Birth defects remain a critical public health challenge that impacts child survival, neurodevelopment, and the overall quality of life of affected families. Through decades of sustained efforts, China has established a comprehensive three-tier prevention and control system for birth defects. This framework is characterized by government leadership, support from the maternal and child healthcare network, multidisciplinary clinical collaboration, primary healthcare implementation and technology-driven innovation. Large-scale periconceptional folic acid supplementation, free national preconception health examinations and comprehensive thalassemia control programs in southern China demonstrate the scalability of primary prevention. Non-invasive prenatal testing, chromosomal microarray analysis and prenatal exome sequencing have advanced secondary prevention from risk identification toward etiological diagnosis. Newborn screening for inherited metabolic disorders, hearing loss and congenital heart disease, together with precision treatment and emerging gene therapy of hereditary deafness, has extended tertiary prevention from early detection to outcome improvement. The essential value of the Chinese experience lies in integrating population prevention, precision diagnosis, timely intervention, long-term follow-up, and reproductive risk management into a seamless continuum of care. Future priorities should focus on health outcome, shifting from service coverage alone to measurable health benefits through enhanced post-screening management, regional quality assurance, genetic counseling and life-course care.

Birth defects are structural, functional or metabolic abnormalities arising during embryonic development. They encompass a wide spectrum of disorders and are a major public health concern. China has established a full-chain prevention and control system consisting of primary pre-conception prevention, secondary prenatal prevention and tertiary postnatal prevention. Primary prevention targets couples planning pregnancy to reduce risks at the source via genetic screening, avoidance of hazardous environmental exposures, management of pre-existing maternal conditions, and supplementation of key nutrients such as folic acid. Secondary prevention identifies fetal anomalies using prenatal ultrasound, serological screening, non-invasive genetic testing, and invasive prenatal diagnostic procedures including chorionic villus sampling and amniocentesis,and provides appropriate intervention and management. Tertiary prevention enables early diagnosis and treatment through newborn screening for inborn errors of metabolism, hearing impairment and congenital heart disease, followed by individualized therapy and long-term rehabilitation. Treatment strategies vary substantially by phenotype: surgical correction is the mainstay for structural malformations, lifelong dietary or pharmacological management is adopted for inborn errors of metabolism, and supportive rehabilitation care is prioritized for chromosomal disorders. Current challenges include interregional disparities, limited capacity for rare birth defect management, and underdeveloped long-term rehabilitation and social support systems. Continuous improvement of closed-loop full-cycle management is required to reduce disease burden and improve population health.

Objective To evaluate the diagnostic value of whole-exome sequencing (WES) combined with copy number variation (CNV) analysis in children with unexplained developmental delay or intellectual disability (DD/ID), so as to provide a reference for clinical practice. Methods A retrospective study was conducted among 109 children with unexplained DD/ID who visited the Department of Rehabilitation, Anhui Provincial Children′s Hospital, from January to December 2024. WES data were analyzed to systematically evaluate single nucleotide variants (SNV), small insertions/deletions (Indel), and CNV. Pathogenicity was comprehensively interpreted integrating family validation and clinical phenotypes. Results SNV/Indel analysis identified 18 pathogenic and 23 likely pathogenic variants, with a diagnostic yield of 37.61%. Frameshift variants were the most prevalent (36.6%), and heterozygous variants constituted the majority (90.2%). Autosomal dominant inheritance was the most common mode (48.8%). Furthermore, CNV analysis identified 10 pathogenic or 2 likely pathogenic variants involving multiple genes associated with neurodevelopment, increasing the overall diagnostic yield by 11.01%. Conclusion WES combined with CNV analysis significantly improves the molecular diagnostic yield in children with unexplained DD/ID, which provides crucial reference for genetic counseling and precision medicine.

