JAMA Pediatrics最新文献

{"title":"Vaccination Coverage and Sudden Infant Death Syndrome.","authors":"Jacqueline Müller-Nordhorn,Amir Hakimhashemi,Thomas Keil","doi":"10.1001/jamapediatrics.2025.1032","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1032","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"54 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087599","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":"Concerns About Data and Analyses Used in Assessing Fluoride Exposure and Children's IQ Scores.","authors":"James W Antoon,Jayanth V Kumar","doi":"10.1001/jamapediatrics.2025.0932","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0932","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"10 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932819","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":"Tacrolimus or Mycophenolate Mofetil for Frequently Relapsing or Steroid-Dependent Nephrotic Syndrome: A Randomized Clinical Trial.","authors":"Jingjing Wang,Fei Liu,Weili Yan,Jianhua Zhou,Yu Zhang,Liping Rong,Xiaoyun Jiang,Fei Zhao,Chunhua Zhu,Xiaochuan Wu,Xiaoyan Li,Shuzhen Sun,Jing Wang,Mo Wang,Qin Yang,Hong Xu,Jing Chen,Cuihua Liu,Ming Tian,Shipin Feng,Qinwei Duan,Xuhui Zhong,Yun Zhu,Xiaozhong Li,Haidong Fu,Lingfei Huang,Daqing Ma,Jie Ding,Qing Ye,Jianhua Mao","doi":"10.1001/jamapediatrics.2025.0765","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0765","url":null,"abstract":"ImportanceBoth tacrolimus (TAC) and mycophenolate mofetil (MMF) are recommended for children with frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS). However, their comparative effectiveness and safety have not been evaluated through randomized clinical trials.ObjectiveTo compare the effectiveness and safety of TAC and MMF in children with FRNS or SDNS.Design, Setting, and ParticipantsIn this multicenter, open-label randomized clinical trial conducted at 12 pediatric nephrology centers across China, 270 children aged 2 to 18 years with FRNS or SDNS were allocated at a 1:1 ratio to treatment with either TAC or MMF. The study was conducted from November 2019 to July 2023, and data analysis was completed from July 2023 to March 2024.InterventionPatients received either TAC (0.025-0.050 mg/kg, orally twice daily) or MMF (10-15 mg/kg, orally twice daily) for 1 year, along with a tapering regimen of steroids.Main Outcomes and MeasuresThe primary end point was 1-year relapse-free survival. Relapse frequency, cumulative steroid dosage, and safety profiles were also evaluated.ResultsA total of 292 patients from 12 care centers were assessed for eligibility, and 270 patients were randomized to receive either TAC (n = 135) or MMF (n = 135). Among 270 patients, median (IQR) age was 6.91 (4.25-9.96) years, and 70 patients (25.9%) were female. Compared with MMF, the 1-year relapse-free survival rate in the TAC group was 1.86-fold higher (hazard ratio [HR], 2.86; 95% CI, 1.79-4.76; P < .001) in the intention-to-treat analysis. This difference was also significant after adjusting for the per-protocol analysis (HR, 2.78; 95% CI, 1.72-4.55; P < .001). The mean (SD) time to first relapse was significantly longer in the TAC group (323.99 [98.33] days) compared to the MMF group (263.21 [132.84] days). Furthermore, the TAC group showed a lower annual relapse rate than the MMF group (17.78% vs 41.48%) and required a significantly lower mean (SD) cumulative steroid dose (0.22 [0.10] mg/kg/day vs 0.34 [0.22] mg/kg/day). The safety profile was similar in both groups.Conclusions and RelevanceIn this randomized clinical trial, compared with MMF, a 1-year course of TAC therapy significantly extended the period of relapse-free survival in children with FRNS or SDNS.Trial RegistrationClinicalTrials.gov Identifier: NCT04048161.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"37 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932980","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":"Darbepoetin, Red Cell Mass, and Neuroprotection in Preterm Infants: A Randomized Clinical Trial.","authors":"Robin K Ohls,Abhik Das,Sylvia Tan,Jean R Lowe,Kurt Schibler,Sandra Sundquist Beauman,Edward F Bell,Abbot R Laptook,Mariana Baserga,Ravi M Patel,David P Carlton,John Flibotte,Cathy Grisby,Rosemary D Higgins,Seetha Shankaran,Kristi Watterberg,Anna Maria Hibbs,Waldemar A Carlo,Tarah T Colaizy,Krisa P Van Meurs,Stephen D Kicklighter,Ryan Moore,Christina Sollinger,Lina F Chalak,Sarvin Ghavam,Brenda B Poindexter,Jon E Tyson,C Michael Cotten,Michelle L