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Perzanowski MS, Rauh V, Ramphal B, Acosta L, Hoepner L, Rundle AG, Perera FP, Herbstman J, Miller RL, Margolis AE. Rhinorrhea and watery eyes in infancy and risk of attention-deficit hyperactivity disorder in school-age children. Dev Psychobiol 2024; 66:e22497. [PMID: 38689370 DOI: 10.1002/dev.22497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 05/02/2024]
Abstract
Increased parasympathetic nervous system (PNS) activity is associated with attention-deficit/hyperactivity disorder (ADHD) inattentive symptoms, but not hyperactive-impulsive symptoms, and may contribute to inattentive subtype etiology. Guided by prior work linking infant rhinorrhea and watery eyes without a cold (RWWC) to PNS dysregulation, we examined associations between infant RWWC and childhood ADHD symptoms in a longitudinal cohort of Black and Latinx children living in the context of economic disadvantage (N = 301 youth: 158 females, 143 males). Infant RWWC predicted higher inattentive (relative risk [RR] 2.16, p < .001) but not hyperactive-impulsive (RR 1.53, p = .065) ADHD symptoms (DuPaul scale), administered to caregivers at child age 8-14 years. Stratified analyses revealed that these associations were present in females but not males, who were three times more likely to have higher ADHD current total symptoms if they had infant RWWC than if they did not. Additionally, associations between RWWC and inattention symptoms were observed only in females. RWWC may thus serve as a novel risk marker of ADHD inattentive-type symptoms, especially for females.
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Affiliation(s)
- Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Virginia Rauh
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Bruce Ramphal
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Luis Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Lori Hoepner
- Data Coordinating Center, Columbia University, New York, New York, USA
- Department of Environmental and Occupational Health Sciences, SUNY Downstate Health Sciences University School of Public Health, Brooklyn, New York, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Frederica P Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy E Margolis
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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Balalian AA, Stingone JA, Kahn LG, Herbstman JB, Graeve RI, Stellman SD, Factor-Litvak P. Perinatal exposure to polychlorinated biphenyls (PCBs) and child neurodevelopment: A comprehensive systematic review of outcomes and methodological approaches. ENVIRONMENTAL RESEARCH 2024; 252:118912. [PMID: 38615789 DOI: 10.1016/j.envres.2024.118912] [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: 01/15/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs), extensively used in various products, prompt ongoing concern despite reduced exposure since the 1970s. This systematic review explores prenatal PCB and hydroxylated metabolites (OH-PCBs) exposure's association with child neurodevelopment. Encompassing cognitive, motor development, behavior, attention, ADHD, and ASD risks, it also evaluates diverse methodological approaches in studies. METHODS PubMed, Embase, PsycINFO, and Web of Science databases were searched through August 23, 2023, by predefined search strings. Peer-reviewed studies published in English were included. The inclusion criteria were: (i) PCBs/OH-PCBs measured directly in maternal and cord blood, placenta or breast milk collected in the perinatal period; (ii) outcomes of cognitive development, motor development, attention, behavior, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) among children≤18 years old. Quality assessment followed the National Heart, Lung, and Blood Institute's tool. RESULTS Overall, 87 studies were included in this review. We found evidence for the association between perinatal PCB exposure and adverse cognitive development and attention issues in middle childhood. There appeared to be no or negligible link between perinatal PCB exposure and early childhood motor development or the risk of ADHD/ASD. There was an indication of a sex-specific association with worse cognition and attention scores among boys. Some individual studies suggested a possible association between prenatal exposure to OH-PCBs and neurodevelopmental outcomes. There was significant heterogeneity between the studies in exposure markers, exposure assessment timing, outcome assessment, and statistical analysis. CONCLUSIONS Significant methodological, clinical and statistical heterogeneity existed in the included studies. Adverse effects on cognitive development and attention were observed in middle childhood. Little or no apparent link on both motor development and risk of ADHD/ASD was observed in early childhood. Inconclusive evidence prevailed regarding other neurodevelopmental aspects due to limited studies. Future research could further explore sex-specific associations and evaluate associations at lower exposure levels post-PCB ban in the US. It should also consider OH-PCB metabolites, co-pollutants, mixtures, and their potential interactions.
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Affiliation(s)
- Arin A Balalian
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Question Driven Design and Analysis Group (QD-DAG), New York, NY, USA.
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Julie B Herbstman
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Richard I Graeve
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Halle Saale, Germany
| | - Steven D Stellman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Bondi BC, Tassone VK, Bucsea O, Desrocher M, Pepler DJ. A Systematic Review of Neurodevelopmental Assessments in Infancy and Early Childhood: Developing a Conceptual Framework, Repository of Measures, and Clinical Recommendations. Neuropsychol Rev 2024:10.1007/s11065-024-09641-7. [PMID: 38693469 DOI: 10.1007/s11065-024-09641-7] [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] [Received: 07/24/2023] [Accepted: 04/01/2024] [Indexed: 05/03/2024]
Abstract
The first 6 years of life are when 90% of brain development occurs, setting the foundation for lifelong neurodevelopment. The field of infant and early childhood neurodevelopment has made marginal advancements since introduced in 1988. There remains a gap in knowledge around early neurodevelopmental domains and trajectories given that there are few established assessment procedures for infants and young children and controversies around reserving assessments until school age. Throughout this systematic review, we (1) identified neurodevelopmental assessment measures employed in the literature by domain and age of assessment, (2) compiled a repository of 608 domain-specific neurodevelopmental assessment measures, and (3) established a preliminary conceptual framework for cross-domain neurodevelopmental assessments across infancy and early childhood. This review adhered to PRISMA guidelines and spanned three databases (PsycINFO, MEDLINE, PubMed). Articles were reviewed for (1) infancy and early childhood (0-6 years), (2) neurodevelopmental measures, and (3) English language. This systematic review spanned 795 articles from 1978 to 2020 with international representation. Advancements in assessment methods (e.g. measures, domains, frameworks) are essential for the evaluation of early neurodevelopmental profiles to inform early interventions, thus harnessing the neuroplasticity and dynamic development notable during early childhood. We hope this work catalyzes future research and clinical guidelines around early assessments methods.
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Affiliation(s)
- Bianca C Bondi
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Vanessa K Tassone
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Oana Bucsea
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Mary Desrocher
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Debra J Pepler
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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Beebe B, Abdurokhmonova G, Lee SH, Dougalis G, Champagne F, Rauh V, Algermissen M, Herbstman J, Margolis AE. Mother-infant self- and interactive contingency at four months and infant cognition at one year: A view from microanalysis. Infant Behav Dev 2024; 74:101920. [PMID: 38237345 PMCID: PMC10956369 DOI: 10.1016/j.infbeh.2023.101920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/02/2023] [Accepted: 12/31/2023] [Indexed: 03/17/2024]
Abstract
Although a considerable literature documents associations between early mother-infant interaction and cognitive outcomes in the first years of life, few studies examine the contributions of contingently coordinated mother-infant interaction to infant cognitive development. This study examined associations between the temporal dynamics of the contingent coordination of mother-infant face-to-face interaction at 4 months and cognitive performance on the Bayley Scales of Infant Development at age one year in a sample of (N = 100) Latina mother-infant pairs. Split-screen videotaped interactions were coded on a one second time base for the communication modalities of infant and mother gaze and facial affect, infant vocal affect, and mother touch. Multi-level time-series models evaluated self- and interactive contingent processes in these modalities and revealed 4-month patterns of interaction associated with higher one-year cognitive performance, not identified in prior studies. Infant and mother self-contingency, the moment-to-moment probability that the individual's prior behavior predicts the individual's future behavior, was the most robust measure associated with infant cognitive performance. Self-contingency findings showed that more varying infant behavior was optimal for higher infant cognitive performance, namely, greater modulation of negative affect; more stable maternal behavior was optimal for higher infant cognitive performance, namely, greater likelihood of sustaining positive facial affect. Although interactive contingency findings were sparse, they showed that, when mothers looked away, or dampened their faces to interest or mild negative facial affect, infants with higher 12-month cognitive performance were less likely to show negative vocal affect. We suggest that infant ability to modulate negative affect, and maternal ability to sustain positive affect, may be mutually reinforcing, together creating a dyadic climate that is associated with more optimal infant cognitive development.
