US Children Research Articles

Sometimes, Only Some Siblings Go to Foster Care: Exploring Split Sibling Groups in a Nationwide Sample.

Research on sibling separation in foster care often focuses on cases where all siblings are removed. However, separation can also occur when only some children are placed in care, a scenario that is underexplored. This study investigates: the frequency of partial sibling placements; differences between placed and non-placed siblings, as well as split versus intact sibling groups; and the risk of re-report and future placement for non-placed children in split groups compared to those in intact groups. US child maltreatment report (CMR) and foster care caseload data are accessed from National Child Abuse and Neglect Data System (NCANDS) and Adoption and Foster Care Reporting System (AFCARS). Sibling groups are assigned based on shared CMR in 2018. At least 27.4% of sibling groups, where at least one child is placed, are split. These groups have wide age ranges between children. Children in split groups left at home are at higher risk of placement than children in non-split groups.

Guideline-Concordant Antibiotic Use in Children With Community-Acquired Pneumonia.

Despite national guidelines on appropriate antibiotic therapy, there is wide variation in antibiotic decision-making for children with community-acquired pneumonia. This study sought to determine prevalence and factors associated with guideline-concordant antibiotic use in children presenting with pneumonia to the emergency department (ED). We enrolled children aged younger than 18years presenting to the ED at 2 US children's hospitals between September 2017 and May 2019 with clinical and radiographic pneumonia. The primary outcome was guideline-concordant antibiotic use as defined by the 2011 Infectious Diseases Society of America pediatric pneumonia guideline and local expert consensus. Outcomes included proportion of antibiotic use and proportion of guideline-concordant treatment. We used multivariable logistic regression models to determine associations of comorbidities and functional limitations, clinical findings, and radiographic characteristics with overall antibiotic use and guideline-concordant treatment. Among 772 included children, 573 received antibiotics (74.2%), and 441 (57.1%) received guideline-concordant antibiotic treatment. Antibiotic initiation was less likely in those with interstitial findings on chest radiograph (adjusted odds ratio [aOR], 0.14; 95% CI, 0.07-0.25) and negative results or nonperformance of viral testing (aOR, 0.39; 95% CI, 0.24-0.65). Guideline-concordant treatment was more likely in those with chest indrawing (aOR, 2.22; 95% CI, 1.34-3.66) and less likely in those with clinically significant effusion (aOR, 0.21; 95% CI, 0.06-0.76). Among children presenting to the ED with pneumonia, more than 40% received treatment inconsistent with guideline recommendations. These observations underscore opportunities to improve appropriate antibiotic use in this population.

Trends in Respiratory Pathogen Testing at US Children's Hospitals.

