) using linked health and education records. Neurodisability was identified from hospital admiss...

IntroductionMortality rates in infancy and childhood are lower in females than males. However, for children admitted to Paediatric Intensive Care Units (PICU), mortality has been reported to be lower in males, although males have higher admission rates. This female mortality excess for the subgroup of children admitted in intensive care is not well understood. To address this, we carried out a systematic literature review to summarise the available evidence. Our review studies the differences i...

ObjectiveTo examine the association of admission NICU strain with neonatal mortality and morbidity. Study Design2008-2021 South Carolina cohort using linked vital statistics and discharge data of 22-44 weeks GA infants, born at hospitals with [&ge;] level 2 unit and [&ge;]5 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...

BackgroundUnited Kingdom national guidelines recommend that investigation of infants (aged <12 months) with suspected physical abuse should always include computed tomography (CT) head scans. Studies report a range of yields for occult intracranial injuries in infants. AimsTo gauge the yield of occult intracranial injuries on CT head scans in infants who underwent radiological investigations for suspected physical abuse, and compare selected demographic, clinical and radiological features in in...

BackgroundDespite its common early onset, little is known about the prevalence and clinical presentation of avoidant restrictive food intake disorder (ARFID) in very young children, hindering early identification and intervention. Differentiating ARFID from normative selective eating is particularly challenging, yet validated parent-reported screening tools are lacking. This study aimed to estimate the point prevalence and describe the clinical characteristics of ARFID in preschoolers. It also e...

ObjectiveTo investigate whether delayed school entry (DSE) benefits outcomes related to everyday functioning and participation in very preterm-born children. MethodsWe conducted a systematic review according to Cochrane standard. Additionally, we analyzed data of 1620 children born before 32 weeks of gestation at five and ten years from a prospective cohort study. Children with DSE were compared to those with age-appropriate school entry (ASE) regarding everyday functioning and participation, u...

BackgroundThere is evolving evidence of significant differences in severity and outcomes of coronavirus disease 2019 (COVID-19) in children compared to adults. Underlying medical conditions associated with increased risk of severe disease are based on adult data, but have been applied across all ages resulting in large numbers of families undertaking social shielding (vulnerable group). We conducted a retrospective analysis of children with suspected COVID-19 at a Specialist Childrens Hospital ...

The intrauterine environment strongly influences development. Neurodevelopmental effects of in utero exposure to maternal SARS-CoV-2 infection are widely speculated but currently unknown. The COVID-19 Mother Baby Outcomes (COMBO) initiative was established at Columbia University Irving Medical Center (CUIMC) in New York City to prospectively study the health and wellbeing of infants with and without in utero exposure to maternal SARS-CoV-2 infection. We report findings on 6-month neurodevelopmen...

BackgroundPediatric emergency departments (PEDs) often face high volumes of low-acuity visits, reflecting gaps in primary care access and socio-economic disparities. We investigated how neighborhood socio-economic vulnerability, pediatrician availability, and proximity to the PED jointly influence PED utilization in Geneva, Switzerland. MethodsIn this retrospective ecological study (Jan 2023-Dec 2024), we aggregated all PED visits for children aged 0-16 years by neighborhood and Canadian Triage...

BackgroundLong COVID remains incompletely understood in children and adolescents with scant Australian data available. We aimed to assess the impacts of the 2021 Delta variant of SARS-CoV-2 outbreak on symptoms and functioning 12 weeks post-acute infection in a cohort of children and adolescents. MethodsThe parents (or next of kin) of 11864 children and adolescents from a population catchment who had mandatory contact with Sydney Childrens Hospital Network facilities during acute SARS-CoV-2 inf...

BackgroundInterventions introduced in 2020 to reduce the spread of SARS-CoV-2 led to a widespread reduction in childhood infections, including respiratory syncytial virus (RSV), in the subsequent year. However, from the spring of 2021 onwards the United Kingdom and Ireland began to experience an unusual out of season epidemic of childhood respiratory disease. MethodsWe conducted a prospective observational cohort study (BronchStart), enrolling children aged 0-23 months presenting with clinician...