Journal of Pediatrics最新文献

{"title":"The Relationship Between Hispanic Ethnicity and Outcomes for Infants Born Extremely Preterm","authors":"Jane E. Brumbaugh MD ,&nbsp;Carla M. Bann PhD ,&nbsp;Edward F. Bell MD ,&nbsp;Colm P. Travers MD ,&nbsp;Betty R. Vohr MD ,&nbsp;Elisabeth C. McGowan MD ,&nbsp;Heidi M. Harmon MD, MS ,&nbsp;Waldemar A. Carlo MD ,&nbsp;Susan R. Hintz MD, MS Epi ,&nbsp;Andrea F. Duncan MD, MS","doi":"10.1016/j.jpeds.2025.114474","DOIUrl":"10.1016/j.jpeds.2025.114474","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the association between maternal ethnicity and infant survival to discharge without major morbidity.</div></div><div><h3>Study design</h3><div>This is secondary analysis of a prospective cohort of infants born &lt;27 weeks of gestation at National Institute of Child Health and Human Development Neonatal Research Network centers from 2006 through 2020. The primary outcome was survival to discharge without major morbidity (sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia grade 3, intracranial hemorrhage grade ≥3, periventricular leukomalacia, and advanced retinopathy of prematurity). Outcomes were compared by ethnicity and adjusted for center, perinatal characteristics, and sociodemographic characteristics.</div></div><div><h3>Results</h3><div>Of 14 029 subjects, 2155 (15%) were Hispanic, 6116 (44%) non-Hispanic Black, and 5758 (41%) non-Hispanic White. Infants of Hispanic mothers had the lowest survival to discharge without major morbidity (Hispanic 523/2099 [25%], non-Hispanic Black 1701/5940 [29%], non-Hispanic White 1494/5597 [27%], <em>P</em> = .002). Adjusted odds of survival without major morbidity differed between Hispanic and non-Hispanic Black (adjusted odds ratio [aOR] 0.80, 95% CI 0.69-0.93), but not between Hispanic and non-Hispanic White infants (aOR 1.07, 95% CI 0.92-1.25). At 2 years, children of non-Hispanic White mothers had the lowest incidence of neurodevelopmental impairment (Hispanic 544/1235 [44%], non-Hispanic Black 1574/3482 [45%], and non-Hispanic White 1004/3182 [32%], <em>P</em> &lt; .001). Odds of impairment were greater for Hispanic than non-Hispanic White children (aOR 1.25, 95% CI 1.05-1.48) but did not differ between Hispanic and non-Hispanic Black children (aOR 0.88, 95% CI 0.74-1.04).</div></div><div><h3>Conclusions</h3><div>In a multicenter cohort, infants of Hispanic mothers had lower odds of survival to discharge without major morbidity than infants of non-Hispanic Black mothers and similar odds of survival without major morbidity as infants of non-Hispanic White mothers.</div></div><div><h3>ClinicalTrials.gov ID</h3><div>Generic Database: <span><span>NCT00063063</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114474"},"PeriodicalIF":3.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043408","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":"Data Collection Variability Across Neonatal Hypoxic-Ischemic Encephalopathy Registries","authors":"Eric S. Peeples MD, PhD ,&nbsp;Ulrike Mietzsch MD ,&nbsp;Eleanor Molloy MBBCh, PhD ,&nbsp;Gabrielle deVeber MD ,&nbsp;Khorshid Mohammad MD ,&nbsp;Janet S. Soul MD ,&nbsp;Danielle Guez-Barber MD, PhD ,&nbsp;Betsy Pilon ,&nbsp;Vann Chau MD ,&nbsp;Sonia Bonifacio MD ,&nbsp;Jehier Afifi MBBCh, MSc ,&nbsp;Alexa Craig MD ,&nbsp;Pia Wintermark MD","doi":"10.1016/j.jpeds.2025.114476","DOIUrl":"10.1016/j.jpeds.2025.114476","url":null,"abstract":"<div><h3>Objective</h3><div>To assess variability among data elements collected among existing neonatal hypoxic-ischemic encephalopathy (HIE) data registries worldwide and to determine the need for future harmonization of standard common data elements.</div></div><div><h3>Study design</h3><div>This was a cross-sectional study of data elements collected from current or recently employed HIE registry data forms. Registries were identified by literature search and email inquiries to investigators worldwide. Data elements were categorized by group consensus.</div></div><div><h3>Results</h3><div>A total of 1281 data elements were abstracted from 22 registries based in 14 countries, including 3 middle-income countries. Registries had a median of 106.5 distinct data elements per registry (range 59-458). The most commonly collected data were related to pregnancy, therapeutic hypothermia, and short-term hospital outcomes. The least consistently collected data were laboratory values other than acid/base status values. Only 4 variables were consistently collected in every registry. Five registries included neurodevelopmental follow-up fields and 5 others linked their data to a separate follow-up registry.