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Effect of a lifestyle intervention among pregnant women with overweight on neonatal adiposity: A randomized controlled clinical trial 超重孕妇的生活方式干预对新生儿肥胖的影响:随机对照临床试验
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-12 DOI: 10.1016/j.earlhumdev.2024.106038
Naiara Franco Baroni , Mariana Rinaldi Carvalho , Izabela da Silva Santos , Ana Vitória Lanzoni Chaves , Daniela Elias Goulart de Andrade Miranda , Lívia Castro Crivellenti , Daniela Saes Sartorelli

Background

The excess neonatal adiposity is considered a risk factor for the development of childhood obesity and the birth weight is a marker of health throughout life.

Aims

To evaluate the effect of a lifestyle intervention conducted among pregnant women with overweight on neonatal adiposity and birth weight.

Methods

A total of 350 pregnant women were recruited and randomly allocated into the control (CG) and intervention (IG) groups. Pregnant women in the IG were invited to participate in three nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed foods, following the NOVA food classification system, which categorizes foods according to the extent and purpose of industrial processing, and the regular practice of physical activity. Neonatal adiposity was estimated using a previously validated anthropometric model. Adjusted linear regression models were used to measure the effect.

Results

Adopting the modified intention-to-treat principle, data from 256 neonates were analyzed for birth weight, and data from 163 for body composition estimation. The treatment had no effect on the proportion of fat mass [β 0.52 (95 % CI −1.03, 2.06); p = .51], fat-free mass [β −0.50 (95 % CI −2.45, 1.45); p = .61] or birth weight [β 53.23 (95 % CI −87.19, 193.64); p = .46].

Conclusions

In the present study, the lifestyle counselling used had no effect on neonatal adiposity or birth weight. Future studies should investigate the effect of more intensive interventions.

背景新生儿过多的脂肪被认为是导致儿童肥胖的风险因素,而出生体重则是一生健康的标志。方法共招募了 350 名孕妇,并将她们随机分配到对照组(CG)和干预组(IG)。干预组的孕妇应邀参加了三次营养辅导课,辅导课的内容是鼓励孕妇食用未加工和微加工食品,而不是超加工食品,辅导课采用了诺瓦食品分类系统,该系统根据工业加工的程度和目的对食品进行分类,并鼓励孕妇定期进行体育锻炼。新生儿脂肪含量是通过之前验证的人体测量模型估算的。结果采用修正的意向治疗原则,分析了 256 名新生儿的出生体重数据和 163 名新生儿的身体成分估计数据。治疗对脂肪含量[β 0.52 (95 % CI -1.03, 2.06); p = .51]、无脂肪含量[β -0.50 (95 % CI -2.45, 1.45); p = .61]和出生体重[β 53.23 (95 % CI -87.19, 193.64); p = .46]均无影响。今后的研究应调查更深入的干预措施的效果。
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引用次数: 0
Associations between 2D:4D from direct and radiographic measurements with handgrip strength in young adult Tuvans 直接测量和放射学测量得出的 2D:4D 值与图瓦人青壮年手握力之间的关系
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-08 DOI: 10.1016/j.earlhumdev.2024.106037
Marina Butovskaya , Yulia Adam , Valery Batsevich , Todd K. Shackelford , Bernhard Fink

Background

Digit ratio (2D:4D) – the relative lengths of the index and ring finger – is sexually dimorphic (male < female), possibly because of the sex-differentiated impact of prenatal androgenization on fetal development in the 1st trimester. The sex difference remains stable with age and has been reported in children, adolescents, and adults from industrialized and non-industrialized societies. Handgrip strength (HGS) also is sexually dimorphic (males > females) and correlates negatively with 2D:4D.

Aims

To examine in a sample of young adult Tuvans from Siberia (Russian Federation): i) the association between 2D:4D measured directly from the palms with 2D:4D measured from radiographic images of the same individuals and ii) the associations between 2D:4D and HGS in Tuvan men and women.

Study design and subjects

The study was cross-sectional. Participants were Tuvans (n = 185; 80 men; mean age = 21.02 years). 2D:4D was measured with a caliper from the ventral surface of the palm (both hands) and from radiographic images (left hand). HGS of both hands was measured with a digital hand dynamometer. Body height and weight were measured with an anthropometer and a body composition scale.

