JAMA Pediatrics最新文献

{"title":"Egg Allergy Prevalence Before and After Guidelines for Earlier Egg Introduction.","authors":"Jennifer J Koplin, Desalegn Markos Shifti, Victoria X Soriano, Rushani Wijesuriya, Margarita Moreno-Betancur, Alexsandria Odoi, Anne-Louise Ponsonby, Kirsten P Perrett, Adrian J Lowe, Mimi L K Tang, Katrina J Allen, Shyamali C Dharmage, Rachel L Peters","doi":"10.1001/jamapediatrics.2026.2080","DOIUrl":"10.1001/jamapediatrics.2026.2080","url":null,"abstract":"<p><strong>Importance: </strong>Egg allergy is among the most common food allergies in infants. Allergy prevention guidelines have been updated globally based on evidence that earlier egg introduction reduces the risk of egg allergy, and these guidelines have been adopted widely. However, the association of this guideline change with the prevalence of egg allergy is unclear.</p><p><strong>Objective: </strong>To estimate the change in population prevalence of egg allergy after a guideline update recommending earlier introduction of egg into the infant diet.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study included infants aged 11 to 15 months in 2 population-based samples, recruited using identical methods when attending their 12-month immunization visit at immunization centers in Melbourne, Australia, before (2007-2011) and after (2018-2019) an update to allergy prevention guidelines. To isolate an association between a change in prevalence of egg allergy and the guideline change, direct regression standardization was used to estimate prevalence in the 2018-2019 sample had the distribution of known risk factors remained the same as in the 2007-2011 sample. Multiple imputation was used to address missing data. Prespecified subgroup analyses were conducted for infants with early eczema and stratified by parent country of birth. Data were analyzed between March 2025 and March 2026.</p><p><strong>Exposures: </strong>Data on demographics, food allergy risk factors, egg introduction, and reactions were collected via questionnaires.</p><p><strong>Main outcome and measures: </strong>Infants underwent skin prick tests to egg, and those with positive results underwent oral food challenges.</p><p><strong>Results: </strong>A total of 7209 of 9500 eligible infants were included from 2 cohorts: 5276 infants (median [IQR] age, 12.4 [12.2-12.9] months; 50.8% [2665 of 5244] males; response rate, 76% [5276 of 6957]) from the 2007-2011 cohort and 1933 infants (median [IQR] age, 12.5 [12.2-13.0] months; 51.8% [1001 of 1932] males; response rate, 76% [1933 of 2543]) from the 2018-2019 cohort. The median (IQR) age at egg introduction decreased from 8 (6-10) months in 2007-2011 to 6 (6-8) months in 2018-2019. After adjusting for known allergy risk factors, the prevalence of egg allergy decreased from 9.2% in 2007-2011 to 7.6% in 2018-2019 (adjusted absolute difference, -1.6 [95% CI, -3.3 to -0.005] percentage points). In infants with early eczema, egg allergy decreased from 34.6% to 21.9% (adjusted absolute difference, -12.7 [95% CI, -20.0 to -5.4] percentage points).</p><p><strong>Conclusions and relevance: </strong>This study provides population-level evidence that updated infant feeding guidelines recommending earlier introduction of egg led to measurable reductions in the population prevalence of egg allergy. The findings suggest that guideline updates informed by randomized trial evidence may be associated with a reduction in fo","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1015-1023"},"PeriodicalIF":17.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198969","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":"Survival Trends of People With Spina Bifida From 1950-2020.","authors":"Charles H Schlaepfer, Suzanne M Lange, Glen A Lau, Joshua J Horns, Anthony J Schaeffer","doi":"10.1001/jamapediatrics.2026.2241","DOIUrl":"10.1001/jamapediatrics.2026.2241","url":null,"abstract":"<p><strong>Importance: </strong>People with spina bifida historically have worse survival. Despite health care improvements, survival improvement data are mixed.</p><p><strong>Objectives: </strong>To compare survival for people with spina bifida to an unaffected cohort and to determine if survival for people with spina bifida has improved from 1950 to 2020.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study was conducted using state databases to determine survival of individuals with spina bifida and an unaffected population. Demographic, health care, and epidemiological data were extracted from the Utah Population Database from the period January 1950 to December 2019. People with spina bifida were matched by birth year, sex, and county of residence to Utah residents without spina bifida. Data were analyzed from March 2025 to April 2026.