Early human development最新文献_第6页

Predicting mid-term hearing and developmental outcome in clinically inapparent congenital cytomegalovirus infection with hearing loss at birth 预测临床不明显的先天性巨细胞病毒感染伴出生听力损失的中期听力和发育结局。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-11 DOI: 10.1016/j.earlhumdev.2025.106412

Pui Khi Chung , Fleurtje A.J. Schornagel , J. Goeman , Ann C.T.M. Vossen

objective

To assess the predictive value of clinical factors in children with clinically inapparent congenital cytomegalovirus infection (cCMV) and sensorineural hearing loss, for hearing and neurodevelopmental outcome.

Study design

This was a post hoc analysis of data from a nonrandomized trial performed in 37 infants (25 treated with 6 weeks valganciclovir, 12 controls) with cCMV and hearing loss, diagnosed after failing Newborn Hearing Screening. Candidate predictors were head circumference, birth weight, gestational age, neuroimaging results, and baseline hearing loss laterality. The primary outcome was the absolute change in hearing in the best ear (dB) from baseline to follow-up at 18–22 months. Secondary outcomes included change in hearing per ear (‘total-ear’ analysis) and neurodevelopmental outcomes measured by the Bayley Scales of Infant Development (BSID-III) at 18–22 months. Per candidate factor, bivariate linear regression models adjusted for treatment were performed.

Results

No correlations were found between candidate predictors and the primary hearing outcome. Linear correlations were observed for neurodevelopmental outcomes: severity of neuroimaging abnormalities was associated with cognitive and motor BSID-III scores (both P < 0.001) and head circumference with motor score (P < 0.001). No severe motor delay was seen in children with a head circumference above −1 SD, and infants with mild or moderate neuroimaging abnormalities generally had normal development or mild delay. Severe cognitive and motor delays were observed only in those with severe neuroimaging findings.

Conclusions

In children with clinically inapparent cCMV and hearing loss, head circumference and neuroimaging severity may be useful for predicting cognitive and motor outcomes.

目的：探讨临床不明显先天性巨细胞病毒感染（cCMV）合并感音神经性听力损失患儿的临床因素对听力和神经发育预后的预测价值。研究设计：这是对一项非随机试验数据的事后分析，该试验在37名患有cCMV和听力损失的婴儿（25名接受6周缬更昔洛韦治疗，12名对照组）中进行，这些婴儿在新生儿听力筛查失败后被诊断为听力损失。候选预测因子包括头围、出生体重、胎龄、神经影像学结果和基线听力损失偏侧性。主要终点是18-22个月时最佳耳（dB）的听力从基线到随访的绝对变化。次要结果包括每只耳朵的听力变化（“全耳”分析）和18-22个月时Bayley婴儿发育量表（BSID-III）测量的神经发育结果。对每个候选因子进行双变量线性回归模型校正。结果：候选预测因子与主要听力结果无相关性。神经发育结局观察到线性相关：神经影像学异常的严重程度与认知和运动bdd - iii评分相关（均为P）。结论：在临床不明显的cCMV和听力损失的儿童中，头围和神经影像学严重程度可能有助于预测认知和运动结局。

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引用次数: 0

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-10 DOI: 10.1016/j.earlhumdev.2025.106411

Rafael Oliveira Fernandes , Simone Lanius dos Reis , Joana da Costa Eschiletti , Julia Jaekel , Renato Soibelmann Procianoy , Rita C. Silveira

Of 13.4 million children born preterm each year globally, 12 million are born in low- and middle-income countries (LMICs). Children born very preterm (<32 weeks gestation; VP) and/or with very low birth weight (<1500 g; VLBW) may grow up with low health-related quality of life (HRQoL); however, information on this topic remains scarce in LMICs. Therefore, the aim of this study was to compare HRQoL between children born VP/VLBW and their term-born peers in Brazil.

Methods

This observational study assessed children born VP and/or VLBW compared with term-born peers, aged 8 to 14 years. Clinical evaluations and the Pediatric Quality of Life Inventory (PedsQL 4.0) were administered.

Results

A total of 140 children were evaluated: 81 in the VP/VLBW group (11.4 ± 1.7 years; 42 girls and 39 boys) and 59 in the term-born group (mean age: 11.0 ± 1.2 years; 26 girls and 33 boys). Preterm children reported lower total HRQoL scores compared to the term-born group, after adjusting for biological and social confounders (mean difference − 5.6 [95 % CI: −10.0, –1.2]). Parents of VP/VLBW group rated their children's total HRQoL as lower (mean difference − 7.5 [95 % CI: −12.8, −2.1]), especially in the psychosocial scores (mean difference − 8.4 [95 % CI: −13.7, −3.2]) compared to parents of term-born children. VP/VLBW girls presented the lowest total HRQoL scores, especially in the emotional dimension. Neonatal morbidities did not impact HRQoL within the VP/VLBW group.

Conclusion

School-aged children born VP/VLBW in an LMIC exhibit lower HRQoL than their term-born peers. Particular attention should be paid to HRQoL among girls born VP/VLBW and how it may affect their mental health needs.

