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Balasubramanian H, Ahmed J, Ananthan A, Srinivasan L, Mohan D. Comparison of parent or caregiver-completed development screening tools with Bayley Scales of Infant Development: a systematic review and meta-analysis. Arch Dis Child 2024:archdischild-2023-326771. [PMID: 38811056 DOI: 10.1136/archdischild-2023-326771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/10/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Parent/caregiver-completed developmental testing (PCDT) is integral to developmental care in children; however, there is limited information on its accuracy. In this systematic review, we compared the diagnostic accuracy of PCDT with concurrently administered Bayley Scales of Infant Development for detection of developmental delay (DD) in children below 4 years of age. METHODS We searched databases PubMed, Embase, CINAHL, PsycINFO and Google Scholar until November 2023. Bivariate and multiple thresholds summary receiver operating characteristics were used to obtain the summary sensitivity and specificity with 95% CIs. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used for risk of bias assessment. RESULTS A total of 38 studies (31 in the meta-analysis) were included. Ages and Stages Questionnaire (ASQ) and Parent Report of Children's Abilities-Revised (PARCA-R) were the most commonly evaluated PCDTs. ASQ score >2 SD below the mean had an overall sensitivity of 0.72 (0.6, 0.82) and 0.63 (0.50, 0.75) at a median specificity of 0.89 (0.82, 0.94) and 0.81 (0.76, 0.86) for diagnosing moderate to severe DD and severe DD, respectively. PARCA- R had an overall sensitivity of 0.69 (0.51, 0.83) at median specificity of 0.75 (0.64, 0.83) for predicting severe DD. Participant selection bias and partial verification bias were found in over 50% of the studies. The certainty of evidence was low for the studied outcomes. CONCLUSIONS The most commonly studied parental tools, ASQ and PARCA-R, have moderate to low sensitivity and moderate specificity for detecting DD in young children. High risk of bias and heterogeneity in the available data can potentially impact the interpretation of our results. PROSPERO REGISTRATION NUMBER CRD42021268629.
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Affiliation(s)
| | - Javed Ahmed
- Department of Neonatology, McMaster Childrens Hospital and McMaster University, Hamilton, Ontario, Canada
| | - Anitha Ananthan
- Department of Neonatology, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Lakshmi Srinivasan
- Department of Pediatrics, The Childrens Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Diwakar Mohan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Yasumitsu-Lovell K, Thompson L, Fernell E, Eitoku M, Suganuma N, Gillberg C. Validity of the ESSENCE-Q neurodevelopmental screening tool in Japan. Dev Med Child Neurol 2024. [PMID: 38760958 DOI: 10.1111/dmcn.15956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 05/20/2024]
Abstract
AIM To assess the validity of the Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire (ESSENCE-Q), a simple screening tool for neurodevelopmental problems, in Japan. METHOD Parents/caregivers completed the 11-item ESSENCE-Q for 77 612 children aged 2 years 6 months included in a national birth cohort study. Information about neurodevelopmental disorders (NDDs: autism spectrum disorder; intellectual disability and/or developmental language disorder; motor delay/motor disorder) was collected at age 3 years. Each ESSENCE-Q item was scored on a binary (0,1) scale, with a total score range of 0 to 11. Total scores and individual items were compared across children with and without NDDs. RESULTS NDDs were recorded in 854 children (1.1%). With a total ESSENCE-Q score cut-off of ≥3, receiver operating characteristic curve analysis showed an area under the curve of 0.91, with sensitivity 84.9%, specificity 84.8%, positive predictive value 5.9%, and negative predictive value 99.8%. The proportion of parental concerns at 2 years 6 months differed significantly by NDD status for communication (89.5% vs 14.2%) and general development (80.2% vs 7.4%). ESSENCE-Q total scores were moderately negatively correlated (-0.36, p < 0.001) with Japanese Ages and Stages Questionnaire scores. INTERPRETATION The parent/caregiver-completed ESSENCE-Q is useful as a tool for screening out children with neurotypical development at this early age. Further research into longer-term predictive validity will be possible as more NDD diagnoses are given as the children grow up.
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Affiliation(s)
- Kahoko Yasumitsu-Lovell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Kochi Gillberg Neuropsychiatry Centre, Kochi, Japan
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Lucy Thompson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Kochi Gillberg Neuropsychiatry Centre, Kochi, Japan
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Cao Q, Wang R, Zhou R, Huang X, Li Y, Zhu H, Qiao X, Huang W. The early development of offspring born to women with polycystic ovary syndrome: Insights from a prospective birth cohort study in Southwestern China. Psychoneuroendocrinology 2024; 163:106984. [PMID: 38340540 DOI: 10.1016/j.psyneuen.2024.106984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE This prospective cohort study aimed to investigate the effect of maternal polycystic ovary syndrome (PCOS) on the offspring early development. METHODS A total of 91 mother-child pairs, consisting of 33 PCOS and 58 non-PCOS, were recruited. Peripheral blood tests were performed during 12-16, 24-28, and 32-36 weeks of gestation. Ages & Stages Questionnaires (ASQ) were utilized to assess the motor development of offspring at 27 months of age. Logistic regression models were employed to compare groups and control confounding variables. RESULTS Women with PCOS had a higher level of testosterone and free androgen index than the non-PCOS group in all three detection windows. There were no intergroup differences in any of the five domains of specific ASQ domain scores or the body measurements of the offspring at 27 months old. Stratification by sex of offspring suggested that no significant differences were detected in the male offspring. However, in the female offspring, the PCOS group exhibited lower gross motor scores in female offspring than the non-PCOS group (48.1 ± 11.8 vs. 55.2 ± 8.1, P = 0.027), as well as lower fine motor scores (48.5 ± 8.5 vs. 53.6 ± 11.0, P = 0.028). The gross motor score of female offspring in the PCOS group remained lower even after adjustments. Each 1 ng/mL increase in testosterone at 12-16 weeks of gestation was associated with a decrease in gross motor score of female offspring by 12.2 (95% CI = -23.3 to -1.0, P = 0.038). The highest tertile of testosterone at 12-16 weeks of gestation was associated with a 7.75-point decrease in gross motor score of female offspring compared to the lowest tertile of testosterone (95% CI = -14.9 to -0.6, P = 0.040), with a significant linear trend observed (P for trend = 0.031). CONCLUSIONS The findings of this study suggest that maternal PCOS could exert a negative influence on the gross motor development of female offspring, potentially associated with intrauterine androgen exposure during the early stages of pregnancy.
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Affiliation(s)
- Qi Cao
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Ruiying Wang
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Rong Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xin Huang
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yujing Li
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Huili Zhu
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xinyu Qiao
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Wei Huang
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Key Laboratory of Chronobiology of National Health Commission (Sichuan University), Chengdu, Sichuan 610041, PR China.
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Putnick DL, Bell EM, Tyris J, McAdam J, Ghassabian A, Mendola P, Sundaram R, Yeung E. Place-Based Child Opportunity at Birth and Child Development from Infancy to Age 4. J Pediatr 2024; 267:113909. [PMID: 38220066 PMCID: PMC10978256 DOI: 10.1016/j.jpeds.2024.113909] [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: 09/29/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The objective of this study was to evaluate whether the children's neighborhood quality, as a measure of place-based social determinants of health, is associated with the odds of developmental delay and developmental performance up to the age of 4 years. STUDY DESIGN Mothers of 5702 children from the Upstate KIDS Study, a longitudinal population-based cohort of children born from 2008 through 2010, provided questionnaire data and a subset of 573 children participated in a clinic visit. The Child Opportunity Index 2.0 was linked to home census tract at birth. Probable developmental delays were assessed by the Ages and Stages Questionnaire up to 7 times between 4 and 36 months, and developmental performance was assessed via the Battelle Developmental Inventory at the age of 4 years. RESULTS In unadjusted models, higher neighborhood opportunity was protective against developmental delays and was associated with slightly higher development scores at age 4. After adjusting for family-level confounding variables, 10-point higher Child Opportunity Index (on a 100-point scale) remained associated with a lower odds of any developmental delay (OR = .966, 95% CI = .940-.992), and specifically delays in the personal-social domain (OR = .921, 95% CI = .886-.958), as well as better development performance in motor (B = 0.79, 95% CI = 0.11-1.48), personal-social (B = 0.64, 95% CI = 0.003-1.28), and adaptive (B = 0.69, 95% CI = 0.04-1.34) domains at age 4. CONCLUSIONS Community-level opportunities are associated with some aspects of child development prior to school entry. Pediatric providers may find it helpful to use neighborhood quality as an indicator to inform targeted developmental screening.
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Affiliation(s)
- Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY
| | - Jordan Tyris
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; Division of Hospital Medicine, Children's National Hospital, Washington, DC
| | - Jordan McAdam
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine, New York, NY
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Edwina Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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Prasad S, Beg S, Badran D, Masciullo L, Huddy C, Khalil A. Neurodevelopmental outcome in complicated twin pregnancy: prospective observational study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 63:189-197. [PMID: 37550962 DOI: 10.1002/uog.27448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/08/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Twin pregnancy is associated with increased perinatal mortality and morbidity, but long-term neurodevelopmental outcome remains underinvestigated. The primary objective of this study was to investigate the incidence of adverse neurodevelopment after 1 year of age in complicated monochorionic diamniotic (MCDA) twin pregnancies compared with uncomplicated twin pregnancies. METHODS This was a prospective cohort study conducted at St George's University Hospital NHS Foundation Trust, London, UK. Women with a twin pregnancy culminating in at least one surviving child, aged between 12 and 60 months (corrected for prematurity) at the time of assessment, were invited to complete the relevant Ages and Stages Questionnaire® version 3 (ASQ-3) test. The two study groups were: (1) complicated MCDA twin pregnancies, including those with twin-twin transfusion syndrome, twin anemia-polycythemia sequence, selective fetal growth restriction, twin reversed arterial perfusion sequence and/or single intrauterine demise; and (2) uncomplicated MCDA and dichorionic diamniotic twin pregnancies. The primary outcome measure was an abnormal ASQ-3 score, defined as a score of more than 2 SD below the mean in any one of the five domains. Mixed-effects multivariable logistic regression analysis was performed to determine whether a complicated MCDA twin pregnancy was associated independently with an abnormal ASQ-3 score. RESULTS The study included 174 parents who completed the questionnaire for one or both twins; therefore, 327 ASQ-3 questionnaires were available for analysis. Of those, 117 (35.8%) were complicated MCDA twin pregnancies and 210 (64.2%) were controls. The overall rate of an abnormal ASQ-3 score in children born of a complicated MCDA twin pregnancy was nearly double that of those from uncomplicated twin pregnancies (14.5% vs 7.6%; P = 0.056). Children born of a complicated MCDA twin pregnancy had a significantly higher rate of impairment in the gross-motor domain compared with the control group (8.5% vs 2.9%; P = 0.031). Complicated MCDA twin pregnancies that underwent prenatal intervention had a significantly higher rate of abnormal ASQ-3 score compared with those that did not undergo prenatal intervention (28.1% vs 1.7%; P < 0.001). On multilevel logistic regression analysis, complicated MCDA twin pregnancy was an independent predictor of abnormal ASQ-3 score (adjusted odds ratio, 3.28 (95% CI, 3.27-3.29); P < 0.001). CONCLUSIONS This study demonstrates that survivors of complicated MCDA twin pregnancies have a higher rate of adverse neurodevelopmental outcome, independently of prematurity. Long-term neurodevelopmental follow-up in these pregnancies can ensure timely and optimal management of those affected. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S Prasad
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - S Beg
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - D Badran
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - L Masciullo
- Department of Obstetrics and Gynecology, Cristo Re Hospital, Rome, Italy
| | - C Huddy
- Department of Neonatology, St George's University Hospital, London, UK
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Twins and Multiples Centre for Research and Clinical Excellence, London, UK
- Fetal Medicine Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Fitzpatrick C, Johnson A, Laurent A, Bégin M, Harvey E. Do parent media habits contribute to child global development? Front Psychol 2024; 14:1279893. [PMID: 38268807 PMCID: PMC10806121 DOI: 10.3389/fpsyg.2023.1279893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 01/26/2024] Open
Abstract
Background/objective Parents of preschoolers' report using screen media frequently. More frequent screen use by parents may undermine child development by displacing time for foundational parent-child interactions. The objective of the present study is to examine the extent to which parent screen use contributes to child global development 1 year later. Methods Data are from a cohort of 315 preschoolers from Nova Scotia, Canada and their parents during the COVID-19 pandemic. Parents reported the number of hours per day they spent using screens, as well as child screen time and sex, and parent educational attainment. Our outcome is child global development scores, which combine assessments of communication, cognitive, personal-social, and motor skills measured at 4.5 using the Ages and Stages Questionnaire (ASQ) (N = 249, 79% retained). Results Parents in our sample spent on average 6.35 h per day using screen media outside of work (SD = 3.07) and children spent on average 3.43 h per/day using screens. Multivariate linear regression indicated that each 1-h increase in parents daily screen media use, corresponded to a 1.25 decrease in child global development scores, B = -1.25 p < 0.05, 95% CI between -2.37 and -0.13. Conclusion Our results indicate that parent screen use may represent a key component of children's media ecology. Given the importance of global development in early childhood for later health and achievement, the present results suggest that interventions should include parent screen use habits in media wellness interventions.
