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Giacomini I, Villamor E, Lourenço BH, Zhu M, Seeley AL, Matijasevich A, Cardoso MA. Impaired head circumference growth and behavioural problems in childhood: Longitudinal findings from the MINA-Brazil birth cohort. Paediatr Perinat Epidemiol 2024. [PMID: 39364779 DOI: 10.1111/ppe.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 09/09/2024] [Accepted: 09/19/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Previous evidence on the relation between early head circumference (HC) growth and behavioural outcomes in preschoolers has been inconsistent. OBJECTIVE We aimed to investigate whether HC growth from birth to 5 years of age was related to internalising or externalising behavioural problems at 5 years of age in a sex-specific manner. METHODS Among 303 girls and 318 boys from the MINA-Brazil birth cohort, we examined the associations between changes in HC from birth to 5 years of age and internalising and externalising behaviour problem scores at 5 years according to the Strengths and Difficulties Questionnaire for parents. HC values were transformed into sex- and age-specific z-scores (HCZ) using World Health Organisation standards, and the differences between values at 5 years of age and birth were classified into quintiles. We estimated adjusted mean differences with 95% confidence intervals in behavioural problem scores between HCZ change quintiles using multivariable linear regression by sex. To examine nonlinear associations, we included cubic spline terms. RESULTS Head circumference growth from birth to 5 years of age was inversely and nonlinearly associated with internalising problems in girls. Compared with girls at the lowest quintile of HC growth, those above had an adjusted 1.27 (95% confidence interval 0.28, 2.27) points lower mean internalising problems score. This association was mostly driven by HC growth during the first 2 years. We found no association between HC growth and externalising behaviour in either sex. CONCLUSIONS Impaired HC growth was related to higher mean internalising problem scores at 5 years of age in girls but not in boys. HC growth was not associated with externalising problems.
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Affiliation(s)
- Isabel Giacomini
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Eduardo Villamor
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Mia Zhu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Allison L Seeley
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa UNL, Lisbon, Portugal
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Kakaroukas A, Abrahamse-Berkeveld M, Hayes L, McNally RJQ, Berrington JE, van Elburg RM, Embleton ND. Formula with large, milk phospholipid-coated lipid droplets in late-moderate preterm infants: a double-blind RCT. Pediatr Res 2024:10.1038/s41390-024-03476-x. [PMID: 39294239 DOI: 10.1038/s41390-024-03476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 07/24/2024] [Accepted: 08/01/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Limited evidence exists on the preferred feeding method when breastfeeding is not possible in late and moderate preterm (LMPT) infants. This RCT evaluates growth, safety, and tolerance of a concept infant formula (IF) with large, milk phospholipid-coated lipid droplets enriched in dairy lipids in LMPT infants with primary objective to demonstrate non-inferiority of daily weight gain from randomization to 3 months corrected age compared to a standard IF. METHODS LMPT infants were randomized before or around term equivalent age to either the concept (n = 21) or standard IF (n = 20). Forty-one breastfed (BF) infants served as reference. RESULTS Due to unintended low recruitment, non-inferiority in daily weight gain could not be demonstrated for the Concept compared to the Control group, but was compared to the BF group. Other outcomes were similar between the formula groups, except for an apparent larger head circumference gain in the Concept group. No apparent differences in growth and body composition outcomes were observed between the Concept and BF reference groups. CONCLUSION This small-scale study suggests the concept IF is a safe alternative for parents who choose IF to feed their LMPT infant. Larger trials are needed to better determine impacts on head growth or body composition. IMPACT In a small group of late and moderate preterm infants, growth from randomization until 3 months corrected age of infants fed with a concept infant formula with large, milk phospholipid-coated lipid droplets was not -significantly different from infants fed a standard infant formula. Infants in the Concept group had non-significant larger gain in head circumference compared to the Control group; larger trials are needed to confirm this finding. Both formulas were well-tolerated, with no differences in adverse events. The concept formula is potentially a safe alternative for parents of moderate to late preterm infants who choose to use formula milk.
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Affiliation(s)
- Andreas Kakaroukas
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, UK
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Louise Hayes
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Richard J Q McNally
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Janet E Berrington
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ruurd M van Elburg
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Nicholas D Embleton
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, UK.
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
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van de Lagemaat M, Ruys CA, Muts J, Finken MJ, Rotteveel J, van Goudoever JB, Lafeber HN, van den Akker CH, Schrijver-Levie NS, Boonstra V, von Lindern JS, de Winter P, van Brakel MJ, Drewes AJ, Westra M. Growth and body composition of infants born moderate-to-late preterm fed a protein- and mineral-enriched postdischarge formula compared with a standard term formula until 6 months corrected age, a randomized controlled trial. Am J Clin Nutr 2024; 120:111-120. [PMID: 38719093 DOI: 10.1016/j.ajcnut.2024.04.035] [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: 12/04/2023] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Infants born moderate-to-late preterm (i.e., 32 wk-35 wk 6 d gestation) are, analogous to those born very preterm, at risk of later obesity, hypertension, and diabetes. Appropriate early life nutrition is key for ensuring optimal growth and body composition, thereby mitigating potential cardiometabolic risks. OBJECTIVES We aimed to compare growth and body composition between infants born moderate-to-late preterm fed isocaloric but protein- and mineral-enriched postdischarge formula (PDF) or standard term formula (STF) until 6 mo corrected age (CA; i.e., after term equivalent age [TEA]). METHODS After enrollment (≤7 d postpartum), infants received PDF if (fortified) mother's own milk (MOM) was insufficient. At TEA, those receiving >25% of intake as formula were randomized to either continue the same PDF (n = 47) or switch to STF (n = 50); those receiving ≥75% of intake as MOM (n = 60) served as references. At TEA and 6 mo CA, we assessed anthropometry and body composition using both dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography (ADP). RESULTS Feeding groups had similar gestational age (median [25th percentile;75th percentile]: 34.3 [33.5; 35.1] wk), birthweight (mean ± standard deviation [SD]: 2175 ± 412 g), anthropometry, and body composition at TEA. At 6 mo CA, infants fed PDF had slightly, but significantly, greater length (67.6 ± 2.5 and 66.9 ± 2.6 cm, P < 0.05) and larger head circumference (43.9 ± 1.3 and 43.4 ± 1.5 cm, P < 0.05) compared to infants fed STF. Also, infants fed PDF had higher lean mass (LM) and bone mineral content estimated by DXA (4772 ± 675 and 4502 ± 741 g; 140 ± 20 and 131 ± 23 g, respectively; P < 0.05). ADP estimates, however, were not statistically different between feeding groups. CONCLUSIONS Infants born moderate-to-late preterm demonstrated modest increases in length, head circumference, LM, and bone mineral content when fed PDF compared to STF for 6 mo after TEA. This trial was registered at the International Clinical Trial Registry Platform as NTR5117 and NTR NL4979.
