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Aim: To assess the association between problematic smartphone usage and anxiety and depression in adolescents. Methods: A cross‐sectional study in five schools in the UK were included. The primary outcome was moderate anxiety (GAD‐7 ≥10) symptoms and secondary outcomes were moderate depression symptoms (PHQ‐9 ≥10) and insomnia. Problematic smartphone usage was assessed using screentime and the Smartphone Addiction Scale. A multi‐level logistic regression was fitted and adjusted Odds Ratio (aOR) with 95% confidence intervals (95% CI) reported. A mediation analysis was conducted. Results: Of the five included schools, 657 adolescents aged 16–18 years were enrolled. The median age was 17.5 years (17–18 [IQR]) and 508 (77.3%) were female. Of these 188 (28.6%) exhibited moderate anxiety and 226 (34.4%) moderate depression symptoms. Almost two thirds (421, 64.1%) have tried to cut down their smartphone use and 81 (12.5%) wanted help to reduce use. Problematic smartphone use was associated with increased anxiety (aOR = 2.03, 95% CI 1.28–3.23); depression (aOR = 2.96, 95% CI 1.80–4.86); and insomnia (aOR = 1.64, 95% CI 1.08–2.50). Screentime was not associated with anxiety (β = 0.99, 95% CI 0.91–1.08); or depression (β = 0.98, 95% CI 0.89–1.07). Problematic smartphone use had a significant direct, indirect and total effect on both anxiety and depression. Conclusion: Problematic smartphone usage was associated with anxiety and depression, independent of screentime. Interventions are needed to reduce problematic use. [ABSTRACT FROM AUTHOR]

Aim: To undertake a systematic review and meta‐analysis exploring school‐age neurodevelopmental outcomes of children after low‐grade intraventricular haemorrhage (IVH). Method: The published and grey literature was extensively searched to identify observational comparative studies exploring neurodevelopmental outcomes after IVH grades 1 and 2. Our primary outcome was neurodevelopmental impairment after 5 years of age, which included cognitive, motor, speech and language, behavioural, hearing, or visual impairments. Results: This review included 12 studies and over 2036 infants born preterm with low grade IVH. Studies used 30 different neurodevelopmental tools to determine outcomes. There was conflicting evidence of the composite risk of neurodevelopmental impairment after low‐grade IVH. There was evidence of an association between low‐grade IVH and lower IQ at school age (−4.23, 95% confidence interval [CI] –7.53, −0.92, I2 = 0%) but impact on school performance was unclear. Studies reported an increased crude risk of cerebral palsy after low‐grade IVH (odds ratio [OR] 2.92, 95% CI 1.95, 4.37, I2 = 41%). No increased risk of speech and language impairment or behavioural impairment was found. Few studies addressed hearing and visual impairment. Interpretation: This systematic review presents evidence that low‐grade IVH is associated with specific neurodevelopmental impairments at school age, lending support to the theory that low‐grade IVH is not a benign condition. What this paper adds: The functional impact of low‐grade intraventricular haemorrhage (IVH) at school age is unknown.Low‐grade IVH is associated with a lower IQ at school age.The risk of cerebral palsy is increased after low‐grade IVH.Low‐grade IVH is not associated with speech and language impairment. What this paper adds: The functional impact of low‐grade intraventricular haemorrhage (IVH) at school age is unknown.Low‐grade IVH is associated with a lower IQ at school age.The risk of cerebral palsy is increased after low‐grade IVH.Low‐grade IVH is not associated with speech and language impairment. [ABSTRACT FROM AUTHOR]

Introduction: Over 3000 infants suffer a brain injury around the time of birth every year in England. Although these injuries can have important implications for children and their families, our understanding of how these injuries affect children's lives is limited., Methods and Analysis: The aim of the CHERuB study (Childhood Health and Educational outcomes afteR perinatal Brain injury) is to investigate longitudinal childhood health and educational outcomes after perinatal brain injury through the creation of a population-matched cohort study. This study will use the Department of Health and Social Care definition of perinatal brain injury which includes infants with intracranial haemorrhage, preterm white matter injury, hypoxic ischaemic encephalopathy, perinatal stroke, central nervous system infections, seizures and kernicterus. All