Journal of Pediatrics最新文献

{"title":"Evaluation of an Influenza Vaccination Program in the Pediatric Emergency Department","authors":"Amethyst Alayari MD ,&nbsp;Sonja I. Ziniel PhD, MA ,&nbsp;Ethan Hawkins MA ,&nbsp;Joan Mackenzie MS, APRN, CPNP-PC, CPEN ,&nbsp;Suchitra Rao MBBS, MSCS","doi":"10.1016/j.jpeds.2025.114541","DOIUrl":"10.1016/j.jpeds.2025.114541","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate influenza vaccine administration rate among eligible patients in pediatric emergency departments (EDs) following the introduction of a standardized vaccination program.</div></div><div><h3>Study design</h3><div>We conducted a retrospective study of children ≥6 months of age evaluated in a tertiary care pediatric ED and 3 affiliated ED sites. Our preintervention period was September 2019 through April 2020, and intervention period was September 2020 through April 2023. Our intervention comprised nursing education, standing orders, and a best practice advisory in the electronic health record. Our primary outcome was administration of influenza vaccine in the ED.</div></div><div><h3>Results</h3><div>There were 51 581 and 144 811 children in the preintervention and intervention periods with 64 705 and 172 021 ED encounters, respectively. The intervention increased the odds of vaccination by 15.22 (95% CI: 12.39-18.70), from 272 influenza vaccines in the preintervention period to 1892, 2141, and 755 in the intervention seasons (<em>P</em> &lt; .001). During the intervention period, children who received influenza vaccines compared with those who did not were more likely to be older (median 8.5 years vs 5.8 years), of Black race (8.4% vs 7.2%) or multiple/other race (26.0% vs 19.8%), Hispanic ethnicity (46.0% vs 34.7%), with public insurance (64.3% vs 56.0%), and of lower acuity triage level 4 or 5 (64.2% vs 56.8%), <em>P</em> &lt; .001 for all.</div></div><div><h3>Conclusions</h3><div>Implementation of a standardized influenza vaccination program in the ED can increase vaccination rates, particularly among minority and government-insured children. These interventions can address vaccine disparities and are easily sustainable with potential to reduce the public health burden of influenza.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"282 ","pages":"Article 114541"},"PeriodicalIF":3.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patent Ductus Arteriosus, Hydrocortisone, and Outcome among Infants Born Extremely Preterm: Secondary Analysis of the Hydrocortisone Trial","authors":"Meera N. Sankar MD ,&nbsp;Valerie Chock MD, MSEpi ,&nbsp;Faith Myers MD ,&nbsp;Alexis S. Davis MD, MSEpi ,&nbsp;Scott McDonald BS ,&nbsp;Matthew A. Rysavy MD, PhD ,&nbsp;Matthew Laughon MD, MPH ,&nbsp;Shazia Bhombal MD ,&nbsp;Krisa P. Van Meurs MD ,&nbsp;Abhik Das PhD ,&nbsp;William E. Benitz MD ,&nbsp;Kristi Watterberg MD","doi":"10.1016/j.jpeds.2025.114535","DOIUrl":"10.1016/j.jpeds.2025.114535","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether hydrocortisone (HC) modified the relationship of patent ductus arteriosus (PDA) to outcomes among infants born extremely preterm and enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NRN) HC trial.</div></div><div><h3>Study design</h3><div>This was a <em>posthoc</em> secondary analysis of infants born &lt;30 weeks’ gestation and enrolled in the NRN HC Trial. The primary outcome was moderate to severe bronchopulmonary dysplasia (BPD) or death. Secondary outcomes included moderate to severe BPD, death, necrotizing enterocolitis, late-onset sepsis, days of mechanical ventilation, oxygen supplementation, Z-scores for growth, home oxygen, BPD severity, neurodevelopmental impairment, and moderate to severe cerebral palsy. Analyses for interaction between PDA (defined as treatment to achieve PDA closure) and HC were performed for the primary and secondary outcomes.