Non-nutritive suck (NNS; sucking without feeding) is among the earliest oromotor behaviors in infants and has been shown to be associated with future neurodevelopmental outcomes. Prior work has shown that by 12 months, NNS bursts become shorter and stronger compared to 3 months, but when this shift occurs within the first year remains unclear. Twenty-four full-term infants participated in this prospective, longitudinal study with repeated measures at 3, 6, 9, and 12 months. Infants sucked on a custom pacifier with a pressure transducer for ∼5 min. NNS outcomes included burst duration (s), frequency (Hz), amplitude (cmH₂O), bursts/min, cycles/burst, and cycles/min. As infants aged, their NNS patterns changed significantly. By nine months, the suck duration, bursts/min, cycles/burst, and cycles/min had decreased and by twelve months, these measures showed even further reduction, reflecting continued changes in sucking across the first year of life. The most pronounced NNS changes occurred between 6 and 9 months, coinciding with the introduction of solids and a decreased reliance on NNS. These findings highlight when NNS patterns shift during infancy, providing a reference for identifying age-appropriate targets for infants. This study emphasizes the dynamic nature of NNS during infancy and underscores the need for further assessment and exploration of its developmental trajectory.
{"title":"Longitudinal changes in infant non-nutritive sucking across the first year of life","authors":"Alaina Martens , Natalie Peterman , Kristen Allison , Katharine Radville , Hayden Kamiya , Emily Zimmerman","doi":"10.1016/j.earlhumdev.2025.106440","DOIUrl":"10.1016/j.earlhumdev.2025.106440","url":null,"abstract":"<div><div>Non-nutritive suck (NNS; sucking without feeding) is among the earliest oromotor behaviors in infants and has been shown to be associated with future neurodevelopmental outcomes. Prior work has shown that by 12 months, NNS bursts become shorter and stronger compared to 3 months, but when this shift occurs within the first year remains unclear. Twenty-four full-term infants participated in this prospective, longitudinal study with repeated measures at 3, 6, 9, and 12 months. Infants sucked on a custom pacifier with a pressure transducer for ∼5 min. NNS outcomes included burst duration (s), frequency (Hz), amplitude (cmH₂O), bursts/min, cycles/burst, and cycles/min. As infants aged, their NNS patterns changed significantly. By nine months, the suck duration, bursts/min, cycles/burst, and cycles/min had decreased and by twelve months, these measures showed even further reduction, reflecting continued changes in sucking across the first year of life. The most pronounced NNS changes occurred between 6 and 9 months, coinciding with the introduction of solids and a decreased reliance on NNS. These findings highlight when NNS patterns shift during infancy, providing a reference for identifying age-appropriate targets for infants. This study emphasizes the dynamic nature of NNS during infancy and underscores the need for further assessment and exploration of its developmental trajectory.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106440"},"PeriodicalIF":2.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667732","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 : 2025-11-23DOI: 10.1016/j.earlhumdev.2025.106453
Aysu Kahraman , Ayşe Numanoğlu Akbaş , Özge Çankaya
Objective
It is recommended that General Movements Assessment, Hammersmith Infant Neurologic Examination (HINE) and magnetic resonance imaging be used together for the early identification of infants at risk for neurodevelopmental problems. This study aimed to investigate the agreement and relationship between the Motor Optimality Score-Revised (MOS-R) and HINE.
Methods
MOS-R and HINE were performed on the same day in 79 infants with corrected ages between 9 and 17 weeks. The agreement between the two scales was analyzed by intraclass correlation coefficient (ICC) test and the correlation was analyzed by Spearman correlation coefficient.
Results
The median (interquartile range 25–75) gestational age and birth weight of the infants were 36 (30–39) weeks and 2340 (1400–3095) grams respectively. There was moderate agreement (ICC = 0.627) and high correlation (p < 0.001, r = 0.744) between MOS-R and HINE global scores.
Conclusion
Despite the results, the two assessment tools assess both overlapping and distinct components of infants' development and should be considered complementary. Using them together will provide a more comprehensive insight into infants' body functions and neurodevelopmental risk.
{"title":"The complementary roles of the motor optimality score and Hammersmith infant neurological examination","authors":"Aysu Kahraman , Ayşe Numanoğlu Akbaş , Özge Çankaya","doi":"10.1016/j.earlhumdev.2025.106453","DOIUrl":"10.1016/j.earlhumdev.2025.106453","url":null,"abstract":"<div><h3>Objective</h3><div>It is recommended that General Movements Assessment, Hammersmith Infant Neurologic Examination (HINE) and magnetic resonance imaging be used together for the early identification of infants at risk for neurodevelopmental problems. This study aimed to investigate the agreement and relationship between the Motor Optimality Score-Revised (MOS-R) and HINE.</div></div><div><h3>Methods</h3><div>MOS-R and HINE were performed on the same day in 79 infants with corrected ages between 9 and 17 weeks. The agreement between the two scales was analyzed by intraclass correlation coefficient (ICC) test and the correlation was analyzed by Spearman correlation coefficient.</div></div><div><h3>Results</h3><div>The median (interquartile range 25–75) gestational age and birth weight of the infants were 36 (30–39) weeks and 2340 (1400–3095) grams respectively. There was moderate agreement (ICC = 0.627) and high correlation (<em>p</em> < 0.001, <em>r</em> = 0.744) between MOS-R and HINE global scores.</div></div><div><h3>Conclusion</h3><div>Despite the results, the two assessment tools assess both overlapping and distinct components of infants' development and should be considered complementary. Using them together will provide a more comprehensive insight into infants' body functions and neurodevelopmental risk.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106453"},"PeriodicalIF":2.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621594","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}
To evaluate the suitability (feasibility and ease of use) of a novel, wireless, non-adhesive device for cardiorespiratory monitoring directly after birth.
