Early human development最新文献

Aerobic and anaerobic competence in preterm born children at the age of 10–14 years 10-14岁早产儿的有氧和无氧能力

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-12 DOI: 10.1016/j.earlhumdev.2026.106482

Peter Andriessen , Julia Meijer , Anke Moret , Noortje van den Dungen , Martine van Dam , Ellen de Kort , Wendy Aertssen

Background

Preterm birth has been associated with reduced motor competence and may contribute to diminished aerobic and anaerobic endurance.

Objective

To assess physical fitness in preterm-born youth and explore perinatal and earlier motor performances as mediators.

Methods

Eighty preterm infants (<30 weeks' gestation), previously assessed for motor performance at 5.5 and 8 years, were re-evaluated at 10–14 years using the Movement Assessment Battery for Children, the Modified Shuttle Test-Paeds (MSTP), and a 4 × 10 m sprint test.

Results

Only 39% of participants at age 10–14 years scored within the normal motor range (total motor score > 16th percentile). Mean MSTP-predicted peak VO₂ was 37.7 ± 5.7 ml/kg/min, with 55% below the 10th percentile. Sprint time averaged 13.9 ± 1.3 s, with 64% below the 10th percentile. Maternal education was significantly associated with normal motor development, but not with aerobic or anaerobic capacity. Males showed higher anaerobic capacity than females. Weak correlations were observed between total motor scores and both aerobic and anaerobic outcome measures. Using total motor scores as input, the binary classification of aerobic and anaerobic capacity - based on thresholds for normal performance - showed poor discriminative ability.

Conclusion

Although children may attain motor scores within the normal range, the majority demonstrated aerobic and anaerobic fitness levels below normative standards. These findings highlight persistent physical fitness challenges in children born extremely preterm and support the need for direct assessment of aerobic and anaerobic capacity alongside standard follow-up evaluations.

背景：早产与运动能力下降有关，并可能导致有氧和无氧耐力下降。目的评价早产儿的身体素质，探讨围产期和早期运动表现对早产儿身体素质的影响。方法80例（妊娠30周）早产儿，先前在5.5岁和8岁时进行运动表现评估，在10 - 14岁时使用儿童运动评估电池、改良穿梭测试板（MSTP）和4 × 10米冲刺测试重新评估。结果只有39%的10-14岁的参与者在正常运动范围内得分（总运动得分>； 16百分位）。平均mstp预测峰值VO 2为37.7±5.7 ml/kg/min， 55%低于第10百分位数。冲刺时间平均为13.9±1.3秒，64%低于第10百分位。母亲教育程度与正常运动发育显著相关，但与有氧或无氧能力无关。雄性的无氧能力高于雌性。总的运动评分与有氧和无氧结果测量之间存在弱相关性。以运动总分作为输入，有氧和无氧能力的二元分类——基于正常表现的阈值——显示出较差的区分能力。结论虽然儿童的运动得分在正常范围内，但大多数儿童的有氧和无氧健康水平低于规范标准。这些发现强调了极度早产儿童持续存在的体能挑战，并支持了在标准随访评估的基础上直接评估有氧和无氧能力的必要性。

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引用次数: 0

Chrononutrition: 24-hour variation in macronutrients in very preterm human milk 时间营养：早产儿母乳中常量营养素的24小时变化

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-12 DOI: 10.1016/j.earlhumdev.2026.106481

Alja Bijlsma , Demy van Gilst , Inês Chaves , Irwin K.M. Reiss , Koen F.M. Joosten , Stefanie M.P. Kouwenhoven , Marijn J. Vermeulen , Jorine A. Roelants

Background

Human milk composition varies in time to meet the evolving growth and developmental requirements of infants. While 24-hour (diurnal) variations in human milk composition for term-born infants have been reported, evidence concerning diurnal variation of preterm human milk composition remains inconclusive.

Research aim

To examine the presence of diurnal variations in macronutrient content in very preterm human milk.

Method

Milk samples were donated by mothers of very preterm infants (<30 weeks gestation). Milk series (defined as sequential milk samples collected from one mother) consisted of 13 to 17 (median 15) samples, collected over three consecutive days. Milk macronutrient (fat, true protein and carbohydrates) content were measured using mid-infrared spectrophotometry (Miris HMA™). Rhythmicity analyses and logistic regression analyses were performed to explore associations between macronutrient rhythmicity and pregnancy duration (weeks), infants' sex, and lactational stage).

