JAMA Pediatrics最新文献

{"title":"Cash Transfers in the Perinatal Period and Investigations of Infant Maltreatment.","authors":"Sumit Agarwal, H Luke Shaefer, Samiul Jubaed, William Schneider, Eric D Finegood, Mona Hanna","doi":"10.1001/jamapediatrics.2026.1602","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1602","url":null,"abstract":"<p><strong>Importance: </strong>Infants are most vulnerable to child maltreatment, in part due to poverty during the perinatal period. In 2024, the prenatal and infant cash prescription program Rx Kids was launched in Flint, Michigan, achieving nearly 100% aggregate uptake and providing every expectant mother with unconditional cash transfers during pregnancy and infancy.</p><p><strong>Objective: </strong>To examine whether implementation of the Rx Kids prenatal and infant cash prescription program was associated with changes in child welfare system involvement.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study used administrative data from Children's Protective Services in Michigan among infants born January 1, 2021, through December 31, 2024. Synthetic difference-in-differences-a robust method for aggregate-level data and a single treated city-was used to compare changes in outcomes in Flint before and after implementation of Rx Kids relative to the corresponding change in control cities without the program. Data analysis was conducted from March 19, 2025, to March 4, 2026.</p><p><strong>Exposure: </strong>Flint residence among infants born in 2024 after Rx Kids implementation.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was investigated maltreatment allegations within the first 6 months of life. Secondary outcomes included type of allegation (neglect vs nonneglect) and substantiated allegations.</p><p><strong>Results: </strong>In the 3 years prior to the implementation of Rx Kids, the proportion of infants with an investigated allegation within the first 6 months of life was 21.7% (646 of 2971 infants) in Flint and 19.5% (3921 of 20 124 infants) among control cities. After implementation of Rx Kids in 2024, the investigated allegation rate decreased to 15.5% (165 of 1065 infants) in Flint, falling below the investigated allegation rate of 20.6% (1303 of 6317 infants) among the control cities. Rx Kids was associated with a statistically significant 7.0-percentage-point decrease (95% CI, -12.9 to -1.0; P = .02) in the investigated allegation rate, corresponding to a 32% decrease relative to the preintervention period. There was a decrease in the rate of neglect-related, nonneglect-related, and substantiated allegations; these were directionally consistent with the primary outcome but not statistically significant. Results were robust to alternative model specifications.</p><p><strong>Conclusions and relevance: </strong>In this study, the Rx Kids prenatal and infant cash prescription program was associated with a significant reduction in investigated allegations of maltreatment among infants. These findings provide important evidence about the role of economic stability in preventing child welfare system involvement.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paternal Mortality During Early Childhood.","authors":"Craig F Garfield, Clarissa D Simon, Chris Harrison, Michael Woods, Katy Bedjeti, John T Carter","doi":"10.1001/jamapediatrics.2026.1217","DOIUrl":"10.1001/jamapediatrics.2026.1217","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-Aligned Evaluation for Length-of-Stay Forecasting-Reply.","authors":"Derek Mathieu, Ben Y Reis, Jay G Berry","doi":"10.1001/jamapediatrics.2026.1214","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1214","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Childhood HIV Outcomes-Meeting Basic Needs Matters.","authors":"Maria Trent","doi":"10.1001/jamapediatrics.2026.1277","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1277","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Living Skill Profiles in Adolescents With Autism and Developmental Disabilities.","authors":"Patrick S Powell, Lucy M Cronin-Golomb, Lisa D Wiggins, Aimee Alexander, Nuri M Reyes, Cy Nadler, Elizabeth Wise, Maureen S Durkin, Angela Thompson-Paul, Matthew Maenner","doi":"10.1001/jamapediatrics.2026.1306","DOIUrl":"10.1001/jamapediatrics.2026.1306","url":null,"abstract":"<p><strong>Importance: </strong>Understanding early predictors of independent performance of daily living skills (DLS) in adolescents with autism can guide targeted interventions to promote independence and improve outcomes.</p><p><strong>Objective: </strong>To compare DLS performance among adolescents with autism, other developmental disabilities (DD), and the general population (POP), and identify early childhood predictors of independently performed DLS acquired by adolescence.