在全球每年1340万早产儿童中，有1200万出生在低收入和中等收入国家。非常早产（妊娠32周；VP）和/或出生体重极低（1500 g； VLBW）的儿童长大后健康相关生活质量（HRQoL）可能较低；然而，关于这一主题的信息在中低收入国家仍然很少。因此，本研究的目的是比较巴西出生VP/VLBW的孩子和足月出生的同龄人的HRQoL。方法：本观察性研究评估了8 - 14岁的早产儿和/或重度新生儿。进行临床评估和儿童生活质量量表（PedsQL 4.0）。结果共对140例患儿进行评估：VP/VLBW组81例（11.4±1.7岁，女孩42例，男孩39例），足月组59例（平均年龄11.0±1.2岁，女孩26例，男孩33例）。在调整了生物和社会混杂因素后，早产儿报告的HRQoL总分低于足月出生组（平均差异为- 5.6 [95% CI: - 10.0, -1.2]）。与足月出生儿童的父母相比，VP/VLBW组的父母认为他们的孩子的总HRQoL较低（平均差值为- 7.5 [95% CI: - 12.8, - 2.1]），特别是在社会心理评分方面（平均差值为- 8.4 [95% CI: - 13.7, - 3.2]）。VP/VLBW女生的HRQoL总分最低，尤其是在情感维度上。新生儿发病率不影响VP/VLBW组的HRQoL。结论中低收入人群中出生VP/VLBW的学龄儿童的HRQoL低于足月出生的同龄人。应特别关注出生低体重/超低体重女孩的HRQoL及其如何影响她们的心理健康需求。

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引用次数: 0

Prenatal hormonal signature (2D:4D) and dental maturation in childhood: a prospective study 产前激素特征（2D:4D）和儿童牙齿成熟：一项前瞻性研究。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-09 DOI: 10.1016/j.earlhumdev.2025.106410

Türkan Ünal , Fatma Nur Kızılay , Emine Gülşen

Background

The second-to-fourth digit ratio (2D:4D) is a stable anthropometric marker thought to reflect prenatal androgen–estrogen balance. Although 2D:4D has been linked to developmental timing, its association with dental maturation remains unclear. This study evaluated whether 2D:4D relates to dental development in children and assessed its potential as a complementary biomarker.

Methods

In this study, 300 healthy children (150 girls, 150 boys; 6–12 years) were enrolled. Bilateral 2D:4D was measured with digital calipers (0.01 mm accuracy). Dental age was determined from panoramic radiographs using Demirjian's method. Analyses included t-tests/ANOVA, Pearson correlations, and multiple linear regression with chronological age, sex, body mass index (BMI), and 2D:4D as covariates. Hand-specific and sex-stratified comparisons were pre-specified; multiple testing was controlled using the Benjamini–Hochberg false-discovery rate (FDR) procedure, with significance set at q < 0.05 (false discovery rate–adjusted p-value).

Results

Mean chronological age was 9.10 ± 1.99 years, dental age 9.09 ± 2.03 years, and BMI 16.51 ± 1.89 kg/m². 2D:4D showed clear sex differences (higher in girls, p < 0.001). Chronological and dental ages were strongly correlated (r = 0.976, p < 0.001). In the overall sample, dental age correlated weakly with 2D:4D (right: r = 0.155, p = 0.007; left: r = 0.135, p = 0.019). Sex-stratified analyses indicated a positive but non-significant trend in girls (right: r = 0.135, p = 0.099; left: r = 0.110, p = 0.181) and no association in boys (all p > 0.05). In multivariable models, chronological age was the strongest predictor (p < 0.001); 2D:4D contributed independently (β = 0.12–0.16, p < 0.001), while BMI was not significant.

Conclusions

2D:4D shows a weak association with dental maturation at the population level. Within-sex analyses reveal a non-significant positive trend in girls and no association in boys. As a simple, non-invasive measure, 2D:4D may provide supportive information alongside radiographic methods; confirmation in larger, longitudinal, sex-specific cohorts is warranted.

背景：第二与第四指比值（2D:4D）是一种稳定的人体测量指标，被认为可以反映产前雄激素与雌激素的平衡。虽然2D:4D与发育时间有关，但其与牙齿成熟的关系尚不清楚。本研究评估了2D:4D是否与儿童牙齿发育有关，并评估了其作为补充生物标志物的潜力。方法：在本研究中，300名健康儿童（150名女孩，150名男孩，6-12岁）入组。用数字卡尺（精度0.01 mm）测量双侧2D:4D。采用Demirjian的方法从全景x线片确定牙龄。分析包括t检验/方差分析、Pearson相关性和以实足年龄、性别、体重指数（BMI）和2D:4D为协变量的多元线性回归。手特异性和性别分层的比较是预先指定的；采用Benjamini-Hochberg误发现率（FDR）程序控制多重检验，显著性设为q。结果：平均实足年龄为9.10±1.99岁，牙龄为9.09±2.03岁，BMI为16.51±1.89 kg/m2。2D:4D表现出明显的性别差异（女孩较高，p < 0.05）。在多变量模型中，实足年龄是最强的预测因子(p)。结论：在人群水平上，2D:4D显示出与牙齿成熟的弱关联。性别内分析显示，女孩有不显著的积极趋势，男孩没有关联。作为一种简单、无创的测量方法，2D:4D可以与x线摄影方法一起提供支持性信息；在更大的、纵向的、性别特定的队列中进行确认是有必要的。

