Early human development最新文献_第8页

The three-dimensional course of cranial development of very preterm infants during the first year of life 早产儿出生后第一年颅骨发育的三维过程。

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-10-10 DOI: 10.1016/j.earlhumdev.2024.106131

P. Santander , A. Quast , J. Hubbert , P. Meyer-Marcotty , K.O. Hensel , C. Bergmann , S. Schmidt , J.K. Dieks

Background

Cranial measurements are crucial for evaluating preterm general development because they are a surrogate tool for evaluating brain growth. Usually, they are based on tape-measured head circumference; however, a three-dimensional (3D) approach expands the diagnostic spectrum to the evaluation of cranial volume and shape.

Aims

Very preterm (vPT) infants face multiple risks and obstacles in their early development. In this study, we analyze the risk for cranial anomalies of vPT compared with term-born (TB) infants during the first year of life.

Study design and subjects

In this single-centre prospective cohort study, 23 vPT and 24 TB healthy infants were assessed. At term equivalent age (TEA) of vPT and time of birth of TB, and 1, 3, 6 and 12 months of postmenstrual age, respectively, a 3D head scan was performed and cephalometrically evaluated regarding cranial growth (head circumference, cranial volume) and shape.

Results

Head circumference and cranial volume showed a similar course in vPT and TB. Cranial shape differed significantly between vPT and TB. At TEA, vPT showed longer and narrower heads (dolichocephaly), a difference that disappeared around the 6th month of life. Presence of plagiocephaly was initially similar in vPT and TB, with an increasing difference between both groups with a peak at six months when 34.8 % of the vPT versus none of the TB showed a moderate to severe plagiocephaly (p = 0.004). In vPT, cranial volume significantly correlated with cranial shape, whereas dolichocephaly at TEA had no influence on the further course of plagiocephaly.

Conclusion

Cranial development of vPT follows a different course than of TB in terms of cranial shape anomalies, while cranial growth remains unaffected.

German Clinical Trials Register number: DRKS00022558.

背景：颅骨测量对于评估早产儿的总体发育至关重要，因为它们是评估大脑发育的替代工具。然而，三维（3D）方法将诊断范围扩展到了颅骨体积和形状的评估。在这项研究中，我们分析了与足月儿（TB）相比，早产儿在出生后第一年出现头颅异常的风险：在这项单中心前瞻性队列研究中，我们对 23 名 vPT 婴儿和 24 名 TB 健康婴儿进行了评估。分别在 vPT 和 TB 出生时的足月等效年龄（TEA），以及月龄后 1、3、6 和 12 个月时，进行 3D 头部扫描，并对头颅生长（头围、头颅体积）和形状进行头颅测量评估：结果：vPT 和 TB 的头围和头颅体积的发育过程相似。vPT和TB的颅骨形状有明显差异。在出生后第 6 个月，这种差异消失。vPT和肺结核患儿最初的颅骨后凸畸形情况相似，但两组患儿的颅骨后凸畸形情况差异越来越大，在6个月时达到顶峰，34.8%的vPT患儿出现中度至重度颅骨后凸畸形，而肺结核患儿则没有（p = 0.004）。在vPT中，颅骨体积与颅骨形状有明显的相关性，而在TEA时的双侧颅骨畸形对颅骨畸形的进一步发展没有影响：结论：就颅形异常而言，vPT 的颅骨发育过程与肺结核不同，而颅骨生长则不受影响。德国临床试验注册编号：DRKS00022558：DRKS00022558。

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引用次数: 0

Maternal depressed mood and serotonergic antidepressant treatment during pregnancy differentially shape the continuity between fetal–newborn neurobehaviour 孕期母体抑郁情绪和血清素能抗抑郁药治疗对胎儿-新生儿神经行为的连续性有不同影响。

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-10-06 DOI: 10.1016/j.earlhumdev.2024.106129

Kayleigh S.J. Campbell , Ursula Brain , Gillian E. Hanley , Tim F. Oberlander , Ken I. Lim

Background

Prenatal serotonin reuptake inhibitor (SRI) antidepressant exposure is associated with newborn neurobehavioural disturbances, but it remains unclear whether this reflects a transient pharmacologic condition or an altered neurodevelopmental trajectory emerging in utero from sustained gestational SRI exposure.

