JAMA Pediatrics最新文献

{"title":"A Broader Perspective on School Phone Policies.","authors":"Nathan Tureck","doi":"10.1001/jamapediatrics.2026.3058","DOIUrl":"10.1001/jamapediatrics.2026.3058","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1163-1164"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701312","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":"Reexamining the Association of Cardiovascular Disease With Neurodevelopmental Disorders in Offspring.","authors":"Marianna Karachaliou","doi":"10.1001/jamapediatrics.2026.3061","DOIUrl":"10.1001/jamapediatrics.2026.3061","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1164-1165"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701357","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":"Considering School Environment and Child Vulnerability in Absenteeism-Reply.","authors":"Michelle Shankar, Samantha R Levano, Rebecca Dudovitz","doi":"10.1001/jamapediatrics.2026.3418","DOIUrl":"10.1001/jamapediatrics.2026.3418","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1171-1172"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864965","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.2026.4400","DOIUrl":"10.1001/jamapediatrics.2026.4400","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1172-1173"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865003","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":"Erythropoietin for Neonatal Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial.","authors":"Helen G Liley, Rod W Hunt, Rachel L O'Connell, Malcolm R Battin, Iona Novak, Yvonne W Wu, Roberta Ballard, Lisa Askie, Nadia Badawi, Alpana Ghadge, Susan E Jacobs, Sandra E Juul, Lucille Sebastian, Deepika Wagh, R John Simes","doi":"10.1001/jamapediatrics.2026.3082","DOIUrl":"10.1001/jamapediatrics.2026.3082","url":null,"abstract":"<p><strong>Importance: </strong>Therapeutic hypothermia (TH) is the standard of care to improve outcomes following neonatal hypoxic-ischemic encephalopathy (HIE), but mortality and morbidity remain high, prompting research into treatment adjuncts.</p><p><strong>Objective: </strong>To assess whether erythropoietin (EPO) plus TH improves outcomes in infants with moderate or severe HIE.</p><p><strong>Design, setting, and participants: </strong>The PAEAN (Preventing Adverse Outcomes of Neonatal Hypoxic Ischaemic Encephalopathy with Erythropoietin) study was a phase 3, multicenter, double-blinded, placebo-controlled randomized clinical trial conducted in 24 neonatal intensive care units in Australia, New Zealand, and Singapore. Infants 35 weeks' gestation or older, less than 23 hours old, with perinatal depression (umbilical cord arterial pH <7.0 or base excess ≥12 mmol/L or, at 10 minutes, Apgar score ≤5 or still receiving resuscitation), and moderate or severe HIE (modified Sarnat criteria) who had commenced TH within 6 hours of birth were eligible for inclusion. Study recruitment was conducted between May 2016 and March 2021, with data collection completed in September 2024. Data analysis was performed from September 2024 to October 2025.</p><p><strong>Intervention: </strong>Intravenous EPO, 1000 IU/kg (5 doses over the first week), or placebo.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was a composite of death or moderate or severe motor or cognitive disability using standardized neurological and developmental assessments at 2 years. Moderate or severe disability comprised motor deficit (diagnosis of cerebral palsy with Gross Motor Function Classification Scale score ≥2) or moderate or severe cognitive deficit using Bayley Scales of Infant Development, Third Edition. Secondary outcomes included death, disabilities alone, and safety.</p><p><strong>Results: </strong>From 2016 to 2021, 313 infants were randomized (EPO: n = 156; placebo: n = 157). Baseline characteristics (including mean [SD] gestational age at birth: 39.4 [1.7] weeks vs 39.3 [1.6] weeks and ratio of moderate:severe encephalopathy: 78%:22% vs 77%:23%) and loss to follow-up (10.2% overall) were similar across both groups. There were 67 (42.9%) and 59 (37.6%) female infants, respectively. There was no significant difference in the primary outcome (EPO: 47 of 138 [34.1%] vs placebo: 41 of 143 [28.7%]; relative risk, 1.19; 95% CI, 0.84-1.68; P = .33), in secondary outcomes (death: 22 of 146 [15.1%] vs 18 of 149 [12.1%]; P = .45; cerebral palsy: 22 of 120 [18.3%] vs 22 of 127 [17.3%]; motor deficit: 13 of 120 [10.8%] vs 15 of 127 [11.8%]; cognitive deficit: 20 of 113 [17.7%] vs 16 of 118 [13.6%]), or in any safety outcomes.