Respiratory pathogen testing has been a common deimplementation focus. The COVID-19 pandemic brought new considerations for respiratory testing; recent trends in testing rates are not well understood. To measure trends in respiratory testing among encounters for acute respiratory infections among children and adolescents (aged <18 years) from 2016 to 2023, assess the association of COVID-19 with these trends, and describe associated cost trends. This retrospective serial cross-sectional study included emergency department (ED) encounters and hospitalizations in US children's hospitals among children and adolescents with a primary acute infectious respiratory illness diagnosis. Data were ascertained from the Pediatric Health Information System database from January 1, 2016, to December 31, 2023. Respiratory pathogen testing. The primary outcome was the percentage of encounters with respiratory testing over time. Interrupted time series models were created to assess the association of COVID-19 with testing patterns. The inflation-adjusted standardized unit cost associated with respiratory testing was also examined. There were 5 090 923 eligible encounters among patients who were children or adolescents (mean [SD] age, 3.36 [4.06] years); 55.0% of the patients were male. Among these encounters, 87.5% were ED only, 77.9% involved children younger than 6 years, and 94.5% involved children without complex chronic conditions. Respiratory testing was performed in 37.2% of all encounters. The interrupted time series models demonstrated increasing prepandemic testing rates in both ED-only encounters (slope, 0.26 [95% CI, 0.21-0.30]; P < .001) and hospitalizations (slope, 0.12 [95% CI, 0.07-0.16]; P < .001). Increases in respiratory testing were seen at the onset of the COVID-19 pandemic in both ED-only encounters (level change, 33.78 [95% CI, 31.77-35.79]; P < .001) and hospitalizations (level change, 30.97 [95% CI, 29.21-32.73]; P < .001), associated initially with COVID-19-only testing. Postpandemic testing rates remained elevated relative to prepandemic levels. The percentage of encounters with respiratory testing increased from 13.6% [95% CI, 13.5%-13.7%] in 2016 to a peak of 62.2% [95% CI, 62.1%-62.3%] in 2022. While COVID-19-only testing decreased after 2020, other targeted testing and large-panel (>5 targets) testing increased. The inflation-adjusted standardized unit cost associated with respiratory testing increased from $34.2 [95% CI, $33.9-$34.6] per encounter in 2017 to $128.2 [95% CI, $127.7-$128.6] per encounter in 2022. The findings of this cross-sectional study suggest that respiratory testing rates have increased over time, with large increases at the onset of the COVID-19 pandemic that have persisted. Respiratory testing rates and related costs increased significantly, supporting a need for future deimplementation efforts.

Outcomes After Thoracoscopic and Open Repair of Esophageal Atresia With Tracheoesophageal Fistula at US Children's Hospitals.

Outcomes After Thoracoscopic and Open Repair of Esophageal Atresia With Tracheoesophageal Fistula at US Children's Hospitals.

Early life stress and pubertal predictors of subsequent substance use in a national diverse sample of adolescents: Sex and substance type matter.

Early life stress and pubertal predictors of subsequent substance use in a national diverse sample of adolescents: Sex and substance type matter.

Epidemiology of Pediatric Alopecia Areata.

This contemporary scoping narrative review examines the epidemiology of pediatric alopecia areata (AA), focusing on incidence, prevalence, racial and ethnic differences, and comorbidities. Articles containing original epidemiology on pediatric AA published between 2013 and 2024 were identified. From these studies, the estimated US child and adolescent incidence of AA is between 13.6 and 33.5 per 100,000 person-years, and the prevalence of AA is between 0.04% and 0.11%. Incidence and prevalence rates vary widely by geographic region and nation. A general pattern of highest estimated lifetime prevalence in North African and Middle Eastern nations, followed by high-income North American countries, then by Asian and Western European nations, and, lastly, by Latin America and sub-Saharan Africa emerged. Though infrequently reported, racial and ethnic differences were noted in the largest pediatric-specific studies: Hispanic/Latino, Black, and Asian children were affected by AA at higher rates compared to those who self-identify as White/Caucasian. AA carried a high burden of comorbidities, including atopic disease, vitiligo, mental illness, and thyroid conditions. The existing pediatric epidemiology can help identify potential disparities in care and guide additional research, advocacy, and policy.

Invasive Haemophilus influenzae Disease at a US Children's Hospital in the SARS-CoV-2 Era.

National data previously demonstrated an increase in invasive disease due to non-type b Haemophilus influenzae from the 2000s to the 2010s. Significant shifts in the epidemiology of respiratory pathogens in children have occurred in the post-SARS-CoV-2 era. We examined pediatric invasive H. influenzae disease in the pre- and post-SARS-CoV-2 years. Invasive H. influenzae infections were identified from culture records of the Texas Children's Hospital microbiology laboratory from January 2011 to December 2023. Invasive cases were considered those with isolation of H. influenzae from a sterile site. The annual number of cases/1000 admissions was used as a surrogate for incidence. One hundred twenty-four cases of invasive disease were identified. The median age was 1.9 years, and 57% had pre-existing comorbidities. The most common diagnosis was bacteremia without a focus (50%), followed by pneumonia (27%). An increase in invasive disease occurred from 2011 to 2019 (P < 0.001) followed by a decline from 2020 to 2021 (P = 0.04) and a subsequent resurgence (P < 0.001). Bacteremia declined in 2020 followed by an increase in 2022 (P = 0.003); 50% of pneumonia cases occurred in the final 2 study years. The most common strain types were nontypeable H. influenzae (NTHi, 52.4%), type a (17.5%) and type f (15.9%). NTHi declined in 2020 followed by a peak in 2022, exceeding prepandemic rates (P = 0.001). Respiratory viruses were codetected in 52.9% of those tested. The frequency of pediatric invasive H. influenzae has undergone change throughout the SARS-CoV-2 pandemic. Recent increases in disease activity are driven by NTHi presenting as bacteremia and pneumonia. Given the high burden of disease, these trends should continue to be monitored.

