Early human development最新文献_第7页

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

The impact of early intervention on early spontaneous movements of infants: a systematic review 早期干预对婴儿早期自发运动的影响：一项系统综述。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-24 DOI: 10.1016/j.earlhumdev.2025.106403

Dilara Bozgan-Baş , Bilge Nur Yardımcı-Lokmanoğlu , Akmer Mutlu

Background

Early intervention in infants can impact the process of neural differentiation during the period when the brain is highly plastic. However, it is unclear whether early intervention can similarly affect early spontaneous movements of infants.

Aim

To determine the effects of early intervention approaches on early spontaneous movements in infants.

Methods

Studies were eligible if they enrolled infants in any early intervention program and assessed early spontaneous movements using a general movements assessment pre- and post-intervention. Five databases were searched and the PRISMA guideline was followed. The Cochrane Risk of Bias Tool-2 and the Risk of Bias in Non-randomized Studies of Interventions were used to identify risk of bias. GRADE approach was used to assess the certainty of the evidence.

Results

Ten studies (involving 633 participants) were included. Most of the studies had a high or serious risk of bias, and the certainty of the evidence was low to very low. The studies varied in their intervention approaches, intensity, and inclusion criteria. The most common early intervention methods were motor interventions, such as physiotherapy, or parental involvement. In four out of five studies which showed an improvement, this improvement occurred during the fidgety period.

Conclusions

Early intervention in infants could influence the spontaneous movements, particularly during the fidgety period. The generalizability and comparability of the results are limited due to the heterogeneity of the methods, the low certainty of evidence and the high risk of bias. Future research should investigate the impact of high-level evidence approaches on early spontaneous movements.

背景：在婴儿大脑可塑性很强的时期，早期干预可以影响神经分化的过程。然而，尚不清楚早期干预是否能同样影响婴儿的早期自发运动。目的：探讨早期干预方法对婴儿早期自主运动的影响。方法：如果将婴儿纳入任何早期干预计划，并使用干预前和干预后的一般运动评估来评估早期自发运动，则研究符合条件。检索了5个数据库，并遵循了PRISMA指南。采用Cochrane偏倚风险工具-2和非随机干预研究的偏倚风险来确定偏倚风险。GRADE方法用于评估证据的确定性。结果：纳入10项研究（633名受试者）。大多数研究有很高或严重的偏倚风险，证据的确定性很低或很低。这些研究的干预方法、强度和纳入标准各不相同。最常见的早期干预方法是运动干预，如物理治疗，或父母参与。在显示改善的五分之四的研究中，这种改善发生在烦躁期。结论：早期干预可以影响婴儿的自发运动，特别是在烦躁期。由于方法的异质性、证据的低确定性和高偏倚风险，结果的通用性和可比性受到限制。未来的研究应该调查高水平证据方法对早期自发运动的影响。

{"title":"The impact of early intervention on early spontaneous movements of infants: a systematic review","authors":"Dilara Bozgan-Baş , Bilge Nur Yardımcı-Lokmanoğlu , Akmer Mutlu","doi":"10.1016/j.earlhumdev.2025.106403","DOIUrl":"10.1016/j.earlhumdev.2025.106403","url":null,"abstract":"<div><h3>Background</h3><div>Early intervention in infants can impact the process of neural differentiation during the period when the brain is highly plastic. However, it is unclear whether early intervention can similarly affect early spontaneous movements of infants.</div></div><div><h3>Aim</h3><div>To determine the effects of early intervention approaches on early spontaneous movements in infants.</div></div><div><h3>Methods</h3><div>Studies were eligible if they enrolled infants in any early intervention program and assessed early spontaneous movements using a general movements assessment pre- and post-intervention. Five databases were searched and the PRISMA guideline was followed. The Cochrane Risk of Bias Tool-2 and the Risk of Bias in Non-randomized Studies of Interventions were used to identify risk of bias. GRADE approach was used to assess the certainty of the evidence.</div></div><div><h3>Results</h3><div>Ten studies (involving 633 participants) were included. Most of the studies had a high or serious risk of bias, and the certainty of the evidence was low to very low. The studies varied in their intervention approaches, intensity, and inclusion criteria. The most common early intervention methods were motor interventions, such as physiotherapy, or parental involvement. In four out of five studies which showed an improvement, this improvement occurred during the fidgety period.</div></div><div><h3>Conclusions</h3><div>Early intervention in infants could influence the spontaneous movements, particularly during the fidgety period. The generalizability and comparability of the results are limited due to the heterogeneity of the methods, the low certainty of evidence and the high risk of bias. Future research should investigate the impact of high-level evidence approaches on early spontaneous movements.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106403"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205983","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

The evidence for neonatal arginine supplementation — A narrative review 新生儿补充精氨酸的证据-叙述性回顾。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-23 DOI: 10.1016/j.earlhumdev.2025.106402

F. Callaghan , C. Morgan

Arginine is proteomic conditionally essential amino acid in the neonatal period. As well as being necessary for protein synthesis and growth, it is a highly functional amino acid playing a key role in many metabolic pathways critical to neonatal health. These include the urea cycle and ammonia detoxification, spermidine synthesis, immune modulation and acting as the key substrate for nitric oxide synthesis. The arginine-nitric oxide (NO) pathway is an important mechanism by which hypoargininaemia may contribute to neonatal morbidity, particularly necrotising enterocolitis and potentially sepsis, pulmonary disease and post-operative recovery. The role of the inhibitory metabolite asymmetric dimethylarginine in the arginine-NO pathway has been recognised but the neonatal clinical implications have yet to be established.

