JAMA Pediatrics最新文献

英文中文

Reassessing the Inclusion of Race in Prenatal Screening for Open Neural Tube Defects. 重新评估种族纳入产前筛查开放神经管缺陷。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-06 DOI: 10.1001/jamapediatrics.2024.5913

William Butler, Rebecca G Ramesh, Jonathan von Reusner, Lorraine Dugoff, Sindhu K Srinivas, Christina C Pierre, Daniel S Herman

引用次数: 0

Fluoride Exposure and Children's IQ Scores: A Systematic Review and Meta-Analysis. 氟化物暴露与儿童智商：一项系统回顾和荟萃分析。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-06 DOI: 10.1001/jamapediatrics.2024.5542

Kyla W Taylor, Sorina E Eftim, Christopher A Sibrizzi, Robyn B Blain, Kristen Magnuson, Pamela A Hartman, Andrew A Rooney, John R Bucher

Importance: Previous meta-analyses suggest that fluoride exposure is adversely associated with children's IQ scores. An individual's total fluoride exposure comes primarily from fluoride in drinking water, food, and beverages.Objective: To perform a systematic review and meta-analysis of epidemiological studies investigating children's IQ scores and prenatal or postnatal fluoride exposure.Data sources: BIOSIS, Embase, PsycInfo, PubMed, Scopus, Web of Science, CNKI, and Wanfang, searched through October 2023.Study selection: Studies reporting children's IQ scores, fluoride exposure, and effect sizes.Data extraction and synthesis: Data were extracted into the Health Assessment Workplace Collaborative system. Study quality was evaluated using the OHAT risk-of-bias tool. Pooled standardized mean differences (SMDs) and regression coefficients were estimated with random-effects models.Main outcomes and measures: Children's IQ scores.Results: Of 74 studies included (64 cross-sectional and 10 cohort studies), most were conducted in China (n = 45); other locations included Canada (n = 3), Denmark (n = 1), India (n = 12), Iran (n = 4), Mexico (n = 4), New Zealand (n = 1), Pakistan (n = 2), Spain (n = 1), and Taiwan (n = 1). Fifty-two studies were rated high risk of bias and 22 were rated low risk of bias. Sixty-four studies reported inverse associations between fluoride exposure measures and children's IQ. Analysis of 59 studies with group-level measures of fluoride in drinking water, dental fluorosis, or other measures of fluoride exposure (47 high risk of bias, 12 low risk of bias; n = 20 932 children) showed an inverse association between fluoride exposure and IQ (pooled SMD, -0.45; 95% CI, -0.57 to -0.33; P < .001). In 31 studies reporting fluoride measured in drinking water, a dose-response association was found between exposed and reference groups (SMD, -0.15; 95% CI, -0.20 to -0.11; P < .001), and associations remained inverse when exposed groups were restricted to less than 4 mg/L and less than 2 mg/L; however, the association was null at less than 1.5 mg/L. In analyses restricted to low risk-of-bias studies, the association remained inverse when exposure was restricted to less than 4 mg/L, less than 2 mg/L, and less than 1.5 mg/L fluoride in drinking water. In 20 studies reporting fluoride measured in urine, there was an inverse dose-response association (SMD, -0.15; 95% CI, -0.23 to -0.07; P < .001). Associations remained inverse when exposed groups were restricted to less than 4 mg/L, less than 2 mg/L, and less than 1.5 mg/L fluoride in urine; the associations held in analyses restricted to the low risk-of-bias studies. Analysis of 13 studies with individual-level measures found an IQ score decrease of 1.63 points (95% CI, -2.33 to -0.93; P < .001) per 1-mg/L increase in urinary fluor