Aim

This study explored longitudinal relationships between third-trimester fetal physiology and newborn neurobehaviour, and determined whether early neurobehavioural continuity is shaped by prenatal SRI or depression exposure.

Methods

Participants were 127 pregnant mothers and their fetal-newborn offspring. Four groups were defined based on antenatal depressive symptoms and SRI treatment: Control (n = 51), Depressed (unmedicated; n = 35), SRI-Depressed (n = 26) and SRI-Non-Depressed (n = 15). Doppler measures of fetal heart rate (fHR), motor activity and vascular hemodynamics were obtained at 36-weeks' gestation, then newborn neurobehavioural maturity was evaluated at postnatal day-7. Partial least squares analysis was used to identify latent correlations between fetal-newborn measures; associations were further studied with hierarchical regression testing group moderation.

Results

Two dimensions described 74% of the covariance between fetal physiologic and newborn neurobehavioural measures (permuted p < 0.05). Three latent fetal-newborn relationships were significantly moderated by group: (1) lower fHR variability, and (2) greater fHR decelerations, predicted lower alertness/orientation scores but only in SRI-Depressed-group newborns; and (3) lower fetal cerebrovascular resistance predicted lower motor scores in Depressed-group newborns. SRI treatment to euthymia was not associated with fetal-newborn neurobehavioural disturbances.

Conclusions

Maternal depression, both unmedicated and SRI-treated with persistent/poorly-managed mood symptoms, differentially shaped fetal-newborn neurobehavioural continuity. These findings suggest that neurobehavioural disturbances may predate birth, and underscore the importance of effective mental health management during pregnancy.

背景：产前5-羟色胺再摄取抑制剂（SRI）抗抑郁剂暴露与新生儿神经行为紊乱有关，但目前仍不清楚这是否反映了一种短暂的药理状况，还是妊娠期SRI持续暴露导致的子宫内神经发育轨迹改变。目的：本研究探讨了第三孕期胎儿生理和新生儿神经行为之间的纵向关系，并确定产前SRI或抑郁暴露是否会影响早期神经行为的连续性：参与者为 127 名孕妇及其胎儿-新生儿后代。根据产前抑郁症状和 SRI 治疗情况分为四组：对照组（n = 51）、抑郁组（未用药；n = 35）、SRI-抑郁组（n = 26）和 SRI-非抑郁组（n = 15）。在妊娠 36 周时对胎儿心率（fHR）、运动活动和血管血流动力学进行多普勒测量，然后在出生后第 7 天对新生儿神经行为成熟度进行评估。利用偏最小二乘法分析确定了胎儿-新生儿测量指标之间的潜在相关性；通过分层回归测试组间调节作用进一步研究了相关性：结果：两个维度描述了胎儿生理指标与新生儿神经行为指标之间 74% 的协方差（经置换的 p 结论）：母亲抑郁，无论是未接受药物治疗还是接受 SRI 治疗且情绪症状持续/控制不佳，都会对胎儿-新生儿神经行为的连续性产生不同程度的影响。这些研究结果表明，神经行为紊乱可能在出生前就已存在，并强调了在孕期进行有效心理健康管理的重要性。

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引用次数: 0

Mental health screening for parents following surgical neonatal intensive care unit (NICU) discharge 新生儿重症监护室（NICU）手术出院后对父母进行心理健康筛查。

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-10-02 DOI: 10.1016/j.earlhumdev.2024.106128

Nadine Griffiths , Sharon Laing , Kaye Spence , Maralyn Foureur , Himanshu Popat , Holly Gittany , Lynn Sinclair , Nadine KASPARIAN