Objective To analyze the mutation profiles of 48 inherited metabolic disorders (IMDs) and 4 common deafness-associated genes among newborns in Shannan, Tibet, in order to provide baseline data for early screening and prevention of genetic diseases in high-altitude regions. Methods Live-born neonates delivered in 12 health service centers in the Shannan region between December 15, 2021, and December 31, 2022, were enrolled. Tandem mass spectrometry was performed in 1 456 newborns to measure amino acids, organic acids, and fatty-acid metabolites. In addition, 1 497 newborns were screened for 20 common variants in four deafness-associated genes (GJB2, GJB3, SLC26A4, and MT-RNR1). Screening results were summarized descriptively. Results The initial positive screening rate for IMDs was 1.79% (26/1 456), covering nine categories of suspected IMDs/abnormal screening profiles. Hyperphenylalaninemia (8 cases, 34.6%, including 1 suspected case) was the most prevalent, followed by propionic acidemia/methylmalonic acidemia (7 cases, 26.9%) and primary carnitine transporter deficiency (4 cases, 15.4%). The positive screening rate for the four deafness genes was 1.74% (26/1 497). MT-RNR1 variants were the most frequent (14 cases, 53.8%), followed by GJB2 variants (8 cases, 30.8%). Conclusions The initial positive rate of IMD screening in Shannan is higher than the national average and reported in Qinghai, another plateau region of China, and the carrier rate of common deafness genes is lower than the national average. This study provides a scientific reference for optimizing newborn screening strategies and preventing genetic diseases in high-altitude regions.

Objective To investigate the implementation effect of newborn screening for inherited metabolic diseases (IMDs) in Northwestern Guizhou, and to characterize the genetic mutation spectrum, so as to understand the regional epidemiological features and provide evidence for early diagnosis and intervention of birth defects. Methods This retrospective study included 46 078 newborns screened in eight counties or districts of Bijie in northwestern Guizhou between September 2023 and September 2024.Dried blood spot amino acids and acylcarnitines were analyzed by tandem mass spectrometry to screen for 33 IMDs.Screen-positive newborns were recalled for repeat testing and genetic diagnosis.The screen-positive rate, genetically confirmed case detection rate, and pathogenic variant distribution were analyzed. Results Among 46 078 neonates screened by MS/MS, 270 cases were positive, yielding a positive rate of 0.59%.Genetic testing was completed in 249 newborns, and 26 were confirmed to have IMDs, yielding an overall detection rate of 0.56‰.The confirmed disorders comprised hyperphenylalaninemia (n=7), short-chain acyl-CoA dehydrogenase deficiency (n=7), 2-methylbutyryl-CoA dehydrogenase deficiency (n=6), hypermethioninemia (n=5), and citrin deficiency (n=1).Twenty-two variants in six genes were identified, including a novel MAT1A frameshift variant[c.680dup (p.Arg228GlnfsTer38)]and two candidate recurrent ACADS variants. Conclusions The detection rate of IMD in northwestern Guizhou is relatively high.Hyperphenylalaninemia, short-chain acyl-CoA dehydrogenase deficiency, and 2-methylbutyryl-CoA dehydrogenase deficiency are the most frequently identified disorders, and evidence of ethnic clustering is observed.These disorders should be prioritized in local newborn screening programs.Genetic diagnosis and counseling should be strengthened in areas with ethnically clustered populations, while surveillance of newly identified and recurrent variants should be continued to optimize birth-defect prevention and control strategies.