</div></div><div><h3>Conclusion</h3><div>Many HIE registries are collecting patient data around the world, but there is considerable variability in the number, type, and format of data collected. Future attempts to develop standard common data elements to harmonize data collection globally will be crucial to facilitate worldwide collaboration and to optimize management and outcome of neonatal HIE.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114476"},"PeriodicalIF":3.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043404","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":"Physiologic Pulmonary Phenotyping of Infants Born Preterm and Post-Discharge Respiratory Morbidity","authors":"Robert S. Tepper MD, PhD ,&nbsp;Brandie D. Wagner PhD ,&nbsp;Jeffrey Bjerregaard RRT ,&nbsp;Christina Tiller RRT ,&nbsp;Laura Amos RN ,&nbsp;Greg Sokol MD ,&nbsp;Dominic Adducci BS ,&nbsp;Steven H. Abman MD","doi":"10.1016/j.jpeds.2025.114475","DOIUrl":"10.1016/j.jpeds.2025.114475","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether airway and parenchymal function identifies subgroups of infants born preterm according to the predominant pulmonary pathophysiology, and whether these subgroups have different risks for respiratory disease during infancy.</div></div><div><h3>Study design</h3><div>We prospectively enrolled a cohort of 125 infants born preterm with planned clinical follow-up after neonatal intensive care unit discharge. The study included monthly questionnaires for wheeze and visits to a physician or care provider for any respiratory illness. In addition, infant lung function testing near 5 months corrected-age included measures of airways and parenchymal function using forced expiratory flows, alveolar volume (V_A), and the carbon monoxide transfer constant (diffusion capacity of lung [D_L]/V_A). Phenotypes were defined using 2 approaches: an a priori defined phenotypes based on forced expiratory flow 75% and D_L/V_A z-scores, and an unbiased approach to classifying infants using k-means clustering.</div></div><div><h3>Results</h3><div>We identified 4 pulmonary physiologic phenotypes that distinguished participants with predominantly decreased airway and/or parenchymal function. Although the worst physiologic phenotypes were associated with a lower gestational age at birth, these phenotypes had a better predictive value than gestational age, sex, and diagnosis of bronchopulmonary dysplasia for increased respiratory morbidity during infancy (area under the curve = 0.71 vs 0.63 for respiratory illness and 0.69 vs 0.63 for wheeze).</div></div><div><h3>Conclusions</h3><div>Physiologic pulmonary phenotypes of infants born preterm were associated with differential risks for respiratory morbidities as infants, which may identify heterogeneous risks for long-term respiratory sequelae to individualize therapeutic strategies.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114475"},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043406","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":"Rural School-Based Health Centers: Meeting Children Where They Are to Improve Asthma Outcomes.","authors":"James Bohnhoff, Abby Fleisch, Jill S Halterman","doi":"10.1016/j.jpeds.2025.114473","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114473","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114473"},"PeriodicalIF":3.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024794","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":"Neurodevelopmental Outcomes after Fetoscopic Myelomeningocele Repair","authors":"Romain Corroenne MD, PhD ,&nbsp;Sabrina Rangwani BS ,&nbsp;William E. Whitehead MD ,&nbsp;Rebecca M. Johnson MS, CCRP ,&nbsp;Ahmed A. Nassr MD ,&nbsp;Cara Buskmiller MD ,&nbsp;Jessian L. Munoz MD, PhD ,&nbsp;Jonathan Castillo MD, MPH ,&nbsp;Heidi Castillo MD ,&nbsp;Roopali V. Donepudi MD ,&nbsp;Michael A. Belfort MD, PhD ,&nbsp;Magdalena Sanz Cortes MD, PhD","doi":"10.1016/j.jpeds.2025.114472","DOIUrl":"10.1016/j.jpeds.2025.114472","url":null,"abstract":"<div><h3>Objectives</h3><div>To report the neurodevelopmental outcomes after a fetoscopic myelomeningocele repair and to compare them with children who had an open hysterotomy repair or a postnatal repair.