Results

2D:4D ratios and anthropometric measures (including HGS) were sexually dimorphic. Men had lower 2D:4D and higher HGS than women. Direct measures of 2D:4D correlated positively with 2D:4D measured from radiographs. Body mass index (BMI) was a significant predictor of HGS for both sexes. Male right 2D:4D and female right and left 2D:4D correlated negatively with HGS after controlling for the influence of BMI. There were no associations with radiographic measurements of 2D:4D.

Conclusion

Our findings provide evidence of sexual dimorphism in 2D:4D among young adult Tuvans. Together with previous research on Tuvan children and adolescents, these findings provide clear evidence of 2D:4D sexual dimorphism in pre- and postpubertal Tuvans. The small negative association between 2D:4D and HGS corresponds to similar reports across populations, suggesting that 2D:4D is a weak correlate of muscular fitness.

背景数字比(2D:4D)--食指和无名指的相对长度--具有性别二态性(男性和女性),这可能是由于产前雄性激素对胎儿在怀孕头三个月的发育产生了性别差异的影响。这种性别差异随着年龄的增长而保持稳定,在工业化和非工业化社会的儿童、青少年和成年人中均有报道。研究设计与研究对象该研究为横断面研究。参与者为图瓦人(n = 185;80 名男性;平均年龄 = 21.02 岁)。2D:4D 用卡尺从手掌腹面(双手)和放射影像(左手)进行测量。双手的 HGS 用数字手部测力计测量。结果2D:4D比率和人体测量指标(包括HGS)具有性别二态性。男性的 2D:4D 比女性低,HGS 比女性高。2D:4D 的直接测量值与通过X光片测量的 2D:4D 值呈正相关。体重指数(BMI)是预测男女 HGS 的重要指标。在控制了体重指数的影响后,男性右侧 2D:4D 和女性左右侧 2D:4D 与 HGS 呈负相关。结论:我们的研究结果提供了图瓦人青壮年 2D:4D 性别二形性的证据。结合以前对图瓦儿童和青少年的研究,这些发现清楚地证明了青春期前和青春期后图瓦人的 2D:4D 性别二态性。2D:4D 与 HGS 之间的微小负相关与不同人群的类似报告相符,这表明 2D:4D 与肌肉健康的相关性较弱。
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引用次数: 0
Association between decreased cord blood inter-alpha inhibitor levels and neonatal encephalopathy at birth 脐带血中α间抑制剂水平降低与新生儿出生时脑病之间的关系
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-07 DOI: 10.1016/j.earlhumdev.2024.106036
Lynn Bitar , Barbara S. Stonestreet , Yow-Pin Lim , Joseph Qiu , Xiaodi Chen , Imran N. Mir , Lina F. Chalak

Background

Inter-alpha inhibitor proteins (IAIPs) are structurally related proteins found in the systemic circulation with immunomodulatory anti-inflammatory properties. Reduced levels are found in inflammatory related conditions including sepsis and necrotizing enterocolitis, and in neonatal rodents after exposure to hypoxia ischemia. In the current study, cord blood IAIP levels were measured in neonates with and without exposure to hypoxic-ischemic encephalopathy (HIE).

Methods

This is a prospective cohort study including infants born ≥36 weeks over a one-year period. Term pregnancies were divided into two groups: a “reference control” (uncomplicated term deliveries), and “moderate to severe HIE” (qualifying for therapeutic hypothermia). IAIPs were quantified using a sensitive ELISA on the cord blood samples.

Results

The study included 57 newborns: Reference control group (n = 13) and moderate/severe HIE group (n = 44). Measurement of IAIP cord blood concentrations in moderate to severe HIE group [278.2 (138.0, 366.0) μg/ml] revealed significantly lower IAIP concentrations compared with the control group [418.6 (384.5, 445.0) μg/ml] (p = 0.002).

Conclusions

These findings suggest a potential role for IAIPs as indicators of neonates at risk for HIE. IAIP levels could have diagnostic implications in the management of HIE. Future research is required to explore the relationship between HIE and IAIPs as biomarkers for disease severity.

Category of study

Translational.