Objective To assess treatment adherence among children with phenylketonuria (PKU), and to examine the associations and pathways linking socioeconomic factors, individual characteristics, and treatment-related behaviors with adherence, so as to provide evidence for improving PKU outcomes. Methods This retrospective study included 169 children with PKU who were diagnosed at the Newborn Screening Center of Shanxi Children′s Hospital (Shanxi Maternal and Child Health Care Hospital) between April 1, 2016, and December 31, 2023, and who remained in follow-up through December 31, 2024.Good treatment adherence was defined as meeting both of the following criteria: at least six blood phenylalanine (Phe) measurements in the past year and Phe concentrations within the target range in ≥70% of measurements.The participants were classified into good-adherence (n=78) and poor-adherence (n=91) groups.Univariate and multivariable logistic regression analyses were used to identify factors associated with treatment adherence, and structural equation modeling (SEM) was used for path analysis. Results Maternal education of junior college level or higher (OR=2.492, 95%CI: 1.133 - 5.477), urban residence (OR=2.625, 95%CI: 1.272 - 5.418), and a monthly household income of CNY 4 000 - 8 000 (OR=2.245, 95%CI: 1.018 - 4.925) or >CNY 8 000 (OR=4.055, 95%CI: 1.070 - 15.370) were associated with higher odds of good treatment adherence(P<0.05).Older age (OR=0.456, 95%CI: 0.240 - 0.871) and a longer interval before initiation of dietary treatment (OR=0.958, 95%CI: 0.930 - 0.987) were associated with lower odds of good treatment adherence (P<0.05).SEM showed that socioeconomic factors and time to initiation of dietary treatment were directly associated with treatment adherence, with standardized path coefficients of 0.614 and -0.186, respectively.Socioeconomic factors were also indirectly associated with treatment adherence through time to initiation of dietary treatment (standardized path coefficient=0.044). Conclusions Family socioeconomic status is directly associated with treatment adherence in children with PKU and is also indirectly associated with adherence through the timing of dietary treatment initiation.The results may help guide targeted interventions to improve treatment adherence.

Objective To determine the optimal parameter combinations of auditory stimulation frequency, duration, and music type for premature infants, in order to provide evidence for clinical interventions. Methods An L₂₇(3¹³) orthogonal experimental design was adopted. A total of 189 premature infants hospitalized in the Neonatal Intensive Care Unit (NICU) of NanjingWomen and Children′s Healthcare Hospital from April to September 2024 were enrolled in this study, and were randomly assigned to 27 groups. Range analysis and analysis of variance (ANOVA) were utilized to evaluate the effect of three factors related to auditory stimulation (music type, stimulation frequency, and duration) on weight, length, and head circumference gain, as well as the time to achieve full oral feeding, the time to achieve full enteral feeding, and Neonatal Behavioral Neurological Assessment (NBNA) scores. Results After excluding 9 ineligible cases, a total of 180 preterm infants were ultimately enrolled in the study.The type of music significantly affected the gains in body weight, head circumference, and body length, as well as the time to achieve full oral feeding and NBNA scores (F=4.673, 4.618, 4.528, 5.673, 7.528, P<0.05). Stimulation frequency significantly influenced the gains in body weight, head circumference, and body length, along with the time to achieve full oral feeding and the time to achieve full enteral feeding (F=4.760, 5.142, 6.318, 5.966, 4.748, P<0.05). The duration of stimulation significantly impacted NBNA scores (F=7.424, P=0.015). Furthermore, a significant interaction between music type and duration on NBNA scores was observed (F=4.031, P=0.044). Conclusions The optimal parameter combination for auditory stimulation in premature infants is maternal live lullaby singing administered three times a day for 30 minutes per session. It is recommended to prioritize this protocol in clinical developmental supportive care for premature infants.

