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Jia SJ, Jing JQ, Yang CJ. A Review on Autism Spectrum Disorder Screening by Artificial Intelligence Methods. J Autism Dev Disord 2024:10.1007/s10803-024-06429-9. [PMID: 38842671 DOI: 10.1007/s10803-024-06429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE With the increasing prevalence of autism spectrum disorders (ASD), the importance of early screening and diagnosis has been subject to considerable discussion. Given the subtle differences between ASD children and typically developing children during the early stages of development, it is imperative to investigate the utilization of automatic recognition methods powered by artificial intelligence. We aim to summarize the research work on this topic and sort out the markers that can be used for identification. METHODS We searched the papers published in the Web of Science, PubMed, Scopus, Medline, SpringerLink, Wiley Online Library, and EBSCO databases from 1st January 2013 to 13th November 2023, and 43 articles were included. RESULTS These articles mainly divided recognition markers into five categories: gaze behaviors, facial expressions, motor movements, voice features, and task performance. Based on the above markers, the accuracy of artificial intelligence screening ranged from 62.13 to 100%, the sensitivity ranged from 69.67 to 100%, the specificity ranged from 54 to 100%. CONCLUSION Therefore, artificial intelligence recognition holds promise as a tool for identifying children with ASD. However, it still needs to continually enhance the screening model and improve accuracy through multimodal screening, thereby facilitating timely intervention and treatment.
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Affiliation(s)
- Si-Jia Jia
- Faculty of Education, East China Normal University, Shanghai, China
| | - Jia-Qi Jing
- Faculty of Education, East China Normal University, Shanghai, China
| | - Chang-Jiang Yang
- Faculty of Education, East China Normal University, Shanghai, China.
- China Research Institute of Care and Education of Infants and Young, Shanghai, China.
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Yumul JN, McKinlay A, Anderson V, Catroppa C. Behaviour outcomes three months after mild TBI in preschool children. Neuropsychol Rehabil 2024; 34:600-618. [PMID: 37354534 DOI: 10.1080/09602011.2023.2224030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/02/2023] [Indexed: 06/26/2023]
Abstract
This study examined parents' report of behaviour in preschoolers after a mild traumatic brain injury (mTBI), compared the proportion of preschoolers with elevated behaviour ratings between the mTBI and limb injury (LI) groups, and explored injury, premorbid child, and parent variables that may be associated with parents' report of behaviour at three months post-injury. Children aged 2-5 years with a mTBI (n = 13) or mild LI (n = 6) were recruited from the emergency department. Behaviour was assessed using the Child Behaviour Checklist. Preliminary findings showed that post-injury behaviour ratings remained in the normal range. The mTBI group had higher scores than the LI group at three months post-injury in terms of sleep; however, this may have been pre-existing. Two children with mTBI received borderline-clinically significant ratings on diagnostic-level anxiety problems at the three-month follow-up, while none of the limb-injured controls obtained elevated behaviour ratings. Parent-rated post-injury behaviour was significantly associated with premorbid child functioning and parental stress, which needs to be explored in greater detail using larger preschool mTBI samples.
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Affiliation(s)
- Joy Noelle Yumul
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Audrey McKinlay
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Lasutschinkow PC, Bo J, Warschausky S, Raghunathan T, Berglund P, Huth-Bocks A, Taylor HG, Staples AD, Cano J, Le Doux GN, Lukomski A, Larson JCG, Lajiness-O'Neill R. Convergent Validity Between the Motor Domain of PediaTrac TM and Ages and Stages in Term and Preterm Infants at 2, 4, 6, and 9 Months of Age. Assessment 2024:10731911241241144. [PMID: 38581112 DOI: 10.1177/10731911241241144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
The primary aim of this study was to evaluate the convergent validity of the Motor domain (MOT) of PediaTracTM v3.0, an online developmental tracking instrument based on caregiver reports, with fine and gross motor domains (ASQ-FM and ASQ-GM) of the Ages and Stages Questionnaire (ASQ-3) in infants between 2- and 9 months of age. Participants were caregivers of 571 infants born term or preterm (gestational age <37 weeks) enrolled in a multi-site psychometric study of PediaTracTM. Findings revealed significant correlations between MOT and ASQ-3 scores at 2, 4, 6, and 9 months across time periods, term-preterm status, and biological sex. A significantly higher percentage of infants born preterm, compared with those born at term, was identified as a moderate or high risk on both the ASQ-3 and PediaTrac. Future investigations are warranted to further examine the psychometric properties of the MOT domain, including sensitivity, specificity, and positive and negative predictive value.
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Affiliation(s)
| | - Jin Bo
- Eastern Michigan University, Ypsilanti, USA
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McLennan G, Dale SE, Gillim L, Weinblatt V, Wallerstein R, Naides SJ. Developing a Prospective Gestational Lyme Disease Study. Methods Mol Biol 2024; 2742:259-278. [PMID: 38165628 DOI: 10.1007/978-1-0716-3561-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Lyme disease in pregnancy is understudied. The few available reports of Borrelia infection during pregnancy collecting clinical outcomes, with or without confirmed fetal infection both in utero and neonatal, are limited to case reports and small series. Population-based studies are not available. We propose a prospective study of Borrelia infection during pregnancy based in obstetrical practices in both endemic and nonendemic areas, with long term follow-up of pregnancy outcomes and development assessment of offspring infected or exposed to Borrelia in utero using current serological, microscopic, culture, and molecular techniques. In addition to detection of Borrelia burgdorferi sensu stricto, additional Borrelia species and other pathogens known to be transmitted by ticks will be tested. Serial biospecimens including maternal and cord blood, maternal peripheral blood mononuclear cells and urine, and, when clinically indicated, amniotic fluid, chorionic villi, intrauterine cord blood, will be collected with clinical data, imaging, and for infections treatment medications. Offspring will be followed until age 5 years with annual developmental assessments to assess pregnancy outcomes. The study will require parallel development of a biorepository with strategies for management, data security and data sharing. A public-private partnership will be required to support the study.
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Affiliation(s)
- Graham McLennan
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Suzanne E Dale
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Laura Gillim
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Vivian Weinblatt
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Robert Wallerstein
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Stanley J Naides
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA.
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Maqbool S, Brown N, Farid A, Ali A, Iftikhar K, Bari A, Ullah E, Hafeez S. Construction and validation of ShaMaq developmental screening tool. Child Care Health Dev 2024; 50:e13123. [PMID: 37153970 DOI: 10.1111/cch.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 02/27/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION The diagnosis of developmental delay and early intervention ameliorates long-term sequelae. There is a need for an appropriate, regionally adapted and reliable developmental screening tool to be used in low and middle-income countries with scarce resources. AIM The aim of this research is to construct and validate a screening tool for identifying developmental delay in Pakistani children. METHOD ShaMaq developmental screening tool (SDST) was developed consisting of five proformas to be administered at different age groups: 6-8 weeks (Group 1), 6-10 months (Group 2), 18-24 months (Group 3), 3-3.5 years (Group 4), and 4.5-5.5 years (Group 5). On an average, Groups 1-3 took 10-15 min, whereas Groups 4 and 5 took 20-25 min. We sampled children between the ages of 6 weeks to 5.5 years and tested them all within their designated age groups. Internal consistency was assessed by Cronbach's alpha. Interobserver testing was done for reliability and concurrent validity was undertaken by using the senior consultant developmental paediatrician's final diagnosis as the gold standard. RESULTS Out of 550 healthy children, 8-19% in the five groups were found to have some form of developmental delay using SDST. Approximately 50% of the families were in the low-to-moderate income bracket, and nearly 93% lived in a joint family system. Internal consistency of items in the five groups ranged from 0.784 to 0.940, whereas both interobserver reliability and concurrent validity ranged from 0.737 to 1.0. SDST showed 94.4% sensitivity and 92.9% specificity. CONCLUSION SDST is an effective tool for identifying delay in healthy children with good internal consistency, reliability, and validity.
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Affiliation(s)
- Shazia Maqbool
- Department of Developmental & Behavioural Paediatrics, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Nick Brown
- International Maternal Child Health Department, Kvinnors och barns hälsa, Uppsala University, Uppsala, Sweden
- Department of Child Health, Aga Khan University, Karachi, Pakistan
- Barn och ungdoms avdelning, Länssjukhuset Gävleborg, Gävle, Sweden
| | - Aisha Farid
- Department of Developmental & Behavioural Paediatrics, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Anam Ali
- Department of Developmental & Behavioural Paediatrics, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Kamila Iftikhar
- Department of Developmental & Behavioural Paediatrics, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Attia Bari
- Department of Pediatric Medicine, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Ehsan Ullah
- Department of Developmental & Behavioural Paediatrics, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Shahid Hafeez
- Department of Developmental & Behavioural Paediatrics, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
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Gorrie A, Saad R, Garside L, Bailie C, Wargon O. Gross motor development in children with epidermolysis bullosa. Child Care Health Dev 2024; 50:e13194. [PMID: 38108617 DOI: 10.1111/cch.13194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/25/2023] [Accepted: 10/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Epidermolysis bullosa (EB) is a group of rare, congenital skin disorders, characterized by skin fragility and formation of blisters. The gross motor outcomes of children with EB are not known. OBJECTIVES The primary objective of the study was to measure the proportion of gross motor delay in children with EB. The secondary objectives were to measure the difference in gross motor outcomes between EB sub-types and change in gross motor outcomes over time. METHODS Children with EB, aged between one month and five and a half years of age, attending the Sydney Children's Hospital, Epidermolysis Bullosa Clinic, were eligible. Carers completed Ages and Stages Questionnaires, Third Edition, on behalf of their children. Questionnaires were scored, and outcomes were compared to age-expected norms. RESULTS There were 24 participants to complete a questionnaire. Eleven participants completed additional questionnaires over the 24 month study duration. The proportion of children with EB with gross motor delay was greater than age-expected norms (29.17% vs. 2.5%). The delay occurred in children with recessive dystrophic (80%) and epidermolysis bullosa simplex (33.33%) sub-types, but not dominant dystrophic (0%). No children with Junctional EB or Kindler EB joined this study. CONCLUSIONS This study demonstrates a difference in gross motor outcomes in children with EB. Children with recessive dystrophic and epidermolysis bullosa simplex should be prioritized for monitoring of, and intervention for, gross motor outcomes through multidisciplinary care. Further research investigating long-term outcomes for children with EB and the effectiveness of interventions would be beneficial.
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Affiliation(s)
- Andrew Gorrie
- School of Clinical Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Rebecca Saad
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- School of Nursing and Midwifery, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Lydia Garside
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Claire Bailie
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Orli Wargon
- School of Clinical Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
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Aizawa M, Murakami K, Takahashi I, Ohseto H, Noda A, Shinoda G, Orui M, Ishikuro M, Obara T, Hamada H, Iwama N, Saito M, Sugawara J, Kuriyama S. Association between frequency of breakfast intake before and during pregnancy and developmental delays in children: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Nutr J 2023; 22:66. [PMID: 38053088 DOI: 10.1186/s12937-023-00901-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Although an association between maternal nutritional intake and developmental delays in children has been demonstrated, the association of the timing of meal intake and development delays remains unclear. We examined the association between breakfast intake frequency before and during pregnancy and developmental delay in children. METHODS Of the pregnant women who participated in the Tohoku Medical Megabank Project Three-Generation Cohort Study, 7491 answered the required questions and were analyzed. The frequency of breakfast intake from pre- to early pregnancy and from early to mid-pregnancy was classified into four groups: daily, and 5-6, 3-4, and 0-2 times/week. Child developmental delays at age 2 and 3.5 years were assessed using the Ages & Stages Questionnaire, Third Edition. Logistic regression models were constructed to examine the association between breakfast intake frequency in pregnant women and developmental delays in children aged 2 and 3.5 years. RESULTS The proportion of pregnant women who had breakfast daily was 78.1% in pre- to early pregnancy, and 82.2% in early to mid-pregnancy. The proportion of children with developmental delays was 14.7% and 13.4% at age 2 and 3.5 years, respectively. Compared with the risk in children of women who had breakfast daily from pre- to early pregnancy, children of women who had breakfast 0-2 times/week had a higher risk of developmental delays at 2 years of age: odds ratio (OR) 1.30, (95% confidence interval [CI], 1.02-1.66). The risk of developmental delays at age 2 years increased in the children of women who had breakfast 0-2 times/week in early to mid- pregnancy: OR 1.75 (95% CI, 1.32-2.32). The risk of developmental delays at age 3.5 years did not increase in the children of women who had breakfast 0-2 times/week from pre- to early and early to mid-pregnancy: OR 1.06 (95% CI, 0.81-1.39 and OR 1.15 (95% CI 0.84-1.57), respectively. CONCLUSION For women with a low frequency of breakfast intake from pre- to mid-pregnancy there was an association with developmental delays in their children at age 2, but not at 3.5 years.
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Affiliation(s)
- Misato Aizawa
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan.
| | - Ippei Takahashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
| | - Hisashi Ohseto
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
| | - Aoi Noda
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Genki Shinoda
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
| | - Masatsugu Orui
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Noriyuki Iwama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Suzuki Memorial Hospital, 3-5-5 Satonomori, Iwanuma, Miyagi, 989-2481, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, 980-8572, Japan
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Khan N, Khan MA, Khan MA, Ejaz A, Warraitch A, Ishaq S, Salahuddin E, Khan HJ, Walley JD. Is Early Childhood Development Care at Public Health Facilities in Pakistan Effective? A Cluster Randomized Controlled Trial. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300037. [PMID: 37903571 PMCID: PMC10615232 DOI: 10.9745/ghsp-d-23-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/25/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Significant brain development in children occurs from birth to 2 years, with environment playing an important role. Stimulation interventions are widely known to be effective in enhancing early childhood development (ECD). This study aims to assess the feasibility and effectiveness of integrating ECD care delivered by lady health visitors (LHVs) at public health facilities in rural Pakistan. METHOD A cluster randomized controlled trial was conducted through public health facilities in 2 districts of Punjab, Pakistan. A total of 22 clusters (rural health centers and subdistrict hospitals) were randomly allocated to receive routine care (control: n=11 clusters, 406 mother-child pairs) or counseling (intervention: n=11 clusters, 398 mother-child pairs). All children aged 11-12 months without any congenital abnormality were eligible for enrollment. The intervention was delivered by the LHVs to mothers with children aged 12-24 months in 3 quarterly sessions. RESULTS The primary outcome was the prevention of ECD delays in children aged 24 months (assessed with the Ages and Stages Questionnaire-3). Analysis was done on an intention-to-treat basis. A total of 804 mother-child pairs were registered in the study, of which 26 (3.3%) pairs were lost to follow-up at the endpoint. The proportion of children with 2 or more developmental delays was significantly less in the intervention arm (13%) as compared to the control arm (41%) at an endpoint (odds ratio=0.21; 95% confidence interval=0.11, 0.42). Children in the intervention arm also had significantly better anthropometric measurements when aged 24 months than the children in the control arm. CONCLUSION The integrated ECD care intervention for children aged 12-24 months at public health facilities was found to be effective in enhancing ECD and reducing the proportion of children with global development delays.
