儿童新型冠状病毒肺炎1例病例报告

正1病例资料女,1岁8个月,家居湖北省武汉市武昌区,1月28日因发热(体温最高38℃)在母亲陪同下从入住酒店到甘肃省兰州市肺科医院[我院,严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2)感染定点医院],以新型冠状病毒肺炎(COVID-19)疑似病例收入院隔离排查。1月27日患儿父亲因间歇发热10 h从同一入住酒店到我院就诊遂隔离排查,1月28日咽拭子SARS-CoV-2核酸检测阳性确诊感染。入院查体及辅助检查:T 36.7℃,P 88·min-1,R 20·min-1,BP 132/68 mm Hg;胸廓未见异常,呼吸节律规则,肋间隙未见异常,胸壁无压痛,无胸骨叩痛。双乳对称,未触及包块。呈胸式呼吸,呼吸运动双侧对称,肋间隙未见明显异常。语颤正常,未触及胸膜摩擦感,未触及皮下捻发感。     

云南省瑞丽市新型冠状病毒感染/肺炎成人和儿童本土病例的流行病学及临床特征

背景：2021年3月和7月云南省瑞丽市发生了2次境外输入病例导致的新型冠状病毒（SARS-CoV-2）感染的局部疫情,而且国内不断有输入病例导致的局部疫情出现。 目的：探讨SARS-CoV-2感染的成人与儿童本土病例流行病学及临床特征,为预防和治疗SARS-CoV-2感染提供借鉴。 设计：病例系列报告。 方法：回顾性收集云南省瑞丽市SARS-CoV-2感染病例定点医院（中医傣医医院）2021年3月29日至4月30日（简称3月疫情,SARS-CoV-2）和2021年7月4~31日［简称7月疫情,新型冠状病毒德尔塔变异株（Delta-CoV）］收治的由输入病例感染的成人和儿童本土病例,采集人口学、流行病学史和临床特征资料。 结果：成人和儿童病例分别为192例（3月和7月疫情分别为112例和80例）和16例（3月和7月疫情分别为5例和11例）;①儿童病例均未接种疫苗,成人仅7月疫情期间15例（18.8%）接种1剂型疫苗,19例接种了2剂型疫苗第1剂,14例（17.5%）接种了第2剂;②成人和儿童通过流行病学调查为密接者3月疫情分别为3.6%和40.0%,7月疫情分别为20.2%和54.5%,P＜0.05。③2次疫情成人和儿童病例无危重型和死亡病例,成人以轻型和普通型为主,儿童以无症状感染、轻型和普通型为主。④成人有基础疾病3月和7月疫情分别为17.0%和13.8%,P＜0.05;7月疫情儿童基础疾病1例为乙肝。⑤7月疫情成人发热病例（41.2%）较3月疫情（15.2%）占比高,P＜0.05,7月疫情儿童发热病例45.4%。⑥成人7月疫情较3月疫情乏力和咽部不适占比更高,儿童以咳嗽和咽部不适为主。⑦成人淋巴细胞减少病例7月疫情较3月疫情占比更高,P＜0.05,儿童仅在7月疫情出现1例;成人病例LDH、ALT、AST、CRP和D-二聚体升高者占比7月疫情均高于3月疫情,儿童仅在7月疫情 LDH、AST、CRP和D-二聚体升高各2例（18.2%）。⑧儿童肺部CT以双肺多发磨玻璃影、浸润影为主,成人病例还表现为以肺外带多发小斑片影及间质改变。⑨2次疫情儿童无氧疗病例,成人氧疗时间7月疫情（150 h）较3月疫情（96 h）更长;2次疫情成人连续二次核酸转阴时间接近(19 d vs 22 d),儿童病例7月疫情（32 d）较3月疫情（15 d）更长,P＜0.05。 结论：Delta-CoV较SARS-CoV-2感染的成人和儿童本土病例临床表现更重;儿童较成人病例临床表现轻,但核酸转阴时间较成人明显延长;Delta-CoV流行期间,成人病例36.3%完成了疫苗接种。     