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引用次数: 0

Parental perceptions of academic competence following extremely preterm birth 父母对极度早产后学业能力的看法。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-08 DOI: 10.1016/j.earlhumdev.2025.106408

Kaitlyn Corso , Peter J. Anderson , Michael Takagi , Alice Burnett , Deanne K. Thompson , Lex W. Doyle , Jeanie Cheong , Leona Pascoe , Simonne E. Collins

Background

Children born extremely preterm (EP) and/or extremely low birthweight (ELBW) face increased risk of academic difficulties and gaps exist in providing educational support. Parental perceptions of academic competence influence educational support access; however, little is known about parental perceptions in the EP/ELBW population.

Aims

To 1) examine parental perceptions of academic competence in children born EP/ELBW and full-term/normal birthweight (FT/NBW) at 6–7 and 17–18 years; 2) characterise the relationship between perceived competence and educational support access; and 3) explore factors associated with parental perceptions.

Methods

Participants surveyed from two cohorts within the Victorian Infant Collaborative Study, including parents of 71 EP/ELBW and 76 FT/NBW children aged 6–7 years, and parents of 28 EP/ELBW and 34 FT/NBW adolescents aged 17–18 years. Parents completed the Academic Competence subscale of the MacArthur Health and Behaviour Questionnaire and reported on educational support access.

Results

Parents of EP/ELBW children rated their children's overall academic competence below parents of FT/NBW children (6–7 years: standardised mean difference [SMD] = −0.92, 95 % CI [−1.35, −0.50]; 17–18 years: SMD = −0.73, 95 % CI [−1.41, −0.05]), with differences observed across core and non-core academic subjects. Lower parental perceptions were associated with increased school-based educational support, particularly for those born EP/ELBW (6–7 years: OR = 0.38, 95 % CI 0.22, 0.67; 17–18 years: OR = 0.42, 95 % CI 0.19, 0.91), but not external support access.

Conclusion

Understanding parental perceptions of academic competence in children born EP/ELBW provides insight for supporting families during educational transitions and ensuring appropriate educational support access.

背景：极早产（EP）和/或极低出生体重（ELBW）的儿童面临着学业困难的风险增加，并且在提供教育支持方面存在差距。父母对学业能力的认知影响教育支持的获得；然而，对EP/ELBW人群中父母的看法知之甚少。目的：1)研究6-7岁和17-18岁EP/ELBW和足月/正常出生体重（FT/NBW）儿童的父母对学业能力的看法；2)表征感知能力与教育支持获取的关系；3)探讨与父母观念相关的因素。方法：参与者来自维多利亚婴儿合作研究的两个队列，包括71名EP/ELBW和76名FT/NBW的6-7岁儿童的父母，以及28名EP/ELBW和34名FT/NBW的17-18岁青少年的父母。家长完成了麦克阿瑟健康与行为问卷的学业能力子量表，并报告了获得教育支持的情况。结果：EP/ELBW儿童的家长对其孩子的整体学业能力的评价低于FT/NBW儿童的家长（6-7岁：标准化平均差异[SMD] = -0.92, 95% CI[-1.35, -0.50]； 17-18岁：SMD = -0.73, 95% CI[-1.41, -0.05]），在核心科目和非核心科目之间存在差异。较低的父母认知与学校教育支持的增加有关，特别是对于那些出生时为EP/ELBW的儿童（6-7岁：OR = 0.38, 95% CI 0.22, 0.67； 17-18岁：OR = 0.42, 95% CI 0.19, 0.91），但与获得外部支持无关。结论：了解父母对EP/ELBW出生的孩子学业能力的看法，为在教育过渡期间支持家庭和确保适当的教育支持提供了见解。

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引用次数: 0

High school graduation among adolescents born preterm: A Canadian population-based cohort study 早产青少年高中毕业率：一项基于加拿大人群的队列研究。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-06 DOI: 10.1016/j.earlhumdev.2025.106404

Deepak Louis , Ava Nykiforuk , Sapna Oberoi , Monica Sirski , Ruben Alvaro , Mary Seshia M , Diane Moddemann , Lisa M. Lix , Chelsea Ruth , Allan Garland

Objective

To evaluate the association between preterm birth (<37 weeks) and high school graduation.

Methods

Population-based cohort of adolescents born in Manitoba, Canada between 1986 and 2002 whose graduation data were available in the administrative database. High school graduation (primary outcome) was defined as completion of 30 course credits in grades 9–12 without needing a modified (M) course or an individualized education plan (IEP) and finishing high school within 4 years of entering grade 9. Logistic regression model tested the association between preterm birth and primary outcome.