</p><p><strong>Conclusions and relevance: </strong>Per the results of this multicenter randomized clinical trial, EPO did not demonstrate any adjunctive effect to hypothermia, but no safety concerns were evident.</p><p><strong>Trial registrati","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1085-1093"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591402","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":"Renin-Angiotensin-Aldosterone System Inhibition in Pediatric Chronic Kidney Disease.","authors":"Chun-Hsien Yu, Ching-Feng Cheng","doi":"10.1001/jamapediatrics.2026.2894","DOIUrl":"10.1001/jamapediatrics.2026.2894","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1162"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663889","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":"Family-Centered Child Obesity Treatment: The TEAM UP Randomized Clinical Trial.","authors":"Amanda E Staiano, Stephen R Cook, Richard I Stein, Alyssa M Button, Robert L Newton, Robbie A Beyl, Alison Baker, Jeanne Lindros, Anne-Marie Conn, Amy S Braddock, R Robinson Welch, Denise E Wilfley","doi":"10.1001/jamapediatrics.2026.3067","DOIUrl":"10.1001/jamapediatrics.2026.3067","url":null,"abstract":"<p><strong>Importance: </strong>Families have limited access to pediatric weight management services.</p><p><strong>Objective: </strong>To compare the effectiveness of enhanced standard of care (ESOC) with family-based behavioral treatment (FBT) vs ESOC alone in reducing percent over median body mass index (percent median BMI) among children and adolescents with obesity. ESOC+FBT was hypothesized to reduce relative weight more than would ESOC alone.</p><p><strong>Design, setting, and participants: </strong>This was a pragmatic, comparative-effectiveness randomized clinical trial (2019-2024). Data collectors were blinded, and patients were followed up at 18 months. The setting included a total of 41 primary care clinical practices in Louisiana, New York, Missouri, and Illinois. Children and adolescents aged 6 to 15 years with obesity were referred by their primary care practitioner (PCP) or self-selected into the trial.</p><p><strong>Interventions: </strong>ESOC was led by the PCP and intensified depending on a child's response. ESOC+FBT included all ESOC components plus meetings with an FBT interventionist, focusing on nutritious eating, physical activity, positive parenting strategies, and management of social and environmental cues. Both interventions lasted 12 months.</p><p><strong>Main outcomes and measures: </strong>Change in percent median BMI at 12 months (end of treatment).</p><p><strong>Results: </strong>A total of 1631 parents completed the web screen for their child, and 901 parent-child dyads were excluded or declined participation before randomization. The final sample of 730 children, each with a participating parent, had a mean (SD) age of 10.8 (2.5) years, 387 (54%) were female, 337 (47%) had Medicaid, and 160 (22%) had food insecurity. At the end of the treatment period, children in the group receiving ESOC+FBT experienced a significant reduction in percent median BMI (-6.4; 95% CI, -8.29 to -4.43) vs ESOC (-2.6; 95% CI, -4.46 to -0.71), with a mean between-group difference of -3.8 units (95% CI, -6.20 to -1.34 units; P = .002). Children's quality of life improved across both treatment arms at months 12 and 18. Similarly, weight-associated quality of life improved in both treatment arms, with greater improvements in ESOC+FBT at the end of the treatment period (6.8; 95% CI, 5.33-8.30 vs 4.8; 95% CI, 3.40-6.17; difference, 2.0 units; 95% CI, 0.05-4.00 units). There were no adverse events related to trial participation.</p><p><strong>Conclusions and relevance: </strong>Results of this randomized clinical trial show that ESOC+FBT demonstrated a significantly larger reduction in child percent median BMI than did ESOC alone. These findings support the added value of incorporating FBT into pediatric primary care settings and its feasibility in reaching a geographically and socioeconomically diverse patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03843424.