Parental Monitoring and Its Associations With Adolescent Sexual Risk Behavior: A Meta-analysis.

Pediatrics. 2015 Dec;136(6):e1587-99. doi: 10.1542/peds.2015-0305.

Dittus PJ, Michael SL, Becasen JS, Gloppen KM, McCarthy K, Guilamo-Ramos V.

CONTEXT: Increasingly, health care providers are using approaches targetingparents in an effort to improve adolescent sexual and reproductive health.Research is needed to elucidate areas in which providers can target adolescentsand parents effectively. Parental monitoring offers one such opportunity, givenconsistent protective associations with adolescent sexual risk behavior. However,less is known about which components of monitoring are most effective and mostsuitable for provider-initiated family-based interventions.
OBJECTIVE: We performed a meta-analysis to assess the magnitude of associationbetween parental monitoring and adolescent sexual intercourse, condom use, andcontraceptive use.
DATA SOURCES: We conducted searches of Medline, the Cumulative Index to Nursingand Allied Health Literature, PsycInfo, Cochrane, the Education ResourcesInformation Center, Social Services Abstracts, Sociological Abstracts, Proquest, and Google Scholar.
STUDY SELECTION: We selected studies published from 1984 to 2014 that werewritten in English, included adolescents, and examined relationships betweenparental monitoring and sexual behavior.

DATA EXTRACTION: We extracted effect size data to calculate pooled odds ratios(ORs) by using a mixed-effects model.

RESULTS: Higher overall monitoring (pooled OR, 0.74; 95% confidence interval[CI], 0.69-0.80), monitoring knowledge (pooled OR, 0.81; 95% CI, 0.73-0.90), and rule enforcement (pooled OR, 0.67; 95% CI, 0.59-0.75) were associated withdelayed sexual intercourse. Higher overall monitoring (pooled OR, 1.12; 95% CI,1.01-1.24) and monitoring knowledge (pooled OR, 1.14; 95% CI, 1.01-1.31) wereassociated with greater condom use. Finally, higher overall monitoring wasassociated with increased contraceptive use (pooled OR, 1.42; 95% CI, 1.09-1.86),as was monitoring knowledge (pooled OR, 2.27; 95% CI, 1.42-3.63).

LIMITATIONS: Effect sizes were not uniform across studies, and most studies were cross-sectional.
CONCLUSIONS: Provider-initiated family-based interventions focused on parentalmonitoring represent a novel mechanism for enhancing adolescent sexual andreproductive health.

Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis.

J Pediatr. 2016 Jan;168:132-143.e3. doi: 10.1016/j.jpeds.2015.09.032. Epub 2015 Oct 21. PubMed PMID: 26500108.

Pinto-Sánchez MI, Verdu EF, Liu E, Bercik P, Green PH, Murray JA, Guandalini S, Moayyedi P.

OBJECTIVE:  To assess the evidence regarding the effect of time of gluten introduction and breastfeeding on the risk of developing celiac disease (CD).

STUDY DESIGN:  We included randomized controlled trials and observational studies evaluating the proper timing for introducing gluten to the infant diet, the appropriate quantity of gluten consumption at weaning, and the effect of breastfeeding on CD risk. Studies were located through the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), EMBASE (Ovid), and System for Information on Grey Literature in Europe (SIGLE). Two independent authors collected the data.

RESULTS:  A total of 1982 studies were identified, 15 of which were eligible for data extraction. A meta-analysis was performed on 2 randomized controlled trials, 10 cohort studies, and 1 case-control study. There was a 25% increase in CD risk with late (>6 months) vs recommended (4-6 months) gluten introduction (risk ratio [RR], 1.25; 95% CI, 1.08-1.45). There was no significant effect of breastfeeding vs no breastfeeding on CD risk (OR, 0.55; 95% CI, 0.28-1.10), with substantial heterogeneity (I2 = 92%) among studies.

CONCLUSION: There is currently no evidence to support that early introduction of gluten to the infant diet increases the risk of CD; however, late introduction of gluten may be associated with increased risk of CD. More studies are needed that control for potential confounders and that evaluate environmental factors in low-risk families.