Admission to the surgical neonatal intensive care unit (sNICU) is a stressful experience. Care is often complex, with inherent risks and potential complications. This study describes the implementation of an outpatient mental health screening process for parents of infants admitted to a sNICU. Parents of infants aged >34 weeks gestation with a congenital anomaly requiring neonatal surgery participated in this prospective observational study. Standardised measures to screen for parenting stress (Parenting Stress Index™ Fourth Edition Short Form) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) were administered at the first outpatient visit scheduled when the infant's corrected gestational age was 4 months. A triage algorithm was developed, to review the initial screening results prompting appropriate action and intervention. Positive screens were triaged as evaluate (assess within 48 h), targeted information (email contact), or escalate response (same day risk assessment). Demographic factors associated with parental stress and depressive symptoms were explored. Forty parents (response rate: 88 %) participated in screening. A high portion of parents (52.5 %) required secondary screening, for parenting stress (n = 10), depressive symptoms (n = 5) or both stress and depressive symptoms (n = 6). Socioeconomic disadvantage was positively associated with parenting stress (p = 0.02) and greater depressive symptoms with parent education levels (p = 0.01). Results indicate screening of parent mental health in the outpatient setting is feasible. Use of a triage algorithm helped prioritise parent follow-up and facilitate workflows. Parent mental health screening should be prioritised within and beyond the sNICU to support family and infant outcomes during this critical period of development.

入住新生儿外科重症监护病房（sNICU）是一种紧张的经历。护理工作通常很复杂，存在固有风险和潜在并发症。本研究介绍了针对入住新生儿重症监护病房（sNICU）的婴儿家长实施的门诊心理健康筛查流程。妊娠期大于 34 周、患有先天性畸形并需要进行新生儿手术的婴儿的父母参与了这项前瞻性观察研究。在婴儿的矫正胎龄为 4 个月时，在第一次门诊就诊时进行标准化测量，以筛查育儿压力（育儿压力指数™ 第四版简表）和抑郁症状（流行病学研究中心抑郁量表）。我们制定了一套分流算法，以审查初步筛查结果，从而采取适当的行动和干预措施。阳性筛查结果被分流为评估（48 小时内评估）、目标信息（电子邮件联系）或升级响应（当天风险评估）。研究还探讨了与家长压力和抑郁症状相关的人口统计学因素。40 名家长（回复率：88%）参加了筛查。大部分家长（52.5%）需要进行二次筛查，筛查内容包括养育压力（10 人）、抑郁症状（5 人）或压力和抑郁症状（6 人）。社会经济劣势与养育压力呈正相关（p = 0.02），抑郁症状与父母教育水平呈正相关（p = 0.01）。结果表明，在门诊环境中对家长进行心理健康筛查是可行的。使用分流算法有助于确定家长随访的优先次序并促进工作流程。在新生儿重症监护病房内外都应优先考虑对家长进行心理健康筛查，以便在婴儿成长的关键时期为家庭和婴儿提供支持。

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引用次数: 0

Non-nutritional use of human milk as a therapeutic agent in neonates: Brain, gut, and immunologic targets 母乳作为新生儿治疗剂的非营养用途：大脑、肠道和免疫目标。

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-27 DOI: 10.1016/j.earlhumdev.2024.106126

Rebecca Hoban , Krystle M. Perez , D. Taylor Hendrixson , Gregory C. Valentine , Katie M. Strobel

Human milk (HM) exposure improves short- and long-term outcomes for infants due to a complex milieu of bioactive, stem cell, anti-inflammatory, anti-microbial, and nutritive components. Given this remarkable biologic fluid, non-nutritional utilization of HM as a targeted therapeutic is being explored in pre-clinical and clinical studies. This article describes recent research pertinent to non-nutritional uses of HM for neurologic, gastrointestinal, and infectious pathologies in neonates, as well as future directions.

人乳（HM）具有生物活性、干细胞、抗炎、抗微生物和营养成分，其复杂的环境可改善婴儿的短期和长期预后。鉴于这种出色的生物液体，人们正在临床前和临床研究中探索将母乳作为靶向治疗的非营养性利用。本文介绍了有关 HM 非营养性用于治疗新生儿神经、胃肠道和感染性病症的最新研究以及未来发展方向。

引用次数: 0

“Sink or swim”: mothers' experiences of extremely preterm infants after 15 years from birth "沉浮"：极早产儿出生 15 年后母亲的经历。

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-25 DOI: 10.1016/j.earlhumdev.2024.106123

Camilla Pisoni , Serena Grumi , Maria Letizia Minniti , Linda Gasparini , Annalisa Saracino , Cecilia Naboni , Stefano Ghirardello , Renato Borgatti , Simona Orcesi

Objectives

To evaluate the experience of parenting a preterm infant from birth to adolescence and to raise awareness of the complexity of premature birth and the child's subsequent developmental journey for the entire family.