Neonates dependent on parenteral nutrition are particularly vulnerable to hypoargininaemia. Both parenteral and enteral arginine supplementation has been shown in a small number of clinical trials to reduce the risk of necrotising enterocolitis. This evidence has been sufficient to result in recommendations for arginine supplementation in systematic reviews and international guidelines. The potential benefits from reducing the risk of other neonatal complications such as sepsis and prolonged postoperative recovery have not been studied. No arginine side effects have been reported but the studies are not large enough to provide complete assurance. The methods of parenteral and enteral arginine supplementation also require further research to establish optimal timing, dose and target plasma level. Nevertheless, arginine supplementation relatively easy to implement in clinical practice and remains a potentially cost effective method in reducing serious neonatal morbidities.

精氨酸是新生儿期蛋白质组学条件必需氨基酸。它不仅是蛋白质合成和生长所必需的，而且是一种功能强大的氨基酸，在许多对新生儿健康至关重要的代谢途径中起着关键作用。其中包括尿素循环和氨解毒、亚精胺合成、免疫调节和作为一氧化氮合成的关键底物。精氨酸-一氧化氮（NO）途径是低精氨酸血症可能导致新生儿发病率的重要机制，特别是坏死性小肠结肠炎和潜在的败血症、肺部疾病和术后恢复。抑制性代谢物不对称二甲基精氨酸在精氨酸-一氧化氮途径中的作用已被认识到，但新生儿临床意义尚未确定。依赖肠外营养的新生儿特别容易发生低精氨酸血症。在少数临床试验中，肠外和肠内补充精氨酸均显示可降低坏死性小肠结肠炎的风险。这一证据足以在系统评价和国际指南中推荐补充精氨酸。降低其他新生儿并发症（如败血症和术后恢复时间延长）的潜在益处尚未得到研究。没有精氨酸副作用的报道，但研究的规模还不足以提供完全的保证。肠外和肠内补充精氨酸的方法也需要进一步研究，以确定最佳的时间、剂量和目标血浆水平。然而，精氨酸补充在临床实践中相对容易实施，并且仍然是降低严重新生儿发病率的潜在成本有效的方法。

{"title":"The evidence for neonatal arginine supplementation — A narrative review","authors":"F. Callaghan , C. Morgan","doi":"10.1016/j.earlhumdev.2025.106402","DOIUrl":"10.1016/j.earlhumdev.2025.106402","url":null,"abstract":"<div><div>Arginine is proteomic conditionally essential amino acid in the neonatal period. As well as being necessary for protein synthesis and growth, it is a highly functional amino acid playing a key role in many metabolic pathways critical to neonatal health. These include the urea cycle and ammonia detoxification, spermidine synthesis, immune modulation and acting as the key substrate for nitric oxide synthesis. The arginine-nitric oxide (NO) pathway is an important mechanism by which hypoargininaemia may contribute to neonatal morbidity, particularly necrotising enterocolitis and potentially sepsis, pulmonary disease and post-operative recovery. The role of the inhibitory metabolite asymmetric dimethylarginine in the arginine-NO pathway has been recognised but the neonatal clinical implications have yet to be established.</div><div>Neonates dependent on parenteral nutrition are particularly vulnerable to hypoargininaemia. Both parenteral and enteral arginine supplementation has been shown in a small number of clinical trials to reduce the risk of necrotising enterocolitis. This evidence has been sufficient to result in recommendations for arginine supplementation in systematic reviews and international guidelines. The potential benefits from reducing the risk of other neonatal complications such as sepsis and prolonged postoperative recovery have not been studied. No arginine side effects have been reported but the studies are not large enough to provide complete assurance. The methods of parenteral and enteral arginine supplementation also require further research to establish optimal timing, dose and target plasma level. Nevertheless, arginine supplementation relatively easy to implement in clinical practice and remains a potentially cost effective method in reducing serious neonatal morbidities.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106402"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250431","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

Gut microbiota as a risk and protective factor in neonatal necrotizing enterocolitis: An integrative review 肠道菌群作为新生儿坏死性小肠结肠炎的风险和保护因素：一项综合综述

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-22 DOI: 10.1016/j.earlhumdev.2025.106401