背景α间抑制蛋白(IAIPs)是一种结构相关的蛋白质,存在于全身循环中,具有免疫调节抗炎特性。在败血症和坏死性小肠结肠炎等炎症相关疾病中,以及在新生啮齿动物缺氧缺血后,都会发现IAIPs水平降低。本研究测量了缺氧缺血性脑病(HIE)新生儿和未患缺氧缺血性脑病新生儿的脐带血 IAIP 水平。足月妊娠分为两组:"参照对照组"(无并发症的足月分娩)和 "中度至重度 HIE"(符合治疗性低温条件)。采用敏感的 ELISA 方法对脐带血样本中的 IAIPs 进行定量分析:参考对照组(13 例)和中度/重度 HIE 组(44 例)。与对照组[418.6 (384.5, 445.0) μg/ml]相比,中度至重度 HIE 组的 IAIP 脐带血浓度[278.2 (138.0, 366.0) μg/ml]测量结果显示明显较低 (p = 0.002)。IAIP水平可能对HIE的管理具有诊断意义。未来的研究需要探索 HIE 与作为疾病严重程度生物标志物的 IAIPs 之间的关系。
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引用次数: 0
Commentary on Segal (2024) “Assortative parenting and assortative cross-parenting: New views of parental preference for selected children” 评论 Segal (2024):"同类亲子关系和同类交叉亲子关系:父母对所选子女偏好的新观点"
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-04 DOI: 10.1016/j.earlhumdev.2024.106035
Glenn Weisfeld PhD
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引用次数: 0
Evaluating the relationship between aEEG findings and two-year prognosis in neonates with severe hyperbilirubinemia 评估严重高胆红素血症新生儿脑电图结果与两年预后之间的关系
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-03 DOI: 10.1016/j.earlhumdev.2024.106031
Hassan Boskabadi , Susan Hashemi Sadr , Azadeh Darabi

Objective

Identifying factors that can better predict the prognosis of neonates with hyperbilirubinemia is important. In this study, we aimed to evaluate the relationship between electroencephalography (EEG) findings and two-year prognosis in neonates with severe hyperbilirubinemia.

Methods & materials

In a cohort prospective study, we studied neonates with a total serum bilirubin level of higher than 18 mg/dL, who were admitted to the neonatal intensive care unit (NICU) of Ghaem hospital, Mashhad, Iran. EEG was recorded upon admission, for all neonates. Patients' data, including demographic characteristics, admission information, and pregnancy and birth data were gathered by obtaining history from parents and studying case files. Also, the relationship between initial EEG findings and final developmental status was assessed.

Results

Mean and standard deviation age of patients were 5.46 ± 3.13 days and average serum total bilirubin level was 23.97 ± 4.34 mg/dL at admission. Our findings revealed a significant correlation between the presence of trace alternant on EEG and developmental delay (P = .001). Presence of trace alternant waves on initial EEG at admission was significantly associated with developmental delay in the two year (P = .005).

Conclusion

These results indicate a relationship between developmental prognosis and the severity of hyper bilirubinemia in neonates. Also, our findings show that the presence of trace alternate waves on the initial EEG is significantly associated with developmental delay of the neonate in the future.

目的确定能更好地预测高胆红素血症新生儿预后的因素非常重要。在这项研究中,我们旨在评估严重高胆红素血症新生儿的脑电图(EEG)结果与两年预后之间的关系。在一项队列前瞻性研究中,我们研究了伊朗马什哈德 Ghaem 医院新生儿重症监护室(NICU)收治的血清总胆红素水平高于 18 mg/dL 的新生儿。所有新生儿入院时均记录了脑电图。通过向父母询问病史和研究病例档案,收集了患者的数据,包括人口统计学特征、入院信息、怀孕和出生数据。结果 患者入院时的平均年龄(5.46±3.13)天,平均血清总胆红素水平(23.97±4.34)毫克/分升。我们的研究结果表明,脑电图上出现痕量交替波与发育迟缓之间存在明显的相关性(P = .001)。结论:这些结果表明,新生儿的发育预后与高胆红素血症的严重程度之间存在关系。此外,我们的研究结果表明,最初脑电图上出现的微量交替波与新生儿未来的发育迟缓有明显关系。
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引用次数: 0
Commentary: Assortative parenting and assortative cross-parenting: New views of parental preference for selected children 评论:同卵双生和异卵双生:父母对所选子女偏好的新观点
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-03 DOI: 10.1016/j.earlhumdev.2024.106034
Hila Segal

