Pub Date : 2025-03-12DOI: 10.1016/j.earlhumdev.2025.106248
Gaby Stegmann-Woessner , Peter Bartmann , Barbara Mitschdoerfer , Dieter Wolke
Background
Adults born preterm face greater social, cognitive, mental and physical challenges in adulthood than their full term born peers according to longitudinal studies. In contrast, little is known about the lived experiences of adults born preterm.
Objective
The study investigates the lived experiences of adults born preterm across the life course and their views on health care support.
Methods
A qualitative study of 21 participants completing semi structured interviews analyzed through content analysis.
Results
Over half of adults born preterm report trauma and feeling of otherness since early childhood, high sensitivity to the environment, higher introversion/shyness and social or performance related anxiety. Over half reported that their parents were traumatized by the preterm birth and tried to compensate by overprotective parenting that, however, stifled them becoming independent. Over half experienced bullying victimization and many have continuing mental health problems. Overload by demands in school or work is a consistent theme that makes it hard to have the energy to socialize. Many received physical therapy in childhood and most had psychotherapy in adulthood. Many feel that health professionals trivialize the long-term effects of prematurity and most find support from their parents or peer network.
Conclusions
Prematurity has significantly shaped the life of adults born preterm. Greater awareness and recognition of the unique needs of this group are essential to provide adequate support. Existing services fail to address these needs highlighting an urgent demand for enhanced social and psychological services for educational and workplace settings.
{"title":"Forever premature: Adults born preterm and their life challenges","authors":"Gaby Stegmann-Woessner , Peter Bartmann , Barbara Mitschdoerfer , Dieter Wolke","doi":"10.1016/j.earlhumdev.2025.106248","DOIUrl":"10.1016/j.earlhumdev.2025.106248","url":null,"abstract":"<div><h3>Background</h3><div>Adults born preterm face greater social, cognitive, mental and physical challenges in adulthood than their full term born peers according to longitudinal studies. In contrast, little is known about the lived experiences of adults born preterm.</div></div><div><h3>Objective</h3><div>The study investigates the lived experiences of adults born preterm across the life course and their views on health care support.</div></div><div><h3>Methods</h3><div>A qualitative study of 21 participants completing semi structured interviews analyzed through content analysis.</div></div><div><h3>Results</h3><div>Over half of adults born preterm report trauma and feeling of otherness since early childhood, high sensitivity to the environment, higher introversion/shyness and social or performance related anxiety. Over half reported that their parents were traumatized by the preterm birth and tried to compensate by overprotective parenting that, however, stifled them becoming independent. Over half experienced bullying victimization and many have continuing mental health problems. Overload by demands in school or work is a consistent theme that makes it hard to have the energy to socialize. Many received physical therapy in childhood and most had psychotherapy in adulthood. Many feel that health professionals trivialize the long-term effects of prematurity and most find support from their parents or peer network.</div></div><div><h3>Conclusions</h3><div>Prematurity has significantly shaped the life of adults born preterm. Greater awareness and recognition of the unique needs of this group are essential to provide adequate support. Existing services fail to address these needs highlighting an urgent demand for enhanced social and psychological services for educational and workplace settings.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"204 ","pages":"Article 106248"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-08DOI: 10.1016/j.earlhumdev.2025.106238
Rachel Mullaly , Aisling Smith , Orla Franklin , Naomi McCallion , Afif EL-Khuffash
Objective
This study aims to identify initial clinical and echocardiographic markers in preterm infants which may predict failure of medical therapy to close a high-risk patent ductus arteriosus (PDA).
Study design
This was an observational cohort study conducted in a level III NICU. Infants born <29 weeks gestation were treated with medical therapy if they were deemed high-risk as per the EL-Khuffash PDA Severity Score (PDAsc). Treatment-failure infants were compared to treatment-success infants.
Results
110 infants were high-risk (58 responders, 52 non-responders). Initial differences in clinical and echocardiographic characteristics between infants in the treatment-failure and treatment-success groups, respectively, included a lower gestational age (25.2 ± 1.3 vs 25.9 ± 1.4; p < 0.01), higher PDAsc (7.8 ± 1.9 vs 7.0 ± 1.5; p < 0.01), lower incidence of pre-eclampsia (3 (6 %) vs 12 (21 %); p = 0.02), lower mitral E:A ratio (0.78 ± 0.13 vs 0.90 ± 0.27; p = 0.02), higher LA:Ao ratio (1.7 ± 0.6 vs 1.4 ± 0.5; p = 0.02), lower celiac artery systolic velocity(m/s) (0.36 ± 0.12 vs 0.46 ± 0.20; p = 0.02) and higher global longitudinal strain (GLS) (%) (20.8 ± 3.1 vs 18.1 ± 4.4; p < 0.01). In a multivariate logistic regression model, GLS remained the only independent predictor of medical therapy failure (OR 0.83, 95 % CI 0.70–0.98, p = 0.03).