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Affiliation(s)
- Beatrice Beebe
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032, USA.
| | - Gavkhar Abdurokhmonova
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742, USA
| | - Sang Han Lee
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY 10032, USA; The Nathan Kline Institute, Orangeburg, NJ, 10962, USA, New York University Grossman School of Medicine, New York, NY 10032, USA
| | - Georgios Dougalis
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032, USA
| | - Frances Champagne
- Department of Psychology, University of Texas, Austin, TX 78712, USA
| | - Virginia Rauh
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Molly Algermissen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Amy E Margolis
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Duarte A, Martins S, Augusto C, Silva MJ, Lopes L, Santos R, Rosário R. The impact of a health promotion program on toddlers' socio-emotional development: a cluster randomized study. BMC Public Health 2024; 24:415. [PMID: 38331822 PMCID: PMC10854086 DOI: 10.1186/s12889-024-17953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The first 3 years of life are a critical period for the development of socio-emotional skills, highlighting the importance of socio-emotional development in early childhood. This study aimed to evaluate the effectiveness of a health promotion intervention program on the socio-emotional development of children aged 12 to 42 months during the COVID-19 pandemic. METHODS A total of 344 children from 15 childcare centers participated in this study, with six centers in the intervention group and nine in the control group. Childcare teachers in the intervention group received a 6-month training program aimed at promoting healthy lifestyles, including topics such as diet, sleep, physical activity, and sedentary behavior. Sociodemographic and anthropometric measures were assessed at baseline, and socio-emotional development was assessed using the Bayley Scales of Infant and Toddler Development - Third Edition (Bayley-III) at baseline and post-intervention. RESULTS After the intervention, a significant difference in socio-emotional development was observed between children with mothers of varying education levels. Specifically, children whose mothers had lower education levels demonstrated significantly greater socio-emotional development (B = 19.000, p = 0.028) compared to the control group. In contrast, there was no significant difference in socio-emotional development among children with mothers from higher education levels. CONCLUSION These findings suggest that intervention programs for childcare teachers can effectively promote healthy socio-emotional development in children from socioeconomically disadvantaged backgrounds. Future intervention programs should consider tailoring their approaches to target disadvantaged populations. TRIAL REGISTRATION This cluster randomized controlled trial was registered in the Clinical Trials database/platform on 09/09/2019 (number NCT04082247).
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Affiliation(s)
- Ana Duarte
- School of Nursing, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal
- UICISA:E, The Health Sciences Research Unit: Nursing, School of Nursing of Coimbra, Coimbra, Portugal
- CIEnf, Research Centre in Nursing, School of Nursing, University of Minho, Braga, Portugal
- CIEC, Research Centre on Child Studies, Institute of Education, University of Minho, Braga, Portugal
| | - Silvana Martins
- ProChild CoLAB Against Poverty and Social Exclusion - Association, Campus de Couros, Rua de Vila Flor, Guimarães, 4810-225, Portugal
| | - Cláudia Augusto
- School of Nursing, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal
- UICISA:E, The Health Sciences Research Unit: Nursing, School of Nursing of Coimbra, Coimbra, Portugal
- CIEnf, Research Centre in Nursing, School of Nursing, University of Minho, Braga, Portugal
| | - Maria José Silva
- School of Nursing, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal
- UICISA:E, The Health Sciences Research Unit: Nursing, School of Nursing of Coimbra, Coimbra, Portugal
- CIEnf, Research Centre in Nursing, School of Nursing, University of Minho, Braga, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
| | - Rute Santos
- Institute of Education, University of Minho, Braga, Portugal
| | - Rafaela Rosário
- School of Nursing, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal.
- UICISA:E, The Health Sciences Research Unit: Nursing, School of Nursing of Coimbra, Coimbra, Portugal.
- CIEnf, Research Centre in Nursing, School of Nursing, University of Minho, Braga, Portugal.
- CIEC, Research Centre on Child Studies, Institute of Education, University of Minho, Braga, Portugal.
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Duarte A, Martins S, Lopes L, Silva MJ, Augusto C, Santos R, Rosário R. Is the association between sleep and socio-emotional development mediated by weight in toddlers aged 12 to 36 months? Front Psychol 2023; 14:1190081. [PMID: 38125855 PMCID: PMC10731978 DOI: 10.3389/fpsyg.2023.1190081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Childhood is an important stage for socio-emotional development. Understanding the associations of lifestyle habits with the healthy development of social and emotional skills is crucial for better interventions early in life. This study aims to analyze the association between sleep and socio-emotional development in toddlers aged 12 to 36 months and examine whether weight mediated these associations. Methods This study is part of a cluster randomized controlled trial developed in Portuguese childcare centers. A sample of 344 children (176 females) enrolled in the study. Participants' anthropometrics were measured while at childcare centers using standardized procedures. Body mass index (BMI) was computed as the body weight/height2 (kg/m2) ratio. Sleep quality was collected with the Tayside Children's Sleep Questionnaire, a 10-item scale that evaluates the child's ability to initiate and maintain sleep. Two additional questions regarding sleep duration were added. Parental questionnaires assessed the child's sex and date of birth, socioeconomic status, and total energy intake (TEI). Motor (fine and gross) was assessed using Bayley-III scales and socio-emotional (SE) by the Greenspan Social-Emotional Growth Chart questionnaire. Linear regression models were used to examine the associations between sleep (duration and quality) and SE with adjustments for sex, age, BMI, mothers' education, motor development, and TEI. Mediation analysis was conducted using path analysis. Results SE development was significantly associated with nighttime sleep duration even when adjusted for confounders (β = 0.223; 95% CI: 0.001, 0.004 and β = 0.168; 0.0003, 0.003; respectively). Sleep quality was not significantly associated with SE development, and the weight did not explain the associations between sleep and SE development. Conclusion This study supports that sleep duration is directly associated with SE development in toddlers. From a public health perspective, sleep duration should be prioritized in intervention programs to improve socio-emotional development early in life.
