Early human development最新文献

Background: In animal models, derangements in paternal one‑carbon metabolism, giving rise to elevated serum total homocysteine (tHcy) concentrations, can impair sperm DNA integrity and chromatin methylation signatures, with consequences for embryonic gene expression, (neuro)development and growth. We hypothesize that, in humans, elevated serum tHcy similarly impairs prenatal development.

Methods: In a prospective periconception cohort, 881 pregnant women (<10 weeks of gestation) and their partners were enrolled from 2010 to 2022. Inclusion required paternal serum tHcy measurement in the first trimester. First trimester crown-rump length (CRL) and embryonic volume (EV) measurements were assessed on longitudinal three-dimensional ultrasound scans using virtual reality. Estimates of second trimester fetal biometry and birth outcomes were extracted from medical records. Associations between paternal tHcy and prenatal growth trajectories were assessed using linear mixed and piecewise regression models, adjusting for confounders.

Results: Paternal tHcy concentrations were on average two-fold higher than those of female partners, with men more frequently exhibiting hyperhomocysteinemia. In piecewise regression models, paternal tHcy ≥15 μmol/L compared to <15 μmol/L was associated with decreased first trimester CRL (Δ slope coefficient -0.016, P = 0.019). The association persisted for fetal transcerebellar diameter (Δ slope coefficient -0.060, P = 0.002), abdominal circumference (Δ slope coefficient -0.393, P = 0.022), femur length (Δ slope coefficient -0.115, P = 0.005) and estimated fetal weight (Δ slope coefficient -2.703, P = 0.003). No associations were found with birth weight or adverse birth outcomes.

Conclusions: Paternal tHcy may serve as a potential biomarker for prenatal growth. In preconception care, the benefit of assessing paternal tHcy concentrations and promoting multivitamin use warrants further investigation.

Background: Low birth weight (LBW) has been linked to the risk of developmental disabilities. However, few studies have been large enough to assess the associations between children's mental health (anxiety, depression) and a comprehensive range of developmental disabilities in a large general children's population, and limited studies have examined dose-response associations.

Methods: This population-based, nationally representative cross-sectional study included 35,379 children aged 6-17 years who participated in the 2022-2023 National Survey of Children's Health (NSCH) in the U.S from July 2022 to January 2024. Data of NSCH survey were based on retrospective parental or primary caregiver self-reports. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable logistic regression models to explore the association between low or high birth weight, anxiety, depression, behavior problems, developmental delay, intellectual disability, speech disorder, learning disability, autism spectrum disorder (ASD), and attention deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD).

Results: The weighted prevalence for each of the adverse outcomes was as follows: anxiety, 10.6; depression, 5.0; behavior problems, 7.6; developmental delay, 5.3; intellectual disability, 0.8; speech disorder, 6.5; learning disability, 6.6; ASD, 3.2; and ADD/ADHD, 10.5. The prevalence of LBW was 9.5 (95%CI, 8.9-10.2, [weighted]). LBW was associated with a higher risk of anxiety (OR, 1.14 [95% CI, 1.02-1.27]), behavior problems (OR, 1.29 [95% CI, 1.14-1.47]), developmental delay (OR, 2.18 [95% CI, 1.91-2.48]), intellectual disability (OR, 2.00 [95% CI, 1.45-2.75]), speech disorder (OR, 1.61 [95% CI, 1.42-1.84]), learning disability (OR, 1.69 [95% CI, 1.49-1.92]), ASD (OR, 1.32 [95% CI, 1.09-1.59]) and ADD/ADHD (OR, 1.36 [95% CI, 1.22-1.52]), respectively. There was no statistically significant association between high birth weight and anxiety, depression, or any developmental disabilities. The dose-response analysis showed a decreasing association between increasing birth weight and anxiety, behavior problems, developmental delay, intellectual disability, speech disorder, learning disability, ASD, and ADD/ADHD, respectively. Similar results were obtained in the sensitivity analyses. Compared to youth without LBW and PTB, youth with LBW and PTB have the highest risk of outcomes.

Conclusion: In conclusion, this large population-based, nationally representative, comprehensive study demonstrates that LBW was associated with a higher risk of anxiety and developmental disabilities in US youths aged 6-17 years. Our findings suggested that for monitoring, maintaining, and supporting the health of children born with LBW.

Purpose: This study evaluated the impact of Multimodal Neurologic Enhancement (MNE), a music therapy intervention, on clinical outcomes of preterm infants (< 34 weeks; N = 106) and a subgroup of extremely preterm infants (< 28 weeks; n = 20).

