Pediatrics open science最新文献

{"title":"Co-occurring Conditions and Education Services Among Transition-Age Adolescents With Autism.","authors":"Lauren A Russell, Susan Williams, Kelly A Shaw, Monica Dirienzo, Elise T Pas, Amanda V Bakian, Ellen M Howerton, Deborah A Bilder, Amy Esler, Libby Hallas, Christine M Ladd-Acosta, Matthew J Maenner, Sarah C Tinker, Robert T Fitzgerald, Alonzo J Olivarez, Amelia Solis, Leann DaWalt, Maureen S Durkin, Maya Lopez, Jennifer Hall-Lande, Walter Zahorodny, Yi-Chen Wu, Josephine Shenouda, Yvette D Schwenk, Dedria McArthur, Anita Washington, Allison E Hudson, Luisa Gomez Bustamante, Madison Mitamura, Carolyn Skowyra, Mary E Patrick","doi":"10.1542/pedsos.2026-001469","DOIUrl":"10.1542/pedsos.2026-001469","url":null,"abstract":"<p><strong>Objectives: </strong>This study describes sociodemographic characteristics, co-occurring mental and behavioral health conditions, services provided in individualized education programs (IEPs), and transition planning goals for adolescents with autism spectrum disorder (ASD) in a population-based sample.</p><p><strong>Methods: </strong>The study included 4311 adolescents aged 16 years in 2022 from the Autism and Developmental Disabilities Monitoring Network. All lived within defined catchment areas in 9 states and had an ASD diagnostic code or special education exceptionality. Health and education records from when the adolescents were aged 12 to 16 years were reviewed.</p><p><strong>Results: </strong>Adolescents with ASD had high prevalence of language delay (51.6%), attention-deficit hyperactivity disorder (51.1%), and anxiety (42.7%). Few adolescents had an IQ or adaptive test in their records (25.5% and 19.1%, respectively). Most adolescents with an IEP had a transition plan in their records (94.8%), and most had the federally-required postsecondary education (95.7%) and employment goals (95.5%), whereas fewer had the optional postsecondary living goal (43.3%). The prevalence of many elements on the IEP and transition plans varied widely by site. The prevalence of some co-occurring mental and behavioral health conditions and use of school services differed by median household income.</p><p><strong>Conclusions: </strong>Adolescents with ASD have high prevalence of co-occurring mental and behavioral conditions, with limited information on recent IQ and adaptive testing, potentially impacting service needs and receipt. The variability in the prevalence of IEP elements and service provision across different sites highlights the complexities in addressing the diverse transition needs and health outcomes for adolescents with ASD.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palpation vs Ultrasonography Assessments of Infant Breast Buds: Considerations for Minipuberty Studies.","authors":"Paige E Tomer, Andrea Kelly, Virginia A Stallings, Kassa Darge, Eileen G Ford, Walter J Rogan, David M Umbach, Mandy Goldberg","doi":"10.1542/pedsos.2026-001705","DOIUrl":"https://doi.org/10.1542/pedsos.2026-001705","url":null,"abstract":"","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injuries in Children Undergoing Subspecialty Abuse Evaluations Because of Intimate Partner Violence.","authors":"M Katherine Henry, Gunjan Tiyyagura, Joanne N Wood, Jan Leonard, Kristine A Campbell, Daniel M Lindberg, Angela N Bachim, Farah W Brink, Lori D Frasier, Nancy S Harper, Claire Hickey, Natalie Laub, John D Melville, Hannah Sahud, Philip V Scribano","doi":"10.1542/pedsos.2025-001301","DOIUrl":"10.1542/pedsos.2025-001301","url":null,"abstract":"<p><strong>Background and objectives: </strong>Intimate partner violence (IPV) and child physical abuse often co-occur, but the frequency and risk factors for abusive injuries in IPV-exposed children remain unknown. Our objectives were to (1) determine frequency of skeletal surveys (SSs) and neuroimaging use because of IPV and their diagnostic value in children aged less than 24 months evaluated by a child abuse pediatrics specialist (CAP) and (2) identify factors associated with performance of and findings on SS and neuroimaging.</p><p><strong>Methods: </strong>We conducted a retrospective study of children aged less than 24 months undergoing CAP consultations because of IPV exposure from February 2021 to February 2024 in a multicenter child abuse research network. We analyzed use of SS and neuroimaging and associations between imaging use and sociodemographic factors and associations between imaging positivity and clinical factors (age, injury-related chief complaint, presenting trauma history, injury on physical examination).</p><p><strong>Results: </strong>Among 326 children, 305 (93.6%) underwent SSs, with 29 (9.5%) positive for a new fracture. Among 267 children without signs/symptoms of head trauma, 110 (41.2%) had neuroimaging, with 7 (6.4%) positive for intracranial injury. There was no disproportionality in SS use, but race/ethnicity and insurance type were associated with the use of neuroimaging. The presence of an injury on physical examination finding was associated with newly identified fractures (15.7% vs 6.4%; <i>P</i> = .009).