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Affiliation(s)
- Nida Khan
- Association for Social Development, Islamabad, Pakistan.
| | | | | | - Amna Ejaz
- Association for Social Development, Islamabad, Pakistan
| | | | - Sehrish Ishaq
- Association for Social Development, Islamabad, Pakistan
| | | | | | - John D Walley
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, United Kingdom
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Letourneau N, Anis L, Novick J, Pohl C, Ntanda H, Hart M. Impacts of the Attachment and Child Health (ATTACH TM) Parenting Program on Mothers and Their Children at Risk of Maltreatment: Phase 2 Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3078. [PMID: 36833770 PMCID: PMC9961631 DOI: 10.3390/ijerph20043078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Early adversity (e.g., family violence, parental depression, low income) places children at risk for maltreatment and negatively impacts developmental outcomes. Optimal parental reflective function (RF), defined as the parent's ability to think about and identify thoughts, feelings, and mental states in themselves and in their children, is linked to secure attachment and may protect against suboptimal outcomes. We present the results of Phase 2 randomized control trials (RCTs) and quasi-experimental studies (QES) of the Attachment and Child Health (ATTACHTM) parental RF intervention for families with children at risk for maltreatment. Phase 2 parents experiencing adversity, along with their children aged 0-5 years (n = 45), received the 10-12-week ATTACHTM intervention. Building on completed Phase 1 pilot data, Phase 2 examined outcomes of long-standing interest, including parental RF and child development, as well as new outcomes, including parental perceived social support and executive function, and children's behavior, sleep, and executive function. RCTs and QES revealed significant improvements in parents' RF, perception of social support, and executive function, children's development (i.e., communication, problem-solving, personal-social, and fine motor skills), and a decrease in children's sleep and behavioral problems (i.e., anxiety/depression, attention problems, aggressive behavior, and externalizing problems), post-intervention. ATTACH™ positively impacts parental RF to prevent negative impacts on children at risk of maltreatment.
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Affiliation(s)
- Nicole Letourneau
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Faculty of Nursing, and Cumming School of Medicine, Departments of Pediatrics, Psychiatry and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lubna Anis
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jason Novick
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Carrie Pohl
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Henry Ntanda
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Martha Hart
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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10
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Saliaj A, Zahaj M, Vasilika P, Mechili EA. Long-term impact of tobacco exposure during pregnancy on children's psychomotor development. Pediatr Int 2023; 65:e15388. [PMID: 36251534 DOI: 10.1111/ped.15388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 10/14/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Both active and second-hand smoking (SHS) can cause complications during pregnancy and after delivery. This study aimed to assess how tobacco exposure (active and passive) during the fetal period could impact the psychomotor development of children when they attain the age of 3-6 years. METHODS The study included 160 mothers and their 3-6 year-old children. Two research groups were set up of children born to active or SHS mothers during the period when they were pregnant and a control group of children of non-smoking mothers. The parameters of the psychomotor development of the children were measured using the Age & Stage Questionnaires 3® (ASQ-3). RESULTS Children, whose mothers were smokers themselves or who were exposed to SHS during the period of pregnancy had an average psychomotor development score of 221 points versus 243.5 points in the control group. Twenty-six percent had delays (near or under the cut-off scores) in one of the assessed psychomotor areas and 60% had two or more psychomotor delays; 36% of children whose mothers were not exposed to smoking during pregnancy had normal psychomotor development and only 34% presented multiple psychomotor delays. CONCLUSIONS Fetuses exposed to tobacco are more likely to achieve a psychomotor development in the 'monitor' and 'fail' areas compared to the non-exposed control group. The children exposed to smoking during their fetal development should be considered as a group at risk of developmental delays, therefore they should be closely monitored and supported by caregivers and developmental pediatricians.
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Affiliation(s)
- Aurela Saliaj
- Department of Health care, Faculty of Health, University 'Ismail Qemali' of Vlora, Vlora, Albania
| | - Majlinda Zahaj
- Department of Nursing, Faculty of Health, University 'Ismail Qemali' of Vlora, Vlora, Albania
| | - Prifti Vasilika
- Department of Nursing, Faculty of Health, University 'Ismail Qemali' of Vlora, Vlora, Albania
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11
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Company-Córdoba R, Accerenzi M, Simpson IC, Ibáñez-Alfonso JA. ‘Mens sana in corpore Sano’: Home food consumption implications over child cognitive performance in vulnerable contexts. Front Psychol 2022; 13:994399. [PMID: 36389522 PMCID: PMC9665114 DOI: 10.3389/fpsyg.2022.994399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
Diet directly affects children’s physical and mental development. Nonetheless, how food insecurity and household food consumption impact the cognitive performance of children at risk of social exclusion remains poorly understood. In this regard, children in Guatemala face various hazards, mainly related to the socioeconomic difficulties that thousands of families have in the country. The main objective of this study was to analyze the differences in cognitive performance considering food insecurity and household food consumption in a sample of rural and urban Guatemalan children and adolescents at risk of social exclusion. Child cognitive performance was assessed in 134 children and adolescents (age M = 11.37; SD = 3.54) from rural and urban settings. Language, attention, and executive functions were assessed using neuropsychological tasks. Differences in cognitive performance in each level of food insecurity and household diet consumption were compared using the Mann–Whitney U test. A stepwise multivariate regression analysis was conducted to determine which factors may influence cognitive scores. The results showed that rural and urban groups did not differ in terms of food insecurity. However, considering just rural areas, differences were found between groups with food security and insecurity in attention and executive function tasks. Moreover, differences were found in food consumption for certain groups of food (e.g., meat, U = 1,146, p < 0.001, g = 0.72). Regarding regressions, protein food consumption (e.g., meat and fish), which is related to having a more balanced diet, was a relevant factor in executive performance. Contrary to what we expected, performance in attentional tasks was not related to the consumption of any food group. These findings could help politicians and decision-makers to select actions focused on improving diet balance and food security in families at risk of social exclusion. It is necessary to carry out more specific studies on the factors related to diet that affect the cognitive development of minors at risk of social exclusion. In addition, it is necessary to study the implementation of alternative interventions that include low-cost nutrients, thus ensuring that minors have access to a more balanced diet.
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Affiliation(s)
- Rosalba Company-Córdoba
- Human Neuroscience Lab, Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
- ETEA Foundation, Development Institute of Universidad Loyola Andalucía, Córdoba, Spain
| | - Michela Accerenzi
- ETEA Foundation, Development Institute of Universidad Loyola Andalucía, Córdoba, Spain
| | - Ian Craig Simpson
- Department of Experimental Psychology, Universidad de Granada, Granada, Spain
| | - Joaquín A. Ibáñez-Alfonso
- Human Neuroscience Lab, Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
- ETEA Foundation, Development Institute of Universidad Loyola Andalucía, Córdoba, Spain
- *Correspondence: Joaquín A. Ibáñez-Alfonso,
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12
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Malak R, Fechner B, Stankowska M, Wiecheć K, Szczapa T, Kasperkowicz J, Matthews-Kozanecka M, Brzozowska TM, Komisarek O, Daroszewski P, Samborski W, Mojs E. The Importance of Monitoring Neurodevelopmental Outcomes for Preterm Infants: A Comparison of the AIMS, GMA, Pull to Sit Maneuver and ASQ-3. J Clin Med 2022; 11:6295. [PMID: 36362524 PMCID: PMC9657223 DOI: 10.3390/jcm11216295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/04/2022] [Accepted: 10/24/2022] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Clinicians and parents should closely monitor the neurodevelopment of very preterm infants. The aim of our study was to compare whether neurodevelopmental assessments completed by parents and those done by specialists yielded similar outcomes. We wanted to check whether the assessments completed by specialists and parents were comparable in outcomes to emphasize the important roles of early assessment of a child and of the parents in their child's treatment and medical care. Another aim was to check whether or not the pull to sit maneuver from the Neonatal Behavioral Assessment Scale (NBAS) is still a parable item in well-known scales of neurodevelopment. METHODS We assessed 18 preterm neonates in the fourth month of corrected age with scales such as the General Movement Assessment (GMA), the Alberta Infant Motor Scale (AIMS), and the pull to sit maneuver from the NBAS. Finally, we asked parents to complete the Ages and Stages Questionnaire, Third Edition (ASQ-3). RESULTS We found that the respective assessments completed by specialists and parents are comparable in outcomes. We also found that the pull to sit item from the NBAS was still a valid test since it showed similar findings to those from the AIMS, the GMA, and the ASQ-3. CONCLUSIONS The pull to sit item from the NBAS is an important item for assessment of very preterm infants. Specialists should also take into consideration the input and concerns of parents when planning for treatment and intervention.
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Affiliation(s)
- Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Brittany Fechner
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Marta Stankowska
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Katarzyna Wiecheć
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznan, Poland
| | - Tomasz Szczapa
- Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, II Department of Neonatology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Joanna Kasperkowicz
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Teresa Matthews Brzozowska
- Department of Orthodontics and Masticatory Dysfunction, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Oskar Komisarek
- The Chair and Clinic of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Department of Plastic, Reconstructive and Aesthetic Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-821 Bydgoszcz, Poland
| | - Przemysław Daroszewski
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznan, Poland
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13
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Muthusamy S, Wagh D, Tan J, Bulsara M, Rao S. Utility of the Ages and Stages Questionnaire to Identify Developmental Delay in Children Aged 12 to 60 Months: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:980-989. [PMID: 36036913 PMCID: PMC9425289 DOI: 10.1001/jamapediatrics.2022.3079] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/30/2022] [Indexed: 01/23/2023]
Abstract
Importance The Ages and Stages Questionnaire (ASQ) is a commonly used developmental screening tool, but its utility is debated. Objectives To conduct a a systematic review and meta-analysis to evaluate ASQ's utility as a screening or diagnostic tool to identify developmental delay in children aged 12-60 months. Data Sources Medline, EMBASE, CINAHL, PsycINFO, and Mednar were searched from inception until December 2021. Study Selection Studies meeting both criteria were included. ASQ was performed at age 12 to 60 months or where the median age at ASQ was at least 12 months and formal developmental assessments were done within 2 months of ASQ. Data Extraction and Synthesis True positive, false positive, false negative, and true negatives from individual studies were extracted. Meta-analysis was conducted with Stata version 16.1. Risk of bias was assessed using the QUADAS-2 tool. Certainty of evidence (COE) was assessed using GRADE guidelines. Main Outcomes and Measures Ability of ASQ scores more than 2 SDs below the mean in more than 1 domain (ASQ-2SD) to identify any developmental delay or severe delay. Based on generally accepted interpretation of likelihood ratio (LR) values, a positive LR (PLR) more than 5 and a negative LR (NLR) of 0.2 or less were considered necessary to rule in or rule out developmental delay, respectively, with at least moderate probability. Results Initial search yielded 5777 citations of which 43 were included in the review. Of them, 36 were included in the meta-analysis. The pooled sensitivity, specificity, PLR, and NLR are as follows: ASQ-2SD to predict any delay in 1 or more domain (n = 16), 0.77 (95% CI, 0.64-0.86), 0.81 (95% CI, 0.75-0.86), 4.10 (95% CI, 3.17-5.30), and 0.28 (95% CI, 0.18-0.44); ASQ-2SD to predict severe delay in 1 or more domain (n = 15), 0.84 (95% CI, 0.75-0.90), 0.77 (95% CI, 0.71-0.82), 3.72 (95% CI, 2.98-4.64), and 0.20 (95% CI, 0.13-0.32); ASQ-2SD motor domain to predict motor delay (n = 7), 0.41 (95% CI, 0.26-0.57), 0.94 (95% CI, 0.87-0.97), 6.5 (95% CI, 3.8-11.1), and 0.63 (95% CI, 0.50-0.81); and ASQ-2SD cognitive domain to predict cognitive delay (n = 2), 0.44 (95% CI, 0.24-0.65), 0.93 (95% CI, 0.81-0.95), 6.4 (95% CI, 2.4-16.8), and 0.61 (95% CI, 0.43-0.86). The COE was low/very low. Conclusions and Relevance If a child aged 12 to 60 months passes all ASQ domains, there is a moderate probability that they do not have severe developmental delay (low COE). If a child aged 12-60 months fails the motor or cognitive domain of ASQ, there is a moderate probability that they have some motor or cognitive delay, respectively (very low COE). Trial Registration PROSPERO (CRD42021268543).