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Affiliation(s)
- Ana Duarte
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Research Centre on Child Studies (CIEC), Institution of Education, University of Minho, Braga, Portugal
| | - Silvana Martins
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
| | - Maria José Silva
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Nursing Research Centre, School of Nursing, University of Minho, Braga, Portugal
- School of Nursing, University of Minho, Braga, Portugal
| | - Cláudia Augusto
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Nursing Research Centre, School of Nursing, University of Minho, Braga, Portugal
- School of Nursing, University of Minho, Braga, Portugal
| | - Rute Santos
- Research Centre on Child Studies (CIEC), Institution of Education, University of Minho, Braga, Portugal
- Institute of Education, University of Minho, Braga, Portugal
| | - Rafaela Rosário
- The Health Sciences Research Unit: Nursing (UICISA: E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Research Centre on Child Studies (CIEC), Institution of Education, University of Minho, Braga, Portugal
- Nursing Research Centre, School of Nursing, University of Minho, Braga, Portugal
- School of Nursing, University of Minho, Braga, Portugal
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McCann S, Mason L, Milosavljevic B, Mbye E, Touray E, Colley A, Johnson W, Lloyd-Fox S, Elwell CE, Moore SE. Iron status in early infancy is associated with trajectories of cognitive development up to pre-school age in rural Gambia. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002531. [PMID: 37910494 PMCID: PMC10619872 DOI: 10.1371/journal.pgph.0002531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/03/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Iron deficiency is among the leading risk factors for poor cognitive development. However, interventions targeting iron deficiency have had mixed results on cognitive outcomes. This may be due to previous interventions focusing on the correction of iron deficiency anaemia in late infancy and early childhood, at which point long lasting neural impacts may already be established. We hypothesise that the relationship between iron status and cognitive development will be observable in the first months of life and will not be recovered by 5 years of age. METHODS Using data from the Brain Imaging for Global Health (BRIGHT) Study in Gambia (n = 179), we conducted mixed effects modelling to assess the relationship between iron status at 5 months of age and trajectories of cognitive development from 5 months- 5 years using (i) a standardised measure of cognitive development (Mullen Scales of Early Learning) and (ii) an eye-tracking assessment of attention processing (visual disengagement time). RESULTS All infants were iron sufficient at 1 month of age. At 5 and 12 months of age 30% and 55% of infants were iron deficient respectively. In fully adjusted analyses, infants in the lowest tercile of soluble transferrin receptor (sTfR) (best iron status) achieved MSEL Cognitive Scores on average 1.9 points higher than infants in the highest sTfR tercile (p = 0.009, effect size = 0.48). There was no evidence that this group difference was recovered by 5 years of age. Infants in the lowest sTfR tercile had visual disengagement time 57ms faster than the highest tercile (p = 0.001, effect size = 0.59). However, this difference diminished by early childhood (p = 0.024). CONCLUSION Infants are at risk of iron deficiency in early infancy. A relationship between iron status and cognitive development is apparent from 5 months of age and remains observable at 5 years of age. One mechanism by which iron availability in early infancy impacts brain development may be through effects on early attentional processing, which is rapidly developing and has substantial nutritional requirements during this period. To support neurocognitive development, prevention of iron deficiency in pre- and early postnatal life may be more effective than correcting iron deficiency once already established.
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Affiliation(s)
- Samantha McCann
- Department of Women and Children’s Health, King’s College London, London, United Kingdom
| | - Luke Mason
- Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | | | - Ebrima Mbye
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Ebou Touray
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Alhassan Colley
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sarah Lloyd-Fox
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Clare E. Elwell
- Department of Medical Physics, University College London, London, United Kingdom
| | - Sophie E. Moore
- Department of Women and Children’s Health, King’s College London, London, United Kingdom
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Alberge C, Ehlinger V, Noack N, Bolzoni C, Colombié B, Breinig S, Dicky O, Delobel M, Arnaud C. Early psychomotor therapy in very preterm infants does not improve Bayley-III scales at 2 years. Acta Paediatr 2023; 112:1916-1925. [PMID: 37191836 DOI: 10.1111/apa.16848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/17/2023]
Abstract
AIM To assess the efficacy of post-hospital psychomotor therapy in the development of very preterm infants at nine and 24 months. METHODS We conducted a randomised controlled study at Toulouse Children's Hospital between 2008 and 2014 among preterm infants aged under 30 weeks. All infants in both groups could benefitt from physiotherapy to prevent motor disorders. The intervention group received 20 early post-hospital psychomotor therapy sessions. The development was assessed by the Bayley Scale Infant Development at nine and 24 months. RESULTS The intervention and control group contained 77 and 84 infants, respectively, with 57 infants in each group undergoing assessment at 24 months. Boys accounted for 56% of the population. Median gestational age was 28 weeks, range 25-29. The development scores at 24 months did not significantly differ between the randomisation groups. At 9 months, we observed improvements in global motricity (mean difference 0.9 point, p = 0.04) and fine motricity for the subgroup containing educationally underserved mothers (mean difference 1.6 point, p = 0.008). There was no significant difference in neuromotor functioning between the two groups. CONCLUSION The benefits of psychomotor therapy were short-lived and did not persist post-intervention. Our results and this organisational model encouraged us to persevere towards similar multi-professional care.
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Affiliation(s)
- Corine Alberge
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | | | - Nathalie Noack
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | | | - Bruno Colombié
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | - Sophie Breinig
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Odile Dicky
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
- Neonatology Department, Toulouse University Children's Hospital, Toulouse, France
| | - Malika Delobel
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Catherine Arnaud
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
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Decsi T, Marosvölgyi T, Szabó É. Docosahexaenoic Acid in Formulas for Term Infants: The Way from Pioneer Idea to Mandatory Dietary Recommendation. Life (Basel) 2023; 13:1326. [PMID: 37374109 DOI: 10.3390/life13061326] [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] [Received: 04/07/2023] [Revised: 05/23/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
Docosahexaenoic acid (DHA) is a novel mandatory constituent of breast-milk-substitute infant formula in Europe. The aim of the present narrative review was to summarize available data in connection with the background of the novel European mandatory dietary recommendation to add at least 20 mg/100 kcal (4.8 mg/100 kJ) DHA to infant formula. The literature search with the expression "docosahexaenoic acid with (infant or human milk or formula)" revealed nearly 2000 papers, including more than 400 randomized controlled trials (RCTs). DHA is a persistent constituent of human milk (HM) with a worldwide mean level of 0.37% (standard deviation: 0.11%) of all fatty acids in HM. RCTs on supplementing DHA to lactating women showed some indications, though no direct evidence of the beneficial effect of enhanced HM DHA on the development of breastfed infants. The most-recent Cochrane review of RCTs investigating the effect of DHA supplementation to infant formula for full-term infants reported no evidence for recommending supplementation. The controversy between the Cochrane view and the actual recommendation may be related to the numerous hurdles in organizing high-quality studies in this field. On the basis of the official food composition recommendation, today in Europe, DHA should be considered as a fatty acid essential for infants.
