JAMA Pediatrics最新文献

{"title":"Emergency Department Visits and Hospitalizations for Unintentional Exposures to Oral Prescription Medications Among Young Children.","authors":"Matthew Daubresse, Amy E Seitz, Amy Ho, Rebekah Lee, Maribeth C Lovegrove, Andrew I Geller, Jennifer Lind Lyles, Tamra E Meyer","doi":"10.1001/jamapediatrics.2025.6147","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6147","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naloxone and Buprenorphine Treatment for Adolescent Opioid Overdose and Opioid Use Disorder: A Review.","authors":"Alexis Ball, Christopher Buresh, Scott E Hadland","doi":"10.1001/jamapediatrics.2025.6113","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6113","url":null,"abstract":"<p><strong>Importance: </strong>The ongoing opioid-related overdose crisis in the US is increasingly affecting adolescents and is exacerbated by the widespread availability of illicitly manufactured fentanyl. Adolescents face significant gaps in care for prevention and treatment of opioid use and opioid-related harms. Regulatory changes have impacted the availability of 2 lifesaving medications, naloxone and buprenorphine. This narrative review summarizes the current knowledge of opioid use, overdoses, and opioid use disorder (OUD) among US adolescents in the context of fentanyl, and reviews the use of naloxone and buprenorphine, for overdose reversal and OUD treatment, respectively.</p><p><strong>Observations: </strong>Owing to their developmental stage, adolescents are uniquely vulnerable to initiating substances, experiencing substance-related harms, and developing substance use disorders. From 2018 through 2023, morbidity and mortality have increased from use of opioids, particularly fentanyl, among youth. Naloxone and buprenorphine are safe and highly effective medications for opioid overdose reversal and OUD treatment, respectively. Regulations for these medications have changed to address the worsening overdose epidemic. Naloxone is approved for over-the-counter sales (including by adolescents younger than 18 years). Any clinician with a US Drug Enforcement Administration-controlled substance license can now prescribe buprenorphine for OUD without a waiver. These policy changes present critical opportunities to save lives and reduce inequities among adolescents.</p><p><strong>Conclusion and relevance: </strong>Harms from opioids are increasingly affecting adolescents with a notable rise in overdose fatalities in the past 5 years. Regulatory changes for naloxone and buprenorphine have occurred to improve access to both these medications. Despite these changes, adolescents continue to have low access to these life-saving interventions. Ensuring that clinicians have the knowledge to provide both medications to adolescents is a key step to addressing the epidemic of adolescent drug overdoses and reducing opioid-related harms.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considering Racism in Child Maltreatment Research.","authors":"Lindsay N Overhage, Logan N Beyer, Iheoma U Iruka","doi":"10.1001/jamapediatrics.2025.6168","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6168","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Among Youth and Young Adults With Autism Spectrum Disorder, Intellectual Disability, or Cerebral Palsy.","authors":"Kelly A Shaw, Dedria McArthur, Deborah A Bilder, Michelle M Hughes, Charles E Rose, Amanda V Bakian, Maureen S Durkin, Robert T Fitzgerald, Ellen M Howerton, Christine Ladd-Acosta, Maya Lopez, Elise T Pas, Walter Zahorodny, Monica DiRienzo, Mary E Patrick, Zachary Warren, Anita Washington, Allison Hudson, Sydney Pettygrove, Josephine Shenouda, Matthew J Maenner","doi":"10.1001/jamapediatrics.2025.6120","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6120","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Autism spectrum disorder (ASD), intellectual disability (ID), and cerebral palsy (CP) are lifelong neurodevelopmental conditions accompanied by varying impairments. US mortality data for these groups are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare mortality and causes of death among a multisite cohort identified at age 8 years with ASD, ID, or CP with the general population through youth or young adulthood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;Nine US sites identified 32 787 individuals who met case definitions for ASD, ID, and/or CP at age 8 years during active population-based cross-sectional surveillance conducted biennially from 2000 through 2016 by the US Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network. Individuals were linked to death certificates through 2021. Cases with multiple conditions (18.9%) were included in each case group. General population data from the National Vital Statistics System were matched to ADDM Network sites and years of participation. Analyses were completed in 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure(s): &lt;/strong&gt;ASD, ID, or CP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Death and International Classification of Diseases, 