Prevalence, Socio-Demographic Characteristics, and Co-Morbidities of Autism Spectrum Disorder in US Children: Insights from the 2020–2021 National Survey of Children’s Health

Prevalence, Socio-Demographic Characteristics, and Co-Morbidities of Autism Spectrum Disorder in US Children: Insights from the 2020–2021 National Survey of Children’s Health

Rehabilitation's Vital Role in Pediatric Cancer Care: A Mixed Methods Study.

Rehabilitation (i.e., physical, occupational, speech therapy) aims to optimize function and quality of life (QOL) but is not consistently integrated into oncology care. This study aimed to develop a rehabilitation information sheet informed by the rehabilitation experiences of children diagnosed with cancer before age 19 and their parents/caregivers. This mixed methods, primarily qualitative study was conducted at two US children's hospitals. Eligible participants included childhood cancer survivors (CCS) aged 12-25 years who were referred to one or more rehabilitation therapies following diagnosis. Parents/Caregivers were eligible if their child was diagnosed with cancer before age 19 and referred to rehabilitation. Participants completed a semi-structured interview in English. Qualitative findings guided the development of a rehabilitation information sheet. CCS and caregiver participants and oncology and rehabilitation clinicians at the study sites provided feedback on the information sheet through an electronic survey. Thirteen CCS, 33 parents/caregivers, and 36 clinicians participated. Participants described how engaging in rehabilitation promoted normalcy following a new pediatric cancer diagnosis and supported self-confidence and mental health. Participants wanted information about rehabilitation soon after the child's diagnosis and emphasized that they prioritized rehabilitation during cancer care. Common barriers to rehabilitation included treatment side effects, insurance, and outpatient scheduling, whereas clear communication and working with consistent providers supported engagement. Almost all individuals (99%) reported the information sheet was easy to understand and the amount of information was just right (86%). Rehabilitation is highly valued by CCS and parents/caregivers, necessitating its integration into pediatric cancer care.

Adopting national recommendations for clinical management of pediatric obesity in primary care.

The World Health Organization reports that more than 390 million children and adolescents have obesity, with the US facing a prevalence of 14 million among this population and incurring an annual medical cost of $1.3 billion. Childhood and adolescent obesity stems from genetic, environmental, and socioecological factors, indicating the need for an evolving approach to pediatric obesity management. The updated 2023 American Academy of Pediatrics guideline for evaluation and treatment of pediatric obesity advocates for a child-centric strategy, considering health equity, racism, weight bias stigmatism, and adverse childhood experiences. Management includes intensive health behavior and lifestyle treatment, partnership with communities to build comprehensive treatment programs, promotion of early intervention, consideration of pharmacotherapy for children age 12 years and older, selective use of bariatric surgery, screening for and treatment of comorbidities, integration of mental health treatment, and use of motivational interviewing to engage patients in their care. Pediatric primary care providers play a key role in identification of obesity and encouragement of obesity treatment. Proactive management of childhood obesity benefits individuals, families, and the nation. Early intervention holds the promise of substantial cost savings on obesity-related healthcare. Healthcare providers wield significant influence in reducing childhood morbidity and enhancing the overall health of US children and adolescents.

