Pub Date : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4752
Jonathan S Litt,Haresh M Kirpalani
{"title":"Stasis in Outcomes After Preterm Birth-As Good As It Gets?","authors":"Jonathan S Litt,Haresh M Kirpalani","doi":"10.1001/jamapediatrics.2025.4752","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4752","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"245 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644860","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 : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4381
{"title":"Change to Open Access Status.","authors":"","doi":"10.1001/jamapediatrics.2025.4381","DOIUrl":"10.1001/jamapediatrics.2025.4381","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1367"},"PeriodicalIF":18.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4943
Charlotte H Tiplady,Jonathan P Mynard,Moya Vandeleur,Gyan Ainkaran,Sherly X Li,Rachel Climie,David P Burgner,Terence Dwyer,Catherine Quinlan,Danielle K Longmore
ImportanceThe prevalence of high blood pressure in children is increasing, with health consequences reaching into adulthood. Individual-level interventions may help address the burden of high blood pressure at a population level, but there is less evidence from pediatric settings.ObjectiveTo assess the effectiveness of school- or community-based lifestyle interventions to reduce high blood pressure in children (aged 3-18 years) and identify components that support effectiveness.Evidence ReviewOvid MEDLINE, Embase, and PubMed were searched for studies from June 2013 to March 2024. Randomized clinical trials and quasi-experimental studies were assessed using the following strict inclusion criteria: longer than 6-month intervention duration, participants aged 3 to 18 years, major aim to modify cardiometabolic risk, and measurement of blood pressure before and after the intervention. Interventions aimed at specific patient groups were excluded. Quality assessment was performed using the Joanna Briggs Institute critical appraisal tools. Blood pressure before and after the intervention was extracted, with the mean difference in blood pressure recorded. Data analysis was performed from June 2023 to July 2024.FindingsA total of 27 studies were included, of which 13 reported a beneficial effect on blood pressure; 24 studies targeted physical activity, 15 targeted nutrition, 16 targeted education, and 11 included family involvement. Of 14 multicomponent studies, 9 reported a beneficial effect on blood pressure.Conclusions and RelevanceIn this systematic review, results indicate that lifestyle interventions can have a beneficial effect on blood pressure in the pediatric population, with multicomponent designs targeting both physical activity and nutrition showing the most promise. Future research should aim to further clarify intervention design and physical activity dosage, feasibility, and scalability, along with the long-term success of interventions that promote healthy blood pressure in children.
{"title":"Lifestyle Interventions Addressing Blood Pressure in Children: A Systematic Review.","authors":"Charlotte H Tiplady,Jonathan P Mynard,Moya Vandeleur,Gyan Ainkaran,Sherly X Li,Rachel Climie,David P Burgner,Terence Dwyer,Catherine Quinlan,Danielle K Longmore","doi":"10.1001/jamapediatrics.2025.4943","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4943","url":null,"abstract":"ImportanceThe prevalence of high blood pressure in children is increasing, with health consequences reaching into adulthood. Individual-level interventions may help address the burden of high blood pressure at a population level, but there is less evidence from pediatric settings.ObjectiveTo assess the effectiveness of school- or community-based lifestyle interventions to reduce high blood pressure in children (aged 3-18 years) and identify components that support effectiveness.Evidence ReviewOvid MEDLINE, Embase, and PubMed were searched for studies from June 2013 to March 2024. Randomized clinical trials and quasi-experimental studies were assessed using the following strict inclusion criteria: longer than 6-month intervention duration, participants aged 3 to 18 years, major aim to modify cardiometabolic risk, and measurement of blood pressure before and after the intervention. Interventions aimed at specific patient groups were excluded. Quality assessment was performed using the Joanna Briggs Institute critical appraisal tools. Blood pressure before and after the intervention was extracted, with the mean difference in blood pressure recorded. Data analysis was performed from June 2023 to July 2024.FindingsA total of 27 studies were included, of which 13 reported a beneficial effect on blood pressure; 24 studies targeted physical activity, 15 targeted nutrition, 16 targeted education, and 11 included family involvement. Of 14 multicomponent studies, 9 reported a beneficial effect on blood pressure.Conclusions and RelevanceIn this systematic review, results indicate that lifestyle interventions can have a beneficial effect on blood pressure in the pediatric population, with multicomponent designs targeting both physical activity and nutrition showing the most promise. Future research should aim to further clarify intervention design and physical activity dosage, feasibility, and scalability, along with the long-term success of interventions that promote healthy blood pressure in children.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"110 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644859","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 : 2025-11-24DOI: 10.1001/jamapediatrics.2025.4498