Study design
Prospective observational study in which monitor data of healthy newborn infants were collected by applying and connecting a wireless belt directly after birth without skin preparation. Study duration was at least 30 min. Data were retrospectively analyzed. Primary endpoint was the success of displaying HR and RR within two minutes after device application. Secondary endpoints were the continuity and reliability of the monitor data throughout the monitored period, and the caregivers experience of ease of device application.
Results
As per sample size calculation, monitor data were collected in 39 infants. The measurement was successful in all 39 cases, with a median time to signal display of 4 s (IQR: 3.0–5.0), maximum 91 s. The time needed to obtain a signal did not depend on the degree of vernix. With regard to continuity of data registration, heart rate (HR) and respiratory rate (RR) signals were detectable for 94 % of the time (HR 94 %, RR 97 %).
Conclusion
A new wireless device was feasible for cardiorespiratory monitoring directly after birth without preparing the wet skin and without disturbing parent-infant skin to skin interaction.
目的评价一种新型无线、无粘连装置在新生儿出生后直接进行心肺监护的适用性（可行性和易用性）。研究设计前瞻性观察性研究，在健康新生儿出生后不做皮肤准备，直接应用并连接无线带收集监测数据。研究时间至少30分钟。回顾性分析资料。主要终点是在设备应用后两分钟内成功显示HR和RR。次要终点是整个监测期间监测数据的连续性和可靠性，以及护理人员对设备应用的易用性的体验。结果按样本量计算，收集监测数据39例。39例测量均成功，信号显示的中位时间为4 s (IQR: 3.0-5.0)，最长时间为91 s。获得信号所需的时间并不取决于黑化的程度。关于数据登记的连续性，心率（HR）和呼吸率（RR）信号在94%的时间内被检测到（HR 94%, RR 97%）。结论一种新型的无线监护装置可用于新生儿出生后直接进行心肺监护，无需准备湿皮肤，且不干扰母婴皮肤间的相互作用。
{"title":"Wireless monitoring directly after birth in term neonates: A feasibility study","authors":"Marisse Meeus , Heleen Dingemanse , Corrie Jacobs , Maartje van Dalen , Anne Nieuwenhuis , Julie Lateur , Irma Pernot","doi":"10.1016/j.earlhumdev.2025.106454","DOIUrl":"10.1016/j.earlhumdev.2025.106454","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the suitability (feasibility and ease of use) of a novel, wireless, non-adhesive device for cardiorespiratory monitoring directly after birth.</div></div><div><h3>Study design</h3><div>Prospective observational study in which monitor data of healthy newborn infants were collected by applying and connecting a wireless belt directly after birth without skin preparation. Study duration was at least 30 min. Data were retrospectively analyzed. Primary endpoint was the success of displaying HR and RR within two minutes after device application. Secondary endpoints were the continuity and reliability of the monitor data throughout the monitored period, and the caregivers experience of ease of device application.</div></div><div><h3>Results</h3><div>As per sample size calculation, monitor data were collected in 39 infants. The measurement was successful in all 39 cases, with a median time to signal display of 4 s (IQR: 3.0–5.0), maximum 91 s. The time needed to obtain a signal did not depend on the degree of vernix. With regard to continuity of data registration, heart rate (HR) and respiratory rate (RR) signals were detectable for 94 % of the time (HR 94 %, RR 97 %).</div></div><div><h3>Conclusion</h3><div>A new wireless device was feasible for cardiorespiratory monitoring directly after birth without preparing the wet skin and without disturbing parent-infant skin to skin interaction.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106454"},"PeriodicalIF":2.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621593","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 : 2025-11-21DOI: 10.1016/j.earlhumdev.2025.106441
K. Zandbergen , A.G.M.G.J. Mulders , L. van der Bas , A.H.J. Koning , S. Galjaard , J. Mulder , E.A.P. Steegers , M. Rousian
The aim of this research was to assess the feasibility and reproducibility of first-trimester biometric and volumetric measurements of the fetal urinary tract (FUT) using three-dimensional (3D) ultrasound (US) and Virtual Reality (VR), and to establish reference curves. In a prospective cohort, 2D- and 3D-US datasets of pregnancies (gestational age (GA) 11+0–14+6 weeks) were obtained. Novel biometric and volumetric FUT measurements were performed using 3D VR and compared with 2D US measurements. Reproducibility was evaluated through intra-, interobserver and intersystem agreement (ICC, Bland-Altman). All measurements were plotted against GA to create reference curves. A total of 108 3D-US datasets (mean GA 12+6 weeks (SD 5 days) mean CRL 67 mm (SD 9.0 mm)) were selected randomly. Using 3D VR, intra- and interobserver analyses showed moderate-good agreement for all FUT measurements (ICCs >0.77) and renal calyces (ICCs 0.51–0.83). Volumetric measurements showed the highest agreement (ICC >0.96). Comparison of 2D-US and 3D VR demonstrated good agreement (ICC 0.81). Mean relative differences were <10 % for all measurements except coronal renal calyx measurements. All FUT dimensions increased with GA and reference curve were constructed. First-trimester FUT measurements using 3D VR are feasible and reproducible, except for renal calyces. These measurements provide an in-vivo description of early FUT growth with potential diagnostic value for anomalies.