Conclusion
These findings highlight a distinct subgroup of high-risk preterm infants who are unlikely to respond to medical therapy, emphasising the need for an individualised approach to PDA management. Integrating clinical and echocardiographic markers with risk-based scoring systems may improve early identification of treatment non-responders and guide alternative therapeutic strategies.
{"title":"Clinical and echocardiographic predictors of medical therapy failure for patent ductus arteriosus closure in preterm infants: Insights from a risk-based treatment approach","authors":"Rachel Mullaly , Aisling Smith , Orla Franklin , Naomi McCallion , Afif EL-Khuffash","doi":"10.1016/j.earlhumdev.2025.106238","DOIUrl":"10.1016/j.earlhumdev.2025.106238","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify initial clinical and echocardiographic markers in preterm infants which may predict failure of medical therapy to close a high-risk patent ductus arteriosus (PDA).</div></div><div><h3>Study design</h3><div>This was an observational cohort study conducted in a level III NICU. Infants born <29 weeks gestation were treated with medical therapy if they were deemed high-risk as per the EL-Khuffash PDA Severity Score (PDAsc). Treatment-failure infants were compared to treatment-success infants.</div></div><div><h3>Results</h3><div>110 infants were high-risk (58 responders, 52 non-responders). Initial differences in clinical and echocardiographic characteristics between infants in the treatment-failure and treatment-success groups, respectively, included a lower gestational age (25.2 ± 1.3 vs 25.9 ± 1.4; <em>p</em> < 0.01), higher PDAsc (7.8 ± 1.9 vs 7.0 ± 1.5; p < 0.01), lower incidence of pre-eclampsia (3 (6 %) vs 12 (21 %); <em>p</em> = 0.02), lower mitral E:A ratio (0.78 ± 0.13 vs 0.90 ± 0.27; p = 0.02), higher LA:Ao ratio (1.7 ± 0.6 vs 1.4 ± 0.5; <em>p</em> = 0.02), lower celiac artery systolic velocity(m/s) (0.36 ± 0.12 vs 0.46 ± 0.20; p = 0.02) and higher global longitudinal strain (GLS) (%) (20.8 ± 3.1 vs 18.1 ± 4.4; <em>p</em> < 0.01). In a multivariate logistic regression model, GLS remained the only independent predictor of medical therapy failure (OR 0.83, 95 % CI 0.70–0.98, <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>These findings highlight a distinct subgroup of high-risk preterm infants who are unlikely to respond to medical therapy, emphasising the need for an individualised approach to PDA management. Integrating clinical and echocardiographic markers with risk-based scoring systems may improve early identification of treatment non-responders and guide alternative therapeutic strategies.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"204 ","pages":"Article 106238"},"PeriodicalIF":2.2,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578680","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}
Pub Date : 2025-03-07DOI: 10.1016/j.earlhumdev.2025.106239
Salma El Emrani , Esther J.S. Jansen , Jelle J. Goeman , Jacqueline U.M. Termote , Enrico Lopriore , Nicoline E. Schalij-Delfos , Lotte E. van der Meeren
The purpose of this study was to determine the independent association between placental inflammation and the development of retinopathy of prematurity (ROP). This retrospective cohort study included 591 neonates born with a gestational age (GA) ≤32 weeks and/or a birthweight (BW) ≤1500 g. Clinical data were retrospectively collected, and placentas were reexamined for acute (e.g. chorioamnionitis and funisitis) and chronic placental inflammation (e.g. chorioamnionitis, villitis of unknown etiology and chronic deciduitis). Severe acute chorioamnionitis was defined as the presence of confluent polymorphonuclear leukocytes or subchorionic microabscesses. Outcomes explored were GA, BW, small for gestational age (SGA), mechanical ventilation duration, postnatal corticosteroids, sepsis, necrotizing enterocolitis, and ROP. Acute histological chorioamnionitis and funisitis were associated with lower GA, lower SGA rates, increased duration of mechanical ventilation and increased ROP rates, while chronic chorioamnionitis and villitis were associated with higher GA and increased SGA rates. BW was significantly lower in neonates with chronic deciduitis. Subanalysis of placentas without maternal and fetal vascular malperfusion also showed increased rates of severe acute chorioamnionitis (42 % vs. 21 %), funisitis (61 % vs. 35 %) in neonates with ROP. Multivariable regression analysis revealed two placental inflammatory factors to be independently associated with ROP: severe acute chorioamnionitis (OR 2.1; 95 % CI 1.1–3.8) and funisitis (OR 1.7; 95 % CI 1.0–2.9). Structured placental evaluation of the presence of severe acute chorioamnionitis and funisitis is valuable in predicting the development of ROP. This increased risk of ROP development could be integrated into the neonatal treatment approach of high-risk neonates in a very early stage in order to reduce ROP.
