Rivista di formazione e di aggiornamento professionale del pediatra e del medico di base, realizzata in collaborazione con l'Associazione Culturale Pediatri

Keywords: Socioemotional development; Preschool children; Child Behavior Checklist; Postpartum depression; Maternal mood; Pandemic; Behavioral outcomes; Pediatric awareness Abstract Background/Objectives: Maternal post-partum mood alterations and the COVID-19 pandemic are recognized risk factors for children’s socioemotional difficulties. This study aims to assess behavioral outcomes in preschool children born to mothers previously screened for post-partum depression (EPDS >9), comparing cohorts evaluated during and after the pandemic through the Child Behavior Checklist (CBCL 1½–5). Methods: A retrospective observational study was conducted on a sample of 52 children aged 1.5-3 years, whose mothers had previously been screened with Edinburgh Post-natal Depression Scale (EPDS) for another project. Two cohorts were defined by the birth date (during pandemic: Jan 2022-April2022 ; post-pandemic: October 2023-November 2023). Primary outcomes were CBCL T-scores in correlation with EPDS scores, the secondary outcome was the correlation with pandemic period. Group differences were tested using appropriate parametric (t-test) or non-parametric (Mann–Whitney U) tests for continuous data, and χ² or Fisher’s exact tests for categorical data. Sensitivity analyses confirmed robustness. Results: Children assessed in the post-pandemic period showed significantly lower internalizing and Total Problems T-scores compared to those assessed during the pandemic, while Externalizing problems T-scores remained similar. The proportion of children in clinical CBCL range decreased in post-pandemic period. Conclusions: Findings suggest a partial post-pandemic improvement in emotional-behavioral functioning among children. Such results may help raise pediatricians’ awareness of unusual demeanors or subtle behavioral cues in children born during the pandemic.

Background: Growth impairment is a major component of pediatric inflammatory bowel disease (IBD), yet the prognostic role of baseline nutritional status remains debated. We assessed the impact of nutritional status at diagnosis on subsequent medical and surgical disease course. Methods: We retrospectively studied 183 children with IBD (84 Crohn’s disease, 99 ulcerative colitis) followed for at least 18 months. Patients were classified at diagnosis using BMI Z-scores as underweight (n = 35), normal weight (n = 123), or overweight/obese (n = 25). Multivariable regression models—adjusted for diagnosis, biological sex, age at diagnosis, and extraintestinal manifestations/comorbidities—evaluated relapse burden, surgical resection, and longitudinal anthropometric recovery at last follow-up. Results: Baseline underweight status was not independently associated with a higher relapse burden or time to first relapse. A sensitivity analysis excluding surgically resected patients showed higher estimated relapse rates for underweight patients, though these did not reach statistical significance. In exploratory analyses, baseline underweight showed a borderline, non-significant association with subsequent surgical resection (adjusted OR 2.68, 95% CI 0.97–7.27; p = 0.056), warranting validation in larger prospective cohorts. Exploratory VEO-IBD analyses were limited by small subgroup size; within UC, a higher crude resection frequency was observed in VEO-UC than in older-onset UC (15.0% vs. 1.3%), but this finding should be interpreted cautiously. At follow-up, 85.7% of initially underweight patients reached normal weight. Higher baseline BMI Z-score was independently associated with higher follow-up BMI Z-score, whereas therapeutic escalation and total relapse burden were not independently associated with follow-up BMI Z-score. Persistent stunting was very rare (1.9%), precluding multivariable analysis. Conclusions: Baseline underweight showed a suggestive but non-significant association with subsequent surgical resection, warranting confirmation in larger prospective cohorts, while it was not independently associated with medical disease instability. Substantial weight recovery occurred during pediatric IBD follow-up. Baseline BMI Z-score was associated with BMI Z-score at follow-up, although substantial between-patient variability remained unexplained.

Background/Objectives: Maternal postpartum depressive symptoms and the COVID-19 pandemic have both been identified as potential risk factors for socioemotional difficulties in children. This study aimed to assess behavioral outcomes in young children born to mothers previously screened for postpartum depressive symptoms, comparing cohorts evaluated during and after the pandemic using the Child Behavior Checklist (CBCL 1½–5). Methods: An observational follow-up cohort study was conducted on 52 mother–child dyads derived from a previously established maternal cohort screened with the Edinburgh Postnatal Depression Scale (EPDS). Two cohorts were defined according to the child’s birth period: during-pandemic (January–April 2022) and post-pandemic (October–November 2023) groups. Behavioral outcomes were assessed using CBCL 1½–5. Group differences were tested using parametric or non-parametric methods for continuous variables and χ2 or Fisher’s exact tests for categorical variables. Exploratory regression models and sensitivity analyses were also performed. Results: Children assessed in the post-pandemic cohort showed a lower prevalence of non-normal internalizing scores than those assessed in the during-pandemic cohort, whereas externalizing outcomes and Total Problems did not significantly differ between groups. In exploratory models, a child’s age showed a near-significant association with internalizing outcomes, suggesting that developmental stage at assessment may have contributed to the observed cohort difference. Maternal SARS-CoV-2 infection at delivery was not associated with children’s behavioral outcomes. Conclusions: These findings suggest a possible difference in internalizing behavioral profiles between children assessed in during-pandemic and post-pandemic cohorts. However, this pattern should be interpreted cautiously because the cohorts differed substantially in age at follow-up, and age-related factors may have affected symptom detectability. Continued longitudinal follow-up will be important to clarify whether the observed differences persist over time.