Journal of Pediatrics最新文献

{"title":"Caffeinated Culture and the Price of Power: Rethinking Youth Heart Health in the Age of Energy Drinks.","authors":"Alina Yang","doi":"10.1016/j.jpeds.2025.114551","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114551","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114551"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694683","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":"Methodological Concerns About a Validation Study.","authors":"Pieter Degraeuwe","doi":"10.1016/j.jpeds.2025.114550","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114550","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114550"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694687","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":"Reply to Letter to the Editor.","authors":"Agnes Jermendy, Laszlo Szakacs, Sylke J Steggerda","doi":"10.1016/j.jpeds.2025.114548","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114548","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114548"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694688","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":"Prematurity and Congenial Diaphragmatic Hernia: Revisiting Outcomes in a Contemporary Cohort.","authors":"Petru I Alexe, Ana Sanchez Torres, Ashley H Ebanks, Enrico Danzer, Krisa van Meurs, Matthew T Harting, Carmen Mesas Burgos","doi":"10.1016/j.jpeds.2025.114545","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114545","url":null,"abstract":"<p><strong>Objective: </strong>To describe outcomes in a contemporary cohort of infants born at gestational age (GA) <34 weeks with congenital diaphragmatic hernia (CDH).</p><p><strong>Study design: </strong>Data from the multicenter, multinational CDH Study Group (CDHSG) registry on patients born between 1995 to 2022 were analyzed. Variables including prenatal characteristics and therapy, postnatal management, and outcomes to discharge were evaluated. A t-test was used for continuous variables, and for categorical variables, Fisher exact test.</p><p><strong>Results: </strong>13471 CDH patients were entered into the registry during the study period. 810 (6%) were born at < 34 weeks´ GA. The survival rate for the preterm cohort was 45%, and 43.5% were not repaired. Survival after surgical repair was 79%, mean age at surgery was 11 days of life (DOL), and 65% required patch repair. Extracorporeal life support (ECLS) was used in only 7% of the cases, and 35% survived. 48.9% had an associated anomaly. Oxygen at 30 DOL was required by 76.7%. Very preterm birth (<32 weeks´ GA) occurred in 361 patients (2.8%), with a 39.3% survival rate and a high rate of non-repairs (50.1%). The incidence of birth at <34 weeks´ GA for those undergoing fetal tracheal occlusion (FETO) was 30%.</p><p><strong>Conclusion: </strong>Survival rates for infants born preterm with CDH remain low and the implementation of FETO is likely to increase the rate of prematurity in CDH. The high rate of non-repair is a significant contributor to lower survival and more aggressive use of ECLS and surgical repair may improve survival.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114545"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674837","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":"Prenatal Substance Exposure and Multi-Level Predictors of Child Protection System Reporting.","authors":"Julia Reddy, Carolyn T Halpern, Davida M Schiff, Hendree Jones, Anna Austin, Laura Faherty, Rebecca Rebbe, Anissa Vines, Emily Putnam-Hornstein","doi":"10.1016/j.jpeds.2025.114546","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114546","url":null,"abstract":"<p><strong>Objective: </strong>To describe child protection system (CPS) reports after delivery and examine associations between individual- and hospital-level predictors and CPS reporting in a cohort of infants with prenatal substance exposure.</p><p><strong>Study design: </strong>This state-level, retrospective cohort study used administrative data to analyze births to Black, White, and US-born Hispanic mothers with documented prenatal substance exposure. We used a random intercept mixed-model with individual- and hospital-level predictors to capture any association between birth hospital and CPS reporting. Interaction terms allowed for different effects dependent on characteristics of the delivering parent and the dominant demographics of the hospital setting.</p><p><strong>Results: </strong>Among 260,525 births during 2018 in California, 2.6% had documented substance exposure, with observed racial differences in substance use and type. Nearly 4% of births to Black mothers had documented cannabis exposure compared with roughly 1% among White and Hispanic mothers. The delivery hospital explained 24% of variance in CPS reporting. Hierarchical models revealed race and insurance-type differences in the likelihood a CPS report followed a substance exposed birth. Namely, publicly-insured births in hospitals where majority births were covered by private insurance had nearly twice the probability of being reported compared with those with private insurance.</p><p><strong>Conclusions: </strong>We found variation in CPS reporting of births with diagnosed substance exposure at the hospital level, and interactions between hospital- and individual-level characteristics in their association with the likelihood of CPS reporting. Associations offer insight into potential areas of bias and inconsistency in policy implementation that might be diminished through improved decision-making tools and provider training.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114546"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674840","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":"Language of Caregiver and Pediatric Day-of-Surgery Cancellations.","authors":"Brittany L Willer, Christian Mpody, Savannah Aepli, Sibelle Aurelie Yemele Kitio, Joseph D Tobias, Olubukola O Nafiu, Nathalia Jimenez","doi":"10.1016/j.jpeds.2025.114547","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114547","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationship between language used by a caregiver and day-of-surgery cancellations, and to distinguish whether neighborhood opportunity influences this relationship.