</p><p><strong>Conclusions: </strong>Current evidence supports use of SSs in children aged less than 24 months undergoing medical evaluations after exposure to IPV. Further research is needed to assess risk factors for positive findings on SSs and neuroimaging with larger sample sizes.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Cervical Spine Injury Imaging Decision-Making in Pediatric Trauma Patients.","authors":"Fahd A Ahmad, Sara Malone, Ana Baumann, Megan E Gregory, Jack Stevens, Christopher R Carpenter, Annie J Truelove, Julie C Leonard","doi":"10.1542/pedsos.2025-000850","DOIUrl":"10.1542/pedsos.2025-000850","url":null,"abstract":"<p><strong>Objectives: </strong>The Pediatric Emergency Care Applied Research Network (PECARN) cervical spine injury (CSI) clinical prediction rule (CPR) was developed to reduce unnecessary imaging in pediatric trauma patients while ensuring accurate diagnosis. This study aimed to identify barriers and facilitators to future implementation of this rule in diverse emergency department settings.</p><p><strong>Methods: </strong>We conducted 40 interviews with 48 clinicians, including emergency department physicians, surgeons, nurses, and advanced practice providers at 21 healthcare facilities across the United States. Semi-structured interviews explored determinants impacting implementation, guided by the Tailored Implementation for Chronic Diseases (TICD) framework. We conducted a deductive thematic analysis using the TICD domains as a priori codes. Three researchers independently coded the transcripts and identified key themes aligned with the TICD framework.</p><p><strong>Results: </strong>Barriers included limited guideline accessibility, workflow disruptions, and inconsistent integration with electronic health records. Clinicians' concerns regarding the applicability and adherence to guidelines were also significant. Facilitators identified included institutional support, stakeholder engagement, and targeted education that addressed knowledge gaps. Implementation strategies varied by context, with suggestions for electronic health record-based decision tools in resource-equipped facilities and external aids, such as pocket cards, in lower-resource settings. Addressing legal concerns, clinician resistance, and workflow alignment emerged as critical priorities.</p><p><strong>Conclusion: </strong>Implementing the PECARN CSI clinical prediction rule requires addressing contextual barriers such as workflow challenges, clinician adherence, and technology integration. Context-sensitive strategies are essential for successful adoption and improved decision-making in pediatric trauma care. Future research should evaluate the impact of these strategies on clinician behavior and patient outcomes.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent Social Networks and School Engagement Across the High School Transition.","authors":"Jacquelin Rankine, Alison Culyba, Robert W S Coulter, Elizabeth Miller, Galen Switzer, Erin Yoshida-Ehrmann, Guadalupe Arellano, Rebecca Dudovitz","doi":"10.1542/pedsos.2025-000875","DOIUrl":"10.1542/pedsos.2025-000875","url":null,"abstract":"<p><strong>Objectives: </strong>School engagement predicts high school graduation and improved health in adolescence and beyond. We examine associations between school engagement and social network characteristics during the transition to high school.</p><p><strong>Methods: </strong>We secondarily analyzed data from a trial of a college readiness program across five high schools in Southern California. Participants completed baseline (end of 8^th/beginning of 9^th grade) and follow-up (end of 9^th grade) surveys. Surveys assessed participants' social network composition (relationship type, supportiveness, peer behaviors) and structure (network size, betweenness centrality, density) and school engagement. Linear mixed-effects models examined associations of baseline network characteristics with concurrent (baseline) and future (follow-up) school engagement.</p><p><strong>Results: </strong>Participants (n=431) were predominantly Latino (82.8%). In-network teachers were inversely associated with concurrent school engagement (β=-1.16, <i>p</i>=0.02) but positively associated with future school engagement (β=1.12, <i>p</i>=0.02). In-network sources of support were positively associated with concurrent (β=0.21, <i>p</i>=0.02) and future (β=0.29, <i>p</i>=0.001) school engagement. In-network peer behaviors including thinking it is important to do well in school (β=0.54, <i>p</i>=0.03) and attend class (β=0.47, <i>p</i>=0.03), not getting in trouble at school (β=-0.56, <i>p</i><0.001), and being highly school engaged (β=0.24, <i>p</i>=0.01) were associated with concurrent school engagement. Greater peer network density was associated with lower concurrent school engagement (β=-0.37, <i>p</i>=0.02).