10th revision (ICD-10) International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) causes from death certificate linkage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 145 deaths among 23 393 people with ASD, 285 deaths among 14 031 people with ID, and 123 deaths among 1612 people with CP. Increased mortality compared with the general population was seen for ASD (hazard ratio [HR], 1.35; 95% CI, 1.15-1.59), ID (HR, 4.35; 95% CI, 3.87-4.88), and CP (HR, 9.62; 95% CI, 8.06-11.48). Further stratified by sex and co-occurring ID, mortality for ASD was higher only for females with co-occurring ID (HR, 5.04; 95% CI,3.21-7.91) compared with females in the general population. The distribution of causes of death varied across groups. The most common underlying cause of death ICD-10 chapters were external causes of morbidity and mortality (V01-Y98) for the general population and ASD case group, and diseases of the nervous system (G00-G99) for CP and ID case groups. The only ICD-10 chapter hazard of death that was not elevated for ID and CP compared with the general population was external causes as underlying cause of death. Mortality from external causes was also not elevated as underlying or any cause of death for ASD. There were also notable subchapter mortality differences with important clinical and public health implications. Only 11% of those with ASD, 1% of those with ID, and 49% of those with CP had an ICD-10 code for the respective disability on their death certificate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this study, individuals with ASD, ID, or CP experienced higher mortality from a range of causes compared with the gene","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ages and Stages Questionnaire-Not an Outcome Measure.","authors":"Amy K Connery, Alison M Colbert, Renee Lajiness-O'Neill","doi":"10.1001/jamapediatrics.2025.6171","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6171","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for the Development of Food Allergy in Infants and Children: A Systematic Review and Meta-Analysis.","authors":"Nazmul Islam, Alexandro W L Chu, Falana Sheriff, Farid Foroutan, Gordon H Guyatt, Romina Brignardello-Petersen, Paul Oykhman, Alfonso Iorio, Ariel Izcovich, Katherine M Morrison, Yetiani Roldan Benitez, Rachel J Couban, Dorota Borovsky, Yiming Zhang, Leonardo Ologundudu, Keerthana Pasumarthi, Syed Fahad Farooq, Kyle Tong, Wang-Choi Tang, Haseeb Faisal, Muhammad Faran Khalid, Mohammad Saad Asif, Shannon French, Susan Waserman, R Sharon Chinthrajah, Hugh A Sampson, S Shahzad Mustafa, Jay A Lieberman, Kirsi M Järvinen, Sally Bailey, Philippe Bégin, Scott H Sicherer, Jennifer Gerdts, Melanie Carver, Lynda Mitchell, Kelly Cleary, Matthew J Greenhawt, Julie Wang, Aikaterini Anagnostou, Marcus S Shaker, Anita Chandra-Puri, Patricia C Fulkerson, Robert A Wood, Derek K Chu","doi":"10.1001/jamapediatrics.2025.6105","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6105","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The incidence and risk (predictive) factors for early life food allergy development remain uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To estimate the incidence and quantify risk factors for food allergy development.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;MEDLINE and Embase were systematically searched to January 1, 2025. Data were analyzed from June 1, 2025, to November 25, 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection: &lt;/strong&gt;Incidence estimates included studies confirming food allergy via food challenge. Risk factor analyses included cohort, case-control, and cross-sectional studies in any language assessing children younger than 6 years using multivariable analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction and synthesis: &lt;/strong&gt;Paired reviewers independently extracted data. Random-effects meta-analyses pooled incidence and adjusted odds ratios (ORs). Risk of bias was assessed using the QUIPS tool, and certainty of evidence assessed using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome and measure: &lt;/strong&gt;The primary outcome was food allergy to age 6 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 190 studies involving 2.8 million participants across 40 countries were analyzed. Among studies using food challenge, overall food allergy incidence was likely 4.7% (moderate certainty). Among 176 studies identifying 342 risk factors with varying certainty, the strongest and most certain factors included prior allergic conditions (eg, atopic dermatitis [eczema] within the first year of life [OR, 3.88; risk difference [RD], 12.0%; 95% CI, 8.8%-15.7%], allergic rhinitis [OR, 3.39; RD, 10.1%; 95% CI, 6.7%-14.4%], and wheeze [OR, 2.11; RD, 5.0%; 95% CI, 2.1%-8.8%]), severity of atopic dermatitis (OR, 1.22; RD, 1.0%; 95% CI, 0.6%-1.6%), increased skin transepidermal water loss (OR, 3.36; RD, 10.0%; 95% CI, 6.3%-14.8%), filaggrin gene sequence variations (OR, 1.93; RD, 4.2%; 95% CI, 2.4%-6.4%), delayed solid food introduction (eg, peanut