ABSTRACT Aim Elexacaftor/Tezacaftor/Ivacaftor (ETI) has markedly improved clinical outcomes in cystic fibrosis (CF). However, its effects on gastrointestinal (GI) function, nutrition and pancreatic enzyme therapy in children remain insufficiently described. This study aimed to characterise GI‐related changes during the first year of ETI treatment in Swedish children with CF. Methods In this prospective, multicentre study at three paediatric CF centres, children aged 6–17 years who initiated ETI were assessed at baseline, 6 and 12 months. Outcomes included GI symptoms and the use of GI‐related medication, health‐related quality of life (CFQ‐R), nutritional status, PERT use and faecal elastase. Longitudinal changes were analysed using generalised least squares regression. Results Sixty‐two participants (mean age 11.7 years) completed follow‐up. The total mean combined number of reported GI symptoms declined from 1.5 to 0.9 ( p = 0.005), although no individual symptom changed significantly after 12 months of ETI treatment ( p > 0.05). CFQ‐R Digestive scores improved by 7.8 points ( p = 0.002). PERT dose decreased by 1.3 × 10 3 units/kg/day ( p < 0.001), while BMI z‐scores and faecal elastase remained unchanged. Conclusion ETI therapy reduced gastrointestinal symptoms and improved digestive quality of life in children with CF, accompanied by lower PERT use but unchanged pancreatic function and growth.
ABSTRACT Aim The aim was to investigate if there was an association between early skin‐to‐skin contact after preterm birth and breastfeeding status at discharge. Methods This was a register‐based study using data from the Swedish Neonatal Quality register 2020–2024. In total, 9914 infants born before 35 weeks of gestation were included. The outcome was breastfeeding at discharge from the neonatal unit, assessed using two variables: breastfeeding at the breast and receiving breast milk. The exposure was early skin‐to‐skin contact, defined as within the first 24 h after birth. Odds ratios were estimated for the total population and stratified for gestational age groups. Results Skin‐to‐skin contact within the first 24 h was associated with higher odds of partial breastfeeding at the breast at discharge, aOR 1.47 (95% CI 1.32–1.64), and higher odds of partially and exclusively receiving breast milk. Among extremely preterm infants, skin‐to‐skin contact was associated with higher odds of exclusive breastfeeding at the breast, aOR 2.22 (95% CI 1.35–3.64). Conclusion Early skin‐to‐skin contact was associated with higher odds of partial breastfeeding at discharge in the total study population and with exclusive breastfeeding in extremely preterm infants.
ABSTRACT Aim Perinatal stroke can cause lifelong morbidities. Outcome prediction is important for parental guidance and follow‐up. We studied characteristics of acute perinatal stroke in a Finnish cohort. Methods We performed a population‐based study, identifying infants with acute neonatal cerebral ischemia or sinovenous thrombosis (CSVT) in Southern Finland from 2010 to 2023. We analysed the incidence of stroke types, seizures, anti‐seizure medication use, and outcomes. Results Altogether 88 infants (1 in 3101 live births) were diagnosed with acute perinatal stroke: 67% with arterial ischemic stroke (AIS), 22% with hemorrhagic stroke (HS) and 11% with CSVT. Seizures and anti‐seizure medication use occurred in 78% of infants. Cranial ultrasound infrequently recognized AIS but usually noted haemorrhage. During follow‐up, 34% of infants had no adverse outcome diagnosis. The most common outcome was cerebral palsy (CP, 35%). A combination of CP with epilepsy or seizures was more frequent in infants with AIS than in those with other stroke types. Conclusion The distribution of stroke types, symptoms, and adverse outcomes aligns with the previous literature. Acute seizures were common in AIS and HS patients. No recurrent strokes occurred during follow‐up and underlying infant‐related etiologies were rarely identified.
ABSTRACT Aim To examine temporal trends in cerebral palsy (CP) birth prevalence and changes in functional severity in Sweden between 2000 and 2019. Methods This population‐based registry study included all children with CP born in Sweden between 2000 and 2019. Annual CP birth prevalence was calculated using Poisson regression. Changes in functional severity were assessed using the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels across birth cohorts, with ordinal logistic regression used to examine their association. Results In total 4281 participants were included. CP birth prevalence decreased over the study period with a rate ratio per year of 0.985 (95% confidence interval 0.980–0.990) corresponding to a 1.5% annual reduction. The proportion of children with milder impairment increased over time. In crude analyses: children born in 2015–2019 had lower odds of higher MACS levels (OR 0.70, 95% CI 0.60–0.83, p ≤ 0.001), and GMFCS level (OR 0.77, 95% CI 0.65–0.92, p = 0.003) than those born in 2000–2004. Conclusion CP birth prevalence in Sweden decreased significantly between 2000 and 2019. A shift toward milder functional impairment was observed in more recent birth cohorts and occurred alongside changes in CP subtype distribution.
ABSTRACT Aim To evaluate delivery patterns following in utero transfer (IUT) to a London tertiary neonatal intensive care unit, examining gestational age, referral indication, transfer‐to‐delivery interval, and maternal length of stay. Methods Retrospective cohort study of women accepted for IUT at St George's Hospital, London (2021–2025), between 22 + 0–27 + 6 weeks' gestation (or 28–29 weeks with multiples/expected birth weight < 800 g) for threatened extremely preterm birth. Data were extracted from BadgerNet, maternity records, and delivery suite databases; Fisher's exact test was used for categorical comparisons. Results Of 126 IUT episodes, 53 (42%) delivered at the tertiary centre; median transfer‐to‐delivery interval was 1 day (mean 2.02). Delivery rates averaged ~10%/day over the first 5 days. Transfers from outside the local network delivered within 24 h more often (18%). Among 73 (58%) who did not deliver, median length of stay was 4 days. Delivery was less likely at 22–24 weeks (32% vs. 50% at ≥ 25 weeks) and significantly associated with sepsis ( p = 0.01), chorioamnionitis ( p < 0.001), pathological CTG ( p = 0.006), and Doppler abnormalities ( p = 0.02). Conclusion Over half of women undergoing IUT did not deliver during admission. Infection and fetal compromise indications were most strongly associated with delivery, supporting liberalised IUT acceptance and capacity planning.