重要性：先前的荟萃分析表明，氟化物暴露与儿童智商分数呈负相关。个人接触的氟化物总量主要来自饮用水、食物和饮料中的氟化物。目的：对调查儿童智商得分与产前或产后氟化物暴露的流行病学研究进行系统回顾和荟萃分析。数据来源：BIOSIS、Embase、PsycInfo、PubMed、Scopus、Web of Science、CNKI、万方，检索截止至2023年10月。研究选择：报告儿童智商分数、氟化物暴露和效应大小的研究。数据提取与综合：将数据提取到健康评估工作场所协同系统中。使用OHAT偏倚风险工具评估研究质量。采用随机效应模型估计合并标准化平均差异（SMDs）和回归系数。主要结果和测量：儿童的智商分数。结果：纳入的74项研究（64项横断面研究和10项队列研究）中，大多数在中国进行（n = 45）；其他地点包括加拿大(n = 3),丹麦(n = 1),印度(n = 12)、伊朗(n = 4),墨西哥(n = 4),新西兰(n = 1),巴基斯坦(n = 2),西班牙(n = 1),和台湾(n = 1)。52项研究被评为高风险偏倚，22项研究被评为低风险偏倚。64项研究报告了氟化物暴露量与儿童智商之间的负相关关系。对59项研究进行分组水平的分析，包括饮用水中氟化物、氟牙症或其他氟化物暴露的测量(47项偏倚风险高，12项偏倚风险低；n = 20 932名儿童)显示氟暴露与智商呈负相关(综合SMD， -0.45；95% CI, -0.57 ~ -0.33；结论和相关性：本系统综述和荟萃分析发现，在大量多国流行病学文献中，尿液和饮用水中的氟化物测量值与儿童智商之间存在负相关和剂量反应关系。当仅通过浓度低于1.5 mg/L的饮用水来估计氟化物暴露时，氟化物暴露与儿童智商之间的剂量-反应关系数据有限且不确定。这些发现可为今后氟化物暴露的综合公共卫生风险-效益评估提供信息。

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引用次数: 0

Evidence That Intervention Dosage Is Associated With Better Outcomes in Autism. 有证据表明，干预剂量与自闭症的更好疗效相关。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4710

Thomas W Frazier, Lacey Chetcuti, Mirko Uljarevic

引用次数: 0

Pediatric Exclusivity Revenues for Cancer Drugs. 癌症药物的儿科独家经营收入。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4449

Ameet Sarpatwari, Liam Bendicksen, Douglas S Hawkins, Lia Gore, Florence T Bourgeois

引用次数: 0

Maternal Obesity and Sudden Unexpected Infant Death-Reply. 产妇肥胖与婴儿意外猝死--回复。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4713

Darren Tanner, Juan Lavista Ferres, Edwin A Mitchell

引用次数: 0

Screen Time Before 2 Years of Age and Risk of Autism at 12 Years of Age. 2 岁前的屏幕时间与 12 岁时的自闭症风险。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4432

Ping-I Lin, Weng Tong Wu, Yue-Liang Leon Guo

引用次数: 0

Time Trends in the Burden of Environmental Heat and Cold Exposure Among Children and Adolescents. 儿童和青少年暴露于环境冷热负担的时间趋势。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4392

Yi-Sheng He, Fan Cao, Xiao Hu, Yu-Chen Liu, Sha-Sha Tao, Peng Wang, Shengping Hou, Hai-Feng Pan

Importance: Environmental heat and cold exposure (EHCE) remains the principal preventable cause of morbidity and mortality in children and adolescents globally.

Objective: To report EHCE-related burden and analyze its temporal trends among children and adolescents from 1990 to 2019.

Design, setting, and participants: This repeated cross-sectional study used data from the Global Burden of Disease Study 2019, which encompassed 204 countries and territories from 1990 to 2019. Children and adolescents aged 0 to 19 years were included in the study. Data analysis occurred from December 2023 to March 2024.

Exposure: EHCE in children and adolescents from January 1990 to December 2019.

Main outcomes and measures: The primary outcomes were cases and rates of EHCE incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Global trends in these metrics were also analyzed by sex, age, and sociodemographic index (SDI), which is a comprehensive indicator of the socioeconomic status of a country or region. A linear regression model was used to calculate AAPCs and a joinpoint regression model was used to identify the years in which trends changed significantly.

