Digital media, including television, the internet, social media, video games, and interactive assistants, form the digital ecosystem. When this digital ecosystem is designed with children's unique developmental needs in mind, it can support learning and well-being. In contrast, digital ecosystems that prioritize engagement and commercialization often encourage prolonged use, which in turn can displace healthy behaviors (eg, movement behaviors, sleep), and contribute to negative outcomes. This policy statement follows the conceptual framework of the socioecological model, depicting nested circles of care including: children's own characteristics, their caregivers, the digital ecosystem, as well as broader societal systems. Given the interconnected nature of these influences and systems, "media and children" cannot be viewed solely through the lens of individual child behaviors or screen limits alone. Recommendations are provided for families, pediatric providers, practitioners (eg, psychologists, social workers, counselors, educators, researchers), industry, and policy makers, aiming to provide strengths-based solutions and promote a more child-centered digital ecosystem.
{"title":"Digital Ecosystems, Children, and Adolescents: Policy Statement.","authors":"Tiffany Munzer,Joanna Parga-Belinkie,Libby Matile Milkovich,Suzy Tomopoulos,Taiwo Ajumobi,Corinn Cross,Roslyn Gerwin,Sheri Madigan,R Psych, ","doi":"10.1542/peds.2025-075320","DOIUrl":"https://doi.org/10.1542/peds.2025-075320","url":null,"abstract":"Digital media, including television, the internet, social media, video games, and interactive assistants, form the digital ecosystem. When this digital ecosystem is designed with children's unique developmental needs in mind, it can support learning and well-being. In contrast, digital ecosystems that prioritize engagement and commercialization often encourage prolonged use, which in turn can displace healthy behaviors (eg, movement behaviors, sleep), and contribute to negative outcomes. This policy statement follows the conceptual framework of the socioecological model, depicting nested circles of care including: children's own characteristics, their caregivers, the digital ecosystem, as well as broader societal systems. Given the interconnected nature of these influences and systems, \"media and children\" cannot be viewed solely through the lens of individual child behaviors or screen limits alone. Recommendations are provided for families, pediatric providers, practitioners (eg, psychologists, social workers, counselors, educators, researchers), industry, and policy makers, aiming to provide strengths-based solutions and promote a more child-centered digital ecosystem.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"2 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005569","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}
Pub Date : 2026-01-20DOI: 10.1542/peds.2025-073003
Jonathan D Hron,Brenda L Dodson
{"title":"Electronic Health Records and the Risk of Medication Errors.","authors":"Jonathan D Hron,Brenda L Dodson","doi":"10.1542/peds.2025-073003","DOIUrl":"https://doi.org/10.1542/peds.2025-073003","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"65 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005237","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}
Pub Date : 2026-01-20DOI: 10.1542/peds.2024-070043
Alison Merchant,Erin Fitzpatrick,Johanna I Westbrook,Melissa T Baysari,Bayzidur Rahman,Ling Li,Geoffrey R Ambler,Magdalena Z Raban
OBJECTIVEHigh-risk medicine (HRM) prescribing errors in pediatrics are a safety concern. Technology-related errors (TREs) occur when the design of computerized provider order entry (CPOE) facilitates errors. We aimed to measure the proportion of HRM errors that were TREs and the HRM TRE rate at 2 pediatric hospitals, describe TRE types, and examine their underlying mechanisms.METHODSWe identified 7014 HRM orders from retrospective medical record review of 18 951 medication orders for 2192 pediatric inpatients at 2 hospitals with the same CPOE in 2020. HRM prescribing errors were classified by clinical error type (eg, wrong dose, route) and potential harm. TREs were identified and their mechanisms (how they occurred-eg, selection error, editing error) classified. The rate was TREs/100 HRM orders. CI was estimated from Poisson models for rates and Wilson method for proportions.RESULTSOf the HRM orders, 20% (n = 1404) had at least 1 error. Of 1589 errors, 23.8% (n = 378) were TREs, with a rate of 5.39/100 HRM orders (95% CI, 4.86-5.96), and 32.5% (95% CI, 28.0-37.4) were potentially serious. TREs most frequently resulted in duplicate drug errors (47.4% of TREs; 95% CI, 42.4-52.4) and wrong-dose errors (20.9% of TREs; 95% CI, 17.1-25.3). The medications most frequently associated with TREs were insulin, anticoagulants, and narcotics. The most frequent TRE mechanism was "workflow" issues.CONCLUSIONSOne in 4 HRM prescribing errors was technology related, one-third were potentially serious, and almost half were duplicate drug errors. Understanding HRM TREs can inform CPOE optimization to mitigate these errors and improve safety.
