Latest Pediatrics and Child Health research

Top 10 this week

Week of 1 November 2026

1. 1

   Prone positioning and high-frequency oscillatory ventilation in early paediatric acute respiratory distress syndrome (PROSpect): an international, two-by-two factorial, response-adaptive, phase 3, randomised controlled trial

   Lancet (London, England) · Q1 journal · RCT · Evidence level 1 (High) · 31 October 2026

   In an international trial of 424 children with moderate-to-severe acute respiratory distress syndrome, prone positioning and high-frequency oscillatory ventilation did not improve ventilator-free days compared with standard approaches; deaths also did not differ between groups. The trial stopped early, and some complications were more frequent with prone positioning or oscillatory ventilation, offering no support for their routine first-line use.

2. 2

   Cariprazine in the Treatment of Pediatric Patients With Irritability Associated With Autism Spectrum Disorder: A Randomized Controlled Trial

   Journal of the American Academy of Child and Adolescent Psychiatry · Q1 journal · RCT · Evidence level 1 (High) · 22 October 2026

   In an 8-week randomized trial of 155 youth ages 5 to 17, 68.9% taking cariprazine were rated much or very much improved in irritability, compared with 38.0% taking placebo; irritability scores also improved more with the drug. About half had treatment-emergent side effects, most often sleepiness or headache, and longer-term safety and benefit remain unknown.

3. 3

   Instrumental Support Calls vs. Caring Contacts Texts to Prevent Suicide in Adolescents and Adults: The SPARC Randomized Clinical Trial

   The American journal of psychiatry · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   Randomized trial examines suicide-prevention follow-up in adolescents

4. 4

   Preschool Physical Activity Policy and Children's Physical Activity: A Pragmatic Cluster Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

   In 124 Stockholm preschools, children's moderate-to-vigorous activity rose by about 6 minutes per day in both groups, with the new policy adding just 0.3 minutes compared with usual practice. Total activity and steps also showed no added gain, suggesting that adopting a policy alone may not change children's activity; how to translate preschool rules into measurable behavior remains unclear.

5. 5

   A nationwide prospective randomized trial for diagnosing developmental disorders demonstrates genome sequencing outperforms standard of care

   Genome medicine · Q1 journal · RCT · Evidence level 1 (High) · 5 October 2026

   In a nationwide randomized trial of 567 people with unexplained developmental disorders, genome sequencing had a 39.8% diagnostic yield, compared with 30% for standard testing, largely by finding more small genetic changes. After accounting for differences between groups, the advantage fell to 7.3 percentage points and was not statistically clear, so the size of the benefit remains uncertain.

6. 6

   Individually Targeted Human Milk Fortification: A Randomized Clinical Trial

   JAMA pediatrics · Q1 journal · RCT · Evidence level 1 (High) · 14 September 2026

   In a double-blind trial of 130 infants born 24-30 weeks, point-of-care milk analysis guided extra protein or fat but did not improve weight, length, head-circumference z scores, fat-free mass, or near-term brain MRI compared with standard fortification. Both groups met nutrient targets, suggesting routine targeted fortification is unnecessary.

7. 7

   Effects of an e-health enhanced multicomponent outpatient intervention for children and adolescents with overweight or obesity in routine primary care (STARKIDS): a cluster-randomized controlled trial

   The Lancet regional health. Europe · Q1 journal · RCT · Evidence level 1 (High) · 14 October 2026

   At 12 months, 33% of children and adolescents receiving STARKIDS had a BMI z-score reduction of at least 0.2, compared with 22% receiving one-time counseling. The groups no longer differed at 18 months, and adolescents' quality of life did not improve significantly; the early weight benefit may need more ongoing support to last.

8. 8

   Dexamethasone Eye Drops to Prevent Treatment-Requiring Retinopathy of Prematurity: The DROPROP Randomized Clinical Trial

   JAMA Pediatrics · Q1 journal · Review / opinion · Evidence level 1 (High) · 1 November 2026

   Dexamethasone eye drops to prevent ROP progression

9. 9

   Telemedicine Consultation for Pediatric Trauma in Community ED Visits and Parent Experience of Care: A Stepped-Wedge Cluster-Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

   In a randomized trial across 10 community emergency departments, telemedicine consultations with pediatric trauma specialists did not significantly change parents' overall care ratings or distress, or how often children were transferred. Parents rated discharge and transfer experiences more favorably with telemedicine, but that was a subscale finding; whether better transition communication translates into meaningful benefits remains unknown.

10. 10

    Pharmacological Interventions for Neurological Manifestations of Ataxia-Telangiectasia: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials

    Cerebellum (London, England) · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 31 October 2026

    Across six randomized trials of drugs for ataxia-telangiectasia, two levacetylleucine trials showed no significant pooled improvement on an ataxia rating scale, with results varying substantially. A separate pooled analysis found better scores with erythrocyte-encapsulated dexamethasone, but neither trial met its primary neurological endpoint. The findings leave treatment effects uncertain and highlight the need for better outcome measures.

