Error in the Results Section
This article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

More Evidence Linking Autoimmune Diseases to ADHD
The evidence for bidirectional links between the immune system and the central nervous system has accumulated over the last few decades. One important area within this field of research is the association between maternal autoimmune diseases and mental disorders. Several previous epidemiologic studies have found autoimmune diseases to be associated with mental disorders, with the largest evidence base being for associations with schizophrenia, bipolar disorder, depression, and autism spectrum disorder, and much fewer studies having examined associations with attention-deficit/hyperactivity disorder (ADHD), tic disorders, a...
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Association of Home Quarantine and Mental Health Among Teenagers in Wuhan, China, During the COVID-19 Pandemic
This cross-sectional study investigates the prevalence of depression and anxiety and their associations with lifestyle changes among adolescents in Wuhan, China, during the coronavirus disease 2019 pandemic. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Pros and Cons in Using Population-Based Registers for Assessing the Fetal Safety of Drugs
To the Editor Andersson et al investigate the risk of adverse fetal outcomes associated with the use of a second-generation antihistamine (fexofenadine) among 2962 pregnancies with fexofenadine use matched in a 1:1 ratio with those with the use of the currently recommended second-generation antihistamines (cetirizine). No association has been noted between fexofenadine use during pregnancy and increased risk of major birth defects, spontaneous, preterm birth, and stillbirth. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Nonintervention Is Not Noninferior to Oral Ibuprofen for Treatment of Patent Ductus Arteriosus
To the Editor This Letter highlights the flaws of a recent randomized clinical trial by Sung et al that concluded that nonintervention is noninferior to oral ibuprofen for patent ductus arteriosus (PDA) treatment in reducing death or bronchopulmonary dysplasia (BPD) in preterm infants. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Pros and Cons in Using Population-Based Registers for Assessing the Fetal Safety of Drugs —Reply
In Reply We thank Triunfo et al for their interest in our article. They relevantly note that caution is warranted when drawing conclusions from registry-based studies owing to the limitations of observational designs, including the lack of randomization. With the view that randomized clinical trials are in general unlikely to be conducted within the field of drug safety in pregnancy, observational data provide means to help inform patients, clinicians, and drug regulatory agencies on this issue. In addition, while the relative rarity of both exposure and outcomes brings difficulties in performing studies of drug safety in ...
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Nonintervention Is Not Noninferior to Oral Ibuprofen for Treatment of Patent Ductus Arteriosus —Reply
In Reply We thank Razak for the comments on our randomized clinical trial comparing nonintervention and oral ibuprofen treatment for patent ductus arteriosus (PDA). (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Maternal Autoimmune Disease and ADHD in Children
This cohort study uses data from the New South Wales Perinatal Data Collection database to assess whether the presence of maternal autoimmune disease is associated with attention-deficit/hyperactivity disorder in children. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Association of Cannabis Use With Self-harm and Mortality Risk Among Youths With Mood Disorders
This cohort study uses Medicaid data to examine associations of cannabis use disorder with self-harm, suicide, and overall mortality risk in youths with mood disorders. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Contribution of Glucose Meter Error to Misclassification of Neonatal Glycemic Status
This Viewpoint discusses point-of-care testing with glucose meters in the neonatal intensive care unit and the implications of glucose meter error in this population. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 19, 2021 Category: Pediatrics Source Type: research