Results

Of the 22 milk series studied, 12 (55%) showed 24-hour rhythmicity in one or more macronutrients. Fat content showed rhythmicity in 41% of the series, with varying peak times. For carbohydrates, protein and calculated energy content, rhythmicity was only identified in 18%, 14% and 27% of the milk series, respectively. Longer pregnancy duration was associated with increased odds of rhythmicity (odds ratio 2.1 (95% confidence interval 1.02–4.21), p = 0.04), but not with sex or stage of lactation.

Conclusions

Over half of the preterm human milk samples exhibited diurnal macronutrient rhythmicity, mainly in fat levels. The observed rhythms had varying peak times, suggesting phase differences of the maternal rhythms.

人类的母乳成分随时间的变化而变化，以满足婴儿不断变化的生长和发育需求。虽然已报道足月婴儿母乳成分24小时（日）变化，但关于早产儿母乳成分日变化的证据仍不确定。研究目的探讨早产儿母乳中常量营养素含量的昼夜变化。方法极早产儿（孕30周）母亲捐献的乳汁标本。牛奶系列（定义为从一位母亲连续收集的牛奶样本）包括13至17个样本（中位数为15个），连续三天收集。采用中红外分光光度法（Miris HMA™）测定牛奶常量营养素（脂肪、真蛋白质和碳水化合物）含量。节律性分析和逻辑回归分析探讨了大量营养素节律性与妊娠持续时间（周）、婴儿性别和哺乳期之间的关系。结果在研究的22种牛奶中，12种（55%）在一种或多种常量营养素中表现出24小时节律性。脂肪含量在41%的系列中表现出节律性，具有不同的峰值时间。对于碳水化合物，蛋白质和计算的能量含量，节律性分别仅在18%，14%和27%的牛奶系列中被确定。较长的妊娠期与节律性几率增加相关（优势比2.1(95%可信区间1.02-4.21),p = 0.04），但与性别或哺乳期无关。结论半数以上的早产儿母乳样品表现出昼夜常量营养素节律性，主要表现在脂肪水平上。观察到的节律有不同的峰值时间，表明母体节律的相位差异。

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引用次数: 0

Digit ratio (2D:4D) and neonatal head circumference: Evidence for oestrogenization in human brain evolution? 手指比例（2D:4D）和新生儿头围：人类大脑进化中雌激素发生的证据？

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-10 DOI: 10.1016/j.earlhumdev.2026.106479

Barış Özener , John T. Manning , Berna Ertuğrul , Fatih Aydık

Objectives

The second-to-fourth digit ratio (2D:4D) is widely thought to be a correlate of first trimester sex steroids, such that it is negatively correlated to testosterone and positively correlated to oestrogen. The 2D:4D has been linked to many physical and behavioural traits, including intelligence. However, little attention has been paid to its association with neonatal characteristics. Here we focus on associations between neonatal 2D:4D and head circumference as the latter variable is correlated with intelligence.

Material and methods

Our sample was 225 full-term (37–41 weeks) newborns comprising 125 girls and 100 boys. Recumbent length, weight, head circumference and right and left second and fourth digit lengths were measured. In addition to biological measures, maternal education was recorded as a proxy for sociodemographic status. Hierarchical multiple linear regression analyses were conducted separately for each sex to assess associations.

Results

For males, recumbent length and right 2D:4D were significantly positively associated with head circumference. Mother's education level was not related to head circumference. For females, recumbent length and birth weight were significant positive predictors of head circumference, digit ratios and mother's education showed no association. The independent variables accounted for more variance in head circumference for male newborns than for females.

Conclusions

We have found that right 2D:4D of newborns is positively correlated to head circumference, the effect was strongest for boys and independent of recumbent length and weight. High 2D:4D is associated with high prenatal oestrogen and head circumference is positively linked to intelligence. We discuss our findings in the context of oestrogenization in human brain evolution.