{"title":"Comprehensive assessment of placental inflammation: Novel approach in predicting retinopathy of prematurity","authors":"Salma El Emrani , Esther J.S. Jansen , Jelle J. Goeman , Jacqueline U.M. Termote , Enrico Lopriore , Nicoline E. Schalij-Delfos , Lotte E. van der Meeren","doi":"10.1016/j.earlhumdev.2025.106239","DOIUrl":"10.1016/j.earlhumdev.2025.106239","url":null,"abstract":"<div><div>The purpose of this study was to determine the independent association between placental inflammation and the development of retinopathy of prematurity (ROP). This retrospective cohort study included 591 neonates born with a gestational age (GA) ≤32 weeks and/or a birthweight (BW) ≤1500 g. Clinical data were retrospectively collected, and placentas were reexamined for acute (e.g. chorioamnionitis and funisitis) and chronic placental inflammation (e.g. chorioamnionitis, villitis of unknown etiology and chronic deciduitis). Severe acute chorioamnionitis was defined as the presence of confluent polymorphonuclear leukocytes or subchorionic microabscesses. Outcomes explored were GA, BW, small for gestational age (SGA), mechanical ventilation duration, postnatal corticosteroids, sepsis, necrotizing enterocolitis, and ROP. Acute histological chorioamnionitis and funisitis were associated with lower GA, lower SGA rates, increased duration of mechanical ventilation and increased ROP rates, while chronic chorioamnionitis and villitis were associated with higher GA and increased SGA rates. BW was significantly lower in neonates with chronic deciduitis. Subanalysis of placentas without maternal and fetal vascular malperfusion also showed increased rates of severe acute chorioamnionitis (42 % vs. 21 %), funisitis (61 % vs. 35 %) in neonates with ROP. Multivariable regression analysis revealed two placental inflammatory factors to be independently associated with ROP: severe acute chorioamnionitis (OR 2.1; 95 % CI 1.1–3.8) and funisitis (OR 1.7; 95 % CI 1.0–2.9). Structured placental evaluation of the presence of severe acute chorioamnionitis and funisitis is valuable in predicting the development of ROP. This increased risk of ROP development could be integrated into the neonatal treatment approach of high-risk neonates in a very early stage in order to reduce ROP.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"204 ","pages":"Article 106239"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-07DOI: 10.1016/j.earlhumdev.2025.106240
Qi Yuen Kong , Juin Yee Kong , Mei Chien Chua , Pooja Agarwal Jayagobi , Wee Meng Han , Chengsi Ong
During a global recall of the sole human milk fortifier (HMF) available in Singapore, our centre identified an alternative strategy through partial fortification using a high caloric preterm formula to mitigate malnutrition in very low birthweight preterm infants. Adequate growth was observed and there were no reported adverse events.
{"title":"An alternative fortification strategy to optimize growth in preterm infants during a period of human milk fortifier shortage","authors":"Qi Yuen Kong , Juin Yee Kong , Mei Chien Chua , Pooja Agarwal Jayagobi , Wee Meng Han , Chengsi Ong","doi":"10.1016/j.earlhumdev.2025.106240","DOIUrl":"10.1016/j.earlhumdev.2025.106240","url":null,"abstract":"<div><div>During a global recall of the sole human milk fortifier (HMF) available in Singapore, our centre identified an alternative strategy through partial fortification using a high caloric preterm formula to mitigate malnutrition in very low birthweight preterm infants. Adequate growth was observed and there were no reported adverse events.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"204 ","pages":"Article 106240"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591940","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}
Pub Date : 2025-03-05DOI: 10.1016/j.earlhumdev.2025.106237
Zeyuan Sun , Lu Zhang , Qiaoyue Ge , Chenghan Xiao , Oliver Gale-Grant , Shona Falconer , Andrew Chew , Chuan Yu , A. David Edwards , Chiara Nosarti , Zhenmi Liu
Introduction
Older gestational age (GA) has been associated with more favourable cognitive outcomes in preterm children. Recent evidence suggests this may also apply to term-born children. This study aims to examine the association between GA and early neurodevelopmental outcomes in children born at term in China and the UK.