{"title":"Reference curves of first-trimester novel measurements of the fetal urinary tract using three-dimensional ultrasound and Virtual Reality","authors":"K. Zandbergen , A.G.M.G.J. Mulders , L. van der Bas , A.H.J. Koning , S. Galjaard , J. Mulder , E.A.P. Steegers , M. Rousian","doi":"10.1016/j.earlhumdev.2025.106441","DOIUrl":"10.1016/j.earlhumdev.2025.106441","url":null,"abstract":"<div><div>The aim of this research was to assess the feasibility and reproducibility of first-trimester biometric and volumetric measurements of the fetal urinary tract (FUT) using three-dimensional (3D) ultrasound (US) and Virtual Reality (VR), and to establish reference curves. In a prospective cohort, 2D- and 3D-US datasets of pregnancies (gestational age (GA) 11<sup>+0</sup>–14<sup>+6</sup> weeks) were obtained. Novel biometric and volumetric FUT measurements were performed using 3D VR and compared with 2D US measurements. Reproducibility was evaluated through intra-, interobserver and intersystem agreement (ICC, Bland-Altman). All measurements were plotted against GA to create reference curves. A total of 108 3D-US datasets (mean GA 12<sup>+6</sup> weeks (SD 5 days) mean CRL 67 mm (SD 9.0 mm)) were selected randomly. Using 3D VR, intra- and interobserver analyses showed moderate-good agreement for all FUT measurements (ICCs >0.77) and renal calyces (ICCs 0.51–0.83). Volumetric measurements showed the highest agreement (ICC >0.96). Comparison of 2D-US and 3D VR demonstrated good agreement (ICC 0.81). Mean relative differences were <10 % for all measurements except coronal renal calyx measurements. All FUT dimensions increased with GA and reference curve were constructed. First-trimester FUT measurements using 3D VR are feasible and reproducible, except for renal calyces. These measurements provide an in-vivo description of early FUT growth with potential diagnostic value for anomalies.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106441"},"PeriodicalIF":2.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621595","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 : 2025-11-19DOI: 10.1016/j.earlhumdev.2025.106445
Fırat Koç
Objective
This study aimed to examine the associations between digit ratio (2D:4D), handgrip strength (HGS), and aggression in young adults, proposing a biobehavioral model to elucidate the biological foundations of aggressive behavior. Sex differences in these associations were also explored.
Methods
A total of 410 Turkish university students (208 males, 202 females) aged 18–25 participated in the study. Sociodemographic data were collected, and aggression was measured using the Buss–Perry Aggression Questionnaire (BPAQ). The lengths of the second and fourth digits were measured bilaterally using a digital caliper, and handgrip strength was assessed with a Camry EH101 digital dynamometer following standardized procedures. Analyses included sex-stratified correlations, multiple regressions, and group comparisons across HGS tertiles.
Results
Males showed significantly lower right-hand 2D:4D ratios (0.931 vs. 0.963; p < .001), higher handgrip strength (47.3 kg vs. 27.6 kg; p < .001), and elevated aggression scores (76.9 vs. 65.3; p < .001) compared to females. Right-hand 2D:4D was negatively correlated with both HGS (r = −0.32, p < .01) and aggression (r = −0.26, p < .01), while HGS was positively associated with aggression (r = +0.18, p < .05). In simple regression, right-hand 2D:4D significantly predicted aggression (β = −0.29, R2 = 0.045, p < .001). A multiple regression including 2D:4D, sex, HGS, and age explained 27 % of the variance in aggression (R2 = 0.27, F(4,405) = 25.41, p < .001), with HGS remaining a significant predictor (β = +0.10, p = .023). Aggression also varied across HGS tertiles (F(2,407) = 12.7, p < .001), with higher aggression scores observed in the highest-strength group. Notably, the negative association between 2D:4D and aggression was stronger in males and non-significant in females, indicating potential sex-specific biological pathways.
Conclusion
These findings support a biobehavioral framework in which both digit ratio and physical strength are linked to aggression, particularly in males. The results align with formidability-based models of aggression, emphasizing the role of prenatal androgen exposure and musculoskeletal capacity in shaping behavioral tendencies. Integrating anatomical and functional traits offers valuable insight into the biological underpinnings of aggression.