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Affiliation(s)
- Tamás Decsi
- Department of Pediatrics, Medical School and Clinical Centre, University of Pécs, 7623 Pécs, Hungary
- Cochrane Hungary, Clinical Centre, University of Pécs, 7623 Pécs, Hungary
| | - Tamás Marosvölgyi
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Éva Szabó
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, 7624 Pécs, Hungary
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Bakken KS, Kvestad I, Bjørkevoll SMG, Solvik BS, Kaldenbach S, McCann A, Holten-Andersen MN, Ersvær E, Konijnenberg C, Strand TA. Vitamin B 12 status in infancy and the effect of a vitamin B 12 injection in infants with subclinical vitamin B 12 deficiency: study protocol for a register-based randomised controlled trial. BMJ Open 2023; 13:e069102. [PMID: 37080624 PMCID: PMC10124272 DOI: 10.1136/bmjopen-2022-069102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Vitamin B12 (cobalamin) is crucial for optimal child development and growth, yet deficiency is common worldwide. The aim of this study is twofold; (1) to describe vitamin B12 status and the status of other micronutrients in Norwegian infants, and (2) in a randomised controlled trial (RCT), investigate the effect of vitamin B12 supplementation on neurodevelopment in infants with subclinical vitamin B12 deficiency. METHODS AND ANALYSIS Infant blood samples, collected at public healthcare clinics, are analysed for plasma cobalamin levels. Infants with plasma cobalamin <148 pmol/L are immediately treated with hydroxocobalamin and excluded from the RCT. Remaining infants (cobalamin ≥148 pmol/L) are randomly assigned (in a 1:1 ratio) to either a screening or a control group. In the screening group, baseline samples are immediately analysed for total homocysteine (tHcy), while in the control group, the baseline samples will be analysed after 12 months. Screening group infants with plasma tHcy >6.5 µmol/L, are given an intramuscular injection of hydroxocobalamin (400 µg). The primary outcomes are cognitive, language and motor development assessed using the Bayley Scales of Infant and Toddler Development at 12 months of age. ETHICS AND DISSEMINATION The study has been approved by the Regional Committee for Medical and Health Research Ethics (ref: 186505). Investigators who meet the Vancouver requirements will be eligible for authorship and be responsible for dissemination of study findings. Results will extend current knowledge on consequences of subclinical vitamin B12 deficiency during infancy and may inform future infant feeding recommendations. TRIAL REGISTRATION NUMBER NCT05005897.
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Affiliation(s)
- Kjersti S Bakken
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
- Center for International Health, University of Bergen, Bergen, Norway
| | - Ingrid Kvestad
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
| | - Sol Maja Graasvold Bjørkevoll
- Center for International Health, University of Bergen, Bergen, Norway
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
| | - Beate Stokke Solvik
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
- Center for International Health, University of Bergen, Bergen, Norway
| | - Siri Kaldenbach
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Adrian McCann
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
| | - Mads Nikolaj Holten-Andersen
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Ersvær
- Department of Medical Biochemistry and Blood Bank Laboratory Services, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Biotechnology, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Carolien Konijnenberg
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Tor A Strand
- Center for International Health, University of Bergen, Bergen, Norway
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
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Chandyo RK, Kvestad I, Ulak M, Ranjitkar S, Hysing M, Shrestha M, Schwinger C, McCann A, Ueland PM, Basnet S, Shrestha L, Strand TA. The effect of vitamin B12 supplementation during pregnancy on infant growth and development in Nepal: a community-based, double-blind, randomised, placebo-controlled trial. Lancet 2023; 401:1508-1517. [PMID: 37031691 DOI: 10.1016/s0140-6736(23)00346-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Vitamin B12 is required for healthy infant growth and development, but low and marginal vitamin B12 status is endemic in low-income and middle-income countries. We aimed to measure the effect of vitamin B12 supplementation from early pregnancy until 6 months post partum on infant growth and neurodevelopment. METHODS In this community-based, double-blind, placebo-controlled trial, we randomly assigned (1:1) 800 pregnant women (aged 20-40 years) who were up to 15 weeks pregnant-recruited from home visits and outpatient departments at three hospitals in Nepal-to daily supplementation with 50 μg oral vitamin B12 or placebo until 6 months postpartum. Independent scientists generated the list that linked allocation to participants' study identification number. Participants were masked to group assignment and all investigators were masked until data cleaning was completed. The primary outcomes were length-for-age Z score (LAZ) at age 12 months and the cognitive composite score of the Bayley Scales of Infant and Toddler Development (3rd edition) at age 6 months and 12 months. The primary and secondary outcomes, including adverse events, were assessed in the intention-to-treat population, for all participants with available outcome data. This trial is registered with ClinicalTrials.gov, NCT03071666. FINDINGS 800 eligible pregnant women were enrolled in the trial between March 28, 2017, and Oct 15, 2020, with 400 women randomly assigned to each group. Follow-up was completed on May 18, 2022. At baseline, 569 (71%) of 800 women had plasma vitamin B12 indicating low or marginal status (<221 pmol/L). We found no effect of vitamin B12 on the primary outcomes. The mean LAZ at age 12 months were -0·57 (SD 1·03) in the B12 group and -0·55 (1.03) in the placebo group (366 infants in the vitamin B12 group vs 363 infants in the placebo group) with a mean difference of -0·02 (95% CI -0·16 to 0·13). The mean cognitive composite scores were 97·7 (SD 10·5) in the B12 group and 97·1 (10·2) in the placebo group, with a mean difference of 0·5 (95% CI -0·6 to 1·7) measured in 364 and 361 infants. Stillbirths or infant deaths occurred in three (1%) of 374 women in the vitamin B12 group and nine (2%) of 379 women in the placebo group. INTERPRETATION Although vitamin B12 deficiency was prevalent in our study population and vitamin B12 supplementation from early pregnancy substantially improved vitamin B12 status, supplementation did not improve infant growth or neurodevelopment. Our findings support the current WHO recommendations of no routine vitamin B12 supplementation during pregnancy. FUNDING Research Council of Norway.
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Affiliation(s)
- Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Manjeswori Ulak
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Bergen, Norway
| | - Suman Ranjitkar
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, Bergen, Norway
| | - Merina Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Catherine Schwinger
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Bergen, Norway
| | - Adrian McCann
- Bevital, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | | | - Sudha Basnet
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Laxman Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Tor A Strand
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway.
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12
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Nina Banerjee P, McFadden K, Shannon JD, Davidson LL. Preterm Birth and Other Measures of Infant Biological Vulnerability: Associations with Maternal Sensitivity and Infant Cognitive Development. Matern Child Health J 2023; 27:698-710. [PMID: 36759432 DOI: 10.1007/s10995-023-03590-y] [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] [Accepted: 01/18/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Low birth weight (LBW), biological vulnerability that includes preterm birth (PTB) and small for gestational age (SGA), is associated with reduced maternal sensitivity ("making accurate inferences about an infant's physical and emotional needs and responding appropriately") and impaired infant cognitive development. However, research does not examine if preterm birth, SGA, or both drive these associations. This study separated these measures of biological vulnerability to examine associations of LBW, PTB, and SGA with maternal sensitivity and infant cognitive development (controlling for maternal depression, breastfeeding, and demographic covariates). METHODS The sample included 6900 9-month-old infants from the Early Childhood Longitudinal Study-Birth Cohort and used birth certificate data, maternal interviews, assessments of maternal sensitivity and infant cognitive development. Multiple linear regressions examined LBW, PTB, and SGA associations with concurrent measures of maternal sensitivity and infant cognition. RESULTS Of the biological vulnerabilities, preterm birth had the strongest negative association with maternal sensitivity (F1,6450 = 29.48 versus 15.33 and 5.51, ps < .001) and infant cognitive development (F1,6450) = 390.65 versus 248.02 and 14.43, ps < .001). In the final regression model, preterm birth and maternal sensitivity were uniquely associated with infant cognitive development (R2 = .05, p < .001), after controlling for maternal depression, breastfeeding, and demographics. CONCLUSION In this nationally representative infant sample infants, PTB had a stronger negative association with both maternal sensitivity and infant cognitive development in comparison to SGA or LBW. The LBW designation combines infants born preterm with SGA infants, potentially minimizing differences in developmental outcomes of PTB and SGA infants.