</p><p><strong>Conclusions: </strong>Building connections to supportive peers and adults may enhance adolescents' school engagement. Like other adolescent health behaviors, school engagement may be influenced by the behaviors of peers in adolescents' social circles. Interventions that target multiple social network-mediated behaviors may be particularly beneficial to adolescent health and education.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy RCT of 3 Intensive Infant/Toddler Therapies for Unilateral Cerebral Palsy.","authors":"Stephanie C DeLuca, Sharon Landesman Ramey, Amy R Darragh, Mark Conaway, Jill C Heathcock, Warren Lo, Andrew M Gordon, Mary Rebekah Trucks, Dory Wallace, Thais Invencao Cabral","doi":"10.1542/pedsos.2025-000676","DOIUrl":"https://doi.org/10.1542/pedsos.2025-000676","url":null,"abstract":"<p><strong>Objectives: </strong>Unilateral cerebral palsy (UCP) can result in lifelong upper extremity (UE) neuromotor impairment. While both constraint-induced movement therapy (CIMT) and bimanual training have demonstrated efficacy for children with UCP, there was limited evidence to inform treatment decision-making in children aged between 6 and 24 months. Thus, we performed a comparative efficacy trial testing 3 high-dose therapist-delivered interventions, 2 CIMT interventions varied by constraint type to bimanual/no-constraint intervention for use in treating this age group of children with UCP.</p><p><strong>Patients and methods: </strong>Fifty-eight infants/toddlers with UCP diagnosis, aged 6 to 24 months, were enrolled and randomized. Exclusion criteria were uncontrolled seizures, fragile health, prior CIMT/bimanual therapy, and recent botulinum toxin. Participants were randomly assigned (1:1:1) to 1 of 3 treatments all delivered 3 hours/d and 5 days/wk for 4 weeks: CIMT/full-time cast, CIMT/part-time splint, or bimanual/no constraint. Anonymized assessments at baseline, end of treatment (EoT), and 6 months posttreatment included the Mini-Assisting Hand Assessment (AHA) for bimanual abilities and the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) Fine-Motor (FM) subscale on each UE for FM abilities.</p><p><strong>Results: </strong>Fifty-three infant/toddlers completed treatment and EoT assessment (mean age, 17.2 months), and 41 completed 6-month assessment. All groups had gains from intervention: Mini-AHA scores (<i>P</i> < .003) and Bayley-III FM/paretic side (<i>P</i> < .002). Bayley-III FM/nonparetic side also improved across groups (<i>P</i> < .001). The CIMT/full-time cast showed larger gains on Bayley-III FM/nonparetic side when compared with bimanual/no constraint (difference, 5.9; 95% CI, 1.2-10.5; <i>P</i> = .015).</p><p><strong>Conclusion: </strong>The trial confirms comparable benefits from therapist-delivered CIMT and bimanual/no-constraint interventions for infants/toddlers with UCP aged between 6 and 24 months.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium Supplementation Algorithm to Promote Growth in Infants Who Are Preterm: Randomized Clinical Trial.","authors":"Brianna M Liberio, Gregory M Sokol, Hannah Rakow, Kelly Mosesso, Valerie Hole, William W Wong, Shaji K Chacko, Jeffrey L Segar","doi":"10.1542/pedsos.2025-001089","DOIUrl":"10.1542/pedsos.2025-001089","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effectiveness of an algorithm using urine sodium (Na) concentration to guide dietary Na supplementation compared with standard care to promote growth in infants who are preterm.</p><p><strong>Methods: </strong>A randomized trial was conducted in 4 neonatal units in Indianapolis, Indiana, involving infants between 25^0/7 to 29^6/7 weeks gestation with birthweight > 500 g. Study arms consisted of standard care or use of algorithm beginning at 14 to 17 days postnatal age. The primary outcomes were somatic growth (weight, length, and head circumference) measured by change in Z-score between aged 2 weeks and 36 weeks postmenstrual age (PMA). Secondary outcomes included total body water and body composition.</p><p><strong>Results: </strong>Of 260 eligible infants, 90 were consented and randomized, with 45 allocated to each arm and 43 in each arm completing the study. Thirty-eight (88%) infants randomized to the study algorithm had a low urine Na that qualified for Na supplementation (4 mEq/kg/d). Infants assigned the algorithm received more Na (5.75 ± 0.96 mEq/kg/d) than infants assigned the standard care (3.62 ± 1.25 mEq/kg/d); caloric intake did not differ. Change in weight Z-score from study entry until 36 weeks PMA was not statistically different between groups (0.16 ± 0.41 vs 0.04 ± 0.63, algorithm vs control; <i>P</i> = .16). Infants assigned the algorithm displayed a significantly more rapid increase in weight between weeks 0 to 7 of the study than infants assigned the standard care. Total body water and fat-free mass did not differ at 32 weeks PMA.</p><p><strong>Conclusion: </strong>Na supplementation guided by urine Na concentration did not significantly improve weight gain in infants 25^0/7 to 29^6/7 weeks gestation at 36 weeks PMA.