Methods
Participants were term-born children from two cohorts, the Sichuan Multi-stratified Infants and Early Life (SMILE) study in China and the Developing Human Connectome Project (dHCP) in the UK. Early cognitive outcomes were assessed at 6 months in the SMILE study, and at 18 months in the dHCP. Linear regression models were conducted to examine the association between GA at birth and early cognitive outcomes in each cohort separately.
Results
A sample of 1245 participants from the SMILE study and 406 participants for the dHCP were included in the analysis. In the SMILE study, longer GA was associated with better mental developmental (B = 2.47 [1.60, 3.34], P < .001) and psychomotor outcomes (B = 2.91 [2.01, 3.82], P < .001), after controlling for sex, parental education, family yearly income, maternal age, maternal depressive symptoms, and birth weight; in the dHCP, longer GA was associated with better cognitive (B = 1.35 [0.33, 2.37], P = .010) and motor outcomes (B = 1.49 [0.59, 2.39], P = .001), after controlling for sex, relative social deprivation, maternal depressive symptoms and birth weight.
Conclusions
Older GA in term-born toddlers is associated with more favourable developmental outcomes across different cultural contexts.
{"title":"Gestational age at birth and cognitive outcomes in term-born children: Evidence from Chinese and British cohorts","authors":"Zeyuan Sun , Lu Zhang , Qiaoyue Ge , Chenghan Xiao , Oliver Gale-Grant , Shona Falconer , Andrew Chew , Chuan Yu , A. David Edwards , Chiara Nosarti , Zhenmi Liu","doi":"10.1016/j.earlhumdev.2025.106237","DOIUrl":"10.1016/j.earlhumdev.2025.106237","url":null,"abstract":"<div><h3>Introduction</h3><div>Older gestational age (GA) has been associated with more favourable cognitive outcomes in preterm children. Recent evidence suggests this may also apply to term-born children. This study aims to examine the association between GA and early neurodevelopmental outcomes in children born at term in China and the UK.</div></div><div><h3>Methods</h3><div>Participants were term-born children from two cohorts, the Sichuan Multi-stratified Infants and Early Life (SMILE) study in China and the Developing Human Connectome Project (dHCP) in the UK. Early cognitive outcomes were assessed at 6 months in the SMILE study, and at 18 months in the dHCP. Linear regression models were conducted to examine the association between GA at birth and early cognitive outcomes in each cohort separately.</div></div><div><h3>Results</h3><div>A sample of 1245 participants from the SMILE study and 406 participants for the dHCP were included in the analysis. In the SMILE study, longer GA was associated with better mental developmental (B = 2.47 [1.60, 3.34], <em>P</em> < .001) and psychomotor outcomes (B = 2.91 [2.01, 3.82], <em>P</em> < .001), after controlling for sex, parental education, family yearly income, maternal age, maternal depressive symptoms, and birth weight; in the dHCP, longer GA was associated with better cognitive (B = 1.35 [0.33, 2.37], <em>P</em> = .010) and motor outcomes (B = 1.49 [0.59, 2.39], <em>P</em> = .001), after controlling for sex, relative social deprivation, maternal depressive symptoms and birth weight.</div></div><div><h3>Conclusions</h3><div>Older GA in term-born toddlers is associated with more favourable developmental outcomes across different cultural contexts.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"204 ","pages":"Article 106237"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.earlhumdev.2025.106229
Simone Teresa Böhm-González , Sarah Detemple , Jasmin Gruß , Angela Kribs , Astrid Berner-Rodoreda , Christoph Härtel , Jörg Dötsch , Annic Weyersberg
Background
During the first pandemic lockdown restrictive regulations were implemented in hospitals. Parents of preterm babies were particularly affected due to a long hospital stay. The aim of this study is to investigate how pandemic regulations during the first lockdown impacted the birth and perinatal experiences of parents of preterm babies.
Methods
For this qualitative study, we interviewed ten parents who had a preterm baby (28 to 32 gestational weeks) during the first lockdown in Germany. The interviews were analysed using reflexive thematic analysis.