Meghan Zimmer,Jiada Zhan,Cristina Gago,Teresa T Fung,Cindy W Leung,Erica L Kenney
{"title":"Prepandemic National Estimates of Toddler and Child Diet Quality by WIC Participation Status.","authors":"Meghan Zimmer,Jiada Zhan,Cristina Gago,Teresa T Fung,Cindy W Leung,Erica L Kenney","doi":"10.1001/jamapediatrics.2025.4498","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4498","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"33 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582981","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 : 2025-11-24DOI: 10.1001/jamapediatrics.2025.4332
Maria Isabel Angulo,Geisel R Collazo,Lindsay A Thompson
{"title":"What Parents and Teens Need to Know About Testicular Pain.","authors":"Maria Isabel Angulo,Geisel R Collazo,Lindsay A Thompson","doi":"10.1001/jamapediatrics.2025.4332","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4332","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"100 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582982","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 : 2025-11-24DOI: 10.1001/jamapediatrics.2025.4786
Ludvig Daae Bjørndal,Elizabeth C Corfield,Laurie J Hannigan,Ziada Ayorech,Cynthia M Bulik,Hunna J Watson,Lisa Dinkler,Samuel J R A Chawner,Stefan Johansson,Ole A Andreassen,Helga Ask,Alexandra Havdahl
ImportanceA narrow range of food consumption and/or restricted eating is a core feature of avoidant/restrictive food intake (ARFI) disorder. However, there is limited knowledge of developmental characteristics of children with ARFI and its etiological influences, which constrains research, prevention, and intervention efforts.ObjectiveTo estimate the prevalence of ARFI phenotypes in a population-based sample, examine developmental characteristics across childhood, and investigate the genetic architecture of ARFI using genome-wide association analyses.Design, Setting, and ParticipantsThis preregistered study used data from children born from 1999 to 2009 in the population-based Norwegian Mother, Father, and Child Cohort Study (MoBa), with mother-reported data on ARFI symptoms at 3 and 8 years and linkage with diagnostic data from population health registries. Data were analyzed from March 2024 to May 2025.ExposuresMultiple items were used to identify children with broad ARFI. These children were subclassified into 3 groups based on symptom persistence: ARFI-broad transient (only at age 3 years), emergent (only at age 8 years), and persistent (ages 3 and 8 years). Children in these groups with 1 or more indicators of clinical significance (eg, nutritional deficiency) were further classified into ARFI-clinical subgroups.Main Outcomes and MeasuresARFI groups were compared across developmental characteristics from 6 months to 14 years. Genome-wide methods were used to examine single-nucleotide variant (SNV) heritability (SNV-h2), conduct genetic association analyses, and quantify genetic correlations with other phenotypes.ResultsOf 35 751 children with available ARFI assessments at 3 and 8 years (18 236 male [51%]), the prevalence of ARFI-broad persistent, transient, and emergent was 2129 (6.0%), 6338 (17.7%), and 3001 (8.4%), respectively. The prevalence of ARFI-clinical persistent, transient, and emergent was 624 (1.8%), 1157 (3.2%), and 484 (1.4%), respectively (2265 [6.3%] overall). Children with ARFI-broad persistent exhibited more developmental difficulties compared with children with no ARFI. SNV-h2 ranged from 8% to 16%. Two independent genome-wide significant loci were identified. For ARFI-clinical, a significant association was identified with ADCY3 (z = 5.42; P = 3.03 × 10-8). Small to moderate genetic correlations were observed for ARFI-broad, ARFI-clinical and mental health, cognitive/educational, anthropometric, food-associated, and gastrointestinal disorder phenotypes.Conclusions and RelevanceThis cohort study found that the prevalence of ARFI in the general pediatric population was substantial, and affected children had an associated elevated risk of developmental difficulties across multiple domains. Findings suggest a need for broad support interventions and advance understanding of the genetic underpinnings of ARFI.