关于儿童新型冠状病毒肺炎的系统综述

该综述的目的是描述儿童新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）的临床特征,重点探讨儿童不易感染COVID-19的可能原因,以及儿童免疫反应是否比成人更好。为此,确定了以下3个研究问题：（1）为什么儿童COVID-19病例临床症状较成人轻？（2）儿童COVID-19患者的临床表现、诊断和治疗如何？（3）痊愈后病毒排毒期持续多久？我们检索了MEDLINE、Embase、Cochrane Central Register of Controlled Trials和Cochrane Database of Abstracts of Reviews of Effects等数据库,以及有英文翻译的国外文献。并从谷歌学术和美国微生物学会收集了其他的信息和数据。从收集的文献中,提取患者的年龄、合并症、治疗方法及对病死率、发病率影响的相关信息。该综述表明,与成人相比,儿童不易患COVID-19,若患上COVID-19,其症状较成人轻。儿童COVID-19发病率较低,病情较成人轻,这可能归因于许多理论和原因,然而所涉及的机制尚不完全清楚。 引用格式:     

病例报告和系统综述表明临床诊断新型冠状病毒肺炎后儿童或受到类似成人的长期影响

目的:成人感染新型冠状病毒肺炎后出现持续症状,越来越多的文献报道了新型冠状病毒肺炎的长期影响,但儿科相关资料缺乏。方法:该文报道5例瑞典儿童新型冠状病毒肺炎,长期症状由父母报告。检索MEDLINE、EMBASE、Web of Science数据库,medRxiv/bioRxiv预印本服务器上截至2020年11月2日的文...     

关于儿童新型冠状病毒肺炎的系统综述（英文）

该综述的目的是描述儿童新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)的临床特征,重点探讨儿童不易感染COVID-19的可能原因,以及儿童免疫反应是否比成人更好。为此,确定了以下3个研究问题:(1)为什么儿童COVID-19病例临床症状较成人轻?(2)儿童COVID-19患者的临床表现、诊断和治疗如何?(3)痊愈后病毒排毒期持续多久?我们检索了MEDLINE、Embase、Cochrane Central Register of Controlled Trials和Cochrane Database of Abstracts of Reviews of Effects等数据库,以及有英文翻译的国外文献。并从谷歌学术和美国微生物学会收集了其他的信息和数据。从收集的文献中,提取患者的年龄、合并症、治疗方法及对病死率、发病率影响的相关信息。该综述表明,与成人相比,儿童不易患COVID-19,若患上COVID-19,其症状较成人轻。儿童COVID-19发病率较低,病情较成人轻,这可能归因于许多理论和原因,然而所涉及的机制尚不完全清楚。[中国当代儿科杂志,2021,23 (11):1080-1090]     

上海市境外输入性儿童新型冠状病毒感染38例病例系列报告

目的：了解上海市收治的境外输入性儿童新型冠状病毒（SARS-CoV-2）感染病例的流行病学和临床特征。方法：收集2020年3月14日至2020年4月8日在上海市入境的38例经呼吸道标本核酸检测阳性确诊的SARS-CoV-2感染的儿童病例资料,分析其流行病学史、临床表现、实验室检查、胸部影像学以及治疗和转归情况。结果：38例患儿中,无症状感染16例（42.1%）,非重症肺炎14例（36.8%）,轻型8例（21.1%）;37例（97.4%）来自欧洲和北美;26例（68.4%）无明确感染病例接触史或者聚集发病,12例（31.6%）有家庭内或学生宿舍内感染病例接触史。非肺炎组和肺炎组病例性别和年龄差异无统计学意义 （P>0.05）。14例肺炎病例随访影像学均显示肺部病灶吸收治愈。16例无症状感染者在住院期间未出现症状和肺部影像学异常。7例有发热,热程平均2.5 d,11例有咳嗽,5例有咽痛,4例有鼻塞和流涕症状,6例使用过1~6 d羟氯喹治疗。38例均治愈出院,住院时间平均（18.5±3.4）d。结论：境外输入性儿童SARS-CoV-2感染病例以无症状感染常见。有肺炎和无肺炎实验室检查结果无明显特异性。无症状感染者和非重症病例不推荐常规胸部影像学复查。     