目的：人们普遍认为，第二指与第四指的比例（2D:4D）与妊娠早期的性类固醇激素有关，因此，它与睾酮呈负相关，与雌激素呈正相关。2D:4D与许多身体和行为特征有关，包括智力。然而，很少有人关注其与新生儿特征的关系。在这里，我们关注新生儿2D:4D和头围之间的关联，因为后者与智力相关。材料和方法：我们的样本是225个足月（37-41周）新生儿，其中125个女孩和100个男孩。测量平卧长度、体重、头围、左右二、四指长度。除生物指标外，还将产妇教育作为社会人口地位的代表进行了记录。分层多元线性回归分析分别对每个性别进行评估关联。结果：男性平躺长度和右侧2D:4D与头围呈显著正相关。母亲的受教育程度与头围无关。对于女性，卧位长度和出生体重是头围的显著正预测因子，而手指比和母亲的受教育程度没有关联。独立变量对男婴头围的影响大于女婴。结论：新生儿右2D:4D与头围呈正相关，其中男孩影响最大，与平卧长度和体重无关。2D:4D高与产前雌激素高有关，头围与智力呈正相关。我们在人类大脑进化中的雌激素化背景下讨论我们的发现。

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引用次数: 0

From the first months to later ages: Early spontaneous movements and developmental outcomes in extremely low birth weight infants 从最初的几个月到以后的年龄：极低出生体重婴儿的早期自发运动和发育结果

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-06 DOI: 10.1016/j.earlhumdev.2026.106478

Doğan Porsnok , Bilge Nur Yardımcı-Lokmanoğlu , Hasan Tolga Çelik , Akmer Mutlu

Background

Extremely low birth weight (ELBW; <1000 g) infants are at high-risk for developmental problems; however, no such long-term study has been conducted in this group before in our country. This study aimed to compare the early spontaneous movements and later developmental outcomes of ELBW infants with those of term born normal birth weight (NBW) infants, and to examine the association between the early spontaneous movements and later developmental outcomes at 9-to 12-months of corrected age and at 24-to 42-months in ELBW infants.

Methods

Early spontaneous movements of all infants were assessed using the Motor Optimality Score-Revised (MOS-R) at 9-to 20-weeks of corrected age. Developmental outcomes, including cognitive, language and motor domains, were performed using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) at 9-to 12-months of corrected age in ELBW infants, and at 24-to 42-months of age in both ELBW and term NBW infants.

Results

The study included 61 ELBW infants and 50 term NBW infants. ELBW infants had lower MOS-R results (p = 0.017) and lower cognitive (p < 0.001), language (p < 0.001), and motor domains (p < 0.001) outcomes at 24-to 42-months of age compared to term NBW infants. MOS-R and its subcategories were found to be associated with all Bayley-III domains (r = 0.492–0.603, p < 0.05) at both the 9-to 12-months and 24-to 42-months of age.

Conclusions

It is highlighted that ELBW infants have lower results than NBW infants, including MOS-R from the early period of life. MOS-R results may serve as a crucial tool to identify ELBW infants who are at higher risk for developmental parameters.

出生体重极低（ELBW; <；1000克）的婴儿有发育问题的高风险；然而，国内尚未对这一群体进行长期的研究。本研究旨在比较ELBW婴儿与足月正常出生体重（NBW）婴儿的早期自发运动和后期发育结局，并研究ELBW婴儿9- 12个月矫正年龄和24- 42个月早期自发运动与后期发育结局之间的关系。方法采用运动优化评分-修正（MOS-R）对所有婴儿在9 ~ 20周龄时的早期自发运动进行评估。发育结果，包括认知，语言和运动领域，使用Bayley婴幼儿发育量表第三版（Bayley- iii），在9- 12个月矫正年龄的ELBW婴儿，以及24- 42个月的ELBW和足月NBW婴儿中进行。结果本研究纳入61例低体重儿和50例足月新生儿。与NBW足月婴儿相比，ELBW婴儿在24- 42月龄时具有较低的MOS-R结果（p = 0.017）和较低的认知（p < 0.001）、语言（p < 0.001）和运动域（p < 0.001）结果。在9 ~ 12月龄和24 ~ 42月龄，MOS-R及其亚类均与所有Bayley-III结构域相关（r = 0.492-0.603, p < 0.05）。结论ELBW婴儿在生命早期的MOS-R指标均低于NBW婴儿。MOS-R结果可以作为识别发育参数风险较高的ELBW婴儿的关键工具。

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引用次数: 0

Exploring the association between parent touch attitudes and experiences with duration of skin-to-skin contact and holding in preterm infants 探讨父母接触态度与早产儿皮肤接触和抱持持续时间的关系

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-03 DOI: 10.1016/j.earlhumdev.2025.106476

Hilde K. Jacobsen , Bente S. Tandberg , Nina M. Kynø , Uta Sailer

Background

Skin-to-skin contact (SSC) provides extensive benefits for preterm infants and is highly recommended. However, parental SSC duration in Neonatal Intensive Care Units (NICU) varies considerably, with contributing factors poorly understood. Parents' perspectives on, and prior experiences with touch may influence SSC duration.