Method: A randomized trial was utilized, where infants were randomized to receive MNE or standard of care and matched based on gestational age at birth, sex, and neurologic injury. Infants in the MNE group received eight, 20-minute MNE sessions, beginning at 32 weeks post menstrual age (PMA). Analysis included negative binomial and linear regression, adjusting for relative covariates.

Principal results: Across the full cohort and the extremely preterm subgroup, there were no significant differences in PMA at discharge, duration of oxygen therapy (days), PMA at transition off oxygen therapy, or transition to full oral feeding (days). Among the extremely preterm subgroup, MNE was associated with a significantly shorter length of stay (days) (IRR = 0.81, corresponding to β̂ = -0.21; 95% CI for IRR: 0.68, 0.98).

Major conclusions: These findings suggest that MNE may offer targeted benefits for extremely preterm infants. This study highlights the potential of MNE as a safe, feasible intervention to support clinical outcomes during Neonatal Intensive Care Unit admission for preterm infants.

Background: Synthetic oxytocin (OXT) is widely used for labor induction or augmentation; however, its effects on postpartum maternal-neonatal OXT dynamics, neonatal feeding ability, and breastfeeding remain unclear. This study aimed to elucidate the impact of intrapartum maternal and neonatal synthetic OXT balance, neonatal sucking ability, and breastfeeding outcomes.

Methods: At 24-48 h postpartum, maternal and neonatal salivary OXT levels were measured before and after breastfeeding. Neonatal sucking ability was assessed after 5 min of non-nutritive sucking (NNS), and breastfeeding practices were evaluated at 72 h and 1 month postpartum. Participants were classified into the With and Without OXT groups based on intrapartum OXT exposure.

Results: Forty-nine dyads (23 With OXT, 26 Without OXT) were analyzed. No significant between-group differences were observed in breastfeeding practices and maternal salivary OXT. Regression models confirmed no association with intrapartum OXT. In neonates, salivary OXT was significantly lower in the With OXT group. Intrapartum OXT exposure independently predicted lower pre-breastfeeding OXT and post-breastfeeding OXT. NNS analyses revealed fewer bursts, longer pauses, and greater pause variability in the With OXT group. Higher OXT doses and longer durations correlated with prolonged unstable pauses. Higher pre-breastfeeding neonatal OXT and greater OXT change across feeding correlated with shorter NNS peak intervals, indicating that higher salivary OXT levels are associated with more efficient sucking performance.

Conclusions: Intrapartum OXT did not significantly affect maternal OXT but was associated with reduced neonatal salivary OXT and weaker sucking patterns, suggesting that exogenous OXT interferes with neonatal OXT regulation and early feeding.

Objective: To assess whether early brainstem volume (BV) is associated with the intensity of respiratory and hemodynamic support in very preterm (PT) infants.

Study design: We performed a prospective cohort study of very low birthweight infants (VLBWI) (birthweight ≤1500 g and/or gestational age ≤32 weeks) admitted to the NICU between 2018 and 2021. Infants with major congenital anomalies, chromosomal syndromes, metabolic disease, or CNS infection were excluded. Early brain MRI was obtained before 36 weeks' postmenstrual age (PMA), and BV was quantified using an atlas-based segmentation pipeline. Respiratory support in the first 72 h of life was classified as no ventilation, non-invasive ventilation, or invasive mechanical ventilation, and hemodynamic support was quantified with the vasoactive-inotropic score (VIS; 0 vs >0). Associations between BV and ventilation or VIS were assessed using linear, multinomial, and logistic regression models adjusted for gestational age (GA) at birth and PMA.

Results: Early MRI was performed in 79 infants (mean GA 29.1 ± 2.5 weeks; mean PMA 31.9 ± 2.4 weeks). Mean BV was 4.09 ± 0.17 cm³ in infants without ventilation, 3.35 ± 0.57 cm³ with non-invasive ventilation, and 2.60 ± 0.74 cm³ with invasive ventilation, and 3.17 vs 2.45 cm³ in those with VIS = 0 vs VIS>0. In adjusted models, both respiratory support and VIS>0 were independently associated with smaller BV, and, conversely, lower BV was associated with higher odds of invasive ventilation and VIS > 0 (p < 0.05).

Conclusions: Early BV is closely associated to the intensity of respiratory and vasoactive support in PT infants and support further evaluation as a potential imaging biomarker for risk stratification in this population.