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Affiliation(s)
- P Nina Banerjee
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY, USA.
| | - Karen McFadden
- Department of Early Childhood Education/Art Education Department, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Jacqueline D Shannon
- Department of Early Childhood Education/Art Education Department, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Leslie L Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY, USA
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13
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Ulak M, Kvestad I, Chandyo RK, Ranjitkar S, Hysing M, Schwinger C, Shrestha M, Basnet S, Shrestha LP, Strand TA. The effect of infant vitamin B 12 supplementation on neurodevelopment: a follow-up of a randomised placebo-controlled trial in Nepal. Br J Nutr 2023; 129:41-48. [PMID: 35152918 PMCID: PMC9816651 DOI: 10.1017/s0007114522000071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/20/2021] [Accepted: 01/06/2022] [Indexed: 01/21/2023]
Abstract
The most critical period for brain development is before a child's second birthday. Standardised tests measuring neurodevelopment are more reliable when administered after this period. Severe vitamin B12 deficiency affects brain development and function. In a randomised, double-blind, placebo-controlled trial in 600 Nepalese infants (6-11 months at enrolment), we found no effect of 2 µg vitamin B12 daily for a year on neurodevelopment. The primary objective of the current study was to measure the effect of the intervention on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) full scale intelligence quotient (FSIQ). We measured the effect on the Bayley Scales of Infant and Toddler Development 3rd edition at age 30-35 months (n 555). At age 42-47 months (n 533), we used the WPPSI-IV and subtests from the Neuropsychological Assessment, 2nd edition (NEPSY-II). We also used the FSIQ to estimate subgroup specific effects. The mean (sd) WPPSI-IV FSIQ in the vitamin B12 group was 84·4 (8·4) and 85·0 (8·6) in the placebo group (mean difference -0·5 (95 % CI -1·97, 0·94), P = 0·48). There were no effect of the vitamin B12 on any of the other neurodevelopmental outcomes and no beneficial effect in any of the subgroups. In conclusion, providing 2 µg of vitamin B12 for a year in infants at risk of vitamin B12 deficiency does not improve preschool cognitive function.
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Affiliation(s)
- Manjeswori Ulak
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ram Krishna Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Suman Ranjitkar
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Catherine Schwinger
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Merina Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sudha Basnet
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Laxman P. Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Tor A. Strand
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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14
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Balalian AA, Graeve R, Richter M, Fink A, Kielstein H, Martins SS, Philbin MM, Factor-Litvak P. Prenatal exposure to opioids and neurodevelopment in infancy and childhood: A systematic review. Front Pediatr 2023; 11:1071889. [PMID: 36896405 PMCID: PMC9989202 DOI: 10.3389/fped.2023.1071889] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/23/2023] [Indexed: 02/23/2023] Open
Abstract
Aim This systematic review aims to estimate the relationship between prenatal exposure to opioids and neurodevelopmental outcomes and examines potential sources of heterogeneity between the studies. Methods We searched four databases through May 21st, 2022: PubMed, Embase, PsycInfo and the Web of Science according to a specified search strings. Study inclusion criteria include: (1) cohort and case-control peer-reviewed studies published in English; (2) studies comparing neurodevelopmental outcomes among children with prenatal opioid-exposure (prescribed or used non-medically) vs. an unexposed group. Studies investigating fetal alcohol syndrome or a different primary prenatal exposure other than opioids were excluded. Two main performed data extraction using "Covidence" systematic review platform. This systematic review was conducted in accordance with PRISMA guidelines. The Newcastle-Ottawa-Scale was used for quality assessment of the studies. Studies were synthesized based on the type of neurodevelopmental outcome and the instrument used to assess neurodevelopment. Results Data were extracted from 79 studies. We found significant heterogeneity between studies due to their use of different instruments to explore cognitive skills, motor, and behavioral outcomes among children of different ages. The other sources of heterogeneity included: procedures to assess prenatal exposure to opioids; period of pregnancy in which exposure was assessed; type of opioids assessed (non-medical, medication used for opioid use dis-order, prescribed by health professional), types of co-exposure; source of selection of prenatally exposed study participants and comparison groups; and methods to address lack of comparability between exposed and unexposed groups. Cognitive and motor skills as well as behavior were generally negatively affected by prenatal opioid exposure, but the significant heterogeneity precluded a meta-analysis. Conclusion We explored sources of heterogeneity in the studies assessing the association between prenatal exposure to opioids and neurodevelopmental outcomes. Sources of heterogeneity included different approaches to participant recruitment as well as exposure and outcome ascertainment methods. Nonetheless, overall negative trends were observed between prenatal opioid exposure and neuro-developmental outcomes.
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Affiliation(s)
- Arin A Balalian
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Richard Graeve
- Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Richter
- Social Determinants of Health Group, Department of Sport and Health Sciences, Technical University of Munich (TUM), Germany
| | - Astrid Fink
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Groß-Gerau, Germany
| | - Heike Kielstein
- Institut für Anatomie und Zellbiologie, Martin-Luther-Universität Halle, Halle (Saale), Germany
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Morgan M Philbin
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
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15
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Blok LER, Boon M, van Reijmersdal B, Höffler KD, Fenckova M, Schenck A. Genetics, molecular control and clinical relevance of habituation learning. Neurosci Biobehav Rev 2022; 143:104883. [PMID: 36152842 DOI: 10.1016/j.neubiorev.2022.104883] [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: 04/22/2022] [Revised: 08/08/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022]
Abstract
Habituation is the most fundamental form of learning. As a firewall that protects our brain from sensory overload, it is indispensable for cognitive processes. Studies in humans and animal models provide increasing evidence that habituation is affected in autism and related monogenic neurodevelopmental disorders (NDDs). An integrated application of habituation assessment in NDDs and their animal models has unexploited potential for neuroscience and medical care. With the aim to gain mechanistic insights, we systematically retrieved genes that have been demonstrated in the literature to underlie habituation. We identified 258 evolutionarily conserved genes across species, describe the biological processes they converge on, and highlight regulatory pathways and drugs that may alleviate habituation deficits. We also summarize current habituation paradigms and extract the most decisive arguments that support the crucial role of habituation for cognition in health and disease. We conclude that habituation is a conserved, quantitative, cognition- and disease-relevant process that can connect preclinical and clinical work, and hence is a powerful tool to advance research, diagnostics, and treatment of NDDs.
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Affiliation(s)
- Laura Elisabeth Rosalie Blok
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
| | - Marina Boon
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
| | - Boyd van Reijmersdal
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
| | - Kira Daniela Höffler
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
| | - Michaela Fenckova
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands; Department of Molecular Biology and Genetics, Faculty of Science, University of South Bohemia in Ceske Budejovice, Branisovska 31, 37005, Ceske Budejovice, Czech Republic.
| | - Annette Schenck
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
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16
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Rusnak SN, Rocha-Hidalgo J, Blanchfield OA, Odier M, Sawaf T, Barr R. The development of the object sequencing imitation task to measure working memory in preschoolers. J Exp Child Psychol 2022; 218:105372. [DOI: 10.1016/j.jecp.2022.105372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 12/23/2021] [Accepted: 01/02/2022] [Indexed: 11/29/2022]
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Ryberg R, Wiggins L, Moore KA, Daily S, Piña G, Klin A. Measuring state-level infant and toddler well-being in the United States: Gaps in data lead to gaps in understanding. CHILD INDICATORS RESEARCH 2022; 15:1063-1102. [PMID: 35924079 PMCID: PMC9345511 DOI: 10.1007/s12187-021-09902-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 06/15/2023]
Abstract
Children who are nurtured, protected, and supported in the first years of life tend to have better individual outcomes and are more likely to grow to become healthy, productive adults. Child well-being varies across states, yet the field lacks a comprehensive review of infant and toddler indicators measured at the state-level. This paper reviews indicators of well-being from the prenatal period to three years that meet certain a priori criteria. Most of the child-level indicators identified were in the physical health domain; relatively fewer indicators were found in the early cognition and language or social-emotional-behavioral domains. While some states are making progress toward developing integrated early childhood data systems, more work is needed to provide robust data on infant and toddler development. These results highlight the need to develop a broader range of indicators of infant and toddler well-being and improve measurement sources to better inform policies and programs advancing population health.