11例Delta变异株新型冠状病毒肺炎儿童病例的临床特征分析

目的 探讨儿童Delta变异株新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）的流行病学及临床特征,分析其与儿童普通COVID-19的差异。 方法 回顾性选取2021年8~9月确诊的Delta变异株COVID-19和2020年2~3月确诊COVID-19的14岁以下儿童16例为研究对象。将16例患儿按照病毒变异情况分为变异组（n=11）与普通组（n=5）,对两组流行病学、临床特征及实验室检查资料进行比较。 结果 临床症状发生比例在变异组与普通组间比较差异无统计学意义（P>0.05）。白细胞计数、淋巴细胞计数和血小板计数在两组间比较差异无统计学意义（P>0.05）;变异组中性粒细胞计数低于普通组（P<0.05）;两组均没有淋巴细胞减少病例。变异组肌酸激酶同工酶增高比例较普通组多见（P<0.05）;而乳酸脱氢酶、D-二聚体、C-反应蛋白、白细胞介素-6增高比例与普通组比较差异无统计学意义（P>0.05）。9例变异组患儿在入院第2周有5例检测出IgM抗体阳性,均检测出IgG抗体阳性;入院第3周9例患儿IgM抗体水平呈下降趋势,8例患儿IgG抗体水平呈下降趋势。 结论 Delta变异株感染性增强,对儿童心肌的损害高于普通COVID-19。儿童感染Delta变异株后,IgG抗体出现时间与IgM抗体基本相同。     

儿童肺结节临床和影像学特征74例病例系列报告

背景：健康儿童肺结节日益增多,但相关研究较少,诊断治疗存在问题和挑战。 目的：总结儿童肺结节的临床和影像学特征及转归,为临床诊疗和随访提供参考依据。 设计：病例系列报告。 方法：回顾性收集2015年1月1日至2021年12月30日在复旦大学附属儿科医院（我院）呼吸科门诊就诊、年龄<18岁、诊断为肺结节、随访≥6个月的连续病例,排除恶性肿瘤、免疫缺陷病、结核和先天性肺气道畸形的患儿。通过门诊病历提取：性别,发现肺结节时年龄,就诊时间,行影像学检查的原因,发现肺结节的影像学检查方式,影像学检查指征,肺结节的伴随或合并疾病诊断,最终疾病诊断,随访胸部CT肺结节情况。 主要结局指标：肺结节检出率和随诊结局。 结果：74例儿童肺结节病例进入本文分析,平均发现年龄为（8.7±3.9）岁,>8岁者44例（59.5%）,男49例（66.2%）,肺结节经胸部CT发现67例（90.5%）。 51例在我院有肺结节影像学资料,其中肺结节直径<5 mm 32例、~10 mm 10例、>10 mm 9例。双侧肺结节18例,单侧肺结节33例;1个结节24例,~10个结节22例,>10个结节5例;以圆/类圆形（29例）和混合形（16例）为主;边缘以光滑为主（41例）;肺结节以实性为主（37例）,混合性7例,磨玻璃5例,部分实性2例。39例随访了胸部CT。首次随访CT的时间为发现后3.3（1,6）月,14例（35.9%）缩小或减少,9例（23.1%）无变化,8例（20.5%）消失,8例（20.5%）增大或增多。结节增大或增多的8例患儿初诊年龄（8.1±3.0）岁;结节直径5（2.5,15）mm;在我院随访CT的7例中,结节数目1个3例,~10个和~20个各1例,>20个2例。圆/类圆形3例,混合形4例;边缘光滑4例,欠光滑1例,晕征1例,毛刺征1例;结节实性6例,混合性1例。5例（结节直径均>10 mm）患儿行肺活检。共8例明确诊断,其中4例肺活检病理诊断明确,肺结节病2例,厌氧菌感染和炎性肌纤维母细胞瘤各1例;4例临床诊断,肺部感染3例,外伤引起肺结节1例。66例肺结节患儿未能确诊,拟诊肺部感染4例,拟诊肉芽肿性病变、肺占位性病变、结缔组织疾病和血管源性病变各1例,58例诊断肺结节待查。 结论：儿童肺结节潜在的检出率值得重视,总体诊断率低,需要动态影像学随访,>10 mm结节临床检查未确诊时有必要行肺活检病理诊断。     

儿童新型冠状病毒感染/肺炎疑似和确诊病例快速筛查和临床实践指南

正1指南制定1.1指南制定方法学概述依照WHO紧急公共卫生事件的快速风险评估手册提供的快速建议指南(Rapid Advice Guidelines)方法学[1]进行。鉴于新型冠状病毒(SARSCoV-2)感染为突发传染性疾病,也鉴于目前儿童病例不多且症状不重,更多的医生和护士参与疑似病例筛查,少数医生和护士参与疑似和确诊病例诊治,本指南没有考虑通过PICO构建临床问题,而是基于收治的疑似病例和确诊病例进行诊治过程的全面描述。     

