PEDIATRICS

OBJECTIVE Evidence-based care guidelines and clinical pathways are central to quality, equitable, and standardized pediatric asthma care. We sought to improve delivery of optimal guideline-concordant asthma care, defined as documentation of (1) medical and social-environmental risk assessment, (2) a maintenance medication plan, and (3) accurate asthma action plan at discharge. Specifically, we so…

OBJECTIVES This study set out to describe imported pediatric malaria in the United States over an 8-year period, including patient demographics, clinical outcomes, and risk factors for severe disease. METHODS A retrospective descriptive study of pediatric patients treated for malaria at 9 hospitals in the United States from 2016 to 2023 was conducted to analyze patient demographics, clinical outc…

We present 2 case reports of the benefits of the subcutaneous once-weekly glucagon-like peptide 1 receptor agonist (GLP-1RA) therapy semaglutide in adolescents with type 1 diabetes (T1D) complicated by obesity. Two female individuals (17 and 12 years old) with T1D who have automated and continuous insulin delivery systems presented with marked weight gain, increasing insulin requirement, and subo…

OBJECTIVES The Bayley is widely used for developmental assessment of young children. Reports suggest that Bayley-III overestimates scores and underidentifies developmental delay. Hypothesis: Using preterm cohort data, Bayley-4 scores will be lower than Bayley-III, with higher rates of developmental delay. METHODS Data are from the SuPreme Study, a prospective observational cohort of 1601 very pre…

BACKGROUND AND OBJECTIVES Biannual preventive dental visits are recommended to promote good oral health and identify problems, yet children in many families do not receive this care due to time-related barriers. Paid sick leave mandates have the potential to relieve parental time constraints and facilitate scheduling and attending pediatric dental visits; thus, we sought to evaluate the effects o…

BACKGROUND Families and clinicians need more information about complications associated with congenital pulmonary malformations (CPMs) to engage in shared decision-making about surgery for asymptomatic children. The study’s aim was to prospectively describe symptoms in children with a CPM and to identify markers associated with surgical removal because of symptoms. METHODS MALFPULM is a prospecti…

OBJECTIVES We hypothesized that the incidence, clinical presentation, isolate serotypes, and isolate antibiotic susceptibility of Streptococcus pneumoniae causing pneumonia in children varied before and through the course of the COVID-19 pandemic. METHODS Patients aged 18 years or younger at 8 children’s hospitals in the United States admitted with culture-positive pneumonia were identified. Sero…

In March 2022, the US Food and Drug Administration issued a drug safety communication (DSC) recommending monitoring of thyroid function in children up to 3 years of age who receive intravascular injection of iodinated contrast media (IV ICM) for medical imaging. In response, a group of pediatric and imaging experts convened to review the current scientific evidence on thyroid dysfunction after IV…

Despite widespread recognition that mental and emotional concerns in childhood have risen to an unprecedented high, there continues to be a sense of hesitancy in approaching mental and emotional development in pediatrics. This hesitancy is related to pervasive barriers including lack of comfort, time, and perhaps most importantly, lack of resources to offer families. However, research supports th…

BACKGROUND AND OBJECTIVES Enhanced premium tax credits (PTCs) for Affordable Care Act Marketplace plans expired in 2026. We described families across income groups potentially affected by PTC policy changes and simulated net premiums. METHODS We performed a cross-sectional simulation using the 2023 National Survey of Children's Health, classifying families by federal poverty level (FPL) into the …

Pediatric hospitals track extensive operational metrics, yet strain recognition and mitigation are shaped by institutional priorities, professional norms, and measurement limitations. Improving strain management may require multidimensional measurement approaches and policy-level changes to strengthen pediatric care infrastructure.

During a decade when ED opioid prescribing to adolescents decreased substantially, subsequent opioid-related harms nearly doubled in Alberta. Broad deprescribing measures in the ED may not effectively combat the opioid epidemic in this province. However, caution should remain for patients with longer prescription durations, frequent ED use, and mental health or substance use comorbidity and furth…

In this issue of Pediatrics, Kutz et al report the incidence of type 1 diabetes (T1D) in youth younger than 20 years in Chile from 2007 to 2023.1 They identified a wave-like pattern in the incidence of T1D following the onset of the pandemic. This began with an increase in 2020 and 2021 that exceeded previous predictions, before declining to predicted rates in 2022 and 2023. This finding is consi…

This study includes relevant data after 2021 and regarding severity. A significant increase in T1D incidence was found during the COVID-19 pandemic, paired with a higher severity at onset, returning to the prepandemic trend afterward. A causal relationship may be argued.

Primary adrenal insufficiency, or Addison disease, can be caused by an autoimmune process and presents with poor growth, poor weight gain, nausea, vomiting, fatigue, and skin hyperpigmentation. During times of stress or illness, patients with untreated or insufficiently treated adrenal insufficiency are at risk for adrenal crisis progressing to hypotensive shock, lethargy, confusion, coma, and de…

BACKGROUND SARS-CoV-2 vaccination during pregnancy reduces COVID-19 risk in infancy. Whether maternal vaccination before pregnancy similarly protects infants against COVID-19 is unknown. METHODS We examined the effectiveness of maternal messenger RNA SARS-CoV-2 vaccination before and during pregnancy in preventing COVID-19 in infants aged 0–6 months born between July 1, 2021, and June 30, 2023, a…

INTRODUCTION In 2015, the Indian Health Service reported an obesity prevalence rate of 29.7% for American Indian/Alaska Native children aged 2 to 19 years. The purpose of these annual evaluations is to describe the prevalence of obesity, prediabetes, and diabetes for American Indian children living on one reservation in the Northern Great Plains. METHODS From 2019–2020 through 2022–2023, American…