</p><p><strong>Design, setting, and participants: </strong>This longitudinal study collected data from caregivers of adolescents 12 to 16 years old (2018-2021) with a mean follow-up of 9.7 (range, 7-12) years. The study took place at 4 US sites that surveyed caregivers of adolescents from the Study to Explore Early Development (SEED). Participants included caregivers of adolescents who participated in SEED at ages 2 to 5 years. Analyses were conducted June to August 2025.</p><p><strong>Exposure: </strong>Adolescents who met diagnostic criteria for autism at ages 2 to 5 years.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was independent DLS in adolescence measured with the Waisman Activities of Daily Living scale. Other measures included early learning abilities, social symptoms, emotional functioning, and intellectual disability (ID) in adolescence. Model-based recursive partitioning identified early childhood predictors of independent DLS acquired by adolescence.</p><p><strong>Results: </strong>The analytic sample included 852 caregivers of adolescents (median age, 14.7 years; 533 male [63%] and 319 female [37%]): 204 with autism, 341 with other DD, and 307 in the POP group. Adolescents with autism had lower Waisman Activities of Daily Living Scale scores (median [IQR], 24.5 [17-29]) compared with the DD (30 [IQR, 26-33]) and POP groups (32 [IQR, 30-33]) (P < .001). Compared with the DD and POP groups, adolescents with autism performed fewer DLS independently with frequency decreasing as skill complexity increased. Among adolescents with autism or other DD, those with lower expressive language and fine motor skills in early childhood acquired the fewest number of independent DLS, while those with stronger expressive language, without ID, and with fewer attention problems in early childhood acquired the greatest number of independent DLS.</p><p><strong>Conclusion and relevance: </strong>In this study, DLS were lower in adolescents with autism compared with adolescents without autism. Early expressive language, fine motor skills, and attention problems predicted wide variation in the independent DLS acquired by adolescents with autism and other DD. These findings highlight potential early prognostic indicators that may help prioritize early support to improve DLS acquisition and promote greater independence.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Outcomes Following Acute Kidney Injury in Children: A Systematic Review and Meta-Analysis.","authors":"Jitendra Meena, Shanzey Ali, Cal Robinson, Jason H Greenberg, Dua Kamran, Akash Deep, Saihajleen Dhillon, Dima Sabeeh, Heather M Ajoy, Myanca Rodrigues, Jogender Kumar, Lehana Thabane, Emma Ulrich, Rahul Chanchlani","doi":"10.1001/jamapediatrics.2026.1357","DOIUrl":"10.1001/jamapediatrics.2026.1357","url":null,"abstract":"<p><strong>Importance: </strong>Acute kidney injury (AKI) is a common complication among hospitalized children and may have lasting kidney and cardiovascular consequences. However, the long-term risks after pediatric AKI have not been comprehensively quantified.</p><p><strong>Objective: </strong>To estimate the pooled incidence and relative risk with odds ratio of chronic kidney disease (CKD), mortality, hypertension, and proteinuria following AKI in hospitalized children.</p><p><strong>Data sources: </strong>PubMed, Embase, and Web of Science were searched from January 2007 through November 2025 without language restrictions.</p><p><strong>Study selection: </strong>Studies were included if they reported at least 1 long-term outcome (CKD, mortality, hypertension, or proteinuria) following AKI in hospitalized children. Studies limited to children with obstructive lesions, primary vascular disorders (eg, hemolytic uremic syndrome) or solid organ transplant were excluded.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently extracted data and assessed risk of bias. Random-effects meta-analyses were performed to estimate pooled cumulative incidences and odds ratios (ORs) with 95% CIs.</p><p><strong>Main outcomes and measures: </strong>Cumulative incidence and odds of CKD, mortality, hypertension, and proteinuria following pediatric AKI.</p><p><strong>Results: </strong>Of 17 068 screened records, 39 studies comprising 16 151 participants were included. The pooled cumulative incidences following AKI were 17% (95% CI, 12-22) for CKD, 6% (95% CI, 3-8) for mortality, 20% (95% CI, 12-29) for proteinuria, and 16% (95% CI, 11-23) for hypertension. In 23 studies with non-AKI comparators and follow-up ranging from 3 months to 18 years, AKI was associated with increased odds of CKD (OR, 1.74; 95% CI, 1.02-2.95) and mortality (OR, 1.92; 95% CI, 1.35-2.75) but not proteinuria (OR, 1.18; 95% CI, 0.62-2.25) or hypertension (OR, 1.29; 95% CI, 0.72-2.31). Greater AKI severity was associated with a higher odds of CKD (stages 2-3: OR, 2.84; 95% CI, 1.49-4.15; stage 1: OR, 1.72; 95% CI, 1.11-2.67).