Error in Author ’s Name
This article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

In Fetal Therapy, an Obligation to Temper Excitement With Caution
Innovations in diagnostic techniques, genomic analysis, stem cell treatments, and gene therapies have the potential to revolutionize our approach to many birth defects and genetic diseases that we are presently able to manage only after birth. In their review of gene and stem cell therapies for fetal care in this issue of JAMA Pediatrics, O ’Connell et al provide a comprehensive perspective on current practice and the probable future for affected pregnancies. Many of the treatments described are presently at the experimental stage. In the theoretical case study of corrected hemophilia before birth, the authors descri...
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

Percentage of Children Who Developed Type 1 Diabetes After Rotavirus Vaccination
To the Editor I thank the authors for their interest in exploring the hypothesis of rotavirus vaccination and type 1 diabetes in children. In their study, 0.0475% of children who received the complete rotavirus vaccine series developed type 1 diabetes, and 0.0603% of children who did not receive the rotavirus vaccine developed type 1 diabetes (P  = .006). This is similar to findings in several other large cohorts, indicating that the percentage of children who developed type 1 diabetes was lower in the group that was vaccinated (Table). This is in contrast to the findings in a smaller study, although type 1 d...
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

The Percentage of Children Who Developed Type 1 Diabetes After Rotavirus Vaccination —Reply
In Reply We thank Rogers for her interest in our article. The question of whether rotavirus vaccination may affect the risk of type 1 diabetes (T1D) is certainly worthwhile to investigate using a variety of epidemiologic methods. Although information from cohort studies can be analyzed in several different ways, we feel that MarketScan data, which we used in our analysis, is best analyzed with person-time as the denominator, as was done by Rogers and colleagues in their study on this topic. While the timing of viral challenge with wild-type rotavirus may be unknown in our study population, the timing of vaccination is well...
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

Association Between Human Papillomavirus Vaccination School-Entry Requirements and Vaccination
This cross-sectional study examines initiation of human papillomavirus vaccination in US jurisdictions with vs those without policies requiring vaccination for school entry. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

Attitudes and Psychological Factors Associated With Behaviors Among US Adolescents During COVID-19
This survey study examines psychological factors associated with adolescents ’ behaviors during the coronavirus disease 2019 pandemic. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

Gene and Stem Cell Therapies for Fetal Care
This Review discusses in utero stem cell transplant and in utero gene therapy as treatment of myriad genetic diseases that can be diagnosed prenatally. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

Ending the Diagnostic Odyssey —Is Whole-Genome Sequencing the Answer?
This Viewpoint describes the implications of pending legislature authorizing Medicaid payments for whole-genome sequencing. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 29, 2020 Category: Pediatrics Source Type: research

Error in Title and Corresponding Author Address
The Letter to the Editor originally titled “Potential Association of Screen Use With Brain Development in Preschool-Aged Children,” published online May 11, 2020, should instead be titled “Science Has Not Proven That Screen Use Impacts Children's Brain Development.” Additionally, the corresponding author address was updated. This art icle was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Intergenerational Associations of Parental Mental Illness and Child Health
Western medicine ’s traditional approach to physical and mental illnesses as distinct domains is increasingly giving way to a better understanding of health as a unitary construct as knowledge of the strong interrelationship of these conditions increases. Mental disorders are associated with individual distress an d disability, and an increasing body of evidence documents poorer physical health and markedly diminished life expectancy among individuals with mental illness compared with the general population. Mental illness is highly prevalent among adults of child-rearing age, with available data suggesting t hat app...
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Short-term Treatment of Migraine in Children and Adolescents
This article summarizes an updated guideline from the American Academy of Neurology and American Headache Society on the short-term treatment of migraine in children and adolescents. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Pregnancy Stress, Anxiety, and Depression Sequela on Neonatal Brain Development
To the Editor We read with interest the article by Wu et al, which demonstrated an association of maternal psychological distress with in utero brain development in fetuses with congenital heart disease (CHD). The study found that the maternal stress was associated with smaller left hippocampal, right hippocampal, and cerebellar volumes only among women carrying fetuses with CHD. However, this study did not show similar finding in women carrying healthy fetuses, despite the fact that 27% of women in the control group tested positive for stress, 26% for anxiety, and 9% for depression. Could authors please investigate whethe...
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Pregnancy Stress, Anxiety, and Depression Sequela on Neonatal Brain Development —Reply
In Reply We thank Abbasi and Puusepp-Benazzouz for raising an important question about our study that was published in JAMA Pediatrics, “Association of Maternal Psychological Distress With In Utero Brain Development in Fetuses With Congenital Heart Disease.” In healthy fetuses, we reported that maternal trait anxiety was negatively associated with left and right hippocampal volumes. However, these associations were no longer sig nificant after adjusting for multiple testing. Following Abbasi and Puusepp-Benazzouz’s suggestion, we further investigated whether brain volumes were different in healthy fetuses...
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Parental Mental Illness and Child Injury Occurrence, Hospitalization, and Death During Early Childhood
This cohort study compares injury event rates among Taiwanese children with and without parents with serious mental illness. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Fostering Healthy Mental, Emotional, and Behavioral Development in Child Health Care
This Viewpoint discusses a National Academies of Sciences, Engineering, and Medicine report that assesses the evidence for promoting healthy mental, emotional, and behavioral development. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 22, 2020 Category: Pediatrics Source Type: research