Aims

To investigate how parental attitudes toward and experiences with touch relate to SSC and holding durations, and to explore how these durations vary by relationship (mother/father), infant gestational age (GA) and parents' level of education.

Study design

Observational Study.

Subjects

Parents (n = 123) of preterm infants (n = 69), GA 27⁰–36⁶, admitted to a Norwegian family-centered care NICU providing 24/7 parental presence, participated.

Outcome measures

Daily parental SSC and holding durations (one week), video-evaluation of occurrence of slow, gentle and faster stroking, and Touch Experiences and Attitudes Questionnaire.

Results

Mothers provided significantly more SSC (p = .024) and holding (p = .005) than fathers. Parents provided significantly more SSC for infants at GA 27–30 (p = .029) and GA 31–33 (p = .036) than for GA 34–36, while significantly more holding for GA 31–33 (p = .022) and GA 34–36 (p = .001) than GA 27–30. No relation between parents' touch attitudes and experiences, affective touch awareness, or education, and SSC and holding duration was observed.

Conclusion

Maternal status and GA predicted SSC and holding duration yet explained the variance only partially. Parents' touch attitudes and experiences showed no association. This suggests that contextual, clinical or systemic factors may predominantly determine SSC and holding provision.

背景皮肤与皮肤接触（SSC）为早产儿提供了广泛的好处，强烈推荐。然而，父母在新生儿重症监护病房（NICU）的SSC持续时间差异很大，影响因素知之甚少。父母对触摸的看法和先前的经验可能影响SSC持续时间。目的探讨父母对触摸的态度和触摸体验与SSC和触摸持续时间的关系，并探讨这些持续时间如何随父母关系（母亲/父亲）、婴儿胎龄（GA）和父母的教育水平而变化。研究设计观察性研究。参与研究的早产儿（n = 69）的父母（n = 123）， GA 270-366，住在挪威以家庭为中心的NICU，提供全天候父母在场。结果测量：每日父母SSC和抚摸持续时间（一周），慢速、轻柔和快速抚摸发生的视频评估，以及触摸体验和态度问卷。结果母亲提供的SSC （p = 0.024）和抱持（p = 0.005）显著高于父亲。与GA 34-36相比，GA 27-30 （p = 0.029）和GA 31-33 （p = 0.036）的父母提供的SSC显著高于GA 34-36，而GA 31-33 （p = 0.022）和GA 34-36 （p = 0.001）的父母提供的SSC显著高于GA 27-30。父母的触摸态度和经验、情感触摸意识、教育程度与SSC和抱持时间没有关系。结论母性和GA对SSC和持有时间有预测作用，但只能部分解释差异。父母的触摸态度和经历没有关联。这表明，环境、临床或系统因素可能主要决定SSC和保持提供。

