JAMA Pediatrics最新文献

{"title":"Congenital TORCH Infections and Neurodevelopmental Outcomes","authors":"Hugo Sjöqvist, Christina Dalman, David Mataix-Cols, Reneé M. Gardner, Håkan Karlsson","doi":"10.1001/jamapediatrics.2026.4229","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4229","url":null,"abstract":"Importance Congenital TORCH (toxoplasmosis, syphilis, rubella, cytomegalovirus, or herpes simplex) infections are established causes of severe fetal injury, yet their population-level contribution to neurodevelopmental and psychiatric outcomes, independent of familial confounding, remains yet to be quantified. Objective To investigate whether congenital TORCH infections are associated with neurodevelopmental and psychiatric outcomes, including autism and intellectual disability, as well as academic performance, using population-based and sibling-controlled analyses. Design, Setting, and Participants This nationwide, population-based cohort study with sibling comparisons was conducted using linked data from Swedish national health, birth, insurance, education, and death registers. Individuals born in Sweden between 1987 and 2021, including individuals diagnosed with a congenital TORCH infection, were included. Full siblings were identified for within-family comparisons. Individuals were followed up from birth until death, emigration, or December 31, 2023. Data were analyzed from November ‎2025 to July 2026. Exposure Clinically diagnosed congenital TORCH infections, identified from national registers, including cytomegalovirus, <jats:italic toggle=\"yes\">Toxoplasma gondii</jats:italic> , rubella, and herpes simplex viruses. Main Outcomes and Measures Autism (with and without co-occurring intellectual disability), intellectual disability (by severity), attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, Tourette and chronic tic disorders, nonaffective psychosis, and standardized school grades at age 16 years were assessed. Associations were estimated with hazard ratios (HRs) using Cox regression and sibling-comparison models. Results Among 3 666 002 individuals born in Sweden, including 3 665 027 individuals without TORCH infections (1 883 911 male [51.4%]; mean [SD] follow-up, 20.50 [11.15] years) and 975 individuals with TORCH infections (532 male [54.6%]; mean [SD] follow-up, 18.70 [10.39] years), congenital TORCH infections were associated with increased risks of intellectual disability (HR, 7.22; 95% CI, 6.14-8.49) and autism (HR, 3.10; 95% CI, 2.55-3.76), with similar or greater HRs in sibling comparisons (intellectual disability: HR, 11.28; 95% CI, 5.97-21.33; autism: HR, 3.19; 95% CI, 1.97-5.15). Risks increased with greater severity of intellectual disability, with HRs ranging from 3.01; 95% CI, 2.21-4.11 for mild to 23.51; 95% CI, 18.06-30.60 for severe to profound intellectual disability) and were greater for autism with (HR, 6.23; 95% CI, 4.69-8.28) vs without (HR, 1.97; 95% CI, 1.51-2.57) co-occurring intellectual disability. No consistent associations were observed for obsessive-compulsive disorder, and associations with attention-deficit/hyperactivity disorder attenuated in sibling analyses. Individuals who were exposed had lower school grades in adolescence (TORCH-associated decrease = −1.50 points; 95% CI, −2.60 ","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149010079","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":"Adolescents’ Experiences of Online Harms by Platform","authors":"Angela Y. Lee, Carmen H. J. Lim, Sunny Xun Liu, R. Kang Xing Jin, Anneke Buffone, Ravi Iyer, Zachary Rausch, Jonathan Haidt, Nathanael J. Fast, Jeffrey T. Hancock, Eleni Linos","doi":"10.1001/jamapediatrics.2026.4692","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4692","url":null,"abstract":"Importance Concerns about the risks adolescents face online are rising, and existing research on online harms rarely examines platform-level differences. Objective To estimate the prevalence of negative experiences reported by US adolescents online, offline, and across 20 different online platforms using a national survey. Design, Setting, and Participants This was a cross-sectional, nationally representative, pilot survey of US adolescents aged 13 to 17 years conducted from February to December 2025 through the probability-based Understanding America Study panel. Self-reported use and negative experiences on 20 online platforms (eg, Facebook, Instagram, Snapchat, TikTok, and YouTube) were assessed. Exposures Self-reported use of 20 online communication platforms (eg, Facebook, Instagram, TikTok, Snapchat, and YouTube) in the past 4 weeks. Main Outcomes and Measures Prevalence of adolescents’ reporting experiencing major risks and harms online, offline, and for each of 20 online platforms in the last 4 weeks. Harms include harassment, sexual solicitation, exposure to violent content, and technology-related sleep disruption. Survey-weighted logistic regression examined demographic associations. Results The weighted sample