Error in Open Access Status
This article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Defining Very Preterm Populations for Systematic Reviews With Meta-analyses
This review compares the selection criteria, findings, and heterogeneity of systematic reviews with meta-analyses of cognitive outcomes among children considered very preterm at birth. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Cumulative Incidence of Child Protection Services Involvement Before Age 5 Years in 153  670 Australian Children
This study examines the incidence of notifications to and investigations, substantiations, and out-of-home care placements by child protection services for children aged 0 to 5 years in New South Wales, Australia. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Comparing the Roles of Omalizumab and Ultraviolet Therapy in Treating Severe Pediatric Atopic Dermatitis
To the Editor In their study, Chan et al report the effectiveness of omalizumab in treating severe pediatric atopic dermatitis, with significant clinical benefit. While these encouraging results suggest that omalizumab may be a viable treatment option for this patient group, the Editorial on this study succinctly raised the issue of cost-effectiveness because the cost of omalizumab administration could amount to greater than $100  000 per year. Thus, there needs to be a strong rationale for using omalizumab in favor of other treatment options. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Toward Inclusion of Youths With Psychiatric Disorders in Brain-Body Research
To the Editor Laurent et al reported compelling findings regarding the association of obesity with brain structure and function. The study excluded children with attention-deficit/hyperactivity disorder, schizophrenia, or autism spectrum disorder. The article does not specifically indicate whether other psychiatric disorders were evaluated. Major depressive disorder and bipolar disorder are known to confer increased risk and premature onset of cardiovascular disease. Unfortunately, these and other psychiatric conditions are perpetually overlooked when considering brain-body associations such as those illuminated by Laurent...
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Comparing the Roles of Omalizumab and Ultraviolet Therapy in Treating Severe Pediatric Atopic Dermatitis —Reply
In Reply We thank Park for the comments on our study. We would like to point out that the Atopic Dermatitis Anti-IgE Pediatric Trial (ADAPT) did not set out to study the role of ultraviolet (UV) therapy in atopic dermatitis (AD) or compare it with omalizumab in children. The study on UV therapy quoted by Park was not a randomized clinical trial. Therefore, the results are not directly comparable and should be interpreted with caution. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Toward Inclusion of Youths With Psychiatric Disorders in Brain-Body Research —Reply
In Reply In their letter, Goldstein et al bring attention to the interesting idea that the association between body mass index (BMI) and cortical thickness as reported in our study may be complicated by an interaction with psychiatric status. Adolescents with significant psychiatric conditions are more likely to be receiving medications that may influence appetite, energy level, weight gain, and potential metabolic dysregulation. Goldstein et al note preliminary empirical support for this perspective in 2 small but independent samples of bipolar patients. We attempted to replicate the referenced finding on frontal lobe thi...
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Nonintervention vs Oral Ibuprofen for Patent Ductus Arteriosus in Preterm Infants
This randomized clinical trial evaluates the noninferiority of nonintervention compared with oral ibuprofen therapy for reduction of bronchopulmonary dysplasia and death in very preterm infants with patent ductus arteriosus. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Prenatal Drug Abuse and Brain Structure, Tissue Organization, and Metabolite Levels in Newborns
This cohort study assesses the association of prenatal maternal drug exposure to marijuana, cocaine, and opioids with organization of the newborn brain and infant neurodevelopmental outcomes at age 12 months. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Association of Prenatal Opioid Exposure With Precentral Gyrus Volume in Children
This cross-sectional study identifies structural differences of the precentral gyrus among children with reported prenatal opioid exposure compared with children with no reported exposure, controlling for present social factors. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 8, 2020 Category: Pediatrics Source Type: research

Inhaled Isotonic Saline for Bronchiolitis
To the Editor I read with interest the meta-analysis by House et al showing that inhaled isotonic saline may have a beneficial therapeutic effect in bronchiolitis. While I am glad that they included our study in their analysis, I wish to point out that a novel element of our study was the use of a physiologic outcome measure to assess response to inhaled albuterol and isotonic saline, namely, respiratory inductance plethysmography (RIP). We observed no significant changes in the variables assessed by House et al (respiratory rate, oxygen saturation, and respiratory distress assessment index). However, 30% of albuterol-trea...
Source: JAMA Pediatrics - June 8, 2020 Category: Pediatrics Source Type: research