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Affiliation(s)
| | - Lisa Wiggins
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Ami Klin
- Marcus Autism Center, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
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18
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Rodriguez N, Tessier CA, Mandhane PJ, Pei J, Simons E, Moraes TJ, Turvey SE, Subbarao P, Kozyrskyj AL. Sex-specific associations among infant food and atopic sensitizations and infant neurodevelopment. Front Pediatr 2022; 10:734428. [PMID: 36389362 PMCID: PMC9648178 DOI: 10.3389/fped.2022.734428] [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: 07/01/2021] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Food sensitization is a first and strong indicator of immune deviation in the progression to other allergic conditions. Sensitization to food or other allergens and related inflammation during critical windows of infant development may adversely affect neurodevelopmental milestones. However, additional research is needed to test this association further. METHODS Associations between atopic (any food or aeroallergen) or food sensitization (specific to egg, soybean, peanut, and milk) at age 1 year and neurodevelopment up to 2 years of age were evaluated in the national CHILD Cohort Study, with a secondary aim examining whether these associations were sex-specific. Food and atopic sensitization were assessed by skin prick tests (SPT) in 1-year-old infants, with neurodevelopment assessed using the cognitive, language, motor, and social-emotional subscales of the Bayley Scales of Infant Development (BSID-III) administered at 1 and 2 years of age. RESULTS Atopic sensitization was present among 16.4% of infants, while 13.4% had food sensitizations. Only socioemotional scores reached statistical significance among the four BSID-III domains. Both atopic and food sensitization at 1 year of age was associated with lower social-emotional scores, independent of the infant's ethnicity. These findings were sex-specific and only observed among boys, among whom social-emotional scores were lowered by 5 points if atopic sensitization was present (-5.22 [95% CI: -9.96, -0.47], p = 0.03) or if food sensitization was present (-4.85 [95% CI: -9.82,0.11], p = 0.06). Similar results were observed using the standard SPT cut-off of ≥3 mm - for atopic sensitization (-5.17 [95% CI: -11.14, -0.80], p = 0.09) and for food sensitization (-4.61 [95% CI: -10.96, 1.74], p = 0.15). CONCLUSION In our study of term infants, we found an inverse, cross-sectional association between atopic and food sensitization status and social-emotional development scores in male children but not female children.
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Affiliation(s)
- Nicole Rodriguez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carmen A Tessier
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Piushkumar J Mandhane
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Elinor Simons
- Department of Pediatrics and Child Health, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Theo J Moraes
- Department of Pediatrics, Faculty of Medicine, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
| | - Stuart E Turvey
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Faculty of Medicine, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Department of Obstetrics and Gynecology, School of Public Health, University of Alberta, Edmonton, AB, Canada
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Juvrud J, Haas SA, Lindskog M, Astor K, Namgyel SC, Wangmo T, Wangchuk, Dorjee S, Tshering KP, Gredebäck G. High quality social environment buffers infants' cognitive development from poor maternal mental health: Evidence from a study in Bhutan. Dev Sci 2021; 25:e13203. [PMID: 34897908 DOI: 10.1111/desc.13203] [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: 03/09/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 12/01/2022]
Abstract
Poor maternal mental health negatively impacts cognitive development from infancy to childhood, affecting both behavior and brain architecture. In a non-western context (Thimphu, Bhutan), we demonstrate that culturally-moderated factors such as family, community social support, and enrichment may buffer and scaffold the development of infant cognition when maternal mental health is poor. We used eye-tracking to measure early building blocks of cognition: attention regulation and social perception, in 9-month-old Bhutanese infants (N = 121). The cognitive development of Bhutanese infants in richer social environments was buffered from poor maternal mental health, while for infants in environments with lower rates of protective social environment factors, worse maternal mental health significantly predicted greater costs for infant attention, a fundamental building block cognition. International policies and interventions geared to improve maternal mental health and child health outcomes should incorporate each regions' unique family, cultural, and community support structures.
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Affiliation(s)
- Joshua Juvrud
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Sara A Haas
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Marcus Lindskog
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kim Astor
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Sangay C Namgyel
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Tshering Wangmo
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Wangchuk
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Sithar Dorjee
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | | | - Gustaf Gredebäck
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
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20
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Federico A, Shi D, Bradshaw J. Agreement Between Parental Report and Clinician Observation of Infant Developmental Skills. Front Psychol 2021; 12:734341. [PMID: 34795613 PMCID: PMC8593390 DOI: 10.3389/fpsyg.2021.734341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
Understanding the convergence between parent report and clinician observation measures of development is important and became even more critical during the COVID-19 pandemic as clinician contact with families was significantly limited. Previous research points to inconsistencies in the degree of agreement between parents and clinicians and very little research has examined these associations for infants within the first year of life. This study investigated the association between parent report and clinician observation measures of social communication and motor skills in 27 young infants who were assessed at 9 and 12 months of age. Results suggest a strong relation between clinician and parent rated motor skills, but weak to moderate associations between clinician and parent rated communication skills. Infant temperament played a significant role in parent ratings of infant communication. Together, these results provide support for data collection via parent report or clinician observation of infant motor skills, but suggest that multiple measures of infant communication may be helpful to obtain high-quality, perhaps more accurate, assessment social-communication skills. Specifically, multiple parent report measures along with an observation of parent-infant interactions will likely provide a more rich and accurate characterization of infant social-communication abilities.
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Affiliation(s)
| | | | - Jessica Bradshaw
- Department of Psychology, University of South Carolina, Columbia, SC, United States
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21
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Tan H, Blasco P, Lewis T, Ostmo S, Chiang MF, Campbell JP. Neurodevelopmental outcomes in preterm infants with retinopathy of prematurity. Surv Ophthalmol 2021; 66:877-891. [PMID: 33667496 PMCID: PMC8351023 DOI: 10.1016/j.survophthal.2021.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
Over the past decade there has been a paradigm shift in the treatment of retinopathy of prematurity (ROP) with the introduction of antivascular endothelial growth factor (anti-VEGF) treatments. Anti-VEGF agents have the advantages of being easier to administer, requiring less anesthesia, having the potential for improved peripheral vision, and producing less refractive error than laser treatment. On the other hand, it is known that intravitreal administration of anti-VEGF agents lowers VEGF levels in the blood and raises the theoretical concern of intraocular anti-VEGF causing deleterious effects in other organ systems, including the brain. As a result, there has been increased attention recently on neurodevelopmental outcomes in infants treated with anti-VEGF agents. These studies should be put into context with what is known about systemic comorbidities, socioeconomic influences, and the effects of extreme prematurity itself on neurodevelopmental outcomes. We summarize what is known about neurodevelopmental outcomes in extremely preterm infants with ROP, discuss the implications for determining the neurodevelopmental status using neurodevelopmental testing as well as other indicators, and review the existing literature relating to neurodevelopmental outcomes in babies treated for ROP.