</p><p><strong>Study design: </strong>We performed a retrospective study of 173,533 children <18 years of age at a single institution who were scheduled for ambulatory surgery from 2017 through 2022. We estimated the odds of day-of-surgery cancellation by caregiver language, stratifying by neighborhood opportunity. We then determined the relative excess risk due to interaction (RERI) of LOE with neighborhood opportunity.</p><p><strong>Results: </strong>Day-of-surgery cancellation occurred in 3.7% and 5.2% of children with caregivers using English and LOE, respectively (p<0.001). Children from disadvantaged neighborhoods with caregivers using English had 23% lower odds of cancellation than those using LOE for care (OR 0.77, 95%CI 0.71-0.85; p<0.001). Children from advantaged neighborhoods with caregivers using English had 38% lower odds of cancellation than those using LOE for care (OR 0.62, 95%CI 0.52-0.72; P<0.001). The interaction between language and neighborhood advantage was not significant, indicating that neighborhood advantage does not appear to buffer those using LOE from cancellations (RERI: -0.06, 95%CI -0.21-0.08; p=0.40).</p><p><strong>Conclusions: </strong>Children with caregivers using LOE for care experience higher odds of day-of-surgery cancellation than children with caregivers using English, regardless of neighborhood opportunity. Decreasing language barriers is key to equitable surgery access.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114547"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674901","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":"Can We Optimize Retinopathy of Prematurity Screening by Combined Risk Score Analysis?","authors":"Emma Banwell, Daniel York, Sravanthi Vegunta, Carrie Torr, Bradley A Yoder","doi":"10.1016/j.jpeds.2025.114544","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114544","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a composite metric incorporating the DIGIROP-Birth (DRB) and Neonatal Research Network BPD Outcome Estimator (NRN BPD) for predicting severe retinopathy of prematurity requiring treatment (TR-ROP).</p><p><strong>Study design: </strong>This was a retrospective cohort study of 990 infants born prematurely undergoing dilated eye exams between January 2010 and August, 2023. We performed a chart review to assess a primary outcome of TR-ROP, and secondary outcome of stage 2 or greater ROP. DRB and 14-day NRN-BPD scores were quantified for each infant, and optimal thresholds for predicting TR-ROP were analyzed using receiver operator characteristic (ROC) curves. Sensitivity and specificity for TR-ROP were assessed.</p><p><strong>Results: </strong>Of the 990 infants, 364 (36.8%) had stage 2 or greater ROP and 68 (6.9%) had TR-ROP. ROC analysis with (95% CI) showed areas under the curve (AUC) of 0.867 (0.829-0.906) for DRB and 0.845 (0.809-0.881) for NRN-BPD. Optimal cutoff scores were 1.7 for DRB and 40% for NRN-BPD with respective sensitivities of 97% and 96%. Composite screening for babies meeting either cutoff allowed 100% sensitivity for predicting TR-ROP while decreasing number of infants qualifying for screening from 990 to 562 (43% reduction).</p><p><strong>Conclusions: </strong>A composite metric using DigiROP-Birth and NRN BPD Outcome Estimator scores may allow an early, simple approach to predict TR-ROP with 100% sensitivity, yet allow significant reduction in the number of infants requiring screening eye exams. Additional large validation studies are needed.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114544"},"PeriodicalIF":3.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671840","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":"Evaluation of an Influenza Vaccination Program in the Pediatric Emergency Department.","authors":"Amethyst Alayari, Sonja I Ziniel, Ethan Hawkins, Joan Mackenzie, Suchitra Rao","doi":"10.1016/j.jpeds.2025.114541","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114541","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate influenza vaccine administration rate among eligible patients in pediatric emergency departments (ED) following the introduction of a standardized vaccination program.</p><p><strong>Study design: </strong>We conducted a retrospective study of children ≥6 months of age evaluated in a tertiary care pediatric emergency department (ED) and three affiliated ED sites. Our pre-intervention 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.</p><p><strong>Results: </strong>There were 51,581 and 144,811 children in the pre-intervention 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 pre-intervention period to 1,892, 2,141, and 755 in the intervention seasons (p < 0.001). During the intervention period, children who received influenza vaccines compared with those who did not were more likely to be older (median 8.5 yrs vs 5.8 yrs), 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%), p < 0.001 for all.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"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":"Effect of Intermittent Hypoxemia and Hyperoxemia during the Neonatal Period on Control of Breathing Function among Infants Born Extremely Preterm.","authors":"Nelson Claure, Jose Tolosa, Deepak Jain, Alini Schott, Ana Cecilia Aguilar, Alaleh Dormishian, Eduardo Bancalari","doi":"10.1016/j.jpeds.2025.114542","DOIUrl":"10.1016/j.jpeds.2025.114542","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between intermittent hypoxemia (IH) and hyperoxemia (HOX) during the first 28 days with peripheral and central chemoreception at 36 weeks postmenstrual age among infants born extremely preterm.</p><p><strong>Study design: </strong>For this observational study 52 infants born at 23 to 28 weeks of gestational age were enrolled. Mean daily IH frequency (SpO₂<80% for ≥10s) and percent of time in HOX (SpO₂≥98% while FiO₂>.21) were calculated for the first 28 days of life. At 36 weeks postmenstrual age (PMA), 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.</p><p><strong>Results: </strong>Multivariable generalized linear models showed increasing IH and HOX were independently associated with an attenuated ventilatory response to 100% O₂ at 36 weeks PMA. IH and HOX were not significantly associated with an attenuated ventilatory response to CO₂.</p><p><strong>Conclusions: </strong>In these infants born extremely preterm, neonatal intermittent hypoxemia and hyperoxemia 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 intermittent hypoxemia or hyperoxemia were not associated with reduced central chemoreception.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"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}