BACKGROUND AND OBJECTIVE The cash-value benefit (CVB) in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) supports low-income households with young children to purchase fruits and vegetables. Our objective was to estimate whether the amounts households spent with the CVB increased after recent policy changes. METHODS In this natural experiment from 2017 to 2022 among 485 560 Massachusetts WIC-participating households with children aged less than 4 years, an interrupted time series analysis estimated the association between (1) an initial CVB increase from $9 per month for children to $35 per month in June 2021 and (2) an adjustment to $24 per month for children with the absolute cash value and proportion redeemed of the CVB each month. RESULTS Before the first CVB change in June 2021, households (who often had multiple WIC participants within) redeemed an average of $11.45 per month, or 85% of the total benefit issued. In June 2021, the average dollar amount redeemed per household immediately increased (+$21.73; 95% CI, $21.27 to $22.19) and then stayed steady. In October 2021, the amount redeemed immediately decreased (−$6.89, 95% CI, −$7.38 to −$6.39) but then started gradually increasing by $0.57 per month (95% CI, $0.17 to $0.96). No significant trends were observed in the proportion of CVB redeemed, which remained consistently high. CONCLUSIONS Increasing the CVB amount was associated with substantial increases in the amount of WIC benefits spent on fruits and vegetables for households with young children. These households’ consistent, high use of the increased CVB suggests the evidence-based increase to this benefit addressed an unmet need.
OBJECTIVE Pediatric vulvar lichen sclerosus (VLS) is an inflammatory dermatosis that often presents with pruritus, dysuria, and constipation and can lead to long-term sequelae including scarring. Epidemiologic and clinical data in diverse US pediatric populations are limited. We aimed to characterize demographic and clinical features of pediatric VLS in a large health maintenance organization. METHODS Retrospective cohort study of female patients aged 0 to 18 years diagnosed with VLS in Kaiser Permanente Southern California from 2009 to 2019. Inclusion required at least 2 International Classification of Diseases, Ninth/Tenth Revision codes for LS diagnosis codes within 6 months, with at least 1 in-person evaluation. Electronic medical record review of 167 patients confirmed diagnoses, demographics, presenting and diagnosing specialties, differential diagnoses, examination findings, and biopsy rates. RESULTS VLS was identified in 167 patients, predominantly in prepubertal girls (7.3 ± 3.6 years) with broad ethnic representation (Hispanic, 46.1%, white, 28.7%). VLS was associated with autoimmune comorbidities including vitiligo, scleroderma, and systemic lupus erythematosus. Pediatricians and dermatologists diagnosed LS nearly equally. Biopsy confirmation rate was 6%. Common differential diagnoses were candidiasis and vitiligo; nonaccidental trauma was considered in 17 patients and was associated with delayed diagnosis and management. CONCLUSION These data provide a comprehensive profile of pediatric VLS in a large US health system and highlight age patterns, racial and ethnic distributions, complex clinical presentations, and common differential diagnoses that lead to diagnostic delays. These findings support heightened clinical awareness, early recognition, and multidisciplinary management in diverse pediatric populations.
OBJECTIVE We aimed to compare perinatal and neurodevelopmental outcomes between very low birth weight (VLBW) preterm infants conceived by assisted reproductive technology (ART) and infants conceived spontaneously. METHODS This retrospective multicenter cohort study used data from the Taiwan Premature Infant Follow-up Network database on infants born between 1998 and 2017. Primary outcomes were survival to hospital discharge and neurodevelopmental impairment (NDI) at 2 years’ corrected age. Adjusted risk ratios (aRRs) for NDI were estimated using modified Poisson regression with broader and confounder-only adjustment strategies, with prespecified sensitivity analyses including multiple gestation. RESULTS The study population comprised 19 901 preterm VLBW infants, of whom 3762 (18.9%) were conceived by ART. Compared with the spontaneous conception group, the ART group had more multiple gestations and older, more educated parents (all P < .001). Survival to hospital discharge was higher among ART-conceived infants than among spontaneously conceived infants (86.3% vs 84.8%; P = .03), whereas NDI at 2 years’ corrected age was lower in crude comparisons (21.6% vs 23.5%; P = .05). In modified Poisson regression analyses, ART exposure was not significantly associated with NDI in the broader adjusted model (aRR, 0.96; 95% CI, 0.89–1.03) or the confounder-only model (aRR, 0.93; 95% CI, 0.85–1.02). In a broader sensitivity model additionally including multiple gestation, the association was borderline (aRR, 0.91; 95% CI, 0.83–1.00). CONCLUSION In our cohort, VLBW preterm infants conceived by ART had an adjusted risk of NDI comparable to that of spontaneously conceived infants.
