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In This Issue of JAMA Pediatrics |

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JAMA Pediatr. 2016;170(9):819. doi:10.1001/jamapediatrics.2015.2550.
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In this secondary analysis of data from a randomized clinical trial, Nunes and coauthors examine the protective effect of maternal immunization up to 6 months after birth in 2049 infants. While vaccine efficacy was 85.6% in the first 8 weeks of life, the protective effect and antibody titers waned rapidly thereafter. Munoz’s editorial discusses the need for more immunogenic vaccines for pregnant women and the need to optimize passive immunity for their infants.

In children with febrile urinary tract infections (UTIs), a delay in the initiation of antibiotic therapy has been hypothesized to increase the risk for renal scarring. Using data from 2 large longitudinal studies, Shaikh and coauthors examine the effect of treatment delay on outcome in 482 children 2 to 72 months of age with febrile UTIs. A delay in antibiotic administration of 48 hours or more after fever onset increased the odds of renal scarring by 47%. In their editorial, Marquez and Palazzi discuss the need for prompt testing and initiation of antibiotic therapy pending culture confirmation in children suspected of having a febrile UTI.

Neonates undergoing noncardiac surgery have a relatively high postoperative mortality rate. Goobie and coauthors examine preoperative anemia (hematocrit <40%) in neonates included in the American College of Surgeons National Surgical Quality Improvement Program. The adjusted odds of postoperative mortality was 2.6 in infants with preoperative anemia compared with those with nonanemic hematocrits. In their editorial, Higgins and coauthors discuss the potential implications of this study and the need to conduct trials of transfusion in this population.

Continuing Medical Education and Journal Club

Severe obesity is associated with limitations in mobility and higher incidence of multijoint musculoskeletal pain. In this follow-up of patients receiving bariatric surgery in the Teen-LABS study by Ryder and coauthors, 206 teens with severe obesity were followed up for 24 months after surgery. By 6 months after surgery, there were meaningful improvements in function mobility and musculoskeletal pain, which maintained up to the 24-month follow-up point. Functional mobility in adolescents with severe obesity can be improved in a relatively short period following bariatric surgery.

Prior studies have found an association between induction and augmentation of labor and increased risk for autism spectrum disorders (ASDs) in offspring. Oberg and coauthors conduct a nationwide study in Sweden for all 1.3 million births over a 14-year period. There was a significant association between labor induction and risk for ASD, but this disappeared when compared with induction-discordant siblings. In an editorial, Coury discusses what is known about this and other factors associated with the risk for ASD.






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