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In This Issue of JAMA Pediatrics
July 2015


JAMA Pediatr. 2015;169(7):615. doi:10.1001/jamapediatrics.2014.2136

Delayed cord clamping reduces the risk for subsequent iron deficiency during the first 4 months of life and can potentially result in improved neurodevelopment. Andersson and colleagues follow up 263 children at low risk for iron deficiency in a randomized clinical trial of delayed cord clamping compared with early clamping to examine their neurodevelopmental outcomes at age 4 years. Delayed clamping improved scores in the fine-motor and social domains at 4 years of age, especially in boys. The editorial by Rabe et al discusses the implications of this intervention for improving global infant health.


Although surgical advances have resulted in successful transplants using neonatal donors, the actual practice of neonatal organ donation after circulatory determination of death remains uncommon. Stiers and colleagues review the experience of neonatal organ donation at a large health care system. Almost half of the deaths of neonates met criteria for donation after circulatory determination of death but less than 10% were appropriately referred for potential organ donation. At present, a disconnect exists between donor potential and the identification and timely referral that lead to successful transplants.

Continuing Medical Education and Journal Club

Invasive pneumococcal disease (IPD) is a leading cause of pneumonia, meningitis, and bacteremia in children. Farnham and colleagues examine the changes in the epidemiology and incidence of IPD in children younger than 5 years in New York City after the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in March 2010. The incidence of IPD decreased by 69.6% and by 82.5% in disease caused by serotypes in PCV13. Feemster’s editorial reminds us of the benefits of vaccine and the current threats to child health from vaccine exemption laws.


Childhood sleepwalking and sleep terrors are 2 parasomnias with a risk for serious injury for which familial aggregation has been shown. In this longitudinal cohort study, Petit and colleagues examine the prevalence of these disorders and the risk for sleepwalking in children who had sleep terrors when younger. One-third of children had sleep terrors, peaking at 1½ years of age, and 13% had sleepwalking at age 10 years. As many as one-third of the children who had early childhood sleep terrors developed sleepwalking later in childhood.

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Stunting (short length for age) and wasting (low body mass index for age) are widely used to assess child nutrition, while newborns tend to be assessed solely on their weight. Victora and colleagues examine risk factors for stunting and wasting in 51 200 newborns. Of the 26 conditions studied, short maternal height, younger maternal age, smoking, drug use, and clinically suspected intrauterine growth restriction were most strongly related to stunting, while neonatal intensive care unit stay, respiratory distress syndrome, transient tachypnea, and no oral feeding for more than 24 hours were more strongly related to wasting.

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