Baack,Omid Fathi,Sara B DeMauro,Matthew M Laughon,Ann Marie Reynolds,Andrea F Duncan,Sarah Winter,Deanne E Wilson-Costello,Myriam Peralta-Carcelen,Betty R Vohr,Heidi M Harmon,Susan R Hintz,Brenna Cavanaugh,Roy J Heyne,Stephanie Merhar,Ricardo Mosquera,Elizabeth Sewell,William F Malcolm,Laurie A Richards,Kristen L Benninger,Andrea Trembath,","doi":"10.1001/jamapediatrics.2025.0807","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0807","url":null,"abstract":"ImportancePrevious studies suggest that administration of erythropoiesis-stimulating agents darbepoetin or erythropoietin to preterm infants results in fewer transfusions, fewer donor exposures, and improved neurodevelopmental outcome.ObjectiveTo determine if, compared with placebo, preterm infants randomized to weekly darbepoetin would have greater red cell mass during hospitalization and better neurocognitive outcome at 22 to 26 months' corrected age.Design, Setting, and ParticipantsThis randomized clinical trial was conducted between September 2017 and November 2019 for infants 23 0/7 to 28 6/7 weeks' gestation in 19 US Neonatal Research Network centers comprising 33 neonatal intensive care units. Follow-up occurred through January 2023. Infants were randomized by 36 hours after birth to weekly placebo or darbepoetin (10 μg/kg) through 35 weeks' postmenstrual age. Iron administration and transfusions were administered by protocol. Study data were analyzed from June to October 2023.Main Outcomes and MeasuresThe primary outcome was the mean cognitive composite score on the Bayley Scales of Infant Development, third edition (Bayley-III) at 22 to 26 months' corrected age. The lowest possible score (54) was assigned to infants who died.ResultsA total of 650 infants (322 darbepoetin; 328 placebo; mean [SD] gestational age, 26.2 [1.7] weeks; 328 female [50.5%]) were enrolled. Five hundred eighty-three infants (291 darbepoetin; 292 placebo) had the primary outcome determined (90% of those enrolled). Mean (SD) cognitive scores were similar between groups: 80.7 (19.5) darbepoetin vs 80.1 (18.7) placebo, adjusted mean difference, -0.23 (95% CI, -3.09 to 2.64). Compared with infants receiving placebo, more infants in the darbepoetin group were transfusion free (40% [127 of 319] vs 21% [70 of 327]; adjusted relative risk [RR], 1.3; 95% CI, 1.2-1.5), received fewer transfusions (mean [SD], 2.3 [3.1] vs 3.3 [3.5]), were exposed to fewer donors (mean [SD], 1.6 [2.3] vs 2.2 [2.3]), had higher red cell mass by week 2 of age (adjusted mean difference, 3.2; 95% CI, 1.7-4.7), and higher mean hematocrit by week 2 of age (adjusted mean difference, 2.8; 95% CI, 2.1-3.6), and were less likely to have bronchopulmonary dysplasia greater than grade 1 (35% [91 of 261] vs 46% [128 of 277]; RR, 0.78; 95% CI, 0.64-0.96). The incidence of retinopathy of prematurity stage greater than 2 was similar between groups, 13% (35 of 273) in the darbepoetin group vs 16% (45 of 279) in the placebo group. There were no differences in adverse effects between groups.Conclusions and RelevanceResults of this randomized clinical trial reveal that this dose and dosing schedule of darbepoetin did not improve cognitive scores of preterm infants at 22 to 26 months' corrected age. Darbepoetin significantly increased red cell mass resulting in higher hematocrit values, fewer transfusions, and fewer donor exposures.Trial RegistrationClinicalTrials.gov Identifier: NCT03169881.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"76 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932979","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":"Frequent and Problem Gambling in Public School Students.","authors":"Serena M King,Katharine Adamyk,Jasper Weinburd,Randy Stinchfield","doi":"10.1001/jamapediatrics.2025.0925","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0925","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"8 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932935","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":"US Children Living With a Parent With Substance Use Disorder.","authors":"Sean Esteban McCabe,Vita V McCabe,Ty S Schepis","doi":"10.1001/jamapediatrics.2025.0828","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0828","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"37 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933011","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":"Sexual Health of US Transgender Boys, Nonbinary Youth, and Cisgender Girls.","authors":"Michele L