{"title":"High-Risk Medicines and Technology-Related Prescribing Errors in 2 Pediatric Hospitals.","authors":"Alison Merchant,Erin Fitzpatrick,Johanna I Westbrook,Melissa T Baysari,Bayzidur Rahman,Ling Li,Geoffrey R Ambler,Magdalena Z Raban","doi":"10.1542/peds.2024-070043","DOIUrl":"https://doi.org/10.1542/peds.2024-070043","url":null,"abstract":"OBJECTIVEHigh-risk medicine (HRM) prescribing errors in pediatrics are a safety concern. Technology-related errors (TREs) occur when the design of computerized provider order entry (CPOE) facilitates errors. We aimed to measure the proportion of HRM errors that were TREs and the HRM TRE rate at 2 pediatric hospitals, describe TRE types, and examine their underlying mechanisms.METHODSWe identified 7014 HRM orders from retrospective medical record review of 18 951 medication orders for 2192 pediatric inpatients at 2 hospitals with the same CPOE in 2020. HRM prescribing errors were classified by clinical error type (eg, wrong dose, route) and potential harm. TREs were identified and their mechanisms (how they occurred-eg, selection error, editing error) classified. The rate was TREs/100 HRM orders. CI was estimated from Poisson models for rates and Wilson method for proportions.RESULTSOf the HRM orders, 20% (n = 1404) had at least 1 error. Of 1589 errors, 23.8% (n = 378) were TREs, with a rate of 5.39/100 HRM orders (95% CI, 4.86-5.96), and 32.5% (95% CI, 28.0-37.4) were potentially serious. TREs most frequently resulted in duplicate drug errors (47.4% of TREs; 95% CI, 42.4-52.4) and wrong-dose errors (20.9% of TREs; 95% CI, 17.1-25.3). The medications most frequently associated with TREs were insulin, anticoagulants, and narcotics. The most frequent TRE mechanism was \"workflow\" issues.CONCLUSIONSOne in 4 HRM prescribing errors was technology related, one-third were potentially serious, and almost half were duplicate drug errors. Understanding HRM TREs can inform CPOE optimization to mitigate these errors and improve safety.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"2 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005476","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}
Pub Date : 2026-01-20DOI: 10.1542/peds.2025-075319
Katherine E Remick,Ashley A Foster,Aaron R Jensen,Regan F Williams,Elizabeth Stone,Madeline Joseph,Gregory P Conners,Kathleen Brown,Marianne Gausche-Hill, , , , , ,
This is a revision of the previous 2018 joint technical report titled "Pediatric Readiness in the Emergency Department." Children have unique physical and psychosocial needs that are heightened in the setting of serious or life-threatening emergencies. Most ill and injured children and those with mental health emergencies are brought to community hospital emergency departments (EDs) by virtue of proximity. Therefore, all EDs must have the appropriate resources (medications, equipment, policies, and education) and staff to provide effective emergency care for children. This technical report outlines the evidence and rationale supporting resources necessary for EDs to stand ready to care for children of all ages. Although resources within emergency and trauma care systems vary locally, regionally, and nationally, ED staff, administrators, and medical directors can ensure high-quality emergency care is available for all children. The updated recommendations in the accompanying policy statement of the same title are intended to serve as a resource for clinical and administrative leadership of EDs as they strive to improve their readiness for children of all ages.