</div></div><div><h3>Results</h3><div>Of 800 infants enrolled in the NRN HC trial, PDA was treated in 198 HC treated and 197 placebo-treated infants. HC did not modify the relationship of PDA with BPD or death (<em>P</em> = .93). Regardless of HC treatment, PDA was associated with a significant increase in duration of ventilatory support, oxygen supplementation at 36 weeks postmenstrual age (PMA), BPD severity, decreased weight-for-age Z-score at 36 weeks PMA, moderate to severe BPD, or death at 36 weeks PMA and home oxygen support.</div></div><div><h3>Conclusions</h3><div>HC after the second postnatal week did not alter the relationship between PDA and BPD or death among infants born extremely preterm. PDA was associated with several adverse outcomes regardless of HC treatment.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114535"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Platelet Count and Bleeding during Central Line Placement in Critically Ill Children","authors":"Alexandra T. Lucas MD ,&nbsp;Walter Dzik MD","doi":"10.1016/j.jpeds.2025.114539","DOIUrl":"10.1016/j.jpeds.2025.114539","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between platelet count and procedure-related bleeding at the time of central venous line (CVL) placement in critically ill children.</div></div><div><h3>Study design</h3><div>A retrospective cohort study was performed capturing patient admissions to the pediatric intensive care unit between January 1, 2012 to March 1, 2022. Critically ill children between 0 months and 19 years who underwent bedside CVL placement were included. A total of 363 were included in the final analysis.</div></div><div><h3>Results</h3><div>Patients’ platelet counts prior to line placement ranged from 11 000/uL to 735 000/uL. Bleeding was identified in 26 of 363 (7.2%) of patients, and was categorized as 24 (92%) minimal, 2 (8%) moderate, and none severe. Platelet count and platelet transfusion before line placement were both significantly different between bleeding and non-bleeding patients (<em>P</em> = .04 and <em>P</em> = .032). Patients with lower platelet counts had a higher proportion of bleeding events. There were no significant differences between the bleeding and non-bleeding groups in age, sex, history of bleeding, or number of attempts at CVL. Patients with bleeding were not significantly sicker. Regression analysis determined that female sex and transfusion before CVL placement were both significantly associated with bleeding.</div></div><div><h3>Conclusions</h3><div>We found that the platelet count prior to CVL placement was not associated with bleeding events in critically ill pediatric patients. Bleeding was more common in patients receiving platelet transfusions. Additional studies are needed to evaluate further the effect of platelet transfusions on procedure-related bleeding.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114539"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intermittent Hypoxemia and Hyperoxemia during the Neonatal Period on Control of Breathing Function among Infants Born Extremely Preterm","authors":"Nelson Claure MSc, PhD ,&nbsp;Jose Tolosa MD ,&nbsp;Deepak Jain MD ,&nbsp;Alini Schott RN ,&nbsp;Ana Cecilia Aguilar RRT, RN ,&nbsp;Alaleh Dormishian PhD ,&nbsp;Eduardo Bancalari MD","doi":"10.1016/j.jpeds.2025.114542","DOIUrl":"10.1016/j.jpeds.2025.114542","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between intermittent hypoxemia (IH) and hyperoxemia (HOX) during the first 28 days with peripheral and central chemoreception at 36 weeks of postmenstrual age among infants born extremely preterm.</div></div><div><h3>Study design</h3><div>For this observational study, 52 infants born at 23-28 weeks of gestational age were enrolled. Mean daily IH frequency (arterial oxygen saturation &lt;80% for ≥10 seconds) and percent of time in HOX (arterial oxygen saturation ≥98% while the fraction of inspired oxygen was &gt;0.21) were calculated for the first 28 days of life. At 36 weeks of postmenstrual age, respiratory control tests assessed peripheral chemoreception by ventilatory response to 100% O₂ for 30 seconds in which decreased ventilation caused by inhibition of peripheral chemoreceptors reflects their contribution to respiratory drive. Central chemoreception was evaluated by ventilatory response to 4% inspired CO₂ for 10 minutes.