This study examined whether a high protein/energy-controlled diet and exercise pregnancy intervention influences putative emotional regulation (ER) neural activity in two-year-old offspring. Participants were recruited from the Be Healthy in Pregnancy randomized controlled trial. Pregnant individuals (n = 24; >18 years, singleton pregnancy, 12-17 weeks gestation) were randomized to either an intervention (high-protein, energy-controlled diet, nutrition counseling, walking program plus usual pregnancy care [UPC]) or control (UPC only) group. Offspring (n = 12 intervention, n = 12 control) completed resting-state EEG using a 128-channel EEG and a delayed gratification task at age two. Delta-Beta Coupling, an EEG-derived index of ER-related neural function, was measured via correlation between delta (2-4 Hz) and beta (13-30 Hz) power. Children of intervention group participants exhibited a significantly lower delta-beta correlation in frontal (Z = -2.20, p = 0.03), central (Z = -2.34, p = 0.02), and parietal (Z = -2.32, p = 0.02) regions, as well as superior performance on the delayed gratification task (p = 0.04, Hedges' g = 0.89). Prenatal diet and exercise interventions may promote more efficient ER-related neural functioning and behavioral self-regulation in early childhood. These findings suggest modifiable prenatal factors can shape offspring neurodevelopment, supporting early interventions to enhance emotional and cognitive outcomes.

Background: Prematurity a critical determinant of infant's neurodevelopmental outcomes. Parents of preterm infants are more likely to experience mental health issues during and following hospitalization, including depression, post-traumatic stress disorder, and anxiety. Given that at-risk infants are particularly sensitive to the beneficial and harmful effects of their environment, care for vulnerable newborns should not be limited to the period of hospitalization.

Aims: The present research aims to explore early home-based intervention models that may be most appropriate for supporting the development of preterm infants.

Methods: To achieve this objective, a literature review was conducted according to PICO framework and PRISMA method. Articles were included if published between 2008 and 2023. Eligible interventions had to meet the following criteria: take place in the home environment, whether initiated during hospitalization or post-discharge; occur within the first year of life; aim to support psychomotor, cognitive, motor, or emotional development, parent-child interaction, and/or parental mental health.

Results: 28 studies were identified and included in the final analysis. Several programs demonstrating benefits for the infant, the parents, and their interactions. These results highlight a relevant intervention model that targets psychomotor development (motor, emotional and cognitive domains), parental support (including mental health and parent-child interactions) and environmental adaptations (particularly sensory stimuli), rather than focusing solely on child development.

Conclusion: This review underscores the lack of specific recommendations in the literature regarding the content of early home-based interventions for preterm infants and their families, despite documented effectiveness of several programs.

Aim: To investigate the relationship between early motor repertoire, assessed using the General Movements Optimality Score - Revised (GMOS-R), and motor outcomes at 1, 2 and 5-years' corrected age (CA) in infants born <30 weeks' gestation.

Methods: This prospective cohort study included General Movement Assessments recorded at 34 weeks' post menstrual age (PMA) (n = 76) and term equivalent age (n = 66) in infants born <30 weeks' gestation (mean gestational age 27.6 weeks, standard deviation 1.4; 53% male). Early motor repertoire was assessed using the GMOS-R. Motor outcomes were measured using the Alberta Infant Motor Scale (AIMS) and Neurosensory Motor Developmental Assessment (NSMDA) at 1-year CA; the Bayley Scales of Infant and Toddler Development, Third Edition motor composite score and/or cerebral palsy at 2-years' CA; and the Movement Assessment Battery for Children, Second Edition and/or cerebral palsy at 5-years' CA.

Results: Higher GMOS-R scores at both 34 weeks' PMA and term equivalent age were associated with better motor outcomes at 1-year CA (34-weeks: AIMS regression coefficient = 0.35, 95% confidence interval [CI] = 0.05, 0.65, p = 0.02; term equivalent age: regression coefficient = 0.50, 95% CI = 0.14, 0.86, p = 0.01; NSMDA regression coefficient = -0.17, 95% CI = -0.30, -0.03, p = 0.01; term equivalent age: regression coefficient = -0.20, 95% CI = -0.36, -0.04, p = 0.02). However, there was limited evidence of an association between GMOS-R scores and motor outcomes at 2- and 5-years' CA.

Conclusion: Higher GMOS-R scores during the preterm and term period are associated with better motor outcomes at 1-year CA in infants born <30 weeks' gestation, suggesting potential value for early identification of risk of motor delay and subsequent direction of early intervention. This relationship, however, was not evident at 2 and 5-years' CA.