Early human development最新文献

Background

Fetuses with congenital heart defects (CHD) show delayed neurodevelopment, fetal growth restriction (FGR) and placenta related complications. The neurodevelopmental delay may be, partly, attributed to placental factors.

Aim

As both placental development and fetal aortic flow/oxygenation influence neurodevelopment, placentas were compared within fetal CHD groups based on aortic oxygenation and flow, aiming to unravel the true effects in the developmental processes.

Study design

Placental tissues of pregnancies with fetal CHD and healthy controls were selected from biobanks of two Dutch academic hospitals (LUMC, UMCU). Additionally, biometry and Dopplers were assessed.

Subjects

CHD cases with reduced oxygenation (RO) towards the fetal brain were compared to cases with reduced flow (RF) in the aortic arch and healthy controls. Genetic abnormalities, termination of pregnancy, fetal demise and/or multiple pregnancies were excluded.

Outcome measures

Histological outcomes were related to fetal Dopplers and biometry. A placenta severity score was used to assess the severity of placental abnormalities per case.

Results

In CHD, significantly more delayed maturation, maternal vascular malperfusion, fetal hypoxia and higher placenta severity scores (median 14 in RO, 14 in RF, 5 in controls, p < 0.001) were observed. Doppler abnormalities (PI UA > p90, PI MCA < p10, CPR < p10) and FGR were more often found in CHD. There were no differences in placental abnormalities, fetal growth and fetal Dopplers between cases with RO and RF.

Conclusion

Fetal hemodynamics in the ascending aorta could not be related to placenta characteristics. We hypothesize that placental development influences neurodevelopment in excess of hemodynamics in CHD cases.

Background

There is growing evidence that COVID-19 brought changes that immediately affected early language development. Little is known for how long these COVID-19 related changes shaped development. The current study systematically and longitudinally addressed this issue, following up children's language development throughout the first 2.5 years.

Method

The present study follows up on the sample from Frota et al. (2022), which demonstrated that 7–9-month-old infants born and raised during the pandemic do not segment words unlike pre-pandemic peers. Four studies were conducted: (1) word segmentation task at 12 months of age (N_pandemic = 15); (2) word learning task at 20 months of age (N_pandemic = 20); (3) language and communication development up to 30 months of age, via CDI and CSBS parental reports (N_pandemic ranged 25–74); (4) overall development at 30 months of age using the Griffiths Developmental Scales (N_pandemic = 16).

Results

The pandemic sample consistently underperformed in all four studies in comparison to pre-pandemic data. There was no evidence of developed word segmentation abilities at 12 months of age, and no successful word learning at 20 months of age. Lexical development between 12 and 24 months of age was lower than in the pre-pandemic sample, while social communication did not seem to be affected. At 30 months of age, the pandemic sample showed lower scores and lower mental age on the Language and Communication Griffiths' subscale, in comparison to the pre-pandemic data.

Conclusions

Infants born and raised during the pandemic have a poorer language development, that persists at least until 30 months of age.

Aim

To investigate the relationship between the developmental quotient (DQ) at age 3 years and the need for educational support at school age in extremely preterm infants.

Methods

A total of 176 infants with a gestational age of <28 weeks were analyzed. The total DQ and subscales were evaluated using the Kyoto Scale of Psychological Development (KSPD) test. Neurodevelopment at age 3 years was stratified using total DQ in a conventional (DQ < 70 as developmental delay, DQ 70– <85 as subnormal, DQ ≥85 as normal) and a modified way (subdividing normal into DQ 85– <93 as low-normal and DQ ≥93 as high-normal). The prevalence of future educational support was compared for each stratum. Additionally, subscales were compared between those with and without educational support in each total DQ stratum.

Results

In conventional stratification, the prevalence of educational support was 32 (63 %) for developmental delay, 14 (24 %) for subnormal, and 10 (15 %) for normal. In modified stratification, the prevalence was 8 (26 %) for low-normal and 2 (5 %) for high-normal. While there was no significant difference in the odds of educational support between the normal and subnormal, the low-normal had significantly higher odds compared to the high-normal (OR 6.00; 95 % CI, 1.16–30.95, p = 0.03). Among the low-normal stratum, the language-social subscale was significantly lower in those with educational support.