</div></div><div><h3>Results</h3><div>Multivariable generalized linear models showed increasing IH and HOX were independently associated with an attenuated ventilatory response to 100% O₂ at 36 weeks of postmenstrual age. IH and HOX were not significantly associated with an attenuated ventilatory response to CO₂.</div></div><div><h3>Conclusions</h3><div>In these infants born extremely preterm, neonatal IH and HOX were independently associated with attenuated peripheral chemoreception at near-term corrected age. This may reflect reduced peripheral chemoreceptor oxygen sensitivity and may be in part responsible for persistence of respiratory instability in infants born preterm. Neonatal IH or HOX were not associated with reduced central chemoreception.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114542"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Enteral Feed Type with Neurodevelopmental and Neonatal Outcomes among Infants Born Preterm","authors":"Nicole Bando PhD ,&nbsp;Eugene W. Yoon MSc ,&nbsp;Marc Beltempo MD, MSc ,&nbsp;Cecilia de Cabo MD ,&nbsp;Lindsay Colby RN, BScN, MSN ,&nbsp;Wissam Alburaki MD, MSc ,&nbsp;Thevanisha Pillay MD ,&nbsp;Prakesh S. Shah MD, MSc ,&nbsp;Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators","doi":"10.1016/j.jpeds.2025.114536","DOIUrl":"10.1016/j.jpeds.2025.114536","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations between enteral feed type with neurodevelopmental and neonatal outcomes among infants born preterm.</div></div><div><h3>Study design</h3><div>This was a retrospective study of enteral feeds in the first 28 postnatal days in infants born &lt;29 weeks of gestation from 2015 through 2020 in neonatal units of the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network. Feeds were examined as a compositional variable comprised of the proportion of days fed mother's milk, donor milk, mixed feeds, and nil per os (NPO), the proportions of which sum to 1. Associations between enteral feed type with neurodevelopmental outcomes at 18 to 24 months of corrected age and neonatal morbidities were examined.</div></div><div><h3>Results</h3><div>Our cohort included 2104 infants with a mean (SD) gestational age of 26.2 (1.5) weeks (52.9% male). Compositional data analysis revealed a 1-day reallocation from mother's milk to donor milk was associated with greater odds of cognitive (aOR 1.028, 95% CI 1.001-1.056) and language impairment (aOR 1.024, 95% CI 1.002-1.047). Replacing 1 day of mixed feeds, donor milk or NPO with mother's milk was associated with improved cognitive, language and motor development. A 1-day reallocation of NPO to either mother's milk, mixed feeds or donor milk decreased odds of significant neurodevelopmental impairment, cerebral palsy and/or necrotizing enterocolitis.</div></div><div><h3>Conclusions</h3><div>Donor milk in place of mother's milk was associated with poorer cognitive and language development. Providing any human milk reduced neurodevelopmental impairment and necrotizing enterocolitis with reallocations involving mother's milk yielding the most benefit. Promoting early enteral nutrition with mother's milk should be a priority in the care of infants born preterm.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114536"},"PeriodicalIF":3.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine Testing in Children with Viral Symptoms: A Nationwide Analysis of Ambulatory Visits, 2014-2019","authors":"Rachel L. Wattier MD, MHS ,&nbsp;Daniel J. Shapiro MD, MPH ,&nbsp;Hillary L. Copp MD, MS ,&nbsp;Sunitha V. Kaiser MD, MSc ,&nbsp;Adam L. Hersh MD, PhD","doi":"10.1016/j.jpeds.2025.114538","DOIUrl":"10.1016/j.jpeds.2025.114538","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the extent of and factors associated with urine testing in US pediatric ambulatory visits for symptoms commonly associated with viral illness.