Outcomes of Childhood Preventive Intervention Across 2 Generations
This multigenerational cohort study examines possible intervention outcomes on the offspring of parents who had participated in the Raising Healthy Children preventive intervention when they were in elementary school. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 8, 2020 Category: Pediatrics Source Type: research

How to Rapidly Determine First-in-Children Dosing for COVID-19 Therapeutics
Multiple drugs to treat coronavirus disease 2019 (COVID-19) are currently under investigation. As of May 1, 2020, ClinicalTrials.gov lists 409 active studies evaluating various therapeutics to treat COVID-19. Most of these studies enroll exclusively adults, providing limited data on children. However, if efficacy of COVID-19 therapeutics is established in adults, these drugs will also be widely prescribed to children for whom appropriate dosing has not been established. We know from observational studies across multiple therapeutics that inappropriate drug dosing places children at risk for treatment failure, toxicities, a...
Source: JAMA Pediatrics - June 5, 2020 Category: Pediatrics Source Type: research

Investigational Treatments of Coronavirus Disease 2019 in Children
This pharmacokinetic simulation study estimates appropriate pediatric-specific dosing regimens for hydroxychloroquine and remdesivir in the treatment of pediatric patients with COVID-19. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 5, 2020 Category: Pediatrics Source Type: research

Children in the Eye of the Pandemic Storm
On December 31, 2019, no one knew how the world was about to change forever. In Wuhan, China, health care officials alerted the World Health Organization (WHO) of a severe respiratory illness. On March 11, 2020, WHO announced that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was causing the coronavirus disease 2019 (COVID-19) pandemic. Initial clinical data from China and Italy revealed that children were not severely affected. Chinese children younger than 1 year potentially had more severe infection, and as many as 15% were asymptomatic. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 3, 2020 Category: Pediatrics Source Type: research

Epidemiology, Clinical Features, and Disease Severity in Patients With COVID-19 in a Children ’s Hospital
This case series study examines the epidemiology, clinical, and laboratory features of children hospitalized with coronavirus disease 2019 (COVID-19) in New York City, New York. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 3, 2020 Category: Pediatrics Source Type: research

Error in Byline
In the Original Investigation titled “Cycled Phototherapy Dose-Finding Study for Extremely Low-Birth-Weight Infants: A Randomized Clinical Trial,” published online April 27, 2020, there was an error in the author byline. The fourth author’s middle initial should be “A,” not “F,” so his name reads “Wally A. Carlo.” Thi s article was corrected online. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Vaping and Youth —First, Do No Harm
In this issue of JAMA Pediatrics, Lee and colleagues review the evidence on pod-based electronic cigarette (e-cigarette) use among youth and young adults. This is a critical and timely public health issue. Despite gains made in reducing cigarette smoking among youth, the percentage of US high school students who use nicotine products is at its highest level in almost 2 decades. Recent data reveal that this trend is driven largely by the increase in e-cigarette use. In 2019, 27.5% of US high schoolers reported any vaping in the previous 30 days, more than 250% of what was seen in 2017. Today, e-cigarettes are the most commo...
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Frequency and Specificity of Pediatric Health Policy Discussions in Political Campaigns
This cross-sectional study analyzed a database of Congressional candidate campaign websites to assess the frequency and specificity of pediatric health policy discussions in political campaigns. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Multiple Classes of Antibiotic Use in Infancy and Allergic Disease in Childhood
To the Editor We read with great interest the study by Zven et al, which examined whether exposure to antibiotics at infancy is associated with an increased risk of allergic diseases in childhood. Overall, the study showed an increased risk of allergic diseases with exposure to commonly prescribed antibiotics, with adjusted hazard ratios ranging from 1.06 to 1.30 for 5 different classes of antibiotics. However, some potential sources of biases should be taken into consideration when interpreting these results. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Multiple Classes of Antibiotic Use in Infancy and Allergic Disease in Childhood
This study has great epidemiologic implications and is meaningful to the prevention and treatment of allergic diseases. Nevertheless, we have some confusion about the results. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Multiple Classes of Antibiotic Use in Infancy and Allergic Disease in Childhood —Reply
In Reply We appreciate the feedback and responses to our publication titled “Association Between Use of Multiple Classes of Antibiotic in Infancy and Allergic Disease in Childhood” and have provided responses herein. We agree that both breastfeeding and obesity are important factors to consider when evaluating the development of allergic disease in children. Unfortunate ly, we had no access to data regarding breastfeeding status and this remains a limitation of our study. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Association Between Fexofenadine Use During Pregnancy and Fetal Outcomes
This cohort study compares adverse fetal outcomes associated with fexofenadine used during pregnancy with use of cetirizine during pregnancy. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Youth and Young Adult Use of Pod-Based Electronic Cigarettes From 2015 to 2019
This systematic review analyzes factors associated with youth and young adult use of pod-based electronic cigarettes in the US. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

