JAMA Pediatrics最新文献

{"title":"Lasting Burden of Preterm Birth on Health and Health Services.","authors":"Amaris M Keiser,Barbara Schmidt","doi":"10.1001/jamapediatrics.2025.3143","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3143","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"27 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008824","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":"Preterm Birth and Risk of Health Service Use, Morbidity, and Medication Needs at 5 Years.","authors":"Lindsay L Richter,Ye Shen,Sarka Lisonkova,Jeffrey N Bone,Arianne Albert,Matthew S P Ho,Emily Kieran,Edmond S Chan,Cherry Mammen,Carol Lam,Anthony K C Chan,Ashley Roberts,Kristopher T Kang,Michael Castaldo,Dax Rumsey,Tara McGrath,Kevin C Harris,Connie L Yang,Jonathan Wong,Natalie H Chan,James Lee,Shahrad R Rassekh,Jennifer Hutcheon,Joseph Y Ting","doi":"10.1001/jamapediatrics.2025.2724","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2724","url":null,"abstract":"ImportanceNeonatal intensive care has advanced over recent decades, yet premature birth remains associated with increased neonatal mortality and morbidity.ObjectiveTo describe health service use, morbidity, and medication needs up to age 5 years in a contemporary cohort of children born preterm.Design, Setting, and ParticipantsThis population-based cohort study was conducted in British Columbia (BC), Canada, using health service and pharmacy data linked using provincial administrative databases. Data for a sample of 465 338 children born at 22 to 44 weeks' gestational age (GA) in BC from April 2004 to December 2014 were available. After exclusions for missing information on GA or birth weight, incomplete linkage, or loss of registration, the cohort included 448 819 children (96.5%), with 420 309 (93.6%) having complete 5-year follow-up until 2019. Data were analyzed from May 2023 to April 2025.ExposuresGA at birth, grouped into 8 categories: 22 to 24, 25 to 27, 28 to 30, 31 to 33, 34 to 36, 37 to 38, 39 to 41 weeks (reference), and 42 to 44 weeks.Main Outcomes and MeasuresHealth service use (hospitalizations and outpatient visits), morbidity (combined inpatient and outpatient diagnoses), and medication needs (outpatient prescriptions).ResultsOf 448 819 children (mean [SD] age at follow-up, 4.8 [0.69]; 230 351 [51.3%] male), 42 080 (9.4%) were born before 37 weeks. Hospitalization rates within 5 years were higher for children born earlier compared to 39 to 41 weeks: 22 to 24 weeks (risk ratio [RR], 6.37; 95% CI, 5.62-7.22; risk difference [RD], 464.35 per 1000 patients; 95% CI, 395.62-533.08), 25 to 27 weeks (RR, 4.52; 95% CI, 4.15-4.92; RD, 304.21; 95% CI, 271.42-336.99), 28 to 30 weeks (RR, 2.70; 95% CI, 2.49-2.93; RD, 146.9; 95% CI, 128.01-165.78), 31 to 33 weeks (RR, 1.91; 95% CI, 1.81-2.03; RD, 79.08; 95% CI, 69.56-88.61), 34 to 36 weeks (RR, 1.53; 95% CI, 1.49-1.58; RD, 46.03; 95% CI, 42.13-49.92), and 37-38 weeks (RR, 1.16; 95% CI, 1.14-1.18; RD, 13.84; 95% CI, 11.9-15.78). Earlier GA was associated with increased outpatient visits by age 5 years. Children born preterm exhibited higher rates of respiratory (RR, 1.33; 95% CI, 1.30-1.37 to RR, 3.96; 95% CI, 3.30-4.70), endocrine (RR, 1.13; 95% CI, 1.09-1.18 to RR, 2.37; 95% CI, 1.65-3.27), gastrointestinal (RR, 1.26; 95% CI, 1.11-1.43 to RR, 6.36; 95% CI, 3.05-11.49), kidney (RR, 1.17; 95% CI, 1.08-1.26 to RR, 3.39; 95% CI, 1.86-5.59), neurodevelopmental (RR, 1.60; 95% CI, 1.55-1.66 to RR, 8.04; 95% CI, 6.78-9.44), and sleep (RR, 1.35; 95% CI, 1.21-1.51 to RR, 3.39; 95% CI, 1.34-6.87) disorders. Children born preterm were more likely to receive outpatient antibiotics, bronchodilators, corticosteroids, diuretics, and thyroid hormones.Conclusions and RelevanceIn this population-based cohort study, despite neonatal care advancements, children born preterm required more health care resources and faced greater health challenges in their first 5 years.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"24 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008820","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":"Chiles v Salazar—Conversion Effort Bans and Free Speech","authors":"Jack L. Turban, Michael R. Ulrich","doi":"10.1001/jamapediatrics.2025.2988","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2988","url":null,"abstract":"This Viewpoint discusses an upcoming US Supreme Court case that will examine whether Colorado’s ban on conversion efforts for minors appropriately regulates substandard clinical practice or is a viewpoint-based restriction that violates the First Amendment’s protection of free speech.