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Affiliation(s)
- Monique van de Lagemaat
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
| | - Charlotte A Ruys
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Jacqueline Muts
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Martijn Jj Finken
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Department of Pediatric Endocrinology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Joost Rotteveel
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands; Department of Pediatric Endocrinology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Harrie N Lafeber
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Chris Hp van den Akker
- Department of Pediatrics/Neonatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Lafeber AH, de Jong RC, Bosch M, van de Lagemaat M, van Veenendaal NR, Aarnoudse-Moens CSH, Boersma B, van Goudoever JB, de Groof F. Nutritional intake and growth until two years of age in moderate and late preterms. Pediatr Res 2024:10.1038/s41390-024-03231-2. [PMID: 38769401 DOI: 10.1038/s41390-024-03231-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND AND AIM Moderate and late preterm infants (MLPTI) (gestational age 32 0/7-36 6/7 weeks), are at risk for suboptimal growth. This study evaluated adherence to nutritional recommendations until 6 months corrected age (CA), growth until 2 years CA, and associations between nutritional intake and growth until 2 years CA. METHODS We prospectively collected nutritional intakes from 100 MLPTI during the first week of life and at 6 weeks, 3 months, and 6 months CA. Anthropometry was assessed at birth, discharge, term age, and at 6 weeks, 3 months, 6 months, 1 year, and 2 years CA. RESULTS On day 7, <40% reached nutritional recommendations. Thereafter, >80% reached protein recommendations until 6 months of life, but <60% reached energy recommendations. Weight z-scores increased from -0.44 at term-age to 0.59 at 3 months CA, but declined to -0.53 at 2 years CA on the TNO curves. No significant associations were found between nutritional intake and growth until 2 years CA. CONCLUSION No associations were demonstrated between nutritional intakes and growth until 2 years CA, despite not reaching recommended intakes. Despite high efforts to optimize growth, MLPTI find their own growth curve in the first 2 years of life. IMPACT This research is pioneering in identifying how nutrition influences growth in moderate and late preterm infants (MLPTI) up to 2 years corrected age (CA). MLPTI often do not meet the recommended protein and energy intake in their first week of life, suggesting that current guidelines might be too high. No association was demonstrated between nutritional intake and growth of MLPTI in the first 2 years of life. Initially, MLPTI show an increase in weight z-scores from term age up to 3 months CA but experience a decline in weight z-scores at 2 years CA, according to TNO growth charts.
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Affiliation(s)
- Anne H Lafeber
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Roxanne C de Jong
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Mark Bosch
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Monique van de Lagemaat
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development (AR&D), Research Institute, Amsterdam, The Netherlands
| | - Nicole R van Veenendaal
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands
| | - Cornelieke S H Aarnoudse-Moens
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart Boersma
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands
| | - Johannes B van Goudoever
- Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development (AR&D), Research Institute, Amsterdam, The Netherlands
| | - Femke de Groof
- Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands.
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Mielewczyk FJ, Boyle EM. Uncharted territory: a narrative review of parental involvement in decision-making about late preterm and early term delivery. BMC Pregnancy Childbirth 2023; 23:526. [PMID: 37464284 DOI: 10.1186/s12884-023-05845-6] [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: 01/18/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
Almost 30% of live births in England and Wales occur late preterm or early term (LPET) and are associated with increased risks of adverse health outcomes throughout the lifespan. However, very little is known about the decision-making processes concerning planned LPET births or the involvement of parents in these. This aim of this paper is to review the evidence on parental involvement in obstetric decision-making in general, to consider what can be extrapolated to decisions about LPET delivery, and to suggest directions for further research.A comprehensive, narrative review of relevant literature was conducted using Medline, MIDIRS, PsycInfo and CINAHL databases. Appropriate search terms were combined with Boolean operators to ensure the following broad areas were included: obstetric decision-making, parental involvement, late preterm and early term birth, and mode of delivery.This review suggests that parents' preferences with respect to their inclusion in decision-making vary. Most mothers prefer sharing decision-making with their clinicians and up to half are dissatisfied with the extent of their involvement. Clinicians' opinions on the limits of parental involvement, especially where the safety of mother or baby is potentially compromised, are highly influential in the obstetric decision-making process. Other important factors include contextual factors (such as the nature of the issue under discussion and the presence or absence of relevant medical indications for a requested intervention), demographic and other individual characteristics (such as ethnicity and parity), the quality of communication; and the information provided to parents.This review highlights the overarching need to explore how decisions about potential LPET delivery may be reached in order to maximise the satisfaction of mothers and fathers with their involvement in the decision-making process whilst simultaneously enabling clinicians both to minimise the number of LPET births and to optimise the wellbeing of women and babies.