有过敏性疾病史儿童接种新型冠状病毒灭活疫苗后不良事件的病例系列报告

背景：新型冠状病毒疫苗（简称新冠疫苗）接种对于控制疫情大流行并减少新冠肺炎重症发生率具有重要作用,有过敏性疾病史儿童人群接种新冠疫苗中的安全性是现实问题。 目的：为有过敏性疾病史的儿童接种新冠疫苗提供建议。 设计：病例系列报告。 方法：纳入2021年8月12日至2021年12月3日至复旦大学附属儿科医院疫苗咨询门诊咨询新冠疫苗接种的3～17岁儿童和青少年。根据儿童的既往史、目前健康状态以及家长的问题进行个体化评估,给予暂缓接种或推荐接种建议,电话随访接种后72 h内、28 d内和3个月时有无征集的疫苗接种后不良事件（AEFI）以及家长主动报告的任何非征集的不良事件;行AEFI与疫苗的因果关联评估。 主要结局指标：新冠疫苗AEFI。 结果：接受新冠疫苗接种咨询的儿童116例,男67例（57.8%）,女49例,年龄（10.1±3.1）岁,经疫苗咨询门诊个体化评估后推荐接种（组）77例（66.4%）,暂缓接种（组）39例。有过敏性疾病史70例（60.3%）,其中 25例因处于过敏性疾病急性期建议暂缓接种,既往其他疫苗或药物过敏史11例（9.5%）中5例因严重过敏反应期建议暂缓接种,非药物过敏史13例（11.2%）中5例因处于疾病急性期、特应性体质21例（18.1%）中3例因患急性疾病（呼吸道感染）,1例（0.9%因既往接种新冠疫苗1剂过敏）建议暂缓接种。暂缓接种组儿童于疫苗咨询门诊咨询后后3个月行电话随访均未接种新冠疫苗。推荐接种组77例儿童均完成了3次随访,实际接种亚组54例（47例接种了2剂次疫苗,7例接种了1剂次疫苗）;实际未接种亚组23例,两亚组性别、过敏性疾病史、其他疫苗或药物过敏史、非药物过敏史和特应性体质差异均无统计学意义, 年龄差异有统计学意义［（10.4±3.0）岁vs（9.0±3.1）岁,P=0.04］。接种后4 d和28 d的电话随访未报告征集的严重过敏反应。接种后72 h内18例（17.8%）报告征集的不良反应事件,其中皮疹和咳嗽各5例（5.0%）,流涕4例（4.0%）,纳差和发热各3例（3.0%）,咽痛2例 （2.0%）,乏力、肌痛、恶心、呕吐各1例（1.0%）,经判断与新冠疫苗接种有因果关联。接种后28 d和3个月电话随访未再报告征集的不良反应。接种后28 d内家长主动报告5例非征集不良事件,其中特发性皮炎或湿疹发作3例（3.0%）、 过敏性鼻炎发作2例（2.0%）,初步判断与新冠疫苗接种无因果关联。接种后28 d内新冠疫苗AEFI发生率 33.3% （18/54）。 结论：过敏性疾病缓解期、有其他疫苗或药物非严重过敏史、非药物过敏史、特应性体质儿童接种新冠病毒灭活疫苗是安全的,新冠疫苗AEFI均发生在接种后72 h内,与新冠疫苗接种有因果关联。     

Oral findings in children with congenital cholestatic disease: A systematic review of case reports and case series

Multiple causes of congenital neonatal cholestasis have been identified, and are classified as extrahepatic or intrahepatic. Biliary atresia (BA), Alagille syndrome (AGS), and progressive familial intrahepatic cholestasis (PFIC) are the most common of these. Many factors associated with cholestatic diseases are known to degrade the oral health of these children. What are the oral manifestations associated with these diseases in the pediatric population? The aim of this article was to evaluate the impact of congenital cholestasis on oral health in pediatric patients.A systematic review of case reports and case series was carried out in PubMed, the Cochrane Library, and the Web of Science to identify relevant articles in French and English published up to April 2022.The review included 19 studies, 16 case reports, and three case series. Only studies dealing with BA and AGS were found. These studies showed an impact on jaw morphology, dental structure, and periodontal health. The facial dysmorphism observed in AGS was specific. Exposure to high levels of bilirubin during the period of dental calcification led to particular coloration. Regarding periodontal status, gingival inflammation was common in these patients, probably resulting from the use of certain treatment-associated drugs and poor oral hygiene. Cohort studies are needed to confirm the classification of these children as being at high individual risk of caries.Many major oral manifestations are found in children with AGS and BA, confirming the need to include a dentist in the care team of patients with congenital cholestatic disease as early as possible. It appears necessary to carry out individual prospective studies of each phenotype in order to confirm and better describe the oral impact of these cholestatic diseases and provide adequate medical care.     

COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings

ObjectiveWe aimed to provide a meta-analysis of previously published papers on the COVID-19-related clinical features and laboratory findings in children.MethodThis meta-analysis was conducted by using Medline/PubMed, Scopus, Web of Sciences and Google Scholar. Finally, 32 articles were selected for full-text assessment.ResultsThe most frequent symptoms were fever, cough, vomiting, diarrhea, sore throat, and dyspnea. Regarding the combined results of the meta-analysis, fever (46%, 95% CI 40–53%), cough (37%, 95% CI 29–46%), diarrhea (19%, 95% CI 9–28%), and pharyngalgia (13%, 95% CI 5–20%) were the most widely reported symptom. Besides, positive RT-PCR test results (43%, 95% CI 33–53%), low oxygen saturation (38%, 95% CI 25–51%), and elevated D-dimer levels (36%, 95% CI 16–56%) were the most common laboratory findings.ConclusionThis review found that clinical presentations were milder, the prognosis was better, and the mortality rate was lower in children with COVID-19 compared with adult patients; however, children are potential carriers, like adults, and can transmit the infection among the population. Therefore, early identification and intervention in pediatric patients with COVID-19 are essential in order to control the pandemic. Moreover, gastrointestinal symptoms were more common symptoms among children.     

Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics,treatment, and outcomes

ObjectiveThe clinical cases of patients with multisystem inflammatory syndrome (MIS-C) were analyzed via a systematic review and meta-analysis of the clinical findings, treatments, and possible outcomes of articles retrieved via database searches.SourcesThe authors searched the PubMed, Scielo, Web of Science, Science Direct, EMBASA, EBSCO, and Scopus databases for articles containing the keywords “multisystem inflammatory syndrome in children” or “MIS-C” or “PIMS-TS” or “SIMP” and “COVID-19” or “SARS-CoV-2” published between December 1st, 2019 and July 10th, 2021. Patient characteristics, tissue and organ comorbidities, the incidence of symptoms after COVID-19 infection, treatment, and patient evolution in the articles found were evaluated. The data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Newcastle-Ottawa Scale (NOS).FindingsIn total, 98 articles (2275 patients) were selected for demographics, clinical treatment, and outcomes of patients diagnosed with MIS-C. The average age of children with MIS-C, 56.8% of whom were male, was of nine years. Fever (100%), gastrointestinal (GI) (82%), and abdominal pain (68%) were the decisive symptoms for the diagnosis of MIS-C. Shock and/or hypotension were common in patients with MIS-C. Cardiac symptoms (66%) predominated over respiratory (39%) and neurological (28%) symptoms. MIS-C treatment followed the common guidelines for treating children with septic shock and Kawasaki disease (KD) and proved to be effective.ConclusionsThis meta-analysis highlights the main clinical symptoms used for the diagnosis of MIS-C, the differences between MIS-C and KD, and the severity of the inflammatory process and urgency for hospital care.     

Severe hyperphosphatemia after administration of sodium-phosphate containing laxatives in children: case series and systematic review of literature

Introduction

Sodium phosphate-containing laxatives are commonly used as first-line treatment option for constipation in children and adolescents. Hyperphosphatemia is an infrequent, but potentially life-threatening complication of laxative application.

Methods

We report a case series of three children exhibiting severe hyperphosphatemia and hypocalcemia after utilization of sodium phosphate-containing laxatives, necessitating intensive care services in two of three cases. Additionally, we reviewed 32 case reports of similar occurrences.

Results

We identified 28 publications on the subject dating from 1968 to 2010. Mean age of all children in reports was 2.83 years; sex was approximately equally distributed. While 18 patients suffered from either pre-existing gastrointestinal comorbidity or other major systemic disease, no or only unrelated, minor conditions were present in ten children. One-third of patients received laxatives repeatedly before the incident. Findings associated with hyperphosphatemia include lethargy, dizziness, stiffness, tachypnea, tachycardia and severe dehydration in almost all cases, and tetany, carpopedal spasm, and prolonged QT interval in a subset. While about 80% of children recovered without residual findings, three deceased and one incurred persistent hypoxic brain damage.