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Affiliation(s)
- Caroline Fitzpatrick
- Department of Preschool and Elementary School Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Childhood Education, University of Johannesburg, Johannesburg, South Africa
| | - Alexa Johnson
- Department of Childhood Education, University of Johannesburg, Johannesburg, South Africa
| | - Angélique Laurent
- Department of Preschool and Elementary School Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mathieu Bégin
- Department of Preschool and Elementary School Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Elizabeth Harvey
- Département des Sciences de l’Éducation, Université Sainte-Anne, Church Point, NS, Canada
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Beaugrand M, Jaramillo V, Markovic A, Huber R, Kohler M, Schoch SF, Kurth S. Lack of association between behavioral development and simplified topographical markers of the sleep EEG in infancy. Neurobiol Sleep Circadian Rhythms 2023; 15:100098. [PMID: 37424705 PMCID: PMC10329166 DOI: 10.1016/j.nbscr.2023.100098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
The sleep EEG mirrors neuronal connectivity, especially during development when the brain undergoes substantial rewiring. As children grow, the slow-wave activity (SWA; 0.75-4.25 Hz) spatial distribution in their sleep EEG changes along a posterior-to-anterior gradient. Topographical SWA markers have been linked to critical neurobehavioral functions, such as motor skills, in school-aged children. However, the relationship between topographical markers in infancy and later behavioral outcomes is still unclear. This study aims to explore reliable indicators of neurodevelopment in infants by analyzing their sleep EEG patterns. Thirty-one 6-month-old infants (15 female) underwent high-density EEG recordings during nighttime sleep. We defined markers based on the topographical distribution of SWA and theta activity, including central/occipital and frontal/occipital ratios and an index derived from local EEG power variability. Linear models were applied to test whether markers relate to concurrent, later, or retrospective behavioral scores, assessed by the parent-reported Ages & Stages Questionnaire at ages 3, 6, 12, and 24 months. Results indicate that the topographical markers of the sleep EEG power in infants were not significantly linked to behavioral development at any age. Further research, such as longitudinal sleep EEG in newborns, is needed to better understand the relationship between these markers and behavioral development and assess their predictive value for individual differences.
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Affiliation(s)
| | - Valeria Jaramillo
- University of Surrey, School of Psychology, Guildford, United Kingdom
| | - Andjela Markovic
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, Switzerland
| | - Malcolm Kohler
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah F. Schoch
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Salome Kurth
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
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Rah SS, Jung M, Lee K, Kang H, Jang S, Park J, Yoon JY, Hong SB. Systematic Review and Meta-analysis: Real-World Accuracy of Children's Developmental Screening Tests. J Am Acad Child Adolesc Psychiatry 2023; 62:1095-1109. [PMID: 36592715 DOI: 10.1016/j.jaac.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 11/10/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This review presents a list of developmental screening tests used in clinical settings worldwide and provides a broad estimate of their accuracy (PROSPERO: CRD42021236474). METHOD Following the PRISMA Diagnostic Test Accuracy (DTA) guidelines, this review involved searching PubMed, PsycINFO, Cochrane, EMBASE, CINAHL, and Google Scholar (for manual searching). Inclusion criteria included studies published in English through 2020 that compared the accuracy of developmental screening tests against developmental diagnostic tests among children under 13 years of age. Six researchers, in pairs, independently selected the studies and extracted the data. A hierarchical model was applied to meta-analyze the diagnostic accuracy of the tests, and meta-regression was used to identify the moderators using R 4.1.3 software. RESULTS The meta-analysis included 56 studies (17 screening tests and 61 outcomes). The most frequently used screening tests were the Ages and Stages Questionnaire (ASQ), Denver Developmental Screening Test (DDST), and Parent's Evaluation of Developmental Status (PEDS). The pooled sensitivity and specificity were 0.75 (95% CI = 0.69-0.80) and 0.76 (95% CI = 0.71-0.80), and the overall diagnostic accuracy of the total outcomes (area under the curve) was 0.80. High heterogeneity was observed between the included studies with various thresholds of the tests. Participants' developmental concerns at the baseline significantly moderated the accuracy of the screening tests, resulting in double the positive predictive value and prevalence compared to those without the concerns. CONCLUSION We recommend a standardized process of validation studies for diagnostic accuracy, to ensure the effectiveness of developmental screening tests in clinical settings. STUDY PREREGISTRATION INFORMATION Accuracy of Developmental Screening Tools among Children in Real World: a Systematic Review and Meta Analysis; https://www.crd.york.ac.uk/; CRD42021236474.
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Affiliation(s)
- Sung Sil Rah
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minho Jung
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungmin Lee
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Hannah Kang
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Soyoung Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Junghyun Park
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Ju Young Yoon
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Soon-Beom Hong
- Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Duggan C, Irvine AD, O'B Hourihane J, Kiely ME, Murray DM. ASQ-3 and BSID-III's concurrent validity and predictive ability of cognitive outcome at 5 years. Pediatr Res 2023; 94:1465-1471. [PMID: 36841883 PMCID: PMC10589087 DOI: 10.1038/s41390-023-02528-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Early detection of cognitive disability is challenging. We assessed the domain-specific, concurrent validity of the ages and stages questionnaire (ASQ-3) and the Bayley Scales of Infant and Toddler Development (BSID-III), and their ability to predict cognitive delay at school age. METHODS Within a longitudinal birth cohort study, a nested cohort of children was assessed using ASQ-3 and BSID-III at 24 months, and at 5 years using the Kaufmann brief IQ test (KBIT). RESULTS 278 children were assessed using BSID-III and ASQ-3 at 24-months; mean(SD) BW = 3445(506) grams, M:F ratio=52:48. ASQ-3 had reasonable predictive ability (AUROC, p value, sensitivity:specificity) of same domain delay for motor (0.630, p = 0.008, 50%:76.1%) and language (0.623, p = 0.010, 25%:99.5%) at 2 years, but poor ability to detect cognitive delay compared to BSID-III (0.587, p = 0.124, 20.7%/96.8%;). 204/278 children were assessed at 5 years. BSID-III language and cognition domains showed better correlation with verbal and nonverbal IQ (R = 0.435, p < 0.001 and 0.388, p < 0.001 respectively). Both assessments showed high specificity and low sensitivity for predicting delay at 5 years. CONCLUSIONS The ASQ-3 cognitive domain showed poor concurrent validity with BSID-III cognitive score. Both ASQ-3 and BSID-III at 2 years poorly predict cognitive delay at 5 years. IMPACT The ASQ-3 does not adequately detect cognitive delay or predict cognitive delay at 5 years, particularly for children with mild to moderate delay. The ASQ-3 shows reasonable concurrent validity with the motor and language subscales of the BSID-III. Neither early screening nor formal developmental testing demonstrated significant predictive validity to screen for cognitive delay at school age. This article highlights the need to analyse our existing model of using the ASQ-3 to screen for cognitive delay in children aged 2 years.
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Affiliation(s)
- Cian Duggan
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland.
| | - Alan D Irvine
- Department of Clinical Medicine, Trinity College, Dublin, Ireland
- Department of Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Jonathan O'B Hourihane
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland
- The INFANT Research Centre, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- The INFANT Research Centre, University College Cork, Cork, Ireland
- University College Cork, Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Cork, Ireland
| | - Deirdre M Murray
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland
- The INFANT Research Centre, University College Cork, Cork, Ireland
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Miller EB, Canfield CF, Barajas-Gonzalez RG, Chung A, Katter J, Kerker BD. The Children, Caregivers, and Community (C3) study of together growing strong: A protocol for an observational, place-based initiative in Sunset Park, Brooklyn. PLoS One 2023; 18:e0290985. [PMID: 37656726 PMCID: PMC10473505 DOI: 10.1371/journal.pone.0290985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/25/2023] [Indexed: 09/03/2023] Open
Abstract
Reaching population-level impact for families in poverty requires moving beyond a sole focus on individuals, to a wider focus on interactions between individuals and their broader environmental contexts. Place-based initiatives have emerged as a policy response to promote community-level change around these broader interactions between individuals and their local communities through addressing long-standing disparities in housing, employment, education, and health. Together Growing Strong (TGS) is one such place-based initiative focused on transforming the health, wellbeing, and development of young children and their families in Sunset Park, Brooklyn. The Children, Caregivers, and Community (C3) Study is an outcomes-based study designed to assess the trajectories of children and families in Sunset Park along indicators such as family health and wellbeing and child development in relation to TGS program participation. The aims, scope, and protocol of the C3 Study are the subjects of this paper.
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Affiliation(s)
- Elizabeth B. Miller
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Caitlin F. Canfield
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States of America
| | | | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Julie Katter
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Bonnie D. Kerker
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
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11
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Manasyan A, Salas AA, Nolen T, Chomba E, Mazariegos M, Tshefu Kitoto A, Saleem S, Naqvi F, Hambidge KM, Goco N, McClure EM, Wallander JL, Biasini FJ, Goldenberg RL, Bose CL, Koso-Thomas M, Krebs NF, Carlo WA. Diagnostic accuracy of ASQ for screening of neurodevelopmental delays in low resource countries. BMJ Open 2023; 13:e065076. [PMID: 37221030 PMCID: PMC10230914 DOI: 10.1136/bmjopen-2022-065076] [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: 05/29/2022] [Accepted: 04/29/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE The Bayley Scales of Infant Development (BSID) is the most used diagnostic tool to identify neurodevelopmental disorders in children under age 3 but is challenging to use in low-resource countries. The Ages and Stages Questionnaire (ASQ) is an easy-to-use, low-cost clinical tool completed by parents/caregivers that screens children for developmental delay. The objective was to determine the performance of ASQ as a screening tool for neurodevelopmental impairment when compared with BSID second edition (BSID-II) for the diagnosis of moderate-to-severe neurodevelopmental impairment among infants at 12 and 18 months of age in low-resource countries. METHODS Study participants were recruited as part of the First Bites Complementary Feeding trial from the Democratic Republic of Congo, Zambia, Guatemala and Pakistan between October 2008 and January 2011. Study participants underwent neurodevelopmental assessment by trained personnel using the ASQ and BSID-II at 12 and 18 months of age. RESULTS Data on both ASQ and BSID-II assessments of 1034 infants were analysed. Four of five ASQ domains had specificities greater than 90% for severe neurodevelopmental delay at 18 months of age. Sensitivities ranged from 23% to 62%. The correlations between ASQ communications subscale and BSID-II Mental Development Index (MDI) (r=0.38) and between ASQ gross motor subscale and BSID-II Psychomotor Development Index (PDI) (r=0.33) were the strongest correlations found. CONCLUSION At 18 months, ASQ had high specificity but moderate-to-low sensitivity for BSID-II MDI and/or PDI <70. ASQ, when administered by trained healthcare workers, may be a useful screening tool to detect severe disability in infants from rural low-income to middle-income settings. TRIAL REGISTRATION NUMBER NCT01084109.
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Affiliation(s)
- Albert Manasyan
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- Department of Reproductive, Maternal, Newborn, and Child Health, Center for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Ariel A Salas
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Tracy Nolen
- Research Triangle Institute, Durham, North Carolina, USA
| | - Elwyn Chomba
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- University of Zambia, Lusaka, Zambia
| | - Manolo Mazariegos
- Institute of Nutrition for Central America and Panamá (INCAP), Guatemala City, Panama
| | | | | | | | - K Michael Hambidge
- University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Norman Goco
- Research Triangle Institute, Durham, North Carolina, USA
| | | | - Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California Merced, Merced, California, USA
| | - Fred J Biasini
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Robert L Goldenberg
- Department of Obstetrics and Gynecology, Columbia University, New York, New York, UK
| | - Carl L Bose
- The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Nancy F Krebs
- University of Colorado Denver, Denver, Colorado, USA
| | - Waldemar A Carlo
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
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Jaramillo V, Schoch SF, Markovic A, Kohler M, Huber R, Lustenberger C, Kurth S. An infant sleep electroencephalographic marker of thalamocortical connectivity predicts behavioral outcome in late infancy. Neuroimage 2023; 269:119924. [PMID: 36739104 DOI: 10.1016/j.neuroimage.2023.119924] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/24/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Infancy represents a critical period during which thalamocortical brain connections develop and mature. Deviations in the maturation of thalamocortical connectivity are linked to neurodevelopmental disorders. There is a lack of early biomarkers to detect and localize neuromaturational deviations, which can be overcome with mapping through high-density electroencephalography (hdEEG) assessed in sleep. Specifically, slow waves and spindles in non-rapid eye movement (NREM) sleep are generated by the thalamocortical system, and their characteristics, slow wave slope and spindle density, are closely related to neuroplasticity and learning. Spindles are often subdivided into slow (11.0-13.0 Hz) and fast (13.5-16.0 Hz) frequencies, for which not only different functions have been proposed, but for which also distinctive developmental trajectories have been reported across the first years of life. Recent studies further suggest that information processing during sleep underlying sleep-dependent learning is promoted by the temporal coupling of slow waves and spindles, yet slow wave-spindle coupling remains unexplored in infancy. Thus, we evaluated three potential biomarkers: 1) slow wave slope, 2) spindle density, and 3) the temporal coupling of slow waves with spindles. We use hdEEG to first examine the occurrence and spatial distribution of these three EEG features in healthy infants and second to evaluate a predictive relationship with later behavioral outcomes. We report four key findings: First, infants' EEG features appear locally: slow wave slope is maximal in occipital and frontal areas, whereas slow and fast spindle density is most pronounced frontocentrally. Second, slow waves and spindles are temporally coupled in infancy, with maximal coupling strength in the occipital areas of the brain. Third, slow wave slope, fast spindle density, and slow wave-spindle coupling are not associated with concurrent behavioral status (6 months). Fourth, fast spindle density in central and frontocentral regions at age 6 months predicts overall developmental status at age 12 months, and motor skills at age 12 and 24 months. Neither slow wave slope nor slow wave-spindle coupling predict later behavioral development. We further identified spindle frequency as a determinant of slow and fast spindle density, which accordingly, also predicts motor skills at 24 months. Our results propose fast spindle density, or alternatively spindle frequency, as early EEG biomarker for identifying thalamocortical maturation, which can potentially be used for early diagnosis of neurodevelopmental disorders in infants. These findings are in support of a role of sleep spindles in sensorimotor microcircuitry development. A crucial next step will be to evaluate whether early therapeutic interventions may be effective to reverse deviations in identified individuals at risk.