children born with a perinatal brain injury in England between 2008 and 2019 will be included (n=54 176) and two matched comparator groups of infants without brain injury will be created: a preterm control group identified from the National Neonatal Research Data Set and a term/late preterm control group identified using birth records. The national health, education and social care records of these infants will be linked to ascertain their longitudinal childhood outcomes between 2008 and 2023. This cohort will include approximately 170 000 children. The associations between perinatal brain injuries and survival without neurosensory impairment, neurodevelopmental impairments, chronic health conditions and mental health conditions throughout childhood will be examined using regression methods and time-to-event analyses., Ethics and Dissemination: This study has West London Research Ethics Committee and Confidential Advisory Group approval (20/LO/1023 and 22/CAG/0068 issued 20/10/2022). Findings will be published in open-access journals and publicised via the CHERuB study website, social media accounts and our charity partners., Competing Interests: Competing interests: We have no competing interests to declare. CG has received Salary support from the Medical Research Council and has received grant funding paid to his institution from the National Institute for Health Research (NIHR), Action Medical Research, the Canadian Institute for Health Research, the Medical Research Council and from Chiesi Pharmaceuticals. CG has received Payment of travel and accommodation to attend educational meetings from Chiesi Pharmaceuticals. CB is funded by an NIHR Advanced Fellowship Award., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Background: Over 3000 children suffer a perinatal brain injury in England every year according to national surveillance. The childhood outcomes of infants with perinatal brain injury are however unknown., Methods: A systematic review and meta-analyses were undertaken of studies published between 2000 and September 2021 exploring school-aged neurodevelopmental outcomes of children after perinatal brain injury compared with those without perinatal brain injury. The primary outcome was neurodevelopmental impairment, which included cognitive, motor, speech and language, behavioural, hearing or visual impairment after 5 years of age., Results: This review included 42 studies. Preterm infants with intraventricular haemorrhage (IVH) grades 3-4 were found to have a threefold greater risk of moderate-to-severe neurodevelopmental impairment at school age OR 3.69 (95% CI 1.7 to 7.98) compared with preterm infants without IVH. Infants with perinatal stroke had an increased incidence of hemiplegia 61% (95% CI 39.2% to 82.9%) and an increased risk of cognitive impairment (difference in full scale IQ -24.2 (95% CI -30.73 to -17.67) . Perinatal stroke was also associated with poorer academic performance; and lower mean receptive -20.88 (95% CI -36.66 to -5.11) and expressive language scores -20.25 (95% CI -34.36 to -6.13) on the Clinical Evaluation of Language Fundamentals (CELF) assessment. Studies reported an increased risk of persisting neurodevelopmental impairment at school age after neonatal meningitis. Cognitive impairment and special educational needs were highlighted after moderate-to-severe hypoxic-ischaemic encephalopathy. However, there were limited comparative studies providing school-aged outcome data across neurodevelopmental domains and few provided adjusted data. Findings were further limited by the heterogeneity of studies., Conclusions: Longitudinal population studies exploring childhood outcomes after perinatal brain injury are urgently needed to better enable clinicians to prepare affected families, and to facilitate targeted developmental support to help affected children reach their full potential., Competing Interests: Competing interests: CG is funded by the UK Medical Research Council (MRC) through a Transition Support Award. In the past 5 years, he has received support from Chiesi Pharmaceuticals to attend an educational conference and has been investigator on received research grants from the Medical Research Council, National Institute of Health Research, Canadian Institute of Health Research, Department of Health in England, Mason Medical Research Foundation, Westminster Medical School Research Trust and Chiesi Pharmaceuticals. CB is funded by the UK National Institute of Health Research (NIHR) Advanced Fellowship Award., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)