BACKGROUND AND OBJECTIVES Studies suggest that pre-bedtime screen exposure disrupts the circadian rhythm by suppressing melatonin release in the pineal gland. This study investigates melatonin suppression in toddlers after screen exposure in the home environment. We hypothesized that viewing a video as opposed to viewing a picture book before bedtime would suppress melatonin release and disrupt subsequent sleep. METHODS Thirty-two toddlers aged 15 to 24 months participated in a within-subject design. On 2 consecutive evenings, caregivers exposed their toddler for 15 minutes to either a video on a touchscreen with the blue light filter deactivated or to a picture book, starting 45 minutes pre-bedtime. To determine melatonin concentration, caregivers collected 1 saliva sample before exposure (baseline) and 2 saliva samples 5 minutes (post_1) and 20 minutes (post_2) after exposure. Toddlers’ sleep–wake patterns were monitored using actigraphy. RESULTS Multilevel models revealed that salivary melatonin increased from baseline to post_2 irrespective of touchscreen or picture book exposure. Changes in melatonin concentration from baseline to post-exposure measurement and sleep behavior did not differ as a function of exposure condition. Sleep behavior was unrelated to melatonin suppression scores. CONCLUSIONS Contrary to expectations, our results suggest that viewing a 15-minute video on a touchscreen within an hour of bedtime is insufficient to suppress evening melatonin release and disrupt sleep under these experimental conditions in German toddlers. More studies with toddlers under naturalistic conditions are needed to understand the relevance of screen light-induced melatonin suppression as a mechanism to explain relationships between screen exposure and sleep health.
BACKGROUND AND OBJECTIVES In October 2017, BC Children’s Hospital opened the Family Immunization Clinic (FIC)—a permanent immunization clinic within an acute care setting and the first of its kind in Canada. The purpose of this analysis was to describe the characteristics of the populations visiting FIC and evaluate clinic visit reasons over time. METHODS This was a retrospective observational study. Contemporaneously collected data were extracted from the clinic database for encounters between October 1, 2017, and September 30, 2024. Study variables of interest included referral information, patient demographics, patient visit summary, and vaccine information. Linear regression was used to examine trends in clinic activities over time. RESULTS Across the study period, there were 12 245 patients seen at the general clinic and 5218 at the clinic for influenza vaccines only, in a total of 25 186 and 6791 unique visits, respectively. The most common reason for patients aged 18 years or younger visiting the clinic was routine/catchup immunization (74%) and high-risk populations with additional vaccine considerations (14%). Visits from high-risk populations increased significantly over time (P < .05, β = 2.45). Vaccines were administered by FIC nurses for patients while receiving general anesthesia in 103 visits, and such visits also significantly increased over time (P < .05). CONCLUSION Over the study period, FIC has seen an increase in visits from high-risk populations as well as vaccine administration under general anesthesia. Clinical encounters at FIC reflect the changing climate of medical complexity and models an innovative approach to strengthening pediatric health across the region.
OBJECTIVES The detrimental effects of tobacco smoke on children’s health are well known. Although evidence suggests that cigarette excise taxes can reduce adult smoking, it remains unclear whether they reduce the nicotine levels of infants and toddlers—a developmentally vulnerable group. This study tested the effects of 2 North Carolina (NC) cigarette tax increases on children’s cotinine trajectories—a biomarker of nicotine exposure—from infancy to early childhood, as well the extent to which these effects were stronger for children spending fewer hours in childcare (ie, greater time in smoking households). METHODS Observational and salivary biomarker data were collected prospectively from children in NC and Pennsylvania (PA) as part of the Family Life Project, a longitudinal study of low-income families in rural contexts. The analytic sample included 1176 children (of 1292), who provided at least one saliva sample. Difference-in-differences/event-study estimators tested the impact of 2 NC cigarette excise tax increases (+$0.25 in 2005; +$0.05 in 2006) on children’s cotinine trajectories relative to a PA control group. RESULTS The larger tax increase predicted modest-to-moderate reductions in child cotinine levels (Δ −0.22 SD to Δ −0.40 SD). Effects were limited to children living in smoking households and emerged gradually over time. Contrary to expectations, tax effects were not stronger for children attending fewer childcare hours. However, within-child increases in childcare hours predicted reductions in cotinine levels regardless of state or tax phase. CONCLUSIONS AND POLICY IMPLICATIONS Tobacco taxation and childcare attendance may reduce nicotine exposure across infancy and early childhood.