included 472 adolescents (mean [SE] age 14.9 [0.1] years; 46.8% female) from 47 states. Across online and offline contexts, 44.7% witnessed harassment and 29.8% reported experiencing it directly in the past 4 weeks. Online exposure exceeded offline exposure for several harms, including reported exposure to violent imagery (10.7% vs 1.6%), unwanted sexual images (13.4% vs 2.0%), and content encouraging self-harm (9.7% vs 5.2%), while direct harassment was reported at similar rates offline and online (18.5% vs 16.4%). More than half (51.5%) self-reported sleep disruption due to technology use. Prevalence varied by platform. Conclusions and Relevance The findings suggest that negative online experiences are commonly reported by US adolescents and vary across platforms and subgroups of adolescents. Measuring the prevalence of negative online experiences is feasible and analogous to public health risk monitoring frameworks.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"13 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148985100","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":"Error in Figure.","authors":"","doi":"10.1001/jamapediatrics.2026.4551","DOIUrl":"10.1001/jamapediatrics.2026.4551","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968519","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":"Legal and Clinical Liability of Comanaging Pediatric Mental Health With Unregulated AI Chatbots.","authors":"Jack C Lennon","doi":"10.1001/jamapediatrics.2026.3923","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3923","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968687","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":"Mandated Reporting and Systematic Bias in Childhood Adversity Research","authors":"Meredith A. Gruhn","doi":"10.1001/jamapediatrics.2026.3926","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3926","url":null,"abstract":"This Viewpoint describes how mandated reporting requirements contribute to systematic bias in childhood adversity research, with substantial consequences for researcher inquiry and patient disclosure.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"150 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964282","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":"Legal and Clinical Liability of Comanaging Pediatric Mental Health With Unregulated AI Chatbots-Reply.","authors":"Ryan K McBain, Jonathan H Cantor, Hao Yu","doi":"10.1001/jamapediatrics.2026.3929","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3929","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968664","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":"Cumulative Incidence and Prevalence of Autism Spectrum Disorder","authors":"Young Shin Kim, Xiao Liu, Joshua Chang, Yun-Joo Koh, Jihyun Kim, Yuji Choi, Yoon Jae Cho, Eric Fombonne, Bennett L. Leventhal","doi":"10.1001/jamapediatrics.2026.4066","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4066","url":null,"abstract":"Importance Between the 1980s and 2020s, reported autism spectrum disorder (ASD) prevalence has increased markedly, raising public concern. However, most estimates rely on administrative or service-based data vulnerable to diagnostic shifts, service-related ascertainment, and policy-driven incentives. Objective To assess whether 7-year cumulative incidence and prevalence of ASD at age 7 years changed across consecutive birth cohorts. Design, Setting, and Participants Prospective population-based screening and diagnostic assessment was conducted in 12 consecutive birth cohorts in South Korea among children born from January 1998 to December 2010 and ascertained at age 7 years between January 2005 and December 2017. All children aged 7 years entering elementary schools constituted the target population. Among more than 62 000 children, 2077 screened positive and were invited for detailed evaluation, and 881 completed comprehensive diagnostic assessments. Data were analyzed from January 2024 to July 2026. Exposures Birth year and service-use status defined as any history of prior diagnosis or intervention. Main Outcomes and Measures Populationwide standardized screening used the Autism Spectrum Screening Questionnaire; diagnostic assessments, including the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview–Revised, cognitive testing, and record review, were administered to screen-positive children. Clinical consensus best-estimate diagnoses were determined according to <jats:italic toggle=\"yes\">Diagnostic and Statistical Manual of Mental Disorders</jats:italic> , <jats:italic toggle=\"yes\">5th Edition</jats:italic> , criteria. Results Across consecutive birth cohorts, both 7-year cumulative incidence and prevalence estimates of ASD at age 7 years remained stable, ranging from 1.9% (95% CI, 1.5-2.4) to 3.2% (95% CI, 2.7-3.8) for incidence and from 2.0% (95% CI, 1.5-2.6) to 3.4% (95% CI, 2.7-4.0) for prevalence, with no statistically significant increase or decrease. Female children with ASD were disproportionately represented among previously undiagnosed cases identified in general education settings and exhibited distinct phenotypic profiles and substantial unmet clinical needs. Conclusions and Relevance The findings from this cohort study suggest that detection-related factors may contribute substantially to reported increases in ASD occurrence estimates. Interpretation of changes in ASD occurrence estimates should account for methodological differences, changing service-use patterns, and ascertainment context in service-based surveillance systems.