{"title":"Prevalence, Characteristics, and Genetic Architecture of Avoidant/Restrictive Food Intake Phenotypes.","authors":"Ludvig Daae Bjørndal,Elizabeth C Corfield,Laurie J Hannigan,Ziada Ayorech,Cynthia M Bulik,Hunna J Watson,Lisa Dinkler,Samuel J R A Chawner,Stefan Johansson,Ole A Andreassen,Helga Ask,Alexandra Havdahl","doi":"10.1001/jamapediatrics.2025.4786","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4786","url":null,"abstract":"ImportanceA narrow range of food consumption and/or restricted eating is a core feature of avoidant/restrictive food intake (ARFI) disorder. However, there is limited knowledge of developmental characteristics of children with ARFI and its etiological influences, which constrains research, prevention, and intervention efforts.ObjectiveTo estimate the prevalence of ARFI phenotypes in a population-based sample, examine developmental characteristics across childhood, and investigate the genetic architecture of ARFI using genome-wide association analyses.Design, Setting, and ParticipantsThis preregistered study used data from children born from 1999 to 2009 in the population-based Norwegian Mother, Father, and Child Cohort Study (MoBa), with mother-reported data on ARFI symptoms at 3 and 8 years and linkage with diagnostic data from population health registries. Data were analyzed from March 2024 to May 2025.ExposuresMultiple items were used to identify children with broad ARFI. These children were subclassified into 3 groups based on symptom persistence: ARFI-broad transient (only at age 3 years), emergent (only at age 8 years), and persistent (ages 3 and 8 years). Children in these groups with 1 or more indicators of clinical significance (eg, nutritional deficiency) were further classified into ARFI-clinical subgroups.Main Outcomes and MeasuresARFI groups were compared across developmental characteristics from 6 months to 14 years. Genome-wide methods were used to examine single-nucleotide variant (SNV) heritability (SNV-h2), conduct genetic association analyses, and quantify genetic correlations with other phenotypes.ResultsOf 35 751 children with available ARFI assessments at 3 and 8 years (18 236 male [51%]), the prevalence of ARFI-broad persistent, transient, and emergent was 2129 (6.0%), 6338 (17.7%), and 3001 (8.4%), respectively. The prevalence of ARFI-clinical persistent, transient, and emergent was 624 (1.8%), 1157 (3.2%), and 484 (1.4%), respectively (2265 [6.3%] overall). Children with ARFI-broad persistent exhibited more developmental difficulties compared with children with no ARFI. SNV-h2 ranged from 8% to 16%. Two independent genome-wide significant loci were identified. For ARFI-clinical, a significant association was identified with ADCY3 (z = 5.42; P = 3.03 × 10-8). Small to moderate genetic correlations were observed for ARFI-broad, ARFI-clinical and mental health, cognitive/educational, anthropometric, food-associated, and gastrointestinal disorder phenotypes.Conclusions and RelevanceThis cohort study found that the prevalence of ARFI in the general pediatric population was substantial, and affected children had an associated elevated risk of developmental difficulties across multiple domains. Findings suggest a need for broad support interventions and advance understanding of the genetic underpinnings of ARFI.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"46 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582983","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 : 2025-11-24DOI: 10.1001/jamapediatrics.2025.4840
Marion E Granger Howard,Ciaran S Phibbs,Scott Lorch,Molly Passarella,Nansi S Boghossian
ImportanceStudies examining community births (ie, births that occur outside of a hospital setting, such as at home or in a birth center) often misclassify transfers to hospitals as hospital births. Oregon uniquely tracks planned birth location at labor onset.ObjectivesTo examine the association between planned place of delivery and perinatal outcomes in Oregon.Design, Setting, and ParticipantsThis was a population-based cohort study of singleton, nonbreech infants without lethal anomalies born at 37 to 44 weeks' gestation in Oregon between January 2012 and December 2020. Data were analyzed from October 2023 to September 2025.ExposuresPlanned hospital births vs planned community births, including completed community deliveries at home or a birthing center and those resulting in hospital transfer.Main Outcomes and MeasuresOutcomes included fetal, neonatal, and infant death; 5-minute APGAR (appearance, pulse, grimace, activity, and respiration) scores less than 7 or less than 4; neonatal seizure; ventilator support; neonatal intensive care unit admission; delivery procedures; maternal intensive care unit admission; maternal blood transfusion; and severe perineal lacerations. Adjusted logistic regression models were used to determine the association between planned community or planned hospital births and perinatal