Maria Júlia Onofre , Cesar Augusto Cirino Silva , Isadora Caixeta da Silveira Ferreira , Denise Von Dolinger de Brito Röder

Necrotizing enterocolitis (NEC) is characterized by inflammation of the gastrointestinal tract and intestinal necrosis, primarily affecting premature neonates. It is one of the leading causes of morbidity and mortality in this population. This article aims to analyze, based on recent scientific literature, the relationship between intestinal microbiota and the development of NEC in premature neonates, highlighting the main pathophysiological mechanisms and prevention strategies. We conducted an integrative literature review, with search in the Virtual Health Library (VHL) and Pubmed databases, applying the Patient, Intervention, Comparison and Outcomes (PICO) strategy. A total of 178 articles were initially identified, with the application of validated tools to assess the methodological quality of the studies. The final sample included 13 international articles. The main findings show intestinal dysbiosis, activation of immune pathways and metabolic alterations as key elements in the pathogenesis of NEC. On the other hand, the use of probiotics and enrichment of breast milk were associated with beneficial effects. In conclusion, NEC is a multifactorial disease associated with intestinal dysbiosis, with an increase in pathogenic bacteria and a reduction in beneficial bacteria such as Bifidobacterium spp. The activation of pro-inflammatory TLR4 receptors by bacterial LPS favors intestinal damage. Factors such as prematurity, use of antimicrobials, and changes in the composition of breast milk favor microbiota imbalance. Probiotics and breastfeeding are promising strategies for preventing this situation. Therefore, this article gathers pertinent information that can help in understanding the factors involved in NEC.

坏死性小肠结肠炎（NEC）以胃肠道炎症和肠道坏死为特征，主要影响早产儿。它是这一人群发病和死亡的主要原因之一。本文旨在结合近年来的科学文献，分析肠道菌群与早产儿NEC发病的关系，重点阐述其主要病理生理机制和预防策略。我们采用患者、干预、比较和结果（PICO）策略，在虚拟健康图书馆（VHL）和Pubmed数据库中进行了综合文献综述。最初共确定了178篇文章，并应用了经过验证的工具来评估研究的方法学质量。最后的样本包括13篇国际文章。主要研究结果表明，肠道生态失调、免疫途径激活和代谢改变是NEC发病的关键因素。另一方面，益生菌的使用和母乳的富集与有益效果有关。综上所述，NEC是一种与肠道生态失调相关的多因子疾病，致病菌增加，有益菌如双歧杆菌减少，细菌LPS激活促炎TLR4受体有利于肠道损伤。早产、抗菌剂的使用和母乳成分的变化等因素都有利于微生物群失衡。益生菌和母乳喂养是预防这种情况的有希望的策略。因此，本文收集了相关信息，可以帮助理解NEC所涉及的因素。

{"title":"Gut microbiota as a risk and protective factor in neonatal necrotizing enterocolitis: An integrative review","authors":"Maria Júlia Onofre , Cesar Augusto Cirino Silva , Isadora Caixeta da Silveira Ferreira , Denise Von Dolinger de Brito Röder","doi":"10.1016/j.earlhumdev.2025.106401","DOIUrl":"10.1016/j.earlhumdev.2025.106401","url":null,"abstract":"<div><div>Necrotizing enterocolitis (NEC) is characterized by inflammation of the gastrointestinal tract and intestinal necrosis, primarily affecting premature neonates. It is one of the leading causes of morbidity and mortality in this population. This article aims to analyze, based on recent scientific literature, the relationship between intestinal microbiota and the development of NEC in premature neonates, highlighting the main pathophysiological mechanisms and prevention strategies. We conducted an integrative literature review, with search in the Virtual Health Library (VHL) and Pubmed databases, applying the Patient, Intervention, Comparison and Outcomes (PICO) strategy. A total of 178 articles were initially identified, with the application of validated tools to assess the methodological quality of the studies. The final sample included 13 international articles. The main findings show intestinal dysbiosis, activation of immune pathways and metabolic alterations as key elements in the pathogenesis of NEC. On the other hand, the use of probiotics and enrichment of breast milk were associated with beneficial effects. In conclusion, NEC is a multifactorial disease associated with intestinal dysbiosis, with an increase in pathogenic bacteria and a reduction in beneficial bacteria such as <em>Bifidobacterium</em> spp. The activation of pro-inflammatory TLR4 receptors by bacterial LPS favors intestinal damage. Factors such as prematurity, use of antimicrobials, and changes in the composition of breast milk favor microbiota imbalance. Probiotics and breastfeeding are promising strategies for preventing this situation. Therefore, this article gathers pertinent information that can help in understanding the factors involved in NEC.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106401"},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119494","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

Mutual gaze and later social attention development in infants at typical and elevated familial likelihood for ASD and/or ADHD ASD和/或ADHD的典型和高家族可能性婴儿的相互凝视和后来的社会注意发展。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-19 DOI: 10.1016/j.earlhumdev.2025.106398