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Affiliation(s)
- Hao Tan
- Casey Eye Institute, Department of Ophthalmology, Oregon Health and Science University, Portland, OR, USA
| | - Patricia Blasco
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA
| | - Tamorah Lewis
- Children's Mercy Hospital, Divisions of Neonatology and Pediatric Clinical Pharmacology, University of Missouri Kansas City, Kansas City, MO, USA
| | - Susan Ostmo
- Casey Eye Institute, Department of Ophthalmology, Oregon Health and Science University, Portland, OR, USA
| | - Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - John Peter Campbell
- Casey Eye Institute, Department of Ophthalmology, Oregon Health and Science University, Portland, OR, USA.
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22
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DiGirolamo AM, Ochaeta L, Flores RMM. Early Childhood Nutrition and Cognitive Functioning in Childhood and Adolescence. Food Nutr Bull 2021; 41:S31-S40. [PMID: 32522121 DOI: 10.1177/0379572120907763] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Institute of Nutrition of Central America and Panama (INCAP) Longitudinal Study provides a unique opportunity to examine the role of nutrition in cognitive functioning over time, controlling for other sociocultural factors. OBJECTIVE This article describes results of analyses carried out in the INCAP Longitudinal Study on relationships between early childhood nutritional status and supplementation with concurrent and subsequent cognitive development in childhood and adolescence/young adulthood. METHODS Articles were chosen for review that addressed this topic from the original and 1988 follow-up studies; 41 articles were reviewed and key results summarized for relationships between early nutrition and cognition in infancy, early childhood, and adolescence/young adulthood. RESULTS Overall, results suggest strong relationships between indicators of a child's early nutritional status and motor and cognitive development in infancy and through the preschool years, continuing into adolescence/young adulthood, particularly for males. Nutritional supplementation during gestation through 2 years of age was associated with improvements in motor development and small, but consistent improvements in cognitive development during infancy and preschool years, with similar results of greater magnitude found with cognitive functioning in adolescence and young adulthood. Findings remain strong after controlling for various sociocultural factors (eg, socioeconomic status [SES]) and schooling. Among adolescents, significant interactions were found with SES and years of school attained; differences in performance favored Atole over Fresco children, with greatest differences for participants of low SES and those with higher levels of schooling. CONCLUSIONS Results support the need for programs to address unmet nutritional requirements among at-risk mothers and children and potential beneficial effects for human cognitive development.
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Affiliation(s)
- Ann M DiGirolamo
- Georgia Health Policy Center, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA
| | - Laura Ochaeta
- Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
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23
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Bogičević L, Verhoeven M, van Baar AL. Exploring predictors at toddler age of distinct profiles of attentional functioning in 6-year-old children born moderate-to-late preterm and full term. PLoS One 2021; 16:e0254797. [PMID: 34324546 PMCID: PMC8320975 DOI: 10.1371/journal.pone.0254797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/05/2021] [Indexed: 12/03/2022] Open
Abstract
Objective Examining relationships of toddler abilities in attention, cognitive, motor, and language development, and behavioral problems, with distinct attention profiles at 6 years of age in children born moderate-to-late preterm and full term. Method Longitudinal study with a cohort of 88 moderate-to-late preterm and 83 full term born children. At 18 months attention abilities were assessed. At 24 months cognitive, motor, and language development was examined and behavioral problems were screened. At 6 years ten measures of attention were administered, which were used to classify children in one of four attentional functioning profiles (normal attention, overall poorer attention, poorer cognitive attention, and behavioral attention problems). Performance at 18 and 24 months was examined in relation to these four distinct attention profiles, as well as in relation to normal (first profile) versus subaverage attention (second, third, and fourth profiles) using multinomial logistic regressions. Results Orienting and alerting attention, and receptive language were related to distinct attention profiles. Specifically, children with an overall poorer attention profile at 6 years were differentiated by lower orienting attention and receptive language scores at toddler age, while those with a poorer cognitive attention profile showed lower early alerting attention at 18 months. Children with a behavioral attention problems profile at 6 years were differentiated by lower orienting attention but higher alerting attention scores at toddler age. Orienting attention and receptive language, but not alerting attention, at toddler age were related to normal versus subaverage attention, with lower scores predicting subaverage attention. Conclusions Children at risk of poorer attentional functioning at school-age, expressed in distinct attention profiles, already showed differentiated functioning in attention abilities and in language comprehension as toddlers. Distinguishing distinct attention profiles could be important for future research and clinical practice, as is early monitoring of attention and language abilities in children at risk.
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Affiliation(s)
- Lilly Bogičević
- Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
- * E-mail:
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24
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Albert P, Romski M, Sevcik RA, Morris RD. Patterns of Cognition, Communication, and Adaptive Behavior in Children With Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:324-340. [PMID: 34161562 DOI: 10.1352/1944-7558-126.4.324] [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: 06/26/2020] [Accepted: 11/19/2020] [Indexed: 06/13/2023]
Abstract
Young children with developmental disabilities (DD) exhibit a range of strengths and weaknesses in cognitive, language, and adaptive skills. Identifying individual patterns of abilities across these domains is important for informing interventions. This study examines how 129 toddlers with significant developmental delays and less than 10 spoken words perform across different developmental domains and assessment methods (i.e., caregiver report and clinician-administered tests). Children exhibited statistically and clinically meaningful strengths and weaknesses across developmental domains, which may have important implications for differential interventions. Caregiver-reported and clinician-rated measures of cognition, language and adaptive functioning were highly related. However, the relation between caregiver report and clinician ratings was weaker for a subgroup of children with relatively more limited expressive language compared to other children in the sample.
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Affiliation(s)
- Phebe Albert
- Phebe Albert, MaryAnn Romski, Rose A. Sevcik, and Robin D. Morris, Georgia State University
| | - MaryAnn Romski
- Phebe Albert, MaryAnn Romski, Rose A. Sevcik, and Robin D. Morris, Georgia State University
| | - Rose A Sevcik
- Phebe Albert, MaryAnn Romski, Rose A. Sevcik, and Robin D. Morris, Georgia State University
| | - Robin D Morris
- Phebe Albert, MaryAnn Romski, Rose A. Sevcik, and Robin D. Morris, Georgia State University
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25
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Singletary B, Bates R, Justice L. Evaluating associations between maternal social support and cognitive development for infants in poverty. Infant Behav Dev 2021; 63:101546. [PMID: 33636474 DOI: 10.1016/j.infbeh.2021.101546] [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: 09/02/2020] [Revised: 01/05/2021] [Accepted: 02/15/2021] [Indexed: 11/25/2022]
Abstract
Infant cognitive development may be associated with maternal social support, although these relations have not been well-examined for infants living in poverty. We explore whether maternal social support is associated with cognitive development for 113 infants living in poverty. Infant cognition was measured at age 9-12 months using the Bayley Scales of Infant and Toddler Development 3rd edition. Mothers provided information regarding perceived social support received from fathers, family, friends, and community members. Controls included maternal race and infant sex. Linear regression revealed no significant relationships between maternal social support and infant cognition in this sample.