Objective To investigate the associations between maternal pregnancy-related factors and the clinical severity of intellectual developmental disorder/global developmental delay (IDD/GDD) in children, in order to provide evidence for risk stratification and early intervention. Methods A total of 275 children with IDD/GDD who were treated at Xi′an Encephalopathy Hospital of Traditional Chinese Medicine between October 2022 and March 2025 were included.Developmental quotient (DQ) or full-scale intelligence quotient (FSIQ) was assessed using the Gesell Developmental Schedule or the Wechsler Intelligence Scale for Children, Fourth Edition, respectively.Social adaptive functioning was evaluated usingthe Normal Development of Social Skills from Infancy to Junior High School Children.According to medical history,clinical manifestations, and standardized assessments, the children were categorized into mild (n=87), moderate (n=77), and severe (n=111) groups.Variables identified by univariate analysis were entered into a multinomial logistic regression model to examine their associations with IDD/GDD severity, with the severe group as the reference category. Results Univariate analysis showed significant differences in advanced maternal age, maternal iron-deficiency anemia (IDA), electromagnetic-field exposure for >10 h/d during pregnancy and respiratory viral infection during early pregnancy among three groups (P<0.05).In multionmial logistic regression analyses,maternal IDA was associated with severe IDD/GDD in children (OR=2.310, 95%CI: 1.123 - 4.752,P<0.05).EPRVI (moderate: OR=2.338, 95%CI: 1.009 - 5.419; severe: OR=3.387, 95%CI:1.590 - 7.214) and prenatal electromagnetic field exposure >10 h/day (moderate:OR=3.227,95%CI:1.174 - 8.873;severe:OR=2.788,95%CI:1.032 - 7.531)were associated with higher severity levels of IDD/GDD (P<0.05).Advanced maternal age was associated with moderate IDD/GDD (OR=2.891, 95%CI: 1.084 - 7.705,P<0.05). Conclusions Maternal IDA and respiratory viral infection during early pregnancy are independently associated with severe IDD/GDD, suggesting that prenatal iron deficiency and maternal immune activation may contribute to variation in disease severity.Enhanced monitoring of maternal iron status and prevention of infection during early pregnancy may be warranted.

Objective To explore the associations among parental phubbing, responsive caregiving, and parent-child interaction quality in families with infants and toddlers aged 0 to 3 years, so as to provide a theoretical basis for improving home nurturing quality. Methods A convenience sample of 285 parents of children aged 0 to 3 years was recruited from the child health care departments of three tertiary hospitals in Xianyang City between July and November 2025. Data were collected using a general demographic questionnaire, the Parental Phubbing Scale, the Responsive Caregiving Rating Scale, and the Brigance Parent-Child Interaction Scale. Descriptive statistics and correlation analyses were performed using SPSS 27.0, and the mediating effect was examined using the PROCESS macro. Results Parent-child interaction scores were significantly higher for only children (t=3.503, P<0.001) and full-term infants (t=-3.453, P<0.001). Furthermore, significantly higher interaction quality was observed when the primary caregivers were parents (t=5.955), maternal age was ≤35 years old (t=2.698), maternal education was at the postgraduate level or above (F=3.647), residence was in urban areas (t=2.442), and monthly family income ranged from 8 000 to 15 000 RMB (F=3.993) (P<0.05). Parental phubbing was negatively correlated with parent-child interaction quality and responsive caregiving (r=-0.467, -0.504, P<0.01), while responsive caregiving was positively correlated with parent-child interaction quality (r=0.571, P<0.01). After adjusting for relevant demographic covariates, parental phubbing negatively predicted responsive caregiving (β=-0.490, P<0.001) and parent-child interaction quality (β=-0.247, P<0.001), whereas responsive caregiving positively predicted parent-child interaction quality (β=0.416, P<0.001). Responsive caregiving had a significant indirect effect on the association between parental phubbing and parent-child interaction quality, with an indirect effect of -0.204(95%CI:-0.291 to -0.130), accounting for 45.18% of the total effect. Conclusions Parental phubbing is closely related to parent-child interaction quality, and responsive caregiving plays a significant mediating role. Parenting guidance should focus on reducing parental phubbing, improving responsive caregiving so as to promote high-quality parent-child interactions.