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Affiliation(s)
- Saravanan Muthusamy
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Deepika Wagh
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Jason Tan
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Shripada Rao
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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14
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Ochandorena-Acha M, Terradas-Monllor M, López Sala L, Cazorla Sánchez ME, Fornaguera Marti M, Muñoz Pérez I, Agut-Quijano T, Iriondo M, Casas-Baroy JC. Early Physiotherapy Intervention Program for Preterm Infants and Parents: A Randomized, Single-Blind Clinical Trial. CHILDREN 2022; 9:children9060895. [PMID: 35740832 PMCID: PMC9222162 DOI: 10.3390/children9060895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022]
Abstract
Background: The early developmental interventions might be designed with a preventative approach to improving the development of at-risk preterm infants. The present study aimed to evaluate the effectiveness of an early physiotherapy intervention on preterm infants’ motor and global development, and on parents’ stress index. Methods: 48 infants were enrolled and randomized into two groups. Infants allocated to the intervention group received an early physiotherapy intervention, based on parental education sessions and tactile and kinesthetic stimulation during the NICU period, as well as a home-based activity program. The intervention commenced after 32 weeks post-menstrual age and ended at 2 months corrected age. Infants allocated to the control group received the usual care based on the NIDCAP-care. Results: No differences were found between groups on the Alberta Infant Motor Scale at 2- or 8-months corrected age. Infants in the intervention group showed more optimal fine motor, problem-solving, personal-social, and communication development at 1 month corrected age. Conclusions: The results showed no effect on the early physiotherapy intervention. Results might be related to the dose or intensity of the intervention, but also to the poor parental compliance. ClinicalTrials.gov NCT03313427.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Marc Terradas-Monllor
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
- Pain Medicine Section, Anaesthesiology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Catalonia, Spain
- Correspondence:
| | - Laura López Sala
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Maria Engracia Cazorla Sánchez
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Montserrat Fornaguera Marti
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Isabel Muñoz Pérez
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Thais Agut-Quijano
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Martín Iriondo
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Joan Carles Casas-Baroy
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
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15
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Ishikawa K, Azuma N, Ohka M. Intergenerational Transmission of Maternal Adverse Childhood Experiences on Next Generation's Development: A Mini-Review. Front Psychol 2022; 13:852467. [PMID: 35645853 PMCID: PMC9131025 DOI: 10.3389/fpsyg.2022.852467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
(Adverse childhood experiences (ACEs) have extremely harmful impacts on an individual’s physical, social and mental health throughout their life-span. Recently, it has been reported that maternal ACEs increase the risk of developmental delay in the offspring across generations. This mini review focuses on the direct relationship between maternal ACEs and child developmental delay, and potential mediators/moderators that associate their relationship. Six studies were identified using three search engines. The results indicated that four out of six studies reported at least one significant direct association between maternal ACEs and child development. Additionally, maternal biological, psychological, and social factors were identified as mediators or moderators. In summary, we identified that maternal ACEs increased the risk of developmental delay in children via biological and psychosocial pathways. Future research should examine potential buffering factors and identify when it is crucial to break the intergenerational transmission.
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Affiliation(s)
- Keita Ishikawa
- Department of Clinical Psychology, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Natsuko Azuma
- Department of Clinical Psychology, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Mai Ohka
- Department of Clinical Psychology, Graduate School of Education, The University of Tokyo, Tokyo, Japan
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16
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Sun G, Liu Y, Zhang R, Peng C, Geng Y, Zhou F, Hou X, Liu L. Emotional Prosodies Processing and Its Relationship With Neurodevelopment Outcome at 24 Months in Infants of Diabetic Mothers. Front Pediatr 2022; 10:861432. [PMID: 35664869 PMCID: PMC9159506 DOI: 10.3389/fped.2022.861432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Hyperglycemia of pregnancy is a risk not only for later obesity of the offspring but also do harm to their neurodevelopment from fetus. An ERP research has shown that children with autism spectrum disorder (ASD) was characterized by impaired semantic processing. In this study, we used event-related potential (ERP) to assess the procession of different emotional prosodies (happy, fearful, and angry) in neonates of diabetic mothers, compared to the healthy term infants. And to explore whether the ERP measure has potential value for the evaluation of neurodevelopmental outcome in later childhood. A total of 43 full-term neonates were recruited from the neonatology department of Peking University First Hospital from December 1, 2017 to April 30, 2019. They were assigned to infants of diabetic mothers (IDM) group (n = 23) or control group (n = 20) according to their mother's oral glucose tolerance test's (OGTT) result during pregnancy. Using an oddball paradigm, ERP data were recorded while subjects listened to deviation stimulus (20%, happy/fearful/angry prosodies) and standard stimulus (80%, neutral prosody) to evaluate the potential prognostic value of ERP indexes for neurodevelopment at 24 months of age. Results showed that 1) mismatch response (MMR) amplitudes in IDM group were lower than the control; 2) lower MMR amplitude to fearful prosody at frontal lobe was a high risk for increased Modified Checklist for Autism in Toddlers (M-CHAT) scores at 24 months. These findings suggests that hyperglycemia of pregnancy may influence the ability to process emotional prosodies in neonatal brain; it could be reflected by decreased MMR amplitude in response to fearful prosody. Moreover, the decreased MMR amplitude at the frontal lobe may indicated an increased risk of ASD.
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Affiliation(s)
- Guoyu Sun
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yanan Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Rui Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Cheng Peng
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yuehang Geng
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Faliang Zhou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Xinlin Hou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Lili Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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17
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She X, Perera S, Andre M, St. Fleur J, Hilaire J, Evans A, Long J, Wing D, Carpenter C, Wilson K, Palfrey J, Stulac S. Associations Between Parental Depression, Self-efficacy, and Early Childhood Development in Malnourished Haitian Children. Glob Pediatr Health 2022; 9:2333794X221098311. [PMID: 35592789 PMCID: PMC9112296 DOI: 10.1177/2333794x221098311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.
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Affiliation(s)
- Xinshu She
- Stanford U School of Medicine,
Stanford, CA, USA
| | | | | | | | | | - Andrea Evans
- Toronto University School of Medicine,
Toronto, ON, Canada
| | - Jack Long
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | - Delight Wing
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | | | - Kim Wilson
- Harvard U Medical School, Boston, MA,
USA
| | | | - Sara Stulac
- Boston U School of Medicine, Boston,
MA, USA
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18
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Xia Q, Yang Z, Xie Y, Zhu Y, Yang Z, Hei M, Ding Y, Kong W, Kang L, Yang S, Mei Y, Feng Z, Zhang L, Lei Y, Wang P, Dong J, Yang L, Ju J, Chang H, Zhan S, Yu J, Zhang P, Wang R, Guo H, Liu X, Tan H, Liu Y, Zhang Z, Zhen L, Yan J, Liu Z, Yang C, Wang Q, Wang J, Sun L, Zeng H, Li J, Qu W, Wang X, Liu G, Yang X, Liu X, Zhang X, Xu X, Gu Y, Long H, Zhang L, Liu L, Tang Z, Hou X. The Incidence and Characteristics of Perinatal Stroke in Beijing: A Multicenter Study. Front Public Health 2022; 10:783153. [PMID: 35400054 PMCID: PMC8987304 DOI: 10.3389/fpubh.2022.783153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/31/2022] [Indexed: 02/05/2023] Open
Abstract
ObjectiveTo assess the incidence, risk factors, and clinical characteristics of perinatal stroke in Beijing.MethodsThis multicenter prospective study included all the live births from 17 representative maternal delivery hospitals in Beijing from March 1, 2019 to February 29, 2020. Neonates with a stroke were assigned to the study group. Clinical data, including general information, clinical manifestations, and risk factors, were collected. Up until 18 months after birth, neonates were routinely assessed according to the Ages and Stages Questionnaire (ASQ) and/or the Bayley scale. Statistical analysis was done using the chi-squared, t-tests, and logistic regression analysis using SPSS version 26.0.OutcomesIn total, 27 cases were identified and the incidence of perinatal stroke in Beijing was 1/2,660 live births, including 1/5,985 for ischemic stroke and 1/4,788 for hemorrhagic stroke. Seventeen cases (62.96%) of acute symptomatic stroke and convulsions within 72 h (10 cases, 37.04%) were the most common presentations. Ten patients showed no neurological symptoms and were found to have had a stroke through routine cranial ultrasonography after being hospitalized for non-neurological diseases. The risk factors include primiparity, placental or uterine abruption/acute chorioamnionitis, intrauterine distress, asphyxia, and severe infection. In the study group, 11.1% (3/27) of patients had adverse neurodevelopmental outcomes. The patients in the study group had lower scores for the ASQ than those in the control group in the communication, gross, and fine motor dimensions.ConclusionThe incidence of perinatal stroke in Beijing was consistent with that in other countries. Routine neuroimaging of infants with risk factors may enable identification of asymptomatic strokes in more patients. Patients who have suffered from a stroke may have neurological sequelae; therefore, early detection, treatment, and regular follow-ups are beneficial for improving their recovery outcomes.
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Affiliation(s)
- Qianqian Xia
- Pediatric Department, Peking University First Hospital, Beijing, China
| | - Zhao Yang
- Pediatric Department, Peking University First Hospital, Beijing, China
| | - Yao Xie
- Pediatric Department, Peking University First Hospital, Beijing, China
| | - Ying Zhu
- Pediatric Department, Peking University First Hospital, Beijing, China
| | - Zixin Yang
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Mingyan Hei
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yingxue Ding
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Weijing Kong
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Limin Kang
- Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Shengnan Yang
- Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Yabo Mei
- Neonatal Intensive Care Unit of Faculty of Pediatrics, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Zhichun Feng
- Neonatal Intensive Care Unit of Faculty of Pediatrics, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Li Zhang
- Pediatric Department, Haidian Maternal and Child Health Hospital, Beijing, China
| | - Yanzhe Lei
- Pediatric Department, Haidian Maternal and Child Health Hospital, Beijing, China
| | - Ping Wang
- Department of Neonatology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jingyu Dong
- Pediatric Department, Tongzhou Maternal and Child Health Hospital, Beijing, China
| | - Li Yang
- Pediatric Department, Tongzhou Maternal and Child Health Hospital, Beijing, China
| | - Jun Ju
- Pediatric Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hesheng Chang
- Pediatric Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shina Zhan
- Pediatric Department, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Jinqian Yu
- Pediatric Department, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Peng Zhang
- Pediatric Department, Beijing Miyun Maternal and Child Health Hospital, Beijing, China
| | - Ran Wang
- Pediatric Department, Beijing Miyun Maternal and Child Health Hospital, Beijing, China
| | - Hui Guo
- Pediatric Department, Fengtai Maternal and Child Health Hospital, Beijing, China
| | - Xinli Liu
- Pediatric Department, Fengtai Maternal and Child Health Hospital, Beijing, China
| | - Huaqing Tan
- Pediatric Department, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Yakun Liu
- Pediatric Department, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Zhenzong Zhang
- Pediatric Department, The First Hospital of Fangshan, Beijing, China
| | - Lixia Zhen
- Pediatric Department, The First Hospital of Fangshan, Beijing, China
| | - Jinting Yan
- Pediatric Department, Beijing Mentougou Hospital, Beijing, China
| | - Zhan Liu
- Pediatric Department, Beijing Mentougou Hospital, Beijing, China
| | - Chunxia Yang
- Pediatric Department, Changping Women and Children Health Care Hospital, Beijing, China
| | - Qingqing Wang
- Pediatric Department, Changping Women and Children Health Care Hospital, Beijing, China
| | - Jinfeng Wang
- Beijing Pinggu Maternal and Child Health Hospital, Beijing, China
| | - Lifang Sun
- Beijing Pinggu Maternal and Child Health Hospital, Beijing, China
| | - Huihui Zeng
- Pediatric Department, Huairou Maternal and Child Health Care Hospital, Beijing, China
| | - Jing Li
- Pediatric Department, Huairou Maternal and Child Health Care Hospital, Beijing, China
| | - Wenwen Qu
- Department of Pediatrics, Peking University Shougang Hospital and Capital Medical University, Beijing, China
| | - Xuemei Wang
- Department of Pediatrics, Peking University Shougang Hospital and Capital Medical University, Beijing, China
- General Respiratory Department of Beijing Jingdu Children's Hospital, Beijing, China
| | - Guiying Liu
- Department of Pediatrics, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xi Yang
- Department of Pediatrics, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xinxin Liu
- Pediatric Department, Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Xuefeng Zhang
- Pediatric Department, Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Xiaojing Xu
- Pediatric Department, The First Hospital of Tsinghua University, Beijing, China
| | - Yanan Gu
- Pediatric Department, The First Hospital of Tsinghua University, Beijing, China
| | - Hui Long
- Department of Pediatrics, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Li Zhang
- Department of Pediatrics, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Lili Liu
- Pediatric Department, Peking University First Hospital, Beijing, China
- *Correspondence: Lili Liu
| | - Zezhong Tang
- Pediatric Department, Peking University First Hospital, Beijing, China
- Zezhong Tang
| | - Xinlin Hou
- Pediatric Department, Peking University First Hospital, Beijing, China
- Xinlin Hou
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Anunciação L, Squires J, Landeira-Fernandez J, Singh A. An Exploratory Analysis of the Internal Structure of Test Through a Multimethods Exploratory Approach of the ASQ:SE in Brazil. J Neurosci Rural Pract 2022; 13:186-195. [PMID: 35694052 PMCID: PMC9187369 DOI: 10.1055/s-0041-1741503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background
A wide range of exploratory methods is available in psychometrics as means of gathering insight on existing data and on the process of establishing the number and nature of an internal structure factor of a test. Exploratory factor analysis (EFA) and principal component analysis (PCA) remain well-established techniques despite their different theoretical perspectives. Network analysis (NA) has recently gained popularity together with such algorithms as the Next Eigenvalue Sufficiency Test. These analyses link statistics and psychology, but their results tend to vary, leading to an open methodological debate on statistical assumptions of psychometric analyses and the extent to which results that are generated with these analyses align with the theoretical basis that underlies an instrument. The current study uses a previously published data set from the Ages & Stages Questionnaires: Social-Emotional to explore, show, and discuss several exploratory analyses of its internal structure. To a lesser degree, this study furthers the ongoing debate on the interface between theoretical and methodological perspectives in psychometrics.
Methods
From a sample of 22,331 sixty-month-old children, 500 participants were randomly selected. Pearson and polychoric correlation matrices were compared and used as inputs in the psychometric analyses. The number of factors was determined via well-known rules of thumb, including the parallel analysis and the Hull method. Multidimensional solutions were rotated via oblique methods. R and Factor software were used, the codes for which are publicly available at
https://luisfca.shinyapps.io/psychometrics_asq_se/
.
Results
Solutions from one to eight dimensions were suggested. Polychoric correlation overcame Pearson correlation, but nonconvergence issues were detected. The Hull method achieved a unidimensional structure. PCA and EFA achieved similar results. Conversely, six clusters were suggested via NA.
Conclusion
The statistical outcomes for determining the factor structure of an assessment diverged, varying from one to eight domains, which allowed for different interpretations of the results. Methodological implications are further discussed.