The commentary delves into the implications of “assortative parenting” and “assortative cross-parenting,” as introduced by N. L. Segal, and situates these concepts within the framework of current research. It addresses the joys and complexities of raising twins, highlighting how their concurrent development stages can amplify parental favoritism and heighten the challenge of addressing each twin's unique needs. This interplay provides a rich context to investigate assortative parenting practices. Additionally, this paper contemplates the broader picture of twin studies, particularly how the care of monozygotic twins (who share 100 % of their genes) and dizygotic twins (who share 50 % of their genes, on average) may reveal the intertwined nature of genetics and environment in parenting strategies. It also proposes that twins' interactions with other family members, their spouses, and peers can offer profound insights into the phenomena of phenotypic assortative affiliation, enriching our understanding of close relational bonds.

这篇评论深入探讨了 N. L. Segal 提出的 "同类养育 "和 "同类交叉养育 "的含义,并将这些概念置于当前研究的框架内。该书探讨了养育双胞胎的乐趣和复杂性,强调了双胞胎同时处于不同的发展阶段会如何放大父母的偏爱,以及如何增加满足每个双胞胎独特需求的挑战。这种相互作用为研究同类养育实践提供了丰富的背景。此外,本文还对双胞胎研究进行了更广泛的思考,特别是单卵双胞胎(他们共享 100% 的基因)和双卵双胞胎(他们平均共享 50% 的基因)的照顾如何揭示了遗传和环境在养育策略中相互交织的本质。该研究还提出,双胞胎与其他家庭成员、配偶和同龄人之间的互动可为表型同类隶属关系现象提供深刻的见解,丰富我们对亲密关系纽带的理解。
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引用次数: 0
Humanity's evolved nest and its relation to cardiac vagal regulation in the first years of life 人类进化的巢穴及其与生命最初几年心脏迷走神经调节的关系
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-05-03 DOI: 10.1016/j.earlhumdev.2024.106033
Mary S. Tarsha, Darcia Narvaez

Background

The Evolved Developmental Niche (EDN) is a millions-year-old developmental system that matches the maturational schedule of the offspring, optimizing health. Every animal has a developmental niche.

Aims

Humanity has fallen away from providing its EDN. Does it matter?

Study design

Several components of humanity's EDN were reviewed (breastfeeding, positive touch, allomothers, responsive care, free play) in relation to cardiac vagal nerve regulation, a signal of healthy development.

Focal subjects were young children.

Outcome measures

A review of research on the selected EDN components in relation to vagal nerve function was performed. Data were available for all but the allomother component, which is typically not measured by western researchers, although allomothers provide EDN components alongside parents.

Results

Apart from the lack of research on allomother effects, all these EDN components have been shown to influence cardiac vagal regulation in young children.

Conclusions

Converging evidence suggests that providing the EDN in early life may not only support aspects of a child's primal health system, but bolster capacities for social health and wellness, the cornerstone of a positive life trajectory.

背景进化发育生态位(EDN)是一个具有数百万年历史的发育系统,它与后代的成熟时间表相匹配,从而优化健康。每种动物都有一个发育生态位。研究设计回顾了人类 EDN 的几个组成部分(母乳喂养、积极抚触、异体母亲、响应式护理、自由游戏)与心脏迷走神经调节(健康发育的信号)的关系。结果除了缺乏对异体母亲影响的研究外,所有这些 EDN 组成部分都被证明会影响幼儿的心脏迷走神经调节。结论综合证据表明,在生命早期提供 EDN 不仅可以支持儿童原始健康系统的各个方面,还可以增强社会健康和幸福的能力,而这正是积极人生轨迹的基石。
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引用次数: 0
Accuracy and repeatability of fetal facial measurements in 3D ultrasound: A longitudinal study 三维超声胎儿面部测量的准确性和可重复性:纵向研究
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-04-26 DOI: 10.1016/j.earlhumdev.2024.106021
Nerea González-Aranceta , Antonia Alomar , Ricardo Rubio , Silvia Maya-Enero , Antonio Payá , Gemma Piella , Federico Sukno

Objective

Fetal face measurements in prenatal ultrasound can aid in identifying craniofacial abnormalities in the developing fetus. However, the accuracy and reliability of ultrasound measurements can be affected by factors such as fetal position, image quality, and the sonographer's expertise. This study assesses the accuracy and reliability of fetal facial measurements in prenatal ultrasound. Additionally, the temporal evolution of measurements is studied, comparing prenatal and postnatal measurements.