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Affiliation(s)
- Frances J Mielewczyk
- Leicester City Football Club (LCFC) Research Programme, Department of Population Health Sciences, College of Life Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK.
| | - Elaine M Boyle
- Department of Population Health Sciences, College of Life Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK
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Ulmer-Yaniv A, Yirmiya K, Peleg I, Zagoory-Sharon O, Feldman R. Developmental Cascades Link Maternal-Newborn Skin-to-Skin Contact with Young Adults' Psychological Symptoms, Oxytocin, and Immunity; Charting Mechanisms of Developmental Continuity from Birth to Adulthood. BIOLOGY 2023; 12:847. [PMID: 37372132 DOI: 10.3390/biology12060847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/04/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
Premature birth disrupts the continuity of maternal-newborn bodily contact, which underpins the development of physiological and behavioral support systems. Utilizing a unique cohort of mother-preterm dyads who received skin-to-skin contact (Kangaroo Care, KC) versus controls, and following them to adulthood, we examined how a touch-based neonatal intervention impacts three adult outcomes; anxiety/depressive symptoms, oxytocin, and secretory immunoglobulin A (s-IgA), a biomarker of the immune system. Consistent with dynamic systems' theory, we found that links from KC to adult outcomes were indirect, mediated by its effects on maternal mood, child attention and executive functions, and mother-child synchrony across development. These improvements shaped adult outcomes via three mechanisms; (a) "sensitive periods", where the infancy improvement directly links with an outcome, for instance, infant attention linked with higher oxytocin and lower s-IgA; (b) "step-by-step continuity", where the infancy improvement triggers iterative changes across development, gradually shaping an outcome; for instance, mother-infant synchrony was stable across development and predicted lower anxiety/depressive symptoms; and (c) "inclusive mutual-influences", describing cross-time associations between maternal, child, and dyadic factors; for instance, from maternal mood to child executive functions and back. Findings highlight the long-term impact of a birth intervention across development and provide valuable insights on the mechanisms of "developmental continuity", among the key topics in developmental research.
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Affiliation(s)
- Adi Ulmer-Yaniv
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Karen Yirmiya
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Itai Peleg
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Orna Zagoory-Sharon
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Ruth Feldman
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
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Early infancy growth, body composition and type of feeding in late and moderate preterms. Pediatr Res 2022:10.1038/s41390-022-02317-z. [PMID: 36183005 PMCID: PMC9526212 DOI: 10.1038/s41390-022-02317-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Late and moderate preterm (LMPT) infants are at risk for adverse later life outcomes. We determined the association between feeding method at enrolment and growth and body composition of LMPT infants until 3 months corrected age (3mCA). METHODS Infants born between 32+0 and 36+6 weeks of gestation (n = 107) were enrolled up to 4 weeks corrected age and stratified according to feeding at enrolment. We performed anthropometric measurements at enrolment, term equivalent age (TEA) and 3mCA, including skinfold measurements and body composition using dual X-ray absorptiometry (DEXA). RESULTS Feeding method at enrolment was associated with fat mass (FM) (breast 554.9 g, mixed 716.8 g, formula 637.7 g, p = 0.048), lean body mass (LM) (2512 g, 2853 g, 2722 g, respectively, p = 0.009) and lean mass index (LMI) (10.6 kg/m2, 11.6 kg/m2,11.2 kg/m2 respectively, p = 0.008) at TEA, but not 3mCA. Breastfed infants demonstrated greater increase in LM (breast 1707 g, mixed 1536 g, formula 1384 g, p = 0.03) and LMI (1.23 kg/m2, 0.10 kg/m2, 0.52 kg/m2, respectively, p = 0.022) between TEA and 3mCA. CONCLUSIONS Breastfed LMPT infants have lower FM and greater LM increase and LMI increase up to 3mCA compared to formula or mixed-fed infants. These findings stress the importance of supporting breastfeeding in this population. IMPACT Infants born late and moderate preterm age who are exclusively breastfed soon after birth gain more lean mass up to 3 months corrected age compared to mixed- or formula-fed infants. Breastfed infants have lower lean and fat mass at term equivalent age compared to mixed- and formula-fed infants. This is the first study exploring this population's growth and body composition in detail at 3 months corrected age. Our results underline the importance of supporting mothers to initiate and continue breastfeeding at least until 3 months corrected age.