{"title":"Exploring the association between parent touch attitudes and experiences with duration of skin-to-skin contact and holding in preterm infants","authors":"Hilde K. Jacobsen , Bente S. Tandberg , Nina M. Kynø , Uta Sailer","doi":"10.1016/j.earlhumdev.2025.106476","DOIUrl":"10.1016/j.earlhumdev.2025.106476","url":null,"abstract":"<div><h3>Background</h3><div>Skin-to-skin contact (SSC) provides extensive benefits for preterm infants and is highly recommended. However, parental SSC duration in Neonatal Intensive Care Units (NICU) varies considerably, with contributing factors poorly understood. Parents' perspectives on, and prior experiences with touch may influence SSC duration.</div></div><div><h3>Aims</h3><div>To investigate how parental attitudes toward and experiences with touch relate to SSC and holding durations, and to explore how these durations vary by relationship (mother/father), infant gestational age (GA) and parents' level of education.</div></div><div><h3>Study design</h3><div>Observational Study.</div></div><div><h3>Subjects</h3><div>Parents (<em>n</em> = 123) of preterm infants (<em>n</em> = 69), GA 27<sup>0</sup>–36<sup>6</sup>, admitted to a Norwegian family-centered care NICU providing 24/7 parental presence, participated.</div></div><div><h3>Outcome measures</h3><div>Daily parental SSC and holding durations (one week), video-evaluation of occurrence of slow, gentle and faster stroking, and Touch Experiences and Attitudes Questionnaire.</div></div><div><h3>Results</h3><div>Mothers provided significantly more SSC (<em>p</em> = .024) and holding (<em>p</em> = .005) than fathers. Parents provided significantly more SSC for infants at GA 27–30 (<em>p</em> = .029) and GA 31–33 (<em>p</em> = .036) than for GA 34–36, while significantly more holding for GA 31–33 (<em>p</em> = .022) and GA 34–36 (<em>p</em> = .001) than GA 27–30. No relation between parents' touch attitudes and experiences, affective touch awareness, or education, and SSC and holding duration was observed.</div></div><div><h3>Conclusion</h3><div>Maternal status and GA predicted SSC and holding duration yet explained the variance only partially. Parents' touch attitudes and experiences showed no association. This suggests that contextual, clinical or systemic factors may predominantly determine SSC and holding provision.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"214 ","pages":"Article 106476"},"PeriodicalIF":2.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The motor optimality of infants who have had Meningitis in the first months of life: A retrospective study 在生命最初几个月患有脑膜炎的婴儿的运动优化：一项回顾性研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2026-01-03 DOI: 10.1016/j.earlhumdev.2025.106477

Sophie Dixon , Samantha Ashby , Caroline Kuhne , Karen Ray , Larissa Korostenski , Katya Zawada , Anna Mistry , Rosemary Day , Michelle Jackman

Background

Infants who have meningitis are at increased risk of adverse neurodevelopmental outcomes. Early screening tools can add value in identifying infants who may benefit from early intervention supports. The Motor Optimality Score Revised (MOS-R) is a relatively new tool used between 3 and 5 months of age that may have predictive value.

Aim

To describe the motor optimality of infants diagnosed with meningitis and determine whether the MOS-R is associated with development at 12 months of age.

Study design

A retrospective, single-center, cohort study from 2011 to 2023. The MOS-R was taken at 3–4 months corrected gestational age and development was assessed using the Bayley Scales of Infant and Toddler Development (Bayley) III/IV at 12 or 24 months of age.

Subjects

Participants included 73 infants (mean gestational age 37 + 3), admitted to hospital with meningitis before 4 months of age, who had a general movements assessment.

Results

Infants had a mean MOS-R of 22.3 (SD 3.29), with most infants ~~in the study~~ having MOS-R scores indicating mildly reduced optimality (78.8 %). Significant positive correlations were found between MOS-R total scores and the receptive language, expressive language and gross motor domains of the Bayley III/IV. Infants with MOS-R scores <21 were more likely to show developmental delays in cognition, expressive language and receptive language.

Conclusion

For infants who had meningitis, MOS-R scores were associated with development at 12 months of age. The MOS-R, used in addition to GMA may have the potential to identify infants who would benefit from early intervention to support their development. Further research is needed to understand the use of the MOS-R, alongside other screening tools for populations at risk of adverse neurodevelopmental outcomes.

背景：患有脑膜炎的婴儿出现不良神经发育结果的风险增加。早期筛查工具可以增加识别可能受益于早期干预支持的婴儿的价值。运动最优性评分修订（MOS-R）是一种相对较新的工具，用于3至5个月的年龄，可能具有预测价值。目的描述诊断为脑膜炎的婴儿的运动最佳状态，并确定MOS-R是否与12月龄时的发育有关。研究设计：2011 - 2023年回顾性、单中心、队列研究。在矫正胎龄3-4个月时进行MOS-R测试，并在12或24个月时使用Bayley婴幼儿发育量表（Bayley） III/IV进行发育评估。研究对象包括73名婴儿（平均胎龄37 + 3），4个月前因脑膜炎入院，进行一般运动评估。结果婴儿的平均MOS-R为22.3 (SD 3.29)，研究中大多数婴儿的MOS-R评分显示最优性轻度降低（78.8%）。MOS-R总分与接受性语言、表达性语言和大运动域的Bayley III/IV有显著正相关。MOS-R评分为21分的婴儿在认知、表达性语言和接受性语言方面更容易出现发育迟缓。结论：对于患有脑膜炎的婴儿，MOS-R评分与12个月大时的发育有关。与GMA一起使用的MOS-R可能有潜力识别那些将从早期干预中受益的婴儿，以支持他们的发展。需要进一步的研究来了解MOS-R以及其他筛查工具对有不良神经发育结果风险的人群的使用。