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"14 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964280","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":"Individually Targeted Human Milk Fortification","authors":"Mandy Brown Belfort, Banu Ahtam, Katherine A. Bell, Paige Berger, Sara Cherkerzian, Deirdre Ellard, Laurie Foster, Christoph Fusch, Borjan Gagoski, P. Ellen Grant, Manasa Kuncham, Hunter Pepin, Marina Solti, Tina Steele, Lianne Woodward, Terrie Inder","doi":"10.1001/jamapediatrics.2026.4220","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4220","url":null,"abstract":"Importance Human milk is recommended for hospitalized very preterm infants, but the optimal macronutrient fortification strategy is unknown. Objective To compare individually targeted fortification using point-of-care human milk analysis with standard-of-care fortification. Design, Setting, and Participants This double-blind randomized clinical trial enrolled participants from February 2020 to March 2025 at a single academic level III neonatal intensive care unit (NICU), with outcomes assessed through NICU discharge. Very preterm infants born at 24 to 30 completed weeks’ gestation were eligible for inclusion. Data were analyzed from June 2025 to March 2026. Intervention All participants received standard of care comprising maternal and/or pasteurized donor human milk (termed &lt;jats:italic&gt;base milk&lt;/jats:italic&gt; ) fortified with commercial multicomponent human milk fortifier and protein modular, with additional protein and/or fat provided for clinical growth faltering. The intervention group received protein and/or fat beyond standard of care when indicated by milk analysis with midinfrared spectroscopy (Miris Human Milk Analyzer [HMA] version 08-2-02-107 [Miris AB]), targeting minimum true protein of 1 g/dL and energy of 67 kcal/dL in base milk. Main Outcomes and Measures Primary outcomes were &lt;jats:italic&gt;z&lt;/jats:italic&gt; scores of body weight and length at study diet end; fat-free mass measured with air displacement plethysmography; and quantitative metrics from brain magnetic resonance imaging (MRI) near term-equivalent age. Results Of 251 eligible infants, 206 were approached and 130 consented, were randomized, and received the study diet (65 each in the control and intervention groups); 113 infants (87%) completed the study diet though 36 weeks’ postmenstrual age. Mean (SD) gestational age was 28.5 (1.9) weeks, and mean (SD) birth weight was 1165 (298) g. Median (IQR) true protein content of base milk (control: 1.24 [1.13-1.34] g/dL vs intervention: 1.18 [1.12-1.32] g/dL) and total protein intake from base milk and all fortifiers (control: 4.58 [4.44-4.74] g/kg/d vs intervention: 4.47 [4.31-4.60] g/kg/d) were unexpectedly higher in the control group; fat and energy content and intakes were similar between groups. Nutrient intakes all met or exceeded recommended levels in both groups. In intention-to-treat analyses, there was no evidence that &lt;jats:italic&gt;z&lt;/jats:italic&gt; scores of weight, length, and head circumference, body composition, or brain MRI indices differed between groups. Results were similar in analyses limited to infants who completed the study diet. Conclusions and Relevance Findings in this randomized clinical trial do not support routine use of point-of-care human milk analysis to inform individually targeted human milk fortification in the NICU. Trial Registration ClinicalTrials.gov Identifier: &lt;jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/study/NCT03977259","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"33 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964281","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":"Interpreting Prenatal Acetaminophen and Neurodevelopment.","authors":"Shau-Ru Ho, Chi-Nien Chen, Po-Nien Tsao","doi":"10.1001/jamapediatrics.2026.3629","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3629","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912150","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":"Trends in Preclinical and Clinical Obesity Among Adolescents.","authors":"Heqing Tao, Yuting Tan, Ruixin Zhan, Jiayi Wang, Liang Peng, Ligang Liu","doi":"10.1001/jamapediatrics.2026.3932","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3932","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912148","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}