Results

Of 260,561 eligible adolescents, 9846 preterm (5.7 %; <28 wks = 238, 28–33 wks = 1997, 34–36 wks = 7611) and 162,660 term (≥37 weeks) adolescents were included. The median age at entering grade 9 was 14 years [13,14] among both preterm and term adolescents. The % of high school graduation was lowest among extremely preterm children (<28 wks-65 %, 28–33 wks-75 %, 34–36 wks-77 % and term-78 %). Only adolescents born <28 weeks and 28–33 wks, not 34–36 wks, had lower odds of high school graduation compared to term adolescents (<28 wks aOR: 0.49; 95 % CI: 0.37–0.66; 28–33 wks aOR: 0.78; 95 % CI: 0.69–0.88; 34–36 wks aOR: 0.96; 95 % CI: 0.90–1.02). Those needing a M course or IEP were 21 %, 7 %, 5 % and 4 % while the need for school assistance was 20 %, 5 %, 3 % and 2 % among <28 wks, 28–33 wks, 34–36 weeks and term respectively.

Conclusions

Adolescents born extremely and very-moderate preterm had lower high school graduation rates compared to those born term in this population-based cohort.

目的：评价早产的相关性(方法：以人口为基础的队列研究1986年至2002年出生在加拿大马尼托巴省的青少年，其毕业数据可在行政数据库中获得。高中毕业（主要结果）被定义为在不需要修改(M)课程或个性化教育计划（IEP）的情况下完成9-12年级30个课程学分，并在进入9年级的4年内完成高中学业。Logistic回归模型检验早产与主要结局的相关性。结果：260,561名符合条件的青少年中，9846名早产（5.7%）；结论：在这个以人群为基础的队列中，极度早产和极中度早产的青少年的高中毕业率低于足月出生的青少年。

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引用次数: 0

Nutritional status of Egyptian children with cow's milk allergy: A case-control study 埃及牛奶过敏儿童的营养状况：一项病例对照研究

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-05 DOI: 10.1016/j.earlhumdev.2025.106400

Mohammed Gamal , Ahmed Adel Fathy Mohamed , Khaled Amin Nasef Ahmed , Zakaria Elkhayat

Objective

To evaluate Egyptian children's anthropometric measures, hematological parameters, and nutritional indicators with cow's milk allergy (CMA) compared to healthy controls and assessed if these variables had gender-specific relationships.

Study design

We included children with clinically evidenced CMA non-IgE-mediated histories of CM sensitivity and its protein fractions and positive CM results in the challenge test as the case group, while healthy children without any food allergies were controls. Patients' demographics, clinical characteristics, anthropometric measures, hematological parameters, and dietary intake were collected and assessed.

Results

This study involved 102 children with CMA and 100 controls, aged 4.62 to 8.5 years. While 72.5 % of CMA children had normal heights, 61.8 % had impaired weight, and 49 % had a low BMI. CMA children showed significant reductions in iron levels associated with decreases in hematological parameters. CMA children had significantly deficient calcium, magnesium, and vitamin D levels compared to controls, but there were non-significant differences regarding phosphate and zinc levels. The CMA group revealed significant anthropometric indicators differences between males and females and significant differences between genders in the deficient levels of Hb, mean corpuscular volume, calcium, zinc, and vitamin D, while no significant differences between the deficient levels of iron and mean corpuscular hemoglobin. The logistic regression demonstrated that none of the studied factors had predictive potential for distinguishing between CMA patients and control participants.

Conclusion

Children with CMA exhibited impaired growth and significantly reduced hematological parameters and nutrients, emphasizing the importance of individualized nutritional monitoring to ensure adequate nutrient intake and proper growth.

目的：评价埃及牛奶过敏（CMA）儿童的人体测量指标、血液学参数和营养指标，并评估这些变量是否具有性别特异性关系。研究设计：我们将临床证实CMA非ige介导的CM敏感史及其蛋白组分和CM攻毒试验阳性的儿童作为病例组，而没有任何食物过敏的健康儿童作为对照组。收集和评估患者的人口统计学、临床特征、人体测量、血液学参数和饮食摄入量。结果：本研究纳入102例CMA患儿和100例对照组，年龄4.62 ~ 8.5岁。而72.5%的CMA儿童身高正常，61.8%的体重受损，49%的BMI低。CMA儿童表现出与血液参数降低相关的铁水平显著降低。与对照组相比，CMA儿童的钙、镁和维生素D水平明显不足，但磷酸盐和锌水平没有显著差异。CMA组的人体测量指标男女差异显著，Hb、平均红细胞体积、钙、锌、维生素D缺乏水平男女差异显著，铁缺乏水平和平均红细胞血红蛋白缺乏水平男女差异不显著。逻辑回归表明，没有研究的因素具有预测潜力，以区分CMA患者和对照组的参与者。结论：CMA患儿表现为生长障碍，血液学指标和营养物质明显降低，强调个体化营养监测的重要性，以确保充足的营养摄入和正常生长。

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引用次数: 0

Mental health and peer relationship problems in preterm born adolescents: Which factors predict absence of symptoms? 早产青少年的心理健康和同伴关系问题：哪些因素可以预测症状的消失？

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-10-03 DOI: 10.1016/j.earlhumdev.2025.106407

Ayten Bilgin

Background

Preterm birth is associated with difficulties in mental health and peer relationships in adolescence; however, most preterm adolescents do not experience these difficulties.