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引用次数: 0

Early risk factors related to social functioning in young adults born very preterm 早期风险因素与早产儿社会功能相关。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-12-25 DOI: 10.1016/j.earlhumdev.2025.106475

Sarah C.H. Thompson , Rheanna M. Mainzer , Leona Pascoe , Thi-Nhu-Ngoc Nguyen , Lauren Pigdon , Jeanie Cheong , Terrie E. Inder , Lex W. Doyle , Karli Treyvaud , Peter J. Anderson

Background

Individuals born very preterm (VPT; <32 weeks' gestation) are at a greater risk of poorer social outcomes than individuals born at term. However, it remains unclear which subgroups of individuals born VPT are at greater risk of lower social functioning later in life. This study aimed to describe the medical, behavioral, emotional, cognitive, and environmental risks in childhood for lower social functioning in early adulthood among young adults born VPT.

Methods

Participants were assessed on social functioning domains at age 20 years (N = 123) and risk factors were assessed at birth (N = 224), 2 (N = 219) and 7 (N = 197) years of age in the Victorian Infant Brain Study longitudinal cohort. Differences in mean scores of social functioning outcomes and proportions with lower social functioning at 20 years between risk groups were estimated using generalized linear models. Multiple imputation was used to address missing data.

Results

In childhood, greater behavioral and emotional problems, lower cognition, and higher sociodemographic risk were strongly associated with lower social functioning in all domains at age 20. Medical risk was weakly associated with social interaction and social adjustment at age 20.

Conclusions

Children born VPT with higher cognitive, behavioral, emotional, and sociodemographic risk have increased likelihood of lower social functioning in early adulthood than those without risk, and could benefit from receiving earlier support to scaffold the development of social skills.

背景：非常早产个体（VPT）；方法：在维多利亚婴儿脑研究纵向队列中，对参与者在20岁（N = 123）时进行社会功能域评估，并在出生（N = 224）、2 （N = 219）和7 （N = 197）时评估危险因素。使用广义线性模型估计风险组在20岁时社会功能结果的平均得分和较低社会功能比例的差异。采用多重插值解决缺失数据。结果：儿童时期，较大的行为和情绪问题、较低的认知能力和较高的社会人口风险与20岁时各领域较低的社会功能密切相关。20岁时，医疗风险与社会互动和社会适应的相关性较弱。结论：出生时具有较高认知、行为、情感和社会人口风险的VPT儿童在成年早期社会功能低下的可能性比没有风险的儿童高，并且可以从早期支持中获益，以促进社会技能的发展。

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引用次数: 0

Exploring the burden of preterm infant care in Africa: A comprehensive review of current research 探索非洲早产儿护理负担：对当前研究的全面回顾。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-12-20 DOI: 10.1016/j.earlhumdev.2025.106464

Mary Mayowa Adetoye , John Ehi Aboje , Mercy Chisom Agu , Praise Oluwatobi Ogunleke , Eno Abasi Sunday , Babalola David Olaoluwa , Alexander Idu Entonu , Tahav Joshua Kachina , Gbolahan Olatunji , Emmanuel Kokori , Nicholas Aderinto

Objective(s)

Preterm birth, delivery before 37 weeks of gestation, remains a major contributor to neonatal morbidity and mortality worldwide, with sub-Saharan Africa disproportionately affected. This review aimed to examine the multidimensional burden of caring for preterm infants in African contexts, focusing on economic, psychological, social, and health system challenges experienced by caregivers and healthcare providers.

Study design

A narrative review approach was adopted. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online (AJOL), as well as relevant grey literature. Thirty-three studies meeting predefined inclusion criteria were analyzed to identify recurring themes and intervention gaps related to preterm infant care across diverse African settings.

