JAMA Pediatrics最新文献

{"title":"What Parents Should Understand About Lipid Screening in Children","authors":"Michael Silverstein, Michael J. Barry, Lindsay A. Thompson","doi":"10.1001/jamapediatrics.2025.2713","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2713","url":null,"abstract":"This <jats:italic>JAMA Pediatrics</jats:italic> Patient Page describes what parents should consider in deciding whether to have their child screened for high lipid levels.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"48 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899543","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":"Outcomes of Preterm Infants Born at 22 to 23 Weeks' Gestation in 11 International Neonatal Networks.","authors":"Tetsuya Isayama, Mikael Norman, Satoshi Kusuda, Brian Reichman, Liisa Lehtonen, Kei Lui, Mark Adams, Max Vento Torres, Luca Filippi, Malcolm Battin, Ruth Guinsburg, Neena Modi, Stellan Håkansson, Gil Klinger, Maria Fernanda de Almeida, Kjell Helenius, Dirk Bassler, Yi-Chen Su, Prakesh S Shah","doi":"10.1001/jamapediatrics.2025.2958","DOIUrl":"10.1001/jamapediatrics.2025.2958","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Postnatal intensive care for preterm infants born at 22 to 23 weeks' gestation is increasing, although survival rates remain low. Information on outcomes for multiple countries or regions can be important for research, benchmarking, quality improvement, and parental counseling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate survival and major morbidities and their between-network variations in infants born at 22 to 23 weeks' gestation in 11 neonatal networks participating in the International Network for Evaluation of Outcomes (iNeo) in neonates in 12 countries or regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;International registry-based cohort study of infants born at 22 to 23 weeks' gestation from January 1, 2015, through December 31, 2021, without major congenital anomalies who were admitted for neonatal intensive care in 11 national or regional neonatal consortia. Data analysis was performed from December 2, 2023, to June 15, 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Neonatal consortium and gestational age at birth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Survival to neonatal intensive care unit discharge, major neonatal morbidities, and survival without any major morbidities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5019 neonates were included (1084 of 4636 neonates [23%] with a maternal age &gt;35 years; 2641 of 5017 neonates [53%] male); among them, 846 neonates were born at 22 weeks' gestation and 4173 were born at 23 weeks' gestation. Variations between contributing networks for perinatal management at 22 and 23 weeks' gestation, respectively, include any antenatal steroids (ranges of 18%-83% and 57%-98%), cesarean birth (0%-42% and 5%-73%), and outborn (0%-26% and 0%-22%). Significant variations between contributing networks for adjusted probabilities of outcomes at 22 and 23 weeks' gestation, respectively, include survival to discharge (95% CIs of 9%-64% and 16%-80%; P &lt; .001), grade 3 or 4 periventricular hemorrhage (PVH) or periventricular leukomalacia (PVL) (severe PVH or PVL: 24%-65% and 18%-56%; P &lt; .001), survival without severe PVH or PVL (7%-53% and 9%-69%; P &lt; .001), treated retinopathy of prematurity among survivors (32%-57% [P = .008] and 16%-48% [P &lt; .001]), bronchopulmonary dysplasia among survivors (for 23 weeks only: 64%-88%; P &lt; .001), and necrotizing enterocolitis (for 23 weeks only: 6%-28%; P &lt; .001). Standardized incidence ratios showed significant differences in survival and major morbidities in some networks compared with a reference population from all other networks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Substantial international variations were identified in outcomes for infants born at 22 to 23 weeks' gestation who were admitted to 11 neonatal networks in the 12 countries or regions. The variations can be due to differences in systems, care practices, attitudes, and culture; however, identification of variation can help focus efforts toward research aime","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954609","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":"Trends in Industry Marketing of Stimulants to Physicians and Advanced Practice Clinicians","authors":"J. Travis Donahoe, Linnea M. Wilson, Timothy S. Anderson","doi":"10.1001/jamapediatrics.2025.2811","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2811","url":null,"abstract":"This cross-sectional study examines pharmaceutical marketing of stimulants to physicians and advanced practice clinicians and its influence on stimulant use after the COVID-19 pandemic.