Study design

A phenomenological, qualitative approach using semi-structured interviews with open-ended questions was adopted to obtain retrospective, in-depth narratives. Seven mothers of adolescents born preterm with extremely low birth weight (ELBW) and admitted to a neonatal intensive care unit (NICU) participated in the study. Interviews were conducted by a trained researcher in qualitative methods, and independent coders performed data analysis.

Results

Three phases and eight core themes, chronologically organized, emerged from the thematic analysis: starting from preterm birth (panic, fear and uncertainty; hope and a positive attitude to the future; altered parental role), transitioning to life after hospitalization (fatigue and worry about an uncertain future; need of support), and extending into adolescence (adolescents' fragility; overprotection; post-traumatic personal growth).

Conclusions

The birth of a preterm baby has significant repercussions for the entire family, not only in the period immediately following birth but also for many years afterwards, as the traumatic event is retraced with memories that remain both painful and vivid. These findings should be acknowledged by professionals working in the NICU to foster the development of targeted interventions that help parents build resilience, including from a personal growth perspective.

研究目的评估早产儿从出生到青春期的养育经历，提高整个家庭对早产儿的复杂性和孩子随后的成长历程的认识：研究设计：采用现象学定性方法，通过半结构式访谈和开放式问题来获得回顾性的深度叙述。七名早产儿和极低出生体重儿（ELBW）青少年的母亲参与了这项研究，她们都住进了新生儿重症监护室（NICU）。访谈由一名受过定性方法培训的研究人员进行，并由独立的编码人员进行数据分析：专题分析按时间顺序排列出三个阶段和八个核心主题：从早产开始（恐慌、恐惧和不确定性；对未来的希望和积极态度；父母角色的改变），过渡到住院后的生活（疲劳和对不确定未来的担忧；需要支持），并延伸到青春期（青少年的脆弱；过度保护；创伤后的个人成长）：早产儿的出生对整个家庭都会产生重大影响，不仅是在出生后的那段时间，而且在出生后的许多年里都会如此，因为创伤事件会伴随着痛苦而又鲜活的记忆不断重现。在新生儿重症监护室工作的专业人员应认识到这些发现，以促进制定有针对性的干预措施，帮助父母建立复原力，包括从个人成长的角度进行干预。

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引用次数: 0

Oral motor interventions used to support the development of oral feeding skills in preterm infants: An integrative review 用于支持早产儿口腔喂养技能发展的口腔运动干预：综合综述。

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-24 DOI: 10.1016/j.earlhumdev.2024.106125

Carolyn Ibrahim , Patricia Chavez , Delaney Smith , Jenene Craig , Roberta Pineda

Background

One criterion for infant NICU discharge is the ability to meet all nutritional needs by mouth, therefore, it is important to understand interventions that can improve the trajectory to full oral feeding. While many oral motor and feeding interventions are used in clinical practice, it remains unclear which are supported by the literature.

Aim

The aim of this integrative review was to identify and understand what oral motor interventions are defined in the literature to support positive outcomes for preterm infants and their parents.

Methods

An integrative review of studies published from 2002 to 2022 focusing on applied oral motor interventions and their impact on feeding-related outcomes was completed. The systematic search used databases including PubMed, Cochrane, CINAHL, Scopus, and Google Scholar. Studies were included if they used a study population of preterm infants born </= 32 weeks estimated gestational age (EGA) and imposed an oral motor intervention/exposure that commenced prior to 36 weeks postmenstrual age (PMA) while the infant was in the NICU, with outcomes of time to full oral feeding, length of stay (LOS), feeding performance measures, feeding efficiency, weight gain, infant physiology, and/or parental outcomes. Studies were excluded if they were observational, pilot, or feasibility designs; if they enrolled a purposefully healthy sample of infants; had non-relevant outcomes including apnea and incidence of retinopathy of prematurity; had a sample size <30 without a priori calculation of power or had a calculated sample size that was not attained.

Results

Forty articles met inclusion criteria with four different interventions (or a combination of them) identified: nonnutritive sucking, oral motor stimulation [Fucile's protocol, Premature Infant Oral Motor Intervention (PIOMI)], NTrainer, and swallowing exercises.

