Early human development最新文献

Background

The Motor Optimality Score-Revised (MOS-R) is a clinical test of infant spontaneous movement at 3–5 months of age and has been associated with neurodevelopmental outcomes in infants with medical complexity. However the stability of the MOS-R tested at different developmental ages is not yet known.

Aim

To determine if the repeated scoring of the MOS-R remained consistent when tested at two developmental ages in young infants.

Study design

In this prospective cohort study, infants were tested twice with the MOS-R between 12 and 13 weeks corrected age (CA) and 14–16 weeks CA. Bland Altman Plots were used to calculate agreement between the scores. Infants were grouped as having higher or lower medical complexity. MOS-R threshold scores were analyzed to assess changes over time within each group using Fisher's exact test.

Subjects

85 infants with history of hospitalization in a neonatal intensive care unit (NICU).

Results

The MOS-R scores had a high agreement with negligible bias (0.058) between timepoints (95 % CI -1.10, 1.22). Using a MOS-R cut point of 19, infants with higher medical complexity were more likely to change groups between timepoints than infants with lower medical complexity (p = 0.008), but this was not significantly different using cut points of 20 or 21.

Conclusion

The MOS-R scores were stable when measured repeatedly in infants who were hospitalized in a NICU. Infants with high medical complexity had less stable MOS-R scores using certain cut points than infants with lower medical complexity.

Aim

To implement a culturally-adapted screening program aimed to determine the ability of infant motor repertoire to predict early neurodevelopment on the Hammersmith Infant Neurological Examination (HINE) and improve Australian First Nations families' engagement with neonatal screening.

Methods

A prospective cohort of 156 infants (55 % male, mean (standard deviation [SD]) gestational age 33.8 (4.6) weeks) with early life risk factors for adverse neurodevelopmental outcomes (ad-NDO) participated in a culturally-adapted screening program. Infant motor repertoire was assessed using Motor Optimality Score-revised (MOS-R), captured over two videos, 11–13⁺⁶ weeks (V1; <14 weeks) and 14–18 weeks (V2; ≥14 weeks) corrected age (CA). At 4–9 months CA neurodevelopment was assessed on the HINE and classified according to age-specific cut-off and optimality scores as; developmentally ‘on track’ or high chance of either adverse neurodevelopmental outcome (ad-NDO) or cerebral palsy (CP).

Results

Families were highly engaged, 139/148 (94 %) eligible infants completing MOS-R, 136/150 (91 %), HINE and 123 (83 %) both. Lower MOS-R at V2 was associated with reduced HINE scores (β = 1.73, 95 % confidence interval [CI] = 1.03–2.42) and high chance of CP (OR = 2.63, 95%CI = 1.21–5.69) or ad-NDO (OR = 1.38, 95%CI = 1.10–1.74). The MOS-R sub-category ‘observed movement patterns’ best predicted HINE, infants who score ‘4’ had mean HINE 19.4 points higher than score ‘1’ (95%CI = 12.0–26.9). Receiver-operator curve analyses determined a MOS-R cut-off of <23 was best for identifying mild to severely reduced HINE scores, with diagnostic accuracy 0.69 (sensitivity 0.86, 95%CI 0.76–0.94 and specificity 0.40, 95 % CI 0.25–0.57). A trajectory of improvement on MOS-R (≥2 point increase in MOS-R from 1st to 2nd video) significantly increased odds of scoring optimally on HINE (OR = 5.91, 95%CI 1.16–29.89) and may be a key biomarker of ‘on track’ development.

Interpretation

Implementation of a culturally-adapted program using evidence-based assessments demonstrates high retention. Infant motor repertoire is associated with HINE scores and the early neurodevelopmental status of developmentally vulnerable First Nations infants.

Background

In recent years, China has adjusted its fertility policies to optimize the population structure by implementing the two-child and three-child policies. Some patients with systemic lupus erythematosus (SLE) are considering the possibility of having a second child. The issue is whether the offspring from the second childbirth will have favorable long-term developmental outcomes.

Objective

The research aims to investigate the long-term physical, neurological, and social-emotional development outcomes of children born to mothers with SLE at different parities. This study aims to offer valuable insights and references for SLE patients who are considering subsequent pregnancies and require information about potential developmental outcomes for their future children.

Methods

The study conducted a follow-up of children born to SLE mothers who were admitted to the obstetrics department between January 1, 2016, and September 30, 2021. The SLE patients were categorized into two groups based on their history of live delivery: the primiparity group and the multiparity group. The physical development status, including weight, height (length), and other relevant factors, was evaluated in both groups. The Ages and Stages Questionnaires, Third Edition (ASQ-3) was utilized to assess the neurological development in five domains, encompassing communication, gross motor, fine motor, problem solving and personal-social. Social-emotional development was assessed using the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). The weight, height (length), body mass index, and ASQ-3 domain scores were standardized into Z-scores to enable comparison across various ages and genders.