Methods

Three different experts located up to 23 facial landmarks in 49 prenatal 3D ultrasound scans from normal Caucasian fetuses at weeks 20, 26, and 35 of gestation. Intra- and inter-observer variability was obtained. Postnatal facial measurements were also obtained at 15 days and 1 month postpartum.

Results

Most facial landmarks exhibited low errors, with overall intra- and inter-observer errors of 1.01 mm and 1.60 mm, respectively. Landmarks on the nose were found to be the most reliable, while the most challenging ones were those located on the ears and eyes. Overall, scans obtained at 26 weeks of gestation presented the best trade-off between observer variability and landmark visibility. The temporal evolution of the measurements revealed that the lower face area had the highest rate of growth throughout the latest stages of pregnancy.

Conclusions

Craniofacial landmarks can be evaluated using 3D fetal ultrasound, especially those located on the nose, mouth, and chin. Despite its limitations, this study provides valuable insights into prenatal and postnatal biometric changes over time, which could aid in developing predictive models for postnatal measurements based on prenatal data.

产前超声胎儿面部测量有助于识别发育中胎儿的颅面畸形。然而,超声测量的准确性和可靠性会受到胎位、图像质量和超声技师的专业知识等因素的影响。本研究评估了产前超声测量胎儿面部的准确性和可靠性。方法三位不同的专家在妊娠 20 周、26 周和 35 周时对 49 个正常高加索胎儿的产前三维超声扫描结果进行定位,最多可找到 23 个面部地标。结果显示了观察者内部和观察者之间的差异性。结果大多数面部地标显示出较低的误差,观察者内部和观察者之间的总体误差分别为 1.01 毫米和 1.60 毫米。鼻子上的地标最可靠,而耳朵和眼睛上的地标最难测量。总体而言,在妊娠 26 周时获得的扫描结果在观察者的可变性和地标可见度之间实现了最佳平衡。测量结果的时间变化显示,在妊娠晚期,面部下部的生长速度最快。结论颅面部地标可通过三维胎儿超声进行评估,尤其是位于鼻子、嘴巴和下巴的地标。尽管存在局限性,但这项研究为了解产前和产后生物特征随时间的变化提供了宝贵的见解,有助于根据产前数据开发产后测量的预测模型。
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引用次数: 0
Neurocognitive outcomes in moderately preterm born adolescents 中度早产青少年的神经认知结果
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-04-26 DOI: 10.1016/j.earlhumdev.2024.106020
A.E. den Heijer , A.S.N. Jansen , M. van Kersbergen , N.H. van Dokkum , S.A. Reijneveld , J.M. Spikman , M.L.A. de Kroon , A.F. Bos

Background

Early preterm (EP) born children are at risk of neurocognitive impairments persisting into adulthood. Less is known about moderately to late (MLP) preterm born children, especially after early childhood. The aim of this study was to assess neurocognitive functioning of MLP adolescents regarding intelligence, executive and attentional functioning, compared with EP and full-term (FT) adolescents.

Methods

This study was part of the Longitudinal Preterm Outcome Project (LOLLIPOP), a large community-based observational cohort study. In total 294 children (81 EP, 130 MLP, and 83 FT) were tested at age 14 to 16 years, regarding intelligence, speed of processing, attention, and executive functions. We used the Dutch version of the Wechsler Intelligence Scale for Children-Third Edition-Dutch Version (WISC-III-NL), the Test of Everyday Attention for Children, and the Behavioural Assessment of the Dysexecutive Syndrome for Children. We assessed differences between preterm-born groups with the FT group as a reference.