</div></div><div><h3>Study design</h3><div>We included 132 infants (prenatal repair, 93 [69 fetoscopic and 24 open hysterotomy]; postnatal repair, 39). Neurodevelopmental outcomes at or beyond 18 months were evaluated by a developmental pediatrician using the Capute scales (Clinical Adaptive Test [CAT]/Clinical Linguistic &amp; Auditory Milestone Scale [CLAMS]) and/or during parental interview using Developmental Profile 3 test. Scores were examined against reference values at each gestational age. A normal score was defined as ≥70%. Neurodevelopmental scores were compared while adjusting for infants’ age at the time of testing and the need for hydrocephalus treatment.</div></div><div><h3>Results</h3><div>After a fetoscopic repair, normal CLAMS results were observed in 25 of 33 cases (75.8%) and normal CAT in 23 of 33 (69.7%); the Developmental Profile 3 showed normal social-emotional scores in 60 of 65 (92.3%), normal cognition in 55 of 65 (84.6%), normal communication in 51 of 65 (78.5%), normal adaptive behavior in 48 of 65 (73.8%), normal general development in 39 of 65(60%), and normal physical score in 31 of 65 (47.7%) of the cases. Children who underwent a fetoscopic repair had similar neurodevelopmental outcomes compared with those who had an open fetal surgery repair. There was a significantly higher proportion of children with a normal CLAMS (25/33 [75.8%] vs 12/39 [30.8%], <em>P</em> &lt; .01) and normal CAT (23/33 [69.7%] vs 16/39 [41.0%], <em>P</em> = .04) in the fetoscopic group compared with the postnatal repair group.</div></div><div><h3>Conclusions</h3><div>Children who undergo laparotomy-assisted fetoscopic myelomeningocele repair present with normal neurodevelopmental outcomes in two-thirds of the cases included in this study at ≥ 18 months of age and had similar neurodevelopmental outcomes as those who had an open fetal surgery repair.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114472"},"PeriodicalIF":3.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016927","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":"Pediatric Attention-Deficit/Hyperactivity Disorder and Disruptive Mood Dysregulation Disorder: Analyzing National Treatment Trends","authors":"Raman Baweja MD, MS ,&nbsp;Daniel A. Waschbusch PhD ,&nbsp;Lan Kong MS, PhD ,&nbsp;Banku Jairath MD ,&nbsp;Ritika Baweja MD ,&nbsp;Usman Hameed MD ,&nbsp;James G. Waxmonsky MD","doi":"10.1016/j.jpeds.2025.114471","DOIUrl":"10.1016/j.jpeds.2025.114471","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated how a disruptive mood dysregulation disorder (DMDD) diagnosis influences treatment selection and sequencing in children with attention-deficit/hyperactivity disorder (ADHD).</div></div><div><h3>Study design</h3><div>This multicenter, population-based, retrospective cohort study analyzed data from TriNetX Research Network (June 2013 through July 2024). Youth with ADHD (without DMDD) formed the control cohort (n = 631 295). Youth with ADHD + DMDD (n = 24 723) formed the study cohort. Odds ratios (ORs) and relative risks were calculated to analyze associations.</div></div><div><h3>Results</h3><div>Compared with controls, ADHD + DMDD cohort was more likely to be composed of non-Hispanic ethnicity and exhibited higher rates of psychiatric comorbidities, inpatient and emergency service utilization, and billed psychotherapy (ORs range 1.25-6.95). Youth with ADHD + DMDD were more likely to receive ADHD medications (ORs range 1.55-4.80), as well as antidepressants, mood stabilizers, and antipsychotics (ORs range 5.05-13.16). Hispanic youth with DMDD utilized more psychotropics but less psychotherapy, while White youth used all services more. Before the use of non-ADHD medications for aggression, only 25% of ADHD + DMDD youth had a therapy code, and around 11% showed evidence of optimization of ADHD medication. After a DMDD diagnosis, treatment rates for other psychotropics increased more than those for central nervous system stimulants.</div></div><div><h3>Conclusions</h3><div>In youth with ADHD, a DMDD diagnosis is associated with increases in the spectrum of pharmacological and nonpharmacological treatments deployed with patterns varying by race and ethnicity. Antipsychotic and mood stabilizer prescriptions increased most prominently, often before receiving psychotherapy services or efforts to optimize ADHD medication. Future research should address disparities in DMDD treatment patterns and identify the optimal treatment sequences for DMDD.