</p><p><strong>Conclusions and relevance: </strong>The findings in this systematic review and meta-analysis demonstrate that, similar to adults, children experienced increased risk of late adverse outcomes following AKI, particularly CKD and mortality, supporting the need for structured post-AKI follow up.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-Aligned Evaluation for Length-of-Stay Forecasting.","authors":"Henry Bair","doi":"10.1001/jamapediatrics.2026.1211","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1211","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and Protective Factors Associated With HIV-Related Mortality in Children Receiving Antiretroviral Therapy: A Model-Based Meta-Regression.","authors":"Jiawei He, Reshma Kassanjee, Amanda Movo, Magdalene K Walters, Edmond Brewer, Reed J D Sorensen, Simon I Hay, Christopher J L Murray, Abraham Flaxman, Aleksandr Aravkin, Peng Zheng, Hmwe H Kyu","doi":"10.1001/jamapediatrics.2026.1235","DOIUrl":"10.1001/jamapediatrics.2026.1235","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Mortality among children and young adolescents receiving antiretroviral therapy (ART) remains substantially higher in resource-limited settings compared with resource-rich regions. The role of modifiable risk and protective factors in explaining this global variation remains poorly understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify and quantify country-level modifiable risk and protective factors associated with HIV-related mortality among children and young adolescents receiving ART.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This model-based meta-regression analysis linked HIV-related mortality data from cohort studies included in a published systematic review of children and adolescents (aged 0-14 years) receiving ART, with biomedical, behavioral, and structural factors from the Global Burden of Diseases, Injuries, and Risk Factors study 2023. Data were analyzed using penalized regression (ridge regression with cross-validation) and an ensemble machine-learning algorithm (XGBoost). Study data were analyzed from August 2024 to October 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Country-level modifiable covariates, including access to improved water, vaccine coverage against different pathogens, maternal education, underweight proportion, and oral rehydration coverage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Measures included the odds ratios (ORs) of HIV-related mortality while receiving ART associated with modifiable factors, simulations of hypothetical 10% and 20% increases in covariates, and variable importance via Shapley Additive Explanation (SHAP) values.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;HIV-related mortality data from 67 cohort studies were included in this analysis. Access to improved water, pneumococcal conjugate vaccine third-dose (PCV3) coverage, and maternal education demonstrated the strongest independent associations with HIV-related mortality while receiving ART. A 10% increase in improved water access, PCV3 coverage, and maternal education was associated with lower odds of mortality (OR, 0.83; 95% CI, 0.826-0.843; OR, 0.980; 95% CI, 0.972-0.987; and OR, 0.997; 95% CI, 0.996-0.998, respectively). At 20% increases, these protective associations with HIV-related mortality were stronger (OR, 0.695; 95% CI, 0.682-0.711; OR, 0.959; 95% CI, 0.945-0.974; and OR, 0.994; 95% CI, 0.992-0.997, respectively). SHAP-based analyses consistently ranked these 3 factors as most predictive of HIV-related mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Findings of this model-based meta-regression analysis show that improved water access, PCV3 coverage, and maternal education were associated with lower HIV-related mortality among children receiving ART, underscoring the need for integrated public health strategies beyond ART alone. Interventions to strengthen water infrastructure, vaccination programs, and maternal education may help reduce global survival disparities among child","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual Profound Autism Criteria and Unmet Needs Among Autistic Adolescents and Their Caregivers.","authors":"Lisa D Wiggins, Sarah C Tinker, Katie Overwyk, Patrick Powell, Angela Thompson-Paul, Robert Fitzgerald, Steven Rosenberg, Cordelia Robinson Rosenberg, Matthew Maenner","doi":"10.1001/jamapediatrics.2026.1087","DOIUrl":"10.1001/jamapediatrics.2026.1087","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAMA Pediatrics-The Year in Review, 2025.","authors":"Dimitri A Christakis","doi":"10.1001/jamapediatrics.2026.0289","DOIUrl":"10.1001/jamapediatrics.2026.0289","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"479-480"},"PeriodicalIF":18.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}