目的：本研究旨在探讨青少年手指比例（2D:4D）、握力（HGS）与攻击行为的关系，并提出一个生物行为模型来阐明攻击行为的生物学基础。研究人员还探讨了这些关联的性别差异。方法：共410名18-25岁的土耳其大学生（男208人，女202人）参与研究。收集社会人口学数据，采用Buss-Perry攻击问卷（BPAQ）测量攻击行为。用数字卡尺测量双侧无名指和无名指的长度，用凯美瑞EH101数字测力仪按照标准化程序评估双手握力。分析包括性别分层相关性、多元回归和跨HGS分位数的组比较。结果：男性的右手2D:4D比例明显低于男性（0.931 vs 0.963; p = 0.045, p = 0.27， F(4,405) = 25.41, p）。结论：这些发现支持了一个生物行为框架，即手指比例和体力与攻击性有关，尤其是在男性中。研究结果与基于强壮的攻击模型一致，强调了产前雄激素暴露和肌肉骨骼能力在塑造行为倾向中的作用。将解剖学和功能特征结合起来，可以为了解攻击性的生物学基础提供有价值的见解。
{"title":"Digit ratio (2D:4D), physical strength, and aggression in Turkish young adults: A biobehavioral analysis","authors":"Fırat Koç","doi":"10.1016/j.earlhumdev.2025.106445","DOIUrl":"10.1016/j.earlhumdev.2025.106445","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the associations between digit ratio (2D:4D), handgrip strength (HGS), and aggression in young adults, proposing a biobehavioral model to elucidate the biological foundations of aggressive behavior. Sex differences in these associations were also explored.</div></div><div><h3>Methods</h3><div>A total of 410 Turkish university students (208 males, 202 females) aged 18–25 participated in the study. Sociodemographic data were collected, and aggression was measured using the Buss–Perry Aggression Questionnaire (BPAQ). The lengths of the second and fourth digits were measured bilaterally using a digital caliper, and handgrip strength was assessed with a Camry EH101 digital dynamometer following standardized procedures. Analyses included sex-stratified correlations, multiple regressions, and group comparisons across HGS tertiles.</div></div><div><h3>Results</h3><div>Males showed significantly lower right-hand 2D:4D ratios (0.931 vs. 0.963; <em>p</em> < .001), higher handgrip strength (47.3 kg vs. 27.6 kg; <em>p</em> < .001), and elevated aggression scores (76.9 vs. 65.3; <em>p</em> < .001) compared to females. Right-hand 2D:4D was negatively correlated with both HGS (<em>r</em> = −0.32, <em>p</em> < .01) and aggression (<em>r</em> = −0.26, <em>p</em> < .01), while HGS was positively associated with aggression (<em>r</em> = +0.18, <em>p</em> < .05). In simple regression, right-hand 2D:4D significantly predicted aggression (β = −0.29, <em>R</em><sup><em>2</em></sup> = 0.045, <em>p</em> < .001). A multiple regression including 2D:4D, sex, HGS, and age explained 27 % of the variance in aggression (<em>R</em><sup><em>2</em></sup> = 0.27, <em>F</em>(4,405) = 25.41, <em>p</em> < .001), with HGS remaining a significant predictor (β = +0.10, <em>p</em> = .023). Aggression also varied across HGS tertiles (<em>F</em>(2,407) = 12.7, <em>p</em> < .001), with higher aggression scores observed in the highest-strength group. Notably, the negative association between 2D:4D and aggression was stronger in males and non-significant in females, indicating potential sex-specific biological pathways.</div></div><div><h3>Conclusion</h3><div>These findings support a biobehavioral framework in which both digit ratio and physical strength are linked to aggression, particularly in males. The results align with formidability-based models of aggression, emphasizing the role of prenatal androgen exposure and musculoskeletal capacity in shaping behavioral tendencies. Integrating anatomical and functional traits offers valuable insight into the biological underpinnings of aggression.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106445"},"PeriodicalIF":2.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603205","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 : 2025-11-19DOI: 10.1016/j.earlhumdev.2025.106443
Álvaro Hidalgo-Robles , María Del Mar Batista-Guerra , Mónica Gutiérrez-Ortega , Irene León-Estrada , Javier Merino-Andrés
The 2017 international guidelines for early detection of cerebral palsy (CP) provide a framework for identifying and managing infants at risk. Yet their implementation in clinical practice remains limited in some settings and countries. This study aimed to implement these guidelines in a Spanish tertiary hospital and assess their impact on the timing of CP diagnosis and referral to early intervention. A pre/post observational design was used, structured around a three-phase implementation strategy: (1) planning and preparation, (2) installation, and (3) early implementation of systematic screening of infants with “high-risk” markers. We compared a historical baseline cohort (born 2017–2021, n = 18 children diagnosed with CP) and an implementation cohort (born 2022–2023, n = 57 enrolled, n = 4 children diagnosed with CP). Among infants with CP in the implementation cohort, referral to early intervention occurred at a mean corrected age of 1.9 months, “high-risk” of CP designation at 3.7 months, and CP diagnosis at 9.2 months. In the baseline period, mean age at diagnosis was 17.4 months, yielding a mean reduction of 8.2 months during implementation (95 % CI: −13.8 to −2.6, p < 0.05). Twelve key recommendations were partially (50 %) or consistently (20 %) applied. Findings support the feasibility of implementing the guidelines and suggest improved identification and surveillance outcomes, including earlier diagnosis. Structured implementation pathways are needed to integrate these practices into routine care and promote equitable access across health systems.