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Affiliation(s)
- Valeria Jaramillo
- Department of Pulmonology, University Hospital Zurich, Zurich, CH; Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom; Neuromodulation Laboratory, School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Sarah F Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, CH; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, CH; Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, NL
| | - Andjela Markovic
- Department of Pulmonology, University Hospital Zurich, Zurich, CH; Department of Psychology, University of Fribourg, Fribourg, CH
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, CH; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, CH
| | - Reto Huber
- Child Development Center, University Children's Hospital Zurich, Zurich, CH; Children's Research Center, University Children's Hospital Zurich, University of Zurich (UZH), Zürich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, CH; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, CH
| | - Caroline Lustenberger
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, CH; Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
| | - Salome Kurth
- Department of Pulmonology, University Hospital Zurich, Zurich, CH; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, CH; Department of Psychology, University of Fribourg, Fribourg, CH.
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Putnick DL, Trinh MH, Sundaram R, Bell EM, Ghassabian A, Robinson SL, Yeung E. Displacement of peer play by screen time: associations with toddler development. Pediatr Res 2023; 93:1425-1431. [PMID: 35986149 PMCID: PMC9390097 DOI: 10.1038/s41390-022-02261-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Young children's digital media use may adversely affect child development, but the mechanisms of this association are unclear. We evaluated whether screen time displaces reading and peer play time, which are subsequently associated with child development. METHODS When children were 12, 18, 24, 30, and 36 months, mothers (n = 3894) reported the time their children spent on screens, being read to by an adult, and playing with other children. At 36 months, mothers completed the Ages and Stages Questionnaire©, an assessment of their child's developmental status. RESULTS In unadjusted models, screen time from 12 to 36 months was not associated with reading but was associated with less time engaging in play with peers. In adjusted models accounting for developmental delay at 12 months, family and child characteristics, screen time was not directly associated with developmental delay. More peer play time was associated with a lower likelihood of developmental delay, and having higher screen time increased the likelihood of developmental delay indirectly through reduced peer play time. Results were similar for developmental delays in fine and gross motor, communication, and personal-social domains. CONCLUSIONS Screen time in early childhood did not displace reported time spent reading, but did displace reported peer play time. IMPACT Among children 1-3 years of age, more screen time was associated with less time engaged in peer play but not less reading with an adult. Having higher screen time from 1 to 3 years increased the odds of developmental delay indirectly through reduced peer play time. Ensuring that children engage in adequate time playing with peers may offset the negative associations between screen time and child development.
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Affiliation(s)
- Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Mai-Han Trinh
- Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY, USA
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Sonia L Robinson
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Edwina Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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Sheldrick RC, Marakovitz S, Garfinkel D, Perrin EC, Carter AS. Prevalence and Co-Occurrence of Developmental and Emotional-Behavioral Problems in Young Children. Acad Pediatr 2023; 23:623-630. [PMID: 36417968 PMCID: PMC10149553 DOI: 10.1016/j.acap.2022.11.008] [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: 09/13/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE A limited number of studies have estimated the prevalence of emotional-behavioral disorders among young children. None have assessed their co-occurrence with developmental delays using standardized assessment tools. Our objective was to estimate the prevalence of emotional-behavioral disorders and their co-occurrence with developmental delays among young children (2-5.5 years). METHODS Parents of young children (N = 987) enrolled from pediatric waiting rooms completed developmental-behavioral screening questionnaires. Based on results, 585 families were invited to and 439 completed evaluations that included structured diagnostic interviews with parents to assess child psychopathology (Preschool Age Psychiatric Assessment (PAPA)), developmental testing with children (including the Bayley Scales of Infant and Toddler Development, third Edition for children ≤ 42 months; Differential Ability Scales, second Edition for older children), and videotaped observation to establish whether autism risk was sufficient to warrant further evaluation. RESULTS According to PAPA algorithms, 23.0% of children met criteria for a DSM-IV disorder, while 9% qualified for a developmental delay. Presence of delay doubled the odds of having a DSM-IV disorder (OR = 2.1; CI: 1.02-4.3), and presence of disorder doubled the odds of having a moderate-to-severe developmental delay (OR=2.0; CI: 1.10-3.50). Prevalence of DSM-IV disorders (48.8% (95% CI: 33.5-64.5%)) and developmental delays (57.5% (95% CI: 41.7-71.9%)) were both higher among children at risk for autism. While developmental delay did not vary by race/ethnicity, prevalence of DSM-IV disorders was lower among African-American/Black (10.6%; CI: 2.9-18.3) and Hispanic/Latino children (11.1%; CI: 4.3-17.9). CONCLUSIONS Developmental delays and emotional-behavioral disorders among young children seen in pediatric settings are characterized by high prevalence and substantial co-occurrence.
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Affiliation(s)
| | - Susan Marakovitz
- Division of Developmental-Behavioral Pediatrics (S Marakovitz, D Garfinkel, and EC Perrin), Tufts Medical Center, Boston, Mass
| | - Daryl Garfinkel
- Division of Developmental-Behavioral Pediatrics (S Marakovitz, D Garfinkel, and EC Perrin), Tufts Medical Center, Boston, Mass
| | - Ellen C Perrin
- Division of Developmental-Behavioral Pediatrics (S Marakovitz, D Garfinkel, and EC Perrin), Tufts Medical Center, Boston, Mass
| | - Alice S Carter
- Department of Psychology (AS Carter), University of Massachusetts Boston
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Manti F, Giovannone F, Ciancaleoni M, De Vita G, Fioriello F, Gigliotti F, Sogos C. Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5014. [PMID: 36981921 PMCID: PMC10049085 DOI: 10.3390/ijerph20065014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Objectives: The Ages & Stages Questionnaires Third Version (ASQ-3) identifies the risk of developmental delay in children aged 1 to 66 months. The aim of this study was to determine a reliable and valid instrument for the Italian population to enable the screening of children's development. Methods: Data from 2278 Italian children (age range: 1-66 months) were used to evaluate item discrimination power using the corrected item-total correlation. Internal consistency was analyzed by Cronbach's alpha scores and a Confirmative Factor Analysis was conducted to test the factor structure of the test. Data were also collected to examine the ASQ-3 test-retest reliability and concurrent validity, which was investigated using the Griffiths Scales of Child Development, Third Edition, the Peabody Developmental Motor Scale, Second Edition, and the Developmental Profile, Third Edition tools. In order to evaluate discriminant validity, differences between typical development children and several clinical groups have been performed. Finally, two different cut-off scores have been proposed. Results: The results showed that the questionnaires are composed of high-quality items; the original factor structure has been confirmed and strong Pearson product-moment correlation coefficients between the overall and the total for each domain (ranging from 0.73 to 0.88). The Italian version of the ASQ-3 had adequate internal consistency and a strong agreement between observations with two weeks' intervals. Moreover, the test showed a high discriminant validity due to the possibility of fully discriminating between typical development children and several clinical groups. Finally, two different cut-off scores have been identified using ROC curves in order to have a screening and a diagnostic cut-off value. Conclusion: This study evaluated the psychometric properties of the Italian adaptation of ASQ-3 questionnaires. We demonstrated the validity of the ASQ-3 and determined new cut-off scores for Italian children. Early identification and accurate assessment are important starting points to better understand and anticipate the needs of children and their link to services.
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Affiliation(s)
- Filippo Manti
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy
| | - Federica Giovannone
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy
| | | | - Gloria De Vita
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy
| | - Francesca Fioriello
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy
| | - Federica Gigliotti
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy
| | - Carla Sogos
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Roma, Italy
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Verstraete J, Amien R. Cross-Cultural Adaptation and Validation of the EuroQoL Toddler and Infant Populations Instrument Into Afrikaans for South Africa. Value Health Reg Issues 2023; 35:78-86. [PMID: 36905789 DOI: 10.1016/j.vhri.2023.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/15/2022] [Accepted: 01/21/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES The EuroQol Group is exploring the development of a health-related quality of life measure for toddlers and infant populations (EuroQoL Toddler and Infant Populations [EQ-TIPS]) aged 0 to 36 months. This study aimed to report on the cross-cultural adaptation and validity of the South African Afrikaans EQ-TIPS. METHODS The development of the Afrikaans EQ-TIPS followed the EuroQol guidelines including forward-backward translation and cognitive interviews with 10 caregivers of children aged 0 to 36 months. Thereafter, 162 caregivers of children 0 to 36 months of age were recruited from a pediatric hospital inpatient and outpatient facility. The EQ-TIPS; Ages and Stages Questionnaire; face, legs, activity, cry, and consolability; and dietary information were completed by all caregivers. The distribution of dimension scores, Spearman's correlation, analysis of variance, and regression analysis were used to explore the validity of the EQ-TIPS. RESULTS The descriptive system of the EQ-TIPS was generally well understood and accepted by caregivers. The correlation coefficients for concurrent validity were significant and moderate for pain and weak and significant for the other dimensions hypothesized to correlate. Known groups were compared and inpatients had a significantly higher report of pain (χ2 = 7.47, P = .024) and more problems reported across all EQ-TIPS dimensions (recorded on the level sum score) (Kruskal Wallis H = 3.809, P = .05) and reported significantly worse health on the visual analog scale (Kruskal Wallis H = 15.387, P < .001). There were no age-related differences except for a lower report of problems with movement in the 0- to 12-month group (χ2 = 10.57, P = .032). CONCLUSION The Afrikaans version of the EQ-TIPS is well understood and accepted by caregivers and valid for use with children aged 0 to 36 months in South Africa.
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Affiliation(s)
- Janine Verstraete
- Department of Child and Adolescent Health, Faculty of Health Sciences, University of Cape Town, Rondebosch, Cape Town, South Africa.
| | - Razia Amien
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Rondebosch, Cape Town, South Africa
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Classification Performance of the Ages and Stages Questionnaire: Influence of Maternal Education Level. CHILDREN 2023; 10:children10030449. [PMID: 36980009 PMCID: PMC10047153 DOI: 10.3390/children10030449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023]
Abstract
(1) Background: The Ages and Stages Questionnaire—Third Edition (ASQ-3) is a parental screening questionnaire increasingly being used to evaluate the development of preterm children. We aimed to assess the classification performance of the ASQ-3 in preterm infant follow-up. (2) Methods: In this cross-sectional study, we included 185 children from the SEVE longitudinal cohort born <33 weeks of gestational age between November 2011 and January 2018, who had both an ASQ-3 score at 24 months of corrected age (CA) and a revised Brunet–Lézine (RBL) scale score at 30 months of CA. The ASQ-3 overall score and sub-scores were compared to the RBL developmental quotient (DQ) scores domain by domain. The diagnostic performance of the ASQ-3 was evaluated with the RBL as the reference method by calculating sensitivity, specificity, and positive and negative likelihood ratios. A multivariate analysis assessed the association between low maternal education level and incorrect evaluation with the ASQ-3. (3) Results: The ASQ-3 overall score had a specificity of 91%, a sensitivity of 34%, a positive likelihood ratio of 3.82, and a negative likelihood ratio of 0.72. Low maternal education level was a major risk factor for incorrectly evaluating children with the ASQ-3 (odds ratio 4.16, 95% confidence interval 1.47–12.03; p < 0.01). (4) Conclusions: Regarding the low sensitivity and the impact of a low maternal education level on the classification performance of the ASQ-3, this parental questionnaire should not be used alone to follow the development of preterm children
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Measurement properties of the Brain Balance® multidomain developmental survey: validated factor structure, internal reliability, and measurement invariance. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04248-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AbstractThis study aimed to refine and validate a multidomain developmental survey (MDS) used by the Brain Balance® (BB) program. Data were analyzed on 47,571 participants (68.5% male; 4–18 years) whose parents completed the survey before/after 3 months of in-center BB participation. Exploratory Factor Analysis was applied to a training sample (n = 28,254), reducing the original item pool from 98 to 31 items and suggesting a six-factor solution. The six factors were labeled as negative emotionality, reading/writing difficulties, hyperactive-disruptive, academic disengagement, motor/coordination problems, and social communication problems. Exploratory Structural Equation Modeling was applied to two validation samples (n = 9394 and 9923), and the factor structure demonstrated strong goodness-of-fit. Test–retest reliability coefficients (per Pearson correlations) were high for each of the subscales. Finally, the survey’s factor structure appeared equivalent across four groups stratified by reported gender and adolescent status. Overall, the BB-MDS demonstrated strong measurement properties, including validated factor structure, internal reliability, test–retest reliability, and measurement invariance.