Conclusion

Setting high thresholds for total DQ and evaluating detailed subscales at age 3 years may be useful for developmental follow-up in extremely preterm infants.

Background

Higher prenatal testosterone exposure regulates brain development and affects learning and intelligence directly. The digit ratio (2D:4D) is regarded as an indicator of prenatal testosterone exposure. This study aims to investigate the 2D:4D ratios and intelligence levels in individuals with specific learning disorders (SLD) and compare the ratios with healthy subjects.

Methods

The study included a total of 117 patients diagnosed with SLD and 67 healthy controls. We measured the 2D:4D ratios and administered the Wechsler-Intelligence Scale for Children-Revised to assess intelligence quotient (IQ) scores in the SLD group. Sociodemographic data was obtained for both patients and healthy subjects and compared in both groups, as well as 2D:4D ratios.

Results

Compared to healthy controls, both-hand 2D:4D ratios were found to be lower in the SLD group. In addition, male and female participants with SLD showed lower 2D:4D ratios in both hands than controls. The total scores on the WISC-R were found to decrease as the right-hand 2D:4D ratios and the age increased in the SLD group.

Conclusion

Our findings add to the literature examining the influence of prenatal testosterone exposure on learning and intelligence in the SLD sample. Further research in this domain may yield valuable insights into the underlying mechanisms and potential clinical implications for the management of SLDs examining additional variables that could potentially impact alongside the impact of sex hormones on brain development.

Background, Aims

Circadian rhythm maturation may be disturbed in premature infants undergoing neonatal intensive care. We used continuous heart rate recordings across the entire neonatal intensive care period to study circadian rhythm development in preterm infants and to evaluate the roles of postmenstrual (PMA) versus postnatal age (PNA).

Materials and methods

The circadian rhythm was calculated using a cosine fit of heart rate. The circadian rhythm amplitudes were averaged weekly and studied relative to PMA and PNA using the linear mixed effects models, adjusting for clinical variables that could affect the heart rate. The daily circadian rhythms were used to create grand averages for PMA groups: $\le$31, 32–35, and > 35 weeks, and for PNA groups: $\le$30, 31–60, and > 60 days.

Results

Sixty-six infants were evaluated as part of an ongoing prospective study with gestational ages between 23 and 36 weeks. The PMA (1.47 × 10⁻² beats per minute (bpm)/week, P = 2.07 × 10⁻⁸) and PNA (1.87 × 10⁻² bpm/day; P = 1.86 × 10⁻⁶) were significantly associated with the circadian rhythm amplitude independent of covariates. Infants $\le$31 weeks' PMA and $\le$30 days PNA, the phase of circadian rhythm amplitude grand averages showed a peak at night and a nadir during the day. Hereafter the circadian rhythm phase reversed to that established for mature individuals. The highest circadian rhythm amplitudes present >35 weeks' PMA and > 60 days PNA.

Conclusions

Our results indicate circadian rhythm matures with advancing gestation. The reversed circadian rhythm phase during the early postnatal period could be due to premature exposure to the ex-utero environment and warrant further study.

Maternal love and caregiving are pillars for optimal child development and may affect infant outcomes from pregnancy onwards. The present study aimed to examine whether maternal trait mindfulness during pregnancy and pre- and postnatal maternal-infant bonding were associated with maternal perceptions of infant temperament and social-emotional development. In total, 408 Dutch women (M_age = 31.33, SD = 3.59) participated in a prospective perinatal cohort study and completed questionnaires on trait mindfulness, prenatal bonding, postnatal bonding, infant temperament, and infant social-emotional development at 20 and 28 weeks of gestation, and 10 weeks, 6 and 12 months postpartum, respectively. Path analyses demonstrated that higher levels of the trait mindfulness facet non-judging (i.e., refraining from judgments about own feelings and thoughts) were associated with more pre- and postnatal maternal bonding and fewer social-emotional problems as perceived by the mother. Adopting an accepting and non-judgmental attitude may promote positive feelings of bonding and benefit the infant in terms of having fewer social-emotional problems in the first year of life. Mindfulness interventions may be offered to pregnant women in order to enhance maternal bonding and improve infant outcomes after birth.