{"title":"Implementation of guidelines for early detection of cerebral palsy. A single-site study in Spain","authors":"Álvaro Hidalgo-Robles , María Del Mar Batista-Guerra , Mónica Gutiérrez-Ortega , Irene León-Estrada , Javier Merino-Andrés","doi":"10.1016/j.earlhumdev.2025.106443","DOIUrl":"10.1016/j.earlhumdev.2025.106443","url":null,"abstract":"<div><div>The 2017 international guidelines for early detection of cerebral palsy (CP) provide a framework for identifying and managing infants at risk. Yet their implementation in clinical practice remains limited in some settings and countries. This study aimed to implement these guidelines in a Spanish tertiary hospital and assess their impact on the timing of CP diagnosis and referral to early intervention. A pre/post observational design was used, structured around a three-phase implementation strategy: (1) planning and preparation, (2) installation, and (3) early implementation of systematic screening of infants with “high-risk” markers. We compared a historical baseline cohort (born 2017–2021, <em>n</em> = 18 children diagnosed with CP) and an implementation cohort (born 2022–2023, <em>n</em> = 57 enrolled, <em>n</em> = 4 children diagnosed with CP). Among infants with CP in the implementation cohort, referral to early intervention occurred at a mean corrected age of 1.9 months, “high-risk” of CP designation at 3.7 months, and CP diagnosis at 9.2 months. In the baseline period, mean age at diagnosis was 17.4 months, yielding a mean reduction of 8.2 months during implementation (95 % CI: −13.8 to −2.6, <em>p</em> < 0.05). Twelve key recommendations were partially (50 %) or consistently (20 %) applied. Findings support the feasibility of implementing the guidelines and suggest improved identification and surveillance outcomes, including earlier diagnosis. Structured implementation pathways are needed to integrate these practices into routine care and promote equitable access across health systems.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106443"},"PeriodicalIF":2.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660797","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 : 2025-11-19DOI: 10.1016/j.earlhumdev.2025.106444
Zsuzsanna Varga , Miklós Szabó , Tamás Kói , Bence Kas , Nóra Nyilas , Anna Dósa , Dóra Luca Bodócs , Ágnes Jermendy , Anett Ragó
Aim
To assess early language development in infants with hypoxic-ischaemic encephalopathy (HIE), treated with therapeutic hypothermia (TH) who survived without functional motor deficits, and to identify potential neonatal predictive markers for early language delay (ELD).
Methods
In a prospective cohort study, 77 infants with HIE treated with TH were recruited. Cognitive development was assessed using the Bayley Scales of Infant Development, Second Edition, and language development using the MacArthur-Bates Communicative Development Inventory in follow-up studies at a median age of 20 months.
Results
Thirty-two (41 %) infants had favorable cognitive and language development (FCLD group), 19 (25 %) exhibited ELD despite good cognitive skills, and 26 (34 %) showed concomitant adverse cognitive and language development (ACLD group). Despite differences in cognitive outcomes, the language profiles of the ELD and ACLD groups were comparable. No early clinical, socioeconomical, or MRI markers predicted language delay. However, maternal education was strongly associated with cognitive outcomes. Compared with maternal university education, infants of mothers with high school education had 3.9-fold higher odds (95 % CI 1.08–13.97) of adverse cognitive outcomes, and those with maternal elementary school education had 10.2-fold higher odds (95 % CI 2.56–40.31).
Conclusion
One-third of infants with HIE demonstrated favorable cognitive outcomes but concurrent early language delay, highlighting the need for linguistic screening to prevent later learning disorders. Longitudinal studies are warranted to determine whether ELD infants eventually catch up or remain at risk for persistent language deficits.