Discussion

All interventions were associated with positive outcomes and began between 29- and 30-weeks PMA. Detailed information on adverse events (both physiologic and behavioral) in future research could allow for better risk-benefit analysis. The methodology and quality of the studies differed too much to allow for quantitative analysis; however, there does not appear to be compelling evidence that more stimulatory interventions are superior to less stimulatory interventions – a key consideration when working with preterm infants.

背景：新生儿重症监护室（NICU）婴儿出院标准之一是能够通过口腔满足所有营养需求，因此，了解能够改善完全口腔喂养轨迹的干预措施非常重要。虽然临床实践中使用了许多口腔运动和喂养干预措施，但仍不清楚哪些干预措施得到了文献的支持。目的：本综合综述旨在确定和了解文献中定义的口腔运动干预措施，以支持早产儿及其父母取得积极成果：方法：对 2002 年至 2022 年期间发表的研究进行综合回顾，重点关注应用口腔运动干预措施及其对喂养相关结果的影响。系统性检索使用的数据库包括 PubMed、Cochrane、CINAHL、Scopus 和 Google Scholar。如果研究对象为早产儿，则纳入研究结果：40篇文章符合纳入标准，确定了四种不同的干预措施（或其组合）：非营养性吸吮、口腔运动刺激[Fucile方案，早产儿口腔运动干预（PIOMI）]、NTrainer和吞咽练习：讨论：所有干预措施都取得了积极的效果，并在早产儿出生后 29 到 30 周之间开始实施。未来研究中有关不良事件（包括生理和行为）的详细信息可以更好地进行风险效益分析。这些研究的方法和质量差异太大，无法进行定量分析；但是，似乎没有令人信服的证据表明刺激性较强的干预措施优于刺激性较弱的干预措施--这是早产儿工作中的一个关键考虑因素。

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引用次数: 0

Feasibility of a Dutch post-discharge parenting intervention (TOP program) for moderate preterm born infants 针对中度早产儿的荷兰出院后育儿干预（TOP 计划）的可行性

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-18 DOI: 10.1016/j.earlhumdev.2024.106124

Monique Flierman , Eline L. Möller , Raoul H.H. Engelbert , Anton H. van Kaam , Daniël Bossen , Martine Jeukens-Visser

Background and aim

Moderate preterm (MP) birth is associated with an increased risk of developmental problems. However, post-discharge support for this group is scarce. The aim of this study was to evaluate the feasibility of a post-discharge parenting program (TOP program) for MP infants. Three feasibility dimensions were evaluated (1) recruitment capability and compliance, (2) intervention acceptability, and (3) limited efficacy testing.

Methods

A group of MP infants with a gestational age (GA) between 32^0/7‐34^6/7 weeks and their parents received six home visits by a TOP interventionist until 6 months corrected age (CA). A pre-posttest intervention design with quantitative and qualitative measures was used.

Recruitment capability and compliance, acceptability, and satisfaction with the intervention were evaluated using a questionnaire, checklists, interviews, and a focus group. Infant socio-emotional development, parental distress, self-efficacy, and reflective functioning were measured with questionnaires. Observation measurements were used for infant motor development and parental sensitivity.

Results

Thirty-two families completed the six home visits. The satisfaction rate (scale 0–10) was remarkably high (Mean 9.4, range: 8–10). Parents reported that the program was suitable, enhanced their understanding of their infants' developmental needs, and increased their self-efficacy. The infants showed age-appropriate motor and socio-emotional development post-intervention. Parental self-efficacy, reflective functioning, and sensitivity improved from pre to post intervention, with small to large effect sizes.

Conclusion

The study demonstrated high compliance, acceptability, and satisfaction with the TOP program for MP infants with promising infant and parent outcomes. This study contributes to the preparatory work prior to a larger scale evaluation and dissemination.

背景和目的中度早产（MP）与发育问题的风险增加有关。然而，针对这一群体的出院后支持却很少。本研究旨在评估针对中度早产儿的出院后育儿计划（TOP 计划）的可行性。方法一组胎龄（GA）在 320/7-346/7 周之间的 MP 婴儿及其父母接受了 TOP 干预人员的六次家访，直至 6 个月矫正年龄（CA）。通过问卷调查、核对表、访谈和焦点小组对招募能力、依从性、可接受性和干预满意度进行了评估。婴儿的社会情感发展、父母的苦恼、自我效能和反思功能均通过问卷进行测量。结果32 个家庭完成了六次家访。满意度（0-10 分）非常高（平均 9.4 分，范围：8-10 分）。家长们表示，该计划非常适合他们，增强了他们对婴儿发育需求的了解，提高了他们的自我效能感。干预后，婴儿的运动和社会情感发展均与年龄相符。从干预前到干预后，家长的自我效能感、反思功能和敏感性都得到了提高，效果由小到大。这项研究有助于为更大规模的评估和推广做准备。