Association of ADHD and LD with vision abnormalities among the children and adolescents in US, NHANES 1999-2004.

To examine the association of ADHD and LD with visual impairment, uncorrected refractive error, and refractive error (myopia, hyperopia, and astigmatism) among US children and adolescents. A population-based cross-sectional study included 3,385 participants aged 12-15 years from the large, representative sample of US NHANES. The diagnoses of ADHD and LD in children and adolescents, as reported by parents or adolescents themselves, were analyzed. All participants' right eyes were used to calculate the spherical equivalent refractive errors (SER) during the investigation. Myopia, hyperopia, and astigmatism were classified by SER. Visual acuity was categorized into normal, uncorrected refractive error (URE), and visual impairment (VI) according to objectively assessed for each eye. Logistic regression analysis was used to estimate the associations between ADHD and LD and vision abnormalities. Among a total of 3,385 children and adolescents aged 12-15 years, 279 were reported to have a diagnosis of ADHD, and 427 were reported to have a diagnosis of LD. Compared with those without ADHD, children and adolescents with ADHD had an increased risk of hyperopia, with odds ratios (ORs) of 1.66 (95% CI, 1.03-2.67). LD was associated with higher risks of hyperopia (OR = 1.85, 95% CI, 1.17-2.90) and astigmatism (OR = 1.63, 95% CI: 1.18-2.26). After controlling for confounding variables, the results remained stable. LD also increased the risk of vision impairment (OR = 3.05, 95% CI: 1.05-8.90) after controlling for confounders. Stratified analyses showed that ADHD was a risk factor for hyperopia in boys compared with girls (OR = 1.62, 95%CI = 1.03-2.72), in 12-13-year-old individuals compared with 14-15-year-olds (OR = 1.69, 95%CI = 1.05-3.42). LD was a risk factor for hyperopia and astigmatism in girls compared with boys (OR = 2.81, 95%CI = 1.53-5.14; OR = 2.18, 95%CI = 1.22-3.90), and in 12-13-year-old individuals compared with 14-15-year-olds (OR = 1.99, 95%CI = 1.16-3.42; OR = 1.65, 95%CI = 1.07-2.56). Children and adolescents diagnosed with ADHD and LD may be at a greater risk of developing hyperopia and astigmatism. To accurately diagnose and treat children affected by ADHD and LD, healthcare practitioners from various medical specialties should take this association into account.

Maternal smoking during pregnancy and blood lead levels in US children aged 1–15 years: associations modified by age and race

Abstract Objectives Tobacco smoke is an important source of lead exposure. Maternal smoking during pregnancy likely transfers lead from the mother to the child, contributing to increased lead exposure in developing children. The present study aims to examine the association between maternal smoking during pregnancy and blood lead levels (BLL) in children. Methods A total of 18,946 US children aged 1–15 years in the 1999–2016 National Health and Nutrition Examination Survey were included. We defined children with elevated BLL if BLL ≥ 3.5 µg/dL. We estimated odds ratios (ORs) of elevated BLL in children born to mothers who smoked versus nonsmoking mothers. Results A decreasing trend in the prevalence of elevated BLL occurred between 1999 and 2016. After adjustment for the trend and other covariates, children whose mothers smoked during pregnancy had significantly increased odds of having elevated BLL (OR = 1.60; 95% confidence interval [CI] 1.25–2.06) compared to children of nonsmoking mothers. The stratified analyses revealed a significant association existed in children aged 1–5 years (OR = 1.88 [95% CI 1.32–2.68]) and aged 6–10 years (OR = 1.79 [1.07–2.98]), but not in youths (11–15 years, OR = 0.72 [0.37–1.40]). Being born to smoking mothers was found to be associated with high odds of elevated BLL in White (1.93 [1.35–2.77]) and Black children (2.03 [1.43–2.87]), but with low odds in Hispanic children (0.46 [0.23–0.92]). Conclusions The study demonstrates age- and race-specific associations between maternal smoking during pregnancy and BLL among US children. Maternal smoking contributes to lead exposure in early life. Culturally appropriate interventions are needed to further reduce BLL in the pediatric population.