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Affiliation(s)
- Luis Anunciação
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jane Squires
- College of Education, University of Oregon, Eugene, Oregon
| | - J. Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ajay Singh
- Academic Council on the United Nations (UN) System, SGT University, Gurugram, Haryana, India
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20
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Tsuchida T, Yoshida S, Takeuchi M, Kawakami C, Kawakami K, Ito S. A prospective cohort study of the association between the Apgar score and developmental status at 3 years of age: the Japan Environment and Children's Study (JECS). Eur J Pediatr 2022; 181:661-669. [PMID: 34515854 DOI: 10.1007/s00431-021-04249-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/28/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
Apgar score (AS) is a well-established tool for assessing viability of newborns, and its association with subsequent child development has been suggested. We aimed to assess whether Apgar scores (ASs) ≥ 7 (generally considered normal) are associated with the developmental status at 3 years of age while adjusting for perinatal and socioeconomic confounders. We extracted the data of ASs at 1 and 5 min among participants of the Japan Environment and Children's Study datasets, which were used in this nationwide cohort study. The outcomes comprised developmental status that was less than each cutoff value for the following five domains of the Ages & Stages Questionnaire (Japanese version, 3rd edition): communication, gross and fine motor, problem-solving, and personal-social domains. For this objective, we conducted multivariable logistic regression analyses on the data of 54,716 children. Compared with ASs ≥ 9 at 5 min, the adjusted odds ratios (aOR) for delayed development in children with ASs ≤ 8 were 1.31 (95% confidence interval, 1.11-1.56), 1.20 (1.04-1.38), and 1.16 (1.01-1.34), respectively, for gross and fine motor, and problem-solving domains. Among neonates with ASs ≤ 8 at 1 min, when those with ASs ≤ 8 at 5 min were compared with those with ASs ≥ 9 at 5 min, the aOR for gross motor domain was 1.34 (1.11-1.61).Conclusion: ASs ≤ 8 compared with those ≥ 9 at 5 min, even considering the change of AS from 1 to 5 min, were associated with increased ORs for developmental delay in 3-year-olds. Even ASs that are considered normal might affect the subsequent development. What is Known: • Apgar score is a general tool for evaluating the vitality of newborns. It is also basically measured at 1 minute and 5 minutes after birth and the scores of ≥7 are considered normal. • The Apgar scores at each minute affect clinical findings of neonates after birth and the subsequent long-term development. What is New: • Neonates with Apgar scores of ≤8 at 5 minutes compared with those of ≥9, including the change in Apgar score from 1 minute to 5 minutes, are associated with increased odds ratios for developmental status at 3 years of age adjusting for perinatal and socioeconomic confounders.
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Affiliation(s)
- Tetsuya Tsuchida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Chihiro Kawakami
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,National Institute for Environmental Studies, Tsukuba, Japan
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21
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Wang P, Yang Z, Shan M, Lu S, Zhang L, Li S, Hu S, Tian H, Xu Y, Wu D. Maternal and Fetal Outcomes of Acute Leukemia in Pregnancy: A Retrospective Study of 52 Patients. Front Oncol 2022; 11:803994. [PMID: 34970499 PMCID: PMC8712699 DOI: 10.3389/fonc.2021.803994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/26/2021] [Indexed: 12/02/2022] Open
Abstract
Acute leukemia during pregnancy (P-AL) is a rare disease with limited data regarding the management and outcomes of mothers and fetuses. We retrospectively analyzed the characteristics, pregnancy outcomes and maternal and neonatal prognoses of 52 patients with P-AL collected from January 2013 to December 2020 in our center. Seventeen (32.7%) patients received chemotherapy during pregnancy (exposed cohort), while 35 (67.3%) received chemotherapy after abortion/delivery (nonexposed cohort). Twenty-six (50.0%) pregnancies ended with abortion, and 26 (50.0%) babies were born through spontaneous delivery or cesarean section. Seven infants (26.9%) were born in the exposed cohort, while 19 infants (73.1%) were born in the nonexposed cohort. Fetuses in the exposed cohort had lower gestational ages (P=0.030) and birth weights (P=0.049). Considering the safety of the fetus, seven patients in the exposed cohort received low-dose chemotherapy, one patient received all-trans retinoic acid (ATRA) and one patient only received corticosteroids as induction therapy. Patients received low-dose chemotherapy as induction therapy had a lower complete remission (CR) rate (P=0.041), and more patients in this group received HSCT (P=0.010) than patients received intensive chemotherapy. Patients who delayed chemotherapy in the nonexposed cohort experienced a trend toward a higher mortality rate than patients who received timely chemotherapy (P=0.191). The CR (P = 0.488), OS (P=0.655), and DFS (P=0.453) were similar between the exposed and nonexposed cohorts. Overall, the 4-year overall survival (OS) and disease-free survival (DFS) rates were estimated at 49.1% and 57.8%, respectively. All newborns were living, without deformities, or developmental and intellectual disabilities. Our study indicated that P-AL patients in the first trimester might tend to receive chemotherapy after abortion. Both the status of disease and patients’ willingness should be taken into consideration when clinicians were planning treatment strategies in the second or third trimester. Low-dose or delayed chemotherapy might decrease the efficacy of induction therapy and survival rate of patients, but HSCT could improve the prognosis.
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Affiliation(s)
- Peng Wang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhen Yang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Shan
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shenqi Lu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Luwei Zhang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shijia Li
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuhong Hu
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Hong Tian
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Xu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Depei Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
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22
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Alolama FM, Mohammad HM, Alhmid IH, Alhammadi HM. Designing and validating the Dubai Tool for Developmental Screening (DTDS). Front Pediatr 2022; 10:924017. [PMID: 36071880 PMCID: PMC9441853 DOI: 10.3389/fped.2022.924017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early detection of developmental problems is vital for facilitating early access to targeted intervention and augmenting its beneficial outcomes. Standardized developmental screening tools are known to enhance detection rates of developmental problems compared to clinical judgment alone and are widely recommended to be used in infants and young children. Most of the available developmental screening tools have been developed in Western countries. Many of their items may not be suitable for other cultures while others are expensive. Currently, none of the developmental screening tools have been validated in the United Arab Emirates (UAE), with only a few available in the Arabic language. OBJECTIVE To create and validate a developmental screening tool, in both English and Arabic, that is simple, quick to use, and culturally relevant to the United Arab Emirates (UAE) child population aged 9-48 months. METHODS The available literature was used to create a list of developmental milestones in five domains for children aged 9-48 months, divided into seven age groups. The selected milestones were used to create questionnaires in both English and Arabic, which were pilot tested twice. Each time, the results were analyzed and used to select, modify, and rephrase questions. Validation of the Dubai Tool for Developmental Screening (DTDS) was done against Parents' Evaluation of Developmental Status (PEDS) as a gold standard instrument. The DTDS and PEDS were administered cross-sectionally to parents of 1,400 children in seven age groups. Sensitivity, specificity, and kappa agreement of the DTDS compared with PEDS were calculated. RESULTS The DTDS had a sensitivity of 100% in four age groups and 75-78% in the other three age groups. Specificity ranged from 96 to 99% across all age groups. The kappa measure showed substantial agreement in five age groups, a moderate agreement in one age group, and a fair agreement in one age group. CONCLUSIONS The DTDS is a valid screening tool for early identification of developmental delays and disabilities in early childhood.
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Affiliation(s)
- Fatma Mohammad Alolama
- Child Health Section, Specialized Programs Services Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | - Haitham Mahmoud Mohammad
- Child Health Section, Specialized Programs Services Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | - Idris Helal Alhmid
- Child Health Section, Specialized Programs Services Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | - Hanan Mohammed Alhammadi
- Medical Affairs Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
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23
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Viet TH, Nanthamongkolchai S, Munsawaengsub C, Pitikultang S. Positive Parenting Program to Promote Child Development Among Children 1 to 3 Years Old: A Quasi-Experimental Research. J Prim Care Community Health 2022; 13:21501319221089763. [PMID: 35575427 PMCID: PMC9121470 DOI: 10.1177/21501319221089763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: Child development receives lack of concern and the role of parents in
promoting child development is not frequently mentioned in Vietnam. This
study aimed to examine the effectiveness of Positive Parenting Program to
Promote Child Development on maternal knowledge and practice and development
of children aged 1 to 3 years. Methods: This is a quasi-experimental study conducted in Nha Trang city, Vietnam.
There are a total of 60 mothers whose children were identified as suspected
developmental delayed participated in the study. There were 30 mothers who
attended the program as experimental group and 30 mothers who joined the
study as comparison group. Ages and Stages Questionnaires, Third Edition
(ASQ-3) were applied to assess the child development. Descriptive analysis
and paired and independent-samples t-test were applied to
examine the research objectives. Results: The findings suggested that after the program implementation, the maternal
knowledge of child development and child development of the experimental
group were significantly higher than pre-program and the improvements of
these variables were better than the comparison group
(P < .05) while the maternal practice to promote child
development was significantly better only within the experimental group. Conclusions: The program was effective in improving several maternal outcomes and child
development. The study recommends applying the Positive Parenting Program to
Promote Child Development to enhance mother’s knowledge of child development
and child development.
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Affiliation(s)
- Truong Hoang Viet
- Department of Epidemiology and Community Health, School of Medicine, Vietnam National University HCMC, Binh Duong, Vietnam
| | | | - Chokchai Munsawaengsub
- Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Supachai Pitikultang
- Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
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24
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Sprowles JL, Dzwilewski KL, Merced-Nieves FM, Musaad SM, Schantz SL, Geiger SD. Associations of prenatal phthalate exposure with neurobehavioral outcomes in 4.5- and 7.5-month-old infants. Neurotoxicol Teratol 2022; 92:107102. [PMID: 35588931 PMCID: PMC9271634 DOI: 10.1016/j.ntt.2022.107102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
Phthalates are ubiquitous endocrine-disrupting chemicals, and research indicates that prenatal exposure to some phthalates may affect neurodevelopment. In a prospective birth cohort study, five first-morning urine samples collected across pregnancy were pooled and the following phthalate biomarkers assessed: sum of di-(2-ethylhexyl) phthalate metabolites (ΣDEHP), sum of diisononyl phthalate metabolites (ΣDINP), sum of dibutyl phthalate metabolites (ΣDBP), sum of anti-androgenic metabolites (ΣAA), monoethyl phthalate (MEP), and sum of all phthalate metabolites (ΣAll). The Ages & Stages Questionnaires® (ASQ), a standardized parent-reported, age-adapted screening tool, measured communication, personal-social, problem solving, and motor domains in infants at 4.5 and 7.5 months (n = 123). Adjusting for maternal age, annual household income, gestational age at birth, infant age at assessment, and sex, repeated-measures generalized linear regression models were used to examine associations between prenatal phthalate urine biomarker concentrations and domain scores (assuming a Poisson distribution). Beta estimates were exponentiated back to the domain scale for ease of interpretation. Mothers were mostly white and college-educated, and most reported an annual household income of ≥$60,000. Associations of phthalate concentrations with ASQ outcomes are presented as follows: (1) anti-androgenic phthalate metabolites (ΣDEHP, ΣDINP, ΣDBP, and ΣAA), (2) MEP, which is not anti-androgenic, and (3) ΣAll. Overall, anti-androgenic phthalates were associated with higher (i.e., better) scores. However, there were exceptions, including the finding that a one-unit increase in ΣDBP was associated with a 12% increase in problem solving scores in 4.5-month-old females (β = 1.12; 95% CI: 0.99, 1.28; p = 0.067) but a 85% decrease for 7.5-month-old females (β = 0.54; 95% CI: 0.3, 0.99; p = 0.047). In contrast, MEP was associated with poorer scores on several outcomes. Sex- and timepoint-specific estimates demonstrated a one-unit increase in MEP was associated with: a 52% decrease in personal-social scores in 7.5-month-old males (β = 0.66; 95% CI: 0.46, 0.95; p = 0.02), a 39% decrease in fine motor scores in 7.5-month-old males (β = 0.72; 95% CI: 0.52, 0.98; p = 0.035), and a 6% decrease in fine motor scores in 4.5-month-old females (β = 0.94; 95% CI: 0.88, 0.99; p = 0.03). A one-unit increase in ΣAll was associated with a 4% increase in personal-social scores in 4.5-month-old males (β = 1.04; 95% CI: 0.99, 1.1; p = 0.08) but a 17% decrease in 7.5-month-old males (β = 0.85; 95% CI: 0.73, 0.99; p = 0.03). These data suggest age- and sex-specific associations of prenatal phthalates with infant neurobehavior. The current findings should be confirmed by longitudinal studies with larger sample sizes.
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Affiliation(s)
- Jenna L.N. Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA.,Corresponding author at: Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA. (J. L. N. Sprowles)
| | - Kelsey L.C. Dzwilewski
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA
| | - Francheska M. Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Salma M.A. Musaad
- United States Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave., Houston, TX 77030, USA
| | - Susan L. Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA
| | - Sarah D. Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA.,Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Khan Annex Room 2013, 1206 S. Fourth St., Champaign, IL 61820, USA
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25
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Oliva-Arnanz A, Romay-Barrero H, Romero-Galisteo RP, Pinero-Pinto E, Lirio-Romero C, Palomo-Carrión R. Families' Perceptions of the Motor Development and Quality of Life of Their Children Aged 0-3 Years during Home Confinement Due to the COVID-19 Pandemic. A Descriptive Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1149. [PMID: 34943345 PMCID: PMC8700086 DOI: 10.3390/children8121149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022]
Abstract
The child's interaction with the natural environment allows different learning opportunities and favors their motor development, which may be affected after a period of environmental deprivation, a consequence of home confinement due to the COVID-19 pandemic. The main objective of the study was to analyze the different areas of motor development, as well as the quality of life of children aged 0 to 3 years old after home confinement by COVID-19 and the possible correlation between both variables, and the influence of parental stimulation on motor development during this time of exclusive interaction with the immediate environment (home and family). A descriptive study was performed. A simple and anonymous questionnaire was created for parents of children between 0 and 3 years old who lived in Spain during the period of home confinement due to COVID-19 (March to June 2020). The measurement instrument used was a questionnaire made in "Google Forms", where the variables were collected: Motor development (measured through the Ages & Stages Questionnaire, ASQ3), Quality of life (assessed with the Pediatric Quality of Life Inventory, PedsQL) and other variables, such as stimulation, performed during home confinement. Eighty-eight questionnaires were validated. The highest score in the motor development domains were obtained in children 2-3 years old. The motor domain of children aged 2-3 years old that obtained the highest score was communication (M = 54.69 ± 10.03) and the highest score in the quality of life was obtained in children aged 0-1 years old (M = 85.47 ± 12.39), also acquiring the lowest score in the emotional domain in all age groups (0-1, 1-2 and 2-3 years old). The assessment of motor development and quality of life after home confinement due to the COVID-19 pandemic did not determine low values, so it would not have been affected during this period of lack of interaction with the natural environment. Emphasizing that the emotional aspect within quality of life was the lowest score, this indicates that children from 0 to 3 years old need more emotional support in situations of variability of daily routines and of family stress.