Objective To investigate the detection rates of developmental coordination disorder (DCD) among preschool children in Xuzhou, and to identify influencing factors, so as to provide a theoretical basis for its early prevention, diagnosis, and intervention. Methods A cross-sectional study was conducted between March and April 2023. The Chinese version of the Little Developmental Coordination Disorder Questionnaire (Little DCDQ) was used to evaluate the motor coordination abilities of 117 479 preschool children from 611 kindergartens in Xuzhou. According to the total little DCDQ score, children were classified into the normal, suspected, and positive DCD screening groups. χ² test was used to compare differences in DCD screening results among children with different characteristics, and multinomial logistic regression was performed to identify factors associated with suspected and abnormal DCD screening results. Results The screening positivity rate of DCD and suspected rate DCD among preschool children in Xuzhou were 12.0% and 10.9%, respectively. Significant differences were observed among the normal, suspected DCD, and DCD groups in children′s gender, age, mode of delivery, preterm birth, hypoxic asphyxia at birth, maternal smoking during pregnancy, paternal education level, maternal education level, feeding pattern before 6 months of age, daily screen time, daily outdoor activity time, and daily moderate-to-vigorous physical activity time (χ²=27.39 - 2 274.06, P<0.001). Multinomial logistic regression analysis showed that boys, assisted vaginal delivery, preterm birth, hypoxic asphyxia at birth, screen time >2 h/d, outdoor activity time <2 h/d, moderate-to-vigorous physical activity time <1 h/d, mixed or formula feeding before 6 months of age, and lower parental education levels were positively associated with suspected and abnormal DCD screening results(P<0.05). Maternal smoking during pregnancy was positively associated with positive DCD screening results (P<0.05). Older age was negatively associated with lower odds of suspected and positive DCD screening results (P<0.05). Conclusions The detection rates of positive and suspected DCD screening results among preschool children in Xuzhou are relatively high, which is associated with children′s gender, age, lifestyle factors, perinatal factors, and parental education level. Integrated medical and educational efforts are recommended to support early prevention and intervention strategies targeting relevant associated factors.

Objective To determine the prevalence of language developmental delay (LDD) and identify its associated factors among children aged 12 - 35 months, in order to provide a reference for the prevention and early intervention of LDD. Methods A total of 554 children aged 12 - 35 months who underwent routine health examinations at the Department of Child Healthcare, Hanzhong People′s Hospital, between May 2024 and April 2025 were enrolled. Language development was assessed using the Early Language Milestone Scale, with scores at or below the 10th percentile classified as abnormal. General characteristics, perinatal factors, and the family-rearing environment were assessed via questionnaire. Univariate analyses were performed using the chi-square test or Fisher′s exact test, followed by logistic regression to identify factors associated with LDD. Results The prevalence of LDD was 18.41% (102/554). A family history of language disorder was positively associated with abnormalities in speech and language expression (domain A: OR=15.254, 95%CI: 4.410 - 52.762), auditory perception and comprehension (domain B: OR=4.387, 95%CI: 1.471 - 13.081), visual perception and comprehension (domain C: OR=3.641, 95%CI: 1.071 - 12.381), and the total scale score (OR=10.062, 95%CI: 3.196 - 31.669) (P<0.05). Parent-child interaction for <1h/d was positively associated with abnormalities in domains A (OR=2.566, 95%CI: 1.211 - 5.437), B(OR=2.192, 95%CI: 1.120 - 4.291), and C (OR=2.530, 95%CI:1.063 - 5.891) (P<0.05). Weekly peer contact time ≤5 h was positively associated with abnormal scores on dimension A (OR=1.683, 95% CI: 1.036 - 2.733), dimension C (OR=1.806, 95% CI: 1.019 - 3.202), and the total scale score (OR=1.715, 95% CI: 1.070 - 2.749) (all P<0.05). Caregiver education at junior high school level or below was positively associated with abnormalities in domains B (OR=2.769, 95%CI:1.415 - 5.420) and C (OR=2.878, 95%CI:1.189 - 6.964)(P＜0.05). Male sex was positively associated with abnormalities in domain A (OR=2.951, 95%CI:1.726 - 5.046) and the total score (OR=2.027, 95%CI:1.233 - 3.332) (P＜0.05). No exposure to electronic devices was negatively associated with abnormalities in domain B(OR=0.049, 95%CI:0.005 - 0.479) and the total score (OR=0.060, 95%CI:0.009 - 0.383) (P<0.05). Introduction of lumpy foods at 10 - 12 months was negatively associated with abnormalities in domain A (OR=0.357, 95% CI: 0.178 - 0.717), and vaginal delivery was negatively associated with an abnormal total score (OR=0.607, 95% CI: 0.375 - 0.981) (P<0.05). Conclusions The prevalence of LDD among children aged 12 - 35 months in Hanzhong is relatively high and is associated with multiple factors, including genetic factors, the home-rearing environment, and electronic media use. Greater attention should be paid to early language-development screening in infants and young children, together with strengthened family guidance, and targeted interventions.