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Media, Genetics, and Risk for ADHD Symptoms in Children: A Longitudinal Study.","authors":"Samson Nivins, Michael A Mooney, Joel Nigg, Torkel Klingberg","doi":"10.1542/pedsos.2025-000922","DOIUrl":"10.1542/pedsos.2025-000922","url":null,"abstract":"<p><strong>Background: </strong>Children spend significant amount of time using digital media (DM), and longer exposure may increase attention-deficit/hyperactivity disorder (ADHD)-related symptoms, although findings are mixed. We investigated longitudinal association between different types of DM use and ADHD-related symptoms in school-aged children, accounting for genetic predisposition and socioeconomic status.</p><p><strong>Methods: </strong>This study included children from the Adolescent Brain and Cognitive Development Study, followed annually for four years. Estimated time spent on social media, video games, and television/videos was self-reported using Youth Screen Time Survey. ADHD-related symptoms were assessed at each visit with the parent-reported Child Behaviour Checklist. Genetic predisposition was estimated using a polygenic risk score for ADHD (PGS-ADHD).</p><p><strong>Results: </strong>The study included 8324 children (53% boys; mean age: 9.9 years). On average, children spent 2.3 hours/day watching television/videos, 1.4 hours/day on social media, and 1.5 hours/day playing video games. Average social media use was associated with increased inattention symptoms over time (β [SE], 0.03 [0.01]; P<0.001), with a cumulative four-year effect of β=0.15 [SE]=0.03; P<0.001). No associations were found between playing video games or watching television/videos and ADHD-related symptoms. The association between social media use and inattention symptoms was not moderated by sex, ADHD diagnosis, PGS-ADHD, or ADHD medication status. Inattention symptoms were not associated with increased social media use over time.</p><p><strong>Conclusion: </strong>Social media use was associated with an increase in inattention symptoms in children over time. Although the observed effect size was small, it could have significant consequences if behavior changes occur at the population level.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Social Media Use and Mental Health in Emerging Adulthood.","authors":"Jeff R Temple, Elizabeth Baumler, Leila Wood","doi":"10.1542/pedsos.2026-001552","DOIUrl":"10.1542/pedsos.2026-001552","url":null,"abstract":"","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidities in Adolescents With Congenital Heart Disease: A Population-based Study.","authors":"Matthew R Reeder, Lorenzo D Botto, George K Lui, Marcia L Feldkamp, M Jill Glidewell, Wendy M Book, Tessa Crume, Jesse M DeLaRosa, Alfred d'Ottavio, Karrie F Downing, Daphne T Hsu, Amber D Khanna, Sergey Krikov, Nelangi Pinto, Cheryl L Raskind-Hood, Fred H Rodriguez, Aida S Soim, Kevin J Whitehead, Karen Chiswell, Jennifer S Li","doi":"10.1542/pedsos.2025-000967","DOIUrl":"10.1542/pedsos.2025-000967","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the frequency and patterns of comorbidity and multimorbidity in adolescents with congenital heart disease (CHD) using data from a multisite population-based surveillance project.</p><p><strong>Methods: </strong>Adolescents aged 11 to 18 years with at least 1 CHD-related diagnosis code and residing in one of 5 geographic areas in the US were identified using linked clinical and administrative data sources for the years 2011 to 2013. Sites linked data on all inpatient, emergency department, and outpatient visits. Multivariate Poisson regression with robust error estimates was used to assess the association of comorbidity with age, sex, insurance type, race, ethnicity, and CHD severity.</p><p><strong>Results: </strong>The study included 9626 adolescents. Of these, 26% had severe CHDs. Overall, 68% had at least one comorbidity during the study period, and 46% had multiple comorbidities. Noncardiac comorbidities (55%) were more frequent than cardiac comorbidities (40%). Major noncardiac comorbidities included mental health conditions, neurodevelopmental disorders, pulmonary obstructive disease, nutrition-related (overweight, obesity) conditions, and endocrine conditions. Cardiac comorbidities included arrhythmias and residual cardiac disease. Variations by age and sex were minimal, but a higher burden of comorbidity and multimorbidity was associated with CHD severity, multiracial background, and public insurance.</p><p><strong>Conclusions: </strong>Comorbidities, both cardiac and noncardiac, are prevalent in adolescents with CHD, underscoring the need for targeted care strategies in this age group and effective transition programs from pediatric to adult CHD care.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 4","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13606679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}