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Characteristics of tummy time and dose-response relationships with development in infants. Eur J Pediatr 2023; 182:113-121. [PMID: 36224434 DOI: 10.1007/s00431-022-04647-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 01/12/2023]
Abstract
This study aimed to examine change in tummy time patterns and preferences in the first 6 months of life, as well as dose-response relationships between tummy time duration and development at 2, 4, and 6 months. Participants were parents of infants from the Early Movers project in Edmonton, Canada (baseline: n = 411). At 2, 4, and 6 months, infant tummy time duration and preference (i.e., 1 = really likes to 5 = really dislikes) and development (i.e., Ages & Stages Questionnaire (ASQ-3) communication, fine motor, gross motor, problem-solving, personal-social) were measured by a parental questionnaire. In a subsample (n = 127), tummy time patterns (i.e., bout frequency, mean and median bout length) were measured using a 3-day time-use diary. Tummy time bout frequency, bout length, and preference significantly increased over time. Linear dose-response relationships between tummy time duration and development outcomes were observed at 4 (gross motor) and 6 months (all development outcomes). Moreover, at 2 months, 30-44 min/day of tummy time was associated with a higher total development score (vs. < 15 min/day; B = 11.14; 95%CI: 1.60, 20.68). At 6 months, 61-120 min/day (vs. < 30 min/day; B = 27.12; 95%CI: 11.93, 42.32) and > 120 min/day (vs. < 30 min/day; B = 33.80; 95%CI: 18.90, 48.70) of tummy time were associated with higher total development scores. Differences in threshold doses between some developmental outcomes were observed. Conclusion: In the first 6 months of life, increases were observed in tummy time preference as well as tummy time bout frequent and length. This finding may explain why the optimal amount of tummy time needed for more advanced development appeared to increase with age. What is Known: • Tummy time is a type of physical activity in infancy. International and national guidelines recommend at least 30 minutes of tummy time per day for infants who are not yet mobile. What is New: • In the first six months of life, preference for tummy time as well as tummy time bout frequency and length increased. • Tummy time duration had dose-response associations with several development outcomes, and the optimal amount of tummy time needed for more advanced development appeared to increase with age.
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20
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Yunilda E, Gunardi H, Medise BE, Oswari H. The Indonesian version of Ages and Stages Questionnaire
III
accuracy compared to Bayley Scales of Infant Development
III. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Erva Yunilda
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Hartono Gunardi
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Bernie Endyarni Medise
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Hanifah Oswari
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
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21
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Muthusamy S, Wagh D, Tan J, Bulsara M, Rao S. Utility of the Ages and Stages Questionnaire to Identify Developmental Delay in Children Aged 12 to 60 Months: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:980-989. [PMID: 36036913 PMCID: PMC9425289 DOI: 10.1001/jamapediatrics.2022.3079] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/30/2022] [Indexed: 01/23/2023]
Abstract
Importance The Ages and Stages Questionnaire (ASQ) is a commonly used developmental screening tool, but its utility is debated. Objectives To conduct a a systematic review and meta-analysis to evaluate ASQ's utility as a screening or diagnostic tool to identify developmental delay in children aged 12-60 months. Data Sources Medline, EMBASE, CINAHL, PsycINFO, and Mednar were searched from inception until December 2021. Study Selection Studies meeting both criteria were included. ASQ was performed at age 12 to 60 months or where the median age at ASQ was at least 12 months and formal developmental assessments were done within 2 months of ASQ. Data Extraction and Synthesis True positive, false positive, false negative, and true negatives from individual studies were extracted. Meta-analysis was conducted with Stata version 16.1. Risk of bias was assessed using the QUADAS-2 tool. Certainty of evidence (COE) was assessed using GRADE guidelines. Main Outcomes and Measures Ability of ASQ scores more than 2 SDs below the mean in more than 1 domain (ASQ-2SD) to identify any developmental delay or severe delay. Based on generally accepted interpretation of likelihood ratio (LR) values, a positive LR (PLR) more than 5 and a negative LR (NLR) of 0.2 or less were considered necessary to rule in or rule out developmental delay, respectively, with at least moderate probability. Results Initial search yielded 5777 citations of which 43 were included in the review. Of them, 36 were included in the meta-analysis. The pooled sensitivity, specificity, PLR, and NLR are as follows: ASQ-2SD to predict any delay in 1 or more domain (n = 16), 0.77 (95% CI, 0.64-0.86), 0.81 (95% CI, 0.75-0.86), 4.10 (95% CI, 3.17-5.30), and 0.28 (95% CI, 0.18-0.44); ASQ-2SD to predict severe delay in 1 or more domain (n = 15), 0.84 (95% CI, 0.75-0.90), 0.77 (95% CI, 0.71-0.82), 3.72 (95% CI, 2.98-4.64), and 0.20 (95% CI, 0.13-0.32); ASQ-2SD motor domain to predict motor delay (n = 7), 0.41 (95% CI, 0.26-0.57), 0.94 (95% CI, 0.87-0.97), 6.5 (95% CI, 3.8-11.1), and 0.63 (95% CI, 0.50-0.81); and ASQ-2SD cognitive domain to predict cognitive delay (n = 2), 0.44 (95% CI, 0.24-0.65), 0.93 (95% CI, 0.81-0.95), 6.4 (95% CI, 2.4-16.8), and 0.61 (95% CI, 0.43-0.86). The COE was low/very low. Conclusions and Relevance If a child aged 12 to 60 months passes all ASQ domains, there is a moderate probability that they do not have severe developmental delay (low COE). If a child aged 12-60 months fails the motor or cognitive domain of ASQ, there is a moderate probability that they have some motor or cognitive delay, respectively (very low COE). Trial Registration PROSPERO (CRD42021268543).
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Affiliation(s)
- Saravanan Muthusamy
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Deepika Wagh
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Jason Tan
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Shripada Rao
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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22
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Yim G, Minatoya M, Kioumourtzoglou MA, Bellavia A, Weisskopf M, Ikeda-Araki A, Miyashita C, Kishi R. The associations of prenatal exposure to dioxins and polychlorinated biphenyls with neurodevelopment at 6 Months of age: Multi-pollutant approaches. ENVIRONMENTAL RESEARCH 2022; 209:112757. [PMID: 35065939 DOI: 10.1016/j.envres.2022.112757] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND Prenatal exposure to persistent organic pollutants, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), dioxin-like polychlorinated biphenyls (DL-PCBs), and nondioxin-like PCBs (NDL-PCBs), has been hypothesized to have a detrimental impact on neurodevelopment. However, the association of prenatal exposure to a dioxin and PCB mixture with neurodevelopment remains largely inconclusive partly because these chemical levels are correlated. OBJECTIVES We aimed to elucidate the association of in utero exposure to a mixture of dioxins and PCBs with neurodevelopment measured at 6 months of age by applying multipollutant methods. METHODS A total of 514 pregnant women were recruited between July 2002 and October 2005 in the Sapporo cohort, Hokkaido Study on Environment and Children's Health. The concentrations of individual dioxin and PCB isomers were assessed in maternal peripheral blood during pregnancy. The mental and psychomotor development of the study participants' infants was evaluated using the Bayley Scales of Infant Development-2nd Edition (n = 259). To determine both the joint and individual associations of prenatal exposure to a dioxin and PCB mixture with infant neurodevelopment, Bayesian kernel machine regression (BKMR) and quantile-based g-computation were employed. RESULTS Suggestive inverse associations were observed between in utero exposure to a dioxin and PCB mixture and infant psychomotor development in both the BKMR and quantile g-computation models. In contrast, we found no association of a dioxin and PCB mixture with mental development. When group-specific posterior inclusion probabilities were estimated, BKMR suggested prenatal exposure to mono-ortho PCBs as the more important contributing factors to early psychomotor development compared with the other dioxin or PCB groups. No evidence of nonlinear exposure-outcome relationships or interactions among the chemical mixtures was detected. CONCLUSIONS Applying the two complementary statistical methods for chemical mixture analysis, we demonstrated limited evidence of inverse associations of prenatal exposure to dioxins and PCBs with infant psychomotor development.
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Affiliation(s)
- Gyeyoon Yim
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Machiko Minatoya
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | | | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Atsuko Ikeda-Araki
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan; Hokkaido University Faculty of Health Sciences, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Chihiro Miyashita
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Reiko Kishi
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan.
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23
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Alshaikh B, Abo Zeed M, Yusuf K, Guin M, Fenton T. Effect of enteral zinc supplementation on growth and neurodevelopment of preterm infants: a systematic review and meta-analysis. J Perinatol 2022; 42:430-439. [PMID: 34006967 DOI: 10.1038/s41372-021-01094-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/29/2021] [Accepted: 04/30/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To evaluate effect of enteral zinc supplementation on growth and neurodevelopmental outcomes of preterm infants. STUDY DESIGN A systematic review and meta-analysis of randomized-controlled trials (RCTs) examining growth and neurodevelopmental outcomes after zinc supplementation in preterm infants. RESULTS Of eight RCTs involving 742 infants included, seven reported growth anthropometrics at 3-6 months corrected age (CA) and two reported neurodevelopmental outcomes at 6-12 months CA. Zinc supplementation was associated with increased weight z-score (weighted mean difference (WMD) = 0.50; 95% CI 0.23-0.76, heterogeneity I2 = 89.1%; P < 0.01), length z-score (WMD = 1.12; 95% CI 0.63-1.61, heterogeneity I2 = 96.0%; P < 0.01) and motor developmental score (WMD = 9.54; 95% CI 6.6-12.4 heterogeneity I2 = 0%; P = 0.52). There was no effect on head circumference and total developmental score. Evidence is "moderate" certainty for weight and length and "very low" certainty for neurodevelopment. CONCLUSION Zinc supplementation may enhance weight gain and linear growth in preterm infants. There is a lack of data about relationship between zinc supplementation and neurodevelopment.
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Affiliation(s)
- Belal Alshaikh
- Neonatal Nutrition and Gastroenterology Program, University of Calgary, Calgary, AB, Canada.
- Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | | | - Kamran Yusuf
- Neonatal Nutrition and Gastroenterology Program, University of Calgary, Calgary, AB, Canada
| | - Madhusudan Guin
- Neonatal Nutrition and Gastroenterology Program, University of Calgary, Calgary, AB, Canada
| | - Tanis Fenton
- Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Nutrition Services, Alberta Health Services, Calgary, AB, Canada
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24
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Tveten KM, Strand LI, Riiser K, Nilsen RM, Dragesund T. The ability of the Ages and Stages Questionnaire (ASQ) to indicate motor difficulties in infants in primary care. Physiother Theory Pract 2022:1-7. [PMID: 35321635 DOI: 10.1080/09593985.2022.2056553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Delayed achievement of motor milestones may be an early indicator of motor difficulties. Parent-reported questionnaires may serve as an efficient, low-cost screening to identify infants in need of further clinical assessment, and thus be a helpful tool in busy health care centers. PURPOSE To examine the ability of the Ages and Stages Questionnaire, second edition (ASQ-2) to indicate motor difficulties in infants using the Infant Motor Profile (IMP) as the reference standard. METHODS A cross-sectional design was applied to examine the correlation between parent-reported data of the ASQ-2 and data from physiotherapist assessment using IMP. Included were 432 mainly low-risk infants aged 3-12 months from primary care. RESULTS Overall, ASQ-2 gross and fine motor scores did not correlate well with the IMP total or domain scores. The ASQ-2 gross motor cut point (> 2SD below the mean), showed 34.3% sensitivity and 96.7% specificity using the 15th percentile from IMP performance domain as reference standard. The positive predictive value to indicate motor difficulties was 48%. CONCLUSION The motor domains of ASQ-2 have poor ability to identify infants with motor difficulties as indicated by their IMP scores in low-risk infants.
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Affiliation(s)
- Kine Melfald Tveten
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kirsti Riiser
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Roy Miodini Nilsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tove Dragesund
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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25
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Putnick DL, Bell EM, Ghassabian A, Robinson SL, Sundaram R, Yeung E. Feeding Problems as an Indicator of Developmental Delay in Early Childhood. J Pediatr 2022; 242:184-191.e5. [PMID: 34774577 PMCID: PMC8882156 DOI: 10.1016/j.jpeds.2021.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine whether feeding problems are indicators of developmental delay. STUDY DESIGN In this prospective longitudinal cohort study, mothers of 3597 children (49% female, 35% multiples) reported on their children's feeding problems and developmental delays (using the Ages and Stages Questionnaire [ASQ]) when children were age 18, 24, and 30 months. Average scores of feeding problems were computed at each age, as well as a categorical score indicating a persistently high number of feeding problems ≥90th percentile across time. The Battelle Developmental Inventory, Second Edition (BDI-2) was used to assess development in 5 domains for a subset of children at 4 years. RESULTS In adjusted analyses, feeding problems (per point increase) were increasingly associated with 6 ASQ domains from 18 months (OR, 1.30-1.98) to 24 months (OR, 2.07-2.69) to 30 months (OR, 3.90-5.64). Compared with children who never experienced feeding problems, children who experienced a high number of feeding problems at 1 or 2 time points were more than twice as likely to have a delay on all ASQ domains (OR, 2.10-2.50), and children who experienced a high number of feeding problems at all 3 time points were ≥4-fold more likely to have a delay on all ASQ domains (OR, 3.94-5.05). Children with 1-point higher feeding problems at 30 months scored 3-4 points lower in all BDI-2 domains at 4 years. CONCLUSIONS Frequent feeding problems, especially those that persist into the third year, could be used to identify children at risk for developmental delay for more targeted screening.