Assessment of Immunization Requirements, Policies, and Practices in a National Cohort of Summer Camps
This study surveys a national cohort of summer camp leadership to assess camps ’ immunization requirements, policies, and practices. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Trends in Pediatric Hospitalizations for Coronavirus Disease 2019
This study examines coronavirus disease 2019 hospitalization trends for pediatric patients in 22 states. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Antiemetic Drugs During Pregnancy: What Can We Learn From Spontaneous Reporting System Database Analyses?
To the Editor We read with interest the Viewpoint by Huybrechts et al concerning the safety of medical therapies during pregnancy, commonly prescribed for off-label use. Because of obvious ethical concerns, pregnant individuals are excluded from randomized clinical trials looking at reproductive outcomes following drug exposures; thus, pregnancy exposure data must be obtained from indirect sources, mostly represented by cohort studies and pregnancy registries. However, there is a considerable lag between the time of drug approval and obtaining sufficient numbers of first-trimester exposures in the pregnancy registries to b...
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Maternal Elimination Diet and Symptoms of Cow ’s Milk Allergy in Breastfed Infants
To the Editor The Special Communication by Munblit et al, “Assessment of Evidence About Common Infant Symptoms and Cow’s Milk Allergy,” concluded that recommendations to manage common infant symptoms as cow’s milk allergy (CMA) are not evidence based, especially in breastfed infants who are not directly consuming cow’s milk. Analysis of the autho rs suggested that for more than 99% of the infants with proven CMA, breast milk from a cow’s milk–consuming mother contains insufficient β-lactoglobulin levels to trigger an allergic reaction. Although the authors admitted limitations...
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Why Is Antibiotic Treatment Rarely Performed in COVID-19 –Positive Children Admitted in Pediatric Intensive Care Units?
To the Editor Shekerdemian et al reported 48 coronavirus disease 2019 –positive children (median age, 13 years) admitted to pediatric intensive care units in the US and Canada. Overall, 83% of children were not treated with antibiotics, and 17% had been treated with azithromycin. We deeply reflected on this, especially considering that 83% were also affected by seve re comorbidities. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Antiemetic Drugs During Pregnancy: What Can We Learn From Spontaneous Reporting System Database Analyses? —Reply
In Reply Recognizing that preapproval randomized clinical trials typically exclude pregnant individuals and that the evidence on pregnancy safety required for drug labels must come from postapproval studies, Mazhar et al make the case for spontaneous reporting system databases, such as the US Food and Drug Administration Adverse Event Reporting System, as a highly valuable source of information about a drug ’s safety and efficacy profile, particularly in frail populations. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Maternal Elimination Diet and Symptoms of Cow ’s Milk Allergy in Breastfed Infants—Reply
In Reply We thank Hilvo for commenting on our article and highlighting studies from the 1980s that reported infant responses to maternal dietary exclusions. In fact, there is a longer history of this concept that a breastfeeding woman ’s dietary intake may cause allergic reactions in her infant, with the first report of infant “allergic” response to maternal intake of chocolate published in 1918. However, as Hilvo rightly points out, and Cochrane reviews have also identified, randomized clinical trial evidence in this field is inconsistent. Case reports, observational studies, and personal and clinical ex...
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Why Is Antibiotic Treatment Rarely Performed in COVID-19 –Positive Children Admitted in Pediatric Intensive Care Units?—Reply
In Reply We thank Fanos and colleagues for their comments regarding our article and specifically referring to the lack of antibiotic use in our cohort of pediatric patients hospitalized with coronavirus disease 2019 (COVID-19). While they correctly state that alterations in gut permeability and subsequent disturbances in the pulmonary microbiome may contribute to severity of lung injury in patients with acute respiratory distress syndrome, we would like to point out that they may have misinterpreted the specific aims of our investigation. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Effect of Family Navigation on Diagnostic Ascertainment Among Children at Risk for Autism
This randomized clinical trial tests the efficacy of family navigation, an individually tailored, culturally informed care management strategy, to increase the likelihood of achieving diagnostic ascertainment among young children at risk for autism spectrum disorder. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Creating Practical Primary Care Supports for Parent-Child Relationships
This Viewpoint discusses how pediatric primary care clinicians can promote literacy to reinforce healthy mental, emotional, and behavioral development in young children. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 11, 2021 Category: Pediatrics Source Type: research