Results

The study revealed that the weight Z-score and BMI Z-score of the children in the multiparity group were significantly higher compared to those in the primiparity group. However, there were no statistically significant differences in the proportions of overweight and obesity between the two groups. In terms of neurological developmental outcomes, the Z-scores of the communication and gross motor domains in the ASQ-3 assessment were significantly higher in the multiparity group compared to those in the primiparity group. The proportion of abnormal screening for social and emotional development in the children of the multiparity group was lower than that of the primiparity group, although this difference did not reach statistical significance.

Conclusions

The long-term weight development, communication and gross motor development of children born to SLE patients in the multiparity group were better than those in the primiparity group. However, there was no significant difference in social-emotional development between the two groups.

Background

Behcet's disease usually progresses with remission during pregnancy, but early subtle changes might be detected in the heart of these fetuses due to inflammation.

Aims

We aimed to evaluate the cardiac functions in fetuses of pregnant women with Behcet's disease (BD).

Study design

Prospective case-control study.

Subjects

This prospective study enrolled pregnant women diagnosed with Behcet's disease before pregnancy. Twenty-four pregnancies with Behcet's disease and 48 healthy pregnancies were included at 32–34 gestational weeks.

Outcome measures

Pulsed-wave Doppler and tissue Doppler imaging (TDI) were used to assess cardiac functions.

Results

Right ventricle (RV) E (early) wave and left ventricle (LV) E were significantly increased in pregnancies with BD (p = .008, p = .041, respectively). Decreased right ventricle E' (peak systolic velocity) was detected with TDI in the case group (6.2 ± 0.5, p < .001). E/E' ratios for RV and LV were significantly increased in the case group (p < .001, p = .001, respectively). The correlation between the duration of the disease and fetal cardiac functions was also evaluated. For RV, E (r = 0.735, p < .001), E' (r = −0.735, p < .001), E/E' (r = 0.894, p < .001), were strongly correlated with the disease duration. The study also showed the correlation between disease duration and LV E' (r = −0.735, p = .005), LV E (r = 0.750, p < .001), and LV E/E' (r = 0.820, p < .001).

Conclusion

This is the first study to evaluate the fetal cardiac functions in fetuses of pregnancies with BD. Although BD usually progresses with remission during pregnancy, early subclinical diastolic changes might occur in the heart of these fetuses due to inflammation.

Background

There is evidence that women with congenital anomalies are at risk of having an infant with the same defect. However, the risk of having an infant with a different type of defect is less well described.

Aims

We evaluated the extent to which offspring of women with congenital anomalies were at risk of having a birth defect, including defects that were similar to or different from their mother's.

Methods

We analyzed a retrospective cohort of 1,311,532 infants born in Canada between 2006 and 2022. The exposure was a maternal congenital anomaly, and the outcome included birth defects in the newborn. We estimated risk ratios (RR) and confidence intervals (CI) for the association of specific maternal anomalies with the risk of having an infant with a similar or different defect using log-binomial regression models adjusted for patient characteristics.

Results

While mothers with anomalies were at risk of having an infant with the same defect, associations with other types of defects were not as strong. For example, compared with no maternal anomaly, maternal urogenital defects were associated with up to 45 times the risk of having an infant with a similar urogenital defect (RR 45.33, 95 % CI 31.92–64.36), but <2 times the risk of having an infant with orofacial clefts (RR 1.89, 95 % CI 1.07–3.34) and clubfoot (RR 1.36, 95 % CI 1.02–1.81).

Conclusion

The findings suggest that maternal congenital anomalies are only weakly associated with occurrence of a different type of defect in offspring.

Background

About 50 % of LBW occurs in term newborns, which is associated with higher infant mortality rates compared to infants of average birth weight. Analysis of feeding practices in at-risk groups is essential to address malnutrition and stunting in infancy.

Aim

To identify feeding practices and anthropometric classification of nutritional status in a cohort of low-birth-weight term infants.

Methods

Methods: Cohort study. A prospective follow-up of 73 term newborns with low birth weight up to six months of age was performed. Feeding practices and anthropometric classification of nutritional were analysed. Data were processed by univariate analysis and multivariate linear regression.

Results

The most common feeding practice was exclusive breastfeeding. Breast milk substitutes are frequent in this population group. The risk of undernutrition ranged from 2.7 % to 19.2 % and of overweight from 4.1 % to 11.0 % during the first six months of life. Low height-for-age risk was the most frequent anthropometric classification during the follow-up period. Average head circumference was consistent in infants with low birth weight. Gestational risk classification, breastfeeding during the first hour of life, and sex of the newborn were predictors of variations in anthropometric indicators.

Conclusions

Exclusive breastfeeding is the most common feeding practice in the population group studied, but using breast milk substitutes is also prevalent. Low height-for-age is the most frequent anthropometric classification. The weight growth rate seems reasonable, but further studies are needed based on gender differences, analysis of the composition of breast milk, and socio-environmental factors involved in growth.

Background

Children with Generalized Joint Hypermobility (GJH) may have a motor developmental delay in the early period and subluxation, fatigue, autonomic dysfunction, and pain arising from ligaments and other soft tissues in advanced ages. Additionally, there is a loss of proprioceptive sensation in children and adults with GJH.