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引用次数: 0

Commercial infant products influence body position and muscle use 商用婴儿产品影响身体姿势和肌肉使用

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-12 DOI: 10.1016/j.earlhumdev.2024.106122

Danielle N. Siegel , Sarah Goldrod , Christopher Wilson , Andrew Bossert , Trevor J. Lujan , Brandi N. Whitaker , John L. Carroll , Erin M. Mannen

The musculoskeletal and motor development of infants is affected by their environment, which varies from being held, lying on a firm flat surface, to seated in various nursery products. Nursery products can alter the body position of infants, particularly the position of the head/neck and trunk, which may inhibit an infant's ability to breathe. With U.S. infants spending an increasing amount of time in seated products, the purpose of this study was to assess muscle activation and body position in four commercial infant products (carrier, bouncer, rocker, and swing) during supine and prone positioning, compared to a firm flat surface. Thirteen healthy infants (age: 4.2 ± 1.4 months; 7 M/6F) were enrolled in this IRB-approved in-vivo biomechanics study. Surface electromyography sensors recorded muscle activity of the erector spinae, cervical paraspinals, quadriceps, and abdominal muscles and retro-reflective markers tracked movements to determine head-neck, trunk, and torso-pelvis flexion/extension in the sagittal plane. While supine, infants exhibited increased head-neck and trunk flexion of up to 21° and 27° above the playmat, respectively, in all seated products. While prone, high abdominal muscle activation compared to the playmat indicates that infants will fatigue faster in seated products. Additionally, the lower muscle activation levels exhibited in younger infants (< 4 months) compared to older infants (≥ 4 months) indicates that younger infants rely on the product design to maintain body position. However, offering infants a variety of environments to move within is important to avoid motor delay, therefore future work should explore how long-term use may impact an infant's development.

婴儿的肌肉骨骼和运动发育受其所处环境的影响，其所处环境从被抱着、躺在坚固的平面上到坐在各种育婴产品中，不一而足。育婴产品会改变婴儿的身体姿势，尤其是头部/颈部和躯干的位置，这可能会抑制婴儿的呼吸能力。随着美国婴儿使用坐式产品的时间越来越长，本研究的目的是评估四种商用婴儿产品（背带、摇椅、摇椅和秋千）在仰卧和俯卧时的肌肉激活情况和身体位置，并与坚固的平面进行比较。13 名健康婴儿（年龄：4.2 ± 1.4 个月；7 男/6 女）参加了这项经 IRB 批准的体内生物力学研究。表面肌电图传感器记录了竖脊肌、颈椎旁肌、股四头肌和腹肌的肌肉活动，逆反射标记追踪运动，以确定矢状面上的头颈、躯干和躯干骨盆屈伸。仰卧时，在所有坐姿产品中，婴儿的头颈部和躯干屈曲度增加，分别比游戏垫高出 21° 和 27°。俯卧时，与游戏垫相比，婴儿的腹部肌肉活化程度较高，这表明婴儿在坐姿产品中会更快地疲劳。此外，与较大的婴儿（≥ 4 个月）相比，较小的婴儿（< 4 个月）表现出较低的肌肉活动水平，这表明较小的婴儿依靠产品设计来保持身体姿势。不过，为婴儿提供各种活动环境对于避免运动迟缓非常重要，因此未来的工作应探讨长期使用产品会对婴儿的发育产生怎样的影响。

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引用次数: 0

The risk of prenatal bisphenol A exposure in early life neurodevelopment: Insights from epigenetic regulation 产前双酚 A 暴露对生命早期神经发育的风险：表观遗传调控的启示

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-11 DOI: 10.1016/j.earlhumdev.2024.106120