Objective

To apply machine learning models to identify key early predictors of better mental health and peer relationships in preterm adolescents.

Methods

The participants of the current study included 1472 preterm and 16,389 full-term individuals from the UK Millennium Cohort Study (2000−02). Early factors included a range of measurements across the following broad categories in infancy and early childhood: sociodemographic, family structure and environment, child-related birth and infancy factors, and early childhood factors. Mental health and peer relationships were assessed at 11, 14, and 17 years using the Strengths and Difficulties Questionnaire.

Results

The prediction model in preterm born adolescents had the highest accuracy for 17 years of age and in hyperactivity/inattention disorders (75 %, 82.7 %, 92 %, at 11, 14 and 17 years respectively) and conduct/oppositional disorders (80 %, 78 %, 87.1 %, respectively). A similar pattern was found in full-term born adolescents. Family structure and environment related factors in early childhood contributed to better mental health and peer relationships problems in both preterm and full-term adolescents. In preterm born adolescents, motor skills in infancy and better cognitive development and emotional regulation in early childhood predicted better mental health and peer relationships.

Conclusions

This study suggests that machine learning can help paediatricians differentiate preterm children who will not develop mental health symptoms and peer relationship problems from those at risk for developing these problems in adolescence.

背景：早产与青春期心理健康和同伴关系困难有关；然而，大多数早产青少年不会遇到这些困难。目的：应用机器学习模型识别早产青少年更好的心理健康和同伴关系的关键早期预测因素。方法：本研究的参与者包括来自英国千禧年队列研究（2000-02）的1472名早产儿和16389名足月个体。早期因素包括一系列在婴儿期和幼儿期的测量：社会人口统计学，家庭结构和环境，与儿童有关的出生和婴儿期因素，以及幼儿期因素。在11岁、14岁和17岁时使用优势和困难问卷评估心理健康和同伴关系。结果：该预测模型在17岁、多动/注意力不集中障碍（分别为75%、82.7%、92%，分别为11岁、14岁和17岁）和品行/对立障碍（分别为80%、78%、87.1%）中准确率最高。在足月出生的青少年中也发现了类似的模式。幼儿期家庭结构和环境相关因素有助于早产儿和足月青少年更好的心理健康和同伴关系问题。在早产的青少年中，婴儿期的运动技能和幼儿期更好的认知发展和情绪调节预示着更好的心理健康和同伴关系。结论：这项研究表明，机器学习可以帮助儿科医生区分那些不会出现心理健康症状和同伴关系问题的早产儿，以及那些在青春期有可能出现这些问题的早产儿。

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引用次数: 0

Heart rate variability is associated with self-regulation and stress neurobehavior in preterm infants 早产儿心率变异性与自我调节和应激神经行为有关。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-29 DOI: 10.1016/j.earlhumdev.2025.106406

E.L. Donnellan , R.B. Govindan , J. Ngwa , N. Andescavage , C. Limperopoulos , A.J. du Plessis

Background

The NICU (neonatal intensive care unit) Network Neurobehavioral Scale (NNNS) quantitatively assesses several distinct neurobehavioral domains. Neurobehavioral states interface with the autonomic nervous system. We sought to determine if autonomic tone, measured by heart rate variability (HRV), is associated with performance on NNNS neurobehavioral subscales.

Methods

Using continuous electrocardiogram recordings, we derived the following HRV measures: short (α1), and long-term (α2) fractal scaling exponents and short (RMS1) and long-term (RMS2) root mean square fluctuations. The NNNS was completed around term equivalent age (TEA). Linear mixed effects models tested associations between six NNNS subscales and HRV metrics. Secondary analyses explored the role of postmenstrual age (PMA) on associations between NNNS and HRV. These associations were further tested in the earliest and latest postnatal NICU weeks for each infant.

Results

We enrolled 39 premature infants (birth gestational age 23–36 weeks). Several HRV metrics were associated with Self-Regulation and Stress. After controlling for common NICU exposures (i.e. ventilation, steroids, caffeine and antibiotics), self-regulation was positively associated with alpha1 and RMS1 (standardized β = 0.262–0.284). Stress was associated negatively with alpha1 and RMS1 (standardized β = −0.283 to −0.286) and positively with alpha2 (standardized β = 0.245). Associations between Self-Regulation and Stress on RMS1 differed by PMA and NICU week, respectively. α1 and α2 at TEA predicted Stress (AUC = 0.730–0.775).

Conclusion

Of the six subscales examined, only Stress and Self-Regulation scores were associated with autonomic metrics in preterm infants. For short-term autonomic fluctuations, PMA and NICU week influenced this relationship. Furthermore, the fractal scaling exponents predict abnormal Stress scores.