D. Ilyka , Y. Jiang , J. Begum-Ali , L. Mason , A. Gui , T. Gliga , S. Lloyd-Fox , E. Jones , T. Charman , M.H. Johnson , The BASIS/STAARS Study Team

Atypical social attention is a feature of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), yet this has not yet been studied during toy-free naturalistic parent-infant interactions in infants at elevated likelihood of developing ADHD (EL-ADHD). We coded mutual gaze from caregiver–infant free-play videos recorded at 4–7 months in infants with typical likelihood (TL; n = 37), elevated likelihood of ASD (EL-ASD; n = 55), ADHD (EL-ADHD; n = 13) or both (EL-ASD + ADHD; n = 13). Face-orienting responses were measured using an eye tracking face pop-out task at 8–12 months, and ASD research diagnosis was established at 36 months. Results showed that EL groups engaged in more mutual gaze than TL peers, revealing a broad alteration in dyadic attention across neurodevelopmental likelihood. However, mutual-gaze duration did not differentiate infants who were later given an ASD diagnosis at age 3 years (n = 14). Furthermore, only in the EL-ASD group greater early mutual gaze predicted reduced subsequent orienting to faces. This association was mainly driven by those diagnosed with ASD at age 3, potentially indicating an ASD-specific developmental pathway. These findings highlight the value of naturalistic paradigms for probing early social attention and the need for larger, jointly analysed EL-ASD and EL-ADHD cohorts to refine neurodevelopmental models of typical and atypical infant social attention.

非典型社会注意是自闭症谱系障碍（ASD）和注意缺陷/多动障碍（ADHD）的一个特征，但这一点尚未在无玩具的自然亲子互动中进行研究，这些互动可能会导致ADHD （EL-ADHD）的发生。我们对4-7个月大的婴儿在典型可能性（TL; n = 37）、ASD （EL-ASD; n = 55）、ADHD （EL-ADHD; n = 13）或两者兼有（EL-ASD + ADHD; n = 13）的婴儿中记录的看护者-婴儿自由游戏视频中的相互注视进行编码。在8-12个月时使用眼动追踪面部弹出任务测量面部定向反应，并在36个月时建立ASD研究诊断。结果显示，与TL组相比，EL组参与了更多的相互凝视，揭示了神经发育可能性中二元注意的广泛变化。然而，相互凝视的持续时间并不能区分3岁时被诊断为ASD的婴儿（n = 14）。此外，只有在EL-ASD组中，更大的早期相互凝视预示着随后对面部的定向减少。这种关联主要是由那些在3岁时被诊断为ASD的人驱动的，可能表明ASD特异性的发育途径。这些发现强调了探索早期社会注意的自然主义范式的价值，以及需要更大的联合分析EL-ASD和EL-ADHD队列来完善典型和非典型婴儿社会注意的神经发育模型。

{"title":"Mutual gaze and later social attention development in infants at typical and elevated familial likelihood for ASD and/or ADHD","authors":"D. Ilyka , Y. Jiang , J. Begum-Ali , L. Mason , A. Gui , T. Gliga , S. Lloyd-Fox , E. Jones , T. Charman , M.H. Johnson , The BASIS/STAARS Study Team","doi":"10.1016/j.earlhumdev.2025.106398","DOIUrl":"10.1016/j.earlhumdev.2025.106398","url":null,"abstract":"<div><div>Atypical social attention is a feature of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), yet this has not yet been studied during toy-free naturalistic parent-infant interactions in infants at elevated likelihood of developing ADHD (EL-ADHD). We coded mutual gaze from caregiver–infant free-play videos recorded at 4–7 months in infants with typical likelihood (TL; <em>n</em> = 37), elevated likelihood of ASD (EL-ASD; <em>n</em> = 55), ADHD (EL-ADHD; <em>n</em> = 13) or both (EL-ASD + ADHD; n = 13). Face-orienting responses were measured using an eye tracking face pop-out task at 8–12 months, and ASD research diagnosis was established at 36 months. Results showed that EL groups engaged in more mutual gaze than TL peers, revealing a broad alteration in dyadic attention across neurodevelopmental likelihood. However, mutual-gaze duration did not differentiate infants who were later given an ASD diagnosis at age 3 years (<em>n</em> = 14). Furthermore, only in the EL-ASD group greater early mutual gaze predicted reduced subsequent orienting to faces. This association was mainly driven by those diagnosed with ASD at age 3, potentially indicating an ASD-specific developmental pathway. These findings highlight the value of naturalistic paradigms for probing early social attention and the need for larger, jointly analysed EL-ASD and EL-ADHD cohorts to refine neurodevelopmental models of typical and atypical infant social attention.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106398"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257557","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

Associations between cardiorespiratory fitness, activity behavior, physical literacy and parental sports participation in children with a critical congenital heart disease 危重先天性心脏病患儿心肺健康、活动行为、身体素质和父母运动参与之间的关系

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-18 DOI: 10.1016/j.earlhumdev.2025.106397

J.J. Noordstar , M.C.A. Sprong , F.C. Lenderink , M.G. Slieker , E.H.J. Hulzebos , T. Takken

Objective

This study investigated associations between cardiorespiratory fitness (CRF), activity behavior (i.e. physical activity and sports participation), physical literacy (motivation, confidence, knowledge and understanding), and parental sports participation in children with critical congenital heart disease (CCHD), and explore differences in children with a single ventricle physiology (SVP) and children with biventricular physiology (BVP).