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Affiliation(s)
- Alicia Oliva-Arnanz
- Department of Physiotherapy in Hospital Gregorio Marañón, 28007 Madrid, Spain;
| | - Helena Romay-Barrero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (C.L.-R.); (R.P.-C.)
- Pediatric-Unit, Hemi-Child-Research (GIFTO), UCLM, 45071 Toledo, Spain
| | | | - Elena Pinero-Pinto
- Department of Physical Therapy, Faculty of Nursery, Physiotherapy and Podiatry, University of Seville, 41004 Seville, Spain;
| | - Cristina Lirio-Romero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (C.L.-R.); (R.P.-C.)
- Pediatric-Unit, Hemi-Child-Research (GIFTO), UCLM, 45071 Toledo, Spain
| | - Rocío Palomo-Carrión
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain; (C.L.-R.); (R.P.-C.)
- Pediatric-Unit, Hemi-Child-Research (GIFTO), UCLM, 45071 Toledo, Spain
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de Ceano-Vivas M, García ML, Velázquez A, Martín del Valle F, Menasalvas A, Cilla A, Epalza C, Romero MP, Cabrerizo M, Calvo C. Neurodevelopmental Outcomes of Infants Younger Than 90 Days Old Following Enterovirus and Parechovirus Infections of the Central Nervous System. Front Pediatr 2021; 9:719119. [PMID: 34650940 PMCID: PMC8505960 DOI: 10.3389/fped.2021.719119] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/30/2021] [Indexed: 11/24/2022] Open
Abstract
Enteroviruses (EVs) and human parechoviruses (HPeVs) are a major cause of central nervous system (CNS) infection in young infants. They have been implicated in neurodevelopmental delay, however limited data are available. The aim of this study is to describe the clinical outcome of young infants and to assess and compare the medium-term neurodevelopment following CNS infections caused by EV and HPeV. A multicentre observational ambispective study was conducted between May 2013 and March 2018. Children under 3 months of age with EV or HPeV CNS infection excluding encephalitis were included. Infants were contacted 1 year after the acute infection and their neurological development was evaluated using the Ages and Stages Questionnaire-3 (ASQ-3). If any area assessed was abnormal during the first round of tests, a second round was completed 6 to 12 months later. Forty-eight young infants with EV and HPeV CNS infection were identified: 33 (68.8%) were positive for EV and 15 (31.3%) for HPeV. At first assessment 14 out of 29 EV (48.3%) and 3 out of 15 HPeV (20%) positive cases presented some developmental concern in the ASQ-3 test. EV-positive infants showed mild and moderate alteration in all domains analyzed and HPeV-positive infants showed mild alterations only in gross and fine motor domains. Significant alterations in communication were observed in EV-positive but not in HPeV-positive infants (31 vs. 0%, p = 0.016). At second assessment 4 out of 13 EV-positive patients (30.8%) showed mild to moderate concerns in communication and gross motor function domains and 3 out of 13 (23.1%) showed significant concern in fine motor function. Although CNS infections without associated encephalitis are generally assumed to be benign our study shows that at a median age of 18 months almost half of the EV-infected infants (48.3%) and 20% of HPeV-positive infants presented some developmental concern in the ASQ-3 test. We recommend monitor the neurological development of infants during the first years of life after HPeV CNS infection and especially after EV CNS infection, even in mild cases, for an early intervention and stimulation of psychomotor development if necessary.
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Affiliation(s)
| | - M. Luz García
- Department of Pediatrics, Severo Ochoa University Hospital, Madrid, Spain
| | - Ana Velázquez
- Department of Pediatrics, La Paz University Hospital, Madrid, Spain
| | | | - Ana Menasalvas
- Department of Pediatrics, Virgen de la Arixaca University Hospital, Murcia, Spain
| | - Amaia Cilla
- Department of Pediatrics, Burgos University Hospital, Burgos, Spain
| | - Cristina Epalza
- Department of Pediatrics, 12 de Octubre University Hospital, Madrid, Spain
| | - M. Pilar Romero
- Department of Microbiology, La Paz University Hospital, Madrid, Spain
| | - María Cabrerizo
- National Centre for Microbiology, Instituto de Salud Carlos III, CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Cristina Calvo
- Department of Pediatric Infectious Diseases, La Paz University Hospital and La Paz Research Institute (IdiPaz), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (Red de Investigación Traslacional en Infectología Pediátrica), Madrid, Spain
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Shin SH, Kim EK, Kim SH, Kim HY, Kim HS. Head Growth and Neurodevelopment of Preterm Infants with Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation. CHILDREN-BASEL 2021; 8:children8100833. [PMID: 34682098 PMCID: PMC8534747 DOI: 10.3390/children8100833] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/21/2022]
Abstract
Spontaneous intestinal perforation (SIP) and surgical necrotizing enterocolitis (NEC) are intestinal conditions requiring surgical intervention in preterm infants. We aimed to compare the head growth and neurodevelopment of preterm infants with SIP and surgical NEC. A retrospective single-center study was performed in preterm infants born at less than 32 weeks of gestation and who had undergone surgery for NEC or SIP. Data from the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) at 24 months of corrected age (CA) and the Korean Ages and Stages Questionnaire (K-ASQ) or Korean Developmental Screening Test (K-DST) at 36 months were collected. Among 82 eligible infants, 60 infants had surgical NEC, and 22 infants were diagnosed with SIP. Head growth was faster until CA 4 months in preterm infants with SIP than in those with surgical NEC. At 36 months, abnormal findings in the K-ASQ or K-DST were more prevalent in the NEC group than in the SIP group in the gross motor (48.2% vs. 0%, p = 0.015), fine motor (40.7% vs. 0%, p = 0.037), cognitive (55.6% vs. 12.5%, p = 0.047), and social domains (44.4% vs. 0%, p = 0.032). More studies evaluating the neurodevelopmental outcomes of preterm infants with surgical NEC and SIP are required.
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Affiliation(s)
- Seung-Han Shin
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.-H.S.); (S.-H.K.); (H.-S.K.)
| | - Ee-Kyung Kim
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.-H.S.); (S.-H.K.); (H.-S.K.)
- Correspondence: ; Tel.: +82-2-2072-3628; Fax: +82-2-2072-0590
| | - Seh-Hyun Kim
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.-H.S.); (S.-H.K.); (H.-S.K.)
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul 03080, Korea;
| | - Han-Suk Kim
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.-H.S.); (S.-H.K.); (H.-S.K.)
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Husain N, Kiran T, Fatima B, Chaudhry IB, Husain M, Shah S, Bassett P, Cohen N, Jafri F, Naeem S, Zadeh Z, Roberts C, Rahman A, Naeem F, Husain MI, Chaudhry N. An integrated parenting intervention for maternal depression and child development in a low-resource setting: Cluster randomized controlled trial. Depress Anxiety 2021; 38:925-939. [PMID: 34010505 DOI: 10.1002/da.23169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Rates of depression among Pakistani mothers are high, leading to poor developmental outcomes in their children. This study tested the effectiveness of a manualized integrated parenting program; Learning through Play Plus (LTP+) for maternal depression in Karachi, Pakistan. METHODS A cluster randomized control trial conducted from January 2014 to December 2015 across 120 villages in Karachi. A total of 774 depressed mothers aged 18-44 years with children aged 0-30 months old, were included. Villages were randomized to receive LTP+ added to treatment as usual (TAU) or TAU alone. Primary outcomes were severity of maternal depression at 3 and 6 months measured by the Edinburgh Postnatal Depression Scale and child socio-emotional development at 6 months measured by the Ages and Stages Questionnaire (ASQ). Secondary outcomes included maternal anxiety, quality of life, social support, parenting competence, and knowledge about child development. RESULTS Mothers in the LTP+ group reported significantly lower depression scores compared to those in the TAU group (6.6 vs. 13.8, effect size [ES]: -7.2; 95% confidence interval [CI]: -8.2, -6.1) at 3 and 6 months (7.2 vs. 12.00; ES: -4.6; 95% CI: -5.9, -3.4). Child socio-emotional development at 6 months was significantly better in the LTP+ group on all domains of the ASQ. There were also statistically significant improvements on all secondary outcomes at 3- and 6-month follow-up. CONCLUSION In low-resource settings like Pakistan, low-cost integrated parenting interventions delivered by lay health workers can provide effective treatment for depressed mothers, leading to improvements in child development.
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Affiliation(s)
| | - Tayyeba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | - Imran B Chaudhry
- University of Manchester, Manchester, UK.,Department of Psychiatry, Ziauddin University, Karachi, Pakistan
| | - Mina Husain
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sadia Shah
- University of Manchester, Manchester, UK.,Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | - Nancy Cohen
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Farhat Jafri
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Shehla Naeem
- Dow University of Health Sciences, Karachi, Pakistan
| | - Zainab Zadeh
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | | | - Farooq Naeem
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Center for Addiction and Mental Health, Toronto, Canada
| | - Muhammad Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Center for Addiction and Mental Health, Toronto, Canada
| | - Nasim Chaudhry
- Pakistan Institute of Living and Learning, Karachi, Pakistan
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The Association between the Five-Minute Apgar Score and Neurodevelopmental Outcomes among Children Aged 8-66 Months in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126450. [PMID: 34203599 PMCID: PMC8296269 DOI: 10.3390/ijerph18126450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 12/05/2022]
Abstract
This study aimed to evaluate the association of the five-minute Apgar score and neurodevelopmental outcomes in children by taking the entire range of Apgar scores into account. Data from the Australian Longitudinal Study of Women’s Health (ALSWH) and Mothers and their Children’s Health (MatCH) study were linked with Australian state-based Perinatal Data Collections (PDCs) for 809 children aged 8−66 months old. Generalized estimating equations were used to model the association between the five-minute Apgar scores and neurodevelopmental outcomes, using STATA software V.15. Of the 809 children, 614 (75.3%) had a five-minute Apgar score of 9, and 130 (16.1%) had an Apgar score of 10. Approximately 1.9% and 6.2% had Apgar scores of 0−6 and 7−8, respectively. Sixty-nine (8.5%) of children had a neurodevelopmental delay. Children with an Apgar score of 0−6 (AOR = 5.7; 95% CI: 1.2, 27.8) and 7−8 (AOR = 4.1; 95% CI: 1.2, 14.1) had greater odds of gross-motor neurodevelopment delay compared to children with an Apgar score of 10. Further, when continuously modelled, the five-minute Apgar score was inversely associated with neurodevelopmental delay (AOR = 0.75; 95% CI: 0.60, 0.93). Five-minute Apgar score was independently and inversely associated with a neurodevelopmental delay, and the risks were higher even within an Apgar score of 7−8. Hence, the Apgar score may need to be taken into account when evaluating neurodevelopmental outcomes in children.
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30
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Sheeran L, Zhao L, Buchanan K, Xenos S. Enablers and Barriers to Identifying Children at Risk of Developmental Delay: A Pilot Study of Australian Maternal and Child Health Services. Matern Child Health J 2020; 25:967-979. [PMID: 33258043 DOI: 10.1007/s10995-020-03077-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Twenty per cent of Australian children enter primary school with at least one area of developmental vulnerability (Commonwealth of Australia. (2018). Australian early development census [AEDC]. Retrieved from https://www.aedc.gov.au/.). This statistic is in the context of Maternal and Child Health (MCH) services offering regular developmental screening up to 8 times between 2 weeks and 3.5 years of age. OBJECTIVES This study investigated: (1) enablers and barriers influencing MCH nurses in identifying children from birth to school age at risk of developmental delay. This focused on their experience, knowledge, attitudes and skills regarding the use of developmental screening tools. And (2) strategies to support MCH nurses and parents to identify children at risk of delay. METHOD This mixed-methods study combined an online questionnaire and three focus groups and participants were MCH Nurses (N = 19) from one Australian municipality. RESULTS MCH nurses surveyed (N = 19) reported more confidence in screening older children compared to children younger than 12 months. 15 of 19 nurses did not have accurate knowledge and skill in using PEDS and Brigance screens. In the focus group interviews (N = 16), time restraints, language used in developmental screening tools, and excessive waiting time for referral were raised as key barriers to identifying children at risk. LIMITATIONS While the study provides rich insight, caution needs to be exercised when making generalisations from the findings given the small number of participants from one municipality. CONCLUSION Recommendations for practice, service management, and further research are provided to improve the process of early detection.
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Affiliation(s)
- Leanne Sheeran
- Discipline of Nursing, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Lin Zhao
- Discipline of Nursing, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
| | - Kerrie Buchanan
- Discipline of Nursing, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Sophia Xenos
- Discipline of Psychology, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
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The Effect of Parenting Quality on Child Development at 36-48 Months in China's Urban Area: Evidence from a Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238962. [PMID: 33276498 PMCID: PMC7731234 DOI: 10.3390/ijerph17238962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 01/18/2023]
Abstract
Environmental exposures, especially parenting quality, are critical for later child development. This study aimed to determine the status of parenting quality and suspected development delay of preschool children in China's urban area and explore the associations between these two factors. The research was based on a birth cohort study conducted in Changsha, Hunan province, China. We used the Parenting Assessment Tool and Ages and Stages Questionnaires, Third Edition (ASQ-3), to measure parenting quality and child development status, respectively. Other data were collected from maternal health manuals and self-administered questionnaires during the follow-up period. The generalized estimating equation was used to examine whether parenting quality was significantly associated with child development outcomes. In the study, good parenting quality was 33.6% measured at 18 months, and suspected development delay was below 10% at 36-48 months among urban China; we observed negative associations between parenting quality scores and child development scores; poor parenting quality had a negative association with suspected development delay [OR and 95% CI: 2.74 (1.17, 6.40)], girls [OR and 95% CI: 0.33 (0.16, 0.69)] and maternal education years (>12 years) [OR and 95% CI: 0.27 (0.12, 0.64)] were protective factors for suspected development delay. Our findings highlighted the importance of good parenting quality among children in urban areas of China through a birth cohort study and may be used to reduce the children at high risk of developmental delay as a future intervention program.