背景：NICU（新生儿重症监护病房）网络神经行为量表（NNNS）定量评估几个不同的神经行为领域。神经行为状态与自主神经系统相连接。我们试图确定通过心率变异性（HRV）测量的自主神经张力是否与NNNS神经行为亚量表的表现有关。方法：利用连续心电图记录，推导出HRV指标：短期（α1）和长期（α2）分形标度指数以及短期（RMS1）和长期（RMS2）均方根波动。NNNS在学期等效年龄（TEA）左右完成。线性混合效应模型测试了6个神经网络神经网络分量表与HRV指标之间的关联。二次分析探讨了经后年龄（PMA）在NNNS和HRV之间的关联中的作用。这些关联在每个婴儿出生后最早和最晚的NICU周进一步测试。结果：我们招募了39例早产儿（出生胎龄23-36周）。几个HRV指标与自我调节和压力有关。在控制常见NICU暴露（即通气、类固醇、咖啡因和抗生素）后，自我调节与alpha1和RMS1呈正相关（标准化β = 0.262-0.284）。应激与α 1和RMS1呈负相关（标准化β = -0.283 ~ -0.286），与α 2呈正相关（标准化β = 0.245）。自我调节与应激在RMS1上的相关性分别因PMA和NICU周而异。TEA α1和α2预测应力（AUC = 0.730 ~ 0.775）。结论：在检查的六个亚量表中，只有压力和自我调节得分与早产儿的自主神经指标相关。对于短期自主波动，PMA和NICU周影响这一关系。此外，分形标度指数预测异常应力得分。

{"title":"Heart rate variability is associated with self-regulation and stress neurobehavior in preterm infants","authors":"E.L. Donnellan , R.B. Govindan , J. Ngwa , N. Andescavage , C. Limperopoulos , A.J. du Plessis","doi":"10.1016/j.earlhumdev.2025.106406","DOIUrl":"10.1016/j.earlhumdev.2025.106406","url":null,"abstract":"<div><h3>Background</h3><div>The NICU (neonatal intensive care unit) Network Neurobehavioral Scale (NNNS) quantitatively assesses several distinct neurobehavioral domains. Neurobehavioral states interface with the autonomic nervous system. We sought to determine if autonomic tone, measured by heart rate variability (HRV), is associated with performance on NNNS neurobehavioral subscales.</div></div><div><h3>Methods</h3><div>Using continuous electrocardiogram recordings, we derived the following HRV measures: short (α1), and long-term (α2) fractal scaling exponents and short (RMS1) and long-term (RMS2) root mean square fluctuations. The NNNS was completed around term equivalent age (TEA). Linear mixed effects models tested associations between six NNNS subscales and HRV metrics. Secondary analyses explored the role of postmenstrual age (PMA) on associations between NNNS and HRV. These associations were further tested in the earliest and latest postnatal NICU weeks for each infant.</div></div><div><h3>Results</h3><div>We enrolled 39 premature infants (birth gestational age 23–36 weeks). Several HRV metrics were associated with Self-Regulation and Stress. After controlling for common NICU exposures (i.e. ventilation, steroids, caffeine and antibiotics), self-regulation was positively associated with alpha1 and RMS1 (<em>standardized β</em> = 0.262–0.284). Stress was associated negatively with alpha1 and RMS1 (<em>standardized β</em> = −0.283 to −0.286) and positively with alpha2 (<em>standardized β</em> = 0.245). Associations between Self-Regulation and Stress on RMS1 differed by PMA and NICU week, respectively. α1 and α2 at TEA predicted Stress (<em>AUC</em> = 0.730–0.775).</div></div><div><h3>Conclusion</h3><div>Of the six subscales examined, only Stress and Self-Regulation scores were associated with autonomic metrics in preterm infants. For short-term autonomic fluctuations, PMA and NICU week influenced this relationship. Furthermore, the fractal scaling exponents predict abnormal Stress scores.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106406"},"PeriodicalIF":2.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212058","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}

引用次数: 0

Development of children at age 7–8 years after intrauterine exposure to selective serotonin reuptake inhibitors (SSRIs) — Results from the Dutch prospective cohort SMOK study 7-8岁儿童在宫内暴露于选择性血清素再摄取抑制剂（SSRIs）后的发育——来自荷兰前瞻性队列SMOK研究的结果

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-26 DOI: 10.1016/j.earlhumdev.2025.106405

Christine N. van der Veere, Anne E. den Heijer, Arend F. Bos

Introduction

Selective serotonin reuptake inhibitors (SSRIs) are used by 2–6 % of pregnant women. Safety regarding the neurodevelopment of the child remains unknown.

Aim

To determine the effect of prenatal exposure to SSRIs on children's outcome at age 7–8 years, adjusted for maternal depression and anxiety.

Methods

This study is part of the Dutch SMOK study. Women (n = 107) were included during pregnancy. At age 7–8 years development of 79 children was examined using tests and questionnaires regarding intellectual ability, executive functioning, attention, social responsiveness, behavior and motor development. Maternal depression and anxiety was determined during pregnancy and at the children's assessment. Differences between SSRI-exposed and non-exposed children were tested using multiple linear regression analyses.