Results
Five themes were identified 1) “Loneliness of pregnant mothers at risk at the maternity ward”, highlights the lack of physical and emotional support, intensified by a tense atmosphere at the hospitals 2) “Losing out on meaningful moments” describes the feeling of being cheated of a ‘real’ birth experience and missing out on the ‘normal life at home’ with a newborn 3) “Fear as a constant companion” refers to the fear of a COVID-19 infection during the hospital stay and ambivalent feelings upon arriving home 4) “Medical care of preterm infants during the pandemic” emphasizes the gaps in medical care of preterm infants but also underscores what went well despite pandemic restrictions and 5) “Mothers taking action to change hospital regulations” portrays their agency.
Conclusion
It is crucial to include scientific, pediatric expertise in future pandemic response planning to rapidly visualize and prevent negative consequences of mitigations measures, such as those described in this study. Protecting elements of family-centered and integrated care should be a priority.
{"title":"“A word that describes it well is ‘lonely’” – Experiencing preterm birth during the first COVID-19 lockdown in Germany: A qualitative study","authors":"Simone Teresa Böhm-González , Sarah Detemple , Jasmin Gruß , Angela Kribs , Astrid Berner-Rodoreda , Christoph Härtel , Jörg Dötsch , Annic Weyersberg","doi":"10.1016/j.earlhumdev.2025.106229","DOIUrl":"10.1016/j.earlhumdev.2025.106229","url":null,"abstract":"<div><h3>Background</h3><div>During the first pandemic lockdown restrictive regulations were implemented in hospitals. Parents of preterm babies were particularly affected due to a long hospital stay. The aim of this study is to investigate how pandemic regulations during the first lockdown impacted the birth and perinatal experiences of parents of preterm babies.</div></div><div><h3>Methods</h3><div>For this qualitative study, we interviewed ten parents who had a preterm baby (28 to 32 gestational weeks) during the first lockdown in Germany. The interviews were analysed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>Five themes were identified 1) “Loneliness of pregnant mothers at risk at the maternity ward”, highlights the lack of physical and emotional support, intensified by a tense atmosphere at the hospitals 2) “Losing out on meaningful moments” describes the feeling of being cheated of a ‘real’ birth experience and missing out on the ‘normal life at home’ with a newborn 3) “Fear as a constant companion” refers to the fear of a COVID-19 infection during the hospital stay and ambivalent feelings upon arriving home 4) “Medical care of preterm infants during the pandemic” emphasizes the gaps in medical care of preterm infants but also underscores what went well despite pandemic restrictions and 5) “Mothers taking action to change hospital regulations” portrays their agency.</div></div><div><h3>Conclusion</h3><div>It is crucial to include scientific, pediatric expertise in future pandemic response planning to rapidly visualize and prevent negative consequences of mitigations measures, such as those described in this study. Protecting elements of family-centered and integrated care should be a priority.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"204 ","pages":"Article 106229"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1016/j.earlhumdev.2025.106227
Julia Jaekel , Peter J. Anderson , Dieter Wolke , Günter Esser , Gorm Greisen , Alicia Spittle , Jeanie Cheong , Anneloes L. van Baar , Marjolein Verhoeven , Noa Gueron-Sela , Naama Atzaba-Poria , Lianne J. Woodward , Erica Neri , Francesca Agostini , Ayten Bilgin , Riikka Korja , Elizabeth C. Loi , Karli Treyvaud
Background and aim
Studies have documented differences in dyadic sensitivity between mothers of preterm (<37 weeks' gestation) and term born children, but findings are inconsistent and studies often include small and heterogeneous samples. It is not known to what extent variations in maternal sensitivity are associated with preterm birth across the full spectrum of gestational age.
Objective
To perform a systematic review and individual participant data (IPD) meta-analysis assessing variations in observed dyadic maternal sensitivity according to child gestational age at birth, while adjusting for known confounders correlated with maternal sensitivity.
Method
We harmonised data from 12 birth cohorts from ten countries and carried out one-stage IPD meta-analyses (N = 3951) using mixed effects linear regression. Maternal sensitivity was z-standardised according to the scores of contemporary term-born controls within each respective cohort. All models were adjusted for child sex, age at assessment, neurodevelopmental impairment, small for gestational age birth, and maternal education.
Results
The fixed linear effect of the association between gestation at birth and maternal sensitivity across all 12 cohorts was small but stable (0.02 per week [95% CI = 0.01, 0.02], p < .001). The binary effects of maternal education (0.32 [0.24, 0.40], p < .001) and child neurodevelopmental impairment (−0.33 [−0.50, −0.17], p < .001) were associated with maternal sensitivity.
