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In This Issue of JAMA Pediatrics |

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JAMA Pediatr. 2016;170(2):99. doi:10.1001/jamapediatrics.2015.2501.
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There is continued confusion regarding the appropriate use of antidepressants during pregnancy. Boukhris and colleagues study 145 456 infants and their mothers’ pregnancies. Use of antidepressants during pregnancy was associated with a 75% greater risk of autism spectrum disorder, even after adjusting for maternal history of depression. The accompanying editorial by King discusses the need to balance the benefits of treating maternal depression during pregnancy with the increased risk of autism in offspring.

Optimizing the quality of parent-child play time is important for children’s language development. Sosa studies parent-infant play sessions with different types of toys and books. Play with traditional toys and with books was accompanied by far better communication and interaction with the child than play with electronic toys. Children vocalized less during play with electronic toys than during play with books. In their editorial, Radesky and Christakis discuss the potential for engaging children in their play with electronic toys but caution about the exclusion of parent engagement that can accompany their use.

Genome-wide association studies have identified genetic risks for obesity. Steinsbekk and colleagues use a longitudinal birth cohort to examine whether genetic risk for obesity is associated with accelerated weight gain in middle childhood (ages 4-8 years) and whether genetic association with accelerated weight gain is mediated by appetite traits. Children at higher genetic risk for obesity had higher baseline body mass index and fat mass compared with lower genetic risk peers and they gained weight and fat mass more rapidly during follow-up, but this weight gain was not mediated by appetite traits. Interventions targeting childhood weight gain may provide one path to mitigating genetic risk, but appetite traits may not be a promising target for such interventions

Child abuse in youth-serving organizations has received considerable attention in the wake of extensive news coverage of such cases. Shattuck and colleagues examine data from 3 national surveys in 2008, 20011, and 2014 of children aged 10 to 17 years. The rate of abuse by persons in youth-serving organizations was 0.4% for the past year and 0.8% over the lifetime. Most of the maltreatment (63.2%) was verbal abuse, and only 6.4% was any form of sexual victimization or assault. Abuse in youth-serving organizations was a relatively rare form of abuse, dwarfed by abuse by family members and other adults.


Although the long-term use of inhaled corticosteroids has a more favorable safety profile than oral steroids, uncertainty about systemic complications persist. Kapadia and colleagues review the endocrine effects of inhaled corticosteroids in children and the properties of various formulations as they relate to adverse outcomes. Clinical effectiveness of these drugs has a strong positive correlation with systemic absorption, and data on an adverse effect profile similar to oral steroids is emerging, albeit milder and with less frequency.





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