Contextualizing Potential Risks of Medications in Pregnancy for the Newborn
This Viewpoint argues that the magnitude of the absolute risk increase, the potential benefits of the medication, and the safety of therapeutic alternatives should be considered when assessing the safety of medications taken during pregnancy. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

The Limitations of Pain Scales —Reply
In Reply Several years ago, we implemented a protocol to manage pain and sedation based on regular clinical pain and sedation assessments in our neonatal intensive care units. At that time, given the significant amount of studies published in that field, we found it extremely difficult to choose 1 scale, among others. These difficulties motivated us to write this systematic review to provide clinicians and researchers with a useful blueprint to facilitate the search for the optimal scale. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 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 - June 1, 2020 Category: Pediatrics Source Type: research

Becoming Your Healthiest Self: An Eat-Well, Get-Fit, Feel-Great Guide for Teens
This Patient Page provides a guide to help teenagers make healthy choices. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - May 26, 2020 Category: Pediatrics Source Type: research

Early Detection and Prevention of Intrauterine Growth Restriction and Its Consequences
Intrauterine growth restriction (IUGR) is a major public health problem and is the second leading cause of perinatal mortality and morbidity worldwide, behind preterm delivery. IUGR refers to a condition in which a fetus is unable to achieve its genetically determined potential growth. IUGR is commonly reported in cases of an estimated fetal weight below the 10th percentile in combination with ultrasonographic evidence of impaired placental function. This functional definition of IUGR seeks to identify a population of fetuses at risk for modifiable but otherwise poor outcomes. Uteroplacental insufficiency is the most commo...
Source: JAMA Pediatrics - May 26, 2020 Category: Pediatrics Source Type: research

Prevalence of Bullying Among Youth Classified as LGBTQ Who Died by Suicide
This cohort study uses data from the National Violent Death Reporting System from 2003-2017 to assess the prevalence of bullying among youth classified as LGBTQ who died by suicide. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - May 26, 2020 Category: Pediatrics Source Type: research

More Details Needed on Association of Placental Weight With Risk of Neonatal Death
To the Editor Maternal and neonatal mortality and stillbirths have received gradually increased attention all over the world. It is urgent to count every mother and infant and understand the causes of death and the contributing factors. Dypvik et al cast eyes on this topic and found that preterm infants with either high or low placental weight had an increased risk of neonatal death. These findings may help to identify infants at increased risk of neonatal death, which is of great significance in clinical and public health. However, we have some concerns about the results and we are eager to see more explorations. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - May 26, 2020 Category: Pediatrics Source Type: research

More Details Needed on Association of Placental Weight With Risk of Neonatal Death —Reply
In Reply We thank Zhang et al for the interest in our article, “Placental Weight and Risk of Neonatal Death.” They address concerns about the validity of our results. First, they ask whether the age of the mother could have biased the results because both placental weight and the risk of neonatal death are influenced by maternal age. In our study, we made a djustment for maternal age. Thus, the estimated association of placental weight with neonatal death is independent of maternal age. We could not study whether our results differ across maternal age groups. We did not have statistical power to perform such an...
Source: JAMA Pediatrics - May 26, 2020 Category: Pediatrics Source Type: research

Cognitive Outcomes in Children With Intrauterine Growth Restriction Who Are Small for Gestational Age
This systematic review and meta-analysis examines whether preterm and term-born neonates with intrauterine growth restriction who are small for gestational age have worse childhood cognitive outcomes than those born appropriate for gestational age. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - May 26, 2020 Category: Pediatrics Source Type: research

Racial/Ethnic Bias in Pediatric Care and the Criminalization of Poverty and Race/Ethnicity
The criminalization of poverty and race/ethnicity is ubiquitous and multifaceted in US society. More than 16% of children were living below the federal poverty level in 2018 according to the latest government statistics; they are the poorest age group in our country. In contrast, the poverty rate for older adults is less than 10%. The intersectionality of poverty and race/ethnicity is a fact of life, with 32% of black children (and 31% of Native American children and 26% of Latinx children) living in poverty vs 11% of white children. Therefore, criminalizing poverty places a much greater burden of harm on children of color...
Source: JAMA Pediatrics - May 18, 2020 Category: Pediatrics Source Type: research

Legal Performance-Enhancing Substances and Use of Anabolic-Androgenic Steroids in Young Adults
This cohort study uses data from the National Longitudinal Study of Adolescent to Adult Health database to describe the association between anabolic-androgenic steroid use and legal performance-enhancing substances in young adults. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - May 18, 2020 Category: Pediatrics Source Type: research