Inequities in Indigenous Youth with Rheumatic Fever in the USA: A Single-Center Study.

Rheumatic heart disease (RHD) is the most common acquired heart disease in children in the USA and worldwide. This study compares the diagnosis and outcomes of Indigenous and non-Indigenous youth with acute rheumatic fever (ARF) and RHD at a US children's hospital serving a several state catchment area with a large Indigenous population (>270 tribes representing 9.2% of the total US Indigenous population). This study involved a retrospective analysis of patients presenting to a major children's hospital between 2008 and 2018. Individuals aged 4-17 with a diagnosis of ARF or RHD were identified using International Classification of Diseases, Ninth and Tenth Revision (ICD-9, 10) codes. Patients with congenital heart disease were excluded. Chart review was performed on 132 individuals with ARF/RHD. 61% of individuals with non-missing race identified as Indigenous (defined as American Indian, Alaska Native, Native Hawaiian, or Pacific Islander). Average age at diagnosis was found to be 10.3 years for Indigenous youth, compared to 9.1 years for non-Indigenous youth. Indigenous youth were more likely to have cardiac involvement at the time of diagnosis. Indigenous youth had higher rates of aortic regurgitation on initial echocardiography, but no other significant differences were found in incidence of echocardiographic findings. Indigenous youth were diagnosed with rheumatic fever at a later age than non-Indigenous youth, and more likely to have cardiac involvement at time of diagnosis, indicating disparities between the two populations. This suggests a need for further study and development of screening tools.

Trends in Timing of Preemptive Kidney Transplantation and Association with Allograft and Survival Outcomes in Children.

There has been a recent trend towards starting dialysis at higher estimated glomerular filtration rates (eGFRs) in children, with no identified survival benefits. We aimed to determine whether there are similar trends in the timing of preemptive kidney transplant and whether higher eGFR (≥15 ml/min/1.73 m2) at preemptive kidney transplant was associated with clinical outcomes among US children. We performed a retrospective cohort study of 1,514 children in the United States Renal Data System who received a preemptive kidney transplant between 2006-2019. In primary analysis, we examined the association between calendar year and eGFR (ml/min/1.73 m2) at the time of preemptive kidney transplant, categorized as higher (eGFR ≥15) versus lower (eGFR <15) using logistic regressions. The relationship between eGFR at preemptive kidney transplant and graft failure or death was assessed using Cox proportional hazards and Fine-Gray models. We found a temporal trend in eGFR at preemptive kidney transplant in children; every five-year increase in calendar period was associated with 55% higher odds (95% confidence interval [CI] 1.35-1.79) of receiving a preemptive kidney transplant at higher eGFR. There was no association between preemptive kidney transplant at higher (versus lower) eGFR and the risk of allograft failure or death (hazard ratio [HR] 1.12, 95% CI 0.87-1.43) over a median follow-up of 5.7 years. There has been a trend towards preemptive kidney transplant at higher eGFR over time in children. Receipt of a preemptive kidney transplant at higher eGFR was not associated with allograft or patient survival. Implications of these trends deserve further study.

Pediatric Drowning and Prehospital Predictors of Critical Illness in the United States.