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1076-1084"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591429","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":"Bone Accrual During Puberty Suppression and Gender-Affirming Therapy in Transgender Adolescents: A Systematic Review and Meta-Analysis.","authors":"Daniele Tienforti, Lorenzo Marinelli, Giovanni Terrana, Riccardo Di Geronimo, Luca Spagnolo, Jeroen Vervalcke, Silvia Ciancia, Marco Giorgio Baroni, Arcangelo Barbonetti, Guy T'Sjoen","doi":"10.1001/jamapediatrics.2026.2470","DOIUrl":"10.1001/jamapediatrics.2026.2470","url":null,"abstract":"<p><strong>Importance: </strong>Puberty is a critical window for bone mass acquisition, determining lifelong fracture risk. Gonadotropin-releasing hormone agonist (GnRHa)-based pubertal suppression followed by gender-affirming hormone therapy (GAHT) is increasingly used in transgender and gender-diverse (TGD) adolescents, raising concerns about peak bone mass.</p><p><strong>Objectives: </strong>To quantify changes in bone mineral density (BMD), bone mineral apparent density (BMAD), and z scores in TGD adolescents undergoing GnRHa with or without GAHT, and to identify predictors of skeletal outcomes.</p><p><strong>Data sources: </strong>PubMed, Scopus, Web of Science, and Cochrane Library, from inception through September 2025.</p><p><strong>Study selection: </strong>Longitudinal cohorts assessing BMD, BMAD, or z scores at the lumbar spine, total hip, or femoral neck in TGD adolescents treated with GnRHa with or without GAHT. Ten studies met the inclusion criteria.</p><p><strong>Data extraction and synthesis: </strong>Data were extracted in duplicate; study quality was assessed using the Newcastle-Ottawa Scale. Random-effects models pooled mean changes across baseline (time 0 [T0]), after GnRHa (T1), and after GAHT (T2), stratified by skeletal site and sex assigned at birth. Metaregressions examined body mass index, age, Tanner stage, and treatment duration.</p><p><strong>Main outcomes and measures: </strong>Dual-energy x-ray absorptiometry-derived BMD, BMAD, and z scores.</p><p><strong>Results: </strong>Ten cohorts comprising 751 adolescents (427 assigned female at birth [AFAB]; 324 assigned male at birth [AMAB]) were included. Lumbar spine z scores declined during GnRHa (AFAB: z-score change, -0.97 [95% CI, -1.09 to -0.85]; AMAB: z-score change, -0.73 [95% CI, -0.93 to -0.53]) despite stable BMD. z Scores used sex-assigned-at-birth normative references. After GAHT, BMD increased (AFAB: BMD mean difference, 0.09 g/cm2 [95% CI, 0.07-0.10 g/cm2]; AMAB: BMD mean difference, 0.13 g/cm2 [95% CI, 0.10-0.16 g/cm2]), with partial z-score recovery; values remained below baseline at T2 (AFAB: z-score change, -0.51 [95% CI, -0.69 to -0.34]; AMAB: z-score change, -0.52 [95% CI, -0.82 to -0.21]) but were not consistently statistically different across skeletal sites. Recovery at the total hip and femoral neck was smaller and more heterogeneous. Higher body mass index, shorter GnRHa duration, and longer GAHT exposure were associated with more favorable outcomes.</p><p><strong>Conclusions and relevance: </strong>This systematic review and meta-analysis found that pubertal suppression followed by GAHT was associated with transient z-score reductions and subsequent BMD increases. At T2, z scores remained numerically below baseline but were not consistently statistically different, suggesting an uncertain rather than demonstrated persistent deficit. Timely GAHT initiation is recommended.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1094-1104"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663891","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 Byline.","authors":"","doi":"10.1001/jamapediatrics.2026.4206","DOIUrl":"10.1001/jamapediatrics.2026.4206","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1172"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864976","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":"Numeric Inconsistencies in the Results and Tables 3 and 5.","authors":"","doi":"10.1001/jamapediatrics.2026.3324","DOIUrl":"10.1001/jamapediatrics.2026.3324","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1172"},"PeriodicalIF":17.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701378","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}