OBJECTIVE Injury is the leading cause of death in children and adolescents. Understanding the association between social determinants of health and pediatric injury is paramount for targeted intervention. We aimed to measure the association between Child Opportunity Index (COI) 2.0 and mortality for injured patients requiring pediatric intensive care unit (PICU) admission, hypothesizing that lower COI is associated with higher mortality. METHODS This was a retrospective, multicenter study of children (aged <18 years) admitted between January 1, 2019 and December 31, 2020 to 15 US PICUs with injury, inclusive of trauma, nonaccidental injury, drowning, ingestion/poisoning, burn/inhalational injury, and suffocation. We measured the association between COI 2.0 (area-based index of social determinants of health for children) and in-hospital mortality (primary outcome) and PICU readmission (secondary outcome) using multivariable logistic regression. RESULTS We included 3778 critically injured children, of whom 235 (6.2%) died. Distribution by COI was: 29% Very Low, 19% Low, 20% Moderate, 16% High, and 16% Very High. After adjustment for age, sex, mechanism, complex chronic condition, and severity of illness, the adjusted odds of mortality were approximately 2.5 times greater for patients with Very Low (aOR 2.4 [1.02–6.05]) and Moderate COI (aOR 2.6 [1.1–6.61]) compared with Very High COI. Low and High COI were associated with nearly 3 times odds of readmission (low aOR 3.18 [1.31–8.94]; high aOR 3.01 [1.23–8.46]). CONCLUSION Very Low and Moderate COI was associated with increased mortality of critically injured children. Further investigation is needed to identify modifiable determinants of child opportunity to decrease pediatric injury.
BACKGROUND/OBJECTIVES Little is known about the timing and risk factors for developing depression among autistic youth. We tested the hypotheses that depression incidence occurs at higher rates and younger ages in autistic vs nonautistic youth and that known depression risk factors in the general population would predict current depression among autistic youth. METHODS We used nationally representative survey data from a cross-section of United States households with children aged 0 to 17 years. We built a logistic regression model estimating the interaction between age and having autism when predicting depression. With the autistic subpopulation, we built a best-fit model of predictors for depression. RESULTS In the logistic regression model predicting depression incidence, autism, age, and other relevant covariates significantly predicted current depression; autism and age significantly interacted such that the increased rate of depression for autistic vs nonautistic youth widens as age of the children increases. We found statistically significant predictors of depression within autistic youth: female sex (adjusted odds ratio [aOR] for male relative to female youths, 0.31), multiple adverse childhood experiences (aOR, 2.94), higher frequency of being bullied (aOR, 7.94), higher intellectual ability (aOR for moderate/severe intellectual disability [ID] relative to no ID, 0.46), higher severity of anxiety symptoms (aOR, 20.24), and older age (aOR, 1.26). CONCLUSIONS Overall, autistic children displayed depression at an earlier age than nonautistic children, with a steady increase through adolescence. Depression prevention efforts are likely to be most impactful if geared toward those whose identities, life experiences, symptoms, and environments put them at higher risk depression.