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Affiliation(s)
- Diane L. Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Erin M. Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine
| | - Sonia L. Robinson
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Edwina Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
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26
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Carson V, Zhang Z, Predy M, Pritchard L, Hesketh KD. Longitudinal associations between infant movement behaviours and development. Int J Behav Nutr Phys Act 2022; 19:10. [PMID: 35090492 PMCID: PMC8800227 DOI: 10.1186/s12966-022-01248-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to address methodological limitations of the evidence that informed national and international movement behaviour guidelines for the early years. Specifically, the primary objective was to examine the longitudinal associations of infant physical activity (i.e., tummy time) and sedentary behaviour (i.e., back time, screen time, reading time, restrained time) with gross motor development. Secondary and tertiary objectives were to examine longitudinal associations of: (1) infant physical activity and sedentary behaviour with communication, fine motor, personal-social, and problem solving development, and (2) sleep time with primary and secondary outcomes. METHODS Participants were 411 parents and their infants from the Early Movers project in Edmonton, Canada. Physical activity, sedentary behaviour, and sleep were measured with a parental questionnaire and the Ages & Stages Questionnaire (ASQ-3) developmental screening tool was administered at 2, 4, and 6 months. Parents reported the dates six major gross motor milestones (i.e., independent sitting, crawling, assisted standing, assisted walking, independent standing, independent walking) were acquired in the first 18 months of life according to World Health Organization criteria. In a subsample (n = 125), gross motor development was assessed using the Alberta Infant Motor Scale (AIMS) at 6 months. RESULTS Higher tummy time across time points was significantly associated with higher ASQ-3 gross motor and personal-social development scores over time, higher total AIMS scores at 6 months, and earlier acquisition of all gross motor milestones. Higher reading time across time points was significantly associated with higher ASQ-3 fine motor, gross motor, personal-social, and total development scores over time. In contrast, higher back time across time points was significantly associated with lower total AIMS scores at 6 months and the later acquisition of assisted standing, assisted walking, and independent walking. Similarly, higher restrained time across time points was significantly associated with a later acquisition of supported walking. CONCLUSIONS Tummy time was consistently longitudinally associated with more advanced gross motor development and reading with more advanced total development. Whereas, some detrimental associations were observed for back and restrained time. Findings support the promotion of tummy time and certain sedentary behaviours (i.e., reading) in young infants to enhance overall development.
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Affiliation(s)
- Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.
| | - Zhiguang Zhang
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Lesley Pritchard
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Vic, Australia
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27
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McArthur BA, Browne D, Racine N, Tough S, Madigan S. Screen Time as a Mechanism Through Which Cumulative Risk is Related to Child Socioemotional and Developmental Outcomes in Early Childhood. Res Child Adolesc Psychopathol 2022; 50:709-720. [PMID: 34997403 DOI: 10.1007/s10802-021-00895-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
Socio-demographic risks are associated with higher child screen time and higher screen time is associated with poor socioemotional and developmental health. Existing studies have not examined children's screen time as a mechanism through which distal risks may be associated with child outcomes. In the current study, we examined whether two proximal factors, screen time and parenting quality, mediate the relation between distal cumulative risk and child outcomes. Participants (N = 1992) were drawn from a birth cohort of mothers and their children (81% white; 46% female). Mothers reported on cumulative risk factors (maternal income, education, depression, stress, marital status, housing instability, unemployment, and maternal history of childhood adversity) during the prenatal period. Parenting quality (ineffective/hostile, positive interactions) and children's screen time (hours/week) were assessed when children were three years of age. Child socioemotional (internalizing and externalizing problems) and developmental (achievement of developmental milestones) outcomes were measured at five years of age. Path analysis revealed indirect effects from cumulative risk to internalizing symptoms and achievement of developmental milestones via screen time. Indirect effects were observed from cumulative risk to internalizing and externalizing behavior via hostile parenting behavior. Over and above the effects of parenting, screen time may be a factor that links structural forms of social disadvantage during the prenatal period to child socioemotional and developmental outcomes. Due to modest effect sizes of screen time, it remains the case that child socioemotional and developmental health should be conceptualized within the context of distal cumulative risk factors such as caregiver psychological and material resources.
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Affiliation(s)
- Brae Anne McArthur
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | | | - Nicole Racine
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Suzanne Tough
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Sheri Madigan
- University of Calgary, Calgary, AB, Canada. .,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
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28
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Sprowles JL, Dzwilewski KL, Merced-Nieves FM, Musaad SM, Schantz SL, Geiger SD. Associations of prenatal phthalate exposure with neurobehavioral outcomes in 4.5- and 7.5-month-old infants. Neurotoxicol Teratol 2022; 92:107102. [PMID: 35588931 PMCID: PMC9271634 DOI: 10.1016/j.ntt.2022.107102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
Phthalates are ubiquitous endocrine-disrupting chemicals, and research indicates that prenatal exposure to some phthalates may affect neurodevelopment. In a prospective birth cohort study, five first-morning urine samples collected across pregnancy were pooled and the following phthalate biomarkers assessed: sum of di-(2-ethylhexyl) phthalate metabolites (ΣDEHP), sum of diisononyl phthalate metabolites (ΣDINP), sum of dibutyl phthalate metabolites (ΣDBP), sum of anti-androgenic metabolites (ΣAA), monoethyl phthalate (MEP), and sum of all phthalate metabolites (ΣAll). The Ages & Stages Questionnaires® (ASQ), a standardized parent-reported, age-adapted screening tool, measured communication, personal-social, problem solving, and motor domains in infants at 4.5 and 7.5 months (n = 123). Adjusting for maternal age, annual household income, gestational age at birth, infant age at assessment, and sex, repeated-measures generalized linear regression models were used to examine associations between prenatal phthalate urine biomarker concentrations and domain scores (assuming a Poisson distribution). Beta estimates were exponentiated back to the domain scale for ease of interpretation. Mothers were mostly white and college-educated, and most reported an annual household income of ≥$60,000. Associations of phthalate concentrations with ASQ outcomes are presented as follows: (1) anti-androgenic phthalate metabolites (ΣDEHP, ΣDINP, ΣDBP, and ΣAA), (2) MEP, which is not anti-androgenic, and (3) ΣAll. Overall, anti-androgenic phthalates were associated with higher (i.e., better) scores. However, there were exceptions, including the finding that a one-unit increase in ΣDBP was associated with a 12% increase in problem solving scores in 4.5-month-old females (β = 1.12; 95% CI: 0.99, 1.28; p = 0.067) but a 85% decrease for 7.5-month-old females (β = 0.54; 95% CI: 0.3, 0.99; p = 0.047). In contrast, MEP was associated with poorer scores on several outcomes. Sex- and timepoint-specific estimates demonstrated a one-unit increase in MEP was associated with: a 52% decrease in personal-social scores in 7.5-month-old males (β = 0.66; 95% CI: 0.46, 0.95; p = 0.02), a 39% decrease in fine motor scores in 7.5-month-old males (β = 0.72; 95% CI: 0.52, 0.98; p = 0.035), and a 6% decrease in fine motor scores in 4.5-month-old females (β = 0.94; 95% CI: 0.88, 0.99; p = 0.03). A one-unit increase in ΣAll was associated with a 4% increase in personal-social scores in 4.5-month-old males (β = 1.04; 95% CI: 0.99, 1.1; p = 0.08) but a 17% decrease in 7.5-month-old males (β = 0.85; 95% CI: 0.73, 0.99; p = 0.03). These data suggest age- and sex-specific associations of prenatal phthalates with infant neurobehavior. The current findings should be confirmed by longitudinal studies with larger sample sizes.
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Affiliation(s)
- Jenna L.N. Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA.,Corresponding author at: Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA. (J. L. N. Sprowles)
| | - Kelsey L.C. Dzwilewski
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA
| | - Francheska M. Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Salma M.A. Musaad
- United States Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave., Houston, TX 77030, USA
| | - Susan L. Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA
| | - Sarah D. Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 N. Matthews Ave., Urbana, IL 61801, USA.,Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Khan Annex Room 2013, 1206 S. Fourth St., Champaign, IL 61820, USA
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Schoch SF, Castro-Mejía JL, Krych L, Leng B, Kot W, Kohler M, Huber R, Rogler G, Biedermann L, Walser JC, Nielsen DS, Kurth S. From Alpha Diversity to Zzz: Interactions among sleep, the brain, and gut microbiota in the first year of life. Prog Neurobiol 2021; 209:102208. [PMID: 34923049 DOI: 10.1016/j.pneurobio.2021.102208] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/04/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
Sleep disorders have been linked to alterations of gut microbiota composition in adult humans and animal models, but it is unclear how this link develops. With longitudinal assessments in 162 healthy infants, we present a so far unrecognized sleep-brain-gut interrelationship. First, we report a link between sleep habits and gut microbiota: daytime sleep is associated with bacterial diversity, and nighttime sleep fragmentation and variability link with bacterial maturity and enterotype. Second, we demonstrate a sleep-brain-gut link: bacterial diversity and enterotype are associated with sleep neurophysiology. Third, we show that the sleep-brain-gut link is relevant in development: sleep habits and bacterial markers predict behavioral-developmental outcomes. Our results demonstrate the dynamic interplay between sleep, gut microbiota, and the maturation of brain and behavior during infancy, which aligns with the lately emerging concept of a sleep-brain-gut axis. Importantly, sleep and gut microbiota represent promising health targets since both can be modified non-invasively. As many adult diseases root in early childhood, leveraging protective factors of adequate sleep and age-appropriate gut microbiota in infancy could constitute a health promoting factor across the entire human lifespan.
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Affiliation(s)
- S F Schoch
- Department of PulmonOlogy, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | | | - L Krych
- Department of Food Science, University of Copenhagen, Denmark
| | - B Leng
- Department of Food Science, University of Copenhagen, Denmark
| | - W Kot
- Department of Plant and Environmental Sciences, University of Copenhagen, Denmark
| | - M Kohler
- Department of PulmonOlogy, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - R Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland
| | - G Rogler
- Department for Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - L Biedermann
- Department for Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - J C Walser
- Genetic Diversity Center, ETH Zurich, Zurich, Switzerland
| | - D S Nielsen
- Department of Food Science, University of Copenhagen, Denmark
| | - S Kurth
- Department of PulmonOlogy, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland; Department of Psychology, University of Fribourg, Fribourg, Switzerland.
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Gleason JL, Yeung E, Sundaram R, Mendola P, Bell EM, Vafai Y, Robinson SL, Putnick DL, Grantz KL. Developmental outcomes in small-for-gestational age twins using a singleton vs twin birthweight reference in Upstate KIDS. Am J Obstet Gynecol MFM 2021; 3:100465. [PMID: 34416423 DOI: 10.1016/j.ajogmf.2021.100465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Limited data exist about the potential developmental delays in appropriately grown twins; furthermore, twins may be at higher risk of developmental delay than singletons. Small-for-gestational age is a risk factor for developmental delay and is based on singleton birthweight references, which may misclassify small-for-gestational age in a subset of appropriately grown twins. OBJECTIVE This study aimed to evaluate the risk of developmental delay in twins classified as small-for-gestational age according to the twin and singleton birthweight references (<10th percentile). STUDY DESIGN In a birth cohort (2008-2010) of twins (n=1790) and singletons (n=3829) where parents completed Ages & Stages Questionnaires for child development between 4 and 36 months, we used a US population-based birthweight reference to categorize singletons and twins as small-for-gestational age. Uncertain small-for-gestational age twins were defined as small-for-gestational age by a singleton reference (<10th percentile) and not by a twin reference, and twin-reference small-for-gestational age twins were defined as small-for-gestational age by a twin reference. Adjusted generalized linear mixed-effects models were used to estimate the odds of failure on any Ages & Stages Questionnaires domain and on each of the 5 domains (fine motor, gross motor, communication, personal-social, and problem-solving domains); random intercepts accounted for repeated measures and twin clustering. RESULTS Compared with non-small-for-gestational age twins (>10th percentile), uncertain small-for-gestational age twins did not have higher odds of Ages & Stages Questionnaires failure (adjusted odds ratio, 1.28; 95% confidence interval, 0.91-1.80). Compared with non-small-for-gestational age singletons, both twin-reference and uncertain small-for-gestational age twins had higher odds of Ages & Stages Questionnaires failure, with the highest risk conferred to twin-reference small-for-gestational age twins (twin-reference adjusted odds ratio, 3.14 [95% confidence interval, 1.94-5.10]; uncertain adjusted odds ratio, 2.35 [95% confidence interval, 1.69-3.26]; P<.01 for trend). Results remained consistent when limiting analyses to term births (≥37 weeks' gestation). CONCLUSION Although a singleton reference may overestimate small-for-gestational age in twins, the findings indicated that a singleton birthweight reference may be appropriate for twins because it identifies more twins at risk of developmental delay than a twin reference.
