Archives of Disease in Childhood

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 ...

ImportanceWhole genome sequencing (WGS) is increasingly used to diagnose severely ill children, yet the long-term impact of a genetic diagnosis on healthcare utilization and resource allocation remains poorly understood. ObjectiveTo determine the influence of a genetic diagnosis via WGS on long-term healthcare utilization metrics in severely ill children. DesignA retrospective cohort study using data from the Next Generation Children study (2016-2020) with record linkage and analysis of primar...

BackgroundEarly relational health (ERH) is thought to buffer the association between early life stress (ELS) and child psychopathology, but limited work has directly tested this hypothesis. ObjectiveWe evaluate mother-infant emotional connection, a facet of ERH, as a buffer of combined and individual impacts of specific ELS exposures (maternal mental health and interpartner conflict) on child psychopathology. MethodsParticipants included mother-infant dyads (n=100) followed longitudinally in t...

ObjectiveTo examine whether screen time predicts interindividual variability regarding pubertal development across adolescence. Study designThis longitudinal cohort study included 10786 participants (47.9% female) from the Adolescent Brain Cognitive Development (ABCD) study. First, associations were examined between average daily screen time (hours/day, parent-reported Screen Time Survey) at baseline (mean age = 9.91 {+/-} 0.63 years) and pubertal timing, derived from Pubertal Development Scale...

BackgroundPediatric poisonings are a significant cause of emergency admissions, often linked to accessible household toxins. This study investigates the epidemiological patterns, clinical presentations, and management strategies at a tertiary care hospital in Algiers, Algeria. MethodsA retrospective descriptive analysis was conducted on anonymized pediatric poisonings cases. Variables included age, sex, type of ingestion, intent (accidental vs. voluntary), substances involved, endoscopic findin...

Background and ObjectivesCurrent potassium reference intervals for neonates fail to account for sampling method differences and prematurity-related factors, leading to unnecessary resampling and interventions. We aimed to establish sampling-specific potassium reference intervals for term and preterm neonates using comprehensive electronic health record data. MethodsWe analyzed 195 606 blood gas measurements from 10 290 neonates (2007-2024) at a tertiary neonatal intensive care unit. After ex-cl...

BackgroundPediatric long COVID is associated with substantial symptom burden, yet evidence-based pharmacologic treatments remain limited. Low-dose naltrexone (LDN) has been proposed as a potential symptomatic therapy, but data in pediatric populations is lacking. MethodsWe conducted a retrospective analysis of pediatric and young adult patients ([≤]25 years) with a clinical diagnosis of long COVID who were prescribed LDN between July 2020 and July 2025 at three multidisciplinary pediatric lo...

Background and ObjectivesPatient portals allow adolescents and caregivers of pediatric patients to better engage with health care, improving their medication adherence, health knowledge, self-efficacy, and receipt of preventive care. However, disparities in access to and comfort with using these portals persist. Hospitalization represents a promising opportunity to address these disparities among a high-risk population. Design/MethodsWe conducted a cross-sectional analysis to identify dispariti...

PurposeCaregivers of children with complex neurodisability frequently experience high caregiving demands, social isolation, unmet support needs, and reduced wellbeing. This paper explores caregivers perceptions of the impact of "Encompass", a ten-modular, community-based group support programme for caregivers of children under five with complex neurodisability, co-facilitated by an expert parent. Materials and methodsThis study formed part of a pilot and feasibility study conducted in two socia...

IMPORTANCEAdverse childhood experience (ACE) scores mask substantial heterogeneity within the 2-, 3-, and [≥]4-ACE exposure categories. The magnitude of this heterogeneity has not been sufficiently quantified. OBJECTIVETo quantify and visualise the heterogeneity of ACE scores. DESIGNCross-sectional analysis of the 2023 National Survey of Childrens Health, an address-based, nationally representative survey. SETTINGUS households. PARTICIPANTSA national sample of 385,000 addresses was drawn....