</p><p><strong>Exposure: </strong>Diagnosis of spina bifida.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was all-cause mortality. Survival rates for people with spina bifida were compared to an unaffected cohort. Interaction terms were used to determine if geography or birth decade modified survival. The secondary analysis quantified longitudinal trends in survival among those with spina bifida from 1950 to 2020.</p><p><strong>Results: </strong>A total of 942 people with spina bifida (487 female [51.7%]) were matched by birth year, sex, and county of residence to 9420 Utah residents without spina bifida (4870 female [51.7%]). Cohorts were similar in demographics but differed by median (IQR) birth weight (spina bifida: 3118 g [2693-3480]; unaffected cohort: 3330 g [3010-3630]; P < .001) and gestational age at birth (spina bifida: 39 weeks [37-40]; unaffected cohort: 39 weeks [38-40]; P < .001). Deaths occurred in 270 spina bifida cases (29%; 1.7/100 person-years) and 257 controls (2.7%; 0.1/100 person-years) (P < .001). Compared to the unaffected cohort, spina bifida survival was worse at 1 month (hazard ratio [HR], 23.8; 95% CI, 18.0-31.5), 1 year (HR, 15.7; 95% CI, 13.0-19.1), 10 years (HR, 10.7; 95% CI, 8.6-13.3), and 30 years (HR, 8.9; 95% CI, 6.9-11.5). Geography did not modify mortality risk. Decadal survival improvements in spina bifida paralleled the unaffected cohort. Compared to those born in the 1980s, survival was worse for those born with the condition in the 1950s and 1960s (1960s 1-year HR: 3.1; 95% CI, 2.0-5.0; 1960s 30-year HR: 3.2; 95% CI, 1.4-7.3). Also relative to the 1980s, there was improved survival for those born with spina bifida in more recent decades at many but not all time points (1990s 20-year HR: 0.4; 95% CI, 0.1-1.2 vs 2000s 20-year HR: 0.2; 95% CI, 0.0-0.7).</p><p><strong>Conclusions and relevance: </strong>Per the results of this cohort study, survival for those with spina bifida improved markedly between 1950 and 2010, yet it was still substantially worse than population levels. Spina bifida survival did not improv","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"987-994"},"PeriodicalIF":17.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251527","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":"Intracranial Pressure Signal Is Not a Treatment Threshold in Pediatric Traumatic Brain Injury-Reply.","authors":"Shruti Agrawal, Roddy O'Donnell, Peter J Hutchinson","doi":"10.1001/jamapediatrics.2026.2853","DOIUrl":"10.1001/jamapediatrics.2026.2853","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1048-1049"},"PeriodicalIF":17.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591478","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":"Intracranial Pressure Signal Is Not a Treatment Threshold in Pediatric Traumatic Brain Injury.","authors":"Dandan Song, Shufu Hou, Jing Gao","doi":"10.1001/jamapediatrics.2026.2850","DOIUrl":"10.1001/jamapediatrics.2026.2850","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1048"},"PeriodicalIF":17.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591514","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":"What Parents Need to Know About Maternal Cannabis Use During Pregnancy","authors":"Jamie O. Lo, Rahul J. D’Mello, Lindsay A. Thompson","doi":"10.1001/jamapediatrics.2026.3578","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3578","url":null,"abstract":"This <jats:italic toggle=\"yes\">JAMA Pediatrics</jats:italic> Patient Page describes the risks of parental cannabis use in pregnancy and while breastfeeding.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"9 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858717","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":"Biliary Events and GLP-1 Receptor Agonist Therapy in Adolescents and Young Adults","authors":"Josélio Rodrigues de Oliveira Filho, Lena Papadakis, Reagan A. Collins, Ghadeer N. Shnawa, Cornelia L. Griggs","doi":"10.1001/jamapediatrics.2026.3918","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3918","url":null,"abstract":"This cohort study explores biliary outcomes associated with use of glucagon-like peptide-1 receptor agonists in youths aged 12 to 21 years with overweight or obesity diagnosis.