Results

The review revealed substantial financial strain on families due to high out-of-pocket expenditures, inadequate insurance coverage, and logistical challenges such as transportation barriers, especially in rural areas. Caregivers frequently experienced anxiety, depression, and social isolation, compounded by poor communication and limited emotional support within health facilities. Health systems were characterized by shortages of essential neonatal equipment, inadequate staffing, inconsistent clinical protocols, and limited training in evidence-based neonatal care. Promising interventions identified included kangaroo mother care, antenatal corticosteroid use, and automated oxygen titration systems.

Conclusion(s)

Caring for preterm infants in Africa involves intersecting economic, emotional, and systemic challenges. Strengthening policy and research frameworks, expanding caregiver support, and implementing culturally sensitive, evidence-based interventions are essential to reduce preterm mortality and alleviate caregiver burden across the region.

目标(s)：早产，即妊娠37周前分娩，仍然是全世界新生儿发病率和死亡率的主要原因，撒哈拉以南非洲受到的影响尤为严重。本综述旨在研究非洲环境下照顾早产儿的多维负担，重点关注照顾者和卫生保健提供者所面临的经济、心理、社会和卫生系统挑战。研究设计：采用叙述性回顾法。对PubMed、Scopus、Web of Science、b谷歌Scholar、African Journals Online （AJOL）以及相关的灰色文献进行了全面的文献检索。分析了33项符合预定义纳入标准的研究，以确定非洲不同环境中与早产儿护理相关的反复出现的主题和干预差距。结果：审查显示，由于自付费用高、保险覆盖面不足以及运输障碍等后勤挑战，特别是在农村地区，家庭面临着巨大的经济压力。护理人员经常感到焦虑、抑郁和社会孤立，再加上卫生设施内沟通不畅和情感支持有限。卫生系统的特点是基本新生儿设备短缺，人员配备不足，临床方案不一致，循证新生儿护理培训有限。确定的有希望的干预措施包括袋鼠妈妈护理，产前皮质类固醇使用和自动氧滴定系统。结论：在非洲，照顾早产儿涉及经济、情感和系统方面的交叉挑战。加强政策和研究框架，扩大对护理人员的支持，实施具有文化敏感性的循证干预措施，对于降低整个地区的早产死亡率和减轻护理人员负担至关重要。

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引用次数: 0

Outcomes in extremely preterm neonates after the introduction of early low-dose hydrocortisone treatment: A retrospective case-control study 引入早期低剂量氢化可的松治疗后极早产儿的结局：一项回顾性病例对照研究。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-12-18 DOI: 10.1016/j.earlhumdev.2025.106463

Ellie Purcell , Pooja Sachdev , Dushyant Batra

Objective

Assess the association between use of early low-dose hydrocortisone (ELDH) in extremely preterm neonates, and bronchopulmonary dysplasia (BPD)-free survival at 36 weeks completed gestational age (CGA), as well as additional secondary outcomes.

Design

Retrospective, matched, case-control study.

Setting

Tertiary neonatal intensive care units in Nottingham University Hospitals NHS Trust (Queens Medical Centre and Nottingham City Hospital).

Patients

188 extremely preterm neonates. 94 historical controls born between 1 October 2017 and 30 September 2019. 94 cases born between 1 January 2020 and 31 December 2021.

Interventions

ELDH using the published PREMILOC study protocol (total dose of 8.5 mg/kg over 10 days) initiated within the first 24 h of life.

Primary outcome measure

Survival without BPD at 36 weeks CGA.

Results

There were no statistically significant associations between the sex, gestational age or birthweight of the groups. There was no significant association between the use of ELDH and increased survival without BPD at 36 weeks CGA (p = 0.153) or reduction in mortality (p = 0.814). Using ELDH was significantly associated with an increased incidence of culture positive late-onset sepsis (p = 0.006), higher non-invasive respiratory support days (p = 0.032) and a longer total length of stay (p = 0.004).

Conclusions

ELDH use was not associated with an improvement in BPD free survival in extremely preterm neonates. The cases had a higher incidence of culture positive late-onset sepsis and longer duration of respiratory support. Further research exploring stratification of preterm neonates that will benefit from ELDH is needed.