Intrapartum Maternal Oxygen Supplementation
It has been estimated that 2 of 3 women in labor in the US receive oxygen supplementation for nonreassuring fetal heart rate patterns at some point during labor. During the course of labor, maternal-fetal oxygen delivery is interrupted by uterine contractions and ceases when the contractions exceed 40 mm Hg in intensity, a level typically exceeded many times before delivery. This hypoxic stress results in the development of significant metabolic acidemia even under normal conditions, with the umbilical artery pH decreasing from a prelabor mean of approximately 7.38 to a mean pH of 7.25 at the time of delivery. These change...
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Autism Spectrum Disorder and the Risk of Substance Use Disorder
Screening for substance use is a priority in adolescent health care. There has long been an acknowledgment of the link between psychiatric diagnoses and substance use disorders (SUDs). One of the cornerstones of the approaches to decreasing SUDs is to screen for and treat these other illnesses. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Translation of a Host Blood RNA Signature Distinguishing Bacterial From Viral Infection Into a a Point-of-Care Test
This study assesses a 2-gene RNA signature that can be translated into a rapid (
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Ways to Support Low-Income, At-Risk Young Children During and After Coronavirus Disease 2019
To the Editor In an issue of JAMA Pediatrics, Dooley et al bring up the important issue of supporting low-income children during coronavirus disease 2019 (COVID-19) and suggest that US Congress should increase investments in evidence-based programs (eg, home visiting and Head Start) and digital learning. Expanding evidence-based programs in the early intervention (EI) and preschool school systems may be more challenging than we thought, even before COVID-19. For instance, approximately 170  000 low–socioeconomic status (SES) children aged 3 or 4 years who were eligible for state-run preschools in California were no...
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Children With Disabilities Must Be More Than an Afterthought in School Reopening
To the Editor The Individuals With Disabilities Education Act, adopted in 1975, mandates that all children have a right to appropriate and free public education services. Fourteen percent of public school enrollees (7.1 million children) receive special education services. Many children served by the Individuals With Disabilities Education Act are at high risk for severe illness if they contract coronavirus disease 2019. Thus, the US Centers for Disease Control and Prevention identifies this group for special consideration when reopening schools. A JAMA Pediatrics Editorial correctly asserted that issues related to school ...
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Rapid Implementation of Model-Based Dosing Recommendations During the Coronavirus Disease 2019 Pandemic
To the Editor With great interest, we read the article by Maharaj et al and the accompanying Editorial by Watt. We can only applaud the authors, the Pediatric Trial Network, and the journal for showing the pediatric community the added value of modeling and simulation in situations where pediatric data are scarce. We would like to take the opportunity to stress the importance of translating these model-based dosing guidelines to clinical care. Most pediatricians are not familiar with pharmacokinetic articles and may be hesitant to use simulated doses from scientific publications in real-life clinic. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Ways to Support Low-Income, At-Risk Young Children During and After Coronavirus Disease 2019 —Reply
In Reply In our article published in May 2020, we highlighted the need for innovative ways of delivering education, health, and social services owing to the disruptions caused by the coronavirus disease 2019 COVID-19 pandemic. As the the pandemic progresses, many school districts have implemented virtual learning during the fall semester. We appreciate Wong ’s identification of a novel way to deliver preschool and early intervention services to children and directly engage parents through employment. Training parents to deliver services could help overcome the challenges that young children face with the virtual lear...
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Rapid Implementation of Model-Based Dosing Recommendations During the Coronavirus Disease 2019 Pandemic —Reply
In Reply We would like to thank de Wildt and colleagues for their thoughtful commentary pertaining to our recently published article. We agree with the authors, who stressed the importance of translating these model-based dosing regimens toward clinical practice. Additionally, we would like to highlight the critical urgency for prospective randomized clinical trials evaluating the pharmacokinetics, safety, and efficacy of investigational treatments for coronavirus disease 2019 (COVID-19) in children. Such clinical investigations are essential to bridge the gap between simulation-based analyses and clinical practice. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation
This systematic review and meta-analysis examines randomized clinical trials on the use of oxygen vs room air in women in labor or undergoing cesarean delivery. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Substance Use Disorder and Its Associations With Psychotropic Agents in Patients With Autism
This cohort study uses data from patients registered in the Taiwan National Health Insurance Research Database to investigate the risk of substance use disorder among patients with autism spectrum disorder compared with controls without autism. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 4, 2021 Category: Pediatrics Source Type: research

Potentials of Telerehabilitation for Families of Children With Special Health Care Needs During the Coronavirus Disease 2019 Emergency —Reply
In Reply We appreciate the comments from Provenzi and Borgatti, who offer perspectives on telerehabilitation solutions during the coronavirus disease 2019 (COVID-19) pandemic in response to our article. As our article noted that children with special health care needs might be more likely to have COVID-19 –related complications, these pediatric neurologists who learned early from Italy’s difficult COVID-19 experience note how families of children who use specialized rehabilitation centers benefitted from telerehabilitation services to mitigate the “hopelessness” resulting from the necessary C OVID-1...
Source: JAMA Pediatrics - January 1, 2021 Category: Pediatrics Source Type: research

JAMA Pediatrics
Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision making. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - January 1, 2021 Category: Pediatrics Source Type: research

One Year Later, How Does COVID-19 Affect Children?
This Patient Page summarizes the current understanding of how children are affected by coronavirus disease 2019 (COVID-19) and gives ways to keep families safe as children continue to grow and thrive. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 28, 2020 Category: Pediatrics Source Type: research

Obesity and Eating Disorder Disparities Among Sexual and Gender Minority Youth
This study assesses obesity, binge eating disorder, anorexia nervosa, and bulimia nervosa among sexual and gender minority children. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 28, 2020 Category: Pediatrics Source Type: research