Results: From 1990 to 2019, EHCE-related incidence, prevalence, mortality, and DALYs showed a downward trend globally. However, an upward trend in EHCE incidence and prevalence was detected between 2010 and 2019 (incidence AAPC, 1.46; 95% CI, 1.05-1.87; prevalence AAPC, 1.25; 95% CI, 1.01-1.50). Regionally, although EHCE-related incidence showed a decreasing trend in most regions from 1990 to 2019, there were still some regions with an increasing trend (Southern sub-Saharan Africa AAPC, 0.23; 95% CI, 0.01-0.44). In 2019, the mortality and DALYs of EHCE were higher among children and adolescents in countries with low SDI levels. Additionally, the burden of EHCE among children and adolescents varied according to sex and age.

Conclusions and relevance: In this cross-sectional study, a global increase was observed in EHCE incidence and prevalence since 2010. Furthermore, children and adolescents in low-SDI regions, which bear the brunt of the climate crisis, were disproportionately impacted. This suggests that future responses to climate change crises should emphasize health equity, which implies that vulnerable populations, such as children and adolescents, should be given priority in the allocation of resources to address climate change.

重要性：环境冷热暴露（EHCE）仍然是全球儿童和青少年发病和死亡的主要可预防原因：报告环境冷热暴露相关负担，并分析 1990 年至 2019 年期间儿童和青少年的时间趋势：这项重复性横断面研究使用了《2019 年全球疾病负担研究》中的数据，该研究涵盖了 1990 年至 2019 年期间的 204 个国家和地区。研究对象包括 0 至 19 岁的儿童和青少年。数据分析时间为 2023 年 12 月至 2024 年 3 月。暴露情况：1990 年 1 月至 2019 年 12 月期间儿童和青少年的 EHCE：主要结果是EHCE发病率、流行率、死亡率、残疾调整生命年（DALYs）和年均百分比变化（AAPCs）的病例和比率。这些指标的全球趋势也按性别、年龄和社会人口指数（SDI）进行了分析，社会人口指数是衡量一个国家或地区社会经济状况的综合指标。采用线性回归模型计算AAPCs，采用连接点回归模型确定趋势发生显著变化的年份：结果：从 1990 年到 2019 年，全球与 EHCE 相关的发病率、流行率、死亡率和残疾调整寿命年数呈下降趋势。然而，在 2010 年至 2019 年期间，发现 EHCE 发病率和流行率呈上升趋势（发病率 AAPC，1.46；95% CI，1.05-1.87；流行率 AAPC，1.25；95% CI，1.01-1.50）。从地区来看，虽然从 1990 年到 2019 年，大多数地区与 EHCE 相关的发病率呈下降趋势，但仍有一些地区呈上升趋势（南部撒哈拉以南非洲 AAPC，0.23；95% CI，0.01-0.44）。2019 年，在 SDI 水平较低的国家，儿童和青少年的 EHCE 死亡率和残疾调整寿命年数都较高。此外，不同性别和年龄的儿童和青少年的长者健康和教育负担也有所不同：在这项横断面研究中，我们观察到自 2010 年以来，EHCE 的发病率和流行率在全球范围内均有所上升。此外，气候危机首当其冲的低SDI地区的儿童和青少年受到的影响尤为严重。这表明，未来应对气候变化危机的措施应强调健康公平，这意味着在分配应对气候变化的资源时，应优先考虑儿童和青少年等弱势群体。

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引用次数: 0

Systemic Corticosteroids to Prevent Bronchopulmonary Dysplasia: Balancing Risk and Reward. 预防支气管肺发育不良的全身性皮质类固醇：平衡风险与回报。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4572

Erik A Jensen

引用次数: 0

JAMA Pediatrics.

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4188

引用次数: 0

Evidence That Intervention Dosage Is Associated With Better Outcomes in Autism-Reply. 干预剂量与自闭症患者更好的治疗效果相关的证据--回复。

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics

Pub Date : 2025-01-01 DOI: 10.1001/jamapediatrics.2024.4707

Micheal Sandbank, James E Pustejovsky

引用次数: 0

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