Methods

Ninety children with CCHD (median age 10.0 [7.0–13.0] years) participated in this prospective observational study. CRF was measured through cardiopulmonary exercise testing (VO₂peak). Activity behavior, physical literacy, and parental sports participation were assessed using validated questionnaires.

Results

CRF was moderately associated with physical activity (r = 0.36, p < .001) and weakly associated with motivation and confidence (r = 0.25, p = .019). No association was found between CRF and sports participation. Children's sports participation was positively associated with maternal (r = 0.23, p = .034) and paternal (r = 0.23, p = .042) sports participation, as well as with motivation and confidence (r = 0.28, p = .009). Children with a SVP (n = 11) had significantly lower CRF than those with BVP (n = 79) (p < .001). No other differences were found between children with a SVP and children with a BVP.

Conclusion

CRF is positively associated with physical activity, motivation and confidence in children with CCHD. Additionally, parental sports participation is associated with children's sports participation. These findings suggest integrating a physical literacy and family-centered approach in interventions aimed to enhance CRF in children with CCHD.

目的：探讨危重型先天性心脏病（CCHD）患儿心肺健康（CRF）、活动行为（即体力活动和运动参与）、身体素养（动机、信心、知识和理解）和父母运动参与的关系，并探讨单心室生理（SVP）患儿和双心室生理（BVP）患儿的差异。方法：90例CCHD患儿（中位年龄10.0[7.0-13.0]岁）参与本前瞻性观察研究。通过心肺运动试验（vo2峰值）测量CRF。活动行为、身体素养和父母的运动参与使用有效的问卷进行评估。结果：CRF与体力活动呈正相关（r = 0.36, p）。结论：CRF与CCHD患儿体力活动、动机和信心呈正相关。此外，父母的体育参与与孩子的体育参与有关。这些发现建议在干预措施中结合身体素养和以家庭为中心的方法，旨在提高CCHD儿童的CRF。

{"title":"Associations between cardiorespiratory fitness, activity behavior, physical literacy and parental sports participation in children with a critical congenital heart disease","authors":"J.J. Noordstar , M.C.A. Sprong , F.C. Lenderink , M.G. Slieker , E.H.J. Hulzebos , T. Takken","doi":"10.1016/j.earlhumdev.2025.106397","DOIUrl":"10.1016/j.earlhumdev.2025.106397","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated associations between cardiorespiratory fitness (CRF), activity behavior (i.e. physical activity and sports participation), physical literacy (motivation, confidence, knowledge and understanding), and parental sports participation in children with critical congenital heart disease (CCHD), and explore differences in children with a single ventricle physiology (SVP) and children with biventricular physiology (BVP).</div></div><div><h3>Methods</h3><div>Ninety children with CCHD (median age 10.0 [7.0–13.0] years) participated in this prospective observational study. CRF was measured through cardiopulmonary exercise testing (VO₂peak). Activity behavior, physical literacy, and parental sports participation were assessed using validated questionnaires.</div></div><div><h3>Results</h3><div>CRF was moderately associated with physical activity (<em>r</em> = 0.36, <em>p</em> < .001) and weakly associated with motivation and confidence (<em>r</em> = 0.25, <em>p</em> = .019). No association was found between CRF and sports participation. Children's sports participation was positively associated with maternal (<em>r</em> = 0.23, <em>p</em> = .034) and paternal (r = 0.23, <em>p</em> = .042) sports participation, as well as with motivation and confidence (<em>r</em> = 0.28, <em>p</em> = .009). Children with a SVP (<em>n</em> = 11) had significantly lower CRF than those with BVP (<em>n</em> = 79) (<em>p</em> < .001). No other differences were found between children with a SVP and children with a BVP.</div></div><div><h3>Conclusion</h3><div>CRF is positively associated with physical activity, motivation and confidence in children with CCHD. Additionally, parental sports participation is associated with children's sports participation. These findings suggest integrating a physical literacy and family-centered approach in interventions aimed to enhance CRF in children with CCHD.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106397"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148430","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

Identifying cognitive vulnerability in school-aged children born preterm: The role of neonatal and early-life factors 识别早产学龄儿童的认知脆弱性：新生儿和早期生活因素的作用

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-18 DOI: 10.1016/j.earlhumdev.2025.106396

Symeon Dimitrios Daskalou , Nikolaos Gerosideris , Georgia Tsakni , Pinelopi Vlotinou , Georgios Bablekos , Ioanna Giannoula Katsouri

Background

Children born preterm are at increased risk for cognitive difficulties. While gestational age is a known predictor, the combined influence of early-life variables such as breastfeeding, NICU stay, and birth weight on later cognitive outcomes remains less understood.

