Pediatric Reports

Objectives: Myelomeningocele is one of the most common dysraphic defects. Does shortening the time of exposure to the toxic effects of amniotic fluid and mechanical trauma in utero on the herniated spinal cord and spinal nerves, thanks to prenatal surgery, reduce the risk of hydrocephalus with improved musculoskeletal function and better function of the urinary and digestive systems? The aim of the study was to compare the clinical effects of prenatal and postnatal surgery for myelomeningocele in pediatric patients. Methods: Comparison of urological, digestive and motor function in children following prenatal versus postnatal repair of myelomeningocele. The study group consisted of 110 children- 46 operated prenatally and 64 patients postnatally. Information about the children’s assessment of shunt-dependent hydrocephalus, motor skills, bladder and bowel function was obtained from a validated survey questionnaire completed by the children’s parents. Results: In the prenatal group, there was a significantly (p = 0.011) lower percentage of hydrocephalus treated with a shunt (45.71%) compared to the postnatal group (78.26%). The prenatal group revealed a lower percentage of paresis (p = 0.0422) and contractures of the lower limbs (p = 0.0108) and varus deformity (p = 0.0272). Also, in the prenatal group, fewer children move with only the use of a wheelchair (p = 0.0280) and more move independently or with orthopedic equipment (p = 0.0280). In prenatal children, the overall grade of vesico-ureteral reflux was significantly lower (p = 0.0105) and there was also a higher percentage of children with self-controlled defecation (p = 0.0395) and fewer children using enemas (p = 0.0269) and oral pharmacological agents (p = 0.0026). Conclusions: In children with myelomeningocele operated prenatally, compared to the postnatal group, shunt-dependent hydrocephalus and bladder and bowel incontinence were observed with significantly less frequency, and there was better musculoskeletal function. More children operated prenatally moved independently or with orthopedic equipment, and fewer used an orthopedic wheelchair. Further studies, particularly in even larger patient groups, are required to assess clinical benefits of prenatal surgery for children with myelomeningocele.

Background/Objectives: Respiratory syncytial virus (RSV) is one of the main pathogens causing infections of the respiratory system. In our study, we investigated whether breastfeeding, compared to feeding with formula milk, has an effect on RSV infection in newborns and infants. Methods: We analyzed 51 patients hospitalized at Department of Pediatrics, Newborn Pathology and Bone Metabolic Diseases, University of Lodz, with RSV infection. The infants were divided into two groups by the type of the feeding mode: breast milk or formula milk. Results: Breastfed infants were hospitalized for less time compared to those fed with milk formula (8 days vs. 11 days, p < 0.05). A multivariate linear regression model showed that babies fed with formula milk spent an average of 1.7 days longer in hospital than those fed with breast milk (95% Cl 0.247–3.209). Conclusions: Breastfeeding could reduce the risk, and in some cases, also the severity of RSV infection.

Background/Objectives: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and infant hospitalization in the US. RSV prevention evolved in 2023 as nirsevimab and maternal RSV pre-fusion vaccine became available for healthy newborns and infants. This study investigates sociodemographic characteristics associated with RSV immunoprophylaxis. Methods: A cross-sectional survey was conducted from November 2023 through March 2024 among a convenience sample of parents of infants aged <8 months who received newborn care or pediatric ambulatory care at a single academic institution in Central Pennsylvania, USA. Logistic regression examined sociodemographic factors associated with RSV immunoprophylaxis uptake. Given the nirsevimab shortage during the 2023–2024 RSV season, a sensitivity analysis was completed for intended immunoprophylaxis. Results: Among 118 participants, 66.9% received RSV immunoprophylaxis while 74.5% intended to receive nirsevimab. Higher income, private insurance, out-of-home childcare, and an adult/partner working in healthcare were associated with intended nirsevimab receipt. Participation in the Women, Infants and Children program was associated with lower rates of intended nirsevimab receipt. Out-of-home childcare was associated with both RSV immunoprophylaxis uptake and intended nirsevimab receipt. Conclusions: Sociodemographic factors significantly influence the intent to receive nirsevimab and RSV immunoprophylaxis uptake. Having an adult/partner in healthcare was the most significant predictor for intent, suggesting that greater health literacy drives immunization intention. Enrollment in out-of-home childcare was the sole predictor of RSV immunoprophylaxis uptake. These findings highlight the importance of policy initiatives that promote equitable access to RSV immunoprophylaxis, including strategies to address socioeconomic barriers, improve health literacy, and ensure consistent availability of preventive agents for all infants.