Results

All children had lower IQ scores after prenatal exposure to SSRIs but significance was lost after adjustment for maternal psychopathology. No differences in outcome were found on attention and motor development. Boys, not girls, scored significantly lower on Theory of Mind tests when they had been exposed to SSRIs (total norm score 7.9 ± 0.8 vs. 9.6 ± 0.5, p = 0.04; verbal norm score 8.6 ± 0.9 vs. 10.7 ± 0.6, p = 0.02). Scores on the Social Responsiveness Scale measuring social impairment were significantly higher in SSRI-exposed boys (50 ± 2 vs. 45 ± 2, p = 0.03). In girls, outcome on these domains was explained by maternal psychopathology, not by prenatal exposure to SSRIs.

Conclusions

Prenatal exposure to SSRIs is associated with increased risk of behavioral problems and social impairment associated with autism spectrum disorders only in boys.

选择性血清素再摄取抑制剂（SSRIs）被2- 6%的孕妇使用。关于儿童神经发育的安全性仍然未知。目的：确定产前暴露于SSRIs对7-8岁儿童结局的影响，调整母亲抑郁和焦虑。方法：本研究是荷兰吸烟研究的一部分。妇女（n = 107）包括在怀孕期间。对79名7-8岁儿童的智力、执行功能、注意力、社会反应、行为和运动发育进行了测试和问卷调查。母亲的抑郁和焦虑是在怀孕期间和孩子的评估中确定的。使用多元线性回归分析检测ssri暴露与非暴露儿童之间的差异。结果：所有儿童在产前暴露于ssri类药物后均有较低的智商得分，但在调整母亲精神病理后无显著意义。在注意力和运动发展方面，结果没有发现差异。当接触SSRIs时，男孩的心理理论测试得分明显低于女孩（总规范得分7.9±0.8比9.6±0.5,p = 0.04；言语规范得分8.6±0.9比10.7±0.6,p = 0.02）。ssri暴露男孩的社会反应量表（Social Responsiveness Scale）得分显著高于ssri暴露男孩（50±2比45±2，p = 0.03）。在女孩中，这些领域的结果可以用母亲的精神病理来解释，而不是产前暴露于SSRIs。结论：仅在男孩中，产前暴露于SSRIs与自闭症谱系障碍相关的行为问题和社交障碍的风险增加有关。

{"title":"Development of children at age 7–8 years after intrauterine exposure to selective serotonin reuptake inhibitors (SSRIs) — Results from the Dutch prospective cohort SMOK study","authors":"Christine N. van der Veere, Anne E. den Heijer, Arend F. Bos","doi":"10.1016/j.earlhumdev.2025.106405","DOIUrl":"10.1016/j.earlhumdev.2025.106405","url":null,"abstract":"<div><h3>Introduction</h3><div>Selective serotonin reuptake inhibitors (SSRIs) are used by 2–6 % of pregnant women. Safety regarding the neurodevelopment of the child remains unknown.</div></div><div><h3>Aim</h3><div>To determine the effect of prenatal exposure to SSRIs on children's outcome at age 7–8 years, adjusted for maternal depression and anxiety.</div></div><div><h3>Methods</h3><div>This study is part of the Dutch SMOK study. Women (<em>n</em> = 107) were included during pregnancy. At age 7–8 years development of 79 children was examined using tests and questionnaires regarding intellectual ability, executive functioning, attention, social responsiveness, behavior and motor development. Maternal depression and anxiety was determined during pregnancy and at the children's assessment. Differences between SSRI-exposed and non-exposed children were tested using multiple linear regression analyses.</div></div><div><h3>Results</h3><div>All children had lower IQ scores after prenatal exposure to SSRIs but significance was lost after adjustment for maternal psychopathology. No differences in outcome were found on attention and motor development. Boys, not girls, scored significantly lower on Theory of Mind tests when they had been exposed to SSRIs (total norm score 7.9 ± 0.8 vs. 9.6 ± 0.5, <em>p</em> = 0.04; verbal norm score 8.6 ± 0.9 vs. 10.7 ± 0.6, <em>p</em> = 0.02). Scores on the Social Responsiveness Scale measuring social impairment were significantly higher in SSRI-exposed boys (50 ± 2 vs. 45 ± 2, <em>p</em> = 0.03). In girls, outcome on these domains was explained by maternal psychopathology, not by prenatal exposure to SSRIs.</div></div><div><h3>Conclusions</h3><div>Prenatal exposure to SSRIs is associated with increased risk of behavioral problems and social impairment associated with autism spectrum disorders only in boys.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106405"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212022","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}

引用次数: 0

Neopterin as a marker of congenital cytomegalovirus infection 新蝶呤作为先天性巨细胞病毒感染的标志物。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-24 DOI: 10.1016/j.earlhumdev.2025.106399

Aleksandra Pietrzyk , Justyna Czech-Kowalska , Michał Zarzecki , Agata Leśniewska , Agata Pleskaczyńska , Ewa Kowalska-Ciszek , Katarzyna Patla , Joanna Klimiuk-Balas , Dariusz Gruszfeld

Background and aims

Neopterin is a marker of cellular immune activation during viral and parasitic infections, with levels typically declining during treatment. Elevated neopterin levels have been observed in the cerebrospinal fluid (CSF) in patients with neuroinfections. This prospective case-control study aimed to evaluate the diagnostic value of neopterin concentrations in body fluids in congenital cytomegalovirus infection (cCMV).