OBJECTIVETo develop a parsimonious, interpretable, and accurate model for predicting discharge for premature infants in the NICU that is suitable for prospective evaluation and integration into clinical workflows. STUDY DESIGNUsing routinely available electronic health record data, we developed and validated NEOnatal Reliable Estimation of Approaching Discharge in Young infants (NEO-READY), a daily-updating model that predicts likelihood of discharge within 5 days for premature infants. RESULT...

ObjectivesVentilator-associated pneumonia (VAP) is a significant complication in pediatric patients with severe bronchiolitis undergoing mechanical ventilation (MV) in pediatric intensive care units (PICUs). The role of respiratory microbiota in VAP development remains underexplored in this vulnerable population. This study aimed to characterize respiratory microbiota in critically ill children with severe bronchiolitis receiving critical care and identify microbial patterns associated with VAP....

BackgroundChildren in contact with childrens social care (CSC) services have high levels of hospital utilisation, but patterns before and after referral remain insufficiently understood. ObjectiveTo evaluate healthcare utilisation two years before and after CSC referral. Participants and settingRetrospective cohort using ECHILD linked health and social care data, including children with a first CSC referral between 2009 and 2018 in England. MethodsWe compared monthly planned and unplanned hos...

BackgroundAsthma is a frequent comorbidity in children with sickle cell disease and has been associated with an increased risk of acute complications, particularly vaso-occlusive crises and acute chest syndrome. However, determinants of clinical severity among children with sickle cell disease and confirmed asthma remain poorly characterized, especially in tropical settings. This study aimed to identify factors associated with clinical severity in this population. MethodsWe conducted an observa...

BackgroundCaregiver skills training programmes are well-researched in the fields of autism and intellectual disability, but children with motor disorders such as cerebral palsy remain underrepresented despite their high prevalence. These caregivers face unique challenges, and group programmes may provide family-centred care through information provision, problem-solving and peer support. MethodsSystematic searches of five databases (CINAHL, Medline, Embase, PsychINFO and ERIC) were conducted fo...

Patient portals are designed to enhance patient and caregiver engagement by providing access to health information, communication with care teams, and telehealth services, yet their impact on health care utilization among hospitalized children is not well understood. In this cross-sectional study, we examined associations between patient portal enrollment and use and hospitalization outcomes among 40,377 children admitted to an urban quaternary or suburban tertiary pediatric hospital between 202...

BackgroundAnti-seizure medications (ASMs) are widely used in neonatal intensive care, but there is limited evidence for their safety and long-term outcomes. Phenobarbital is the only ASM generally recommended for use in neonates, but it has been linked with adverse effects in infants. Other anti-seizure medications, such as fosphenytoin, levetiracetam, and midazolam are used off-label in this population. MethodsWe performed a retrospective observational study of 18,548 infants in intensive care...

IntroductionCentral line-associated bloodstream-infection (CLA-BSI) and catheter-related bloodstream infections (CR-BSI) remain a significant concern in pediatric inpatient units. ObjectiveTo analyze a case series of CLA-BSI and CR-BSI in hospitalized pediatric patients in hospitals with rigorous infection prevention measures. Materials and MethodsThis was an analytical, descriptive, and retrospective study conducted in patients aged 0 to 18 years, admitted between August 2023 and March 2025, ...

BackgroundChildren with tracheostomies experience frequent and recurrent acute respiratory infections (ARIs). While cultured respiratory pathogens can inform ARI diagnosis, it is unknown if their presence in the airway affects future ARI risk. ObjectiveTo identify predictors of frequent (3+) ARIs within 36 months of tracheostomy. MethodsWe conducted a single-center, retrospective cohort study of children with tracheostomies placed between 2010-2016. Medical records were reviewed for each encou...

IntroductionThe circadian clock is an internal, [~]24-hour biological timer that synchronizes physiology with the day-night cycle. Social jetlag (SJL) describes the misalignment between this internal clock and social schedules, a condition affecting approximately 70% of the population and linked to a spectrum of metabolic, mental, and cognitive health issues. This study examined how the 2022 FIFA World Cup disrupted normal childrens sleep routines and other associated factors from parents prospe...