Early human development最新文献

Background

the importance of sucking milk directly at the mother's breast is often underestimated and many aspects of direct breastfeeding of very preterm infants are not investigated.

Aim

The primary endpoint of the study was to identify maternal and infant clinical predictors of direct breastfeeding in a cohort of infants born at <32 weeks of gestation or weighing <1500 g. The secondary endpoint was to evaluate the possible effects of direct breastfeeding on infant neurodevelopment.

Study design

Seventy-two infants born between July 2018 and December 2019 were divided into the subgroup that were directly breastfed (n = 42) and not directly breastfed (n = 30) at discharge. Maternal and infant characteristics were compared, and differences were analysed.

Results

Logistic regression analysis demonstrated that the percentage of maternal milk taken during hospitalization, maternal age, and weight (z-score) at discharge were positively correlated with the likelihood of direct breastfeeding at discharge. Direct breastfeeding was not correlated with the cognitive score at 24 months corrected age.

Conclusions

Direct breastfeeding at discharge is more probable in infants of older mothers who receive more breastmilk and who experience greater weight gain. Direct breastfeeding is not correlated with the cognitive score at 24 months corrected age.

Background

Early detection of developmental problems is important as it allows for early intervention. Previous studies, in high-risk infants, found high predictive values of atypical scores on the Standardized Infant NeuroDevelopmental Assessment (SINDA) for later neurodevelopmental disorders (i.e., cerebral palsy, intellectual disability).

Aims

The present study explored SINDA's predictive values to identify risk of developmental delay at 4–5 years.

Study design

Cohort study.

Subjects

786 low-risk Dutch children (367 boys; median gestational age: 40 (27–42) weeks; mean birth weight: 3455 (SD 577) grams).

Outcome measures

The SINDA was assessed at 2–12 months and risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4–5 years. SINDA's predictive values were determined for five ASQ domains and the total ASQ score for children at risk of marked (all ASQ domains deviant) and any (one or more ASQ domains deviant) developmental delay.

Results

Presence of one atypical SINDA scale score showed low to moderate sensitivities (12–88 %, depending on the SINDA scale and ASQ domain involved), moderate to high specificities (66–94 %), low positive predictive values (PPVs; 3–16 %), and high negative predictive values (NPVs; 95–100 %) for children at risk of marked and any developmental. Presence of multiple atypical SINDA scale scores predicted deviant ASQ domains slightly better (sensitivities = 11–62 %, specificities = 90–98 %, PPVs = 6–30 %, and NPVs = 95–100 %).

Conclusions

In low-risk infants, SINDA's predictive value is low for detecting children at risk of marked and any developmental delay at 4–5 years, as reflected by the low sensitivities. One of the explanations is the relatively low prevalence of developmental delay in low-risk populations. This might have consequences for the application of the SINDA in general healthcare settings (e.g. child health clinics), but further studies are needed to draw this conclusion.

Background

Iron is a vital micronutrient for brain development, influencing myelination, neurotransmitter balance, and the maturation of specific brain cells. Hence iron insufficiency in the foetal, neonatal and infancy period has the potential to influence the neuromotor development.

Aims

We aimed to describe haematological markers of iron at 4 months of age in infants exposed to prenatal anaemia and explore the association with their quality of general movements.

Study design

Cross sectional study nested within the RAPIDIRON-KIDS trial.

Subjects

All infants whose mothers were part of RAPIDIRON-KIDS trial, were eligible to participate in this study when the infants were 4 months old. Children suffering from fever or acute illness on the day of assessment, or with a history of either surgery, or admission to hospital in the first month were excluded.

Outcome measures

Haematological markers of iron (Haemoglobin and Ferritin level) and quality of general movements in infants at 4 months of age.

Results

120 infants were assessed with mean birth weight of 2685.5 g (±384.5) and median gestational age of 39 weeks [Q₁, Q₃:38,40]. There was no significant association between haemoglobin or ferritin levels with fidgety movements (p = 0.18 and p = 0.27, respectively). The combined effect of haemoglobin and ferritin estimates also did not show any significant association with the study groups (p = 0.21).

Conclusion

A majority of infants still had low iron indices at 4 months of age and this was not associated with the quality of general movements. A prospective longitudinal study needs to be considered in infants exposed to prenatal anaemia rather than assessing the outcomes at a single time point.

Purpose

Recently, near-infrared spectroscopy (NIRS) has been proposed for diagnosing patients with neonatal necrotizing enterocolitis (NEC). However, a consensus on the credibility of NIRS in evaluating NEC risk has not been reached. This meta-analysis aimed to evaluate the relationship between NEC and splanchnic regional tissue oxygen saturation (SrSO₂) and cerebral regional tissue oxygen saturation (CrSO₂) detected by NIRS to clarify the clinical value of NIRS in evaluating the risk of NEC.

Methods

Studies using NIRS to monitor regional tissue oxygen saturation (rSO₂) in neonates with NEC published in PubMed, Web of Science, Embase, and the Cochrane Library were searched from their inception to 30 July 2023. Mean difference (MD), pooled sensitivity, and pooled specificity, along with their 95 % confidence intervals (CI), were calculated, and the random-effects model was used for analysis. This study was registered with PROSPERO (no. CRD42022326783).

Results

Fourteen studies including 938 neonates (172 NEC, 766 controls) were identified. SrSO₂ was significantly decreased in patients with NEC (MD: -12.52, 95 % CI: −15.95, −9.08; P < 0.00001), and this decrease was observed even before the diagnosis of NEC (MD: -13.79, 95 % CI: −17.97, −9.62; P < 0.00001). The pooled sensitivity and specificity of SrSO₂ were 0.80 (95 % CI: 0.69, 0.88) and 0.90 (95 % CI: 0.61, 0.98), respectively. However, no significant difference in CrSO₂ was found (MD: -4.37, 95 % CI: −10.62, 1.88; P = 0.17).

Conclusions

SrSO₂, detected by NIRS, could be a valuable non-invasive method for differentiating NEC from non-NEC neonates. It could differentiate prior to NEC diagnosis.

This study examines the effects of birth month on reproduction and mating behavior using historical and contemporary census data from 1820 to 1970. The research examines the effect of birth month on the number of children for women and their male spouses, finding a monthly cycle for both men and women. In addition, the study examines whether birth month influences whether a person has ever been married. In support of previous research, we find clear birth month effects on the number of children for both women and their spouses, while the time series of ever being married shows a 60-month and a 10-year cycle, the latter possibly related to the solar cycle. Although the effects are small, both results, based on a large and representative dataset, indicate the importance of early life factors on mating and reproduction.

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.