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El Shafie AM, Omar ZAL, Bashir MM, Mahmoud SF, Basma EM, Hussein AE, Mostafa AM, Bahbah WA. Development and validation of Egyptian developmental screening chart for children from birth up to 30 months. PeerJ 2020; 8:e10301. [PMID: 33240634 PMCID: PMC7666562 DOI: 10.7717/peerj.10301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/14/2020] [Indexed: 11/20/2022] Open
Abstract
Background Detecting developmental delay in children is an ongoing world commitment, especially for those below three years. To accurately assess the development of children; a culturally appropriate screening tool must be used. Egypt lacks such tool and multiple studies have shown that western tools are not suitable in other cultures. Objectives To develop and validate an easy, rapid, culturally appropriate and applicable screening chart for early detection of developmental delay among Egyptian children from birth up to 30 months and develop a Z-score chart for motor and mental development follow up based on our Egyptian screening chart. Methods A cross sectional randomized study was carried out on 1503 Egyptian children of both genders aged from birth up to 30 months assumed to have normal development according to the inclusion and exclusion criteria. They were selected from vaccination centers and well-baby clinics. Developmental milestones from Baroda development screening test (BDST) were applied on them after items were translated and adapted to Egyptian culture. Egyptian children developmental milestones scores were analyzed and carefully prepared in tables and charts. A 97% pass level of developmental achievements represents the threshold below which children are considered delayed. A Z-score chart for motor and mental development follow up was designed by calculating each age group achievement. The developed Egyptian developmental screening chart (EDSC) was validated against Ages and Stages Questionnaires (ASQ-3) as a reference standard in another different sample of 337 children in different age groups. Results The developed EDSC is represented in a chart format with two curves 50% and 97% pass level. Children considered delayed when the score below 97% pass level. Results revealed a statistically significant difference between EDSC and BDST at 50% and 97% pass levels. A Z-score chart for motor and mental development follow up was designed by calculating each age group achievement. EDSC sensitivity and specificity were calculated 84.38 (95% CI [67.21%–94.72%]) and 98.36 (95% CI [96.22%–99.47%]) respectively with an overall test accuracy 97.03 (95% CI [94.61%–98.57%]) (p ≤ .001). Agreement between EDSC and ASQ-3 was high (kappa score was 0.827) with negative and positive agreement 98.36 and 84.38, respectively. Conclusions Extensive revision of the BDST was needed in order to create and validate a more culturally appropriate Egyptian screening chart. This is the first study to create and validate an Egyptian-specific screening tool, to be rapid and easy to use in Egypt for early detection of developmental delay and enabling early intervention practices. A Z-score curve is reliable for follow up motor and mental development by calculating each age group achievement.
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Affiliation(s)
- Ali M El Shafie
- Department of Pediatrics, Menoufia Faculty of Medicine, Menoufia University, Shebin el-Kom, Menoufia, Egypt
| | - Zein A L Omar
- Department of Pediatrics, Menoufia Faculty of Medicine, Menoufia University, Shebin el-Kom, Menoufia, Egypt
| | | | | | - Elsayedamr M Basma
- Department of Bioinformatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | | | - Wael A Bahbah
- Department of Pediatrics, Menoufia Faculty of Medicine, Menoufia University, Shebin el-Kom, Menoufia, Egypt
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Faruk T, King C, Muhit M, Islam MK, Jahan I, Baset KU, Badawi N, Khandaker G. Screening tools for early identification of children with developmental delay in low- and middle-income countries: a systematic review. BMJ Open 2020; 10:e038182. [PMID: 33234622 PMCID: PMC7684835 DOI: 10.1136/bmjopen-2020-038182] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 10/19/2020] [Accepted: 10/30/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To systematically review, identify and report the screening tools used for early identification of developmental delay in low- and middle-income countries. DESIGN Systematic review. DATA SOURCES Four bibliographic databases: Medline (1946 to 13 July 2020), Embase (1974 to 13 July 2020), Scopus (1823 to 11 July 2020) and PsycINFO (1987 to July week 1 2020). ELIGIBILITY CRITERIA Peer-reviewed original articles published in English addressing validated culturally sensitive developmental screening tools among children aged <5 years were included in this review. DATA EXTRACTION AND SYNTHESIS One author (CK, medical librarian) developed the search strategy. Three authors conducted the database search (phase I: CK; phase II: IJ and MKI). Three authors (TF, IJ and MKI) independently screened the title and abstracts. TF, MKI and GK independently performed the full-text review of the screened articles. During each step of the study selection process, disagreements were resolved through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the systematic review. Data extraction and analysis were performed using MS Excel. Meta-analysis was not possible due to heterogeneity of the study findings. RESULTS We identified 3349 articles, of which 18 studies from 10 countries, reporting 16 screening tools, were selected for qualitative synthesis. Six cultural contexts were explored. Twelve general, two motor and two speech-language tools were identified. Seven of them found to be parent-completed ones. Five screening tools (American Speech-Language and Hearing Association, Guide for Monitoring Child Development, Infant Neurological International Battery, New Delhi-Development Screening Questionnaire and Woodside Screening Technique) reported relatively higher sensitivity (82.5%-100%) and specificity (83%-98.93%). CONCLUSIONS Limited number of culturally sensitive developmental screening tools were validated for children aged <5 years in low- and middle-income countries. Revising existing screening tools in different ethnic and cultural settings and subsequent validation with normative value should be a research priority.
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Affiliation(s)
- Tasnuva Faruk
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
| | - Catherine King
- The Children's Hospital at Westmead Clinical School, The Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mohammad Muhit
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
| | - Md Kafiul Islam
- Department of Electrical and Electronic Engineering, Independent University Bangladesh, Dhaka, Bangladesh
| | - Israt Jahan
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Kamran Ul Baset
- Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
- Road Safety and Driving School, BRAC, Dhaka, Bangladesh
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Gulam Khandaker
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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Madlala HP, Myer L, Malaba TR, Newell ML. Neurodevelopment of HIV-exposed uninfected children in Cape Town, South Africa. PLoS One 2020; 15:e0242244. [PMID: 33206724 PMCID: PMC7673492 DOI: 10.1371/journal.pone.0242244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Evidence shows that antiretroviral (ART) exposure is associated with neurodevelopmental delays in human immunodeficiency virus (HIV)-exposed uninfected (HEU) children. However, there are few insights into modifiable maternal and child factors that may play a role in improving neurodevelopment in HEU children. We used a parent-centric neurodevelopment tool, Ages & Stages Questionnaire (ASQ) to examined neurodevelopment in HEU children at 12-24 months of age, and associations with maternal and child factors. METHODS 505 HIV-infected women (initiated ART pre- or during pregnancy) with live singleton births attending primary health care were enrolled; 355 of their HEU children were assessed for neurodevelopment (gross motor, fine motor, communication, problem solving and personal-social domains) at 12-24 months using age-specific ASQ administered by a trained fieldworker. Associations with maternal and child factors were examined using logistic regression models. RESULTS Among mothers (median age 30 years, IQR, 26-34), 52% initiated ART during pregnancy; the median CD4 count was 436 cells/μl (IQR, 305-604). Most delayed neurodevelopment in HEU children was in gross (9%) and fine motor (5%) functions. In adjusted models, maternal socio-economic status (aOR 0.42, 95% CI 0.24-0.76) was associated with reduced odds of delayed gross-fine motor neurodevelopment. Maternal age ≥35 years (aOR 0.22, 95% CI 0.05-0.89) and maternal body mass index (BMI) <18.5 (aOR 6.76, 95% CI 1.06-43.13) were associated with delayed communication-problem-solving-personal-social neurodevelopment. There were no differences in odds for either domain by maternal ART initiation timing. CONCLUSIONS Delayed neurodevelopment was detected in both gross and fine motor functions in this cohort of HEU children, with strong maternal predictors that may be explored as potentially modifiable factors associated with neurodevelopment at one to two years of age.
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Affiliation(s)
- Hlengiwe P. Madlala
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Thokozile R. Malaba
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Marie-Louise Newell
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Shrestha M, Schwinger C, Hysing M, Chandyo RK, Ulak M, Ranjitkar S, Kvestad I, Sharma S, Shrestha L, Strand TA. Agreement Between Mothers and Fieldworkers While Assessing Child Development Using Ages and Stages Questionnaires, Third Edition in Nepal. Front Psychol 2020; 11:579412. [PMID: 33281678 PMCID: PMC7688742 DOI: 10.3389/fpsyg.2020.579412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/19/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The Ages and Stages Questionnaires, Third Edition (ASQ-3) is becoming a widely used developmental assessment tool. The ASQ-3 can be completed by the caregivers (referred to as “mail out”), or by trained personnel under direct observation of the children (referred to as “home procedure”). Aim: The study was carried out to compare results obtained by the ASQ mail out with those of the ASQ home procedure in a community setting of Bhaktapur, Nepal. Methods: Trained fieldworkers (FWs) performed developmental assessment of 134 children aged 9 months in their homes using the ASQ home procedure. A few days before these assessments, mothers were asked to fill in the same ASQ-3 questionnaire. The concordance correlation coefficient (CCC) was calculated to measure their agreement. Result: The agreement between the ASQ mail out and home procedure was fair for the total score (CCC = 0.54). For the sub-scales, the agreement was good for the gross motor (CCC = 0.65), for the remaining subscales agreement was poor (CCC < 0.4). Conclusion: In resource limited setting like Nepal, the ASQ mail out represents an easy method to assess child development by caretakers at home; however, with the poor agreement between different methods of assessments, we cannot conclude that a single method is superior or most optimal and this question should be investigated further. When either of the method home procedure or mail out is opted, the results should be interpreted with cautions.
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Affiliation(s)
| | - Catherine Schwinger
- Centre for International Health Centre for Intervention Science in Maternal and Child Health, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | | | - Manjeswori Ulak
- Department of Global Public Health and Primary Care Centre for Intervention Science in Maternal and Child Health, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Bergen, Norway
| | - Shakun Sharma
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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Yang R, Zhang Y, Wang H, Xu X. Effects of in-hospital breast feeding on brain function development in preterm infants in China: study protocol for a prospective longitudinal cohort study. BMJ Open 2020; 10:e038879. [PMID: 33040015 PMCID: PMC7549488 DOI: 10.1136/bmjopen-2020-038879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 09/06/2020] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Due to immature brain development, preterm infants are more likely to develop neurological developmental defects compared with full-term infants. Most preterm infants without neurodevelopmental damage can eventually reach the same scholastic level as their same-age peers; however, some show persistent impairment. Breast feeding (BF), which is an important public health measure, is of great significance for preterm infants. Various active substances in breast milk promote the development of the brain and central nervous system in premature infants. We present a protocol for a prospective longitudinal cohort study to explore the effect of in-hospital BF on brain development in preterm infants and possible influencing factors. METHODS AND ANALYSIS This study will enrol 247 Chinese preterm infants (gestational age: 30-34 weeks) delivered in Women's Hospital School of Medicine, Zhejiang University, and transferred to the neonatal intensive care unit. Demographic, clinical and in-hospital BF data will be collected through electronic medical records. Moreover, follow-up data will be obtained by telephone, interview or online. Measurements will be obtained using the Breastfeeding Self-Efficacy Scale-Short Form, neuroimaging with functional near-infrared spectroscopy, extrauterine growth restriction and the Ages and Stages Questionnaire. Follow-up will be performed at 3, 6 and 12 months after birth. ETHICS AND DISSEMINATION This study has been approved by the Women's Hospital School of Medicine Zhejiang University Medical Ethics Committee (2019-058). The study results are expected to be published in peer-reviewed journals and reported at relevant national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR1900027648; Pre-results.
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Affiliation(s)
- Rui Yang
- Nursing Department, Zhejiang University School of Medicine, Hangzhou, China
| | - Yao Zhang
- Nursing College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hua Wang
- Neonatal Intensive Care Units, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Xinfen Xu
- Nursing Department, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
- Haining Maternal and Child Health Hospital, Zhejiang University School of Medicine Women's Hospital, Haining, Zhejiang, China
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Zhao C, Guan H, Shi H, Zhang J, Huang X, Wang X. Relationships between dietary diversity and early childhood developmental outcomes in rural China. MATERNAL AND CHILD NUTRITION 2020; 17:e13073. [PMID: 32902154 PMCID: PMC7729803 DOI: 10.1111/mcn.13073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/12/2020] [Accepted: 07/20/2020] [Indexed: 12/19/2022]
Abstract
The period from birth to 2years of age is highly sensitive with respect to the relationship between nutrition and neurodevelopment, but data regarding the association between dietary diversity and early childhood neurodevelopment are limited. We sought to examine the association of two feeding indicators-minimum dietary diversity (MDD) and minimum meal frequency (MMF)-with the neurodevelopment of children aged 6-23 months, using data from a cross-sectional survey conducted in six rural counties in China. Data on 1,534 children were analysed using logistic regression to explore the associations between dietary diversity and early neurodevelopment, with adjustments for the age, sex and prematurity of the child; the age, sex and educational level of the caregiver; and family size, income and simulative care practices and resources. We found that 32.4% of children had suspected developmental delays based on the Chinese version of the Ages and Stages Questionnaires Version 3, whereas 77.0% and 39.2% failed to meet the MDD and MMF, respectively. Meeting the MDD was associated with a 39% lower risk of developmental delays (AOR = 0.61, 95% CI [0.43, 0.86]). There was a significant association between MDD and reduced likelihood of developmental delays in gross motor, fine motor, problem-solving and personal social subscales, whereas MMF was only associated with a lower risk of developmental delays in the gross motor subscale (AOR = 0.63, 95% CI [0.42, 0.94]). We observed an inverse dose-response relationship between the number of food groups consumed and the risk of developmental delays (P < .001).
