Early human development最新文献

Background

This study aimed to evaluate the effect of ICC (cord clamping within the first 15 s), DCC (delayed cord clamping at 60 s), and cut-UCM (cut-umbilical cord milking, cord clamping within the first 15 s) groups on oxygen saturation (SpO2), heart rate (HR), and perfusion index (PI) up to 10 min after birth in newborn infants.

Methods

We conducted this randomized clinical trial in the delivery unit of a University Hospital with 189 infants born between 35 and 42 weeks of gestation. Participants were randomly assigned to one of three groups: ICC, DCC, and cut-UCM. The primary outcomes measured were SpO2, HR, and PI at the 1st, 3rd, 5th, and 10th minutes after birth. We utilized ANOVA and Bayesian calculations in this study.

Results

There was no difference between the ICC, DCC, and cut-UCM groups in SpO2, HR, and PI values at the 1st, 3rd, 5th, and 10th minutes of life, which did not significantly alter between the three groups in one-way ANOVA. Bayesian repeated-measure ANOVA calculations showed that SpO2 and heart rate results at the 1st, 3rd, 5th, and 10th minutes did not differ between ICC, DCC, and cut-UCM techniques with strong evidence. At the 3rd minute, PI was slightly higher in the DCC and cut-UCM groups compared to the ICC group, with anecdotal evidence. We found no difference between DCC and cut-UCM regarding the 3rd-minute PI, with moderate evidence.

Conclusion

Umbilical clamping procedures (ICC, DCC, and cut-UCM) did not affect SpO2 and HR in the first ten minutes of life, but 3rd-minute PI values were slightly higher in DCC and cut-UCM compared with ICC among late preterm and term neonates.

Background

This longitudinal study aimed to explore the impact of containers on gross motor percentile from 8 to 13 months corrected age during the walking development in moderate to late preterm infants.

Methods

Sixty preterm infants were enrolled in this study, and their monthly assessment the gross motor percentile using the Alberta Infant Motor Scale. Monthly parent interviews focused on collecting information about container characteristics.

Results

Infants exhibited fluctuating percentiles in gross motor development, averaging 37.81 (SD = 21.9; SEM = 1.4). The gross motor skills percentiles varied between 2 and 86 points across the six assessments. Factors significantly associated with gross motor development percentiles were a large container size (Coef. = 15.29; p < 0.001*) and a container with a soft floor surface (Coef. = 3.64; p = 0.042*).

Conclusion

Healthy preterm infants exhibited minimal instability in gross motor development and attained walking independently by 13 months. Placing preterm infants in a baby container during their first year should prioritize a wide space and a soft floor surface to enhance gross motor development.

Modern medicine has revolutionized family planning. Remarkably, women¹ can carry to term embryos with whom they share no genetic connection, a feat made possible through egg donation and/or gestational surrogacy. Our reproductive systems evolved to accommodate embryos that are 50% related to the carrier, not 0% related. Here, we apply evolutionary theory to explain how and why pregnancy is riskier with an unrelated embryo. When a woman gestates an unrelated embryo, she is significantly more likely to develop preeclampsia and other diseases above and beyond the known risks associated with advanced maternal age, IVF, multiple gestation, and subfertility. Such “allogeneic pregnancies” are riskier even in fertile, healthy, commercial surrogates and when the egg is donated by a young, healthy donor. We propose that unrelated embryos present a special immune challenge to the gestational carrier, because they have fewer matching genes to the maternal body—therefore exacerbating symptoms of evolutionary maternal-fetal conflict. Indeed, maternal risks seem lower when the embryo is more related to the carrier, e.g., if a sister donates the egg. Finally, we discuss microchimerism in egg donation pregnancies, whereby wholly foreign cells pass from mother to embryo and vice-versa. We conclude with several medical proposals. First, egg donors and surrogates should be informed of the increased health risks they would face. In considerations of risk, these young, fertile women should not be compared to older, infertile women undergoing IVF; the proper comparison group is other young, fertile women. Second, contrary to some medical advice, perhaps genetically-related egg donors and surrogates should be preferred, all else equal. An immunological matching scheme, like what is used for organ transplants, could improve surrogate pregnancy outcomes. Third, more research is needed on microchimerism, sperm exposure, and the long-term impacts of allogeneic pregnancies on maternal and child health.