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Affiliation(s)
- Britt Singletary
- Crane Center for Early Childhood Research & Policy, The Ohio State University, Columbus, OH, United States.
| | - Randi Bates
- Crane Center for Early Childhood Research & Policy, The Ohio State University, Columbus, OH, United States; College of Nursing, University of Cincinnati, Cincinnati, OH, United States
| | - Laura Justice
- Crane Center for Early Childhood Research & Policy, The Ohio State University, Columbus, OH, United States
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26
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Zelazo PD, Lourenco SF, Frank MC, Elison JT, Heaton RK, Wellman HM, Slotkin J, Kharitonova M, Reznick JS. Measurement of Cognition for the National Children's Study. Front Pediatr 2021; 9:603126. [PMID: 34136435 PMCID: PMC8200393 DOI: 10.3389/fped.2021.603126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 05/04/2021] [Indexed: 12/03/2022] Open
Abstract
The National Children's Study Cognitive Health Domain Team developed detailed plans for assessing cognition longitudinally from infancy to early adulthood. These plans identify high-priority aspects of cognition that can be measured efficiently and effectively, and we believe they can serve as a model for future large-scale longitudinal research. For infancy and toddlerhood, we proposed several paradigms that collectively allowed us to assess six broad cognitive constructs: (1) executive function skills, (2) episodic memory, (3) language, (4) processing speed, (5) spatial and numerical processing, and (6) social cognition. In some cases, different trial sequences within a paradigm allow for the simultaneous assessment of multiple cognitive skills (e.g., executive function skills and processing speed). We define each construct, summarize its significance for understanding developmental outcomes, discuss the feasibility of its assessment throughout development, and present our plan for measuring specific skills at different ages. Given the need for well-validated, direct behavioral measures of cognition that can be used in large-scale longitudinal studies, especially from birth to age 3 years, we also initiated three projects focused on the development of new measures.
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Affiliation(s)
- Philip David Zelazo
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States
| | - Stella F Lourenco
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Michael C Frank
- Department of Psychology, Stanford University, Palo Alto, CA, United States
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States
| | - Robert K Heaton
- Department Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Henry M Wellman
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Jerry Slotkin
- Center for Health Research and Translation, University of Delaware, Newark, DE, United States
| | | | - J Steven Reznick
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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27
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Prado EL, Maleta K, Caswell BL, George M, Oakes LM, DeBolt MC, Bragg MG, Arnold CD, Iannotti LL, Lutter CK, Stewart CP. Early Child Development Outcomes of a Randomized Trial Providing 1 Egg Per Day to Children Age 6 to 15 Months in Malawi. J Nutr 2020; 150:1933-1942. [PMID: 32286620 PMCID: PMC7330477 DOI: 10.1093/jn/nxaa088] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Eggs are a rich source of nutrients important for brain development, including choline, riboflavin, vitamins B-6 and B-12, folate, zinc, protein, and DHA. OBJECTIVE Our objective was to evaluate the effect of the consumption of 1 egg per day over a 6-mo period on child development. METHODS In the Mazira Project randomized controlled trial, 660 children aged 6-9 mo were randomly allocated into an intervention or control group. Eggs were provided to intervention households during twice-weekly home visits for 6 mo. Control households were visited at the same frequency. At enrollment, blinded assessors administered the Malawi Developmental Assessment Tool (MDAT), and 2 eye-tracking tasks using a Tobii-Pro X2-60 eye tracker: a visual paired comparison memory task and an Infant Orienting with Attention task. At endline, 6-mo later, blinded assessors administered the MDAT and eye-tracking tasks plus an additional elicited imitation memory task. RESULTS At endline, intervention and control groups did not significantly differ in any developmental score, with the exception that a smaller percentage of children were delayed in fine motor development in the intervention group (10.6%) compared with the control group (16.5%; prevalence ratio: 0.59, 95% CI: 0.38-0.91). Among 10 prespecified effect modifiers for the 8 primary developmental outcomes, we found 7 significant interactions demonstrating a consistent pattern that children who were less vulnerable, for example, those with higher household wealth and maternal education, showed positive effects of the intervention. Given multiple hypothesis testing, some findings may have been due to chance. CONCLUSION The provision of 1 egg per day had no overall effect on child development in this population of children, however, some benefits may be seen among children in less vulnerable circumstances. This trial was registered at clinicaltrials.gov as NCT03385252.
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Affiliation(s)
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | - Bess L Caswell
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
| | - Matthews George
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | - Lisa M Oakes
- Department of Psychology and Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Michaela C DeBolt
- Department of Psychology and Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Megan G Bragg
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
| | - Charles D Arnold
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
| | - Lora L Iannotti
- Brown School, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | - Chessa K Lutter
- RTI International, Washington DC, School of Public Health, University of Maryland, College Park, MD, USA
| | - Christine P Stewart
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
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28
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Nelson LF, Yocum VK, Patel KD, Qeadan F, Hsi A, Weitzen S. Cognitive Outcomes of Young Children After Prenatal Exposure to Medications for Opioid Use Disorder: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e201195. [PMID: 32186745 PMCID: PMC7081119 DOI: 10.1001/jamanetworkopen.2020.1195] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE The number of children with prenatal opioid exposure to medication for addiction treatment (MAT) with methadone and buprenorphine for maternal opioid use disorder is increasing, but the associations of this exposure with cognitive outcomes are not well understood. OBJECTIVE To examine the strength and consistency of findings in the medical literature regarding the association of prenatal exposure to MAT with early childhood cognitive development, particularly when accounting for variables outside MAT exposure. DATA SOURCES A search strategy obtained publications from PubMed, CINAHL, PsycINFO, Web of Science, and Embase from January 1972 to June 2019. Reference lists from identified articles were searched. STUDY SELECTION Inclusion criteria were cohort studies, studies including children aged 1 to 60 months with at least 2 months of prenatal MAT exposure, studies using standardized direct-observation testing scales, and studies reporting means and SDs. Case reports, case series, historical controls, and reviews were excluded. DATA EXTRACTION AND SYNTHESIS Two authors independently selected studies for inclusion, extracted data, and assessed study quality. Data extracted included demographic characteristics, covariates, sources of bias, and effect estimates. Meta-analysis was performed using random-effects models. This study was conducted according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Data extraction and synthesis were conducted between January 2018 and August 2019. MAIN OUTCOMES AND MEASURES Cognitive test scores and demographic variability between exposed and unexposed groups. RESULTS A total of 16 unique cohorts, described in 27 articles and including 1086 children (485 [44.7%] with MAT exposure), were included in a quantitative synthesis. On meta-analysis, MAT exposure was associated with lower cognitive development scores (pooled standardized mean difference, -0.57; 95% CI, -0.93 to -0.21; I2 = 81%). Multiple subanalyses on demographic characteristics (ie, maternal education, race/ethnicity, socioeconomic status, prenatal tobacco exposure, infant sex) were conducted. In the subanalysis of studies with comparable prenatal exposure to tobacco smoke, the association of MAT exposure with cognitive scores was no longer statistically significant and became homogeneous (standardized mean difference, -0.11; 95% CI, -0.42 to 0.20; I2 = 0%). CONCLUSIONS AND RELEVANCE In this study, predefined subanalyses demonstrated how poor recruitment, particularly imbalances in maternal tobacco use, could contribute to a negative overall association of cognitive development test scores with prenatal MAT exposure. Promoting tobacco cessation for pregnant women with opioid use disorder should be prioritized in this high-risk population.
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Affiliation(s)
- Leah F. Nelson
- Addiction Medicine Fellowship Program, Department of Family and Community Medicine, University of New Mexico, Albuquerque
| | | | - Keisha D. Patel
- Honors College, University of New Mexico, Albuquerque
- Combined BA/MD Program, University of New Mexico, Albuquerque
| | - Fares Qeadan
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City
| | - Andrew Hsi
- Department of Family and Community Medicine, University of New Mexico, Albuquerque
| | - Sherry Weitzen
- Department of Family and Community Medicine, University of New Mexico, Albuquerque
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