Pub Date : 2025-12-29DOI: 10.1001/jamapediatrics.2025.5145
Martin Wabitsch,Stephanie Brandt-Heunemann,Kim Ulrich,Stefanie Zorn
{"title":"Preventing Excess Fat Mass Gain in Severe Pediatric Obesity.","authors":"Martin Wabitsch,Stephanie Brandt-Heunemann,Kim Ulrich,Stefanie Zorn","doi":"10.1001/jamapediatrics.2025.5145","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5145","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"23 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847304","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}
Pub Date : 2025-12-29DOI: 10.1001/jamapediatrics.2025.5379
Alison Mildon,Gillian D Alton,Jo-Anna B Baxter,Bronwyn Underhill,Daniel W Sellen,Deborah L O'Connor
ImportanceBreastfeeding supports lifelong health, but socioeconomic and racial disparities persist. Biases in hospital formula supplementation practices may be an underlying contributor.ObjectiveTo examine whether nonmedically indicated hospital formula supplementation of term-born breastfed newborns is associated with neighborhood socioeconomic status and/or maternal race.Design, Setting, and ParticipantsProvincial registry data were used to build a cohort of all live births of term-born singleton infants who initiated breastfeeding in Ontario, Canada, hospitals from April 1, 2015 through March 31, 2021, and for whom prenatal screening data were available. Of 570 936 eligible births, 148 888 were excluded, primarily due to missing outcome data, preterm birth, or not initiating breastfeeding. These data were analyzed from December 2023 through October 2025.ExposuresThe 2 exposures were socioeconomic status, derived by linking maternal postal codes with 2021 Ontario Marginalization Index neighborhood-level quintiles for material resources, and maternal race (Asian, Black, White, or other [Indigenous, multiracial, or unknown race]), determined from prenatal screening data.Main Outcome and MeasureThe primary outcome was nonmedically indicated formula supplementation, determined from hospital feeding records.ResultsThis cohort included 422 048 maternal-infant dyads, 28% of whom were in the Asian racial group, 7% in the Black racial group, 59% in the White racial group, and 5% in the other racial group. Overall, 27% of infants received nonmedically indicated formula supplementation, with an increase from 23% to 32% over the study period. Participants in the Asian, Black, and other racial groups were more likely than those in the White group to be in the most marginalized socioeconomic quintile (20%, 43%, and 23% vs 16%). Risk of nonmedically indicated formula supplementation increased in a gradient across quintiles of increasing socioeconomic marginalization (quintile 5 vs quintile 1: adjusted relative risk [aRR], 1.68; 95% CI, 1.64-1.72) and was significantly elevated for the Asian (aRR, 2.69; 95% CI, 2.64-2.74), Black (aRR, 2.07; 95% CI, 2.01-2.13), and other (aRR, 1.43; 95% CI, 1.39-1.48) racial groups compared with the White group.Conclusions and RelevanceIn this population-level analysis, nonmedically indicated formula supplementation prevalence was high and increased over time, with elevated risk associated with socioeconomic marginalization and maternal racialization. Increased hospital adherence to breastfeeding support guidelines is needed to improve health equity.
