JAMA Pediatrics最新文献

{"title":"National Trends in Infant Mortality in the US After Dobbs","authors":"Parvati Singh, Maria F. Gallo","doi":"10.1001/jamapediatrics.2024.4276","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4276","url":null,"abstract":"This time series analysis assesses trends in infant mortality after the <jats:italic>Dobbs</jats:italic> decision overturned the constitutional right to abortion.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"65 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452232","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":"Accumulating Robust Evidence for Reducing Vaccine Hesitancy in Early Pregnancy.","authors":"Stefania Triunfo,Luisa Boselli","doi":"10.1001/jamapediatrics.2024.4346","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4346","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"18 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486283","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":"Free Summer Programming and Body Mass Index Among Schoolchildren From Low-Income Households","authors":"Michael W. Beets, Sarah Burkart, Christopher Pfledderer, Elizabeth Adams, R. Glenn Weaver, Bridget Armstrong, Keith Brazendale, Xuanxuan Zhu, Brian Chen, Alexander McLain","doi":"10.1001/jamapediatrics.2024.3693","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.3693","url":null,"abstract":"ImportanceChildren experience accelerated gains in body mass index (BMI) during the summer months when school is not in session. Children from low-income households are most susceptible. Accelerated BMI gain in summer may be due to the removal of the health-promoting structure provided by schools. During summer, a common form of health-promoting structure is summer day camps (SDCs). Summer day camps are predominately fee for service, which creates a financial barrier for children from low-income households. One solution to mitigate accelerated BMI gain is providing free access to an existing SDC.ObjectiveTo investigate whether providing free access to an existing community SDC can mitigate accelerated BMI <jats:italic>z</jats:italic> score (zBMI) gain in elementary school–age children.Design, Setting, and ParticipantsThis randomized clinical trial was conducted during the summers of 2021, 2022, and 2023 in the southeastern United States. Participants were children (kindergarten through fourth grade) from predominantly low-income households who were randomized to attend an SDC operated by a parks and recreation commission or continue summer as usual (control).InterventionFree SDC every weekday (Monday through Friday) for 8 to 10 weeks.Main Outcomes and MeasuresThe primary outcome was between-group differences in change of zBMI measured before school ended (May) and on return to school from summer (late August). Secondary analyses examined the dose response of zBMI change with parent-reported child attendance at SDCs during the summer for all children (intervention and control).ResultsA total of 422 children (mean [SD] age, 8.2 [1.5] years; 202 [48%] female, 220 [52%] male, 292 [69%] at or below 200% federal poverty level, 127 [30%] with food insecurity) were randomized to 1 of 2 conditions: summer as usual (control, n = 199) or free SDC (n = 223). Intent-to-treat analysis indicated mean (SE) change in zBMI at the end of the summer was 0.046 (0.027) for the control and −0.048 (0.025) for the intervention group, representing a significant between-group difference of −0.094 (95% CI, −0.166 to −0.022). Dose-response analyses indicated that every 1 day per week increase in attending an SDC resulted in a −0.034 to −0.018 zBMI reduction, which translates to a gain of 0.046 to 0.080 zBMI for children never attending summer programming vs −0.09 to −0.04 zBMI reduction for children attending summer programming every weekday.Conclusions and RelevanceProviding children free access to existing community summer programming can have a meaningful effect on children’s zBMI gain during the summer. Future studies should replicate these findings across different regions and identify the optimal dose of programming to mitigate unhealthy zBMI gains.Trial RegistrationClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/study/NCT04072549\">NCT04072549</jats:ext-link>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"16 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431387","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":"State Social Expenditures and Preterm Birth and Low Birth Weight in the US","authors":"Lawrence Chang, Henry T. Puls, Michael C. Monuteaux, Jeffrey D. Colvin, Paul J. Chung, Lois K. Lee","doi":"10.1001/jamapediatrics.2024.4267","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4267","url":null,"abstract":"ImportanceAdverse birth outcomes in the US, including preterm birth and low birth weight, are strongly tied to socioeconomic disadvantage and disproportionately impact infants of Black mothers. Increasing investments in social programs represents a potential policy approach to addressing disparities in birth outcomes.ObjectiveTo examine state-level associations of government expenditures on social programs with rates of preterm birth and low birth weight both overall and by race.Design, Setting, and ParticipantsThis cross-sectional, ecological study was conducted among liveborn infants in the 50 US states between January 1, 2011, and December 31, 2019. Data analysis was performed from May 2022 to May 2024.ExposuresYearly state and local government expenditures per low-income person on social programs in the following categories: state refundable Earned Income Tax Credit; cash assistance; childcare assistance; housing and community development; and public health.Main Outcomes and MeasuresYearly state-level rates of preterm birth (gestational age &amp;amp;lt;37 weeks) and low birth weight (&amp;amp;lt;2500 g).ResultsFrom January 1, 2011, to December 31, 2019, there were 35.1 million live births in the US, of which 3.4 million (9.8%) were preterm and 2.8 million (8.1%) were low birth weight. Median (IQR) state social expenditures per low-income person were $1546 ($1074-$2323). Greater total state social expenditures were associated with lower overall rates of preterm birth (adjusted prevalence ratio [aPR] for every increase of $1000 per low-income person, 0.99; 95% CI, 0.97-0.999) but not with overall rates of low birth weight. In secondary analyses, greater state social expenditures were associated with lower preterm birth rates for infants of Black mothers (aPR, 0.96; 95% CI, 0.92-0.999). Greater state expenditures specifically on cash assistance (aPR, 0.64; 95% CI, 0.43-0.94) and housing and community development (aPR, 0.91; 95% CI, 0.84-0.98) were associated with lower preterm birth rates for infants of Black mothers.Conclusions and RelevanceIn this cross-sectional, ecological study, greater state-level expenditures on social programs were associated with reduced rates of preterm birth, particularly for infants of Black mothers. State and local governments may consider bolstering investments in cash assistance and housing and community development to address maternal and infant health disparities.