Journal of Pediatrics最新文献

{"title":"Maternal Mental Health and Emergency Department Visits for Infants Born Preterm and Enrolled in a Transition Home Program Before and During the COVID-19 Pandemic","authors":"Julia Mayne MD ,&nbsp;Katheleen Hawes PhD, RN ,&nbsp;Elisabeth C. McGowan MD ,&nbsp;Richard Tucker BA ,&nbsp;Betty R. Vohr MD","doi":"10.1016/j.jpeds.2025.114753","DOIUrl":"10.1016/j.jpeds.2025.114753","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between maternal mental health (MMH) disorders before and during COVID-19 and infant emergency department (ED) visits 1- and 3-months post-NICU discharge among infants in a transition home program (THP).</div></div><div><h3>Study design</h3><div>Retrospective analysis of a publicly insured neonatal intensive care unit mother-infant dyad cohort enrolled in a THP. Groups were stratified to pre-COVID-19 pandemic (January 1, 2017-March 10, 2020) and COVID-19 pandemic (March 11, 2020-December 31, 2022). Contacts between THP families, social workers, and medical staff via phone and in-person visits were analyzed relative to ED visits and rehospitalizations. Regression models estimating effects of MMH on ED visit rates were examined.</div></div><div><h3>Results</h3><div>Rates of MMH disorders trended upwards between time periods but did not reach significance. Maternal characteristics were similar between time periods, yet infant birth weight was higher during COVID-19. Overall, ED visits decreased during COVID-19 for the total cohort. THP in-person visits for the total cohort decreased during COVID-19 whereas phone contacts remained unchanged. However, for infants with an ED visit during COVID-19, phone and in-person THP visits increased. In regression models, MMH disorder was associated with higher odds of ED visits ≤ 1 month of discharge (OR 2.34, 95% CI 1.11-4.91).</div></div><div><h3>Conclusions</h3><div>Over the entire study period, infants of mothers with MMH disorders had more ED visits ≤ 1 month of discharge compared with infants from women without a MMH disorder. THP staff responded with increased phone and in-person contacts to support mother-infant dyads for those who had an ED visit during both time periods.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114753"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719138","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: Strategies to Sustain and Grow Neonatal Nurse Practitioner Workforce","authors":"Satyan Lakshminrusimha MD, FAAP,&nbsp;Jacqueline Hoffman DNP, APRN, NNP-BC,&nbsp;Colleen R. Moss DNP, APRN, NNP-BC","doi":"10.1016/j.jpeds.2025.114732","DOIUrl":"10.1016/j.jpeds.2025.114732","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"286 ","pages":"Article 114732"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719139","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":"Creation of a Novel Longitudinal Pediatrics Resident Curricular Program Addressing the Medical and Social Needs of Children with Medical Complexity","authors":"Lucas Bruton MD, MEd ,&nbsp;Michael Spewak MD ,&nbsp;Jennifer Grage MD ,&nbsp;Joely Mass MD ,&nbsp;Carolyn Foster MD, MS ,&nbsp;Mary E. McBride MD, MEd","doi":"10.1016/j.jpeds.2025.114751","DOIUrl":"10.1016/j.jpeds.2025.114751","url":null,"abstract":"<div><h3>Objective</h3><div>To implement a newly created, longitudinal resident program for the comprehensive care of children with medical complexity (CMC) and to evaluate change in resident confidence in both medical and social domains.</div></div><div><h3>Study design</h3><div>Using Kern's six-step method of curriculum development, we developed and implemented a curricular program at our institution for all pediatrics residents across an academic year from 2023 to 2024. Program evaluation used retrospective pre-surveys and post-surveys of pediatrics residents assessing overall confidence in completing tasks related to the care of CMC based on published entrustable professional activities.</div></div><div><h3>Results</h3><div>Initial needs assessment data showed that 69.7% of residents felt comfortable/very comfortable caring for CMC in the hospital. In the outpatient setting, &gt;66.7% felt uncomfortable/very uncomfortable and 78.8% were overall uncomfortable. Retrospective presurveys and postsurveys showed improved resident confidence in all 14 assessed tasks with a mean change of 0.63 as measured using a five-point Likert scale, with a <em>P</em> value of &lt;0.01 for all changes.</div></div><div><h3>Conclusions</h3><div>A novel, integrated, longitudinal curricular program addressing medical and social aspects of CMC care grounded in adult learning theory and conceptual frameworks was associated with significant improvements in resident confidence.