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"23 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901728","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":"Testing Bidirectional Associations Between Maternal and Child Depression During Emerging Adolescence","authors":"Jackson M.A. Hewitt, Brae Anne McArthur, Ross D. Neville, Joanne L. Park, Suzanne Tough, Sheri Madigan","doi":"10.1001/jamapediatrics.2025.2822","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2822","url":null,"abstract":"ImportanceResearch has consistently shown links between parent and child depression. The prevailing assumption is that parent depression precedes the onset, persistence, and even exacerbation of child depression. However, it is plausible, albeit infrequently tested, that child depression triggers subsequent parent depression. Clarifying the direction and developmental timing of these associations is critical for designing and advocating for family-centered approaches to pediatric care.ObjectiveTo estimate the longitudinal bidirectional associations between maternal and child depression from middle childhood through emerging adolescence during a period that coincided with the COVID-19 pandemic, and to assess whether these associations are moderated by key sociodemographic factors.Design, Setting, and ParticipantsThis study used data from the All Our Families (Calgary, Alberta, Canada) cohort across multiple waves during and beyond the COVID-19 pandemic when children were aged 10.3 (May 20 to July 15, 2020), 10.9 (March 4 to April 30, 2021), 11.6 (November 22, 2021 to January 17, 2022), and 12.8 (January 16 to July 7, 2024) years. Data were analyzed between March 1 and August 31, 2024, using random-intercept cross-lagged panel models.ExposuresMaternal and child report of depressive symptoms.Main Outcomes and MeasuresThe Behavior Assessment System for Children for child depression and the Center for Epidemiologic Studies Depression Scale-10 for maternal depression.ResultsThe sample included 1801 mother-child dyads (52% boys, 48% girls). Mothers were a mean (SD) 41.6 (4.4) years old at study entry and most had completed postsecondary education (80%), had an annual income more than CAD $100 000 (75%), and were married or in common-law relationships (71.4%). Consistent cross-sectional correlations were observed, reflecting stable between-participant associations for maternal depression and child depression throughout the study period. Within-participant increases in child depression scores at ages 10.3 and 10.9 years were associated with subsequent increases in maternal depression scores at child ages 10.9 (standardized coefficient 0.12; 95% CI, 0.02-0.22) and 11.6 (0.17; 95% CI, 0.07-0.26) years; however, this was not present for maternal depression. These patterns of associations were moderated by household income (difference test for χ&lt;jats:sup&gt;2&lt;/jats:sup&gt;&lt;jats:sub&gt;12&lt;/jats:sub&gt; = 23.0; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .03) and within-participant increases in child depression were consistently associated with subsequent increases in maternal depression for the higher income group.Conclusions and RelevanceContrary to prevailing assumptions, these findings suggest that children’s depression over time may have contributed to worsening maternal depression, rather than the other way around. While these results should be replicated in nonpandemic contexts to confirm their generalizability, they highlight the need for family-centered approaches to mental he","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"88 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899593","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":"Proportion of Obesity-Related Conditions Attributable to Obesity and Overweight in US Youth","authors":"Ashwin K. Chetty, Alissa S. Chen, Alexandra M. Hajduk, Mona Sharifi, James T. Nugent","doi":"10.1001/jamapediatrics.2025.2716","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2716","url":null,"abstract":"This cross-sectional study estimates the population attributable fractions of obesity-related conditions due to obesity and overweight among US adolescents and young adults.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"18 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901730","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":"Safer Child Protective Services Reporting—the BEST Timeout Model","authors":"James B. Metz, Amy D. Roy, Andrea G. Asnes","doi":"10.1001/jamapediatrics.2025.2721","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2721","url":null,"abstract":"This Viewpoint discusses the BEST (Bias, Education and Support, Situational Awareness, and Transparency) Timeout model to reduce the impact of bias, improve clarity about families’ needs, and increase the likelihood that a full explanation for presenting complaints is gathered when considering reporting cases to Child Protective Services.