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Zhu Z, Shen J, Zhu Y, Wang L, Qi Q, Wang X, Li C, Andegiorgish AK, Elhoumed M, Cheng Y, Dibley MJ, Zeng L. Head circumference trajectories during the first two years of life and cognitive development, emotional, and behavior problems in adolescence: a cohort study. Eur J Pediatr 2022; 181:3401-3411. [PMID: 35802207 DOI: 10.1007/s00431-022-04554-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
Abstract
UNLABELLED The associations of early-life head circumference (HC) with child neurodevelopmental and mental health among generally healthy population remain unclear. We aimed to examine the associations of early-life HC trajectories with cognitive development and emotional and behavioral problems in adolescence and to identify the HC growth-sensitive period. We conducted a prospective, community-based birth cohort study in rural western China, and 745 adolescents aged 10-14 years were followed between June and December 2016. We assessed their HC eight times during the first 2 years of life and their adolescent cognitive, emotional, and behavioral outcomes using the Wechsler Intelligence Scale for Children-IV and Youth Self-Report-2001, respectively. We applied group-based trajectory modeling to identify the HC trajectories and conditional growth to derive the HC growth-sensitive periods. We identified five distinct HC trajectories characterized as Start below average-then decrease (7.8% of the sample), Start below average-then increase (6.8%), Start average-then decrease (33%), Consistently average (38%), and Consistently above average (14%). Infants in the trajectory of consistently above average had higher cognitive scores in adolescence compared to those from suboptimal trajectories, with adjusted mean differences ranging from 2.84 to 8.99 points. The conditional gains showed that the HC growth-sensitive period was between 0 and 18 months for child cognition. We found null associations between HC measures and adolescent emotional and behavioral problem scores. CONCLUSION Early-life HC trajectories were associated with adolescent cognitive development. HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months, particularly in resource-limited settings. WHAT IS KNOWN • Postnatal head circumference (HC) has been shown to be associated with cognitive development in infants who were born premature and/or fetal growth restriction, while inconsistent associations were reported among generally healthy populations, especially in low- and middle- income countries, challenging its utility in public health practices. WHAT IS NEW • Adolescents in the HC growth trajectory of consistently above average had higher cognitive scores compared to those with other suboptimal trajectories, while null findings were observed for adolescent emotional and behavioral health. • HC may serve as an inexpensive screening tool to monitor child development at risk during the first 18 months of life, particularly in resource-limited settings.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Jiali Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Yingze Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Liang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xueyao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Amanuel Kidane Andegiorgish
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
- National Institute of Public Health Research (INRSP), BP. 695, Nouakchott, Mauritania
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Michael J Dibley
- The Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xian Jiaotong University Health Science Center, Xi'an, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.
- Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, People's Republic of China.
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Kuula J, Martola J, Hakkarainen A, Räikkönen K, Savolainen S, Salli E, Hovi P, Björkqvist J, Kajantie E, Lundbom N. Brain Volumes and Abnormalities in Adults Born Preterm at Very Low Birth Weight. J Pediatr 2022; 246:48-55.e7. [PMID: 35301016 DOI: 10.1016/j.jpeds.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/03/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess radiographic brain abnormalities and investigate volumetric differences in adults born preterm at very low birth weight (<1500 g), using siblings as controls. STUDY DESIGN We recruited 79 adult same-sex sibling pairs with one born preterm at very low birth weight and the sibling at term. We acquired 3-T brain magnetic resonance imaging from 78 preterm participants and 72 siblings. A neuroradiologist, masked to participants' prematurity status, reviewed the images for parenchymal and structural abnormalities, and FreeSurfer software 6.0 was used to conduct volumetric analyses. Data were analyzed by linear mixed models. RESULTS We found more structural abnormalities in very low birth weight participants than in siblings (37% vs 13%). The most common finding was periventricular leukomalacia, present in 15% of very low birth weight participants and in 3% of siblings. The very low birth weight group had smaller absolute brain volumes (-0.4 SD) and, after adjusting for estimated intracranial volume, less gray matter (-0.2 SD), larger ventricles (1.5 SD), smaller thalami (-0.6 SD), caudate nuclei (-0.4 SD), right hippocampus (-0.4 SD), and left pallidum (-0.3 SD). We saw no volume differences in total white matter (-0.04 SD; 95% CI, -0.13 to 0.09). CONCLUSIONS Preterm very low birth weight adults had a higher prevalence of brain abnormalities than their term-born siblings. They also had smaller absolute brain volumes, less gray but not white matter, and smaller volumes in several gray matter structures.
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Affiliation(s)
- Juho Kuula
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.
| | - Juha Martola
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sauli Savolainen
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Physics, University of Helsinki, Helsinki, Finland
| | - Eero Salli
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Petteri Hovi
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Johan Björkqvist
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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10
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Abstract
Advances in perinatal care have seen substantial improvements in survival without disability for extremely preterm infants. Protecting the developing brain and reducing neurodevelopmental sequelae of extremely preterm birth are strategic priorities for both research and clinical care. A number of evidence-based interventions exist for neuroprotection in micropreemies, inclusive of prevention of preterm birth and multiple births with implantation of only one embryo during in vitro fertilisation, as well as antenatal care to optimize fetal wellbeing, strategies for supporting neonatal transition, and neuroprotective developmental care. Avoidance of complications that trigger ischemia and inflammation is vital for minimizing brain dysmaturation and injury, particularly of the white matter. Neurodevelopmental surveillance, early diagnosis of cerebral palsy and early intervention are essential for optimizing long-term outcomes and quality of life. Research priorities include further evaluation of putative neuroprotective agents, and investigation of common neonatal interventions in trials adequately powered to assess neurodevelopmental outcome.