目的评估低氧缺血性脑病（HIE）患儿经治疗性低温（TH）治疗后无功能性运动缺陷存活的早期语言发育情况，并确定早期语言迟缓（ELD）的潜在新生儿预测标志物。方法在一项前瞻性队列研究中，招募77名接受TH治疗的HIE患儿。在中位年龄为20个月的随访研究中，使用Bayley婴儿发展量表（第二版）评估认知发展，使用麦克阿瑟-贝茨交际发展量表评估语言发展。结果fld组患儿认知和语言发育良好32例（41%），有良好认知能力的患儿19例（25%），有不良认知和语言发育的患儿26例（34%）。尽管认知结果存在差异，但ELD组和ACLD组的语言概况具有可比性。没有早期临床、社会经济或MRI标记预测语言延迟。然而，母亲教育与认知结果密切相关。与受过大学教育的母亲相比，受过高中教育的母亲的婴儿发生不良认知结局的几率高3.9倍（95% CI 1.08 ~ 13.97），受过小学教育的母亲的婴儿发生不良认知结局的几率高10.2倍（95% CI 2.56 ~ 40.31）。结论三分之一的HIE患儿表现出良好的认知结果，但同时存在早期语言迟缓，这突出了语言筛查预防后期学习障碍的必要性。有必要进行纵向研究，以确定ELD婴儿最终是否会赶上或仍有持续语言缺陷的风险。
{"title":"Early language delay among infants with hypoxic-ischaemic encephalopathy after therapeutic hypothermia: A prospective cohort study","authors":"Zsuzsanna Varga , Miklós Szabó , Tamás Kói , Bence Kas , Nóra Nyilas , Anna Dósa , Dóra Luca Bodócs , Ágnes Jermendy , Anett Ragó","doi":"10.1016/j.earlhumdev.2025.106444","DOIUrl":"10.1016/j.earlhumdev.2025.106444","url":null,"abstract":"<div><h3>Aim</h3><div>To assess early language development in infants with hypoxic-ischaemic encephalopathy (HIE), treated with therapeutic hypothermia (TH) who survived without functional motor deficits, and to identify potential neonatal predictive markers for early language delay (ELD).</div></div><div><h3>Methods</h3><div>In a prospective cohort study, 77 infants with HIE treated with TH were recruited. Cognitive development was assessed using the Bayley Scales of Infant Development, Second Edition, and language development using the MacArthur-Bates Communicative Development Inventory in follow-up studies at a median age of 20 months.</div></div><div><h3>Results</h3><div>Thirty-two (41 %) infants had favorable cognitive and language development (FCLD group), 19 (25 %) exhibited ELD despite good cognitive skills, and 26 (34 %) showed concomitant adverse cognitive and language development (ACLD group). Despite differences in cognitive outcomes, the language profiles of the ELD and ACLD groups were comparable. No early clinical, socioeconomical, or MRI markers predicted language delay. However, maternal education was strongly associated with cognitive outcomes. Compared with maternal university education, infants of mothers with high school education had 3.9-fold higher odds (95 % CI 1.08–13.97) of adverse cognitive outcomes, and those with maternal elementary school education had 10.2-fold higher odds (95 % CI 2.56–40.31).</div></div><div><h3>Conclusion</h3><div>One-third of infants with HIE demonstrated favorable cognitive outcomes but concurrent early language delay, highlighting the need for linguistic screening to prevent later learning disorders. Longitudinal studies are warranted to determine whether ELD infants eventually catch up or remain at risk for persistent language deficits.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106444"},"PeriodicalIF":2.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577899","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 : 2025-11-17DOI: 10.1016/j.earlhumdev.2025.106442
Jane P. Daniels , Kate F. Walker , Lucy Bradshaw , Jon Dorling , Shalini Ojha , James Gray , James G. Thornton , Jane Plumb , Stavros Petrou , Susan Ayers , Eleanor Mitchell , Soo Downe , Nicky Grace , Tracey Cooper , Rachel Plachcinski , Sarah Moore , Ann-Marie Jones , Eleanor Harrison , Joanne Brooks , Kerry Barker-Williams , Sebastian Moody
Background
One in five pregnant women/birthing people carry group B streptococcus in the gut or genital tract, and over half of them will pass it to their child during pregnancy, labour (most commonly) or after birth. Most babies exposed to maternal GBS remain well, but 1 in 1750 newborns in the UK and Ireland develop early-onset GBS infection. Introducing routine testing for group B streptococcus (GBS) for all pregnant women and birthing people in late pregnancy may reduce cases of early-onset infection in the newborn but would likely increase the number of women given antibiotics during labour.
The GBS3 trial (ISRCTN49639731) is a cluster-randomised trial involving approximately 320,000 women/birthing people from 80 maternity units in England and Wales. It will determine the clinical and cost-effectiveness of routine testing, compared to the current risk-factor based strategy.
Methods
To obtain details of the timing, coverage and outcome of the testing process and use of IAP, about 130 consecutive maternity records of women who birthed after 32 weeks’ gestation and who were not scheduled for a planned caesarean birth, and the corresponding neonatal records, were scrutinised at each participating maternity unit.
We performed a baseline qualitative study to inform the trial design to explore women’s views on the acceptability of different methods of GBS testing in pregnancy, including self-swabbing procedures.
We explored the acceptability of different methods of routine testing for GBS colonisation to pregnant women and health care professionals (HCPs), and examined the barriers and facilitators to their implementation.
Results
We received detailed demographic data for 9179 women. Overall, in both testing groups, 72 % of women were offered a vaginal-rectal swab for GBS. Of those women offered a swab, 82 % accepted a vaginal-rectal swab. Of the women with a swab taken, 17 % were positive for GBS. 87 % of women had a test result ≥ 4 hours before birth.
Our baseline and embedded qualitative studies found that GBS testing is acceptable to most women and HCPs.
Conclusion
GBS testing is acceptable to pregnant women and health care professionals in the UK. When GBS testing is offered to eligible women, the offer is accepted, the test performed and a result available to guide the offer of IAP in a timely fashion for the majority of women.