Results

Compared to the FT group, MLP adolescents scored significantly lower on two subtasks of the WISC-III-NL, i.e. Similarities and Symbol Search. EP adolescents performed significantly lower on all neuropsychological tests than their FT peers, except for the subtask Vocabulary. The MLP adolescents scored in between FT and EP adolescents on all tasks, except for three WISC-III-NL subtasks.

Conclusions

Neurocognitive outcomes of MLP adolescents fell mostly in between outcomes of their EP and FT peers. MLPs generally performed on a low-average to average level, and appeared susceptible to a variety of moderate neurodevelopmental problems at adolescent age, which deserves attention in clinical practice.

背景早产(Early preterm,EP)儿童有可能在成年后仍存在神经认知障碍。人们对中晚期早产儿(MLP)的了解较少,尤其是在幼儿期之后。本研究的目的是评估中晚期早产儿与早产儿和足月儿相比在智力、执行力和注意力方面的神经认知功能。共有294名儿童(81名早产儿、130名早产儿和83名早产儿)在14至16岁时接受了智力、处理速度、注意力和执行功能方面的测试。我们使用了韦氏儿童智力量表荷兰语版(WISC-III-NL)、儿童日常注意力测试和儿童执行障碍综合征行为评估。我们以FT组为参照,评估了早产组之间的差异。结果与FT组相比,MLP青少年在WISC-III-NL的两个子任务(即相似性和符号搜索)上的得分明显较低。EP青少年在所有神经心理测试中的成绩均明显低于FT青少年,但词汇量子任务除外。除了三项WISC-III-NL子任务外,MLP青少年在所有任务中的得分都介于FT青少年和EP青少年之间。MLP青少年的神经认知结果大多介于EP青少年和FT青少年之间。MLP青少年的表现一般处于低平均水平到平均水平之间,在青春期似乎容易出现各种中度神经发育问题,这值得在临床实践中加以注意。
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引用次数: 0
Impact of neonatal pain and opiate administration in animal models: A meta-analysis concerning pain threshold 新生儿疼痛和鸦片制剂对动物模型的影响:关于疼痛阈值的荟萃分析
IF 2.5 3区 医学 Q1 Medicine Pub Date : 2024-04-26 DOI: 10.1016/j.earlhumdev.2024.106014
Philipp Steinbauer , Tamara Lisy , Francisco J. Monje , Eva Chwala , Brigitte Wildner , Hannah Schned , Philipp Deindl , Angelika Berger , Vito Giordano , Monika Olischar

Background and aim

Neonatal intensive care treatment, including frequently performed painful procedures and administration of analgesic drugs, can have different effects on the neurodevelopment. This systematic review and meta-analysis aimed to investigate the influence of pain, opiate administration, and pre-emptive opiate administration on pain threshold in animal studies in rodents, which had a brain development corresponding to preterm and term infants.

Methods

A systematic literature search of electronic data bases including CENTRAL (OVID), CINAHL (EBSCO), Embase.com, Medline (OVID), Web of Science, and PsycInfo (OVID) was conducted. A total of 42 studies examining the effect of pain (n = 38), opiate administration (n = 9), and opiate administration prior to a painful event (n = 5) in rodents were included in this analysis.

Results

The results revealed that pain (g = 0.42, 95%CI 0.16–0.67, p = 0.001) increased pain threshold leading to hypoalgesia. Pre-emptive opiate administration had the opposite effect, lowering pain threshold, when compared to pain without prior treatment (g = −1.79, 95%CI −2.71–0.86, p = 0.0001).

Differences were found in the meta regression for type of stimulus (thermal: g = 0.66, 95%CI 0.26–1.07, p = 0.001; vs. mechanical: g = 0.13, 95%CI −0.98–1.25, p = 0.81) and gestational age (b = −1.85, SE = 0.82, p = 0.027). In addition, meta regression indicated an association between higher pain thresholds and the amount of cumulative pain events (b = 0.06, SE = 0.03, p = 0.05) as well as severity of pain events (b = 0.94, SE = 0.28, p = 0.001).

Conclusion

Neonatal exposure to pain results in higher pain thresholds. However, caution is warranted in extrapolating these findings directly to premature infants. Further research is warranted to validate similar effects in clinical contexts and inform evidence-based practices in neonatal care.