Objective

To compare cognitive performance between preterm and non preterm school-aged children and identify neonatal and postnatal predictors of verbal and non verbal intelligence.

Methods

A total of 140 children aged 6–12 years (70 preterm, 70 non preterm) were assessed using Raven's Coloured Progressive Matrices (CPM) and Crichton Vocabulary Scale (CVS). Mann–Whitney U tests and multiple linear regressions were used to examine group differences and predictors of cognitive scores. Predictors included gestational age, NICU stay, socioeconomic status (SES), breastfeeding, birth weight, age, and sex. VIF values were used to assess multicollinearity.

Results

Preterm children scored significantly lower than non preterm peers on both CPM (p < 0.001, r = − 0.27) and CVS (p < 0.001, r = − 0.43). Regression models showed that gestational age was a consistent predictor across both scales. Breastfeeding and higher SES were associated with higher CPM and CVS scores, while prolonged NICU stay negatively impacted CVS performance. No multicollinearity issues were detected (VIF < 2.6).

Conclusion

Preterm birth is linked to reduced cognitive performance during middle childhood, especially in verbal reasoning. Breastfeeding and shorter NICU stay may offer protective benefits. These findings highlight the importance of early-life factors and support targeted developmental surveillance and interventions for preterm populations.

早产儿童出现认知障碍的风险增加。虽然胎龄是一个已知的预测因素，但早期生活变量（如母乳喂养、新生儿重症监护室住院时间和出生体重）对后期认知结果的综合影响尚不清楚。目的比较早产儿和非早产儿学龄儿童的认知表现，探讨言语和非言语智力的新生儿和产后预测因素。方法采用Raven's彩色递进矩阵（CPM）和Crichton词汇量表（CVS）对140例6-12岁儿童（早产儿70例，非早产儿70例）进行评估。使用Mann-Whitney U检验和多元线性回归来检验组间差异和认知得分的预测因子。预测因素包括胎龄、新生儿重症监护室住院时间、社会经济地位（SES）、母乳喂养、出生体重、年龄和性别。VIF值用于评估多重共线性。结果早产儿的CPM （p < 0.001, r = - 0.27）和CVS （p < 0.001, r = - 0.43）得分均显著低于非早产儿。回归模型显示胎龄是两个尺度上一致的预测因子。母乳喂养和较高的SES与较高的CPM和CVS评分相关，而延长新生儿重症监护病房的时间会对CVS表现产生负面影响。未检测到多重共线性问题（VIF < 2.6）。结论早产与儿童中期认知能力下降有关，尤其是言语推理能力下降。母乳喂养和较短的新生儿重症监护病房可能提供保护作用。这些发现强调了早期生活因素的重要性，并支持对早产儿群体进行有针对性的发育监测和干预。

{"title":"Identifying cognitive vulnerability in school-aged children born preterm: The role of neonatal and early-life factors","authors":"Symeon Dimitrios Daskalou , Nikolaos Gerosideris , Georgia Tsakni , Pinelopi Vlotinou , Georgios Bablekos , Ioanna Giannoula Katsouri","doi":"10.1016/j.earlhumdev.2025.106396","DOIUrl":"10.1016/j.earlhumdev.2025.106396","url":null,"abstract":"<div><h3>Background</h3><div>Children born preterm are at increased risk for cognitive difficulties. While gestational age is a known predictor, the combined influence of early-life variables such as breastfeeding, NICU stay, and birth weight on later cognitive outcomes remains less understood.</div></div><div><h3>Objective</h3><div>To compare cognitive performance between preterm and non preterm school-aged children and identify neonatal and postnatal predictors of verbal and non verbal intelligence.</div></div><div><h3>Methods</h3><div>A total of 140 children aged 6–12 years (70 preterm, 70 non preterm) were assessed using Raven's Coloured Progressive Matrices (CPM) and Crichton Vocabulary Scale (CVS). Mann–Whitney <em>U</em> tests and multiple linear regressions were used to examine group differences and predictors of cognitive scores. Predictors included gestational age, NICU stay, socioeconomic status (SES), breastfeeding, birth weight, age, and sex. VIF values were used to assess multicollinearity.</div></div><div><h3>Results</h3><div>Preterm children scored significantly lower than non preterm peers on both CPM (<em>p</em> < 0.001, <em>r</em> = − 0.27) and CVS (p < 0.001, <em>r</em> = − 0.43). Regression models showed that gestational age was a consistent predictor across both scales. Breastfeeding and higher SES were associated with higher CPM and CVS scores, while prolonged NICU stay negatively impacted CVS performance. No multicollinearity issues were detected (VIF < 2.6).</div></div><div><h3>Conclusion</h3><div>Preterm birth is linked to reduced cognitive performance during middle childhood, especially in verbal reasoning. Breastfeeding and shorter NICU stay may offer protective benefits. These findings highlight the importance of early-life factors and support targeted developmental surveillance and interventions for preterm populations.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106396"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099985","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