{"title":"Universal maternal testing for group B streptococcus in late pregnancy: process outcomes and alongside qualitative study for the GBS3 trial","authors":"Jane P. Daniels , Kate F. Walker , Lucy Bradshaw , Jon Dorling , Shalini Ojha , James Gray , James G. Thornton , Jane Plumb , Stavros Petrou , Susan Ayers , Eleanor Mitchell , Soo Downe , Nicky Grace , Tracey Cooper , Rachel Plachcinski , Sarah Moore , Ann-Marie Jones , Eleanor Harrison , Joanne Brooks , Kerry Barker-Williams , Sebastian Moody","doi":"10.1016/j.earlhumdev.2025.106442","DOIUrl":"10.1016/j.earlhumdev.2025.106442","url":null,"abstract":"<div><h3>Background</h3><div>One in five pregnant women/birthing people carry group B streptococcus in the gut or genital tract, and over half of them will pass it to their child during pregnancy, labour (most commonly) or after birth. Most babies exposed to maternal GBS remain well, but 1 in 1750 newborns in the UK and Ireland develop early-onset GBS infection. Introducing routine testing for group B streptococcus (GBS) for all pregnant women and birthing people in late pregnancy may reduce cases of early-onset infection in the newborn but would likely increase the number of women given antibiotics during labour.</div><div>The GBS3 trial (ISRCTN49639731) is a cluster-randomised trial involving approximately 320,000 women/birthing people from 80 maternity units in England and Wales. It will determine the clinical and cost-effectiveness of routine testing, compared to the current risk-factor based strategy.</div></div><div><h3>Methods</h3><div>To obtain details of the timing, coverage and outcome of the testing process and use of IAP, about 130 consecutive maternity records of women who birthed after 32 weeks’ gestation and who were not scheduled for a planned caesarean birth, and the corresponding neonatal records, were scrutinised at each participating maternity unit.</div><div>We performed a baseline qualitative study to inform the trial design to explore women’s views on the acceptability of different methods of GBS testing in pregnancy, including self-swabbing procedures.</div><div>We explored the acceptability of different methods of routine testing for GBS colonisation to pregnant women and health care professionals (HCPs), and examined the barriers and facilitators to their implementation.</div></div><div><h3>Results</h3><div>We received detailed demographic data for 9179 women. Overall, in both testing groups, 72 % of women were offered a vaginal-rectal swab for GBS. Of those women offered a swab, 82 % accepted a vaginal-rectal swab. Of the women with a swab taken, 17 % were positive for GBS. 87 % of women had a test result ≥ 4 hours before birth.</div><div>Our baseline and embedded qualitative studies found that GBS testing is acceptable to most women and HCPs.</div></div><div><h3>Conclusion</h3><div>GBS testing is acceptable to pregnant women and health care professionals in the UK. When GBS testing is offered to eligible women, the offer is accepted, the test performed and a result available to guide the offer of IAP in a timely fashion for the majority of women.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106442"},"PeriodicalIF":2.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654114","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 : 2025-11-13DOI: 10.1016/j.earlhumdev.2025.106439
Ashley Xavérine Wiseman , Isabelle Vidal , Christophe Combescure , Cecilia Dallan , Alexandra Wilhelm-Bals , Maria Rodriguez , Paloma Parvex , Jacques Birraux
Background
Congenital malformations of the kidney and/or urinary tract (CAKUT) are nowadays widely detected prenatally and are the first cause of end-stage renal disease and kidney transplantation in children.
Aim
The aim of this study is to explore potential prenatal and postnatal factors associated with the need for postnatal surgery in children prenatally diagnosed with CAKUT.
Methods
Patient data has been prospectively collected from a monocentric database. Were included children diagnosed with CAKUT at the time of routine prenatal ultrasound, between January 1, 2008 and December 31, 2015. Only children with at least 12 months postnatal follow-up were analyzed. Prenatal and postnatal imaging, laboratory results and operative reports were retrospectively reviewed. Based on their CAKUT diagnosis at birth, patients were divided in three groups: high, intermediate, low likelihood of requiring surgical management. Patients from the intermediate sub-group were further analyzed to determine potential clinical or radiological factors associated with need for surgery.
Results
147 patients were included. In total, 39 patients with CAKUT required surgery (26 %). Mean time to surgery was 6 months (0–62 months). 105/147 (71 %) patients had intermediate likelihood of requiring surgical management for their postnatal CAKUT diagnosis. In this subgroup, 30/105 patients (28 %) were operated on. A visible ureter on prenatal ultrasound and an anterior posterior renal pelvis diameter ≥ 10 mm, were associated with postnatal surgical management in our practice.
Conclusion
Prenatal and postnatal ultrasound are important non-invasive tools to detect children with a prenatal CAKUT diagnosis that may require surgery.