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11
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Luo Z, You B, Zhang Y, Tang J, Zheng Z, Jia Y, Wang L, Zeng D, Li H, Wang X. Nonlinear relationship between early postnatal weight gain velocity and neurodevelopmental outcomes in very-low birth weight preterm infants: A secondary analysis based on a published prospective cohort study. Front Pediatr 2022; 10:944067. [PMID: 36425400 PMCID: PMC9679406 DOI: 10.3389/fped.2022.944067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Extrauterine growth restriction among the very-low birth weight preterm infants (VLBWPIs) is associated with poorer cognitive development outcome, while the rapid weight gain in infancy increases the long-term risk of obesity and noncommunicable disease among VLBWPIs. However, the results of research on the association between early postnatal growth velocity and neurodevelopmental outcomes in VLBWPIs are still limited and controversial. OBJECTIVE We aimed to explore the association between the growth velocity in early postnatal and neurodevelopmental impairment (NDI) among VLBWPIs. METHODS This study was a secondary analysis of a previously published prospective cohort. It was based on data on 1,791 premature infants with a birth weight of less than 1500 g, registered in the database of the Premature Baby Foundation of Taiwan between 2007 and 2011. A binary logistic regression model was used to evaluate the association between the weight gain velocity in different periods [from birth to 6 months corrected age (CA), 6 to 12 months CA, and 12 to 24 months CA] and NDI, respectively. The generalized additive model and the smooth curve fitting (penalized spline method) were used to address nonlinearity, and a two-piece-wise binary logistic regression model was added to explain the nonlinearity further. RESULTS Nonlinearities were observed between NDI and the weight gain velocity from birth to 6 months CA [inflection point 20.36, <inflection point: odds ratio (OR) = 0.75, 95% confidence interval (CI) 0.67-0.84, >inflection point: OR = 1.01, 95% CI 0.97-1.05], 6-12 months CA [inflection point 9.44, <inflection point: OR = 0.89, 95% CI 0.84-0.94, >inflection point: OR = 1.05, 95% CI 1.05-(1.00, 1.11)], and 12-24 months CA [inflection point 16.00, <inflection point: OR = 0.93, 95% CI 0.88-0.98, >inflection point: OR = 1.75, 95% CI 1.05-(0.96, 3.08)]. CONCLUSION The neurodevelopmental benefits from a rapid weight gain velocity from birth to 24 months CA might be limited once the growth pace reaches an optimum level. It would help find a pattern of growth that facilitates optimal neurodevelopment, yet minimizes negative health consequences associated with overnutrition further.
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Affiliation(s)
- Zhongchen Luo
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Beibei You
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - You Zhang
- School of Foreign Languages, Chongqing Medical University, Chongqing, China
| | - Jiao Tang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zehong Zheng
- Engineering Training Center, Guizhou Minzu University, Huaxi, Guiyang, China
| | - Yuling Jia
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Li Wang
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Dan Zeng
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Hong Li
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Xiuhong Wang
- School of Nursing, Guizhou Medical University, Guiyang, China.,Department of Nursing, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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12
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Abstract
With advancements in neonatal care and nutrition, the postnatal growth of preterm infants has improved; however, it remains an issue. Accurate assessments of growth using a standardized reference are needed to interpret the intrauterine and postnatal growth patterns of preterm infants. Growth in the earlier periods of life can contribute to later outcomes, and the refinement of postnatal growth failure is needed to optimize outcomes. Catchup growth occurs mainly before discharge and until 24 months of age, and very low birth weight infants in Korea achieve retarded growth later in life. Knowing an infant's perinatal history, reducing morbidity rates during admission, and performing regular monitoring after discharge are required. Preterm infants with a lower birth weight or who were small for gestational age are at increased risk of poor neurodevelopmental outcomes. Furthermore, poor postnatal growth is predictive of adverse neurodevelopmental outcomes. Careful monitoring and early intervention will contribute to better development outcomes and national public health improvements.
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Affiliation(s)
- Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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13
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Fernández de Gamarra-Oca L, Ojeda N, Gómez-Gastiasoro A, Peña J, Ibarretxe-Bilbao N, García-Guerrero MA, Loureiro B, Zubiaurre-Elorza L. Long-Term Neurodevelopmental Outcomes after Moderate and Late Preterm Birth: A Systematic Review. J Pediatr 2021; 237:168-176.e11. [PMID: 34171360 DOI: 10.1016/j.jpeds.2021.06.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To systematically review and perform meta-analyses on the long-term neurodevelopmental outcomes of adults born moderate and late preterm (MLPT) in relation to cognitive functioning and psychiatric disorders. STUDY DESIGN A search was conducted to identify any studies that involved prematurity in adulthood. From these studies, reports that included a group of MLPT adults and included description of cognitive and/or mental health domains (including specific long-term outcomes) were selected. RESULTS In total, 155 publications were identified, but only 16 papers met the inclusion criteria. A small effect size (g = 0.38) was found in MLPT to demonstrate poorer intellectual performance compared with those born at term. Moreover, MLPT adults exhibited greater odds for any psychiatric (OR 1.14), substance use (OR 1.16), mood (OR 1.06), and psychotic disorders (OR 1.40). CONCLUSIONS Despite inconsistency due to the methodologic differences between the selected studies, MLPT showed minor long-term effects into adulthood. However, more studies are needed, because prematurity seems to confer some vulnerability to biological and environmental factors that enhance susceptibility to adverse neurodevelopment outcomes.
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Affiliation(s)
- Lexuri Fernández de Gamarra-Oca
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain
| | - Natalia Ojeda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain.
| | - Ainara Gómez-Gastiasoro
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain
| | - Javier Peña
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain
| | - M Acebo García-Guerrero
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain
| | - Begoña Loureiro
- Neonatal Unit, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Leire Zubiaurre-Elorza
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Bizkaia, Spain
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14
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Kakaroukas A, Abrahamse-Berkeveld M, Berrington JE, McNally RJQ, Stewart CJ, Embleton ND, van Elburg RM. An Observational Cohort Study and Nested Randomized Controlled Trial on Nutrition and Growth Outcomes in Moderate and Late Preterm Infants (FLAMINGO). Front Nutr 2021; 8:561419. [PMID: 33763438 PMCID: PMC7982654 DOI: 10.3389/fnut.2021.561419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 02/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Over the past decades, the preterm birth rate has increased, mostly due to a rise in late and moderate preterm (LMPT, 32–36 weeks gestation) births. LMPT birth affects 6–7% of all births in the United Kingdom and is associated with increased morbidity risk after birth in infancy as well as in adulthood. Early life nutrition has a critical role in determining infant growth and development, but there are limited data specifically addressing LMPT infants, which was the rationale for the design of the current study. Objective: The Feeding Late and Moderate Infants and Growth Outcomes (FLAMINGO) study aims to improve understanding of the longitudinal growth, nutritional needs, and body composition of LMPT infants as well as their microbiome development and neurodevelopment. In addition, having a nested non-inferiority trial enables evaluation of the nutritional adequacy of a concept IMF with large milk phospholipid-coated lipid droplets comprising dairy and vegetable lipids. The primary outcome of this RCT is daily weight gain until 3 months corrected age. Methods: A total of 250 healthy LMPT infants (32+0–36+6 weeks gestational age) with birth weight 1.25–3.0 kg will be recruited to the cohort, of which 140 infants are anticipated to be enrolled in the RCT. During six visits over the first 2 years of life, anthropometry, body composition (using dual energy X-Ray absorptiometry), feeding behavior, and developmental outcomes will be measured. Saliva and stool samples will be collected for oral and gut microbiota assessment. Discussion: The FLAMINGO study will improve understanding of the longitudinal growth, body composition development, and feeding characteristics of LMPT infants and gain insights into their microbiome and neurodevelopment. Study Registration:www.isrctn.com; Identifier ISRCTN15469594.
