This Viewpoint explores the exception from informed consent mechanism in pediatric trials and why this approach is ethically justified and even necessary in pediatric trauma research when traditional consent is not feasible.

ImportanceCo-occurring asthma and attention-deficit/hyperactivity disorder (ADHD) in children increase caregiving complexity and health care use, underscoring the need for holistic interventions addressing both conditions.ObjectiveTo examine the efficacy of an acceptance and commitment therapy–based parenting program (ACT-PAM) on health outcomes in children with asthma and ADHD and their parents over

This survey study estimated the prevalence of diagnosed fetal alcohol spectrum disorder in US children and adolescents using nationally representative data from the 2022 to 2023 National Survey of Children’s Health.

ImportanceRecent evidence suggests that expectant management of hemodynamically significant patent ductus arteriosus (PDA) may confer better outcomes.ObjectiveTo assess clinical outcomes of active treatment vs expectant management of hemodynamically significant PDA in preterm infants.Data SourcesThe PubMed (MEDLINE), Embase, and Cochrane Library databases were searched for randomized clinical trials

This Viewpoint discusses the standard treatment for childhood obesity and advocates a more evidence-based approach to prevent the development of severe comorbidities in children who have obesity.

ImportanceSuicide ideation and suicide-related behavior (eg, suicide attempts) are increasingly prevalent among adolescents. Evidence supports safety planning interventions for adults at risk for suicide; the effectiveness for adolescents is unknown.ObjectiveTo evaluate the effectiveness of safety planning as a standalone intervention for adolescents with suicide ideation and/or suicide-related behavior

Importance Previous studies suggest that administration of erythropoiesis-stimulating agents darbepoetin or erythropoietin to preterm infants results in fewer transfusions, fewer donor exposures, and improved neurodevelopmental outcome. Objective To determine if, compared with placebo, preterm infants randomized to weekly darbepoetin would have greater red cell mass during hospitalization and better

This cross-sectional study estimates the prevalence of US children and adolescents with exposure to parental substance use disorder that meets the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria.

ImportanceResearch documenting the pregnancy experiences of transgender boys and nonbinary youth assigned female at birth (AFAB) in the US is lacking.ObjectiveTo examine AFAB youth sexual health indicators by gender.Design, Setting, ParticipantsSelf-reported data were collected cross-sectionally from 2018 through 2020. Initial analyses were conducted in 2023 and analyses were finalized in September

ImportanceBoth tacrolimus (TAC) and mycophenolate mofetil (MMF) are recommended for children with frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS). However, their comparative effectiveness and safety have not been evaluated through randomized clinical trials.ObjectiveTo compare the effectiveness and safety of TAC and MMF in children with FRNS or SDNS.Design

This JAMA Pediatrics Patient Page discusses health insurance, including Medicaid and the Children’s Health Insurance Program, for children.

ImportanceParental technology use in a child’s presence (hereafter, PTU), often referred to as technoference, is a growing concern in family dynamics, and no studies have quantitatively synthesized associations with children’s health and development.ObjectiveTo systematically review and synthesize literature on associations between PTU in their child’s presence and motor development, cognitive development

ImportancePrenatal cannabis use continues to increase, and cannabis remains the most commonly used illegal substance in pregnancy. Accumulating evidence suggests potential adverse effects on fetal and neonatal outcomes following cannabis use in pregnancy.ObjectiveTo update a living systematic review and meta-analysis to provide a timely understanding regarding cannabis use in pregnancy and fetal and

This JAMA Pediatrics Patient Page describes how parents can help their children build media literacy skills to recognize online misinformation.

ImportanceAccurately measuring maternal mortality trends has been challenging due to changes in data collection. This work disambiguates trends from the effects of introducing the pregnancy checkbox on death certificates and also analyzes closely related fetal and infant mortality.ObjectiveTo describe trends in maternal, fetal, and infant deaths since 2000, including the impact of the COVID-19 pandemic

ImportanceSocial care could be sustained with savings resulting from reduced acute health care utilization.ObjectiveTo evaluate the impact of CommunityRx, a low-intensity, high-scale social care assistance intervention.Design, Setting, and ParticipantsThis double-blind randomized clinical trial took place from November 2020 through August 2023 at an urban children’s hospital with 12-month follow-up

This cohort study assessed annual changes in the Childhood Opportunity Index, a multidimensional measure of neighborhood conditions associated with health outcomes, for hospital-based encounters.