Drowning is a leading cause of injury-related death for US children. The study objectives are to describe the characteristics of pediatric drowning patients receiving emergency medical services (EMS) care in the United States and to identify patient-specific and incident-specific variables associated with critical illness after drowning. This is a cross-sectional study using the 2019 National Emergency Medical Services Information System database. Children below 19 years old with international classification of diseases 10 external cause of injury (E-codes) for drowning were included. Critical illness was defined as a recorded Glasgow Coma Scale score <9 at any time during EMS care. We performed multivariable logistic regression reporting odds ratios (OR) and 95% CI for the outcome of critical illness controlling for demographic and incident characteristics. Our study sample included 1052 patients, and 57% were below 5 years. Critical illness after drowning was identified in 23.9% (n=251). Most drowning patients were transported via advanced life support (88.4% for noncritically ill, 87.3% for critically ill patients). Resuscitation procedures performed by EMS for these patients included the following: 12.7% with assisted ventilation, 6.7% with advanced airway management, and 17.8% with cardiopulmonary resuscitation. There were increased odds of critical illness in males (OR 1.41, 95% CI: 1.03, 1.93) and in children below 1 year (OR 2.54, 95% CI: 1.26, 5.10) and 1 to 4 years (OR 1.61, 95% CI: 1.01, 2.56) compared with 13 to 19 years and decreased odds for urban location (OR 0.60, 95% CI: 0.39, 0.91). Among children receiving EMS care after drowning, 23.9% were critically ill, and predictors of critical illness included male sex, young age, and nonurban locations. Using national EMS data is a novel approach to inform prehospital and emergency department preparedness to improve care for pediatric patients after drowning including pediatric resuscitation procedures by EMS personnel.

Key Nutrient Intakes at Risk Among US Children in the National Health and Nutrition Examination Survey (NHANES) 2015-2016 Stratified by Age and Gender.

Inadequate nutrient intake in childhood can have lasting detrimental developmental and health outcomes. The objective of this study was to identify key nutrient intake gaps among US children. Using the National Health and Nutrition Examination Survey 2015-2016 data, we compared nutrient intakes against dietary reference intakes (DRIs). Participants were grouped by age (in years): 0-0.5, 0.6-1, 1-4, 5-8, 9-14, and 15-19. Gender differences were assessed in the two older groups. Linoleic acid, linolenic acid, vitamin D, and choline were the most consumed at lesser than DRIs in all age groups. Additionally, dietary fiber, vitamin A, vitamin E, vitamin K, folate, iron, and calcium were consumed at lesser than DRIs in 1-19 year olds. They also had an inadequate intake of docosahexaenoic acid (DHA). Children with nutrient intake gaps increased from infancy and toddlerhood to school-age period, with the inflection point at 5-8 years of age when parents have limited control on children's nutrient intake. Above 9 years of age, females had greater nutrient intake gaps than males. Females in the 15-19-year-old segment especially had higher nutrient intake gaps (p < 0.05) for vitamin D, thiamin, riboflavin, vitamin B12, folate, iron, calcium, magnesium, phosphorus, and potassium compared to males. Selected laboratory biomarkers were used to verify the nutrient intake data. Key nutrient intake gaps were identified among different age groups of children in the US, which may have implications for future dietary interventions and target food formulations to help narrow these gaps.

Pediatric Mental Health Boarding: 2017 to 2023.

Boarding for pediatric mental health (MH) conditions is common at US children's hospitals while patients await care at a psychiatric facility. We sought to describe recent trends in boarding encounters and to identify factors associated with prolonged length of stay. We performed a retrospective cross-sectional study analyzing pediatric MH boarding encounters at 40 tertiary children's hospitals included in the Pediatric Health Information System database between January 1, 2017, and December 31, 2023. Children ages 3 to 18 presenting with a primary psychiatric diagnosis were included in the analysis. We assessed trends in boarding encounters and length of stay over time and analyzed variations in boarding practices among hospitals. Risk factors for prolonged boarding (≥9 days) were identified using mixed effects logistic regression models. Between 2017 and 2023, there were 100 784 boarding encounters across 40 hospitals. Median length of stay for boarding encounters increased from 3 to 4 days (P < .001) and 350 (0.3%) children had stays of longer than 100 days. Boarding practices varied significantly by hospital site. Factors associated with prolonged boarding included older age, government insurance type, increasing medical complexity, specific psychiatric disorder, season of presentation, and discharge disposition to home. Boarding while awaiting acute psychiatric care remains common, with a sustained increase in the volume of boarding encounters and length of stay since the onset of the COVID-19 pandemic. Patients with medical and/or psychiatric complexity may be more likely to experience prolonged boarding, highlighting an area for improved access to care.