Paper of the day, last two weeks

• Rotavirus Vaccine Effectiveness Against Hospitalization for Rotavirus Gastroenteritis in Children Under 5 years: A Test-Negative Study in Southern Italy, 2018-2025

  Infectious diseases and therapy · Q1 journal · Case-control · Evidence level 3 (Low) · 3 November 2026

  Rotavirus vaccine effectiveness against hospitalization in young children

• Fluid choice in pediatric diabetic ketoacidosis: a Systematic Review and Meta-Analysis

  European journal of pediatrics · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 3 November 2026

  Paediatric DKA fluid comparison directly informs acute management

• Delayed appendectomy as part of a nonoperative treatment strategy does not increase postoperative complications in children with simple appendicitis-A secondary analysis from a randomized controlled trial (Antibiotics Versus Primary Appendectomy in Children trial)

  Surgery · Q1 journal · RCT · Evidence level 1 (High) · 9 October 2026

  In children with simple appendicitis, complications occurred in 4 of 46 who had delayed surgery after initial nonoperative treatment, compared with 11 of 143 who had surgery first. The secondary analysis found no significant difference in complication rates or severity, but the small delayed-surgery group leaves uncertainty about how closely outcomes compare.

• Five-year outcomes of the STOP-AD randomised controlled trial: Long-term effects of early emollient therapy in high-risk infants

  Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · Q1 journal · RCT · Evidence level 1 (High) · 1 November 2026

  In a five-year follow-up of 177 high-risk children, eczema affected 12.3% of those given twice-daily emollient for eight weeks from birth, compared with 24.0% receiving routine skin care; cases were also less severe. Missing follow-up data leave uncertainty about the size of the benefit, so larger studies must confirm whether this brief treatment prevents eczema long term.

• Clinical presentation of severe malaria in children who received the RTS,S/AS01E malaria vaccine, seasonal malaria chemoprevention or the combination of both interventions in Burkina Faso and Mali

  Malaria journal · Q1 journal · RCT · Evidence level 1 (High) · 22 July 2026

  In Burkina Faso and Mali, severe anemia was the most common presentation among 162 severe malaria cases, affecting half of the children; nearly 86% of cases occurred from July to December, and 79% were in children aged 3 years or younger. Anemia made up a larger share of cases in the seasonal prevention-only group than in the group receiving prevention plus vaccine, but this analysis does not show why.

• A Decade Long Retrospective Cohort Study on Risk Factors and Clinical Outcomes of Carbapenem Resistant Gram-Negative Infections in A Pediatric Intensive Care Unit

  Journal of intensive care medicine · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 29 October 2026

  In this 10-year study of 380 children with Gram-negative infections, 28% had carbapenem-resistant infections; 30-day mortality was 27% in this group, compared with 9% in children with susceptible infections. Only 37% received appropriate empirical treatment, and invasive devices, steroid use, and comorbidities were linked to resistance, though this single-center observational study cannot establish cause and effect.

• Supplementation with fortified balanced energy-protein during pregnancy and lactation and infant growth outcomes in southern Nepal: a community-based 2×2 factorial randomized trial

  The American journal of clinical nutrition · Q1 journal · RCT · Evidence level 1 (High) · 29 October 2026

  In a randomized trial involving 1,554 mothers in rural Nepal, daily fortified energy-protein supplements during pregnancy or early lactation did not improve infants' length or other growth measures at 6 months; results remained unchanged after accounting for birth size. Growth outcomes also showed no benefit at 12 months in a subset, leaving alternative ways to prevent early growth faltering urgently needed.

• Short-course versus standard- or longer-course oral antibiotic therapy for pneumonia and lower respiratory tract infection in children: a systematic review and meta-analysis of randomized controlled trials

  Frontiers in pharmacology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

  Evidence informs outpatient paediatric antibiotic duration for pneumonia

• Effects of a Water, Sanitation and Hygiene Mobile Health Program on Respiratory Illness in Democratic Republic of Congo (DRC): WASHmobile PICHA7 Program

  Tropical medicine & international health : TM & IH · Q1 journal · RCT · Evidence level 1 (High) · 26 October 2026

  In a cluster-randomized trial in eastern Democratic Republic of the Congo, 4% of children under 5 in households receiving WASHmobile reported acute lower respiratory illness, compared with 12% receiving standard messages over 12 months. The program combined weekly voice and text messages with home visits, but symptoms were self-reported and the findings apply to households of diarrhea patients.

• Next-Generation Bed Nets to Control Malaria in Côte d'Ivoire

  NEJM evidence · Q1 journal · RCT · Evidence level 1 (High) · 27 October 2026

  In a cluster-randomized trial, children aged 6 months to 9 years had 0.65 malaria cases per child-year with chlorfenapyr-pyrethroid nets, versus 1.11 with standard pyrethroid-only nets - a 43% lower incidence over 12 months. Piperonyl butoxide-pyrethroid nets also reduced incidence, by 28%; how long these benefits last beyond a year remains unknown.

• Effectiveness of an Inactivated Quadrivalent Influenza Vaccine in Children and Pregnant Women in Rural Bangladesh: A Phase IV Double-Blind, Cluster-Randomized Trial

  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · Q1 journal · RCT · Evidence level 1 (High) · 26 October 2026

  In a cluster-randomized trial in rural Bangladesh, the vaccine was 77% effective against confirmed influenza in children during the 2021 B/Victoria wave. Protection was not significant against H1N1 and estimated effectiveness was negative against H3N2; too few cases occurred among pregnant women to assess their protection, and no indirect protection was seen. The findings support child vaccination, but protection varied by strain.

• Emotion-Focused Behavioral Weight Loss Treatment for Adolescents: A Randomized Clinical Trial

  JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

  In a trial of 166 adolescents, adding emotion regulation skills to family-based weight treatment did not improve weight loss during the 6-month program, but adolescents regained less weight by 12-month follow-up; 22% achieved clinically significant weight loss versus 4% with standard treatment. Emotional eating was also lower, though emotion regulation scores did not differ, and the findings need confirmation beyond two university clinics.

Evidence summaries in Pediatrics and Child Health

• Bronchiolitis
• Kawasaki Disease