ImportanceAlthough early signs of autism are often observed between 18 and 36 months of age, there is considerable uncertainty regarding future development. Clinicians lack predictive tools to identify those who will later be diagnosed with co-occurring intellectual disability (ID).ObjectiveTo predict ID in children diagnosed with autism.Design, Setting, and ParticipantsThis prognostic study involved

ImportancePediatric anesthesia emergence delirium (PAED) is a common complication of general anesthesia and has unknown etiology. Exposure to volatile anesthetics may contribute to PAED, and excessive exposure may occur frequently during routine pediatric anesthesia.ObjectiveTo examine whether use of electroencephalography (EEG) monitoring can reduce PAED by minimizing exposure to sevoflurane while

ImportanceToddler’s fractures (TF) of the tibia are commonly treated with casts and fracture clinic follow-up. However, a prefabricated removable boot might be sufficient and reduce unnecessary follow-up.ObjectivesTo determine whether pain in children with TF treated with a removable boot is not worse than those managed with a circumferential cast at 4 weeks postinjury.Design, Setting, and ParticipantsThis

This cross-sectional study examines the patterns of topical antibiotics dispensation to commercially insured school-aged children with acute infectious conjunctivitis.

ImportancePrior literature has explored the prevalence of motor impairments in autistic individuals, but estimates come from clinical, convenience, or small samples, limiting generalizability. Better understanding of the frequency of motor milestone delays in autistic individuals could improve early identification and subsequently lead to earlier intervention and better developmental outcomes.ObjectiveTo

ImportanceHistorically, Staphylococcus aureus has been a leading cause of morbidity and mortality in the neonatal intensive care unit (NICU). The current incidence and attributable mortality of late-onset invasive S aureus infection in hospitalized infants is unknown.ObjectiveTo estimate the incidence and attributable mortality of late-onset S aureus infection among hospitalized infants in the US.Design

ImportanceAccess to early intervention and rehabilitation services among children with cerebral palsy (CP) remains limited in Bangladesh, which demands an innovative and sustainable service delivery model.ObjectiveTo evaluate the effectiveness of the Sustainable Model of Early Intervention and Telerehabilitation for Children With CP (SMART-CP) model compared with usual care in improving access to and

This Viewpoint explores rising infant mortality rates in the US, including variation among states and associations with Medicaid expansion and abortion restrictions.

ImportanceAn emerging paradigm attributes third-trimester fetal growth deceleration in uncomplicated twin pregnancies to an evolutionary adaptive process. Evaluating longitudinal fetal soft-tissue development may provide important insights into differential fetal growth trajectories between twins and singletons.ObjectiveTo compare twin vs singleton lean and fat tissue growth across pregnancy.Design

This cross-sectional study examines the proportion of the adolescent population potentially facing barriers to abortion access owing to 3 types of state restrictions in the US.

ImportanceAlthough antenatal opioid exposure is associated with impaired brain growth, previous studies are limited by small sample sizes and lack of controls. As a result, the impacts of opioid exposure on the developing brain remain poorly understood.ObjectiveTo compare global, regional, and tissue-specific brain volumes in opioid-exposed newborns vs unexposed controls.Design, Setting, and ParticipantsIn

Importance Despite the unique physiological characteristics and health care needs of pediatric trauma patients, there is a lack of quality indicators (QIs) based on pediatric-specific evidence to support quality improvement in this population. Objective To develop a consensus-based set of QIs for acute pediatric trauma care that considers evidence on effectiveness, safety, cost-effectiveness, equity

This cohort study examines incident and subsequent health care visits associated with traumatic brain injury and stratified by social determinants of health.

ImportanceThe effectiveness of neonatal intensive care in very ill newborns has led to rapid growth in US neonatal intensive care unit (NICU) capacity that is uncorrelated with regional perinatal risk. It is not known if there is an association between growth of regional capacity and newborn mortality.ObjectiveTo estimate the association between change in NICU capacity and neonatal mortality across

This cross-sectional study examines age-specific trends in firearm violence among children and adults in the US after the onset of the COVID-19 pandemic.

This Viewpoint outlines some of the challenges of protecting human participants in multisite studies with a single institutional review board and recommends the development of increased guidance to protect participants.

This Viewpoint describes intrauterine and extrauterine auditory brain development and advocates for use of music therapy for preterm neonates in the neonatal intensive care unit (NICU).

ImportanceThe literature indicates that health care utilization (HCU) of children with untreated moderate-to-severe obstructive sleep apnea is greater than that of matched controls before diagnosis, and treatment is associated with a decline in HCU not observed in those who remain untreated. Research on this topic has been limited to retrospective analyses and observational cohort studies; little is