The ‘organizational-activational hypothesis’ posits that the fetal environment has a lasting impact on offspring physical, cognitive, and behavioral phenotype. An established biomarker for human prenatal testosterone exposure is the second-to-fourth digit ratio (2D:4D). While related facial characteristics and their social perceptions have been investigated in young adults, studies focusing on younger or older age groups are scarce. Standardized facial photographs of 17 Austrian boys aged 4 to 11 years were each rated by 162 adults in Austria (78 female, 84 male) for masculinity, dominance, physical strength, maturity, independence, cuteness, and prettiness. Following high interrater agreement (Cronbach's alphas >0.96), average ratings per face were subjected to a principal component analysis. The first principal component (52 % var. expl.) correlated positively with the boys' age (r = 0.685), whereas the second principal component (37 % var. expl.) reflected organizational effects of prenatal androgen exposure (i.e. androgenization), as shown by a negative correlation with the boys' 2D:4D (r = −0.487). Geometric morphometrics was employed to extract the facial shapes corresponding to these two principal components. Overall, adults consistently attributed masculinity in line with prenatal testosterone exposure, whereby masculinity was assessed as neither pretty nor cute. In contrast to findings within adults, boys' face ratings of dominance and physical strength did not correspond with their masculinity assessments, but rather with the social attributions reflecting age-related developmental progress (maturity and independence). This adds an ontogenetic layer of complexity. Prenatal testosterone exposure influences the development of boys' facial features, which in turn even shape social stereotypes in adults.

Background

Very preterm infants are at increased risk of neurodevelopmental impairments. The Neonatal Visual Assessment (NVA) assesses visual function and outcomes and has been used to assess early neurodevelopmental outcomes. This study aimed to compare NVA results of very preterm and term-born infants and to calculate the sensitivity and specificity of the NVA at term equivalent age (TEA) and three months corrected age (CA) to predict motor and cognitive outcomes at 12 months CA in very preterm infants.

Methods

This prospective observational cohort study recruited infants born before 31 weeks gestation and a healthy term-born control group. The NVA was assessed at TEA and three months CA, and neurodevelopmental outcomes (Bayley Scales of Infant and Toddler Development, Third Edition; Neurosensory Motor Developmental Assessment; Alberta Infant Motor Scale) were performed at 12 months CA. The sensitivity and specificity of the NVA to predict outcomes were calculated based on a previously published optimality score.

Results

248 preterm (54 % male) and 46 term-born infants (48 % male) were analysed. The mean NVA scores of preterm and term-born infants were significantly different at TEA (preterm 3.1$\pm$2.1; term-born 1.2$\pm$1.7, p < 0.001). The NVA had moderate sensitivity (59–78 %) and low specificity (25–27 %) at TEA, and low sensitivity (21–28 %) and high specificity (86–87 %) at three months CA for the prediction of preterm infants' outcomes at 12 months CA.

Conclusion

The NVA at TEA and three months CA was not a strong predictor of motor and cognitive impairments in this contemporary cohort of very preterm infants.

Introduction

The low attendance of families in child developmental follow-up programs for at-risk preterm children is a challenge in Brazil.

Objective

This study evaluates the feasibility of implementing a developmental follow-up program for Brazilian preterm infants in a hybrid format.

Methods

This is an observational, prospective cohort study, involving preterm infants. Longitudinal developmental test results, the participation frequency in the program, and the number of referrals to early intervention programs were used to assess feasibility. The General Movements (GMs) assessment, Alberta Infant Motor Scale (AIMS) and, Survey of Wellbeing of Young Children (SWYC) Milestones were administered via telehealth. The Bayley-III was administered in-person.

Results

Thirty-four preterm infants attended the follow-up until 12 months of corrected age and 18 (52.9 %) concluded all follow-up assessments. Twenty-six (76.5 %) attended all assessments via telehealth, and 26 (76.5 %) attended the in-person assessment. Eighteen (52.9 %) infants showed at least one altered result in development tests. Infants exhibiting abnormal results in the GMs assessment, motor developmental delay according to the AIMS, or developmental delay based on Balley-III were promptly referred to early intervention services.

Conclusion

This study demonstrated high participation rate and low dropout in a developmental follow-up program employing a hybrid format. The substantial number of identified infants with developmental delay emphasizes the importance of timely detection of motor delays to referral to early intervention services.

Background

It is thought that digit ratios (2D:4D) are a correlate of 1st trimester maternal and foetal sex steroids. Here we consider the relationship of 2D:4D to the former.

Method

Digit lengths were directly measured with a calliper at infant age 13 months. Measures of T and E were obtained from mother's blood at 6–8 weeks, 10–11 weeks and 1st trimester means were calculated.