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Affiliation(s)
- Andreas Kakaroukas
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, United Kingdom
| | | | - Janet E Berrington
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, United Kingdom.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Richard J Q McNally
- Faculty of Medical Sciences, Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Christopher J Stewart
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Nicholas D Embleton
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne, United Kingdom.,Faculty of Medical Sciences, Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ruurd M van Elburg
- Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC) Amsterdam, Amsterdam, Netherlands
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15
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Seleem MA, Amer RA. Parenting discipline styles and child psychopathology in a clinical sample of Egyptian children in the Nile Delta region. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00063-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Few, if any, studies evaluated the effect of violent parenting discipline on children’s psychological well-being in the Nile Delta region. The current study aimed to explore the spectrum of violent versus non-violent parenting discipline styles practiced by a sample of Egyptian families who came for psychiatric advice in Tanta Psychiatry and Neurology Center and the effects of such styles on youth’s problem behavior and psychiatric diagnoses. Two hundred and seven families were recruited and interviewed using the Kiddie Schedule of affective disorders and schizophrenia-present and life-time version “K-SADS-PL.” Arabic translated and validated versions of the conflict tactics scale–parent child version (CTS-PC) and the child behavioral checklist questionnaire (CBCL) for ages 6–18 years were used to evaluate parenting discipline styles and child psychopathology, respectively.
Results
Youth (n = 207) had an average age of 10.8 ± 2.8 years and 30% were females. A significant association was noted between all forms of psychological and physical violence against children, in addition to neglectful parenting, and both internalizing and externalizing problems in offspring with no significant differences between mild and severe forms of violence. Parents who were sexually abused as children had more tendency to practice violent discipline strategies on their own children.
Conclusions
All forms of child maltreatment, even mild forms, have a considerable effect on the child psychological development. National policies and legalization should be implemented to decrease child maltreatment and protect children from all forms of physical and sexual abuse.
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16
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Kirkegaard H, Möller S, Wu C, Häggström J, Olsen SF, Olsen J, Nohr EA. Associations of birth size, infancy, and childhood growth with intelligence quotient at 5 years of age: a Danish cohort study. Am J Clin Nutr 2020; 112:96-105. [PMID: 32232408 PMCID: PMC7326594 DOI: 10.1093/ajcn/nqaa051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/24/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The correlates of prenatal and postnatal growth on Intelligence Quotient (IQ) in childhood in term-born children living in high-income countries are not well known. OBJECTIVES We examined how birth size and growth in infancy and childhood were associated with IQ at age 5 y in term-born children using path analysis. METHODS The study sample comprised 1719 children from the Danish National Birth Cohort who participated in a substudy in which psychologists assessed IQ using the Wechsler Primary and Preschool Scales of Intelligence-Revised. Measured weight, length/height, and head circumference at birth, 5 mo, 12 mo, and 5 y were included in a path model to estimate their total, indirect, and direct effects on IQ. All growth measures were included in the model as sex- and age-standardized z-scores. RESULTS After adjusting for potential confounders, a positive association between birth weight and IQ was observed, and 88% of the association was direct. Weight gain in infancy was associated with IQ [per z-score increase from 5 to 12 mo, IQ increased by 1.53 (95% CI: 0.14; 2.92) points] whereas weight gain from 12 mo to 5 y was not associated with IQ. Height and head circumference growth in childhood was associated with IQ [per z-score increase from 12 mo to 5 y, IQ increased by 0.98 (95% CI: 0.17; 1.79) and 2.09 (95% CI: 0.78; 3.41) points, respectively]. CONCLUSIONS In children born at term in an affluent country with free access to health care, higher IQ was seen with greater size at birth and greater weight gain in infancy. Also, greater growth in height and head circumference throughout the first 5 y of life was associated with higher childhood IQ whereas greater weight gain after the first year of life was not.
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Affiliation(s)
| | - Sören Möller
- Open Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Chunsen Wu
- Research Unit of Obstetrics and Gynecology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Sjurdur Frodi Olsen
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Ellen Aagaard Nohr
- Research Unit of Obstetrics and Gynecology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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17
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Cormack BE, Harding JE, Miller SP, Bloomfield FH. The Influence of Early Nutrition on Brain Growth and Neurodevelopment in Extremely Preterm Babies: A Narrative Review. Nutrients 2019; 11:E2029. [PMID: 31480225 PMCID: PMC6770288 DOI: 10.3390/nu11092029] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 12/29/2022] Open
Abstract
Extremely preterm babies are at increased risk of less than optimal neurodevelopment compared with their term-born counterparts. Optimising nutrition is a promising avenue to mitigate the adverse neurodevelopmental consequences of preterm birth. In this narrative review, we summarize current knowledge on how nutrition, and in particular, protein intake, affects neurodevelopment in extremely preterm babies. Observational studies consistently report that higher intravenous and enteral protein intakes are associated with improved growth and possibly neurodevelopment, but differences in methodologies and combinations of intravenous and enteral nutrition strategies make it difficult to determine the effects of each intervention. Unfortunately, there are few randomized controlled trials of nutrition in this population conducted to determine neurodevelopmental outcomes. Substantial variation in reporting of trials, both of nutritional intakes and of outcomes, limits conclusions from meta-analyses. Future studies to determine the effects of nutritional intakes in extremely preterm babies need to be adequately powered to assess neurodevelopmental outcomes separately in boys and girls, and designed to address the many potential confounders which may have clouded research findings to date. The development of minimal reporting sets and core outcome sets for nutrition research will aid future meta-analyses.