Aims

This study aimed to evaluate sensory processing skills in toddlers with GJH.

Study Design

A cross-sectional study.

Subjects

Fifty-eight children aged between 12 and 14 months were included in the study. These children were divided into two groups: with and without GJH (31 with GJH and 27 without GJH).

Outcome measures

The sensory processing skills of the children in the study were evaluated with the Test of Sensory Functions in Infants (TSFI).

Results

The scores in the subtests of TSFI in response to tactile deep pressure, adaptive motor functions, visual-tactile integration, and response to vestibular stimuli were higher in favor of children without GJH (p < 0.05). The total TSFI score was higher in the group without GJH (p < 0.05).

Conclusions

Sensory processing problems were found in toddlers with GJH. Sensory motor development should be evaluated in children with GJH, and an appropriate early intervention program should be planned.

Infants born low birth weight (LBW) and preterm are at risk for developmental delay and cognitive deficits. These deficits can lead to lifelong learning difficulties and high-risk behaviors.

Preterm (PT) and full-term (FT) groups were compared across infant and toddler measures of behavior and development to extract early indicators of executive function (EF). The goal was to extract indicators of EF from standardized infant assessments.

PT (<2500 grams and <37 weeks) and FT (> 2500 grams and >37 weeks) were compared across assessment and EF components were identified from the BSID-III. A multivariate linear model was used to examine group differences.

All children (99 PT and 46 FT) were administered the Bayley III and the DMQ assessments for session 1 (6-8 months). During session 2, N=78 PT and 37 FT (18-20 months), the CBCL was added to previous assessments, and the BRIEF-P was added to previous assessments in session 3, N= 52 PT and 36 FT for session 3 (See Table 1).

Significant change scores were found on BSID-III subtests and EF components across all 3 sessions. The PT group also showed significantly more behavioral concerns on the CBCL at 18 months and 36 months and had lower scores on the BRIEF-P than their FT peers. The number of children born PT (N = 27, 52%) who were in Early Intervention (EI) increased across the 3 sessions. Examining early indicators of EFs supported the development of early identification that could lead to decrease adverse outcomes often associated with preterm birth.

Background

Lactate accumulation is associated with vigorous exercise, cardiovascular disease and a number of cancers. Digit ratio (2D:4D) has also been linked to oxygen metabolism, myocardial infarction and various cancers. Such similarities suggest the possibility that 2D:4D is a biomarker of lactate. Here, we consider the relationship between 2D:4D and lactate during an incremental cardiopulmonary exercise test.

Method

The participants were male professional football players. The treadmill test began at a speed of 8 km/h when the first lactate measurement was taken. The speed was increased by 2 km/h every 3.15 min, with measurements at 10, 12, 14 and 16 km/h.

Results

There were 72 Caucasian and 7 Black participants, results are reported for the most numerous group. Lactate levels increased with running speed and were not correlated with age, body size or body composition. Median splits of digit ratios (right, left and right-left 2D:4D [Dr-l]) were calculated. In comparison to the Low ratio group, the High ratio group showed higher lactate levels across speeds. Effect sizes varied from very large to huge (right 2D:4D), large (left 2D:4D) and medium (Dr-l). At the individual level, positive correlations between digit ratios and lactate at the five different speeds varied from large (right 2D:4D), medium (left 2D:4D) and small (Dr-l).

Conclusion

There were large positive associations between right 2D:4D and lactate at all running speeds. We discuss our findings in relation to oxygen metabolism and suggest that 2D:4D may be a biomarker for lactate in the wider context of the latter's importance in health and disease.

Background

Increased survival rate of extremely preterm children is associated with a higher risk of retinopathy of prematurity (ROP) and long-term sequelae, which implicate retinal changes.

Purpose

To assess an influence of perinatal characteristics on morphology and retinal vascularity of the macula in preterm children.

Methods

A cohort of 123 preterm children at the age of 10.5 years (IQR: 8.12-12.77) was prospectively assessed. Optical coherence tomography angiography (OCTA) was performed using RTVueXR Avanti. Foveal thickness, parafoveal thickness, size of foveal avascular zone (FAZ), superficial and deep vessel density, central choroidal thickness (CCT) were analyzed. The associations between OCTA results and perinatal factors, including the presence of ROP and therapy requirements were assessed in preterm children.

Results

Significantly smaller FAZ, higher foveal thickness and vessel density were noted in children with ROP, Respiratory Distress Syndrome, Bronchopulmonary Dysplasia, required erythropoietin, transfusion or steroids. Foveal thickness was increased in children with ROP (p < 0.001) and following laser treatment (p < 0.05). Thinner CCT was noted in children with a history of sepsis (p < 0.05) and ROP required treatment (p < 0.05). Pregnancy bleeding was associated with higher superficial foveal vessel density (p < 0.05) and smaller FAZ (p < 0.05).

Conclusion

Neonatal factors have a huge impact on retinal development, but the role of prenatal factors should not be neglected in preterm children.