{"title":"Hospital Formula Supplementation Postbreastfeeding Initiation, Neighborhood Economy, and Race.","authors":"Alison Mildon,Gillian D Alton,Jo-Anna B Baxter,Bronwyn Underhill,Daniel W Sellen,Deborah L O'Connor","doi":"10.1001/jamapediatrics.2025.5379","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5379","url":null,"abstract":"ImportanceBreastfeeding supports lifelong health, but socioeconomic and racial disparities persist. Biases in hospital formula supplementation practices may be an underlying contributor.ObjectiveTo examine whether nonmedically indicated hospital formula supplementation of term-born breastfed newborns is associated with neighborhood socioeconomic status and/or maternal race.Design, Setting, and ParticipantsProvincial registry data were used to build a cohort of all live births of term-born singleton infants who initiated breastfeeding in Ontario, Canada, hospitals from April 1, 2015 through March 31, 2021, and for whom prenatal screening data were available. Of 570 936 eligible births, 148 888 were excluded, primarily due to missing outcome data, preterm birth, or not initiating breastfeeding. These data were analyzed from December 2023 through October 2025.ExposuresThe 2 exposures were socioeconomic status, derived by linking maternal postal codes with 2021 Ontario Marginalization Index neighborhood-level quintiles for material resources, and maternal race (Asian, Black, White, or other [Indigenous, multiracial, or unknown race]), determined from prenatal screening data.Main Outcome and MeasureThe primary outcome was nonmedically indicated formula supplementation, determined from hospital feeding records.ResultsThis cohort included 422 048 maternal-infant dyads, 28% of whom were in the Asian racial group, 7% in the Black racial group, 59% in the White racial group, and 5% in the other racial group. Overall, 27% of infants received nonmedically indicated formula supplementation, with an increase from 23% to 32% over the study period. Participants in the Asian, Black, and other racial groups were more likely than those in the White group to be in the most marginalized socioeconomic quintile (20%, 43%, and 23% vs 16%). Risk of nonmedically indicated formula supplementation increased in a gradient across quintiles of increasing socioeconomic marginalization (quintile 5 vs quintile 1: adjusted relative risk [aRR], 1.68; 95% CI, 1.64-1.72) and was significantly elevated for the Asian (aRR, 2.69; 95% CI, 2.64-2.74), Black (aRR, 2.07; 95% CI, 2.01-2.13), and other (aRR, 1.43; 95% CI, 1.39-1.48) racial groups compared with the White group.Conclusions and RelevanceIn this population-level analysis, nonmedically indicated formula supplementation prevalence was high and increased over time, with elevated risk associated with socioeconomic marginalization and maternal racialization. Increased hospital adherence to breastfeeding support guidelines is needed to improve health equity.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"5 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847257","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5280
Dewan Md Sumsuzzman,Congjie Shi,Joanne M Langley,Seyed M Moghadas
ImportanceNirsevimab, a long-acting monoclonal antibody available since 2023, has demonstrated effectiveness in preventing lower respiratory tract infection (LRTI) caused by respiratory syncytial virus (RSV) in clinical trials and postlicensure settings. However, its broader real-world associations with respiratory-related outcomes in infants remain unclear, and characterizing these associations is essential to inform pediatric immunization policy.ObjectiveTo evaluate the real-world association of nirsevimab with LRTI-related hospitalizations and emergency department (ED) visits in infants.Data SourcesMEDLINE, Embase, Web of Science, Scopus, Global Health, and medRxiv databases were systematically searched for observational studies published between January 1, 2023, and June 20, 2025. Data analysis was performed between January 1, 2025, and June 20, 2025.Study SelectionPostlicensure observational studies reporting original data on the effectiveness of nirsevimab immunization programs in infants and children aged 24 months or younger in routine clinical settings were eligible for inclusion.Data Extraction and SynthesisTwo reviewers independently extracted data and assessed study quality using the Critical Appraisal Checklist of the Joanna Briggs Institute. Random-effects meta-analysis was conducted to estimate pooled odds ratios (ORs) and 95% confidence intervals.Main Outcomes and MeasuresPrimary outcomes were all-cause LRTI-related hospitalization, all-cause hospitalization, all-cause LRTI-related ED visit, and RSV-LRTI-related ED visit.ResultsOf 1752 records screened, 15 studies met inclusion criteria; 11 studies were from 5 countries included in the meta-analysis, comprising 236 764 infants and children in the nirsevimab group and 27 522 in the control group. Compared with controls, nirsevimab was associated with lower odds of all-cause LRTI-related hospitalization (OR, 0.38; 95% CI, 0.28-0.53), all-cause LRTI-related ED visits (OR, 0.52; 95% CI, 0.37-0.73), and RSV-LRTI-related ED visits (OR, 0.24; 95% CI, 0.13-0.47). No significant difference was observed in all-cause hospitalizations (OR, 0.56; 95% CI, 0.14-2.20) between the nirsevimab and control groups.Conclusions and RelevanceIn this meta-analysis, nirsevimab was associated with reduced LRTI-related hospitalizations and ED visits in infants and young children. These findings support nirsevimab's potential to reduce respiratory-related morbidity in young children and health care utilization.