{"title":"Pediatric Readiness in the Emergency Department: Technical Report.","authors":"Katherine E Remick,Ashley A Foster,Aaron R Jensen,Regan F Williams,Elizabeth Stone,Madeline Joseph,Gregory P Conners,Kathleen Brown,Marianne Gausche-Hill, , , , , , ","doi":"10.1542/peds.2025-075319","DOIUrl":"https://doi.org/10.1542/peds.2025-075319","url":null,"abstract":"This is a revision of the previous 2018 joint technical report titled \"Pediatric Readiness in the Emergency Department.\" Children have unique physical and psychosocial needs that are heightened in the setting of serious or life-threatening emergencies. Most ill and injured children and those with mental health emergencies are brought to community hospital emergency departments (EDs) by virtue of proximity. Therefore, all EDs must have the appropriate resources (medications, equipment, policies, and education) and staff to provide effective emergency care for children. This technical report outlines the evidence and rationale supporting resources necessary for EDs to stand ready to care for children of all ages. Although resources within emergency and trauma care systems vary locally, regionally, and nationally, ED staff, administrators, and medical directors can ensure high-quality emergency care is available for all children. The updated recommendations in the accompanying policy statement of the same title are intended to serve as a resource for clinical and administrative leadership of EDs as they strive to improve their readiness for children of all ages.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"31 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005021","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}
Pub Date : 2026-01-16DOI: 10.1542/peds.2024-070144
Mary Witt,Joy A Bress,Jonathan P Winickoff,Stephanie L Santoro
OBJECTIVESChildren with Down syndrome (DS) develop skills at varied rates. Data from one academic DS program estimating the timing of skill development in patients with DS were published in October 2024. This study builds on their research through review of caregiver-reported developmental data of individuals with DS.METHODSAs part of our larger study to validate the DS Health Measure, 542 caregivers of individuals with DS aged 0 to 21 years were recruited nationally to complete our survey. We described demographic characteristics, including Child Opportunity Index (COI) corresponding to participants' zip codes, communication style, therapies received, and caregiver coordination efforts. We calculated the percent attainment of 23 developmental skills for 27 age groups, and we compared COI and walking age.RESULTSChildren with DS frequently attained gross motor skills; most children with DS aged 3.5 to 4 years (7 of 9), 4 to 4.5 years (10 of 10) and 4.5 to 5 years (12 of 13) walked independently. The proportion attaining language, self-care, and independence skills varied; most (69%) of our cohort primarily communicated with verbal speech. Most individuals with DS received multiple types of therapies, and most caregivers spent at least 1 to 6 hours coordinating supports and activities per month. COI did not correlate with walking age.CONCLUSIONSOur data build on the existing literature describing developmental skill attainment in DS. In collaboration with data from published studies, our findings can provide a foundation for the creation of a comprehensive developmental skills tool for DS.
{"title":"Caregiver-Reported Attainment of Developmental Skills in Down Syndrome.","authors":"Mary Witt,Joy A Bress,Jonathan P Winickoff,Stephanie L Santoro","doi":"10.1542/peds.2024-070144","DOIUrl":"https://doi.org/10.1542/peds.2024-070144","url":null,"abstract":"OBJECTIVESChildren with Down syndrome (DS) develop skills at varied rates. Data from one academic DS program estimating the timing of skill development in patients with DS were published in October 2024. This study builds on their research through review of caregiver-reported developmental data of individuals with DS.METHODSAs part of our larger study to validate the DS Health Measure, 542 caregivers of individuals with DS aged 0 to 21 years were recruited nationally to complete our survey. We described demographic characteristics, including Child Opportunity Index (COI) corresponding to participants' zip codes, communication style, therapies received, and caregiver coordination efforts. We calculated the percent attainment of 23 developmental skills for 27 age groups, and we compared COI and walking age.RESULTSChildren with DS frequently attained gross motor skills; most children with DS aged 3.5 to 4 years (7 of 9), 4 to 4.5 years (10 of 10) and 4.5 to 5 years (12 of 13) walked independently. The proportion attaining language, self-care, and independence skills varied; most (69%) of our cohort primarily communicated with verbal speech. Most individuals with DS received multiple types of therapies, and most caregivers spent at least 1 to 6 hours coordinating supports and activities per month. COI did not correlate with walking age.CONCLUSIONSOur data build on the existing literature describing developmental skill attainment in DS. In collaboration with data from published studies, our findings can provide a foundation for the creation of a comprehensive developmental skills tool for DS.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986216","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}
Sitosterolemia is a rare autosomal recessive disorder of lipid metabolism, with varied incidence rates of 1/200 000 to 1/1 000 000. The condition often presents prepubertally, but is commonly misdiagnosed as familial hypercholesterolemia. We want to raise clinical suspicion across pediatric generalists and subspecialties with our case report of a 7-year-old girl who presented via ophthalmology following the surgical removal of a lipid keratopathy of her cornea. Four years before her presentation at ophthalmology, she also underwent surgical excision of a large xanthoma from her left buttock. There was no further diagnostic workup at that point. On examination, she had multiple tuberous xanthomas on her knuckles and knees in addition to the corneal deposits. Baseline lipid investigation revealed a markedly elevated total cholesterol of 11.9 mmol/L and an LDL cholesterol of 10.2 mmol/L. She was given a presumptive diagnosis of familial hypercholesterolemia and started on statin therapy, to which she had a partial response. Molecular genetic analysis for familial hypercholesterolemia was negative, but because of the high index of suspicion, an expanded genetics panel was requested that demonstrated compound heterozygous variants in the ABCG5 gene, pathogenic for sitosterolemia. Sterol analysis demonstrated markedly elevated phytosterol levels consistent with the genetic findings. The patient was treated with dietary restriction of plant sterols and Ezetimibe. Computed tomography coronary angiogram showed no coronary artery calcification. An awareness of sitosterolemia amongst pediatricians is vitally important as this condition may present to numerous specialties, as evidenced in this case. Recommended lifestyle and pharmacotherapy interventions differ between sitosterolemia and familial hypercholesterolemia.