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"116 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901729","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":"Reflections on the Use of Mycophenolate Mofetil in Pediatric Nephrotic Syndrome-Reply.","authors":"Jingjing Wang, Qing Ye, Jianhua Mao","doi":"10.1001/jamapediatrics.2025.2704","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2704","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873209","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":"Means Testing and Contraceptive Uptake Among Young People.","authors":"Max Jordan Nguemeni Tiako, Lydia E Pace","doi":"10.1001/jamapediatrics.2025.2594","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2594","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873205","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":"Universal Pharmacare and Contraceptive Dispensations Among Youth.","authors":"Amanda K Downey, Steven E Hanna, Mitchell A Levine, Laura Schummers, G Emmanuel Guindon","doi":"10.1001/jamapediatrics.2025.2585","DOIUrl":"10.1001/jamapediatrics.2025.2585","url":null,"abstract":"<p><strong>Importance: </strong>Previous studies have suggested that removing financial barriers to contraception could help reduce unintended pregnancy.</p><p><strong>Objective: </strong>To assess whether introduction of universal public funding for prescription contraception in Ontario (OHIP+) for individuals younger than 25 years and the amended program, which limited public funding to those without private insurance (OHIP-), is associated with changes in contraceptive dispensations.</p><p><strong>Design, setting, and participants: </strong>Interrupted time-series analyses were used to evaluate whether implementation of either policy was associated with changes in monthly contraceptives dispensed. The setting included a national database on contraceptives dispensed from retail pharmacies between September 2016 and February 2020; data analysis was performed from May 2022 to 2024. Participants included Ontario females aged 15 to 24 years to whom prescriptions were dispensed (intervention) vs controls: (1) Canadian females aged 15 to 24 years, excluding Ontario, and (2) Ontario females aged 25 to 49 years.</p><p><strong>Exposures: </strong>Implementation of free prescription contraception through OHIP+ (January 2018-March 2019) and OHIP- (April 2019-February 2020).</p><p><strong>Main outcomes and measures: </strong>Monthly dispensations of intrauterine devices (IUDs) and oral contraceptive pills (OCPs) per 1000 females overall and by area-level socioeconomic status (SES).</p><p><strong>Results: </strong>After OHIP+, there was an immediate level increase in IUDs dispensed to Ontario females aged 15 to 24 years (intervention) of 0.50 (95% CI, 0.15-0.84) vs 0.03 (95% CI, -0.26 to 0.32) in Canadian females aged 15 to 24 years-a relative increase of 0.48 (95% CI, 0.02-0.91). There was an immediate level increase in OCPs dispensed to Ontario females aged 15 to 24 years of 22.3 (95% CI, 14.8-29.8) vs 7.57 (95% CI, 3.07-12.1) in those aged 25 to 49 years-a relative increase of 14.8 (95% CI, 6.15-23.4). There were no statistically significant changes in monthly dispensation trends after OHIP+ and no statistically significant changes after OHIP-. In areas with lower SES, there was a significant increase in the level for IUDs of 0.64 (95% CI, 0.02-1.26) and for OCPs of 13.2 (95% CI, 1.33-25.0) after OHIP+, and a significant decrease in the level for IUDs of 0.82 (95% CI, -1.55 to -0.09) after OHIP- in Ontario vs Canadian females aged 15 to 24 years. No statistically significant changes in IUD or OCP dispensations were observed in areas with higher SES vs controls.</p><p><strong>Conclusions and relevance: </strong>Results reveal that providing comprehensive and confidential access to prescription contraceptives was associated with increased dispensations among Ontario youth.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873210","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":"Reflections on the Use of Mycophenolate Mofetil in Pediatric Nephrotic Syndrome.","authors":"Michiel F Schreuder","doi":"10.1001/jamapediatrics.2025.2707","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2707","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873207","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}