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Affiliation(s)
- Barbara E Cormack
- Starship Child Health, Auckland City Hospital, Auckland 1023, New Zealand
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Steven P Miller
- Department of Paediatrics, Hospital for Sick Children, Toronto, ON M5G, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON M5S, Canada
| | - Frank H Bloomfield
- Starship Child Health, Auckland City Hospital, Auckland 1023, New Zealand.
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand.
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18
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Abstract
Late preterm infants (born at 340/7-366/7 weeks gestation) have been found to have increased morbidity and mortality compared to full term infants. Research has also been done to explore longer-term neurodevelopmental outcomes. This review details neurodevelopmental outcomes from birth to adulthood for late preterm infants. Outcome studies indicate that they are at increased risk of developmental disability, school failure, behavior problems, social and medical disabilities, and death. Many questions still remain regarding late preterm infant neurodevelopmental outcomes and future research should be done into this topic. Given the high prevalence of late preterm births, even small differences in abilities, special education, and length of education may have broader consequences.
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19
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Muelbert M, Harding JE, Bloomfield FH. Nutritional policies for late preterm and early term infants - can we do better? Semin Fetal Neonatal Med 2019; 24:43-47. [PMID: 30341037 PMCID: PMC6368456 DOI: 10.1016/j.siny.2018.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Late preterm (LP) and early term (ET) infants can be considered the "great dissemblers": they resemble healthy full-term infants in appearance, but their immaturity places them at increased risk of poor short- and long-term outcomes. Nutritional requirements are greater than for full-term babies, but there are few good data on the nutritional requirements for LP and ET babies, leading to substantial variation in practice. Recent data indicate that rapid growth may be beneficial for neurocognitive function but not for body composition and later metabolic health. Breastfeeding the LP or ET infant can be challenging, and mothers of these infants may need additional support to breastfeed successfully. Future research should investigate nutritional requirements of LP and ET infants for optimal growth, addressing both short- and long-term outcomes and the potential trade-off between neurocognitive and metabolic benefits.
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Affiliation(s)
- Mariana Muelbert
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
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20
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Abstract
OBJECTIVES The aim of this study was to investigate the effects of infant and toddler head growth on intelligence scores from early childhood to adulthood in very preterm (<32 weeks gestational age; VP) and/or very low birth weight (<1500 g; VLBW) and term born individuals. METHODS 203 VP/VLBW and 198 term comparisons were studied from birth to adulthood as part of the prospective geographically defined Bavarian Longitudinal Study (BLS). Head circumference was assessed at birth; 5, 20 months; and 4 years of age. Intelligence was assessed with standardized tests in childhood (6 and 8 years: K-ABC) and at 26 years (Wechsler Adult Intelligence Scale, WAIS). Structural equation modeling (SEM) was used to model the effect of head growth on IQ. RESULTS On average, VP/VLBW had lower head circumference at birth (27.61 cm vs. 35.11 cm, mean difference 7.49, 95% confidence interval [7.09-7.90]) and lower adult intelligence scores (88.98 vs. 102.54, mean difference 13.56 [10.59-16.53]) than term born comparison individuals. Head circumference at birth (e.g., total effect β=.48; p<.001 for adult IQ) and head growth in childhood predicted intelligence development from age 6 to 26 years in both VP/VLBW and term born individuals (70% of variance in adult IQ explained by full model). Effects of gestation and birth weight on intelligence were fully mediated by head circumference and growth. CONCLUSIONS This longitudinal investigation from birth to adulthood indicates head growth as a proxy of brain development and intelligence. Repeated early head circumference assessment adds valuable information when screening for long-term neurocognitive risk. (JINS, 2019, 25, 48#x2013;56).
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21
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Underwood MA, Wedgwood S, Lakshminrusimha S, Steinhorn RH. Somatic growth and the risks of bronchopulmonary dysplasia and pulmonary hypertension: connecting epidemiology and physiology 1. Can J Physiol Pharmacol 2018; 97:197-205. [PMID: 30512966 DOI: 10.1139/cjpp-2018-0386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the premature infant, poor growth in utero (fetal growth restriction) and in the first weeks of life (postnatal growth restriction) are associated with increased risk for bronchopulmonary dysplasia and pulmonary hypertension. In this review, we summarize the epidemiologic data supporting these associations, present a novel rodent model of postnatal growth restriction, and review 5 promising mechanisms by which poor nutrition may affect the developing lung. These observations support the hypothesis that nutritional and (or) pharmacologic interventions early in life may be able to decrease risk of the pulmonary complications of extreme prematurity.