{"title":"Sitosterolemia Presenting as Lipid Keratopathy and Xanthomas.","authors":"Eleanor Burke,Michael O'Meara,Niamh McGrath,Damian Griffin","doi":"10.1542/peds.2025-072657","DOIUrl":"https://doi.org/10.1542/peds.2025-072657","url":null,"abstract":"Sitosterolemia is a rare autosomal recessive disorder of lipid metabolism, with varied incidence rates of 1/200 000 to 1/1 000 000. The condition often presents prepubertally, but is commonly misdiagnosed as familial hypercholesterolemia. We want to raise clinical suspicion across pediatric generalists and subspecialties with our case report of a 7-year-old girl who presented via ophthalmology following the surgical removal of a lipid keratopathy of her cornea. Four years before her presentation at ophthalmology, she also underwent surgical excision of a large xanthoma from her left buttock. There was no further diagnostic workup at that point. On examination, she had multiple tuberous xanthomas on her knuckles and knees in addition to the corneal deposits. Baseline lipid investigation revealed a markedly elevated total cholesterol of 11.9 mmol/L and an LDL cholesterol of 10.2 mmol/L. She was given a presumptive diagnosis of familial hypercholesterolemia and started on statin therapy, to which she had a partial response. Molecular genetic analysis for familial hypercholesterolemia was negative, but because of the high index of suspicion, an expanded genetics panel was requested that demonstrated compound heterozygous variants in the ABCG5 gene, pathogenic for sitosterolemia. Sterol analysis demonstrated markedly elevated phytosterol levels consistent with the genetic findings. The patient was treated with dietary restriction of plant sterols and Ezetimibe. Computed tomography coronary angiogram showed no coronary artery calcification. An awareness of sitosterolemia amongst pediatricians is vitally important as this condition may present to numerous specialties, as evidenced in this case. Recommended lifestyle and pharmacotherapy interventions differ between sitosterolemia and familial hypercholesterolemia.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"37 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986215","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}
Pub Date : 2026-01-16DOI: 10.1542/peds.2025-073572
Danielle J Green,Alexa Pagano,Jennifer Goldman,Anjali D Deshmukh
{"title":"Policy Without Penalty: A Review of Pediatric Research Equity Act Noncompliance Letters.","authors":"Danielle J Green,Alexa Pagano,Jennifer Goldman,Anjali D Deshmukh","doi":"10.1542/peds.2025-073572","DOIUrl":"https://doi.org/10.1542/peds.2025-073572","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"30 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986217","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}
Pub Date : 2026-01-15DOI: 10.1542/peds.2025-073393
Junia N de Brito,Alicia Kunin-Batson
{"title":"Early Cardiovascular Health and Cognitive Function in Young Adulthood: New Insights From Childhood.","authors":"Junia N de Brito,Alicia Kunin-Batson","doi":"10.1542/peds.2025-073393","DOIUrl":"https://doi.org/10.1542/peds.2025-073393","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971853","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}
Pub Date : 2026-01-15DOI: 10.1542/peds.2025-071353
Henri Salo,Katja Pahkala,Harri Niinikoski,Hanna Lagström,Pia Salo,Antti Jula,Tapani Rönnemaa,Jorma Sa Viikari,Olli T Raitakari,Suvi P Rovio