OBJECTIVE Although health conditions experienced by children with medical complexity (CMC) are often conceptualized as chronic or lifelong, rapid development during early childhood can result in changing health status. This is particularly relevant for military-connected children, who may experience challenges with health care access and coordination. This study assessed mortality and the duration of observable CMC-qualifying diagnoses among young military-connected CMC and identified factors associated with these outcomes. METHODS This retrospective, longitudinal cohort study analyzed 2005–2020 TRICARE data. Children diagnosed with at least 1 CMC-qualifying condition by 36 months were stratified into 3 mutually exclusive groups: CMC who died within 12 months of diagnosis, children with CMC-qualifying conditions observed 12 months or more after diagnosis, and children with CMC-qualifying conditions observed less than 12 months after diagnosis. Poisson regression was used to identify factors associated with these outcomes. RESULTS Among 73 602 CMC, 43 261 (58.8%) were male, 19 279 (26.1%) were born preterm, and 20 546 (27.9%) had progressive conditions. CMC experienced a mean of 61.5 (SD, 81.7) days with clinical encounters in the 2 years following diagnosis. During this period, 3093 (4.2%) died within 12 months of diagnosis, 40 664 (55.2%) had CMC-qualifying conditions observed for at least 12 months, and 29 845 (40.5%) had CMC-qualifying conditions observed less than 12 months. Preterm birth, chronic conditions affecting 3 or more body systems, and technology dependence were associated with both mortality and CMC-qualifying diagnoses observed after 12 months or more. CONCLUSIONS Among young military-connected CMC, mortality was high. Among survivors, more than 40% did not have any CMC-qualifying conditions observed 12 months or more after diagnosis, indicating the dynamic nature of these conditions or limited documentation in clinical encounters.
OBJECTIVE The primary objective of this study is to examine changes in targeted neurocognitive functions over time and to determine what factors influence these changes. METHODS Participants included 827 cases with mild to moderate chronic kidney disease (CKD). Median chronological age was 11.5 years at study entry, 61% were male, and 39% of mothers had a high school education or less. Cognitive assessment included measures of intelligence, attention regulation, and executive functioning administered at study entry and every 2 years over a span of 8 years. Covariates at study entry included sociodemographic, CKD-related, and selected time-varying factors (eg, estimated glomerular filtration rate [eGFR] annual percent change). Longitudinal linear mixed models were used to examine a priori neurocognitive outcomes. RESULTS After adjustment for covariates, IQ and executive-function ratings increased slightly over time; however, an initial association was shown for greater change in eGFR contributing to significantly lower verbal IQ and full scale IQ over time (ie, ∼1/2 point per 5% decline in eGFR). After correction for multiple comparisons, abnormal birth history and the presence of seizures were associated with declines in IQ (∼1 to 7 points). CONCLUSIONS Findings from this study suggest relative stability in cognition over an 8-year period in children with mild to moderate CKD, although targeted CKD-related variables were significantly associated with lower IQ scores over time. In particular, abnormal birth history and seizures were associated with declines in cognitive functions over time, and clinical evaluation may be warranted when such conditions are present.
OBJECTIVES This study describes sociodemographic characteristics, co-occurring mental and behavioral health conditions, services provided in individualized education programs (IEPs), and transition planning goals for adolescents with autism spectrum disorder (ASD) in a population-based sample. METHODS The study included 4311 adolescents aged 16 years in 2022 from the Autism and Developmental Disabilities Monitoring Network. All lived within defined catchment areas in 9 states and had an ASD diagnostic code or special education exceptionality. Health and education records from when the adolescents were aged 12 to 16 years were reviewed. RESULTS Adolescents with ASD had high prevalence of language delay (51.6%), attention-deficit hyperactivity disorder (51.1%), and anxiety (42.7%). Few adolescents had an IQ or adaptive test in their records (25.5% and 19.1%, respectively). Most adolescents with an IEP had a transition plan in their records (94.8%), and most had the federally-required postsecondary education (95.7%) and employment goals (95.5%), whereas fewer had the optional postsecondary living goal (43.3%). The prevalence of many elements on the IEP and transition plans varied widely by site. The prevalence of some co-occurring mental and behavioral health conditions and use of school services differed by median household income. CONCLUSIONS Adolescents with ASD have high prevalence of co-occurring mental and behavioral conditions, with limited information on recent IQ and adaptive testing, potentially impacting service needs and receipt. The variability in the prevalence of IEP elements and service provision across different sites highlights the complexities in addressing the diverse transition needs and health outcomes for adolescents with ASD.