Interpretation
Gestational age at birth is positively associated with dyadic maternal sensitivity, however, the size of the effect is small. Over and above gestation, maternal education and child neurodevelopmental impairment appear to affect sensitivity, highlighting the importance of considering these factors in future research and intervention designs.
{"title":"The association between gestation at birth and maternal sensitivity: An individual participant data (IPD) meta-analysis","authors":"Julia Jaekel , Peter J. Anderson , Dieter Wolke , Günter Esser , Gorm Greisen , Alicia Spittle , Jeanie Cheong , Anneloes L. van Baar , Marjolein Verhoeven , Noa Gueron-Sela , Naama Atzaba-Poria , Lianne J. Woodward , Erica Neri , Francesca Agostini , Ayten Bilgin , Riikka Korja , Elizabeth C. Loi , Karli Treyvaud","doi":"10.1016/j.earlhumdev.2025.106227","DOIUrl":"10.1016/j.earlhumdev.2025.106227","url":null,"abstract":"<div><h3>Background and aim</h3><div>Studies have documented differences in dyadic sensitivity between mothers of preterm (<37 weeks' gestation) and term born children, but findings are inconsistent and studies often include small and heterogeneous samples. It is not known to what extent variations in maternal sensitivity are associated with preterm birth across the full spectrum of gestational age.</div></div><div><h3>Objective</h3><div>To perform a systematic review and individual participant data (IPD) meta-analysis assessing variations in observed dyadic maternal sensitivity according to child gestational age at birth, while adjusting for known confounders correlated with maternal sensitivity.</div></div><div><h3>Method</h3><div>We harmonised data from 12 birth cohorts from ten countries and carried out one-stage IPD meta-analyses (<em>N</em> = 3951) using mixed effects linear regression. Maternal sensitivity was <em>z</em>-standardised according to the scores of contemporary term-born controls within each respective cohort. All models were adjusted for child sex, age at assessment, neurodevelopmental impairment, small for gestational age birth, and maternal education.</div></div><div><h3>Results</h3><div>The fixed linear effect of the association between gestation at birth and maternal sensitivity across all 12 cohorts was small but stable (0.02 per week [<em>95</em> <em>% CI</em> = 0.01, 0.02], <em>p</em> < .001). The binary effects of maternal education (0.32 [0.24, 0.40], <em>p</em> < .001) and child neurodevelopmental impairment (−0.33 [−0.50, −0.17], <em>p</em> < .001) were associated with maternal sensitivity.</div></div><div><h3>Interpretation</h3><div>Gestational age at birth is positively associated with dyadic maternal sensitivity, however, the size of the effect is small. Over and above gestation, maternal education and child neurodevelopmental impairment appear to affect sensitivity, highlighting the importance of considering these factors in future research and intervention designs.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"203 ","pages":"Article 106227"},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Infants born with congenital anomalies requiring surgery are at greater risk of developmental delays. Early screening tools are needed to identify infants who would benefit from early intervention. This study aimed to investigate the concurrent predictive validity of the General Movements Assessment (GMA), Motor Optimality Score – Revised (MOS-R), Hammersmith Infant Neurological Examination (HINE) and Bayley-III in identifying infants at risk of adverse neurodevelopmental outcomes.
Methods
A retrospective cohort study of 95 surgical infants. Participants were assessed at 3 months using the GMA, MOS-R, HINE, and Bayley-III. Development was assessed at 1 year using the Bayley-III. Logistic regression investigated the relationship between measures at 3 months and developmental outcome, using sensitivity, specificity, positive (PPV) and negative (NPV) predictive value and area under the ROC curve (AUC).
Results
All assessments had a relationship with development. Combining assessments at 3 months did not increase predictive value. MOS-R < 23 or HINE<60 had >70 % sensitivity for identifying delays in ≥2 domains of the Bayley-III at 1 year, and > 80 % accuracy in ruling out infants not at risk. MOS-R < 23 (NPV 0.957), and HINE <60 (NPV 0.971) were significantly correlated with delayed cognition.
Discussion
In a surgical cohort, the concurrent predictive validity of the GMA, MOS-R, HINE and Bayley-III, administered at 3 months of age was low, however all assessment tools showed correlations with outcomes. The HINE and MOS-R might help to identify infants who need support with cognition. Further exploration of early screening tools may help to identify infants who would benefit from early intervention.