Objective To investigate the association of attention control ability with behavioral problems, social functioning, and video electroencephalography (V-EEG) abnormalities in children with attention-deficit/hyperactivity disorder (ADHD), so as to provide reference for clinical assessment and individualized intervention. Methods A total of 130 children with ADHD who attended the Child Health Center of Wuhan First Hospital from June 2022 to June 2025 were enrolled, and their clinical data were retrospectively collected. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the children were classified as inattentive type (ADHD-I, n=49), hyperactive/impulsive type (ADHD-HI, n=36), and combined type (ADHD-C, n=45). All participants completed the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Conners Parent Symptom Questionnaire (PSQ), and Weiss Functional Impairment Rating Scale–Parent Report (WFIRS-P) and underwent video electroencephalography (V-EEG). Behavioral problems, social functioning, and V-EEG abnormality rates were compared among the three ADHD types. After adjustment for age and full-scale intelligence quotient (IQ), partial correlation analyses were used to examine the associations of IVA-CPT attention and response-control quotients with PSQ and WFIRS-P scores. Partial point-biserial correlation analyses were used to assess the associations between these quotients and V-EEG abnormalities. Results No significant differences were found in sex, age, or total IQ among the three groups (P>0.05). Compared with the ADHD-I group, the ADHD-C and ADHD-HI groups had higher scores for conduct problems, hyperactivity/impulsivity, and the hyperactivity index (P<0.05), while the ADHD-C group had higher learning-problem and hyperactivity/impulsivity scores than both other groups (P<0.05). In terms of WFIRS-P, the ADHD-C group scored higher than the ADHD-HI group in the learning/school domain and higher than both other groups in the risk-taking domain (P<0.05). The V-EEG abnormality rates were 18.4%, 22.2%, and 28.9% in the ADHD-I, ADHD-HI, and ADHD-C groups, respectively, with no significant difference among the three groups (P=0.476). After adjustment for age and full-scale IQ, response-control quotients were negatively correlated with conduct problems, hyperactivity/impulsivity, hyperactivity index, and impairment in life skills (partial r=-0.536 to -0.309, P<0.05). Attention quotients were negatively correlated with learning problems and impairment in the learning/school and risk-taking domains (partial r=-0.520 to -0.233, P<0.05). Both attention and response-control quotients were negatively correlated with V-EEG abnormalities (partial point-biserial r=-0.339 to -0.220, P<0.05). Conclusions Different ADHD subtypes exhibit heterogeneity in behavioral problems and social functioning impairments, with the combined subtype being the most severely affected in several domains. Attention and response-control quotients are associated with several measures of behavioral problems and social functioning impairment and with V-EEG abnormalities, suggesting that differences in attention and response control may be related to the clinical heterogeneity of ADHD. However, V-EEG abnormality rates do not differ significantly across ADHD subtypes, limiting their utility for distinguishing different subtypes.