BACKGROUND/OBJECTIVES Sociodemographic factors affect prescription practices and antibiotic stewardship initiatives, yet there is limited information as to whether penicillin allergy label (PAL) is related to sociodemographic factors in rural settings. We hypothesize that PAL in children within our rural health system is associated with clinician characteristics and patient sociodemographic factors such as age, sex, race and ethnicity, insurance type, primary care clinician, and Area Deprivation Index (ADI). METHODS This retrospective case-control study was conducted in a tertiary regional rural health system to describe sociodemographic factors associated with pediatric PAL among children aged 0 to 18 years born between April 9, 2006, and April 9, 2024. RESULTS Among 319 325 children, 9168 (2.9%) were identified with PAL. After adjusting for age, race, sex, and state of residence among pediatric patients, children living outside metropolitan areas and higher ADI decile are directly associated with increased odds of a PAL. Children with PAL are more likely to have commercial insurance compared with Medicaid, although this association was reversed after matched analysis. CONCLUSION Pediatric PAL prevalence is remarkably lower in our rural health setting compared with prior published studies. A near linear relationship between ADI and PAL was observed, with higher ADI associated with increased PAL. Future research is needed to understand the association of sociodemographic factors and indices with PAL in pediatric rural health settings.
OBJECTIVE To evaluate the current state of health care integration within the Safe Babies Court Program (SBCP) and identify barriers and facilitators from the perspectives of families and professionals in the judicial and child welfare systems. METHODS We conducted 21 qualitative interviews with families and professionals engaged with the SBCP, using discovery and action dialogues adapted for individual conversations. We applied the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, focusing on the “Exploration” stage. We conducted 2 phases of qualitative analysis: content analysis followed by rapid qualitative analysis informed by the EPIS framework. Through this 2-phase analytic approach, we combined our understanding of the context within which SBCP works with the identification of specific barriers and facilitators to integration of the health care system. RESULTS Barriers to health care integration include intergenerational Department of Human Services involvement, social determinants of health, lack of communication, trust, collaboration across systems, families not clearly understanding their rights, lack of time and resources, and sustainability. Facilitators include relationship building across systems, specific programs designed to work collaboratively across sectors, and specific individuals with compassion and knowledge of the system and resources. CONCLUSION Factors identified by families and professionals involved with the SBCP will inform interventions to help facilitate health care integration, communication, and cross-sector collaboration for families involved with child welfare.
OBJECTIVES We aimed to describe young children in lower-income households with caregiver incarceration, explore incarceration-related barriers to resources, and investigate associations between Supplemental Nutrition Assistance Program (SNAP) participation and health. We hypothesized that families experienced incarceration-related barriers to resources and that SNAP participation was associated with improved child outcomes. METHODS We conducted a cross-sectional analysis of data from Children’s HealthWatch (April 2021-July 2024), a survey of young children (aged 0–48 months), and caregivers interviewed in 5 US cities. Our analytic sample comprised caregivers of children in lower-income households (publicly insured/uninsured) responding to the question regarding whether the child’s caregiver experienced incarceration (including immigration detention). We assessed characteristics and outcomes (general health, developmental risk, child/household food insecurity) based on caregiver incarceration experience and SNAP participation using descriptive statistics and multivariable logistic regression, controlling for child and caregiver factors. RESULTS Of the sample (N = 4439), 18.1% of caregivers reported that the index child had a caregiver who ever experienced incarceration. Of caregivers of children who experienced caregiver incarceration, 9.8% reported incarceration-related barriers to accessing resources. Among children with caregiver incarceration, SNAP participation was associated with lower adjusted odds of developmental risk (adjusted odds ratio: 0.56, 95% CI [0.36–0.87]). SNAP participation was not associated with child general health or food insecurity. DISCUSSION One in five children in lower-income households had a caregiver who experienced incarceration. Incarceration-related barriers to resources impact households, which may have implications for developmental outcomes for this high-risk population. Reducing barriers to resources may improve the well-being of children whose caregivers have experienced incarceration.
