Smartphone use health outcomes in children and adolescents: A systematic review of behavioral, developmental, and environmental risk pathways

doi:10.12998/wjcc.120669

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 14, Issue 22

This Article

(5)

(7)

(0)

(11)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Clinical Cases

ISSN

2307-8960

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Systematic Reviews

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Cases. Aug 6, 2026; 14(22): 120669
Published online Aug 6, 2026. doi: 10.12998/wjcc.120669

Smartphone use health outcomes in children and adolescents: A systematic review of behavioral, developmental, and environmental risk pathways

Reem Elbeltagi, Hosameldin A Bediwy, Yousif M Elbeltagi, Adel Salah Bediwy, Nermin K Saeed, Mohammed Al-Beltagi

Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt

Mohammed Al-Beltagi, Department of Pediatrics, University Hospital, Arabian Gulf University, Manama 26671, Manama, Bahrain

Nermin K Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Ministry of Health, Manama 12, Bahrain

Nermin K Saeed, Medical Microbiology Section, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Muharraq, Bahrain

Adel Salah Bediwy, Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt

Adel Salah Bediwy, Department of Pulmonology, University Hospital, Arabian Gulf University, Manama 26671, Manama, Bahrain

Yousif M Elbeltagi, Reem Elbeltagi, Department of Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Muharraq, Bahrain

Hosameldin A Bediwy, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt

Author contributions: Al-Beltagi M conceptualized, designed and supervised the study, and drafted the manuscript; Al-Beltagi M and Saeed NK developed the methodology; Al-Beltagi M and Elbeltagi YM conducted the literature search and study selection; Al-Beltagi M and Bediwy AS performed data extraction and synthesis; Al-Beltagi M and Bediwy HA interpreted the findings; Bediwy AS, Bediwy HA, and Elbeltagi R revised the manuscript; Elbeltagi YM and Elbeltagi R prepared figures and visualizations; and all authors approved the final manuscript.

AI contribution statement: AI tools (Grammarly) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Mohammed Al-Beltagi, MD, PhD, Chairman, Consultant, Professor, Department of Pediatrics, Faculty of Medicine, Tanta University, 1 Hassan Radwan Street, Tanta 31511, Algharbia, Egypt. mbelrem@hotmail.com

Received: March 5, 2026
Revised: April 30, 2026
Accepted: July 6, 2026
Published online: August 6, 2026
Processing time: 151 Days and 20.6 Hours

Abstract

BACKGROUND

Smartphone use is nearly ubiquitous among children and adolescents. Although concerns regarding psychosocial effects are well recognized, the broader physical health implications require careful synthesis.

AIM

To synthesize current evidence on problematic smartphone use (PSU) and related health outcomes in children and adolescents, with emphasis on developmental and cognitive changes, metabolic dysregulation, visual and musculoskeletal disorders, obesity risk, and radiofrequency electromagnetic field (RF-EMF) exposure.

METHODS

We conducted a structured systematic review following PRISMA-informed methodology. Multiple databases were searched for observational, experimental, and mechanistic studies examining smartphone exposure in individuals aged 0–18 years. Outcomes of interest included physical activity patterns, adiposity indices, metabolic markers, neurocognitive function, and RF-EMF-related health outcomes. Evidence from cross-sectional, longitudinal, case-control, and mechanistic studies was integrated. Study quality, exposure metrics, and age stratification were considered in interpretation.

RESULTS

A total of 97 studies met the inclusion criteria, comprising predominantly cross-sectional studies, alongside longitudinal cohorts and a limited number of experimental and randomized designs. Across domains, higher smartphone exposure and PSU were consistently associated with adverse health outcomes. Strong and consistent evidence was observed for sleep disruption, with multiple studies demonstrating dose-response relationships between screen exposure - particularly bedtime use - and shorter sleep duration, delayed sleep onset, and poorer sleep quality. Moderate evidence linked smartphone use to mental health outcomes, including depressive symptoms, anxiety, and emotional dysregulation, with stronger associations observed for PSU compared with total screen time. Evidence for neurocognitive outcomes was more heterogeneous, with consistent associations for attentional impairment but mixed findings for working memory and global cognitive function. Across physical health domains, smartphone use was associated with visual strain, musculoskeletal symptoms, and increased risk of being overweight/obesity, largely mediated by sedentary behavior and reduced physical activity. In contrast, evidence regarding RF-EMF exposure did not demonstrate consistent associations with carcinogenic or neurocognitive outcomes, although data remain limited and precautionary approaches are warranted.

CONCLUSION

The most robust health concerns related to smartphone use by children and adolescents appear to arise from behavioral displacement and sleep disruption rather than RF-EMF exposure. Clinical and public health strategies should prioritize reducing excessive screen time, preserving sleep, and promoting physical activity during critical developmental stages.

Keywords: Problematic smartphone use; Obesity; Metabolic dysregulation; Sedentary behavior; Sleep disturbance; Radiofrequency electromagnetic fields; Neurocognitive function; Digital health; Pediatric public health

Core Tip: This review synthesizes multidisciplinary evidence demonstrating that excessive or dysregulated smartphone use in children and adolescents is consistently associated with sleep disruption, attentional dysregulation, emotional symptoms, musculoskeletal strain, visual complaints, and increased metabolic risk. Across domains, dose-response patterns and developmental vulnerability are evident, with early childhood and adolescence representing particularly sensitive periods. Importantly, behavioral mechanisms - especially sleep disturbance, sedentary displacement, and reinforcement-driven problematic smartphone use - appear to mediate most observed risks, whereas current evidence does not confirm serious radiofrequency electromagnetic field-related harm. These findings support a developmentally informed, context-sensitive digital health framework emphasizing sleep hygiene, structured limits, parental modeling, and early identification of problematic use.