OBJECTIVECardiovascular health promotion in adulthood is crucial for early prevention of cognitive decline, but prior data on the role of promotion starting from infancy are scarce. We studied the associations between cardiovascular risk factors from infancy to young adulthood and young adulthood cognitive function.METHODSParticipants from the Special Turku Coronary Risk Factor Intervention Project were observed from infancy to young adulthood on cardiovascular risk factors including serum lipids, glucose metabolism markers, blood pressure, and obesity markers. Exposure in early childhood (age 7 months to 5 years), childhood (6-10 years), early adolescence (11-15 years), and adolescence (16-20 years) were defined. Learning and memory, verbal memory, working memory, reaction time, information processing, and cognitive flexibility were measured at age 26 years.RESULTSHigher childhood and early adolescence body mass index (BMI) and waist circumference associated inversely with cognitive flexibility (BMI: β = -0.240, 95% CI -0.48 to -0.00, P = .05; β = -0.315, 95% CI -0.57 to -0.06, P = .01; waist circumference: β = -0.260, 95% CI -0.51 to -0.01, P = .04; β = -0.257, 95% CI -0.51 to -0.01, P = .05); corresponding associations were observed between BMI and information processing (β = -0.308, 95% CI -0.53 to -0.09, P = .006; β = -0.243, 95% CI -0.47 to -0.01, P = .04). Higher adolescence and early adolescence low-density lipoprotein cholesterol associated inversely with verbal memory (β = -0.268, 95% CI -0.51 to -0.02, P = .03; β = -0.264, 95% CI -0.52 to -0.01, P = .04). Lower childhood and adolescence high-density lipoprotein cholesterol associated inversely with cognitive flexibility (β = -0.318, 95% CI -0.56 to -0.07, P = .01; β = -0.260, 95% CI -0.52 to -0.00, P = .05). Higher systolic blood pressure in childhood associated inversely with cognitive flexibility (β = -0.316, 95% CI -0.58 to -0.06, P = .02).CONCLUSIONAdverse serum lipid profile, high BMI, large waist circumference, and higher blood pressure from infancy to adolescence may associate with poorer cognitive function in young adulthood.
目的：成年期促进心血管健康对早期预防认知能力下降至关重要，但从婴儿期开始促进心血管健康的相关数据很少。我们研究了从婴儿期到青年期的心血管危险因素与青年期认知功能之间的关系。方法对图尔库冠状动脉危险因素特别干预项目的参与者进行从婴儿期到青年期的心血管危险因素的观察，包括血脂、葡萄糖代谢指标、血压和肥胖指标。暴露时间定义为幼儿期（7个月至5岁）、儿童期（6-10岁）、青春期早期（11-15岁）和青春期（16-20岁）。学习记忆、言语记忆、工作记忆、反应时间、信息处理和认知灵活性在26岁时进行测量。结果儿童和青少年早期较高的体重指数（BMI）和腰围与认知灵活性呈负相关（BMI: β = -0.240, 95% CI -0.48 ~ -0.00, P = 0.05; β = -0.315, 95% CI -0.57 ~ -0.06, P = 0.01；腰围：β = -0.260, 95% CI -0.51 ~ -0.01, P = 0.04; β = -0.257, 95% CI -0.51 ~ -0.01, P = 0.05）；BMI与信息加工之间存在相应的相关性（β = -0.308, 95% CI -0.53 ~ -0.09, P = 0.006; β = -0.243, 95% CI -0.47 ~ -0.01, P = 0.04）。较高的青春期和青春期早期低密度脂蛋白胆固醇与言语记忆呈负相关（β = -0.268, 95% CI -0.51至-0.02,P = 0.03; β = -0.264, 95% CI -0.52至-0.01,P = 0.04）。儿童和青少年较低的高密度脂蛋白胆固醇与认知灵活性呈负相关（β = -0.318, 95% CI -0.56至-0.07,P = 0.01; β = -0.260, 95% CI -0.52至-0.00,P = 0.05）。儿童期较高的收缩压与认知灵活性呈负相关（β = -0.316, 95% CI -0.58至-0.06,P = 0.02）。结论婴儿期至青春期不良血脂、高BMI、大腰围和高血压可能与成年后认知功能下降有关。
{"title":"Cardiovascular Risk Factors From Early Childhood and Cognitive Function in Young Adulthood.","authors":"Henri Salo,Katja Pahkala,Harri Niinikoski,Hanna Lagström,Pia Salo,Antti Jula,Tapani Rönnemaa,Jorma Sa Viikari,Olli T Raitakari,Suvi P Rovio","doi":"10.1542/peds.2025-071353","DOIUrl":"https://doi.org/10.1542/peds.2025-071353","url":null,"abstract":"OBJECTIVECardiovascular health promotion in adulthood is crucial for early prevention of cognitive decline, but prior data on the role of promotion starting from infancy are scarce. We studied the associations between cardiovascular risk factors from infancy to young adulthood and young adulthood cognitive function.METHODSParticipants from the Special Turku Coronary Risk Factor Intervention Project were observed from infancy to young adulthood on cardiovascular risk factors including serum lipids, glucose metabolism markers, blood pressure, and obesity markers. Exposure in early childhood (age 7 months to 5 years), childhood (6-10 years), early adolescence (11-15 years), and adolescence (16-20 years) were defined. Learning and memory, verbal memory, working memory, reaction time, information