Methods

Neopterin concentrations were measured in serum, urine and CSF of neonates with confirmed cCMV and compared with a control group. Clinical and audiological examination, biochemical tests, neuroimaging, viral loud in blood and urine and CMV DNA in CSF were performed at baseline and during treatment.

Results

The study group included 58 infants with cCMV (45 (78 %) symptomatic). There were higher baseline neopterin concentrations in the study group than in the control group. Baseline serum neopterin concentrations were higher in infants with intrauterine growth restriction, microcephaly, hepatosplenomegaly, petechiae and with hearing loss. There were higher neopterin concentrations in CSF in infants with clinical symptoms, hearing loss, and those with neuroimaging abnormalities. Neopterin concentrations in body fluids demonstrated good discriminatory ability as a diagnostic marker for cCMV, with an area under the ROC curve (AUC) values of 0. 977 for CSF, 0.895 for serum and 0.87 for urine. Neopterin concentrations were decreasing during treatment.

Conclusions

Serum neopterin concentration may serve as an diagnostic marker reflecting disease severity and can be useful for monitoring the effectiveness of the antiviral treatment. Neopterin concentration in CSF indicates the role of the local immune response of CNS injury.

背景和目的：新蝶呤是病毒和寄生虫感染期间细胞免疫激活的标志物，其水平通常在治疗期间下降。神经感染患者脑脊液（CSF）中已观察到新蝶呤水平升高。本前瞻性病例对照研究旨在评价体液中新蝶呤浓度对先天性巨细胞病毒感染（cCMV）的诊断价值。方法：测定确诊cCMV新生儿血清、尿液和脑脊液中新蝶呤的浓度，并与对照组进行比较。在基线和治疗期间进行临床和听力学检查、生化检查、神经影像学检查、血、尿病毒声和脑脊液巨细胞病毒DNA检测。结果：研究组纳入58例cCMV患儿（45例（78%）有症状）。研究组的新蝶呤基线浓度高于对照组。在宫内生长受限、小头畸形、肝脾肿大、瘀点和听力损失的婴儿中，基线血清新蝶呤浓度较高。有临床症状、听力损失和神经影像学异常的婴儿脑脊液中有较高的新蝶呤浓度。体液中新蝶呤浓度作为cCMV的诊断指标具有良好的区分能力，ROC曲线下面积（AUC）值为0。脑脊液977，血清0.895，尿液0.87。新蝶呤浓度在治疗过程中呈下降趋势。结论：血清新蝶呤浓度可作为反映疾病严重程度的诊断指标，可用于监测抗病毒治疗的有效性。脑脊液中新蝶呤的浓度提示中枢神经系统损伤局部免疫反应的作用。

{"title":"Neopterin as a marker of congenital cytomegalovirus infection","authors":"Aleksandra Pietrzyk , Justyna Czech-Kowalska , Michał Zarzecki , Agata Leśniewska , Agata Pleskaczyńska , Ewa Kowalska-Ciszek , Katarzyna Patla , Joanna Klimiuk-Balas , Dariusz Gruszfeld","doi":"10.1016/j.earlhumdev.2025.106399","DOIUrl":"10.1016/j.earlhumdev.2025.106399","url":null,"abstract":"<div><h3>Background and aims</h3><div>Neopterin is a marker of cellular immune activation during viral and parasitic infections, with levels typically declining during treatment. Elevated neopterin levels have been observed in the cerebrospinal fluid (CSF) in patients with neuroinfections. This prospective case-control study aimed to evaluate the diagnostic value of neopterin concentrations in body fluids in congenital cytomegalovirus infection (cCMV).</div></div><div><h3>Methods</h3><div>Neopterin concentrations were measured in serum, urine and CSF of neonates with confirmed cCMV and compared with a control group. Clinical and audiological examination, biochemical tests, neuroimaging, viral loud in blood and urine and CMV DNA in CSF were performed at baseline and during treatment.</div></div><div><h3>Results</h3><div>The study group included 58 infants with cCMV (45 (78 %) symptomatic). There were higher baseline neopterin concentrations in the study group than in the control group. Baseline serum neopterin concentrations were higher in infants with intrauterine growth restriction, microcephaly, hepatosplenomegaly, petechiae and with hearing loss. There were higher neopterin concentrations in CSF in infants with clinical symptoms, hearing loss, and those with neuroimaging abnormalities. Neopterin concentrations in body fluids demonstrated good discriminatory ability as a diagnostic marker for cCMV, with an area under the ROC curve (AUC) values of 0. 977 for CSF, 0.895 for serum and 0.87 for urine. Neopterin concentrations were decreasing during treatment.</div></div><div><h3>Conclusions</h3><div>Serum neopterin concentration may serve as an diagnostic marker reflecting disease severity and can be useful for monitoring the effectiveness of the antiviral treatment. Neopterin concentration in CSF indicates the role of the local immune response of CNS injury.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106399"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198802","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}

引用次数: 0