{"title":"Nirsevimab Against Hospitalizations and Emergency Department Visits for Lower Respiratory Tract Infection in Infants: A Meta-Analysis.","authors":"Dewan Md Sumsuzzman,Congjie Shi,Joanne M Langley,Seyed M Moghadas","doi":"10.1001/jamapediatrics.2025.5280","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5280","url":null,"abstract":"ImportanceNirsevimab, a long-acting monoclonal antibody available since 2023, has demonstrated effectiveness in preventing lower respiratory tract infection (LRTI) caused by respiratory syncytial virus (RSV) in clinical trials and postlicensure settings. However, its broader real-world associations with respiratory-related outcomes in infants remain unclear, and characterizing these associations is essential to inform pediatric immunization policy.ObjectiveTo evaluate the real-world association of nirsevimab with LRTI-related hospitalizations and emergency department (ED) visits in infants.Data SourcesMEDLINE, Embase, Web of Science, Scopus, Global Health, and medRxiv databases were systematically searched for observational studies published between January 1, 2023, and June 20, 2025. Data analysis was performed between January 1, 2025, and June 20, 2025.Study SelectionPostlicensure observational studies reporting original data on the effectiveness of nirsevimab immunization programs in infants and children aged 24 months or younger in routine clinical settings were eligible for inclusion.Data Extraction and SynthesisTwo reviewers independently extracted data and assessed study quality using the Critical Appraisal Checklist of the Joanna Briggs Institute. Random-effects meta-analysis was conducted to estimate pooled odds ratios (ORs) and 95% confidence intervals.Main Outcomes and MeasuresPrimary outcomes were all-cause LRTI-related hospitalization, all-cause hospitalization, all-cause LRTI-related ED visit, and RSV-LRTI-related ED visit.ResultsOf 1752 records screened, 15 studies met inclusion criteria; 11 studies were from 5 countries included in the meta-analysis, comprising 236 764 infants and children in the nirsevimab group and 27 522 in the control group. Compared with controls, nirsevimab was associated with lower odds of all-cause LRTI-related hospitalization (OR, 0.38; 95% CI, 0.28-0.53), all-cause LRTI-related ED visits (OR, 0.52; 95% CI, 0.37-0.73), and RSV-LRTI-related ED visits (OR, 0.24; 95% CI, 0.13-0.47). No significant difference was observed in all-cause hospitalizations (OR, 0.56; 95% CI, 0.14-2.20) between the nirsevimab and control groups.Conclusions and RelevanceIn this meta-analysis, nirsevimab was associated with reduced LRTI-related hospitalizations and ED visits in infants and young children. These findings support nirsevimab's potential to reduce respiratory-related morbidity in young children and health care utilization.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"185 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801001","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5290
Mark Christopher Navin,Douglas S Diekema
{"title":"Vaccine Policy and Eliminating Nonmedical Exemptions-Read the Room.","authors":"Mark Christopher Navin,Douglas S Diekema","doi":"10.1001/jamapediatrics.2025.5290","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5290","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"41 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801003","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5778
Heidi L Moline,Ayzsa Tannis,Leah Goldstein,Janet A Englund,Mary A Staat,Julie A Boom,Rangaraj Selvarangan,Marian G Michaels,Geoffrey A Weinberg,Natasha B Halasa,Ariana P Toepfer,Rachel E Rutkowski,Abigail Salthouse,Leila C Sahni,Jennifer E Schuster,Laura S Stewart,John V Williams,Daniel C Payne,Eileen J Klein,Peter G Szilagyi,Fatimah S Dawood,