The role of internalising trajectories in adult wealth and social relationships following very preterm birth/very low birth weight 内化轨迹在非常早产/非常低出生体重后的成人财富和社会关系中的作用。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-16 DOI: 10.1016/j.earlhumdev.2025.106395

Yanlin Zhou , Elif Gonen , Peter Bartmann , Dieter Wolke

Background

Individuals born very preterm (VPT; <32 weeks) and/or with very low birth weight (VLBW; <1500 g) are at higher risk for internalising problems and adulthood difficulties. However, internalising symptoms fluctuate over time, and it remains unclear how these patterns of change relate to adult outcomes after VPT/VLBW birth.

Objective

To examine whether internalising trajectories from childhood to early adulthood mediate or moderate the association between VPT/VLBW birth and adult wealth and social relationship difficulties.

Methods

Data were drawn from the Bavarian Longitudinal Study (252 VPT/VLBW, 228 term-born), followed from birth to 34 years. Internalising symptoms were parent-reported at four waves (ages 6, 8, 13 and 26 years) and modelled into trajectories. Path analysis tested direct and indirect effects of VPT/VLBW status on outcomes at 34 years via these trajectories. Moderation was tested using analysis of variance. Covariates included sex, socioeconomic status (SES) at birth, and neurosensory impairments (NSI).

Results

Three internalising trajectories emerged: consistently low (70.4 %), decreasing (15 %), and increasing (14.6 %). The increasing trajectory mediated the association between VPT/VLBW birth and both lower wealth and greater social relationship difficulties. After adjusting for sex, SES, and NSI, only the mediation effect on wealth remained significant. Indirect effects accounted for approximately 15–18 % of the total effects. Interactions between birth group (VPT/VLBW vs. term-born) and internalising trajectory on adult outcomes were non-significant.

Conclusions

Increasing internalising symptoms partially mediate the impact of VPT/VLBW birth on adult wealth and social relationships. Findings highlight the value of continuing mental health support, particularly for those born VPT/VLBW.

背景：非常早产（VPT）个体；目的：研究从童年到成年早期的内化轨迹是否介导或调节了非常早产/VLBW出生与成年财富和社会关系困难之间的关联。方法：数据来自巴伐利亚纵向研究（252名VPT/VLBW， 228名足月出生），从出生到34岁。父母在四个阶段（6岁、8岁、13岁和26岁）报告了内化症状，并建立了轨迹模型。通径分析通过这些轨迹测试了VPT/VLBW状态对34岁时预后的直接和间接影响。使用方差分析检验适度性。协变量包括性别、出生时的社会经济地位（SES）和神经感觉障碍（NSI）。结果：出现了三种内化轨迹：持续低（70.4%）、下降（15%）和增加（14.6%）。增加的轨迹在VPT/VLBW出生与低财富和更大的社会关系困难之间起中介作用。在对性别、社会经济地位和自伤进行调整后，只有财富的中介效应仍然显著。间接效应约占总效应的15- 18%。出生组（VPT/VLBW vs足月出生）和内化轨迹对成年结局的相互作用不显著。结论：内化症状的增加部分介导了VPT/VLBW出生对成人财富和社会关系的影响。研究结果强调了持续心理健康支持的价值，特别是对那些出生时患有VPT/VLBW的人。

{"title":"The role of internalising trajectories in adult wealth and social relationships following very preterm birth/very low birth weight","authors":"Yanlin Zhou , Elif Gonen , Peter Bartmann , Dieter Wolke","doi":"10.1016/j.earlhumdev.2025.106395","DOIUrl":"10.1016/j.earlhumdev.2025.106395","url":null,"abstract":"<div><h3>Background</h3><div>Individuals born very preterm (VPT; <32 weeks) and/or with very low birth weight (VLBW; <1500 g) are at higher risk for internalising problems and adulthood difficulties. However, internalising symptoms fluctuate over time, and it remains unclear how these patterns of change relate to adult outcomes after VPT/VLBW birth.</div></div><div><h3>Objective</h3><div>To examine whether internalising trajectories from childhood to early adulthood mediate or moderate the association between VPT/VLBW birth and adult wealth and social relationship difficulties.</div></div><div><h3>Methods</h3><div>Data were drawn from the Bavarian Longitudinal Study (252 VPT/VLBW, 228 term-born), followed from birth to 34 years. Internalising symptoms were parent-reported at four waves (ages 6, 8, 13 and 26 years) and modelled into trajectories. Path analysis tested direct and indirect effects of VPT/VLBW status on outcomes at 34 years via these trajectories. Moderation was tested using analysis of variance. Covariates included sex, socioeconomic status (SES) at birth, and neurosensory impairments (NSI).</div></div><div><h3>Results</h3><div>Three internalising trajectories emerged: consistently low (70.4 %), decreasing (15 %), and increasing (14.6 %). The increasing trajectory mediated the association between VPT/VLBW birth and both lower wealth and greater social relationship difficulties. After adjusting for sex, SES, and NSI, only the mediation effect on wealth remained significant. Indirect effects accounted for approximately 15–18 % of the total effects. Interactions between birth group (VPT/VLBW vs. term-born) and internalising trajectory on adult outcomes were non-significant.</div></div><div><h3>Conclusions</h3><div>Increasing internalising symptoms partially mediate the impact of VPT/VLBW birth on adult wealth and social relationships. Findings highlight the value of continuing mental health support, particularly for those born VPT/VLBW.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106395"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091324","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