</div></div><div><h3>Study design</h3><div>We analyzed a nationally representative, cross-sectional sample of ambulatory clinic and emergency department (ED) visits among children 2 months to 17 years old (2014 through 2019 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey). Using reason for visit classification codes, we identified visits for respiratory symptoms, diarrhea, or rash; termed “viral symptoms” without reported localizing genitourinary symptoms. We assessed the proportion of these visits with urine testing (urinalysis and/or urine culture) and evaluated factors associated with urine testing using logistic regression.</div></div><div><h3>Results</h3><div>Of 71.3 million (95% CI 64.7-78.0 million) pediatric ambulatory visits per year, 61% (95% CI 59%-63%) were for viral symptoms without reported genitourinary symptoms. Urine testing at these visits accounted for 38% (95% CI 30%-47%) of overall urine testing. Such testing occurred more frequently at ED visits (8.3%; 95% CI 7.4%-9.3%) compared with clinic visits (4.4%; 95% CI 2.5%-7.7%). At ED visits, the adjusted probability of urine testing in the context of viral symptoms was lowest for males age 2 months to &lt;2 years (5%; 95% CI 3%-6%) and highest for females age 12 through 17 years (20%; 95% CI 16%-24%), and females age 6-11 years (13%; 95% CI 11%-16%).</div></div><div><h3>Conclusions</h3><div>Urine testing in children with symptoms of viral or other non-urinary tract infection illnesses occurs frequently at ambulatory visits. This potentially avoidable testing disproportionately occurred in older age groups that have lower risk of urinary tract infection.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114538"},"PeriodicalIF":3.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Disparities in Diagnosis and Treatment of Heterozygous Familial Hypercholesterolemia","authors":"Rachel J. Shustak MD, MSCE ,&nbsp;Abigail Perlstein BA ,&nbsp;Amanda S. Artis MS, MPH ,&nbsp;Alexis Z. Tomlinson PhD ,&nbsp;Vicky Tam MA ,&nbsp;Giordana Martino MSN, CRNP ,&nbsp;Julie A. Brothers MD","doi":"10.1016/j.jpeds.2025.114537","DOIUrl":"10.1016/j.jpeds.2025.114537","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association of social determinants of health and age at heterozygous familial hypercholesterolemia (HeFH) diagnosis and treatment.</div></div><div><h3>Study design</h3><div>We performed a retrospective, single-center study of children with HeFH. Multivariable linear regression models were used to examine the association between Child Opportunity Index (COI) and age at HeFH diagnosis and statin initiation. Additional covariates included sex, race, ethnicity, health insurance type, primary language, body mass index percentile, and low-density lipoprotein cholesterol (LDL-C). To explore potential referral bias, we compared the COI of the study cohort with that of the institution's catchment area.</div></div><div><h3>Results</h3><div>We evaluated 577 patients. The median age at presentation was 12 (9, 14) years and the median LDL-C was 199 (169, 235) mg/dL; 58% were prescribed a statin at a median age of 13 (10, 15) years. There was no association between COI and the age at HeFH diagnosis or statin initiation. On multivariable analysis, Black race was associated with older age at HeFH diagnosis but not statin initiation compared with White race (adjusted estimate 1.1 ± 0.50 yrs, <em>P</em> = .023). Higher LDL-C, male sex, and lower body mass index percentile were associated with younger age at HeFH diagnosis and statin initiation. The COI of the study cohort was significantly higher than that of the catchment area (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Black race was associated with older age at HeFH diagnosis; however, there were no differences in age at statin initiation. The COI of the cohort was significantly higher than that of the catchment area indicating that low COI populations are likely under-referred for HeFH evaluation.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114537"},"PeriodicalIF":3.