背景和目的新生儿重症监护治疗,包括经常进行的疼痛程序和镇痛药物的使用,会对神经发育产生不同的影响。本系统综述和荟萃分析旨在通过对啮齿类动物的动物实验,研究疼痛、阿片类药物的使用和预先阿片类药物的使用对疼痛阈值的影响,啮齿类动物的大脑发育情况与早产儿和足月儿相似。结果结果显示,疼痛(g = 0.42,95%CI 0.16-0.67,p = 0.001)会提高痛阈值,导致痛觉减退。与未预先治疗的疼痛相比,预先服用阿片类药物具有相反的效果,可降低痛阈值(g = -1.79, 95%CI -2.71-0.86, p = 0.0001)。在刺激类型(热刺激:g = 0.66,95%CI 0.26-1.07,p = 0.001;机械刺激:g = 0.13,95%CI -0.98-1.25,p = 0.81)和胎龄(b = -1.85,SE = 0.82,p = 0.027)的元回归中发现了差异。此外,元回归表明,较高的疼痛阈值与累积疼痛事件的数量(b = 0.06,SE = 0.03,p = 0.05)以及疼痛事件的严重程度(b = 0.94,SE = 0.28,p = 0.001)有关。然而,将这些研究结果直接推断到早产儿身上还需谨慎。需要进一步研究以验证临床环境中的类似效应,并为新生儿护理中的循证实践提供依据。
{"title":"Impact of neonatal pain and opiate administration in animal models: A meta-analysis concerning pain threshold","authors":"Philipp Steinbauer ,&nbsp;Tamara Lisy ,&nbsp;Francisco J. Monje ,&nbsp;Eva Chwala ,&nbsp;Brigitte Wildner ,&nbsp;Hannah Schned ,&nbsp;Philipp Deindl ,&nbsp;Angelika Berger ,&nbsp;Vito Giordano ,&nbsp;Monika Olischar","doi":"10.1016/j.earlhumdev.2024.106014","DOIUrl":"https://doi.org/10.1016/j.earlhumdev.2024.106014","url":null,"abstract":"<div><h3>Background and aim</h3><p>Neonatal intensive care treatment, including frequently performed painful procedures and administration of analgesic drugs, can have different effects on the neurodevelopment. This systematic review and meta-analysis aimed to investigate the influence of pain, opiate administration, and pre-emptive opiate administration on pain threshold in animal studies in rodents, which had a brain development corresponding to preterm and term infants.</p></div><div><h3>Methods</h3><p>A systematic literature search of electronic data bases including CENTRAL (OVID), CINAHL (EBSCO), Embase.com, Medline (OVID), Web of Science, and PsycInfo (OVID) was conducted. A total of 42 studies examining the effect of pain (n = 38), opiate administration (n = 9), and opiate administration prior to a painful event (n = 5) in rodents were included in this analysis.</p></div><div><h3>Results</h3><p>The results revealed that pain (g = 0.42, 95%CI 0.16–0.67, <em>p</em> = 0.001) increased pain threshold leading to hypoalgesia. Pre-emptive opiate administration had the opposite effect, lowering pain threshold, when compared to pain without prior treatment (g = −1.79, 95%CI −2.71–0.86, <em>p</em> = 0.0001).</p><p>Differences were found in the meta regression for type of stimulus (thermal: g = 0.66, 95%CI 0.26–1.07, <em>p</em> = 0.001; vs. mechanical: g = 0.13, 95%CI −0.98–1.25, <em>p</em> = 0.81) and gestational age (b = −1.85, SE = 0.82, <em>p</em> = 0.027). In addition, meta regression indicated an association between higher pain thresholds and the amount of cumulative pain events (b = 0.06, SE = 0.03, <em>p</em> = 0.05) as well as severity of pain events (b = 0.94, SE = 0.28, <em>p</em> = 0.001).</p></div><div><h3>Conclusion</h3><p>Neonatal exposure to pain results in higher pain thresholds. However, caution is warranted in extrapolating these findings directly to premature infants. Further research is warranted to validate similar effects in clinical contexts and inform evidence-based practices in neonatal care.</p></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140825625","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}
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Early human development
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