Ybarra,L Zachary DuBois,Elizabeth Saewyc","doi":"10.1001/jamapediatrics.2025.0676","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0676","url":null,"abstract":"ImportanceResearch documenting the pregnancy experiences of transgender boys and nonbinary youth assigned female at birth (AFAB) in the US is lacking.ObjectiveTo examine AFAB youth sexual health indicators by gender.Design, Setting, ParticipantsSelf-reported data were collected cross-sectionally from 2018 through 2020. Initial analyses were conducted in 2023 and analyses were finalized in September 2024. The study took place online, across the 50 US states and Washington, DC. Eligible participants were 14 to 16 years old, read English, and had internet access.Main OutcomeSexual health (ie, self-reported pregnancy and sexually transmitted infections [STIs] lifetime prevalence, condom use, and use of other forms of birth control at last penile-vaginal or penile-anal sex).ResultsBased on weighted data (sample sizes are unweighted), 2109 cisgender girls, 348 transgender boys, and 458 nonbinary AFAB youth were included in analyses. There were 44 transgender boys (14%; 95% CI, 9.4-20.1; P = .24), 67 AFAB nonbinary youth (14%; 95% CI, 10.8-18.8; P = .18), and 397 cisgender girls (18%; 95% CI, 16.0-19.7) who reported ever having penile-vaginal sex. Rates for penile-anal sex were also similar by gender (4% to 6%). Lifetime pregnancy rates were higher for transgender boys (5 [9%]; 95% CI, 2.7-27.1; P = .23) than cisgender (18 [4%]; 95% CI, 2.5-7.1) girls, although not statistically significantly so. Pregnancy rates were similar for AFAB nonbinary youth (5 [5%]; 95% CI, 1.9-13.3; P = .73) compared with cisgender girls. Lifetime STI rates were universally low for all AFAB youth (0.5% to 2.0%). Mean age at first penile-vaginal sex was lower for AFAB nonbinary youth (mean age, 13.6 years; SE, 0.4; P = .003) and transgender boys (mean age, 13.9 years; SE, 0.3; P = .06) compared with cisgender girls (mean age, 14.4 years; SE, 0.1). Condom use at last penile-anal or penile-vaginal sex for transgender boys (24 [16%]; 95% CI, 9.5-27.0; P &lt; .001) and AFAB nonbinary youth (33 [24%]; 95% CI, 16.4-34.2; P &lt; .001) was half that of cisgender girls (245 [49%]; 95% CI, 44.1-54.2). Use of birth control other than condoms at last sex was lower for AFAB nonbinary youth (18 [28%]; 95% CI, 16.2-44.5; P = .14), but similar for transgender boys (20 [42%]; 95% CI, 23.4-62.4; P = .69) compared with cisgender girls (167 [44%]; 95% CI, 38.6-50.0).Conclusion and RelevanceIn this cross-sectional study of sexual health among AFAB youth with a diversity of gender identities, transgender boys were more likely, and nonbinary youth, similarly likely, as cisgender girls to be pregnant during adolescence. Even though overall rates of penile-vaginal sex were similar for transgender boys and AFAB nonbinary youth compared with cisgender girls, half as many transgender boys and AFAB nonbinary youth who had this type of sex used a condom at last sex compared with cisgender girls. As with cisgender girls, transgender boys and AFAB nonbinary youth need to be engaged in affirming and inclusive sexual","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"17 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933013","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":"Concerns About Data and Analyses Used in Assessing Fluoride Exposure and Children's IQ Scores-Reply.","authors":"Kyla W Taylor,Sorina E Eftim,Andrew A Rooney","doi":"10.1001/jamapediatrics.2025.0935","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0935","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"50 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932937","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":"Concerns About Data and Analyses Used in Assessing Fluoride Exposure and Children's IQ Scores.","authors":"Robert C Speth","doi":"10.1001/jamapediatrics.2025.0929","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0929","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"28 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932938","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 Health Insurance for Their Children.","authors":"Lindsay A Thompson","doi":"10.1001/jamapediatrics.2025.1418","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1418","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"46 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915103","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}