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Affiliation(s)
- Chunxia Zhao
- Ministry of Health Key Laboratory of Reproductive Health, Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hongyan Guan
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Huifeng Shi
- Ministry of Health Key Laboratory of Reproductive Health, Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jingxu Zhang
- Ministry of Health Key Laboratory of Reproductive Health, Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xiaona Huang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoli Wang
- Ministry of Health Key Laboratory of Reproductive Health, Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China
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38
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Attell JE, Rose C, Bertolli J, Kotzky K, Squires J, Krishna NK, Satterfield-Nash A, Peacock G, Pereira IO, Santelli ACFES, Smith C. Adapting the Ages and Stages Questionnaire to Identify and Quantify Development Among Children With Evidence of Zika Infection. INFANTS AND YOUNG CHILDREN 2020; 33:95-107. [PMID: 33132516 PMCID: PMC7595748 DOI: 10.1097/iyc.0000000000000161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article describes novel methods of applying the Ages and Stages Questionnaire-3rd edition (ASQ-3) to assess and quantify developmental delay among children following the 2015-2016 Zika virus outbreak in Brazil. Many of the children with Zika virus infection were expected to have severe developmental delay. However, administering the ASQ-3 to caregivers of these children according to standard protocol would have screened for the overall presence of delay but not the severity of delay. We adopted an amended protocol for administration of the ASQ-3 to quantify the developmental functioning of children severely affected by Zika virus infection in this investigation. Protocols for administering the ASQ-3 among this population were drafted in consultation with developmental measurement experts and are presented here. Specific developmental estimates are discussed, including developmental age equivalents, developmental quotients, and developmental quotient z scores. The calculations of these estimates are presented with examples in the context of the 2015-2016 Zika virus outbreak and associated microcephaly among prenatally infected children from 2 states in northeastern Brazil. Potential applications of these methods for estimating developmental ability among similar pediatric populations are discussed.
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Affiliation(s)
| | - Charles Rose
- National Center for Birth Defects and Developmental Disability, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Jeanne Bertolli
- Division of Human Development and Disability, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kim Kotzky
- Division of Human Development and Disability, Oak Ridge Institute for Science and Education, Atlanta, Georgia
| | - Jane Squires
- College of Education, Center on Human Development, University of Oregon, Eugene
| | - Nevin K Krishna
- Division of State and Local Readiness, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ashley Satterfield-Nash
- Division of Human Development and Disability, Oak Ridge Institute for Science and Education, Atlanta, Georgia
| | - Georgina Peacock
- Division of Human Development and Disability, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ana Carolina Faria E Silva Santelli
- Overseas Strategy and Management Branch Brazil, Division of Global HIV & Tuberculosis, U.S. Centers for Disease Control and Prevention, Brasilia, Brazil
| | - Camille Smith
- Division of Congenital and Developmental Disorders, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Winhusen T, Lofwall M, Jones HE, Wilder C, Lindblad R, Schiff DM, Wexelblatt S, Merhar S, Murphy SM, Greenfield SF, Terplan M, Wachman EM, Kropp F, Theobald J, Lewis M, Matthews AG, Guille C, Silverstein M, Rosa C. Medication treatment for opioid use disorder in expectant mothers (MOMs): Design considerations for a pragmatic randomized trial comparing extended-release and daily buprenorphine formulations. Contemp Clin Trials 2020; 93:106014. [PMID: 32353544 PMCID: PMC7184985 DOI: 10.1016/j.cct.2020.106014] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 01/17/2023]
Abstract
Opioid use disorder (OUD) in pregnant women has increased significantly in recent years. Maintaining these women on sublingual (SL) buprenorphine (BUP) is an evidence-based practice but BUP-SL is associated with several disadvantages that an extended-release (XR) BUP formulation could eliminate. The National Drug Abuse Treatment Clinical Trials Network (CTN) is conducting an intent-to-treat, two-arm, open-label, pragmatic randomized controlled trial, Medication treatment for Opioid-dependent expectant Mothers (MOMs), to compare mother and infant outcomes of pregnant women with OUD treated with BUP-XR, relative to BUP-SL. A second aim is to determine the relative economic value of utilizing BUP-XR. Approximately 300 pregnant women with an estimated gestational age (EGA) of 6-30 weeks, recruited from 12 sites, will be randomized in a 1:1 ratio to BUP-XR or BUP-SL, balancing on site, EGA, and BUP-SL status (taking/not taking) at the time of randomization. Participants will be provided with study medication and attend weekly medication visits through 12 months postpartum. Participants will be invited to participate in two sub-studies to evaluate the: 1) mechanisms by which BUP-XR may improve mother and infant outcomes; and 2) effects of prenatal exposure to BUP-XR versus BUP-SL on infant neurodevelopment. This paper describes the key design decisions for the main trial made during protocol development. This Investigational New Drug (IND) trial uniquely uses pragmatic features where feasible in order to maximize external validity, hence increasing the potential to inform clinical practice guidelines and address multiple knowledge gaps for treatment of this patient population.
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Affiliation(s)
- Theresa Winhusen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
| | - Michelle Lofwall
- Departments of Behavioral Science and Psychiatry, University of Kentucky College of Medicine, Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, USA
| | - Hendrée E Jones
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill, 410 North Greensboro St., Carrboro, NC 27510, USA
| | - Christine Wilder
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA
| | - Robert Lindblad
- The Emmes Company, LLC, 401 N Washington Street, Suite 700, Rockville, MD 20850, USA
| | - Davida M Schiff
- Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St Suite 860, Boston, MA 02114, USA
| | - Scott Wexelblatt
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45229, USA
| | - Stephanie Merhar
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45229, USA
| | - Sean M Murphy
- Department of Healthcare Policy & Research, Weill Cornell Medical College, 425 East 61st Street Suite 301, New York, NY 10065, USA
| | - Shelly F Greenfield
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Alcohol, Drug and Addictions and the Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Mishka Terplan
- Friends Research Institute,1040 Park Ave Suite 103, Baltimore, MD 21201, USA
| | - Elisha M Wachman
- Department of Pediatrics, Boston Medical Center, 801 Albany Street, Boston, MA 02119, USA
| | - Frankie Kropp
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA
| | - Jeff Theobald
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA
| | - Mitra Lewis
- The Emmes Company, LLC, 401 N Washington Street, Suite 700, Rockville, MD 20850, USA
| | - Abigail G Matthews
- The Emmes Company, LLC, 401 N Washington Street, Suite 700, Rockville, MD 20850, USA
| | - Connie Guille
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA
| | - Michael Silverstein
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 88 East Newton Street, Boston, MA 02118, USA
| | - Carmen Rosa
- Center for the Clinical Trials Network, National Institute on Drug Abuse, 6001 Executive Blvd, Bethesda, MD 20892, USA
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Nozadi SS, Li L, Clifford J, Du R, Murphy K, Chen L, Seanez P, Burnette C, MacKenzie D, Lewis JL. Use of Ages and Stages Questionnaires™ (ASQ) in a Navajo population: Comparison with the U.S. normative dataset. Child Care Health Dev 2019; 45:709-718. [PMID: 31276599 PMCID: PMC6894904 DOI: 10.1111/cch.12704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/25/2019] [Accepted: 06/30/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Ages and Stages Questionnaires-Third Edition (ASQ-3) is a parent-completed screening to identify young children at-risk for developmental delays in the United States and internationally. Federal programs operating on Navajo Nation use the ASQ-3 to determine the need for early intervention services, even though the ASQ-3 national sample used to establish cutoff scores for referral included only 1% Native American children. OBJECTIVES The current study aimed to compare the ASQ-3 results from a sample of Navajo infants to those from a representative national U.S. sample and to examine the specificity and sensitivity of the ASQ-3 in Navajo population. METHODS The sample included 530 Navajo infants (47.3% males) aged between 1 and 13 months who lived in remote and rural areas across the Navajo Nation. Children's development was assessed during home visits at 2-, 6-, 9-, and 12-month assessment windows. RESULTS Results showed that after 6 months, Navajo children had lower mean scores and higher percentages of children at-risk for developmental delays than those from the national sample. The sensitivities and specificities, estimated using a Bayesian diagnostic approach under both conservative and nonconservative prior range choices, suggested a comparable validity performance to that from other ASQ-3 studies. DISCUSSION The results of this study along with our ongoing comprehensive assessments at 4 years of age inform current programs working with Navajo children to improve early identification of developmental delays.
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Affiliation(s)
- Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
| | - Li Li
- Department of Math and Statistics, University of New Mexico, Albuquerque New Mexico
| | - Jantina Clifford
- Early Intervention Program, University of Oregon, Eugene, Oregon
| | - Ruofei Du
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Kimberly Murphy
- Early Intervention Program, University of Oregon, Eugene, Oregon
| | - Lu Chen
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Navajo Birth Cohort Study Team
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
| | | | - Courtney Burnette
- Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
| | - Johnnye L. Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
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Thorne-Lyman AL, Shrestha M, Fawzi WW, Pasqualino M, Strand TA, Kvestad I, Hysing M, Joshi N, Lohani M, Miller LC. Dietary Diversity and Child Development in the Far West of Nepal: A Cohort Study. Nutrients 2019; 11:nu11081799. [PMID: 31382653 PMCID: PMC6722734 DOI: 10.3390/nu11081799] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/01/2022] Open
Abstract
Poverty adversely affects child development through multiple pathways in low- and middle-income countries. Relationships between diet and child development are poorly understood. In this study, we aimed to explore these associations in a longitudinal cohort of 305 children in rural Nepal (baseline mean age 14 months), evaluating dietary diversity and the consumption of specific food groups at three timepoints over 1.5 years. Child development was assessed using the Ages and Stages questionnaire-version 3 (ASQ-3). Associations between the number of days that children consumed minimum dietary diversity (MDD) (≥4/8 items) and specific food groups over time (range 0–3) and total and subscale ASQ scores at age 23–38 months were estimated using multiple linear and logistic regression, dichotomizing scores at the lowest quartile. After adjusting for confounders, each additional day of consuming MDD was associated with a 35% reduction in the odds of low total ASQ score [OR 0.65, 95% CI (0.46, 0.92)]. The consumption of animal source foods [OR 0.64, (0.46, 0.89)], and vegetables/fruits [OR 0.60, (0.41, 0.90), but not processed foods [OR 0.99, (0.62, 1.59)] was associated with lower odds of low total development. Vegetables, fruits and animal source foods may be important for child development in this setting.
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Affiliation(s)
- Andrew L Thorne-Lyman
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E2545, Baltimore, MD 21205, USA.
| | - Merina Shrestha
- Department of Child Health, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1 Room 1108, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Monica Pasqualino
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E2545, Baltimore, MD 21205, USA
| | - Tor A Strand
- Division for Research, Innlandet Hospital Trust, Lillehammer, Norway and The Center for International Health, University of Bergen, Bergen, Norway
| | - Ingrid Kvestad
- Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Neena Joshi
- Heifer International, Satobato Road, Hattiban, Kathmandu, Nepal
| | - Mahendra Lohani
- Heifer International, 1 World Ave, Little Rock, AR 72202, USA
| | - Laurie C Miller
- Tufts University School of Medicine, 800 Washington St, Boston, MD 02111, USA
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Morgan-Feir M, Abbott A, Synnes A, Creighton D, Pillay T, Zwicker JG. Comparing Standardized and Parent-Reported Motor Outcomes of Extremely Preterm Infants. CHILDREN-BASEL 2019; 6:children6080090. [PMID: 31374875 PMCID: PMC6721327 DOI: 10.3390/children6080090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 11/16/2022]
Abstract
Extremely preterm infants are at increased risk of motor impairment. The Canadian Neonatal Follow-Up Network (CNFUN) afforded an opportunity to study the outcomes of extremely preterm children. The purpose of this study was to compare 18-month corrected age (CA) motor outcomes of extremely preterm infants with parent-reported functional outcomes at 3 years CA. CNFUN data of 1376 infants were used to conduct chi-square analyses to compare Bayley-III motor scores (composite, gross, and fine motor) at 18 months CA with parent-reported Ages and Stages Questionnaire motor scores (gross and fine motor) at 3 years CA. The correlation of motor scores at 18-months CA with parent-reported gross and fine motor scores at 3 years CA was also examined. We found that 1 in 5 infants scoring within or above the average range on the Bayley-III had parent-reported functional fine and gross motor difficulties at 3 years CA. Bayley-III scores were only moderately correlated with functional motor outcomes. Results of the study suggest that the Bayley-III at 18 months CA was able to detect the majority of infants with motor problems, but not all; therefore, ongoing follow-up of extremely preterm infants is required. The Bayley-III motor composite score has greater clinical utility compared to sub-scale scores.
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Affiliation(s)
- Maeve Morgan-Feir
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Andrea Abbott
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Anne Synnes
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
- Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Neonatal Follow-Up Program, BC Women's Hospital, Vancouver V6H 4J4, Canada
| | - Dianne Creighton
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Thevanisha Pillay
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
- Division of Family Practice, Victoria General Hospital, Victoria, BC V8Z 6R5, Canada
| | - Jill G Zwicker
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada.
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada.
- Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada.
- Department of XX, Sunny Hill Health Centre for Children, Vancouver, Canada.
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43
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Blomkvist EAM, Hillesund ER, Helland SH, Simhan I, Øverby NC. Diet and Neurodevelopmental Score in a Sample of One-Year-Old Children-A Cross-Sectional Study. Nutrients 2019; 11:nu11071676. [PMID: 31330901 PMCID: PMC6683026 DOI: 10.3390/nu11071676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 01/28/2023] Open
Abstract
Environmental factors in the first years of life are crucial for a child’s neurodevelopment. Research on the association between breastfeeding and neurodevelopment is inconclusive, while research on the possible association between other dietary factors and neurodevelopment is inadequate in children as young as one year of age. The aim of the present study was to investigate associations between both breastfeeding and other dietary factors and the neurodevelopment of one-year-old children in Norway. Methods: Participants were recruited from kindergartens in four Norwegian counties in 2017. A questionnaire including questions about dietary factors and breastfeeding, and a standardised age-related questionnaire on neurodevelopment (the Ages and Stages Questionnaire), were completed by parents of one-year-olds. Linear regressions adjusting for relevant covariates were conducted to explore the associations. Results: In our sample of 212 one-year-old children, a longer duration of breastfeeding was associated with higher neurodevelopmental scores. Dietary intake of fish, fruits and vegetables was also strongly associated with higher neurodevelopmental scores, even after adjustment for breastfeeding and maternal education. Conclusion: Our results indicate that healthy dietary factors are important for neurodevelopment in young children, with measurable effects already at the age of one year.