Objective To examine the effects of exercise on inhibitory control and prefrontal cortical activity in children, and to investigate the moderating role of cardiorespiratory fitness (CRF), and explore the underlying neural correlates so as to provide reference for promoting children′s health. Methods In September 2021, 140 children aged 7 - 12 years were recruited from Tsinghua University Primary School Changping Campus using convenience sampling.Based on performance on the 20-meter shuttle run test (20mSRT), 42 children with high CRF and 42 with low CRF were selected to participate in a 12-week extracurricular physical activity intervention.Inhibitory control and prefrontal cortical activity were assessed before and after the intervention using the Flanker task and functional near-infrared spectroscopy (fNIRS), respectively. Results After exclusion of participants with missing data, 39 children in the high-CRF group and 38 in the low-CRF group were included in the analysis.At baseline, the high-CRF group had higher 20mSRT scores (t=-10.616, P<0.001), better inhibitory-control performance, reflected by shorter reaction times (F=4.776, P<0.05), and higher oxygenated hemoglobin (oxy-Hb) concentrations in the bilateral dorsolateral prefrontal cortex (DLPFC) than the low-CRF group (left: F=6.568, P<0.05; right: F=15.190, P<0.001).After the intervention, 20mSRT scores remained higher in the high-CRF group than in the low-CRF group (t=-7.017, P<0.001).Right DLPFC oxy-Hb concentration was significantly associated with inhibitory control in both groups (low-CRF group: r=0.469, P<0.01; high-CRF group: r=0.354, P<0.05). Conclusions Exercise intervention improves inhibitory control via right DLPFC activation, which plays a key mediating role.Effects vary across CRF levels, indicating cardiorespiratory fitness as a moderating variable.Future primary school physical activity interventions should prioritize CRF enhancement and adopt stratified approaches based on CRF levels to optimally facilitate children′s inhibitory control development.

Objective To explore the effects of caregiver type (parental vs. grandparental caregiving) and gender differences on the fundamental movement skills (FMS) of preschool children aged 4–5 years, so as to provide a basis for FMS cultivation in this age group. Methods From September and November 2021, a cluster sampling method was used to select 732 preschool children aged 4 - 5 years from six kindergartens in Jinhua City. The Test of Gross Motor Development-3rd Edition (TGMD-3) was used to assess children′s FMS across two dimensions: locomotor skills and object control skills. A two-way ANCOVA was performed to examine the main and interaction effects of caregiver type and gender on children′s FMS development. Results After controlling for paternal and maternal educational levels, significant interaction effects between caregiver type and gender were found for the total FMS score (F=7.640), locomotor skills score (F=4.687), and object control skills score (F=8.242) (P<0.05). The main effect of gender was statistically significant for object control skills (F=4.532, P=0.032), but not for locomotor skills or the total FMS score (both P>0.05). Item-level analyses showed significant main effects of gender on skipping (F=4.028), underhand throwing (F=12.736), two-handed striking of a stationary ball (F=9.965), and kicking a stationary ball (F=9.575) (P<0.05), and significant main effects of caregiver type on underhand throwing (F=4.721) and kicking a stationary ball (F=3.966) (P<0.05). Significant interaction effects between caregiver type and gender were also found for catching (F=4.673), one-hand dribbling of a stationary ball (F=9.170), and one-hand striking of a self-bounced ball (F=6.606) (P<0.05). Conclusions Caregiver type and gender interact synergistically to shape early motor development in young children. Differentiated interventions should be implemented for children from different caregiving backgrounds. A "family-kindergarten-community" collaborative mechanism is recommended, with particular attention to mitigating the potential inhibitory effect of grandparental caregiving on boys′ gross motor development, so as to promote comprehensive and balanced FMS development among preschool children.

Objective To investigate the effects of motor-cognitive dual-task training on balance and gait parameters in children with developmental coordination disorder (DCD), and to compare these effects with those of motor task training and sensory integration training, thereby providing evidence for the rehabilitation of children with DCD. Methods From June to July 2025, a total of 78 children with DCD aged 5 - 8 years were recruited in Huaibei and randomly assigned to a motor-cognitive dual-task group, a motor task group, or a sensory integration group, with 26 children in each group.The intervention lasted 12 weeks and was conducted three times per week for 60 min per session.Balance was assessed using the Movement Assessment Battery for Children-Second Edition (MABC-2), and gait parameters were measured using the GAITRite system before and after the intervention. Results Before the intervention, no statistically significant differences were observed among the three groups in balance scores or gait parameters (P>0.05).After the intervention, MABC-2 balance scores increased significantly from baseline in all three groups (P<0.001), and the between-group difference after the intervention was statistically significant (F=4.854, P=0.010).Regarding gait parameters, the motor-cognitive dual-task group showed significantly greater improvements in stride length (F=4.231), cadence (F=3.195), gait speed (F=4.335), double-support phase (F=8.323), and single-support phase (F=5.583) than the motor task and sensory integration groups (P<0.05), whereas gait cycle improvement did not differ significantly among the three groups (P＞0.05). Conclusions Compared with motor task training and sensory integration training alone, motor-cognitive dual-task training has significant advantages in improving balance and optimizing gait parameters in children with DCD and may provide reference for selecting rehabilitation programs for DCD children.