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"21 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858718","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":"Do No Harm This Time-The Urgency of AI Chatbot Research.","authors":"Dimitri Christakis, Ron Keren","doi":"10.1001/jamapediatrics.2026.3949","DOIUrl":"10.1001/jamapediatrics.2026.3949","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864987","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":"Pediatric Use of Artificial Intelligence for Support and Advice-Developmental Practice or Help-Seeking Substitution?","authors":"Sheri Madigan, Megan M Moreno","doi":"10.1001/jamapediatrics.2026.4058","DOIUrl":"10.1001/jamapediatrics.2026.4058","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864980","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":"Affective Generative Artificial Intelligence Use and Youth Mental Health","authors":"Kamilla Bonnesen, Amanda Krygsman, Sarah Hobson, Daphne Korczak, Tracy Vaillancourt","doi":"10.1001/jamapediatrics.2026.3904","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3904","url":null,"abstract":"Importance Adolescents are increasingly using generative artificial intelligence (AI) as an anonymous emotional support system, yet the association between affective use and mental health remains poorly understood. Objective To examine the association between affective generative AI use and emotional problems among a large, diverse sample of youth. Design, Setting, and Participants This cross-sectional study evaluates Ontario Health and Peer Relations Study data (May 2025 through March 2026) among students in grades 4 through 12 across 4 school boards in Ontario, Canada. Data were analyzed in May 2026. Exposures Affective AI use (emotional support or advice) and functional AI use (school-related tasks). Main Outcomes and Measures Emotional problems were assessed via the Ontario Child Health Study Emotional Behavioral Scales using a validated clinical threshold. Covariates included mattering, loneliness, and demographic characteristics. Results The final analytic sample consisted of 39 761 students (mean [SD] age, 12.8 [2.4] years; 19 291 [48.5%] girls). A total of 8408 participants (21.1%) reported using AI for affective purposes. Female students, gender-diverse students, and students who were Black, Indigenous, or of other racial and ethnic groups besides White were more likely to have used AI for affective purposes compared with boys and White students, respectively. Additionally, students who were older and students who reported using AI for school reported incrementally higher affective AI use. In unadjusted models, affective AI use was associated with significantly higher emotional problem scores (mean [SD] score, 1.04 [0.54] with use vs 0.67 [0.51] without use; &lt;jats:italic toggle=\"yes\"&gt;B&lt;/jats:italic&gt; = 0.37 [95% CI, 0.36 to 0.39]) and were twice as likely to have clinical emotional problems (57.7% vs 29.2%; prevalence ratio, 1.98 [95% CI, 1.91 to 2.04]). In fully adjusted models, affective AI use remained associated with emotional problems ( &lt;jats:italic toggle=\"yes\"&gt;B&lt;/jats:italic&gt; = 0.14 [95% CI, 0.13 to 0.15]), whereas functional AI use showed a modest dose-response association with emotional problems (ranging from &lt;jats:italic toggle=\"yes\"&gt;B&lt;/jats:italic&gt; = 0.01 [95% CI, 0.00 to 0.02] with rare use to &lt;jats:italic toggle=\"yes\"&gt;B&lt;/jats:italic&gt; = 0.04 [95% CI, 0.02 to 0.05] with a lot of use). A significant interaction between affective AI use and gender identity was observed, which was attenuated for gender-diverse students compared with boys ( &lt;jats:italic toggle=\"yes\"&gt;B&lt;/jats:italic&gt; = −0.07 [95% CI, −0.12 to −0.03]) and girls ( &lt;jats:italic toggle=\"yes\"&gt;B&lt;/jats:italic&gt; = −0.08 [95% CI, −0.13 to −0.03]). No significant interaction was observed between affective AI use and school level. Conclusions and Relevance This cross-sectional study suggests that seeking emotional support from generative AI is a unique marker of psychological distress in children and adolescents, independent of mattering or loneliness. Clinical frameworks and di","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"13 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858720","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":"Alcohol Marketing and Youth-Causal and Likely Getting More So.","authors":"David H Jernigan","doi":"10.1001/jamapediatrics.2026.3703","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3703","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813015","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}