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Neurobehavior Predicts Neonatal Opioid Withdrawal Syndrome Severity Prior to Treatment Interventions","authors":"Sarah E. Maylott PhD ,&nbsp;Madeleine Bruce PhD ,&nbsp;Lydia Brown BS ,&nbsp;Ayla J. Castano BS ,&nbsp;Lynne Dansereau MSPH ,&nbsp;Barry Lester PhD ,&nbsp;Elisabeth Conradt PhD","doi":"10.1016/j.jpeds.2025.114533","DOIUrl":"10.1016/j.jpeds.2025.114533","url":null,"abstract":"<div><h3>Objective</h3><div>To utilize the NeoNatal Neurobehavioral Scale (NNNS-II) as a standardized and reliable tool to help guide treatment of neonatal opioid withdrawal syndrome (NOWS) with the goal of improving the consistency and quality of care provided to opioid-exposed newborns.</div></div><div><h3>Study design</h3><div>We examined NOWS severity through several indicators, including the number of pharmacological treatment medications, maximum dose of medications, length of treatment, and maximum score on NOWS observational tools to create an overall severity score for each newborn. Then we examined whether NOWS risk could be detected as early as 24 hours after birth using the NNNS-II to predict NOWS severity.</div></div><div><h3>Results</h3><div>Newborn neurobehavior prior to signs of NOWS predicted NOWS severity. Newborns who were more hypertonic and had poorer quality of movement had higher severity scores.</div></div><div><h3>Conclusion</h3><div>These findings indicate that NOWS risk detection may be enhanced with an early newborn neurobehavioral assessment.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114533"},"PeriodicalIF":3.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0022-3476(25)00059-9","DOIUrl":"10.1016/S0022-3476(25)00059-9","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114519"},"PeriodicalIF":3.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobehavioral Profiles in Opioid-Exposed and Unexposed Neonates","authors":"Stephanie L. Merhar MD, MS ,&nbsp;Kimberly Yolton PhD ,&nbsp;Sara B. DeMauro MD, MSCE ,&nbsp;Traci Beiersdorfer RN, BSN ,&nbsp;Jamie E. Newman PhD ,&nbsp;Scott A. Lorch MD, MSCE ,&nbsp;Deanne Wilson-Costello MD ,&nbsp;Namasivayam Ambalavanan MD ,&nbsp;Ananta Bangdiwala MS ,&nbsp;Myriam Peralta-Carcelen MD ,&nbsp;Brenda B. Poindexter MD ,&nbsp;Jonathan M. Davis MD ,&nbsp;Catherine Limperopoulos PhD ,&nbsp;Carla M. Bann PhD","doi":"10.1016/j.jpeds.2025.114527","DOIUrl":"10.1016/j.jpeds.2025.114527","url":null,"abstract":"<div><h3>Objective</h3><div>To describe distinctive profiles of neurobehavior in opioid-exposed and unexposed neonates.</div></div><div><h3>Study design</h3><div>The Outcomes of Babies with Opioid Exposure study is a multisite, prospective, observational study in neonates born at term with opioid exposure and unexposed controls. As part of the Outcomes of Babies with Opioid Exposure study protocol, certified examiners administered the NeoNatal Neurobehavioral Scales, second edition (NNNS-II) before 6 weeks postnatal age. We used latent profile analysis to determine distinctive classes of neurobehavior and linear mixed effect models to compare NNNS-II scores by exposure status.</div></div><div><h3>Results</h3><div>The study included 291 neonates with NNNS-II, 194 exposed and 97 unexposed. Latent profile analysis resulted in 4 unique classes. Class 4 showed the most signs of stress and included almost exclusively exposed neonates. Scores for exposed neonates were significantly different than unexposed neonates on most NNNS-II subscales. In addition to opioids, associations were found between profile membership and prenatal exposure to benzodiazepines, e-cigarettes/tobacco, and selective serotonin reuptake inhibitors.</div></div><div><h3>Conclusions</h3><div>Neonates with prenatal exposure to opioids and other psychotropic substances have distinctive patterns of neurobehavior. Additional follow-up is needed to determine if these neurobehavioral differences serve as a marker for future problems with attention and behavior.</div></div><div><h3>Clinical Trials.gov Registration</h3><div><span><span>NCT04149509</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114527"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}