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"229 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431386","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":"Risk of Suicidal Ideation or Attempts in Adolescents With Obesity Treated With GLP1 Receptor Agonists","authors":"Liya Kerem, Joshua Stokar","doi":"10.1001/jamapediatrics.2024.3812","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.3812","url":null,"abstract":"ImportanceGlucagon-like peptide 1 receptor agonists (GLP1R) are increasingly being used for the treatment of obesity in adolescents. It is currently unknown whether GLP1R treatment is associated with suicidal ideation or attempts in this population.ObjectiveTo investigate the association between GLP1R initiation and suicidal ideation or attempts in adolescents with obesity.Design, Setting, and ParticipantsRetrospective propensity score–matched cohort study using electronic health records from the TriNetX global federated network between December 2019 and June 2024. The analysis included data from 120 health care organizations, mainly from the USA. Participants were adolescents aged 12 to 18 years with a diagnosis of obesity and evidence of an antiobesity GLP1R prescription or lifestyle intervention without GLP1R within the following year. Cohorts were balanced for baseline demographic characteristics, psychiatric medications and comorbidities, and diagnoses associated with socioeconomic status and health care access using propensity score matching.ExposureInitial prescription of GLP1R (study cohort) or lifestyle intervention without GLP1R (control cohort).Main Outcomes and MeasuresIncidence of suicidal ideation or attempts based on <jats:italic>International Statistical Classification of Diseases and Related Health Problems, Tenth Revision</jats:italic> codes recorded in patient electronic health records during 12 months of follow-up. Diagnoses of upper respiratory tract infections (URTI) were used as negative control outcomes, and gastrointestinal symptoms (GI) were used as positive control outcomes.ResultsA total of 4052 adolescents with obesity and a concomitant antiobesity intervention were identified for the GLP1R cohort and 50 112 were identified for the control cohort. Propensity score matching resulted in 3456 participants in each balanced cohort. Prescription of GLP1R was associated with a 33% reduced risk for suicidal ideation or attempts over 12 months of follow-up (1.45% vs 2.26%; hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; <jats:italic>P = </jats:italic>.02) and a higher rate of GI symptoms (6.9% vs 5.4%; HR, 1.41; 95% CI, 1.12-1.78; <jats:italic>P</jats:italic> = .003) but no difference in rates of URTI diagnoses.Conclusions and RelevanceIn this study, adolescents with obesity prescribed a GLP1R had a lower incidence of suicidal ideation or attempts compared with matched patients not prescribed GLP1R who were treated with lifestyle intervention. These results suggest a favorable psychiatric safety profile of GLP1R in adolescents. The detected reduction in HRs for suicidal ideation among adolescents with obesity prescribed GLP1R suggests potential avenues for future research.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"30 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142431433","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":"Optimizing Public Policies for Pregnancy and Infant Outcomes.","authors":"Scott A Lorch,Michelle M Peña,Diana Montoya-Williams","doi":"10.1001/jamapediatrics.2024.4264","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4264","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"19 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142436163","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":"Naloxone Access Laws and Opioid-Related Overdose Deaths in Youths.","authors":"Michael S Toce,Kenneth A Michelson,Scott E Hadland,Michael C Monuteaux,Florence T Bourgeois","doi":"10.1001/jamapediatrics.2024.3701","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.3701","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"9 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142436169","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":"The Child Opportunity Index and Other Social Determinants of Health Neighborhood Indexes: Important Considerations for Choosing the Correct Index.","authors":"Emily M Bucholz,Amanda D McCormick,Christina Ronai","doi":"10.1001/jamapediatrics.2024.3146","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.3146","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142436164","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":"Portal Confidentiality Concerns and Health Information Sharing and Access.","authors":"Marianne Sharko, Stephanie Niño de Rivera, Natalie Benda, Meghan Reading Turchioe, Xiaoyue Ma, Ruth Masterson Creber, Erika L Abramson","doi":"10.1001/jamapediatrics.2024.3688","DOIUrl":"10.1001/jamapediatrics.2024.3688","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380876","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":"Evaluating Pediatric Macrolide Allergy Using Direct Graded Oral Challenges.","authors":"Carly Sillcox, Sofianne Gabrielli, Andrew O'Keefe, Christine McCusker, Elissa M Abrams, Thomas Eiwegger, Adelle Atkinson, Vy Kim, Ana-Maria Copaescu, Moshe Ben-Shoshan","doi":"10.1001/jamapediatrics.2024.3685","DOIUrl":"10.1001/jamapediatrics.2024.3685","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380874","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}