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Affiliation(s)
- Jessica L Gleason
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Edwina Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Rajeshwari Sundaram
- Biostatistics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Dr Sundaram)
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Erin M Bell
- Departments of Environmental Health Sciences and Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY (Dr Bell)
| | - Yassaman Vafai
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Sonia L Robinson
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Diane L Putnick
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz).
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Hochstedler KA, Bell G, Park H, Ghassabian A, Bell EM, Sundaram R, Grantz KL, Yeung EH. Gestational Age at Birth and Risk of Developmental Delay: The Upstate KIDS Study. Am J Perinatol 2021; 38:1088-1095. [PMID: 32143225 PMCID: PMC7507972 DOI: 10.1055/s-0040-1702937] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age. STUDY DESIGN Development of 5,868 children in Upstate KIDS (New York State; 2008-2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality. RESULTS Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at <32, 32-34, 35-36, 37, 38, and 40 weeks of gestational age were 5.32 (3.42-8.28), 2.43 (1.60-3.69), 1.38 (1.00-1.90), 1.37 (0.98-1.90), 1.29 (0.99-1.67), 0.73 (0.55-0.96), and 0.51 (0.32-0.82). Similar risks of being eligible for Early Intervention Program services were observed (aOR: 4.19, 2.10, 1.29, 1.20, 1.01, 1.00 [ref], 0.92, and 0.78 respectively for <32, 32-34, 37, 38, 39 [ref], 40, and 41 weeks). CONCLUSION Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk.
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Affiliation(s)
- Kimberly A Hochstedler
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Griffith Bell
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Hyojun Park
- Department of Sociology, Utah State University, Logan, Utah
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, New York
| | - Erin M Bell
- Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, New York
| | - Rajeshwari Sundaram
- Biostatistics & Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Edwina H Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Wang P, Xie J, Jiao XC, Ma SS, Liu Y, Yin WJ, Tao RX, Hu HL, Zhang Y, Chen XX, Tao FB, Zhu P. Maternal Glycemia During Pregnancy and Early Offspring Development: A Prospective Birth Cohort Study. J Clin Endocrinol Metab 2021; 106:2279-2290. [PMID: 33982055 DOI: 10.1210/clinem/dgab331] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 12/18/2022]
Abstract
CONTEXT The association of maternal gestational diabetes mellitus (GDM) with neurodevelopmental outcomes remains controversial and evidence that maternal increasing levels of glucose during pregnancy associated with the risk for impaired neurodevelopment were limited. OBJECTIVE To identify the continuous association of increasing maternal glucose levels with neurodevelopmental disorders in offspring and explore the potential contribution of cord metabolites to this association. METHODS The prospective birth cohort study included 1036 mother-child pairs. Primary predictors were maternal exposure GDM and maternal glucose values at a 75-g oral-glucose-tolerance test at 24 to 28 weeks during pregnancy. Primary neurodevelopmental outcomes at 12 months in offspring were assessed by the Ages and Stages Questionnaires, Third Edition (ASQ-3). RESULTS Maternal GDM was associated with failing the communication domain in offspring in the adjusted models [relative risk (RR) with 95% CI: 1.97 (1.11, 3.52)]. Increasing levels of fasting plasma glucose (FPG), 1-h plasma glucose (1-h PG) and 2-h plasma glucose (2-h PG) with 1 SD change were at higher risks in failing the personal social domain of ASQ-3 [RRs with 95% CI for FPG: 1.49 (1.09, 2.04); for 1-h PG: 1.70 (1.27, 2.29); for 2-h PG: 1.36 (1.01, 1.84)]. The linear association was also demonstrated. Compared with girls, boys exposed to higher maternal glucose levels were inclined to the failure of the personal social domain. Mediation analysis showed the contribution of maternal GDM to failure of communication domain mediated by C-peptide. CONCLUSIONS Maternal glucose levels below those diagnostic of diabetes are continuously associated with impaired neurodevelopment in offspring at 12 months.
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Affiliation(s)
- Peng Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Jun Xie
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Xue-Chun Jiao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Shuang-Shuang Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yang Liu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Wan-Jun Yin
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Rui-Xue Tao
- Department of Obstetrics and Gynecology, the First People's Hospital of Hefei City, Hefei, China
| | - Hong-Lin Hu
- Department of endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Zhang
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xian-Xia Chen
- Department of Obstetrics and Gynecology, Anhui Women and Child Health Care Hospital, Hefei, China
| | - Fang-Biao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
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The association between dietary diversity and development among children under 24 months in rural Uganda: analysis of a cluster-randomised maternal education trial. Public Health Nutr 2021; 24:4286-4296. [PMID: 33706831 DOI: 10.1017/s136898002100077x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children. DESIGN A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6-8 months with child development domains (communication, fine motor, gross motor, personal-social and problem solving) at 20-24 months of age. SETTING Rural areas in Kabale and Kisoro districts of south-western Uganda. PARTICIPANTS Children under 24 months. RESULTS After multivariable analysis, DDS at 6-8 months were positively associated with normal fine motor skills development at 20-24 months (AOR = 1·18; 95 % CI 1·01, 1·37; P = 0·02). No significant association was found between DDS and other development domains. Children who were not ill at 6-8 months had higher odds of developing normal communication (AOR = 1·73; 95 % CI 1·08, 2·77) and gross motor (AOR = 1·91; 95 % CI 1·09, 3·36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0·58; 95 % CI 0·33, 0·98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0·05). CONCLUSIONS We found an association between child DDS at 6-8 months and improvement in fine motor skills development at 20-24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20-24 months.
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Neurodevelopmental outcomes in infants following intrapartum maternal oral sildenafil citrate treatment. Am J Obstet Gynecol 2021; 224:316-317. [PMID: 33203527 DOI: 10.1016/j.ajog.2020.10.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
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Schoch SF, Huber R, Kohler M, Kurth S. Which are the Central Aspects of Infant Sleep? The Dynamics of Sleep Composites across Infancy. SENSORS (BASEL, SWITZERLAND) 2020; 20:E7188. [PMID: 33333904 PMCID: PMC7765288 DOI: 10.3390/s20247188] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
Sleep during infancy is important for the well-being of both infant and parent. Therefore, there is large interest in characterizing infant sleep with reliable tools, for example by combining actigraphy with 24-h-diaries. However, it is critical to select the right variables to characterize sleep. In a longitudinal investigation, we collected sleep data of 152 infants at ages 3, 6, and 12 months. Using principal component analysis, we identified five underlying sleep composites from 48 commonly-used sleep variables: Sleep Night, Sleep Day, Sleep Activity, Sleep Timing, and Sleep Variability. These composites accurately reflect known sleep dynamics throughout infancy as Sleep Day (representing naps), Sleep Activity (representing sleep efficiency and consolidation), and Sleep Variability (representing day-to-day stability) decrease across infancy, while Sleep Night (representing nighttime sleep) slightly increases, and Sleep Timing becomes earlier as one ages. We uncover interesting dynamics between the sleep composites and demonstrate that infant sleep is not only highly variable between infants but also dynamic within infants across time. Interestingly, Sleep Day is associated with behavioral development and therefore a potential marker for maturation. We recommend either the use of sleep composites or the core representative variables within each sleep composite for more reliable research.
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Affiliation(s)
- Sarah F. Schoch
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland; (S.F.S.); (M.K.)
- Department of Psychology, University of Zurich, 8006 Zurich, Switzerland
| | - Reto Huber
- Child Development Center, University Children’s Hospital Zurich, 8032 Zurich, Switzerland;
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland; (S.F.S.); (M.K.)
| | - Salome Kurth
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland; (S.F.S.); (M.K.)
- Department of Psychology, University of Fribourg, 1700 Fribourg, Switzerland
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Verstraete J, Ramma L, Jelsma J. Validity and reliability testing of the Toddler and Infant (TANDI) Health Related Quality of Life instrument for very young children. J Patient Rep Outcomes 2020; 4:94. [PMID: 33165662 PMCID: PMC7652950 DOI: 10.1186/s41687-020-00251-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/06/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Despite the high burden of disease in younger children there are few tools specifically designed to estimate Health Related Quality of Life (HRQoL) in children younger than 3 years of age. A previous paper described the process of identifying a pool of items which might be suitable for measuring HRQoL of children aged 0-3 years. The current paper describes how the items were pruned and the final draft of the measure, Toddler and Infant (TANDI) Health Related Quality of Life, was tested for validity and reliability. METHODS A sample of 187 caregivers of children 1-36 months of age were recruited which included children who were either acutely ill (AI), chronically ill (CI) or from the general school going population (GP). The TANDI, an experimental version of the EQ-5D-Y proxy, included six dimensions with three levels of report and general health measured on a Visual Analogue Scale (VAS) from 0 to 100. The content validity had been established during the development of the instrument. The TANDI, Ages and Stages Questionnaire (ASQ), Faces, Leg, Activity, Cry, Consolabilty (FLACC) or Neonatal Infant Pain Scale (NIPS) and a self-designed dietary information questionnaire were administered at baseline. The TANDI was administered 1 week later in GP children to establish test-retest reliability. The distribution of dimension scores, Cronbach's alpha, rotated varimax factor analysis, Spearman's Rho Correlation, the intraclass correlation coefficient, Pearson's correlation, analysis of variance and regression analysis were used to explore the reliability, and validity of the TANDI. RESULTS Concurrent validity of the different dimensions was tested between the TANDI and other instruments. The Spearman's Rho coefficients were significant and moderate to strong for dimensions of activity and participation and significant and weak for items of body functions. Known groups were compared and children with acute illness had the lowest ranked VAS (median 60, range 0-100), indicating worse HRQoL. The six dimensions of the TANDI were tested for internal consistency and reliability and the Cronbach's α as 0.83. Test-retest results showed no variance for dimension scores of movement and play, and high agreement for pain (83%), relationships (87%), communication (83%) and eating (74%). The scores were highly correlated for the VAS (ICC = 0.76; p < 0.001). CONCLUSION The TANDI was found to be valid and reliable for use with children aged 1-36 months in South Africa. It is recommended that the TANDI be included in future research to further investigate HRQoL and the impact of interventions in this vulnerable age group. It is further recommended that future testing be done to assess the feasibility, clinical utility, and cross-cultural validity of the measure and to include international input in further development.
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Affiliation(s)
- Janine Verstraete
- Division of Medicine, Department of Paediatrics and Child Health, Klipfontein Road, Rondebosch, Cape Town, 7700 South Africa
- Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, Cape Town, South Africa
| | - Lebogang Ramma
- Division of Communication Sciences and Disorders, Faculty of Health and Rehabilitation Sciences, Cape Town, South Africa
| | - Jennifer Jelsma
- Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, Cape Town, South Africa
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Hwarng GYH, Ereno IL, Ho SKY, Allen JC, Moorakonda RB, Yeo CL. Accuracy of parent-reported ages and stages questionnaire in assessing the motor and language skills of preterm infants. J Neonatal Perinatal Med 2020; 14:193-202. [PMID: 32894254 DOI: 10.3233/npm-200449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parent-completed tools like the Ages and Stages Questionnaire Third Edition (ASQ-3) are important in developmental screening. As a screening tool, a high negative predictive value (NPV) is critical to avoid missing the diagnosis of developmental delay. This study evaluated the NPV and accuracy of the ASQ-3 in assessing the development of preterm infants. METHODS Infants born at <32 weeks and/or <1250 grams, presenting to the Neonatal Neurodevelopmental Clinic at the Singapore General Hospital for follow-up from January 2014 to June 2017, at 6, 12, and 18 months corrected age, were included. The ASQ-3 and standardized tests - Peabody Developmental Motor Scale-Second Edition (PDMS-2) and Preschool Language Scale, Fourth Edition UK (PLS-4 UK) - were administered. ASQ-3 gross motor and fine motor scores were compared to PDMS-2 at 6 and 12 months, and ASQ-3 communication scores to PLS-4 UK at 18 months. RESULTS At 6 months (n = 145), NPV for gross motor and fine motor were 96.4% (accuracy 80.0%) and 95.4% (accuracy 77.2%) respectively. At 12 months (n = 127), NPV for gross motor and fine motor were 88.9% (accuracy 79.8%) and 82.8% (accuracy 74.0%) respectively. At 18 months (n = 113), NPV for language was 56.9% (accuracy 63.7%). CONCLUSIONS The ASQ-3 showed high NPV and accuracy in screening gross motor and fine motor skills at 6 and 12 months, but not in screening language skills at 18 months. Judicious use of the ASQ-3 may allow for more effective utilization of resources.