ImportanceDuring the 2024-2025 respiratory syncytial virus (RSV) season in the US, nirsevimab and maternal RSV vaccination became widely available to prevent severe RSV disease in infants. Assessments of the real-world effectiveness and impact of both products are needed to inform RSV prevention policy.ObjectivesTo estimate nirsevimab and maternal RSV vaccine effectiveness against medically attended RSV-associated acute respiratory illness (ARI) and to estimate the impact of these products on RSV-associated hospitalizations during 2024-2025.Design, Setting, and ParticipantsPopulation-based surveillance for medically attended ARI was conducted among children younger than 2 years with systematic molecular testing for RSV. Children were enrolled at 7 US pediatric medical centers from October 1, 2024, through April 30, 2025. A test-negative case-control design was used to estimate maternal RSV vaccine and nirsevimab effectiveness.ExposuresTo estimate maternal RSV vaccine effectiveness, the exposure was maternal RSV vaccination among newborns and infants younger than 6 months at medical encounters; to estimate nirsevimab effectiveness, the exposure was nirsevimab receipt among newborns and infants younger than 8 months as of October 1, 2024, or born after that date.Main Outcomes and MeasuresThe primary outcome was medically attended RSV-associated ARI and RSV-associated hospitalization. Immunization effectiveness was calculated as (1 - adjusted odds ratio) × 100%. To estimate population-level impact of RSV prevention products, relative rate reductions were estimated by comparing observed RSV-associated hospitalization rates during 2024-2025 to (1) observed rates in 2017-2020 or (2) counterfactual 2024-2025 rates estimated by a difference-in-differences approach; estimates from both approaches are presented as ranges.ResultsOverall, 5029 children younger than 2 years with medically attended ARI were enrolled during October 2024 to April 2025. Median (IQR) age was 10 months (5-16 months), and 2176 children (43.3%) were female. Among newborns and infants younger than 6 months, maternal RSV vaccine effectiveness was 64% (95% CI, 37%-79%) against any medically attended RSV-associated ARI and 70% (95% CI, 37%-86%) against RSV-associated hospitalization. Nirsevimab effectiveness was 81% (95% CI, 71%-87%) against RSV-associated hospitalization, and nirsevimab remained 77% (95% CI, 42%-92%) effective against RSV-associated hospitalization at 130 to 210 days after receipt. RSV-associated hospitalizations were reduced by 41% to 51% among newborns and infants aged 0 to 11 months, with the highest reduction of 56% to 63% in those aged 0 to 2 months.Conclusions and RelevanceAccording to the results of this population-based surveillance study, during 2024-2025, both maternal RSV vaccine and nirsevimab were estimated to be effective at protecting infants from RSV-associated hospitalizations in their first RSV season, and RSV-associated hospitalization rates in newbor
{"title":"Effectiveness and Impact of Maternal RSV Immunization and Nirsevimab on Medically Attended RSV in US Children.","authors":"Heidi L Moline,Ayzsa Tannis,Leah Goldstein,Janet A Englund,Mary A Staat,Julie A Boom,Rangaraj Selvarangan,Marian G Michaels,Geoffrey A Weinberg,Natasha B Halasa,Ariana P Toepfer,Rachel E Rutkowski,Abigail Salthouse,Leila C Sahni,Jennifer E Schuster,Laura S Stewart,John V Williams,Daniel C Payne,Eileen J Klein,Peter G Szilagyi,Fatimah S Dawood, ","doi":"10.1001/jamapediatrics.2025.5778","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5778","url":null,"abstract":"ImportanceDuring the 2024-2025 respiratory syncytial virus (RSV) season in the US, nirsevimab and maternal RSV vaccination became widely available to prevent severe RSV disease in infants. Assessments of the real-world effectiveness and impact of both products are needed to inform RSV prevention policy.ObjectivesTo estimate nirsevimab and maternal RSV vaccine effectiveness against medically attended RSV-associated acute respiratory illness (ARI) and to estimate the impact of these products