Children

Background/Objectives: Assessing psychosocial burden in families can help identify those at risk and prevent negative effects on children’s well-being. This study (1) describes the longitudinal stability of psychosocial risk patterns; (2) examines group differences in the home learning environment as protective factors and in child behavior problems as an outcome; and (3) tests the moderating role of home learning activities on child behavior problems. We further explore associations with the use of institutional childcare. Methods: Data from 1459 children aged 0–6 years from the representative longitudinal study AID:A 2019 were analyzed across two time points (T1: 2019, T2: 2023). We tested differences in children’s behavioral problems according to risk patterns, home learning environment, and control variables, including institutional care and support service use. Results: The shares of families categorized as low-burdened, economically burdened, parenting-stress-and-conflict-burdened and multiple-burdened remained stable over time, even though individual stability was only moderate. Children in families with parenting stress and conflict as well as those from multiple-burdened families more frequently displayed behavioral problems at T2 than other groups. Educational activity was a protective factor for behavioral problems for most groups, but was a risk factor in conflict-and-stress-burdened families. Similar results were found for the use of universal social/educational prevention services. Conclusions: For most families, a better home learning environment appears to act as a buffer against the effect of risk group membership on children’s emotional well-being. However, in families marked by stress and conflict, the frequency of time together might not be beneficial—possibly because the quality of interactions matters more than the quantity. Universal social and educational services might be a place to address these families and develop targeted support.

Aims: To assess the impact of systemic afterload reduction on cardiorespiratory health in infants with a severe bronchopulmonary dysplasia (BPD)–systemic hypertension–left heart dysfunction (LHD) phenotype. Methods: Ten-year data were prospectively collected and analysed. The cohort included extremely preterm infants with severe BPD–systemic hypertension–LHD pathophysiology, treated with systemic afterload reduction with captopril. Main outcome measures included improvement in oxygenation and echocardiographic measures of LHD. Results: Twenty-six infants with gestation of 26.5 ± 2 weeks and median (interquartile range) birthweight of 900 (582, 1083) g were administered captopril at the corrected gestation median (range) of 40 weeks (37–67). On reassessment after five weeks, oxygen requirements (43 ± 16% to 26 ± 7%, p = 0.0001) and paired pCO₂ decreased (64 ± 9 to 53 ± 9 mm Hg, p = 0.0001). Significant improvements were seen in cardiac indices (diastolic: trans-mitral E/A ratio [1 ± 0.07 to 0.94 ± 0.07, p = 0.0004] and iso-volumic relaxation time [ms] [65 ± 3 to 56 ± 4, p < 0.0001], and systolic: mean velocity of circumferential fibre shortening [circ/s] [1.6 ± 0.2 to 1.9 ± 0.2, p < 0.0001] and left ventricular output [mL/kg/min] [177 ± 34 to 230 ± 54, p = 0.0002]). This coincided with improved aortic pulsatility (40 ± 13 to 50 ± 11 µm, p = 0.005). Conclusions: Systemic hypertension–LHD pathology amongst infants with severe BPD may be under-recognised. Systemic afterload reduction is physiologically suited in a subset of infants with severe BPD.

Background: Low birth weight (LBW) is one of the most significant health issues worldwide, especially in countries with fewer resources. No systematic reviews or meta-analyses on LBW have been conducted in Sudan, the third largest African country. Methods: A systematic review and a meta-analysis were conducted to assess the pooled prevalence of LBW in Sudan and the associated factors. PubMed, Google Scholar, and ScienceDirect were searched for studies on LBW in Sudan. The meta-analysis was performed by calculating the pooled prevalence of LBW. The meta package in R was used for statistical analysis. Results: The final sample comprised 10 studies, with 10,043 neonates enrolled. The overall pooled prevalence of LBW was 13.0% (95% CI [13.0, 14.0]; I² = 47.0%, p = 0.05), without significant heterogeneity. Primiparity (adjusted odds ratio [AOR] = 1.4, 95% CI [1.1, 2.1]), a short interpregnancy interval, lack of iron–folic acid supplementation (AOR = 3.33, CI [1.47, 5.88]), a low level of antenatal/perinatal care (AOR = 2.10, 95% CI [1.30, 3.57]), maternal undernutrition (AOR = 1.66, 95% CI [1.09, 2.53]), and decreasing gestational age of pregnancy (AOR = 0.80, 95% CI [0.66, 0.96]) were associated with LBW in different studies. In three studies, anemia was associated with LBW. Conclusions: This review reveals a high prevalence of LBW in Sudan. The factors identified in this review may help health planners and policymakers design and implement preventive interventions for LBW.