With the rising prevalence of overweight and obesity among children and adolescents, the prevalence of hyperuricemia among children and adolescents has increased significantly. However, safe and effective treatments suitable for pediatric patients remain limited. Recent evidence suggests that the gut microbiota may be an important target for modulating uric acid metabolism. However, most available evidence comes from animal studies and the underlying mechanisms remain incompletely understood. Furthermore, clinical translation faces challenges related to strain safety, long-term efficacy, and practical feasibility. This review summarizes the potential mechanisms by which gut microbiota contribute to the development of pediatric hyperuricemia, with a focus on its roles in regulating purine metabolism, uric acid excretion and reabsorption, and inflammatory responses. In addition, existing microbiota-based interventions are reviewed, and their clinical prospects and limitations are discussed, aiming to provide a theoretical basis and research direction for developing safer and more precise therapeutic strategies for pediatric hyperuricemia.

Neurodevelopmental disorders in preterm infants are influenced by multiple biomedical and environmental factors.Although advances in medical care have substantially improved the survival rate of preterm infants, the incidence of neurodevelopmental impairments remains high.The gut microbiota has emerged as a significant research focus, and its role in regulating neurodevelopment through the microbiota-gut-brain axis has gradually been elucidated.This review summarizes the major factors affecting neurodevelopmental outcomes in preterm infants, including prenatal, perinatal, and postnatal factors, and particularly discusses the potential mechanisms underlying the influence of the microbiota-gut-brain axis on neurodevelopment, aiming to provide a theoretical basis for the early intervention of neurodevelopmental disorders in preterm infants.

The early-life gut microbiota is a crucial biological determinant of neurodevelopment in infants and young children, exerting effects that initiate in early life and persist throughout the lifespan.Understanding how the gut microbiota influences neurocognitive behavior and brain structure/function via key microbial communities represents a major frontier and challenge in gut-brain axis research.This review summarizes the relationship between infant gut microbiota characteristics and neurodevelopment, with the aim of identifying potential clinical biomarkers and providing new insights and directions for predicting and treating neurodevelopmental disorders.

Developmental dyslexia is a common childhood neurodevelopmental disorder that substantially affects academic performance and social functioning. Magnetic resonance imaging (MRI), a noninvasive neuroimaging technique, has been widely used in recent years to investigate its neural mechanisms and the effects of intervention. This review summarizes recent structural and functional MRI findings in children with developmental dyslexia, with emphasis on gray- and white-matter alterations in reading-related brain regions, resting-state and task-based functional connectivity, and intervention-related neuroplastic changes. Integrating multimodal MRI with artificial intelligence-assisted analysis may facilitate early identification and individualized intervention. However, current studies are limited by inadequate sample representativeness, a lack of methodological standardization, and limited reproducibility. Future research should prioritize multicenter collaboration, longitudinal follow-up, and multimodal integration to facilitate the clinical translation and application of neuroimaging in childhood developmental dyslexia.

Early identification and intervention are essential for improving neurodevelopmental outcomes in high-risk infants. The Test of Infant Motor Performance (TIMP) is a motor assessment tool for infants from 34 weeks′ postmenstrual age to 4 months′ corrected age. In the early management of high-risk infants, it can support an integrated three-component model of assessment, guidance, and education.Although TIMP has considerable clinical value, it still has limitations regarding its scope of application, cultural adaptation, and personnel training.This review discusses the clinical value and limitations of TIMP in the early management of high-risk infants,aiming to provide more support for early management strategies for high-risk infants.