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114471"},"PeriodicalIF":3.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015716","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":"The \"Blue Whale\" Sometimes Resurfaces: The Phenomena Underlying Nonsuicidal Injury and Suicide Incitement Among Adolescents.","authors":"Massimo Pettoello-Mantovani, Donjeta Bali, Ida Giardino, Tudor Lucian Pop, Giuseppe Buonocore, Maria Pastore, Mehmet Vural","doi":"10.1016/j.jpeds.2025.114469","DOIUrl":"10.1016/j.jpeds.2025.114469","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114469"},"PeriodicalIF":3.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016036","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":"Rash Decisions: Improving Pediatrician Skills in Dermatologic Diagnosis","authors":"Joel Gupta MD ,&nbsp;Cathryn Sibbald MD ,&nbsp;Miriam Weinstein MD ,&nbsp;Martin Pusic MD, PhD ,&nbsp;Madeline Bell MD ,&nbsp;Nikolas MacLellan MD ,&nbsp;Robert Bobotsis MD ,&nbsp;Rashie Brar MD ,&nbsp;Kathy Boutis BSc, MD","doi":"10.1016/j.jpeds.2024.114436","DOIUrl":"10.1016/j.jpeds.2024.114436","url":null,"abstract":"<div><h3>Objective</h3><div>To examine pediatrician diagnostic skill development of dermatology image-based cases via a web-based tool and to determine case-level variables that were associated with diagnostic error.</div></div><div><h3>Study design</h3><div>This was a multicenter, prospective, cross-sectional study. A convenience sample of pediatric trainees and attendees were eligible for participation. Using a web-based tool, physicians practiced 334 pediatric dermatology image-based cases until they achieved a performance standard. Participants identified whether the case was concerning, the morphologic category, and the specific diagnosis. After every case, participants received corrective feedback and their progress toward the performance standard.</div></div><div><h3>Results</h3><div>Among 185 participants, there was a significant improvement in diagnostic performance in classifying concerning vs nonconcerning (+19.2% [95% CI 17.7, 20.6]), morphologic category (+17.9% [95% CI 16.5, 19.3]), and specific diagnosis (+25.2% [95% CI 23.4, 26.7]). The median number of cases required to achieve the performance standard was 142 (IQR 96, 209; min 58, max 330), with a median time to achievement of 57.3 minutes (IQR 38.7, 84.3). Based on 38 502 case interpretations, children with darker vs lighter skin color had a lower odds of correct identification of “concerning” (OR = 0.87; 95% CI 0.83, 0.93), morphologic category (OR = 0.91; 95% CI 0.85, 0.97), and specific disease (OR = 0.96; 95% CI 0.90; 0.99). Fewer than 60% of participants correctly identified bullous variations of diseases, psoriasis, herpes infections, and nonspecific viral infections.</div></div><div><h3>Conclusions</h3><div>The deliberate practice of dermatologic presentations in the context of an education intervention significantly and efficiently improved pediatrician diagnostic ability. The specific diagnostic challenges identified also provide opportunity for targeted learning opportunities in these areas.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"278 ","pages":"Article 114436"},"PeriodicalIF":3.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824828","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":"Bilateral Primary Congenital Glaucoma in a Newborn","authors":"Alessandra Consales MD,&nbsp;Gabriella Araimo MD,&nbsp;Vittoria Taccani MD,&nbsp;Silvia Osnaghi MD,&nbsp;Maria Francesca Bedeschi MD,&nbsp;Fabio Mosca MD,&nbsp;Monica Fumagalli PhD","doi":"10.1016/j.jpeds.2025.114464","DOIUrl":"10.1016/j.jpeds.2025.114464","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114464"},"PeriodicalIF":3.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016924","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":"Education Needs for Pediatrics Residency Training: Bringing Palliative Care to the Table.","authors":"Emily E Johnston, Angela M Feraco, Jennifer M Snaman","doi":"10.1016/j.jpeds.2025.114463","DOIUrl":"10.1016/j.jpeds.2025.114463","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114463"},"PeriodicalIF":3.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016925","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}