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Affiliation(s)
- G Y H Hwarng
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore
| | - I L Ereno
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore.,Lee Kong Chian School of Medicine, Singapore
| | - S K Y Ho
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - C L Yeo
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Galbally M, Watson SJ, Boyce P, Nguyen T, Lewis AJ. The mother, the infant and the mother-infant relationship: What is the impact of antidepressant medication in pregnancy. J Affect Disord 2020; 272:363-370. [PMID: 32553379 DOI: 10.1016/j.jad.2020.03.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/03/2020] [Accepted: 03/29/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Both antidepressant use and depression in pregnancy have the potential to impact on outcomes for the women, their mother-infant relationship and their infants. METHODS Data were obtained from 485 pregnant women within Mercy Pregnancy and Emotional Wellbeing Study, a pregnancy cohort study. The sampling frame was in three groups: those depressed women taking antidepressants in pregnancy, women with diagnosed depression not taking an antidepressant and control women. Depression was measured using the Structured Clinical Interview for DSM-IV and repeat Edinburgh Postnatal Depression Scale and antidepressant use by repeat self-report, hospital records and blood levels. In addition, data on key maternal, parenting and infant outcomes were collected. RESULTS This study found, for women taking SNRI antidepressant medication there was an elevated rate of pregnancy hypertension. Infants exposed to antidepressants had lower Apgar scores and higher birth weight and this was not associated with dose or class of antidepressant. In contrast, women with higher depressive symptoms had lower maternal antenatal attachment and higher postpartum parenting stress. Both women with depression and those taking antidepressants were less likely to initiate breastfeeding. On the Ages and Stages Questionnaire, there was a significant difference in communication skills in SSRI antidepressant exposed infants at 12 months. LIMITATIONS Individual antidepressants could not be examined and development was only measured to 12 months CONCLUSIONS: Overall, the study identified that antidepressant treatment in pregnancy was significantly associated with only a limited number of poorer maternal and infant outcomes and was not associated with poorer parenting outcomes.
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Affiliation(s)
- Megan Galbally
- College of Science, Health, Education and Engineering, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia; King Edward Memorial Hospital, Australia; Faculty of Health and Medical Sciences, University of Western Australian, Australia.
| | - Stuart J Watson
- College of Science, Health, Education and Engineering, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia
| | - Philip Boyce
- Westmead Clinical School, Sydney Medical School, University of Sydney, Australia
| | - Thinh Nguyen
- Faculty of Health and Medical Sciences, University of Western Australian, Australia
| | - Andrew J Lewis
- College of Science, Health, Education and Engineering, Murdoch University, Australia
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van Baar AL, de Jong M, Maat M, Hooge ITC, Bogičević L, Verhoeven M. Reliability and Validity of the Utrecht Tasks for Attention in Toddlers Using Eye Tracking (UTATE). Front Psychol 2020; 11:1179. [PMID: 32655439 PMCID: PMC7325908 DOI: 10.3389/fpsyg.2020.01179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 05/07/2020] [Indexed: 12/01/2022] Open
Abstract
Attention problems hinder many children in their cognitive and social emotional development. Children at risk for developmental problems, like preterm born infants, are specifically known for attention difficulties. Early identification of attention difficulties is important for application of appropriate stimulation in trying to reduce further problems. Specifically designed instruments with good psychometric characteristics are needed to show difficulties in attention, that may contribute to early identification. The Utrecht Tasks of Attention in Toddlers using Eye tracking (UTATE) is an instrument to measure orienting, alerting and executive attention capacities in young children. Reliability and validity of the UTATE are specifically addressed in three studies, reported in this paper. A sample of 95 term born children assessed at 18 months of age was used that provided data for both the second and third study reported here. In addition, three other small samples were used, of which the first consisted of 12 children at 18 months with test-retest data available that are reported in the first study. Two other samples that were used in the third study, consisted of 14 children measured at 12 months, and 15 children examined at 24 months. The UTATE resulted in reliable information on eye movements and some first support for construct and predictive validity was found. Low scores on the UTATE at 18 months were found to be related to slower cognitive development as measured with the Bayley-III-NL at 24 months. Furthermore, a first indication that the UTATE is able to detect some age differences in attention was found. It is concluded that the UTATE can be used to study attention capacities in toddlers that underlie cognitive functioning and development, but further research is necessary.
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Affiliation(s)
- Anneloes L van Baar
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
| | - Marjanneke de Jong
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
| | - Martine Maat
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
| | - Ignace T C Hooge
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Lilly Bogičević
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
| | - Marjolein Verhoeven
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
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Attell JE, Rose C, Bertolli J, Kotzky K, Squires J, Krishna NK, Satterfield-Nash A, Peacock G, Pereira IO, Santelli ACFES, Smith C. Adapting the Ages and Stages Questionnaire to Identify and Quantify Development Among Children With Evidence of Zika Infection. INFANTS AND YOUNG CHILDREN 2020; 33:95-107. [PMID: 33132516 PMCID: PMC7595748 DOI: 10.1097/iyc.0000000000000161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article describes novel methods of applying the Ages and Stages Questionnaire-3rd edition (ASQ-3) to assess and quantify developmental delay among children following the 2015-2016 Zika virus outbreak in Brazil. Many of the children with Zika virus infection were expected to have severe developmental delay. However, administering the ASQ-3 to caregivers of these children according to standard protocol would have screened for the overall presence of delay but not the severity of delay. We adopted an amended protocol for administration of the ASQ-3 to quantify the developmental functioning of children severely affected by Zika virus infection in this investigation. Protocols for administering the ASQ-3 among this population were drafted in consultation with developmental measurement experts and are presented here. Specific developmental estimates are discussed, including developmental age equivalents, developmental quotients, and developmental quotient z scores. The calculations of these estimates are presented with examples in the context of the 2015-2016 Zika virus outbreak and associated microcephaly among prenatally infected children from 2 states in northeastern Brazil. Potential applications of these methods for estimating developmental ability among similar pediatric populations are discussed.
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Affiliation(s)
| | - Charles Rose
- National Center for Birth Defects and Developmental Disability, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Jeanne Bertolli
- Division of Human Development and Disability, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kim Kotzky
- Division of Human Development and Disability, Oak Ridge Institute for Science and Education, Atlanta, Georgia
| | - Jane Squires
- College of Education, Center on Human Development, University of Oregon, Eugene
| | - Nevin K Krishna
- Division of State and Local Readiness, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ashley Satterfield-Nash
- Division of Human Development and Disability, Oak Ridge Institute for Science and Education, Atlanta, Georgia
| | - Georgina Peacock
- Division of Human Development and Disability, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ana Carolina Faria E Silva Santelli
- Overseas Strategy and Management Branch Brazil, Division of Global HIV & Tuberculosis, U.S. Centers for Disease Control and Prevention, Brasilia, Brazil
| | - Camille Smith
- Division of Congenital and Developmental Disorders, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Avalos LA, Ferber J, Zerbo O, Naleway AL, Bulkley J, Thompson M, Cragan J, Williams J, Odouli R, Kauffman TL, Ball S, Shifflett P, Li DK. Trivalent inactivated influenza vaccine (IIV3) during pregnancy and six-month infant development. Vaccine 2020; 38:2326-2332. [PMID: 32033850 PMCID: PMC7309563 DOI: 10.1016/j.vaccine.2020.01.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Despite recommendations by professional organizations that all pregnant women receive inactivated influenza vaccine, safety concerns remain a barrier. Our objective was to assess the effect of trivalent influenza vaccines (IIV3) during pregnancy on parent report 6-month infant development. METHODS We conducted a multi-site prospective birth cohort study during the 2010-2011 influenza season and followed pregnant women and their newborns through 6 months of age. Information on IIV3 during pregnancy was ascertained from the EHR and self-report. The Ages and Stages Questionnaire-3 (ASQ-3) was completed by the mother to assess 6-month infant neurodevelopment in five domains (communication, gross motor, fine motor, problem-solving, and personal adaptive skills). Scores for each domain above the cut-off point indicating typical development were categorized as "on schedule" while scores in the zones indicating the need for either monitoring or further assessment were categorized as "not on schedule". Multivariable logistic regression was conducted. RESULTS Of the 1225 infant-mother pairs, 65% received IIV3 during pregnancy. In bivariate analysis, infants of women who received IIV3 during pregnancy were moderately-less likely to need monitoring or further assessment in the personal social domain compared with infants of unvaccinated women (10.0% vs. 14.1%, p = 0.033; crude OR (cOR): 0.68(95%CI:0.48,0.97)). However, after controlling for potential confounders, the findings were no longer statistically significant (aOR:0.72,95%CI: 0.49,1.06,p = 0.46). No significant unadjusted or adjusted associations emerged in any other ASQ-3 domain. CONCLUSION There was no significant association between IIV3 exposure during pregnancy and 6-month infant development. Studies of IIV3 during pregnancy to assess longer-term developmental outcomes are indicated.
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Affiliation(s)
- Lyndsay A Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
| | - Jeannette Ferber
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Ousseny Zerbo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Allison L Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States
| | - Joanna Bulkley
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States
| | - Mark Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Janet Cragan
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer Williams
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Roxana Odouli
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Tia L Kauffman
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States
| | - Sarah Ball
- Abt Associates, Cambridge, MA, United States
| | | | - De-Kun Li
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
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Schonhaut L, Pérez M, Armijo I, Maturana A. Comparison between Ages & Stages Questionnaire and Bayley Scales, to predict cognitive delay in school age. Early Hum Dev 2020; 141:104933. [PMID: 31775095 DOI: 10.1016/j.earlhumdev.2019.104933] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the predictive value of the Spanish Ages & Stages Questionnaire third edition adapted for Chilean population (ASQ-Cl) and the Bayley Scale of Infant and Toddler Development 3rd edition (Bayley-III) for cognitive delay at school age, and to identify the domain predictors. METHODOLOGY Data were collected from 306 term and preterm children of medium-high socio-economic level enrolled in a prospective cohort study. Developmental outcomes at 8, 18 and 30 months were assessed via the ASQ-Cl and Bayley-III; at 6-8 years cognitive development was assessed using the Wechsler Intelligence Scale for Children (WISC-III). The area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used. RESULTS Of 227 children studied, 6.6% had cognitive delay. ASQ-Cl and Bayley-III generate equivalent AUC [0.77 and 0.80]. Sensitivity 67% and 53%; specificity of 72% and 88%, positive predictive value of 14% and 24%, negative predictive values of 97% and 96% respectively. Greater predictive validity was obtained at 30 months assessment. Deficit in the communication and gross motor skills and problem-solving domains of the ASQ-Cl and all the Bayley-III domains were significantly associated with cognitive delay. CONCLUSIONS ASQ-Cl can be used to identify children at risk for cognitive delay at 6-8 years of age, being comparable with the Bayley-III. Some domains of ASQ-Cl and all domains of Bayley-III were significant predictors for cognitive delay. These results support the use of ASQ-Cl as a screening tool for developmental delay.
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Affiliation(s)
- Luisa Schonhaut
- Clinica Alemana, Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile.
| | - Marcela Pérez
- Clinica Alemana, Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
| | - Iván Armijo
- Faculty of Psychology, Universidad del Desarrollo, Santiago, Chile
| | - Andrés Maturana
- Clinica Alemana, Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
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Spruijt MS, Lopriore E, J Steggerda S, Slaghekke F, Van Klink JMM. Twin-twin transfusion syndrome in the era of fetoscopic laser surgery: antenatal management, neonatal outcome and beyond. Expert Rev Hematol 2020; 13:259-267. [PMID: 31971028 DOI: 10.1080/17474086.2020.1720643] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Introduction: Twin-twin transfusion syndrome (TTTS) is a devastating complication of monochorionic twin pregnancy and remains a major challenge for worldwide fetal medicine specialists. In TTTS, intertwin transfusion through vascular anastomoses in the shared placenta leads to severe hemodynamic imbalance. This review summarizes the current knowledge of TTTS.Areas covered: The most recent insights concerning the management of TTTS, as well as fetal and neonatal complications are described. Relevant articles were selected based on a Pubmed search using the keywords below. Understanding of the underlying pathophysiology has improved greatly as a result of placental injection studies. Advancements in antenatal management have led to increased perinatal survival and a decreased incidence of neonatal complications, including brain injury and neurodevelopmental impairment.Expert opinion: Further opportunities for improvement comprise technological innovations in laser procedures and the prevention of preterm rupture of membranes with subsequent prematurity. A noninvasive treatment such as high-intensity focused ultrasound (HIFU) seems to hold promise for the future treatment of TTTS. Fetal MRI studies are important to improve our understanding of fetal brain injury and should relate their findings to long-term neurodevelopment. International collaboration and centralization of care are of paramount importance to ensure the best care for our patients.
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Affiliation(s)
- Marjolijn S Spruijt
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Enrico Lopriore
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sylke J Steggerda
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Femke Slaghekke
- Department of Obstetrics, Division of Fetal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeanine M M Van Klink
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
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Concurrent validity of the Ages and Stages Questionnaire and the Bayley Scales of Infant Development III in China. PLoS One 2019; 14:e0221675. [PMID: 31487302 PMCID: PMC6728026 DOI: 10.1371/journal.pone.0221675] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 07/02/2019] [Indexed: 11/19/2022] Open
Abstract
Choosing a valid and feasible method to measure child developmental outcomes is key to addressing developmental delays, which have been shown to be associated with high levels of unemployment, participation in crime, and teen pregnancies. However, measuring early childhood development (ECD) with multi-dimensional diagnostic tests such as the Bayley Scales of Infant and Toddler Development III (Bayley-III) can be time-consuming and expensive; therefore, parental screening tools such as the Ages and Stages Questionnaire (ASQ-3) are frequently an alternative measure of early childhood development in large-scale research. The ASQ is also becoming more frequently used as the first step to identify children at risk for developmental delays before conducting a diagnostic test to confirm. However, the effectiveness of the ASQ-3 is uncertain. In this study, we evaluate the accuracy of the ASQ-3 as a screening measure for children at risk of developmental delay in rural China by age group. To do so, we administered the Bayley-III, widely considered to be the “gold standard” of ECD diagnostic tests, to a sample of 1,831 five to twenty-four month-old children and also administered the ASQ-3 to their caregivers. We then compared the outcomes of the ASQ-3 test to those of the Bayley-III. We find that the ASQ-3 was significantly though weakly correlated with the Bayley-III and that the strength of this correlation increased with child age and was stronger when the mother was the primary caregiver (as compared to the grandmother). We also find that the sensitivity and specificity of ASQ-3 ranged widely. The overall findings suggest that the ASQ-3 may not be a very accurate screening tool for identifying developmentally delayed children, especially for children under 13 months of age or children whose primary caregiver is not the mother.