on RSV-associated hospitalizations during 2024-2025.Design, Setting, and ParticipantsPopulation-based surveillance for medically attended ARI was conducted among children younger than 2 years with systematic molecular testing for RSV. Children were enrolled at 7 US pediatric medical centers from October 1, 2024, through April 30, 2025. A test-negative case-control design was used to estimate maternal RSV vaccine and nirsevimab effectiveness.ExposuresTo estimate maternal RSV vaccine effectiveness, the exposure was maternal RSV vaccination among newborns and infants younger than 6 months at medical encounters; to estimate nirsevimab effectiveness, the exposure was nirsevimab receipt among newborns and infants younger than 8 months as of October 1, 2024, or born after that date.Main Outcomes and MeasuresThe primary outcome was medically attended RSV-associated ARI and RSV-associated hospitalization. Immunization effectiveness was calculated as (1 - adjusted odds ratio) × 100%. To estimate population-level impact of RSV prevention products, relative rate reductions were estimated by comparing observed RSV-associated hospitalization rates during 2024-2025 to (1) observed rates in 2017-2020 or (2) counterfactual 2024-2025 rates estimated by a difference-in-differences approach; estimates from both approaches are presented as ranges.ResultsOverall, 5029 children younger than 2 years with medically attended ARI were enrolled during October 2024 to April 2025. Median (IQR) age was 10 months (5-16 months), and 2176 children (43.3%) were female. Among newborns and infants younger than 6 months, maternal RSV vaccine effectiveness was 64% (95% CI, 37%-79%) against any medically attended RSV-associated ARI and 70% (95% CI, 37%-86%) against RSV-associated hospitalization. Nirsevimab effectiveness was 81% (95% CI, 71%-87%) against RSV-associated hospitalization, and nirsevimab remained 77% (95% CI, 42%-92%) effective against RSV-associated hospitalization at 130 to 210 days after receipt. RSV-associated hospitalizations were reduced by 41% to 51% among newborns and infants aged 0 to 11 months, with the highest reduction of 56% to 63% in those aged 0 to 2 months.Conclusions and RelevanceAccording to the results of this population-based surveillance study, during 2024-2025, both maternal RSV vaccine and nirsevimab were estimated to be effective at protecting infants from RSV-associated hospitalizations in their first RSV season, and RSV-associated hospitalization rates in newbor","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"37 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807919","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5331
Ashwin K Chetty,Alissa S Chen,James T Nugent
{"title":"Clarifying the Burden of Obesity in Youth: Measurement Choices-Reply.","authors":"Ashwin K Chetty,Alissa S Chen,James T Nugent","doi":"10.1001/jamapediatrics.2025.5331","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5331","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"28 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801004","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5109
Valerie J Watnick
{"title":"Change in US Pesticide Policy Still Needed to Protect Children.","authors":"Valerie J Watnick","doi":"10.1001/jamapediatrics.2025.5109","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5109","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"49 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801000","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5376
Cynthia-Mae M Hunt,Lindsay A Thompson
{"title":"What Parents Need to Know About Sleep in Children.","authors":"Cynthia-Mae M Hunt,Lindsay A Thompson","doi":"10.1001/jamapediatrics.2025.5376","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5376","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"45 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800998","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}
Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5274
Brae Anne McArthur,Kristine Lyn Pesigan,Lindsay Berg,Glorianna Sin,Samarpreet Singh,Caitlin McClurg
ImportanceTransgender and gender diverse (TGD) youth face adversities that increase risks for suicidality and nonsuicidal self-injury (NSSI). However, substantial variability in prevalence rates have been reported across the literature.ObjectiveTo provide meta-analytic syntheses of research investigating the prevalence of suicidal ideation, suicide attempts, and NSSI in TGD youth and to examine the moderating effects of sample characteristics and study methods on estimates.Design, Setting, and ParticipantsMEDLINE, Embase, CINAHL, Web of Science, Social Work Abstracts, Scopus, PsycINFO, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses Global databases were searched in January 2025. This meta-analysis included studies of TGD youth aged 25 years and younger measuring suicidal ideation, suicide attempts, and/or NSSI published in English. These data were analyzed from June 2025 to September 2025.Data Extraction and SynthesisData extraction followed the PRISMA guidelines. Random-effects meta-analyses were used to derive the pooled prevalence estimates.Main Outcomes and MeasuresOutcomes included prevalence rates of suicidal ideation, suicide attempts, and NSSI. Sample characteristics (ie, race and ethnicity and gender identity group) and study methods (ie, assessment modality, timeframe, geographical region, and study quality) acted as moderator variables.ResultsFrom 137 studies, 262 nonoverlapping samples with a total of 131 429 TGD youth (mean age, 17.0 [range, 7.5-23.4] years) were included. Pooled prevalence estimates of suicidal ideation, suicide attempts, and NSSI were 48.8% (95% CI, 45.6%-52.0%), 26.2% (95% CI, 23.9%-28.6%), and 46.6% (95% CI, 40.5%-52.7%), respectively. Survey studies yielded higher prevalence rates across all outcomes compared with interview and medical record reviews. Significant moderating effects for ethnicity, gender identity group, timeframe, geographical region, and study quality varied across outcomes.Conclusions and RelevanceIn this meta-analyis, pooled estimates suggested that 1 in 2 TGD youth globally are experiencing suicidal ideation and/or NSSI, and 1 in 4 have experienced a suicide attempt. These pooled estimates are 2 to 3.5 times greater in TGD youth compared with those established for cisgender peers. There is a critical need for improved prevention and intervention efforts to address TGD mental health concerns.
跨性别和性别多元化（TGD）青年面临的逆境增加了自杀和非自杀性自伤（NSSI）的风险。然而，文献中报道的患病率存在很大差异。目的对TGD青少年自杀意念、自杀企图和自伤的患病率进行meta分析，并检验样本特征和研究方法对估计的调节作用。设计、设置和参与者medline、Embase、CINAHL、Web of Science、Social Work Abstracts、Scopus、PsycINFO、Cochrane Central Register of Controlled Trials和ProQuest disserthesis & Theses全球数据库于2025年1月检索。本荟萃分析包括25岁及以下TGD青年的研究，测量自杀意念、自杀企图和/或自伤。这些数据的分析时间为2025年6月至2025年9月。数据提取和合成数据提取遵循PRISMA指南。随机效应荟萃分析用于得出汇总的患病率估计。主要结局和测量结果包括自杀意念、自杀企图和自伤的患病率。样本特征（即种族、民族和性别认同群体）和研究方法（即评估方式、时间框架、地理区域和研究质量）作为调节变量。结果137项研究共纳入262个非重叠样本，共131 429名TGD青年（平均年龄17.0[范围，7.5-23.4]岁）。自杀意念、自杀企图和自伤的合并患病率估计分别为48.8% （95% CI, 45.6%-52.0%）、26.2% （95% CI, 23.9%-28.6%）和46.6% （95% CI, 40.5%-52.7%）。与访谈和病历回顾相比，调查研究得出的所有结果的患病率都更高。种族、性别认同群体、时间框架、地理区域和研究质量的显著调节作用因结果而异。结论和相关性在这项荟萃分析中，综合估计表明，全球每2名TGD青年中就有1名有自杀意念和/或自伤，每4名中就有1名有自杀企图。这些综合估计在TGD青年中比在顺性别同龄人中高2至3.5倍。迫切需要改进预防和干预工作，以解决TGD心理健康问题。
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Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5328
Josna Jojo
{"title":"Clarifying the Burden of Obesity in Youth: Measurement Choices.","authors":"Josna Jojo","doi":"10.1001/jamapediatrics.2025.5328","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5328","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"30 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800999","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}
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