after age 12 months [OR, 2.55; RD, 6.8%; 95% CI, 1.9%-14.6%]), infant antibiotic use (first month [OR, 4.11; RD, 12.8%; 95% CI, 0.4%-40%], first year [OR, 1.39; RD, 1.8%; 95% CI, 0.8%-3.1%], during pregnancy [OR, 1.32; RD, 1.5%; 95% CI, 0.6%-2.5%]), male sex (OR, 1.24; RD, 1.1%; 95% CI, 0.7%-1.6%), firstborn child (OR, 1.13; RD, 0.6%; 95% CI, 0.3%-1.0%), family history of food allergy (eg, mother [OR, 1.98; RD, 4.4%; 95% CI, 2.5%-6.8%], father [OR, 1.69; RD, 3.2%; 95% CI, 1.3%-5.5%], both parents [OR, 2.07; RD, 4.8%; 95% CI, 1.3%-5.5%], siblings [OR, 2.36; RD, 6.0%; 95% CI, 4.4%-8.0%]), parental migration (OR, 3.28; RD, 9.7%; 95% CI, 4.9%-16.3%), self-identification as Black (vs White [OR, 3.93; RD, 12.1%; 95% CI, 5.2%-22.5%], vs non-Hispanic White [OR, 2.23; RD, 5.5%; 95% CI, 3.0%-8.7%]), and cesarean delivery (OR, 1.16; RD, 1.0%; 95% CI, 0.3%-1.2%). Factors like low birth weight, postterm birth, maternal diet, and stress during pregnancy showed no significant risk difference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: ","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Considerations in Pediatric Appendicitis.","authors":"Javier Arredondo Montero","doi":"10.1001/jamapediatrics.2025.5928","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5928","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Considerations in Pediatric Appendicitis.","authors":"Maxime K Collard, Thibault Voron, Jérémie H Lefèvre","doi":"10.1001/jamapediatrics.2025.5937","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5937","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Considerations in Pediatric Appendicitis-Reply.","authors":"Ana Carolina Godinho Cintra, Isabella Faria, Ravi S Radhakrishnan","doi":"10.1001/jamapediatrics.2025.6002","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6002","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG-Guided Anesthesia for the Prevention of Emergence Delirium in Children","authors":"Luwa Haidar, Firas Abadi, Thalia Sarieddine, Andrea Vitali, Fouad A. Zouein, Gaelle Massoud","doi":"10.1001/jamapediatrics.2025.6005","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.6005","url":null,"abstract":"Importance The potential benefits of using electroencephalography (EEG)–guided anesthesia for the prevention of emergence delirium in children remain unclear. Objective To determine whether the intraoperative use of EEG-guided anesthesia is associated with a lower incidence of emergence delirium in pediatric patients. Data Sources PubMed, Embase, and Cochrane databases were searched until July 2025. Searches followed PRISMA guidelines and were registered in PROSPERO. Study Selection From 185 studies screened by 2 authors, 9 randomized clinical trials met the inclusion criteria: patients aged 1 to 18 years undergoing general anesthesia, comparing EEG-guided anesthesia with standard practice. Included studies reported at least 1 of the following outcomes: emergence delirium, pediatric anesthesia emergence delirium score, postanesthesia care unit length of stay, end-tidal sevoflurane concentration, or burst suppression. Data Extraction and Synthesis Data containing risk ratios (RRs) and mean differences (MDs) with 95% CIs were extracted from randomized clinical trials. Quality assessment and certainty of evidence were performed using the Risk of Bias 2 (RoB-2) tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. Main Outcomes and Measures The primary outcome was the incidence of emergence delirium, a common postanesthesia psychomotor pediatric complication measured by pediatric anesthesia emergence delirium score greater than or equal to 10. This outcome was prespecified before data extraction and analysis. Results A total of 1052 patients from 9 included studies were included in this analysis, of whom 535 (50.9%) underwent EEG-guided anesthesia. The incidence of emergence delirium was significantly lower in the EEG-guided group compared with the standard-practice group (27% vs 48%; RR, 0.56; 95% CI, 0.37-0.84; <jats:italic toggle=\"yes\">P</jats:italic> = .005). Maximum pediatric anesthesia emergence delirium scores (MD, −0.87; 95% CI, −1.52 to −0.23; <jats:italic toggle=\"yes\">P</jats:italic> = .008), end-tidal sevoflurane concentration (MD, −0.40; 95% CI, −0.58 to −0.22; <jats:italic toggle=\"yes\">P</jats:italic> &amp;amp;lt;.001), and length of stay in the postanesthesia care unit (MD, −8.20; 95% CI, −13.35 to −3.04; <jats:italic toggle=\"yes\">P</jats:italic> = .002) were also significantly lower in the EEG-guided anesthesia group. There was no statistically significant difference in the number of burst suppression episodes between the 2 groups (12% vs 17%; RR, 0.69; 95% CI, 0.42-1.12; <jats:italic toggle=\"yes\">P</jats:italic> = .14). Conclusions and Relevance This systematic review and meta-analysis reveals that use of EEG-guided anesthesia was associated with a significantly lower risk of emergence delirium compared with standard practice in children.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"285 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}