Trends in Obesity-Related Measures Among US Children, Adolescents, and Adults

Trends in Obesity-Related Measures Among US Children, Adolescents, and Adults

Association of cigarette use with risk of prostate cancer among US males: a cross-sectional study from NHANES 1999–2020

BackgroundAssociation of cigarette use with risk of prostate cancer remains unclear. We performed this study to examine whether cigarette use is associated with increased risk of prostate cancer.MethodsThis cross-sectional study used data from the 1999 to 2020 National Health and Nutrition Examination Survey (NHANES), a population-based nationally representative survey designed to assess the health and nutritional status of US adults and children. Males were eligible if they were aged ≥ 20 years at the time of participation. Cigarette use (ever use, categorized into former use and current use) was defined as having smoked at least 100 cigarettes in life. Smoking duration, cigarettes smoked per day, and smoking pack-years were calculated in former smokers and current smokers. The primary outcome was self-reported diagnosis of prostate cancer by participants. Logistic regression was used to calculate the adjusted odd ratios (aOR) and 95% CI for the associations of cigarette use with risk of prostate cancer, adjusting for demographic characteristics. Subgroup analyses by age group were conducted. Data were analyzed from June 4 to November 30, 2023.ResultsOf the 107 622 participants in 1999–2020 NHANES, 28 170 were included in the analysis. The mean (SD) age of the 28 170 participants was 46.4 (16.4) years, 68.0% were non-Hispanic White. Compared with never smokers, ever (aOR, 2.41 [95% CI, 1.15–5.06]) and former smokers (aOR, 3.56 [95% CI, 1.62–7.85]) had a higher risk of prostate cancer. This higher risk in former (aOR, 3.82 [95% CI, 1.69–8.64]) and ever smokers (aOR, 2.82 [95% CI, 1.27–6.25]) was also found in participants aged 20–59 years. Dose-response analysis showed a positive association between smoking duration (aOR, 1.07 [95% CI, 1.03–1.11]), cigarettes smoked per day (aOR, 1.03 [95% CI, 1.00-1.07]), smoking pack-years (aOR, 1.02 [95% CI, 1.01–1.03]) and risk of prostate cancer in current smokers.ConclusionsThis study suggests that cigarette use was associated with an increased risk of prostate cancer in US males, especially among those aged 20–59 years. Further research utilizing prospective study design and modeling family history is needed to confirm the findings.

Association between maternal smoking during pregnancy and developmental disabilities in US children and adolescents: A cross-sectional study from NHANES.

Maternal smoking during pregnancy is associated with placental DNA methylation and RNA expression, offspring DNA methylation, and affects the decline of mature neurons and the prenatal human brain development trajectory. This study is a secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) spanning 2003 to 2008, comprising 10111 children and adolescents. Inclusion criteria required participants to have complete questionnaire responses regarding maternal smoking during pregnancy and receipt of special education or early intervention services. The risk of developmental disabilities was assessed using a multifactor logistic regression model. In the cohort of 10111 children and adolescents, 727 (7.2%) received special education or early intervention services. Of these participants, 1504 (14.9%) were exposed to maternal smoking during pregnancy. The prevalence of maternal smoking was higher (12.3%) in the group receiving special education or early intervention compared to those who did not (6.3%). After adjusting for other relevant factors in a multifactorial logistic regression model, maternal smoking during pregnancy was significantly associated with an increased likelihood of requiring special education or early intervention services (adjusted odds ratio, AOR=1.51; 95% CI: 1.24-1.83, p<0.001). This cross-sectional analysis found an association between maternal smoking during pregnancy and the need for special education or early intervention services among US children and adolescents, after adjusting for confounding variables. Our findings suggest that maternal smoking during pregnancy may increase the odds of developmental disabilities.