Prevalence and Childhood Precursors of Opioid Use in the Early Decades of Life
This cohort study documents age-related changes in opioid use and analyzes childhood antecedents of opioid use among non-Hispanic White individuals and American Indian individuals. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 28, 2020 Category: Pediatrics Source Type: research

Eva ’s Legacy
This article describes a young patient ’s legacy of resilience, strength, love, hope, and peace. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 28, 2020 Category: Pediatrics Source Type: research

CVD in Childhood Growth Hormone Recipients
Conclusions of causality are still limited and the absolute risk remains low.” (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Using Metrics of Kg (or Lb) Overweight or Obese to Help Interpret and Communicate Magnitudes of Excess Body Mass Index
This study used weight data from a cohort of children aged 7 to 11 years to assess a new method of communicating about body mass index, overweight, and obesity with patients and their families. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Solitary Use of Alcohol and Marijuana by US 12th Grade Students, 1976-2019
This cohort study examines changes in the rates of solitary alcohol and marijuana use among 12th grade students between 1976 and 2019. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Prioritizing Family-Centered Mental Health Care for Pediatric Patients With Eating Disorders
To the Editor The Biel et al article published in JAMA Pediatrics adds to the growing literature suggesting that a family-centered approach is necessary to address pediatric mental health care. We wholeheartedly agree with the authors about the urgent need to implement family-based models in pediatric psychiatry by focusing on parenting skills and family conflict as integrant part of comprehensive treatment plans for children mental health. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Prioritizing Family-Centered Mental Health Care for Pediatric Patients With Eating Disorders —Reply
In Reply We are grateful for the letter from Rogantini et al in response to our Viewpoint, “Pediatric Mental Health Must Be Family Mental Health Care.” We wholeheartedly agree with their strong recommendation to prioritize family-centered approaches to assessment and treatment for children and adolescents with eating disorders. Indeed, there is compelling evidence that eating disorder s very often emerge in the context of problematic family relationships and that treatment outcomes and long-term prognosis improve when these relationship factors are actively addressed in treatment. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Childhood Growth Hormone Treatment and Long-term Cardiovascular Morbidity
This cohort study investigates the long-term risk of overall and severe cardiovascular events in patients previously treated with recombinant human growth hormone in childhood and assesses whether these events are associated with treatment duration or dose. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Optimizing Neonatal Nutrition in Resource-Constrained Settings
This Viewpoint discusses supplemental feeding to support breastfeeding for vulnerable, at-risk neonates, particularly in resource-constrained settings in Africa and Asia. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 21, 2020 Category: Pediatrics Source Type: research

Trends in Use and Perceptions of Nicotine Vaping Among US Youth From 2017 to 2020
This survey study presents nationally representative estimates of recent trends in adolescent nicotine vaping, perceived risk of harm from vaping, accessibility of vaping materials, as well as trends in use of specific vaping brands and flavors. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 15, 2020 Category: Pediatrics Source Type: research

Errors in the Discussion and Funding/Support Sections
This article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 14, 2020 Category: Pediatrics Source Type: research

Error in Additional Contributions
This article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 14, 2020 Category: Pediatrics Source Type: research

Error in Table 4
This article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 14, 2020 Category: Pediatrics Source Type: research

The Promise of Lifestyle Interventions in Individuals With Genetically Higher Risk for Obesity
In this issue of JAMA Pediatrics, Heitkamp et al report an innovative study investigating how specific common genetic variants previously reported for their association with body mass index (BMI) may be associated with weight change during an inpatient, intensive lifestyle intervention for children with overweight or obesity. Among 56 selected genetic variants, researchers identified 5 variants that seemed to be associated with weight changes over 4 to 6 weeks. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 14, 2020 Category: Pediatrics Source Type: research

Providing Neonatal Outcome Estimates as an Intervention
To the Editor We read with interest the article by Kidszun et al, which reported a clinical trial randomizing expectant mothers to higher (60%) vs lower (30%) numerical estimates of survival for a hypothetical infant born at a periviable gestation. The authors showed that the primary outcome, the mothers ’ expressed preference for life-sustaining treatment or comfort care, did not depend on the numerical estimate provided. We would like to raise 2 points with respect to interpreting the authors’ findings. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 14, 2020 Category: Pediatrics Source Type: research

Providing Neonatal Outcome Estimates as an Intervention —Reply
In Reply We thank Rysavy and Haward for their interest in our study and their important comments. They raise 2 critical points: the effects of message framing and the question whether, in general, providing neonatal outcome estimates is a valuable intervention. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - December 14, 2020 Category: Pediatrics Source Type: research