Conclusion

Physicians should be alerted to the possibility of phosphate toxicity in children and adolescents treated with laxatives.     

Guilt,shame, and postpartum infant feeding outcomes: A systematic review

Negative maternal affect (e.g., depression and anxiety) has been associated with shorter breastfeeding duration and poorer breastfeeding intention, initiation, and exclusivity. Other affective states, including guilt and shame, have been linked with formula feeding practice, though existing literature has yet to be synthesised. A narrative synthesis of quantitative data and a framework synthesis of qualitative and quantitative data were conducted to explore guilt and/or shame in relation to infant feeding outcomes. Searches were conducted on the DISCOVER database between December 2017 and March 2018. The search strategy was rerun in February 2020, together yielding 467 studies. The study selection process identified 20 articles, published between 1997 and 2017. Quantitative results demonstrated formula feeders experienced guilt more commonly than breastfeeding mothers. Formula feeders experienced external guilt most commonly associated with healthcare professionals, whereas breastfeeding mothers experienced guilt most commonly associated with peers and family. No quantitative literature examined shame in relation to infant feeding outcomes, warranting future research. The framework synthesis generated four distinct themes which explored guilt and/or shame in relation to infant feeding outcomes: ‘underprepared and ineffectively supported’, ‘morality and perceived judgement’ (breastfeeding), ‘frustration with infant feeding care’ and ‘failures, fears and forbidden practice’ (formula feeding). Both guilt and shame were associated with self‐perception as a bad mother and poorer maternal mental health. Guilt and shame experiences were qualitatively different in terms of sources and outcomes, dependent on infant feeding method. Suggestions for tailored care to minimise guilt and shame, while supporting breastfeeding, are provided.     

Balanitis xerotica obliterans in children and adolescents: A literature review and clinical series

ObjectiveBalanitis xerotica obliterans (BXO) is a chronic inflammatory disease that is considered as male genital variant lichen sclerosis. The incidence varies greatly in different series; diagnosis is mostly clinical but histopathological confirmation is mandatory. Various treatments are described, but there is no consensus that one is the best.Materials and methodsA literature review was made of BXO and lichen sclerosis in boys under 18 years of age, between 1995 and 2013, analyzing demographic dates, treatments and outcomes. In addition to that, we reviewed BXO cases treated in our centers in the last 10 years.ResultsAfter literature review, only 13 articles matched the inclusion criteria. Analyzing those selected, the global incidence of BXO is nearly 35% among circumcised children. Described symptoms are diverse and the low index of clinical suspicion is highlighted. The main treatment is circumcision, with use of topical and intralesional steroids and immunosuppressive agents.ConclusionBXO is a condition more common than we believe and we must be vigilant to find greater number of diagnoses to avoid future complications. The main treatment for BXO is circumcision, but as topical or intralesional treatments are now available with potentially good outcomes, they may be considered as coadjuvants.     

Fathers' involvement and children's developmental outcomes: a systematic review of longitudinal studies

OBJECTIVE: This systematic review aims to describe longitudinal evidence on the effects of father involvement on children's developmental outcomes. METHODS: Father involvement was conceptualized as accessibility (cohabitation), engagement, responsibility or other complex measures of involvement. Both biological fathers and father figures were included. We searched all major databases from the first dates. Data on father involvement had to be generated at least 1 year before measuring offspring outcomes. RESULTS: N = 24 publications were included in the overview: 22 of these described positive effects of father involvement, whereof 16 studies had controlled for SES and 11 concerned the study population as a whole [five socio-economic status (SES)-controlled]. There is certain evidence that cohabitation with the mother and her male partner is associated with less externalising behavioural problems. Active and regular engagement with the child predicts a range of positive outcomes, although no specific form of engagement has been shown to yield better outcomes than another. Father engagement seems to have differential effects on desirable outcomes by reducing the frequency of behavioural problems in boys and psychological problems in young women, and enhancing cognitive development, while decreasing delinquency and economic disadvantage in low SES families. CONCLUSIONS: There is evidence to support the positive influence of father engagement on offspring social, behavioural and psychological outcomes. Although the literature only provides sufficient basis for engagement (direct interaction with the child) as the specific form of 'effective' father involvement, there is enough support to urge both professionals and policy makers to improve circumstances for involved fathering.