processing, and cognitive flexibility were measured at age 26 years.RESULTSHigher childhood and early adolescence body mass index (BMI) and waist circumference associated inversely with cognitive flexibility (BMI: β = -0.240, 95% CI -0.48 to -0.00, P = .05; β = -0.315, 95% CI -0.57 to -0.06, P = .01; waist circumference: β = -0.260, 95% CI -0.51 to -0.01, P = .04; β = -0.257, 95% CI -0.51 to -0.01, P = .05); corresponding associations were observed between BMI and information processing (β = -0.308, 95% CI -0.53 to -0.09, P = .006; β = -0.243, 95% CI -0.47 to -0.01, P = .04). Higher adolescence and early adolescence low-density lipoprotein cholesterol associated inversely with verbal memory (β = -0.268, 95% CI -0.51 to -0.02, P = .03; β = -0.264, 95% CI -0.52 to -0.01, P = .04). Lower childhood and adolescence high-density lipoprotein cholesterol associated inversely with cognitive flexibility (β = -0.318, 95% CI -0.56 to -0.07, P = .01; β = -0.260, 95% CI -0.52 to -0.00, P = .05). Higher systolic blood pressure in childhood associated inversely with cognitive flexibility (β = -0.316, 95% CI -0.58 to -0.06, P = .02).CONCLUSIONAdverse serum lipid profile, high BMI, large waist circumference, and higher blood pressure from infancy to adolescence may associate with poorer cognitive function in young adulthood.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"124 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971898","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}
Pub Date : 2026-01-14DOI: 10.1542/peds.2025-071898
Olla Hamdan,Justin Z Amarin,James W Antoon,Tess Stopczynski,Laura S Stewart,Eileen J Klein,Janet A Englund,Geoffrey A Weinberg,Peter G Szilagyi,John V Williams,Marian G Michaels,Julie A Boom,Leila C Sahni,Mary Allen Staat,Elizabeth P Schlaudecker,Jennifer E Schuster,Rangaraj Selvarangan,Ariana P Toepfer,Heidi L Moline,James D Chappell,Andrew J Spieker,Samantha M Olson,Natasha B Halasa
OBJECTIVEThe COVID-19 pandemic may have affected the care of patients with influenza. We investigated influenza antiviral use and associated factors in children hospitalized with influenza before and during the late COVID-19 pandemic.METHODSWe conducted active surveillance among US children with acute respiratory illness at 7 sites in the New Vaccine Surveillance Network before the COVID-19 pandemic (December 1, 2016 to March 31, 2020) and during the late pandemic period (July 1, 2021 to June 30, 2023). We included children hospitalized within 10 days of symptom onset who had positive test results for influenza by clinical or research testing. Research swabs were collected from all enrolled children; clinical testing was provider-directed. We used mixed-effects Poisson regression to compare incidence proportions of influenza antiviral use in the late pandemic with those of the prepandemic period. We determined factors associated with antiviral use during the late pandemic period using a mixed-effects logistic regression model.RESULTSAmong 1560 children hospitalized with influenza, antiviral use ranged between 48.3% and 56.8% prepandemic but declined to 38.1% in 2021 to 2022 and 46.1% in 2022 to 2023. The estimated antiviral use was 23% lower in the late pandemic (incidence proportion ratio, 0.77; 95% CI, 0.68-0.87) compared with the prepandemic period. During the late pandemic, factors associated with higher odds of antiviral use included an underlying medical condition presence, current season influenza vaccination, clinical influenza testing, intensive care unit admission, and site.CONCLUSIONSInfluenza antiviral use in children hospitalized with influenza remained suboptimal following the COVID-19 pandemic. Our study highlights the need to improve antiviral use in children hospitalized with influenza.
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