Results

There were 69 mother-infant pairs (33 boys). Sex differences in 2D:4D (boys<girls) and in maternal E and T (girls>boys) were found. For mothers of girls: there were negative relationships between 2D:4D and T at 6–8 weeks, 10–11 weeks and 1st trimester means. For infants: girls showed more correlations between 2D:4D and hormones than boys. For boys, there was one positive association between 2D:4D and E and two positive associations for E/T. For girls, 2D:4D was negatively related to T (four correlations) and positively related to E/T (four correlations). Considering associations in the total sample and controlling for sex, at 6–8 weeks right and left 2D:4D were positively related to E. At 10–11 weeks, right and left 2D:4D were negatively related to T. For 1st trimester means, 2D:4D's were positively related to E (right and left) and negatively related to T (right).

Conclusion

Infant 2D:4D was correlated with first trimester maternal sex steroids, particularly at 10–11 weeks. The correlations were negative for T, and positive for E and E/T with weaker effects for male infants. The latter pattern may arise because in boys T produced by foetal testes masks the effect of maternal T.

Background

Preterm children have a higher risk for linguistic delays than full-term infants but are rarely provided with language intervention at an early age. Knowledge on early language interventions targeted to preterm children is scarce, and efficacy of the interventions is rarely reported.

Aim

This systematic review aims to identify interventions for preterm children aged 0–3 years with at least one language outcome. Efficacy of the interventions and quality of the study reports were evaluated.

Study design

The article search was carried out in six databases: EBSCOhost, Scopus, ERIC, LLBA, Ovid, and Web of Science. Effect sizes (Hedges' g) were calculated for language outcomes. Quality of the study reports was assessed using the levels of evidence system by the American Speech-Language-Hearing Association.

Results

The 28 studies identified were divided into three groups: interventions at Neonatal Intensive Care Unit, interventions during the first year, and interventions during the second and/or third years. Most of the interventions focused on supporting child-care and general development. Of the interventions, 61 % were efficacious in supporting language development of preterm children. The most promising results regarding efficacy were interventions conducted during the second and/or third years (80 %). Quality of the reports varied from high/good (89 %) to low (11 %).

Conclusion

The 28 existing studies provide limited evidence of the efficacy of very early interventions promoting language development of preterm children. However, especially the results for interventions conducted during the second and/or third years show promise. More studies, particularly language-focused interventions with longer follow-ups, are needed.

Background and aims

Prosocial behavior such as helping and sharing develops early in childhood. Yet very few studies have investigated physiological and relational factors shaping prosociality among children. Here, we systematically examined the role of prenatal androgen exposure alongside prestige, dominance, and friendship in 3–6-year-old preschoolers' prosocial sharing with familiar peers.

Methods

We tested a sample of 65 children, predominately of European descent. We used a cost-free direct-interaction prosocial choice task to assess children's prosocial tendencies. Second-to-fourth digit ratio (2D:4D) was used as a retrospective biomarker for prenatal androgen exposure. Prestige was measured through behavioral observations of interaction partners and visual regard, dominance through teacher questionnaires, and friendship via peer preference assessments.

Results

We found that children acted prosocially when tested with a familiar peer. Children with lower 2D:4D (higher prenatal androgen exposure) behaved more prosocially. Further, there were marginal associations between the donors' prosocial tendencies and their visual regard as a proxy of their prestige (positive effect) and their teacher-rated dominance relative to the recipient (negative effect). Neither age, sex, nor friendship influenced prosocial choices.

Conclusions

Prenatal androgen exposure, approximated via 2D:4D, was associated with prosocial behavior. In contrast to previous research in older children, higher exposure was related to stronger prosocial tendencies, which corresponds to earlier findings on fairness in adults. Our findings point towards a potential role of sex steroids in the early development of children's social behavior, but they have to be interpreted with caution due to the small sample size of the current study. Nevertheless, they underscore the importance of integrating biological and psychological perspectives, while also highlighting the significance of studying the development of prosocial behavior within peer groups.

Purpose

The study aimed at scoring Indian preterm infants at three months corrected age on the TIMP and then comparing the scores to the United States age-based population scores.

Methods

After obtaining Ethical clearance, participants meeting the inclusion criteria of 53 infants whose parents consented were screened and recruited (N = 47) at a tertiary care hospital. The TIMP was then administered at three months of corrected age.

Results

Data obtained from 47 infants born preterm (Male = 33, Female = 14) at three months corrected age with mean gestational age (34.4 ± 2.36 weeks) and mean birth weight (1.93 ± 0.55 kgs) was analyzed. Indian infants born preterm scored a mean of (98.17 ± 20.90) compared to the US mean of (108 ± 19), suggesting an under-performance. The average scores were lower when comparing the mean of the study group with the US-based age-matched population.

Conclusion

Motor performance scores of Indian preterm infants were low when compared to their US counterparts. Since there exists a difference in the raw score obtained by Indian Preterm infants compared to the US-based population, it may not be appropriate to categorize the motor development of Indian infants based on the US population scores.