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114751"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719134","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":"Diagnosing Subgaleal Hemorrhage in Neonates","authors":"Erin E. Clark DO,&nbsp;Eric K. Zwemer MD,&nbsp;Rachel D. Levy MD","doi":"10.1016/j.jpeds.2025.114747","DOIUrl":"10.1016/j.jpeds.2025.114747","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114747"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719135","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":"An Introduction to Systematic Review and Meta-Analysis for Pediatric Research","authors":"Sixia Chen PhD,&nbsp;Michael P. Anderson PhD","doi":"10.1016/j.jpeds.2025.114726","DOIUrl":"10.1016/j.jpeds.2025.114726","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114726"},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719122","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":"Head Growth in Infants with Benign Enlargement of Subarachnoid Spaces Versus Macrocephaly","authors":"Sasidhar Karuparti MSCI ,&nbsp;Ashlynn Lizer BA ,&nbsp;Farrell Landwehr BS ,&nbsp;Francisco Narro Garcia BS ,&nbsp;Gabrielle Johnson MD ,&nbsp;Gretchen Koller DO ,&nbsp;Diane Aum MD ,&nbsp;Ali Mian MD ,&nbsp;Jennifer M. Strahle MD","doi":"10.1016/j.jpeds.2025.114743","DOIUrl":"10.1016/j.jpeds.2025.114743","url":null,"abstract":"<div><h3>Objective</h3><div>To examine head growth in macrocephalic infants with benign expansion of subarachnoid spaces (BESS) relative to those without imaging abnormalities and World Health Organization (WHO) standard curves.</div></div><div><h3>Study design</h3><div>Patients with macrocephaly who underwent intracranial imaging at St. Louis Children's Hospital between 2012 and 2022 were identified via radiology records search. Records were retrospectively reviewed to identify patients with isolated macrocephaly (without intracranial abnormalities) and BESS (defined by macrocephaly and concurrent imaging diagnosis of BESS by neuroradiology). Nonlinear least-squares regression of head circumference (HC) by cohort and gender was performed and compared with WHO curves.</div></div><div><h3>Results</h3><div>Infants with macrocephaly and BESS (n = 159, 29% female) and macrocephaly without BESS (n = 152, 28% female) were included. Infants with BESS have larger HCs than the WHO 97th-percentile curve (male: <em>P</em> = .0032, female: <em>P</em> &lt; .001) as well as infants with isolated macrocephaly (male: <em>P</em> = .0095, female: <em>P</em> &lt; .001). Ventricle size (estimate: 1.751; 95% CI −0.728-4.230, <em>P</em> = .102), but not subarachnoid space (estimate: −0.057; 95% CI −0.697-0.583, <em>P</em> = .861), appeared to be positively associated with HC z-score, but was not significant. HC rate of change &gt;0.043 cm/day at 5-7 months of age was 82% specific (95% CI 70.0-92.0) for BESS.</div></div><div><h3>Conclusions</h3><div>Infants with BESS have different head growth trajectories compared infants with isolated macrocephaly as well as WHO curves. This study provides preliminary insights into head growth in BESS and may help identify patients more likely to have BESS among those presenting with macrocephaly.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114743"},"PeriodicalIF":3.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700349","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":"Strengthening the Neonatal Workforce: Why the Future of Neonatal Care Depends on Investing in Neonatal Nurse Practitioners","authors":"Jessica Meneses Jones DNP, APRN, NNP-BC, C-NNIC,&nbsp;William L. Hull DNP, APRN, NNP-BC, RNC-NIC, C-ELBW, CNE, DCSD,&nbsp;Meredith Farmer DNP, APRN, NNP-BC","doi":"10.1016/j.jpeds.2025.114730","DOIUrl":"10.1016/j.jpeds.2025.114730","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"286 ","pages":"Article 114730"},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676624","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":"Cyclosporine in Kawasaki Disease: Addressing Limitations and Future Directions","authors":"Moein Ashouri MD,&nbsp;Mahan Khani MD","doi":"10.1016/j.jpeds.2025.114729","DOIUrl":"10.1016/j.jpeds.2025.114729","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"286 ","pages":"Article 114729"},"PeriodicalIF":3.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676623","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":"Sleep Electroencephalogram in Infants Born Moderate to Late Preterm and Association with Subsequent Neurodevelopment","authors":"Soraia Ventura PhD ,&nbsp;Mary Anne Ryan PhD ,&nbsp;Sean R. Mathieson PhD ,&nbsp;Vicki Livingstone PhD ,&nbsp;John M. O'Toole PhD ,&nbsp;Geraldine B. Boylan PhD","doi":"10.1016/j.jpeds.2025.114728","DOIUrl":"10.1016/j.jpeds.2025.114728","url":null,"abstract":"<div><h3>Objective</h3><div>To compare electroencephalographic (EEG) sleep patterns among infants born moderate to late preterm (MLP) and full-term and to evaluate the association of sleep EEG findings in both groups with subsequent neurodevelopment.