{"title":"The predictive validity of HINE, Bayley, general movements and MOS-R in infancy","authors":"Michelle Jackman , Catherine Morgan , Carly Luke , Larissa Korostenski , Katya Zawada , Michelle Juarez , Annabel Webb , Remy Blatch-Williams , Cathryn Crowle","doi":"10.1016/j.earlhumdev.2025.106226","DOIUrl":"10.1016/j.earlhumdev.2025.106226","url":null,"abstract":"<div><h3>Introduction</h3><div>Infants born with congenital anomalies requiring surgery are at greater risk of developmental delays. Early screening tools are needed to identify infants who would benefit from early intervention. This study aimed to investigate the concurrent predictive validity of the General Movements Assessment (GMA), Motor Optimality Score – Revised (MOS-R), Hammersmith Infant Neurological Examination (HINE) and Bayley-III in identifying infants at risk of adverse neurodevelopmental outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 95 surgical infants. Participants were assessed at 3 months using the GMA, MOS-R, HINE, and Bayley-III. Development was assessed at 1 year using the Bayley-III. Logistic regression investigated the relationship between measures at 3 months and developmental outcome, using sensitivity, specificity, positive (PPV) and negative (NPV) predictive value and area under the ROC curve (AUC).</div></div><div><h3>Results</h3><div>All assessments had a relationship with development. Combining assessments at 3 months did not increase predictive value. MOS-<em>R</em> < 23 or HINE<60 had >70 % sensitivity for identifying delays in ≥2 domains of the Bayley-III at 1 year, and > 80 % accuracy in ruling out infants not at risk. MOS-R < 23 (NPV 0.957), and HINE <60 (NPV 0.971) were significantly correlated with delayed cognition.</div></div><div><h3>Discussion</h3><div>In a surgical cohort, the concurrent predictive validity of the GMA, MOS-R, HINE and Bayley-III, administered at 3 months of age was low, however all assessment tools showed correlations with outcomes. The HINE and MOS-R might help to identify infants who need support with cognition. Further exploration of early screening tools may help to identify infants who would benefit from early intervention.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"203 ","pages":"Article 106226"},"PeriodicalIF":2.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534938","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}
Neonatal medicine has advanced significantly over the past few decades, leading to improved survival rates for infants born extremely preterm (EP). Being born extremely preterm increases the risk of various long-term health issues and impairments that may affect an individual's well-being and success in life. As these individuals now reach adulthood, we have limited knowledge of outcomes based on their personal experiences.
Aims
To explore how adults born EP perceive the impact of prematurity throughout their lives into adulthood.
Study design
A qualitative study design within an interpretive paradigm.
Methods
We conducted 11 in-depth interviews with individuals who were born EP (gestational age ≤ 28 weeks) in 1989 to 1990, when they were 33 years old. A semi-structured interview guide was applied asking about if and how being born EP had affected their life and how they had experienced the transition to adulthood. The data were analysed by using reflexive thematic analyse by Braun & Clarke.
Results
Five themes were generated through the analysis: gratitude for life, general vulnerability, adaptability, strong bonding to significant others and nurturance.
Conclusions
The overall impression of the stories shared by adults born EP is that, despite having faced significant physical, mental, social and educational challenges, they seem to have managed well. Through personal resilience and the support of key figures in their lives, they have been able to navigate these difficulties. However, these challenges warrant attention.
{"title":"Experiences of adults born extremely preterm –The impact of prematurity throughout their lives into adulthood","authors":"Bente Johanne Vederhus , Merete R. Benestad , Jorunn Drageset , Beate-Christin Hope Kolltveit","doi":"10.1016/j.earlhumdev.2025.106228","DOIUrl":"10.1016/j.earlhumdev.2025.106228","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal medicine has advanced significantly over the past few decades, leading to improved survival rates for infants born extremely preterm (EP). Being born extremely preterm increases the risk of various long-term health issues and impairments that may affect an individual's well-being and success in life. As these individuals now reach adulthood, we have limited knowledge of outcomes based on their personal experiences.</div></div><div><h3>Aims</h3><div>To explore how adults born EP perceive the impact of prematurity throughout their lives into adulthood.</div></div><div><h3>Study design</h3><div>A qualitative study design within an interpretive paradigm.</div></div><div><h3>Methods</h3><div>We conducted 11 in-depth interviews with individuals who were born EP (gestational age ≤ 28 weeks) in 1989 to 1990, when they were 33 years old. A semi-structured interview guide was applied asking about if and how being born EP had affected their life and how they had experienced the transition to adulthood. The data were analysed by using reflexive thematic analyse by Braun & Clarke.</div></div><div><h3>Results</h3><div>Five themes were generated through the analysis: gratitude for life, general vulnerability, adaptability, strong bonding to significant others and nurturance.</div></div><div><h3>Conclusions</h3><div>The overall impression of the stories shared by adults born EP is that, despite having faced significant physical, mental, social and educational challenges, they seem to have managed well. Through personal resilience and the support of key figures in their lives, they have been able to navigate these difficulties. However, these challenges warrant attention.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"203 ","pages":"Article 106228"},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511797","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}
Pub Date : 2025-02-20DOI: 10.1016/j.earlhumdev.2025.106223
Duong Ngoc Mai , Mai Anh Nguyen Thi , Thu-Tinh Nguyen , Hoang Anh Vu , Phung Nguyen The Nguyen
Background
Olfactomedin 4 (OLFM4) gene polymorphisms have been associated with variations in inflammatory responses and the severity of infections. This study aimed to investigate the association between OLFM4 single nucleotide polymorphisms (SNPs) rs17552047 and rs1891944 and severe outcomes in preterm neonatal sepsis.