Norazirah Mat Nayan , Andrean Husin , Rosfaiizah Siran

Bisphenols are mainly used as protective coatings for plastics and resin-based materials in various consumer products. Industrial producers have a high demand for bisphenol A (BPA) among all bisphenol substitutes for various consumer products. However, according to reports, prolonged exposure to BPA can cause multiple health issues, including neurodevelopmental disorders in young children. BPA exposure during pregnancy has been considered as the primary cause of increasing the risk of neurological disorders in children as their neural systems are designed to respond to any environmental changes during prenatal life. Recently, there has been an increased focus on the effects of prenatal exposure to BPA, as it has been found to alter gene expression related to epigenetic mechanisms like DNA methylation, histone modification, and microRNA expression. Based on the evidence, frequent interactions can lead to inherited changes in an individual's neural profile. In this review, we delve into the current knowledge regarding the toxicity mechanism of BPA for expecting mothers. Next, we will discuss the possible action of BPA on the epigenetic mechanism during brain development. This is especially important to portray an overview on the role of epigenetic modification caused by prenatal BPA exposure and next, give future directions for improving human health risk assessment caused by BPA exposure.

双酚主要用作各种消费品中塑料和树脂基材料的保护涂层。在各种消费品的所有双酚替代品中，工业生产商对双酚 A（BPA）的需求量很大。然而，据报道，长期接触双酚 A 会导致多种健康问题，包括幼儿的神经发育障碍。怀孕期间接触双酚 A 被认为是增加儿童神经系统疾病风险的主要原因，因为他们的神经系统在设计上能够对产前的任何环境变化做出反应。最近，人们越来越关注产前暴露于双酚 A 的影响，因为人们发现双酚 A 会改变与 DNA 甲基化、组蛋白修饰和微 RNA 表达等表观遗传机制有关的基因表达。基于这些证据，频繁的相互作用会导致个体神经特征发生遗传性变化。在本综述中，我们将深入探讨有关双酚 A 对孕妇毒性机制的现有知识。接下来，我们将讨论双酚 A 在大脑发育过程中可能对表观遗传机制产生的作用。这对于概述产前双酚 A 暴露引起的表观遗传学改变的作用尤为重要。

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引用次数: 0

Effects of 4 weeks of play in standing and walking on gross motor ability and segmental trunk control in preterm infants using a playpen: A randomized control trial 4 周的站立和行走游戏对使用游戏围栏的早产儿粗大运动能力和躯干分节控制能力的影响：随机对照试验

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development

Pub Date : 2024-09-11 DOI: 10.1016/j.earlhumdev.2024.106121

Noppharath Sangkarit, Weerasak Tapanya, Chonthicha Panmatchaya, Arpapat Sangpasit, Kanitta Thatawong

Objective

To investigate the effect of computer-based early intervention with a playpen to enhance standing and walking, and to examine the relationship between changes in gross motor percentile and segmental trunk control in preterm infants nine months corrected age.

Methods

Forty infants born before 37 weeks of gestation were randomly assigned to either the experimental or control group. The Alberta Infant Motor Scale (AIMS) and the Segmental Assessment of Trunk Control (SATCo) were administered before and after the intervention. The experimental group, consisting of twenty preterm infants, participated in a computer-based early intervention involving 45 min of play in standing and walking positions, five times a week for 4 weeks.

Results

There were significant between-group differences in the gross motor percentiles of the AIMS (p-value <0.001). In addition, there was a significant difference in all conditions of the SATCo scores (p-value <0.05) compared with baseline score. The change in percentiles of gross motor development was significantly correlated (r_s = 0.643; p-value <0.001) with reactive SATCo during walking in infants in the experimental group.

Conclusion

Early intervention with a playpen in a standing and walking position can be applied to improve changes in gross motor percentiles and segmental trunk control in preterm infants.

方法将 40 名妊娠 37 周前出生的婴儿随机分配到实验组或对照组。在干预前后分别进行阿尔伯塔婴儿运动量表（AIMS）和躯干控制分段评估（SATCo）。实验组由 20 名早产儿组成，他们参加了基于计算机的早期干预，包括 45 分钟的站立和行走姿势游戏，每周 5 次，持续 4 周。此外，与基线分数相比，所有条件下的 SATCo 分数均有显著差异（p 值为 0.05）。实验组婴儿在行走时粗大运动发育百分位数的变化与反应性 SATCo 显著相关（rs = 0.643; p-value<0.001）。

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引用次数: 0