Parental satisfaction on moving from open bay to single-family rooms neonatal intensive care unit 新生儿重症监护病房从开放式病房搬到单人家庭病房的家长满意度。

IF 2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2025-09-13 DOI: 10.1016/j.earlhumdev.2025.106394

Wielenga Joke , Pascual April , Ruhe Kiki , de Ligt Chantal , van Kaam Anton

The purpose of the study was to assess the impact of moving from open bay units (OBU) to single-family rooms (SFR) on parental satisfaction in the Neonatal Intensive Care Unit (NICU) An observational longitudinal cohort study was conducted between February 2021 until January 2024, during which time the setting changed from OBU to SFR with a mixed transitional phase in between. All parents of infants admitted were eligible for inclusion. The Empathic-N was used to measure parental satisfaction. The Empathic-N was filled out by 110 mothers and 76 partners of 148 infants. The overall satisfaction when moving from an OBU and SFRs showed no statistical significant increase for both parents. Partners showed a statistically significant increase in the domains Communication and information (p = .012) and Organization (p = .012) after moving to SFRs. For mothers, only several statements within these domains showed a significant increase after transitioning to SFRs. In conclusion, parental satisfaction increased in specific domains after the transition from an OBU to SFR environment in a level III NICU. However, this improvement was modest and differed between mothers and partners. In case of pre-existing high parental satisfaction rates moving from OBU to SFR is not an important contributor to parental satisfaction.

本研究的目的是评估从开放式病房（OBU）转移到单户病房（SFR）对新生儿重症监护病房（NICU）父母满意度的影响。在2021年2月至2024年1月期间进行了一项观察性纵向队列研究，在此期间，设置从OBU转变为SFR，并在两者之间进行混合过渡阶段。所有入院婴儿的父母均符合入选条件。共情因子n用于衡量父母满意度。共情问卷由148名婴儿的110名母亲和76名伴侣填写。从OBU和SFRs转移后，父母双方的总体满意度没有统计学上的显著提高。合作伙伴在转移到SFRs后，在沟通和信息（p = 0.012）和组织（p = 0.012）领域显示统计学上显著增加。对于母亲来说，这些领域中只有几个陈述在过渡到srr后显着增加。综上所述，三级新生儿重症监护室从OBU环境过渡到SFR环境后，父母在特定领域的满意度有所提高。然而，这种改善是温和的，并且在母亲和伴侣之间存在差异。在已经存在的高父母满意度的情况下，从OBU转移到SFR并不是父母满意度的重要因素。

{"title":"Parental satisfaction on moving from open bay to single-family rooms neonatal intensive care unit","authors":"Wielenga Joke , Pascual April , Ruhe Kiki , de Ligt Chantal , van Kaam Anton","doi":"10.1016/j.earlhumdev.2025.106394","DOIUrl":"10.1016/j.earlhumdev.2025.106394","url":null,"abstract":"<div><div>The purpose of the study was to assess the impact of moving from open bay units (OBU) to single-family rooms (SFR) on parental satisfaction in the Neonatal Intensive Care Unit (NICU) An observational longitudinal cohort study was conducted between February 2021 until January 2024, during which time the setting changed from OBU to SFR with a mixed transitional phase in between. All parents of infants admitted were eligible for inclusion. The Empathic-N was used to measure parental satisfaction. The Empathic-N was filled out by 110 mothers and 76 partners of 148 infants. The overall satisfaction when moving from an OBU and SFRs showed no statistical significant increase for both parents. Partners showed a statistically significant increase in the domains Communication and information (<em>p</em> = .012) and Organization (p = .012) after moving to SFRs. For mothers, only several statements within these domains showed a significant increase after transitioning to SFRs. In conclusion, parental satisfaction increased in specific domains after the transition from an OBU to SFR environment in a level III NICU. However, this improvement was modest and differed between mothers and partners. In case of pre-existing high parental satisfaction rates moving from OBU to SFR is not an important contributor to parental satisfaction.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"211 ","pages":"Article 106394"},"PeriodicalIF":2.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085037","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