BACKGROUND AND OBJECTIVES Cerebral palsy (CP) is the most common cause of lifelong motor disability. Our analysis provides CP prevalence among children aged 4 years and 8 years in 5 communities in 2022. METHODS The Autism and Developmental Disabilities Monitoring (ADDM) Network reviewed health care and education records in 5 US communities in 2022. Children with a CP diagnosis born in 2014 or 2018 were identified. Diagnosis age, CP subtype, functional motor skills, and co-occurring conditions were collected. Prevalence was calculated using 2022 postcensal population estimates. RESULTS Among children aged 8 years, CP prevalence per 1000 ranged from 1.3 (95% CI: 0.9–2.0) in Minnesota to 3.1 (95% CI 2.4–4.0) in Missouri and was 2.4 (95% CI 2.2–2.7) across all 5 sites. Compared with white children, Black children had higher prevalence (2.2 vs 3.3; prevalence ratio (PR): 1.5; 95% CI 1.1–1.9) and were less likely to walk independently (P = 0.042). Spastic CP was the most common subtype (72.1%). Of children with CP, 58.4% walked independently. Children who walked independently were less likely than those who could not to be diagnosed by 24 months (P = 0.046). Among children aged 4 years, CP prevalence was 2.2 per 1000 (95% CI 1.9–2.5), and boys had higher prevalence than girls (PR: 1.2; 95% CI 1.0–1.6). Children born in 2018 had 1.2 (95% CI 1.0–1.4) times higher cumulative incidence of diagnosis by 48 months than those born in 2014. CONCLUSIONS Higher CP prevalence and functional impairments were observed for Black children compared with white children. Earlier CP identification among children aged 4 years could reflect recent improvements in early identification.
OBJECTIVE Maternal smoking across pregnancy and childhood is associated with adverse mental health outcomes in offspring. Few studies have prospectively examined this using administrative data. This study investigated whether maternal smoking from prepregnancy through the child’s early adolescence (age 13 years) was associated with mental health diagnoses in the offspring (ages 18-23 years), identified via medical service use. METHODS Data came from 2082 mother-child dyads in the Québec Longitudinal Study of Child Development (born in 1997-1998) linked to administrative health databases. Maternal smoking was reported when children were aged 5 months and 1.5, 2.5, 3.5, 5, 7, 10, and 13 years. Trajectories were identified using latent class growth analysis. Offspring mental health diagnoses (mood disorders, anxiety disorders, psychotic disorders, and Attention-Deficit/Hyperactivity Disorder [ADHD]) were extracted from administrative databases between ages 18 and 23 years. Poisson regression models were adjusted for key sociodemographic and perinatal confounders. RESULTS Three smoking trajectories were identified: no smoking (77.3%), moderate sustained smoking (∼11 cigarettes/day; 15.1%), and high sustained smoking (∼19 cigarettes/day; 7.4%). Offspring of mothers in the high sustained smoking group had a higher risk of mood (risk ratio [RR], 1.83; 95% CI, 1.28–2.60), anxiety (RR, 1.55; 95% CI, 1.16–2.05), and psychotic (RR, 3.33; 95% CI, 1.43–7.78) diagnoses compared with the offspring of nonsmoking mothers. No associations were observed for moderate sustained smoking or ADHD diagnoses. CONCLUSION High sustained maternal smoking from prepregnancy through child’s early adolescence was associated with increased likelihood of mood, anxiety, and psychotic diagnoses in offspring during young adulthood. Maternal smoking may inform youth mental health screening.
OBJECTIVE Because there is limited research evaluating trends in infectious disease (ID) hospitalizations in California, we aimed to describe and evaluate these trends among pediatric patients (aged 0–17 years) in California. METHODS This is a retrospective cohort study of pediatric patients according to the most recent data available from the California Office of Statewide Health Planning and Development/Health Care Access and Information (OSHPD/HCAI) hospital patient discharge database. Based on prior research, hospitalizations from January 1, 1985, to September 30, 2015, were categorized as ID-related or non-ID–related using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and from October 1, 2015, to December 31, 2021, using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. ID hospitalization rates were calculated per 100 000 total pediatric hospitalizations and per 100 000 population for 4 age groups: infants (<1 year), children (1–5 and 6–11 years), and adolescents (12–17 years), across 5-year time periods from 1985 to 2019 and finally 2020 to 2021. RESULTS Of 10 328 334 total pediatric hospitalizations between 1985 and 2021, 2 499 050 (24.19%) were ID-related. The greatest proportion (66.59%) of ID hospitalizations occurred in infants and children aged less than 5 years. The proportion of ID hospitalizations decreased over time. Population hospitalization rates were highest among infants. Pneumonia, acute appendicitis, and acute bronchitis were the most common ID diagnoses. CONCLUSIONS To our knowledge, this is the first study to characterize pediatric ID hospitalizations in California over recent decades. A significant proportion of pediatric hospitalizations in California were ID-related, with most occurring in infants and young children, but this proportion decreased over time. These hospitalization trends highlight the use of statewide data to inform public health ID control measures.