Purpose

Congenital diaphragmatic hernia (CDH) affects 1 in 3000–5000 newborns. In survivors, long-term complications include gastroesophageal reflux (GER), feeding difficulties, and failure to thrive. Data from the parents' perspective remain scarce. This study aims to report the prevalence and impact of feeding difficulties on CDH families after discharge.

Methods

National web-based survey amongst families with CDH infants in 2021.

Results

Caregivers of 112 CDH survivors participated. The baseline characteristics were representative with 54 % male, 83 % left-sided CDH, prenatal diagnosis in 83 %, and 34 % requiring extracorporeal membrane oxygenation. Most infants (81 %) were discharged within three months, with 62 % feeding by mouth, and 30 % requiring a feeding tube. Persisting feeding difficulties were experienced by 73 %, GER being the most common (66 %), followed by insufficient weight gain (64 %). After discharge, 41 % received medical support for failure to thrive. The primary-care pediatrician was consulted most frequently for information (61 %) and treatment of feeding difficulties (74 %). Therapeutic success was reported in 64 %. A cessation of symptoms was achieved in 89 % within three years.

Conclusion

The majority of CDH infants had persistent feeding difficulties. This survey highlights the impact surrounding feeding problems on CDH families. Further studies and support systems are needed to raise the quality of life in CDH infants and their families.

Aim

Swedish guidelines for therapeutic hypothermia (TH) after perinatal asphyxia were established in 2007, following several randomised studies that demonstrated improved outcomes. We assessed the implementation of hypothermia treatment in a mid-Swedish region with a sizeable proportion of outborn infants.

Method

A population-based TH cohort from 2007 to 2015 was scrutinised for adherence to national guidelines, interhospital transport, including the use of a cooling mattress made of phase change material for thermal management, and outcomes.

Results

Of 136 admitted infants, 99 (73 %) were born outside the hospital. Ninety-eight percent fulfilled the criteria for postnatal depression/acidosis, and all patients had moderate-to-severe encephalopathy. Treatment was initiated within 6 h in 85 % of patients; amplitude-integrated electroencephalography/electroencephalography was recorded in 98 %, cranial ultrasound in 78 %, brain magnetic resonance imaging in 79 %, hearing tests in all, and follow-up was performed in 93 %. Although target body temperature was attained later (p < 0.01) in outborn than in inborn infants, at a mean (standard deviations) age of 6.2 (3.2) h vs 4.4 (2.6) h, 40 % of those transported using the cooling mattress were already within the therapeutic temperature range on arrival, and few were excessively cooled. The mortality rate was 23 %, and 38 % of the survivors had neurodevelopmental impairment at a median of 2.5 years.

Conclusion

The regionalisation of TH, including interhospital transport, was feasible and resulted in outcomes comparable to those of randomised controlled studies.

Background

The study aimed to investigate the association of second and fourth-digit (2D:4D) ratios with metabolic syndrome (MS) and cardiovascular disease risk (CVR).

Method

This case-control study was conducted between February and March 2024 with 200 participants (100 patients +100 controls). Biochemical parameters (glucose, total cholesterol, HDL, LDL, triglycerides, haemogram, HbA1C) were recorded. All participants were evaluated in terms of MS diagnostic criteria. CVR was calculated with the ESC CVD Risk Calculator. Second-digit and fourth-digit measurements were performed and the 2D:4D ratio of both hands and the difference between 2D:4D of both hands (Dr-l) were obtained. The relationship between 2D:4D and MS, CVR, and gender was evaluated. p < .05 was considered statistically significant.

Results

Forty-one percent of the study participants were male. The right-hand 2D:4D (R2D:4D) ratio was 1.009 ± 0.04 and the left-hand 2D:4D (L2D:4D) ratio was 0.991 ± 0.04 (p < .001). R2D:4D ratio was 1.010 ± 0.04 in women and 0.985 ± 0.03 in men (p = .019). R2D:4D (p < .001), Dr-l (p = .001), and CVR (p < .001) were significantly higher in men with MS (+) compared to MS (−).

Conclusion

In our study, the R2D:4D ratio was found to be associated with MS and CVR in men. Low intrauterine androgen exposure may affect the development of MS, but this effect is more prominent in males.