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"29 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928455","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":"Opioid Timeliness in the Emergency Department and Hospitalizations for Acute Sickle Cell Pain","authors":"Ibrahim Gwarzo, Keli D. Coleman, Kenneth McKinley, Angela M. Ellison, Elizabeth R. Alpern, Jacqueline Corboy, Selena Hariharan, Irina Topoz, Morgan Wurtz, Blake Nielsen, Lawrence J. Cook, Claudia R. Morris, Amanda M. Brandow, Andrew D. Campbell, Robert I. Liem, Rachelle Nuss, Charles T. Quinn, Alexis A. Thompson, Anthony Villella, Allison A. King, Ana Baumann, Warren Frankenberger, David C. Brousseau","doi":"10.1001/jamapediatrics.2025.2967","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2967","url":null,"abstract":"ImportanceGuidelines for the timely emergency department (ED) administration of opioids for acute sickle cell disease (SCD) pain lack clear evidence showing associations with reduced hospitalizations.ObjectiveTo evaluate the associations between the timely administration of multiple opioid doses during uncomplicated SCD pain episodes in children and hospitalization.Design, Setting, and ParticipantsThis multisite cross-sectional study used data from the Pediatric Emergency Care Applied Research Network Registry. Included were 12 pediatric EDs from children’s hospitals with comprehensive SCD centers across the US. ED visits by children younger than 19 years with uncomplicated SCD pain at any of the 12 sites between January 1, 2019, and December 31, 2021, were included. Primary diagnosis codes were used to identify visits for SCD pain; visits with any other SCD complication were excluded. Initial data analysis was conducted from April 2024 to April 2025, including revisions. After-revision analyses were done between May and June of 2025.ExposuresThe 2 exposures of interest were as follows: (1) time from ED arrival to first opioid administration (dichotomized as ≤60 minutes of arrival vs >60 minutes from arrival) and (2) time interval between the first and the second opioid administration (dichotomized in separate analyses as ≤30 minutes vs >30 minutes, ≤45 minutes vs >45 minutes, and ≤60 minutes vs >60 minutes).Main Outcomes and MeasuresThe primary outcome was hospitalization at the end of an ED visit.ResultsA total of 2538 patients (mean [SD] age, 12.0 [5.0] years; 1293 male [50.9%]) were included in this study. Of 9233 ED visits, 5023 (54.4%) resulted in hospitalization. First-dose timeliness of opioid administration evaluated alone was associated with decreased hospitalizations (odds ratio [OR], 0.84; 95% CI, 0.75-0.95). Evaluating combined first- and second-dose timeliness of opioid administration for the 7853 visits (85.1%) with 2 or more opioid doses, first-opioid timeliness was associated with reduced odds of hospitalization, even when the second dose was outside 30 minutes (OR, 0.85; 95% CI, 0.74-0.98) or 45 minutes (OR, 0.84; 95% CI, 0.72-0.97). First-dose timeliness combined with a second dose within 30-minute (OR, 0.62; 95% CI, 0.52-0.75), 45-minute (OR, 0.70; 95% CI, 0.59-0.83), and 60-minute (OR, 0.78; 95% CI, 0.67-0.92) intervals achieved the lowest odds of hospitalization.Conclusions and RelevanceThis cross-sectional study found that timely receipt of opioids was associated with a reduction in hospitalizations for SCD pain. The largest decrease in hospitalization was achieved with the first dose within 60 minutes and the second dose within 30 minutes; however, longer second-dose durations were associated with reduced hospitalizations.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"94 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928507","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 Government Spending on New Drugs With Incomplete and Postponed Mandatory Pediatric Trials","authors":"Ian T. T. Liu, Aaron S. Kesselheim","doi":"10.1001/jamapediatrics.2025.2817","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2817","url":null,"abstract":"This cohort study estimates Medicare Part D, Medicaid, and Medicare Part B spending on pediatric drugs approved by the US Food and Drug Administration from 2015 to 2021.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"8 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928515","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":"Treatment of the Patent Ductus Arteriosus.","authors":"Philip T Levy, Cheryl Battersby, Patrick J McNamara","doi":"10.1001/jamapediatrics.2025.2919","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2919","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954629","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":"Treatment of the Patent Ductus Arteriosus-Reply.","authors":"Jiun Lee, Santosi Buvaneswarran, Liang Shen","doi":"10.1001/jamapediatrics.2025.2955","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2955","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954642","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":"Errors in Figure.","authors":"","doi":"10.1001/jamapediatrics.2025.3242","DOIUrl":"10.1001/jamapediatrics.2025.3242","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954665","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":"Error in Results.","authors":"","doi":"10.1001/jamapediatrics.2025.2421","DOIUrl":"10.1001/jamapediatrics.2025.2421","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1047"},"PeriodicalIF":18.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674802","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":"Pediatric Hypertension-A Growing Health Problem.","authors":"Simonetta Genovesi, Marco Giussani, Gianfranco Parati","doi":"10.1001/jamapediatrics.2025.2203","DOIUrl":"10.1001/jamapediatrics.2025.2203","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"952-954"},"PeriodicalIF":18.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730981","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}