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Affiliation(s)
- Mark A Underwood
- a Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA
| | - Stephen Wedgwood
- a Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA
| | | | - Robin H Steinhorn
- b Department of Hospitalist Medicine, Children's National Health System, Washington, DC 20010, USA
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22
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Silveira PP, Pokhvisneva I, Gaudreau H, Rifkin-Graboi A, Broekman BFP, Steiner M, Levitan R, Parent C, Diorio J, Meaney MJ. Birth weight and catch up growth are associated with childhood impulsivity in two independent cohorts. Sci Rep 2018; 8:13705. [PMID: 30209275 PMCID: PMC6135839 DOI: 10.1038/s41598-018-31816-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/28/2018] [Indexed: 02/07/2023] Open
Abstract
Individuals born after intrauterine growth restriction (IUGR) are more impulsive towards palatable foods, but it is not clear 1) if IUGR-related impulsivity is specific for foods and solely based on response inhibition and 2) if the development of impulsivity is due to being born IUGR per se or to growing up fast in the first few years of life (catch up growth). Children were classified in the IUGR group if the birth weight ratio was below 0.85. Delta z score for BMI was used as a measure of catch up growth. In MAVAN (N = 274), impulsivity was measured by the Information Sampling Task from the Cambridge Neuropsychological Test Automated Battery (IST - CANTAB), and in GUSTO using the Sticker Delay Task (N = 327). There is a significant effect of interaction between being born IUGR and the magnitude of catch up growth on the reflection impulsivity from IST-CANTAB at 60 months, in which greater catch up growth associates with greater impulsivity in the IST fixed condition in IUGR children. The finding was reproduced in children from the GUSTO cohort using the Sticker Delay Task. We confirmed that catch up growth interacts with IUGR, having a major role in the development of impulsivity in the first years of life and influencing inhibitory control and decision making processes.
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Affiliation(s)
- Patrícia P Silveira
- Department of Psychiatry, McGill University & Sackler Institute for Epigenetics & Psychobiology at McGill University, Montreal, Quebec, Canada.
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada.
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Hélène Gaudreau
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Anne Rifkin-Graboi
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Meir Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, L8N 3K7, Canada
| | - Robert Levitan
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Carine Parent
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Josie Diorio
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Michael J Meaney
- Department of Psychiatry, McGill University & Sackler Institute for Epigenetics & Psychobiology at McGill University, Montreal, Quebec, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, H4H 1R3, Canada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Taine M, Charles MA, Beltrand J, Rozé JC, Léger J, Botton J, Heude B. Early postnatal growth and neurodevelopment in children born moderately preterm or small for gestational age at term: A systematic review. Paediatr Perinat Epidemiol 2018; 32:268-280. [PMID: 29691880 DOI: 10.1111/ppe.12468] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Clinicians' interest in the long-term effects of early postnatal growth (EPG) is growing. There is compelling evidence linking rapid EPG with later cardiovascular risk, but its neurodevelopmental benefits still remain hypothetical in individuals born moderately preterm (MP) or small for gestational at term (SGAT). METHODS The objective was to perform a systematic review of the relationship between EPG before age 3 years and neurodevelopmental outcome for individuals born MP (32-36 weeks' gestational age) or SGAT. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, 3 independent investigators searched for articles published on this topic in the Web of Science, EMBASE and PubMed from database inception to July 1, 2017. A detailed quality scale was used to evaluate articles. RESULTS We selected 19 articles relying on 12 distinct study populations; 7 articles from 3 study populations were considered at moderate or high quality. The lack of standardisation of growth analysis methods prevented performing a meta-analysis. Overall, EPG was positively associated with neurodevelopmental outcome, especially Intelligence Quotient (IQ) when available. In this relationship, the first 6 months of life might be a critical period. Analysis of the few articles investigating the shape of the relationships revealed a non-linear association, with a plateau for IQ with higher weight gain, which suggests a possible ceiling effect. CONCLUSIONS A positive association was generally found between EPG and neurodevelopmental outcome for individuals born MP or SGAT. Strategies for future epidemiological studies are suggested to improve the characterisation of this relationship.
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Affiliation(s)
- Marion Taine
- Early Determinants of Children's Health and Development Team (ORCHAD), Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Villejuif, France
- Paris Descartes University, Paris, France
- Department of Paediatric endocrinology, Necker Enfants Malades Hospital, Paris, France
| | - Marie-Aline Charles
- Early Determinants of Children's Health and Development Team (ORCHAD), Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Villejuif, France
- Paris Descartes University, Paris, France
| | - Jacques Beltrand
- Paris Descartes University, Paris, France
- Department of Paediatric endocrinology, Necker Enfants Malades Hospital, Paris, France
- Inserm UMR 1016, Cochin Institute, Paris, France
| | - Jean Christophe Rozé
- Department of Paediatric Medicine, Nantes University Hospital, Nantes, France
- Inserm CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France
| | - Juliane Léger
- Department of Paediatric Endocrinology, Robert Debré Hospital, Paris Diderot University, Paris, France
- DHU Protect, Inserm UMR 1141, Paris, France
| | - Jérémie Botton
- Early Determinants of Children's Health and Development Team (ORCHAD), Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Villejuif, France
- University Paris-Sud, University Paris-Saclay, F-92296, Châtenay-Malabry, France
| | - Barbara Heude
- Early Determinants of Children's Health and Development Team (ORCHAD), Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Villejuif, France
- Paris Descartes University, Paris, France
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Natarajan G. Late Preterm Birth and Growth Failure in Childhood: What do we do now? Indian Pediatr 2017; 54:627-628. [PMID: 28891474 DOI: 10.1007/s13312-017-1122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Girija Natarajan
- Professor of Pediatrics and Co-Chief, Division of Neonatology, Wayne State University School of Medicine, Detroit, MI, USA.
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Growth and development in late-preterm infants: what can public policy do? Pediatr Res 2017; 82:178-179. [PMID: 28422944 DOI: 10.1038/pr.2017.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 03/03/2017] [Indexed: 11/08/2022]
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