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Iyen B, Vaz LR, Taggar J, Cooper S, Lewis S, Coleman T. Is the apparently protective effect of maternal nicotine replacement therapy (NRT) used in pregnancy on infant development explained by smoking cessation?: secondary analyses of a randomised controlled trial. BMJ Open 2019; 9:e024923. [PMID: 31300493 PMCID: PMC6629395 DOI: 10.1136/bmjopen-2018-024923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 03/11/2019] [Accepted: 06/13/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To investigate relationships between maternal smoking status in pregnancy and infant development. The largest randomised controlled trial of nicotine replacement therapy (NRT) for smoking cessation in pregnancy, the smoking, nicotine and pregnancy (SNAP) trial, found that at 1 month after randomisation, smoking cessation rates were doubled in the NRT group compared with the placebo group. At delivery, there was no significant difference in cessation rates between groups. Surprisingly, infants born to women randomised to NRT were more likely to have unimpaired development at 2 years. We hypothesised that this apparently protective effect was due to smoking cessation caused by NRT and so, investigate this relationship using the same cohort. DESIGN Secondary analysis of a randomised controlled trial. SETTING Seven antenatal hospitals in the Midlands and North-West England. PARTICIPANTS Eight hundred and eighty-four pregnant smokers randomised to receive either NRT patches or visually-identical placebo in the SNAP trial. Participants' smoking behaviour were recorded at randomisation, 1 month after their target quit date and at delivery. METHODS Using logistic regression models, we investigated associations between participants' smoking measures and infant development (assessed using the Ages and Stages questionnaire) at 2 years. MAIN OUTCOME MEASURES 2 year infant development. RESULTS Developmental impairment was reported for 12.7% of study 2 year olds. Maternal heaviness of smoking at randomisation (OR: 1.26, 95% CI: 0.82 to 1.96, p=0.091), validated smoking abstinence recorded at 1 month after a quit date (OR: 1.02, 95% CI: 0.60 to 1.74, p=0.914) and validated smoking abstinence recorded at both 1 month after a quit date and at the end of pregnancy (OR: 1.52, 95% CI: 0.81 to 2.85, p=0.795) were not independently associated with infant developmental impairment at 2 years. CONCLUSION We found no evidence that NRT treatment improved infants' developmental outcomes through smoking cessation. TRIAL REGISTRATION NUMBER CTA03057/0002/001-0001; Post-results.
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Affiliation(s)
- Barbara Iyen
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Luis R Vaz
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Jaspal Taggar
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Sue Cooper
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Tim Coleman
- Division of Primary Care, University of Nottingham, Nottingham, UK
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Ha S, Yeung E, Bell E, Insaf T, Ghassabian A, Bell G, Muscatiello N, Mendola P. Prenatal and early life exposures to ambient air pollution and development. ENVIRONMENTAL RESEARCH 2019; 174:170-175. [PMID: 30979514 PMCID: PMC6541527 DOI: 10.1016/j.envres.2019.03.064] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/15/2019] [Accepted: 03/25/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Residential proximity to major roadways, and prenatal exposures to particulate matter <2.5 μm (PM2.5) and ozone (O3) are linked to poor fetal outcomes but their relationship with childhood development is unclear. OBJECTIVES We investigated whether proximity to major roadways, or prenatal and early-life exposures to PM2.5 and O3 increase the risk of early developmental delays. STUDY DESIGN Prospective cohort. SETTINGS New York State excluding New York City. PARTICIPANTS 4089 singletons and 1016 twins born between 2008 and 2010. EXPOSURES Proximity to major roadway was calculated using road network data from the NY Department of Transportation. Concentrations of PM2.5 and O3 estimated by the Environmental Protection Agency Downscaler models were spatiotemporally linked to each child's prenatal and early-life addresses incorporating residential history, and locations of maternal work and day-care. OUTCOMES Parents reported their children's development at ages 8, 12, 18, 24, 30 and 36 months in five domains using the Ages and Stages Questionnaire. Generalized mixed models estimated the relative risk (RR) and 95% CI for failing any developmental domain per 10 units increase in PM2.5 and O3, and for those living <1000 m away from a major roadway compared to those living further. Models adjusted for potential confounders. RESULTS Compared to those >1000 m away from a major roadway, those resided 50-100 m [RR: 2.12 (1.00-4.52)] and 100-500 m [RR: 2.07 (1.02-4.22)] away had twice the risk of failing the communication domain. Prenatal exposures to both PM2.5 and ozone during various pregnancy windows had weak but significant associations with failing any developmental domain with effects ranging from 1.6% to 2.7% for a 10 μg/m3 increase in PM2.5 and 0.7%-1.7% for a 10 ppb increase in ozone. Average daily postnatal ozone exposure was positively associated with failing the overall screening by 8 months [3.3% (1.1%-5.5%)], 12 months [17.7% (10.4%-25.5%)], and 30 months [7.6%, (1.3%-14.3%)]. Findings were mixed for postnatal PM2.5 exposures. CONCLUSIONS In this prospective cohort study, proximity to major roadway and prenatal/early-life exposures to PM2.5 and O3 were associated with developmental delays. While awaiting larger studies with personal air pollution assessment, efforts to minimize air pollution exposures during critical developmental windows may be warranted.
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Affiliation(s)
- Sandie Ha
- Department of Public Health, School of Social Sciences, Humanities and Arts, Health Sciences Research Institute, University of California, Merced, CA, USA.
| | - Edwina Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Erin Bell
- Department of Environmental Health Sciences, School of Public Health, University at Albany, NY, USA; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, NY, USA
| | - Tabassum Insaf
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, NY, USA; Center for Environmental Health, New York State Department of Health, Albany, NY, USA
| | - Akhgar Ghassabian
- Departments of Pediatrics, Population Health, and Environmental Medicine, New York University School of Medicine, USA
| | - Griffith Bell
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Neil Muscatiello
- Center for Environmental Health, New York State Department of Health, Albany, NY, USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
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Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study. PLoS One 2019; 14:e0218887. [PMID: 31233553 PMCID: PMC6590817 DOI: 10.1371/journal.pone.0218887] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/11/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction Aggressive nutritional strategy, particularly enhancing early provision of energy and protein, has appeared to reduce postnatal growth failure and improve later developmental outcomes. But the amount of macronutrients required remains unclear. The aim of this study was to investigate the impact of protein and energy intakes during the first two weeks after birth on neurodevelopmental outcomes. Methods This retrospective cohort study of very low birth weight infants born between January 2012 and December 2015 was conducted at one tertiary neonatal intensive care unit. The primary outcome was a neurodevelopmental impairment (NDI) at 2 years corrected age defined by a cerebral palsy or a 24 month Ages and Stages Questionnaires score on any of the five domains lower than 2 standard deviation below the mean score. Multivariable logistic regression analysis was used to adjust for perinatal and postnatal confounders. Results Among 245 (73%) infants discharged home alive, 159 (65%) had follow-up at 2 years. Infants with NDI (55/159, 35%) were more likely male gender (67.3% versus 46.2%, P = 0.02) and experienced more patent ductus arteriosus (PDA) ligation (20% versus 5.8%, P = 0.01) than control. After adjusting for confounders, first-week protein intake (OR: 2.27 [CI: 1.07–5.14]; P < 0.05), second-week non-protein energy intake (OR: 1.03 [CI: 1.01–1.05]; P < 0.01) and PDA ligation (OR: 6.81 [1.80–28.46]; P < 0.01) had significant independent association with higher likelihood of NDI at 2 years. Conclusion Providing nutrition above the optimal level may not be beneficial and may even be harmful. These results confirm the recent recommendation to decrease amino acid intakes published in the latest ESPGHAN guidelines.
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Identifying Autism with a Brief and Low-Cost Screening Instrument-OERA: Construct Validity, Invariance Testing, and Agreement Between Judges. J Autism Dev Disord 2019; 48:1780-1791. [PMID: 29247310 DOI: 10.1007/s10803-017-3440-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Simple and low-cost observational-tools to detect symptoms of Autism Spectrum Disorder (ASD) are still necessary. The OERA is a new assessment tool to screen children eliciting observable behaviors with no substantial knowledge on ASD required. The sample was 99 children aged 3-10: 76 with ASD and 23 without ASD (11/23 had intellectual disability). The 13 remained items exhibited high interrater agreement and high reliability loaded onto a single latent trait. Such model showed excellent fit indices evaluated via confirmatory factor analysis and no item showed differential function in terms of age/sex/IQ. A cutoff of five points or higher resulted in the highest sensitivity (92.75) and specificity (90.91) percentages. OERA is a brief, stable, low-cost standardized observational-screening to identify ASD children.
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Guillot M, Philippe M, Miller E, Davila J, Barrowman NJ, Harrison MA, Ben Fadel N, Redpath S, Lemyre B. Influence of timing of initiation of therapeutic hypothermia on brain MRI and neurodevelopment at 18 months in infants with HIE: a retrospective cohort study. BMJ Paediatr Open 2019; 3:e000442. [PMID: 31206080 PMCID: PMC6542433 DOI: 10.1136/bmjpo-2019-000442] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/08/2019] [Accepted: 03/24/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the influence of timing of initiation of therapeutic hypothermia (TH) on brain injury on MRI and on neurodevelopmental outcomes at 18 months. DESIGN Retrospective cohort study. SETTING Tertiary neonatal intensive care unit in Ontario, Canada. PATIENTS Ninety-one patients with hypoxic ischaemic encephalopathy (HIE) were included, 54 in the early TH group and 37 in the late TH group. INTERVENTION Whole-body hypothermia administered for 72 hours, initiated either before 3 hours of life (early TH) or between 3 and 6 hours of life (late TH). MAIN OUTCOME MEASURES Brain injury on MRI after TH (assessed by two neuroradiologists), and neurodevelopmental outcomes at 18 months old. RESULTS TH was initiated at a median time of 1.4 hours (early TH) and 4.4 hours (late TH). Sixty-four neonates (early TH=36, late TH=28) survived and completed neurodevelopmental assessment at 18 months. Neonates in the early TH group received more extensive resuscitation than neonates in the late TH group (p=0.0008). No difference was observed between the two groups in the pattern or severity of brain injury on MRI, or in the neurodevelopmental outcomes at 18 months. The non-survivors (n=16) had lower Apgar scores at 10 min, more extensive resuscitation, suffered from more severe HIE and had significantly more abnormal cerebral function monitoring. CONCLUSION In this retrospective cohort study, TH initiated early was associated neither with a difference in brain injury on MRI nor better neurodevelopmental outcomes at 18 months.
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Affiliation(s)
- Mireille Guillot
- Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Marissa Philippe
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Elka Miller
- Medical Imaging, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jorge Davila
- Medical Imaging, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Nicholas James Barrowman
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Mary-Ann Harrison
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Nadya Ben Fadel
- Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Stephanie Redpath
- Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Brigitte Lemyre
- Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Grotzinger AD, Cheung AK, Patterson MW, Harden KP, Tucker-Drob EM. Genetic and Environmental Links between : General Factors of Psychopathology and Cognitive Ability in Early Childhood. Clin Psychol Sci 2019; 7:430-444. [PMID: 31440427 PMCID: PMC6706081 DOI: 10.1177/2167702618820018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In adults, psychiatric disorders are highly comorbid, and are negatively associated with cognitive abilities. Individual cognitive measures have been linked with domains of child psychopathology, but the specificity of these associations and the extent to which they reflect shared genetic influences are unknown. This study examines the relation between general factors of cognitive ability (g) and psychopathology (p) in early development using two genetically-informative samples: the Texas "Tiny" Twin project (TXtT; N = 626 individuals, age range = 0.16 - 6.31 years) and the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B; N ≈ 1,300 individual twins, age range = 3.7 - 7.1 years). The total p-g correlation (-.21 in ECLS-B; -.34 in TXtT) was primarily attributable to genetic and shared environmental factors. The early age range of participants indicates that the p-g association is a reflection of overlapping genetic and shared environmental factors that operate in the first years of life.
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Affiliation(s)
- Andrew D. Grotzinger
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX 78712-0187
| | - Amanda K. Cheung
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX 78712-0187
| | - Megan W. Patterson
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX 78712-0187
| | - K. Paige Harden
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX 78712-0187
- Population Research Center, University of Texas at Austin, Austin, TX
| | - Elliot M. Tucker-Drob
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX 78712-0187
- Population Research Center, University of Texas at Austin, Austin, TX
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