{"title":"Predictive factors of surgery in congenital anomalies of the kidney and urinary tract: Insights from a monocentric cohort study","authors":"Ashley Xavérine Wiseman , Isabelle Vidal , Christophe Combescure , Cecilia Dallan , Alexandra Wilhelm-Bals , Maria Rodriguez , Paloma Parvex , Jacques Birraux","doi":"10.1016/j.earlhumdev.2025.106439","DOIUrl":"10.1016/j.earlhumdev.2025.106439","url":null,"abstract":"<div><h3>Background</h3><div>Congenital malformations of the kidney and/or urinary tract (CAKUT) are nowadays widely detected prenatally and are the first cause of end-stage renal disease and kidney transplantation in children.</div></div><div><h3>Aim</h3><div>The aim of this study is to explore potential prenatal and postnatal factors associated with the need for postnatal surgery in children prenatally diagnosed with CAKUT.</div></div><div><h3>Methods</h3><div>Patient data has been prospectively collected from a monocentric database. Were included children diagnosed with CAKUT at the time of routine prenatal ultrasound, between January 1, 2008 and December 31, 2015. Only children with at least 12 months postnatal follow-up were analyzed. Prenatal and postnatal imaging, laboratory results and operative reports were retrospectively reviewed. Based on their CAKUT diagnosis at birth, patients were divided in three groups: high, intermediate, low likelihood of requiring surgical management. Patients from the intermediate sub-group were further analyzed to determine potential clinical or radiological factors associated with need for surgery.</div></div><div><h3>Results</h3><div>147 patients were included. In total, 39 patients with CAKUT required surgery (26 %). Mean time to surgery was 6 months (0–62 months). 105/147 (71 %) patients had intermediate likelihood of requiring surgical management for their postnatal CAKUT diagnosis. In this subgroup, 30/105 patients (28 %) were operated on. A visible ureter on prenatal ultrasound and an anterior posterior renal pelvis diameter ≥ 10 mm, were associated with postnatal surgical management in our practice.</div></div><div><h3>Conclusion</h3><div>Prenatal and postnatal ultrasound are important non-invasive tools to detect children with a prenatal CAKUT diagnosis that may require surgery.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106439"},"PeriodicalIF":2.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563254","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 : 2025-11-09DOI: 10.1016/j.earlhumdev.2025.106436
Hidehiko Maruyama, Shoichiro Amari, Tetsuya Isayama, Yushi Ito
Background
There are few reports describing endotracheal tube (ETT) position changes due to neck rotation. Modifying ultrasonographic measurements of ETT tip and aortic distance, we aim to clarify the ETT tip position changes due to neck rotation.
Methods
Eligibility criteria: (1) birth between October 2022 and September 2023, between 32 and 41 gestational weeks, (2) ventilatory management with ETT fixed at the left mouth corner, and (3) physician judgment that respiratory and circulatory status is relatively stable. We measured the distance between the brachiocephalic artery bifurcation and the ETT tip on one plane in a close parasagittal section from the left neck. We compared them with the neck in right, neutral, and left rotation positions as distances R, N, and L, respectively.
Results
There were 30 study subjects. The means ± standard deviations of distances R, N, and L were 10.4 ± 2.1, 12.9 ± 3.5, and 13.7 ± 3.3 mm, respectively. Repeated measures analysis of variance found significant differences between groups (P < 0.001). A significant difference was found between distances R and N (mean difference − 2.50 [95 % confidence interval, −3.58, −1.42]) and between R and L (−3.31 [−4.72, −1.91]).
Conclusion
The tip position of ETT secured at the left mouth corner was significantly deeper in the right rotation neck position. In addition to left-right neck rotation, flexion-extension neck movement greatly affects ETT position change. Therefore, we must take care of neck movement.
{"title":"Investigation of endotracheal tube position changes due to neck rotation in newborns","authors":"Hidehiko Maruyama, Shoichiro Amari, Tetsuya Isayama, Yushi Ito","doi":"10.1016/j.earlhumdev.2025.106436","DOIUrl":"10.1016/j.earlhumdev.2025.106436","url":null,"abstract":"<div><h3>Background</h3><div>There are few reports describing endotracheal tube (ETT) position changes due to neck rotation. Modifying ultrasonographic measurements of ETT tip and aortic distance, we aim to clarify the ETT tip position changes due to neck rotation.</div></div><div><h3>Methods</h3><div>Eligibility criteria: (1) birth between October 2022 and September 2023, between 32 and 41 gestational weeks, (2) ventilatory management with ETT fixed at the left mouth corner, and (3) physician judgment that respiratory and circulatory status is relatively stable. We measured the distance between the brachiocephalic artery bifurcation and the ETT tip on one plane in a close parasagittal section from the left neck. We compared them with the neck in right, neutral, and left rotation positions as distances <em>R</em>, <em>N</em>, and <em>L</em>, respectively.</div></div><div><h3>Results</h3><div>There were 30 study subjects. The means ± standard deviations of distances <em>R</em>, <em>N</em>, and <em>L</em> were 10.4 ± 2.1, 12.9 ± 3.5, and 13.7 ± 3.3 mm, respectively. Repeated measures analysis of variance found significant differences between groups (<em>P</em> < 0.001). A significant difference was found between distances <em>R</em> and <em>N</em> (mean difference − 2.50 [95 % confidence interval, −3.58, −1.42]) and between <em>R</em> and <em>L</em> (−3.31 [−4.72, −1.91]).</div></div><div><h3>Conclusion</h3><div>The tip position of ETT secured at the left mouth corner was significantly deeper in the right rotation neck position. In addition to left-right neck rotation, flexion-extension neck movement greatly affects ETT position change. Therefore, we must take care of neck movement.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"213 ","pages":"Article 106436"},"PeriodicalIF":2.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145479116","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