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Affiliation(s)
- Eli Anne Myrvoll Blomkvist
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway.
| | - Elisabet Rudjord Hillesund
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway
| | - Sissel Heidi Helland
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway
| | - Indra Simhan
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, 4615 Kristiansand, Norway
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway
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44
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Tanu, Kakkar D. Diagnostic Assessment Techniques and Non-Invasive Biomarkers for Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2019. [DOI: 10.4018/ijehmc.2019070105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Autism spectrum disorder (ASD) is a complex heterogeneous neurological disorder that has led to a spectrum of diagnosis techniques. The screening instruments, medical and technological tools initiate the diagnosis process. Clinicians and psychologists propose therapies depending on the examination done by these methodologies. The literature has accounted dozens of diagnostic methods and alternative and complementary therapies but still lack in highlighting the proper biomarker for early detection and intervention. The emerging multi-modal neuro-imaging techniques have correlated the brain's functional and structural measures and diagnosed ASD with more sensitivity than individual approaches. The purpose of this review article is: (i) to provide an overview of the emerging ASD diagnosis methods and different markers and; (ii) to present the idea of integrating all the individual methods in to a multi-modal diagnostic system to enhance detection sensitivity. This system possesses the potential to diagnose and predict ASD clinically, neurologically & objectively with high detection sensitivity.
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Affiliation(s)
- Tanu
- Dr. B R Ambedkar National Institute of Technology, Jalandhar, India
| | - Deepti Kakkar
- Dr B R Ambedkar National institute of Technology, Jalandhar, India
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45
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Sikander S, Ahmad I, Bates LM, Gallis J, Hagaman A, O’Donnell K, Turner EL, Zaidi A, Rahman A, Maselko J. Cohort Profile: Perinatal depression and child socioemotional development ; the Bachpan cohort study from rural Pakistan. BMJ Open 2019; 9:e025644. [PMID: 31061029 PMCID: PMC6502044 DOI: 10.1136/bmjopen-2018-025644] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/20/2018] [Accepted: 03/08/2019] [Indexed: 01/03/2023] Open
Abstract
PURPOSE This is a prospective pregnancy-birth cohort designed to investigate the effects of depression on socioemotional development of children. Perinatal depression is a risk factor for poor child development and for many it has a recurring chronic course. Thus, the exposure to depression can continue through the early years of the child with detrimental developmental outcomes. PARTICIPANTS Between October 2014 and February 2016, we recruited 1154 pregnant women from a rural subdistrict of Pakistan. Data include longitudinal and repeated measures of maternal psychosocial measures and child growth, cognitive and socioemotional measures. Follow-up include mother-child dyad assessments at 3rd, 6th, 12th, 24th and 36th months of child age. All these follow-ups are community based at the household level. We have competed baseline assessment. FINDINGS TO DATE Of the eligible dyads, we followed 885 (76.6%), 929 (91%) and 940 (93.3%) at 3, 6 and 12 months post-childbirth. We include a subsample mother-child dyad DNA and inflammatory biomarkers, 73 and 104, respectively. FUTURE PLANS While we continue to do 24-month and 36-month follow-up assessments, we plan to follow these mother-child dyads up to the age of 7-8 years with some children being exposed to at least 1 year of school environment. Investigators interested in learning more about the study can contact (jmaselko@unc.edu) and (siham.sikander@hdrfoundation.org).
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Affiliation(s)
- Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Public Health, Health Services Academy, Islamabad, Pakistan
| | - Ikhlaq Ahmad
- Human Development Research Foundation, Islamabad, Pakistan
| | - Lisa M Bates
- Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - John Gallis
- Biostatistics, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Ashley Hagaman
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karen O’Donnell
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Elizabeth Louise Turner
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Atif Rahman
- Child Mental Health Unit, University of Liverpool, Liverpool, UK
| | - Joanna Maselko
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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46
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Small JW, Hix-Small H, Vargas-Baron E, Marks KP. Comparative use of the Ages and Stages Questionnaires in low- and middle-income countries. Dev Med Child Neurol 2019; 61:431-443. [PMID: 29926467 DOI: 10.1111/dmcn.13938] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 11/28/2022]
Abstract
AIM To map the breadth of use of the Ages and Stages Questionnaires (ASQ) in low- and middle-income countries (LMICs) across world regions, and examine procedures for ASQ translation, adaptation, psychometric evaluation, and administration. METHOD We conducted a review of all original, peer-reviewed studies written in English referencing use of the ASQ in LMICs. We used a consensus rating procedure to classify each article into one of four categories: feasibility study, psychometric study, prevalence study, or research study. RESULTS We analysed 53 peer-reviewed articles written in English detailing use of the ASQ in LMICs. We found evidence of ASQ use in 23 LMICs distributed across all world regions. The ASQ was translated into 16 languages. Just over half of the studies reported parent completion of the ASQ (50.9%). We identified eight feasibility studies, 12 psychometric studies, and nine prevalence studies. Study type varied by economy and region. INTERPRETATION Findings suggest broad global use of the ASQ in a range of countries and cultural and linguistic contexts. There is need for further validation studies across all cited regions and countries and in countries ready to begin to design systems for providing universal developmental screening services. WHAT THIS PAPER ADDS The Ages and Stages Questionnaires (ASQ) has been used in at least 23 low- and middle-income countries (LMICs). The ASQ has been translated into at least 16 languages in LMICs. Over half the identified studies reported parent completion of the ASQ.
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Affiliation(s)
- Jason W Small
- Oregon Research Institute, Eugene, OR, USA.,RISE Institute, Washington, DC, USA
| | - Hollie Hix-Small
- RISE Institute, Washington, DC, USA.,Graduate School of Education, Portland State University, Portland, OR, USA
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47
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Kendall S, Nash A, Braun A, Bastug G, Rougeaux E, Bedford H. Acceptability and understanding of the Ages & Stages Questionnaires®, Third Edition, as part of the Healthy Child Programme 2-year health and development review in England: Parent and professional perspectives. Child Care Health Dev 2019; 45:251-256. [PMID: 30661256 PMCID: PMC6849765 DOI: 10.1111/cch.12639] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/08/2019] [Accepted: 01/14/2019] [Indexed: 12/02/2022]
Abstract
BACKGROUND The Healthy Child Programme is the universal public health system in England to assess and monitor child health from 0 to 19. Following a review of measures for closer monitoring at age 2 years, the Department of Health for England implemented the Ages & Stages Questionnaires®, Third Edition (ASQ-3™; Hereon, ASQ-3). AIM The aim of this study was to evaluate the acceptability and understanding of the ASQ-3 in England by health professionals and parents. METHOD A mixed-methods approach was used. This paper reports on the qualitative data drawn from interviews with 40 parents and 12 focus groups with 85 health professionals. The data were analysed using applied thematic analysis. FINDINGS Overall, parents and health professionals found the ASQ-3 acceptable and understandable and could use it as a measure at age 2 years. The ability to work in partnership was valued. Some limitations included potential to cause anxiety, concerns around the safety of some of the items, and use of Americanized language. Health professional's training in the use the ASQ-3 was inconsistent. CONCLUSION The ASQ-3 is an acceptable and understandable measure to use as part of the 2-year assessment with some adaptations to the English context and some standardized training for health professionals.
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Affiliation(s)
- Sally Kendall
- Centre for Health Services StudiesUniversity of KentCanterburyUK
| | - Avril Nash
- Centre for Research in Primary and Community CareUniversity of HertfordshireHatfieldUK
| | - Andreas Braun
- Centre for Research in Primary and Community CareUniversity of HertfordshireHatfieldUK
| | - Gonca Bastug
- Centre for Research in Primary and Community CareUniversity of HertfordshireHatfieldUK
| | - Emeline Rougeaux
- Children's Policy Research Unit, Institute of Child HealthUniversity College LondonLondonUK
| | - Helen Bedford
- Children's Policy Research Unit, Institute of Child HealthUniversity College LondonLondonUK
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48
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Nazarpour S, Ramezani Tehrani F, Sajedi F, Bidhendi Yarandi R, Azizi F. Evaluation of the impact of levothyroxine treatment on the psychomotor developmental status of three-year-old children born to mothers with mild thyroid impairment; Tehran Thyroid and pregnancy study: study protocol for a randomized clinical trial. Trials 2019; 20:86. [PMID: 30691519 PMCID: PMC6350327 DOI: 10.1186/s13063-018-3130-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/11/2018] [Indexed: 11/24/2022] Open
Abstract
Background Despite the known adverse effects of maternal overt hypothyroidism on the neurocognitive development of children, there is uncertainty regarding the impact of gestational thyroid dysfunction or autoimmune thyroiditis on infant/child neurological development. This study aims to evaluate the impact of levothyroxine (LT4) treatment on the psychomotor developmental status of three-year-old children born to mothers with mild thyroid impairment (subclinical hypothyroidismwith/without autoimmune thyroiditis). Methods/Design This is a follow-up study of the Tehran Thyroid and Pregnancy Study, a randomized trial in which subclinical hypothyroid pregnant women were assigned to an intervention group (treated with levothyroxine) or a control group (received no treatment). The primary outcome for the purpose of the present study is the developmental status of the children, aged three years, in five domains (communication, gross motor, fine motor, problem-solving, and social–personal domains) using the Ages and Stages Questionnaire (ASQ). Discussion The study is designed to assess the developmental status of children born to mothers with mild thyroid impairment (subclinical hypothyroidism with/without autoimmune thyroiditis). This study is one of the limited studies available in this field and has the potential to facilitate much-needed information for related public health policies. Trial registration Iranian Registry of Clinical Trials, IRCT2017090314849N5. Registered on 11 September 2017. Iranian Registry of Clinical Trials, IRCT2017090414849N6. Registered on 14 October 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3130-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sima Nazarpour
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran.,Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Firoozeh Sajedi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ramdin T, Ballot D, Rakotsoane D, Madzudzo L, Brown N, Chirwa T, Cooper P, Davies V. Neurodevelopmental outcome of late preterm infants in Johannesburg, South Africa. BMC Pediatr 2018; 18:326. [PMID: 30322374 PMCID: PMC6190537 DOI: 10.1186/s12887-018-1296-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022] Open
Abstract
Background Late preterm infants, previously considered low risk, have been identified to be at risk of developmental problems in infancy and early childhood. There is limited information on the outcome of these infants in low and middle income countries. Methods Bayley scales of infant and toddler development, version III, were done on a group of late preterm infants in Johannesburg, South Africa. The mean composite cognitive, language and motor sub-scales were compared to those obtained from a group of typically developed control infants. Infants were considered to be “at risk” if the composite subscale score was below 85 and “disabled” if the composite subscale score was below 70. Infants identified with cerebral palsy were also reported. Results 56 of 73 (76.7%) late preterm infants enrolled in the study had at least one Bayley assessment at a mean age of 16.5 months (95% CI 15.2–17.6). The mean birth weight was 1.9 kg (95%CI 1.8–2.0) and mean gestational age 33.0 weeks (95% CI 32.56–33.51). There was no difference in the mean cognitive subscales between late preterm infants and controls (95.4 9, 95% CI 91.2–99.5 vs 91.9.95% CI 87.7–96.0). There was similarly no difference in mean language subscales (94.5, 95% CI 91.3–97.7 vs 95.9, 95% CI 92.9–99.0) or motor subscales (96.2, 95% CI 91.8–100.7 vs 97.6, 95% CI 94.7–100.5). There were four late preterm infants who were classified as disabled, two of whom had cerebral palsy. None of the control group was disabled. Conclusions This study demonstrates that overall developmental outcome, as assessed by the Bayley scales of infant and toddler development, was not different between late preterm infants and a group of normal controls. However, 7.1% of the late preterm infants, had evidence of developmental disability. Thus late preterm infants in low and middle income countries require long term follow up to monitor developmental outcome. In a resource limited setting, this may best be achieved by including a parental screening questionnaire, such as the Ages and Stages Questionnaire, in the routine well baby clinic visits.
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Affiliation(s)
- Tanusha Ramdin
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Daynia Ballot
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
| | - David Rakotsoane
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Lethile Madzudzo
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicolette Brown
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias Chirwa
- Department of Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Cooper
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Victor Davies
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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50
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Gonen M, Guler-Yildiz T, Ulker-Erdem A, Garcia A, Raikes H, Acar IH, Ozkan-Yildiz F, Karlidag I, Ucus S, Davis DL. Examining the Association Between Executive Functions and Developmental Domains of Low-Income Children in the United States and Turkey. Psychol Rep 2018; 122:155-179. [PMID: 29436982 DOI: 10.1177/0033294118756334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the relations between executive functions and developmental domains of preschool children from low-income families through an intercultural perspective in the U.S. and Turkey. A total of 471 children and their primary caregivers participated in the Turkey part of the study, while 286 children and their parents engaged in U.S. sample. Regression analyses revealed that fine motor, problem solving, and executive functions of children between two contexts were significantly different from each other. In the U.S., executive functions predicted communication, problem solving, and fine motor development, whereas in the Turkish sample, executive functions did not predict domain scores. Child gender predicted four of five developmental outcomes in the U.S., whereas maternal education predicted two of five outcomes in Turkey. In addition, invariance testing demonstrated that predictors to outcomes were not significantly different between the two countries. Country differences from the first set of outcomes were explained in the context of the research sites, children's socialization, and cultural expectations surrounding child development. This study raises questions about relations between executive functions and developmental domains for future research.
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Affiliation(s)
- Mubeccel Gonen
- Department of Early Childhood Education, Hacettepe University, Ankara, Turkey
| | - Tulin Guler-Yildiz
- Department of Early Childhood Education, Hacettepe University, Ankara, Turkey
| | - Ayca Ulker-Erdem
- Department of Early Childhood Education, Hacettepe University, Ankara, Turkey
| | - Aileen Garcia
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, NE, USA
| | - Helen Raikes
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, NE, USA
| | - Ibrahim H Acar
- Department of Early Childhood Education, Istanbul Medipol University, Istanbul, Turkey
| | - Feyza Ozkan-Yildiz
- Department of Early Childhood Education, Hacettepe University, Ankara, Turkey
| | - Ipek Karlidag
- Department of Early Childhood Education, Hacettepe University, Ankara, Turkey
| | - Sukran Ucus
- Department of Early Childhood Education, Ahi Evran University, Kırşehir, Turkey
| | - Dawn L Davis
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, NE, USA
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