Methods
A prospective observational cohort study was conducted from April 2023 to April 2024, involving all preterm infants diagnosed with neonatal sepsis. Genotyping was performed using real-time polymerase chain reaction, and the associations with severe outcomes were analyzed using genetic models (dominant, recessive, and additive) through multivariate logistic regression and survival analysis.
Results
Among the 174 preterm newborns included in the study, 39 experienced severe outcomes. The AA/AG genotypes of SNP rs17552047 and TT/TC genotypes of rs1891944 were associated with a reduced risk of severe outcomes (adjusted hazard ratio: 0.271, 95 % confidence interval [CI]: 0.115–0.641, p = 0.003, and adjusted hazard ratio: 0.349, 95 % CI: 0.175–0.698, p = 0.003, respectively). The odds of severe outcomes decreased by 65 % for each additional A allele (95 % CI: 0.15–0.78, p = 0.01). The model incorporating both SNPs and clinical variables demonstrated good predictive capability (area under the receiver operating characteristic curve: 0.826, 95 % CI: 0.748–0.903, p = 0.03).
Conclusions
The OLFM4 rs17552047 AA/AG and rs1891944 TT/TC genotypes have been linked to favorable outcomes in neonatal sepsis. These SNPs hold promise for predicting severe outcomes in neonatal sepsis.
{"title":"Protective role of olfactomedin 4 gene polymorphisms in preterm neonates with sepsis","authors":"Duong Ngoc Mai , Mai Anh Nguyen Thi , Thu-Tinh Nguyen , Hoang Anh Vu , Phung Nguyen The Nguyen","doi":"10.1016/j.earlhumdev.2025.106223","DOIUrl":"10.1016/j.earlhumdev.2025.106223","url":null,"abstract":"<div><h3>Background</h3><div>Olfactomedin 4 (<em>OLFM4</em>) gene polymorphisms have been associated with variations in inflammatory responses and the severity of infections. This study aimed to investigate the association between <em>OLFM4</em> single nucleotide polymorphisms (SNPs) rs17552047 and rs1891944 and severe outcomes in preterm neonatal sepsis.</div></div><div><h3>Methods</h3><div>A prospective observational cohort study was conducted from April 2023 to April 2024, involving all preterm infants diagnosed with neonatal sepsis. Genotyping was performed using real-time polymerase chain reaction, and the associations with severe outcomes were analyzed using genetic models (dominant, recessive, and additive) through multivariate logistic regression and survival analysis.</div></div><div><h3>Results</h3><div>Among the 174 preterm newborns included in the study, 39 experienced severe outcomes. The AA/AG genotypes of SNP rs17552047 and TT/TC genotypes of rs1891944 were associated with a reduced risk of severe outcomes (adjusted hazard ratio: 0.271, 95 % confidence interval [CI]: 0.115–0.641, <em>p</em> = 0.003, and adjusted hazard ratio: 0.349, 95 % CI: 0.175–0.698, <em>p</em> = 0.003, respectively). The odds of severe outcomes decreased by 65 % for each additional A allele (95 % CI: 0.15–0.78, <em>p</em> = 0.01). The model incorporating both SNPs and clinical variables demonstrated good predictive capability (area under the receiver operating characteristic curve: 0.826, 95 % CI: 0.748–0.903, <em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>The <em>OLFM4</em> rs17552047 AA/AG and rs1891944 TT/TC genotypes have been linked to favorable outcomes in neonatal sepsis. These SNPs hold promise for predicting severe outcomes in neonatal sepsis.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106223"},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463462","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号