Progress on Theme 4

Improving Child and Adolescent Health and the Transition to Adulthood

Highlighted Programs and Activities

  • NEW: NICHD Neonatal Research Network (NRN)
    The purpose of the NRN is to improve healthcare and outcomes for newborns, such as by finding ways to improve the chances for survival without neurodevelopmental impairment for infants born preterm, low-birth weight, or with other serious conditions. NICHD is updating the NRN to be its primary and first-line infrastructure involved in implementing multisite neonatal clinical trials. The NRN will conduct definitive, rigorous, and reproducible, multisite clinical trials and observational studies in newborns and lactating people, providing evidence to guide neonatology, pediatric pharmacology, and lactation clinical practice. The network infrastructure will include clinical sites, a data coordinating center, and, for the first time, separate grants awarded under separate funding opportunity announcements. Learn more: RFA-HD-23-001 and RFA-HD-23-002.
  • NEW: CAPSTONE Centers for Multidisciplinary Research in Child Abuse and Neglect
    By reissuing the CAPSTONE centers, NICHD will continue to stimulate collaborative research on all forms of child abuse and neglect, and to support dissemination and outreach efforts that bridge research, clinical practice, and policy. Areas of research include: 1) trials to test the efficacy and effectiveness of clinical interventions; 2) longitudinal prospective studies on the long-term effects of specific and understudied types of maltreatment; 3) studies examining the neurobiology of abuse and neglect and the implications for health outcomes; and 4) studies to develop screening tools and clinical assessment measures for early identification and treatment. The centers are also required to include a dissemination and outreach core. Learn more: RFA-HD-23-007.
  • NEW: Community-level interventions for firearm and related violence, injury, and mortality prevention
    NICHD is collaborating with other NIH institutes, centers, and offices to support a network of research projects to develop and test interventions at the community or community organization level to prevent firearm and related violence, injury, and mortality. The network will include phased research projects and a coordinating center to provide overarching support and guidance. Learn more: PAR-22-115 and PAR-22-120.

Selected Recent Advances

  • NEW: COVID-19 vaccination during pregnancy may help protect offspring through age 6 months (PMID: 35129576)
    Researchers sought to determine how long antibodies against the spike protein, which plays a major role in infection, remained in the blood for infants whose mothers were vaccinated or infected during pregnancy. They limited their study to individuals vaccinated against SARS-CoV-2 or infected with the virus from 20 to 32 weeks of pregnancy. Previous studies found that higher levels of antibodies were transferred across the placenta during this time frame, compared to later in pregnancy. The scientists established that vaccinating women against SARS-CoV-2 in mid- to late pregnancy provided their infants at least some protection against COVID-19 through 6 months of age.
  • NEW: Mandatory masking in schools reduced COVID-19 cases during Delta surge (PMID: 35260896)
    Researchers found that schools that employed mandatory masking during the Delta surge of COVID-19 had approximately 72% fewer cases of in-school transmission when compared to schools with optional or partial masking policies. This study included more than 1.1 million students and more than 157,000 staff attending in-person school across nine states: California, Georgia, Kansas, Missouri, North Carolina, Tennessee, Texas, Washington, and Wisconsin.
  • NEW: Adolescents with autism spectrum disorder (ASD) experience gaps in healthcare provider support during the transition to adulthood (PMID: 35165029)
    For many adults with ASD, connections with healthcare providers become less frequent and more difficult once they transition from pediatric to adult healthcare. To understand current transition planning practices, researchers surveyed 74 health professionals (physicians, advanced practice professionals, psychologists, or social workers) who provided services to patients with ASD in the Philadelphia area. The median age of patients when providers began transition-related conversations was 16 years, later than current recommendations to begin in early adolescence. More than one-half of those surveyed (57%) were only “somewhat” or “a little” comfortable having these conversations. About 90% of providers reported discussing at least some topics related to the transition to adult healthcare, but certain key topics were addressed only seldomly. Of particular concern, nearly one-half of providers reported that they did not discuss pregnancy prevention and parenting with patients. Other topics related to basic needs in adulthood, such as housing (28%) and food management (42%), were likewise addressed by only a small sample of providers.
  • NEW: Youth suicides increased in first year of the pandemic (PMID: 35467724)
    To study changes in adolescent suicides during the pandemic, researchers obtained death record data from 14 states: Alaska, Arkansas, California, Colorado, Connecticut, Georgia, Indiana, Montana, Nebraska, New Jersey, Ohio, Oklahoma, Virginia, and Vermont. For each state, they compared the average suicide counts from 2015 to 2019 to suicide counts from 2020, the first year of the pandemic. Although the number and proportion of youth suicide varied among individual states, when all the states were considered together, researchers found an increase in the number of suicides among youth 10 to 19 years of age, and in the proportion of youth suicides compared to the overall population. The authors noted that suicides among adults 35 and older declined during the pandemic, and that, together, the findings suggest the pandemic affected youth differently than adults.
  • High screen-time use and school-age outcomes in extremely preterm children (PMID: 34251406)
    Both preterm birth and increased screen time are associated with an increase in risks of developmental and behavioral problems. Researchers analyzed data from more than 400 children born extremely preterm (before 28 weeks of pregnancy) and found that many had high screen-time use rates, with 57% spending more than 2 hours per day looking at screens. In addition, almost two-thirds had a television/computer in their bedroom. After adjusting for other factors, high screen time (2 hours or more per day) was associated with an increased risk of cognitive, executive function, and behavioral problems at early school age among 6- to 7-year-old children. High screen time was also associated with overweight and less physical activity.
  • No serious adverse events from COVID-19 vaccine in breastfeeding women or their children (PMID: 34492204)
    Researchers found no serious adverse events reported by 180 breastfeeding women—neither to themselves or their infants—who received either the Pfizer or Moderna COVID vaccine. Similar proportions of women reported side effects after the first dose of either vaccine, while women were more likely to report side effects after the second dose of the Moderna vaccine than after the second dose of the Pfizer vaccine. The authors noted that the study data should reassure people regarding the safety of vaccine use in breastfeeding women and their children.
  • Identifying genetic causes of stillbirth (PMID: 32786180)
    This research suggests that whole exome sequencing could provide information for counseling families that experience stillbirth and to inform medical care of future pregnancies.
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