</div></div><div><h3>Study design</h3><div>Infants enrolled at Cork University Maternity Hospital underwent a daytime sleep EEG at 4 months and Griffiths III developmental assessment at 18 months of corrected age. Sleep spindles were manually annotated. Sleep macrostructure (ie, total sleep and sleep stage durations, and latencies to sleep and rapid eye movement [REM]) was assessed. EEG spectral power and coherence were quantified. These features were compared between the groups. Associations between sleep features differing between groups and Griffiths III scores were investigated.</div></div><div><h3>Results</h3><div>The mean (SD) gestational ages for infants born MLP (30/59 females) and term (40/96 females) were 34.5 (1.3) and 39.8 (1.2) weeks, respectively. Both groups showed similar sleep spindle features. Infants born MLP had shorter stage N2 sleep duration (MLP: median [IQR] of 2.75 [1.88-4.63]; term-born: 4.50 [2.50-6.50] minutes, <em>P</em> &lt; .001), had higher non-REM (NREM) power on delta 1 (MLP: 702.49 [557.46-840.67] μV²; term-born: 593.34 [449.21-749.36] μV², <em>P</em> = .011] and delta 2 (MLP: 245.31 [194.17-327.77] μV², term-born: 215.32 [164.78-283.39] μV², <em>P</em> = .028) and diverging coherence. NREM delta 1 and 2 spectral power were positively associated with personal-social-emotional development (partial Spearman correlation (partial r_s) = 0.25, <em>P</em> = .009 and partial r_s = 0.25, <em>P</em> = .011, respectively) and gross motor development (partial r_s = 0.21, <em>P</em> = .028 and partial r_s = 0.20, <em>P</em> = .036, respectively). Some parameters of intrahemispherical and interhemispherical coherence were also correlated with Griffiths III subscales of development.</div></div><div><h3>Conclusions</h3><div>Analyzing multiple sleep EEG features at 4 months corrected age, we identified alterations in sleep biomarkers of infants born MLP compared to those born full term, likely reflecting early differences in brain organization and function and, may indicate divergent trends in brain maturation.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114728"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669018","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":"Opioid-Related Pharmacogenomic Variants in a Retrospective Cohort of High-Risk Hospitalized Infants","authors":"Rabab M. Barq MD ,&nbsp;Shadassa Ourshalimian MPH ,&nbsp;Simran Maggo PhD ,&nbsp;Olivia A. Keane MD, MS ,&nbsp;Jenny Q. Nguyen PharmD ,&nbsp;Matthew A. Deardorff MD, PhD ,&nbsp;Tamorah Lewis MD, PhD ,&nbsp;Ashwini Lakshmanan MD, MS, MPH ,&nbsp;Scott A. Mosley PharmD ,&nbsp;Lorraine I. Kelley-Quon MD, MSHS","doi":"10.1016/j.jpeds.2025.114725","DOIUrl":"10.1016/j.jpeds.2025.114725","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prevalence of opioid-related pharmacogenomic (PGx) variants in high-risk hospitalized infants and to compare these frequencies with broader genetic cohorts to assess implications for precision opioid prescribing.</div></div><div><h3>Study design</h3><div>This retrospective cohort study included infants &lt;1 year of age with high-risk conditions treated at a quaternary children's hospital between 2009 and 2020 who underwent exome sequencing. Variants associated with opioid response (COMT, DRD2/ANKK1, ABCB1, OPRM1, CYP2B6, and CYP2D6) were identified, and frequencies were compared with the Ensembl genomic database using chi-square and Fisher exact tests.</div></div><div><h3>Results</h3><div>Among 111 high-risk infants (62.2% male, 47.7% Hispanic/Latino, 18.0% born prematurely, and 82.0% with congenital heart disease), 68.2% underwent surgery. Overall, 81.1% of infants were homozygous for at least 1 opioid-related PGx variant. Compared with Ensembl data, infants in our cohort had a significantly higher frequency of homozygosity for <em>ABCB1</em>: rs1045642 (43.6% vs 18.7%, <em>P</em> &lt; .001) and rs2032582 (42.7% vs 15.9%, <em>P</em> &lt; .001) and a lower frequency of homozygosity for <em>COMT</em>: rs4818 (2.7% vs 10.3%, <em>P</em> &lt; .001) and <em>OPRM1</em>: rs1799971 (2.7% vs 7.1%, <em>P</em> &lt; .001). All infants with surgical necrotizing enterocolitis (n = 5) were homozygous for at least 1 opioid-related variant. The most common metabolizer phenotypes were intermediate (CYP2B6: 35.5%, CYP2D6: 20.0%) and normal (CYP2B6: 53.9%, CYP2D6: 70.9%).</div></div><div><h3>Conclusions</h3><div>In our cohort, most infants carried at least 1 opioid-related PGx variant, with frequencies differing significantly from broader genetic cohorts. These findings highlight the potential of PGx-guided opioid prescribing to optimize pain management and reduce adverse effects in this population. Larger studies incorporating intronic PGx variants and ancestrally comparable controls are needed to validate these findings and evaluate clinical implications.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"287 ","pages":"Article 114725"},"PeriodicalIF":3.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669017","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}