outcomes. Propensity score analysis was conducted to account for overall differences in measured covariates between groups.ResultsAmong 348 641 birthing individuals (mean [SD] age, 29.0 [5.8] years [77.3%]; 7383 non-Hispanic Black [2.1%], 66 013 Hispanic [18.9%], 235 269 non-Hispanic White [67.6%], and 38 668 [11.1%] other, including Asian/Pacific Islander, American Indian or Alaska Native, and multiple races), 332 313 planned to deliver in a hospital (95.3%) and 16 328 planned to have a community birth (4.7%). There were 2402 planned community births that were transferred to a hospital for delivery (14.7%). Compared to planned hospital births, planned community births had higher odds of 5-minute APGAR score less than 7 (adjusted odds ratio [aOR], 1.34; 95% CI, 1.19-1.50) and ventilator support (aOR, 1.14; 95% CI, 1.05-1.24). Transferred deliveries had increased odds of most adverse outcomes and medical interventions, whereas completed community births were not associated with most perinatal outcomes and had lower odds of most medical interventions. Propensity score-adjusted results aligned with the main findings.Conclusions and RelevanceWhile the risks of perinatal outcomes and likelihood of interventions were generally reduced in completed community births, transferred deliveries had higher odds of most perinatal outcomes and interventions. Misclassifying transfers as hospital births may mask risks associated with planned community births. These risks should be clearly communicated during patient counseling and considered in policy decisions.
{"title":"Planned Community Birth and Birth Outcomes.","authors":"Marion E Granger Howard,Ciaran S Phibbs,Scott Lorch,Molly Passarella,Nansi S Boghossian","doi":"10.1001/jamapediatrics.2025.4840","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4840","url":null,"abstract":"ImportanceStudies examining community births (ie, births that occur outside of a hospital setting, such as at home or in a birth center) often misclassify transfers to hospitals as hospital births. Oregon uniquely tracks planned birth location at labor onset.ObjectivesTo examine the association between planned place of delivery and perinatal outcomes in Oregon.Design, Setting, and ParticipantsThis was a population-based cohort study of singleton, nonbreech infants without lethal anomalies born at 37 to 44 weeks' gestation in Oregon between January 2012 and December 2020. Data were analyzed from October 2023 to September 2025.ExposuresPlanned hospital births vs planned community births, including completed community deliveries at home or a birthing center and those resulting in hospital transfer.Main Outcomes and MeasuresOutcomes included fetal, neonatal, and infant death; 5-minute APGAR (appearance, pulse, grimace, activity, and respiration) scores less than 7 or less than 4; neonatal seizure; ventilator support; neonatal intensive care unit admission; delivery procedures; maternal intensive care unit admission; maternal blood transfusion; and severe perineal lacerations. Adjusted logistic regression models were used to determine the association between planned community or planned hospital births and perinatal outcomes. Propensity score analysis was conducted to account for overall differences in measured covariates between groups.ResultsAmong 348 641 birthing individuals (mean [SD] age, 29.0 [5.8] years [77.3%]; 7383 non-Hispanic Black [2.1%], 66 013 Hispanic [18.9%], 235 269 non-Hispanic White [67.6%], and 38 668 [11.1%] other, including Asian/Pacific Islander, American Indian or Alaska Native, and multiple races), 332 313 planned to deliver in a hospital (95.3%) and 16 328 planned to have a community birth (4.7%). There were 2402 planned community births that were transferred to a hospital for delivery (14.7%). Compared to planned hospital births, planned community births had higher odds of 5-minute APGAR score less than 7 (adjusted odds ratio [aOR], 1.34; 95% CI, 1.19-1.50) and ventilator support (aOR, 1.14; 95% CI, 1.05-1.24). Transferred deliveries had increased odds of most adverse outcomes and medical interventions, whereas completed community births were not associated with most perinatal outcomes and had lower odds of most medical interventions. Propensity score-adjusted results aligned with the main findings.Conclusions and RelevanceWhile the risks of perinatal outcomes and likelihood of interventions were generally reduced in completed community births, transferred deliveries had higher odds of most perinatal outcomes and interventions. Misclassifying transfers as hospital births may mask risks associated with planned community births. These risks should be clearly communicated during patient counseling and considered in policy decisions.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"112 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145583390","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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