目的：评估极早产新生儿早期使用低剂量氢化可的松（ELDH）与36周全胎龄（CGA）无支气管肺发育不良（BPD）生存率之间的关系，以及其他次要结局。设计：回顾性、配对、病例对照研究。环境：诺丁汉大学医院NHS信托（女王医疗中心和诺丁汉市医院）的三级新生儿重症监护室。患者：188例极早产儿。2017年10月1日至2019年9月30日期间出生的94个历史对照。2020年1月1日至2021年12月31日期间出生的94例。干预措施：使用已公布的PREMILOC研究方案（总剂量为8.5 mg/kg，超过10天）在生命的前24小时内开始ELDH。主要结局指标：36周无BPD生存期。结果：两组患者的性别、胎龄和出生体重无统计学意义。使用ELDH与36周CGA时无BPD的生存率增加（p = 0.153）或死亡率降低（p = 0.814）之间无显著相关性。使用ELDH与培养阳性晚发型脓毒症发生率增加（p = 0.006）、无创呼吸支持天数增加（p = 0.032）和总住院时间延长（p = 0.004）显著相关。结论：ELDH的使用与极早产儿无BPD生存的改善无关。培养阳性的晚发型脓毒症发生率较高，呼吸支持持续时间较长。需要进一步研究将受益于ELDH的早产儿分层。

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引用次数: 0

Recent short-term and long-term outcomes of massive pulmonary hemorrhage in extremely low birth weight infants: A nationwide cohort study 极低出生体重儿大量肺出血的近期和长期结果：一项全国性队列研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-12-16 DOI: 10.1016/j.earlhumdev.2025.106460

Yu Seon Kim , Eun Yeob Kim , Hye Jin Cho , Hye Won Cho , Eun Hee Lee , Byung Min Choi

Introduction

To evaluate the short- and long-term outcomes, particularly neurodevelopment, of extremely low birth weight (ELBW) infants with massive pulmonary hemorrhage, in the context of recent improvements in perinatal and neonatal intensive care.

Study design

Data from the prospective registry of the Korean Neonatal Network of ELBW infants born in 69 hospitals across South Korea between 2014 and 2022 were retrospectively analyzed.

Results

Seven hundred and eight (11.2 %) of 6344 ELBW infants were diagnosed with MPH and divided into survivors at discharge (n = 253, 35.7 %) and in-hospital deaths (n = 455, 64.3 %). The annual incidence of MPH significantly declined from 13.9 % in 2014 to 7.7 % in 2022, and was accompanied by a similar decrease in in-hospital mortality.

Surviving infants who experienced MPH had higher rates of in-hospital morbidities. They also showed more adverse neurodevelopmental outcomes than those without MPH. After multivariable adjustment, the risks of cerebral palsy (OR 2.136; 95 % CI 1.253–3.638) and moderate developmental delay on BSID-II/III (OR 2.088; 95 % CI 1.279–3.409) remained significantly higher in MPH survivors.

Conclusion

The incidence and in-hospital deaths of massive pulmonary hemorrhage in ELBW infants have decreased in recent years. However, improved survival may be accompanied by increased in-hospital morbidity and adverse neurodevelopmental outcomes, underscoring the need for ongoing monitoring and strategies to mitigate short- and long-term complications in this high-risk population.

简介：在最近围产期和新生儿重症监护改善的背景下，评估极低出生体重（ELBW）婴儿大量肺出血的短期和长期结局，特别是神经发育。研究设计：回顾性分析韩国新生儿网络2014年至2022年间在韩国69家医院出生的ELBW婴儿的前瞻性登记数据。结果：6344例ELBW婴儿中有778例（11.2%）被诊断为MPH，分为出院时存活（253例，35.7%）和住院死亡（4555例，64.3%）。MPH的年发病率从2014年的13.9%显著下降到2022年的7.7%，住院死亡率也出现了类似的下降。经历MPH的幸存婴儿的住院发病率更高。他们也比那些没有MPH的人表现出更多的不良神经发育结果。多变量调整后，脑瘫（OR 2.136; 95% CI 1.253-3.638）和BSID-II/III中度发育迟缓（OR 2.088; 95% CI 1.279-3.409）的风险在MPH幸存者中仍然显著较高。结论：新生儿肺大出血的发生率和院内死亡率近年来有所下降。然而，生存率的提高可能伴随着住院发病率的增加和不良的神经发育结果，强调需要持续监测和策略，以减轻这一高危人群的短期和长期并发症。

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引用次数: 0