1
|
Sun Z, Lee-Sarwar K, Kelly RS, Lasky-Su JA, Litonjua AA, Weiss ST, Liu YY. Revealing the importance of prenatal gut microbiome in offspring neurodevelopment in humans. EBioMedicine 2023; 90:104491. [PMID: 36868051 PMCID: PMC9996363 DOI: 10.1016/j.ebiom.2023.104491] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND It has been widely recognized that a critical time window for neurodevelopment occurs in early life and the host's gut microbiome plays an important role in neurodevelopment. Following recent demonstrations that the maternal prenatal gut microbiome influences offspring brain development in murine models, we aim to explore whether the critical time window for the association between the gut microbiome and neurodevelopment is prenatal or postnatal for human. METHODS Here we leverage a large-scale human study and compare the associations between the gut microbiota and metabolites from mothers during pregnancy and their children with the children's neurodevelopment. Specifically, using multinomial regression integrated in Songbird, we assessed the discriminating power of the maternal prenatal and child gut microbiome for children's neurodevelopment at early life as measured by the Ages & Stages Questionnaires (ASQ). FINDINGS We show that the maternal prenatal gut microbiome is more relevant than the children's gut microbiome to the children's neurodevelopment in the first year of life (maximum Q2 = 0.212 and 0.096 separately using the taxa at the class level). Moreover, we found that Fusobacteriia is more associated with high fine motor skills in ASQ in the maternal prenatal gut microbiota but become more associated with low fine motor skills in the infant gut microbiota (rank = 0.084 and -0.047 separately), suggesting the roles of the same taxa with respect to neurodevelopment can be opposite at the two stages of fetal neurodevelopment. INTERPRETATION These findings shed light, especially in terms of timing, on potential therapeutic interventions to prevent neurodevelopmental disorders. FUNDING This work was supported by the National Institutes of Health (grant numbers: R01AI141529, R01HD093761, RF1AG067744, UH3OD023268, U19AI095219, U01HL089856, R01HL141826, K08HL148178, K01HL146980), and the Charles A. King Trust Postdoctoral Fellowship.
Collapse
Affiliation(s)
- Zheng Sun
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Kathleen Lee-Sarwar
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Yang-Yu Liu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA; Center for Artificial Intelligence and Modeling, The Carl R. Woese Institute of Genomic Biology, University of Illinois at Urbana-Champaign, Champaign, 61801, USA.
| |
Collapse
|
2
|
Schonhaut L, Maturana A, Cepeda O, Serón P. Predictive Validity of Developmental Screening Questionnaires for Identifying Children With Later Cognitive or Educational Difficulties: A Systematic Review. Front Pediatr 2021; 9:698549. [PMID: 34900855 PMCID: PMC8651980 DOI: 10.3389/fped.2021.698549] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Context: Parent/caregiver completing developmental screening questionnaires (DSQs) for children before 5 years of age is currently recommended. The DSQs recommended by the American Academy of Pediatrics (AAP) are the Ages and Stages Questionnaires (ASQ), Parents' Evaluation of Developmental Status (PEDS), and the Survey of Well-being of Young Children (SWYC). Nevertheless, their predictive validity has not been well-established. Objective: To assess in the current literature, the value of AAP-recommended DSQs (ASQ, PEDS, SWYC) administered between 0 and 5 years of age, for predicting long-term cognitive achievement and/or school performance (CA/SP), after 1 year or more of evaluation and at/or after age 5 years, in the general population. Data Sources: Cochrane, MEDLINE PubMed, CINAHL, EMBASE, Web of Science, Scielo, and Scopus databases (until March 2021). Study Selection: Two authors selected the studies. Forward and backward citation follow-up was done; authors of DSQ were contacted to identify additional studies. Data Extraction: Cohorts were identified, and authors of selected studies were contacted to corroborate and complete extracted data. Results: Thirty-two publications, corresponding to 10 cohorts, were included. All cohorts used ASQ. Only cohort using PEDS was identified but did not meet the inclusion criteria. No cohorts conducted with SWYC were identified. Associations between ASQ and CA/SP were extracted for eight cohorts. The odds ratios were >3, and the area under the curve was 0.66-0.87. A trade-off between sensitivity and specificity was observed. Limitations: Heterogeneity in population characteristics and in DSQ adaptations. Conclusions: A positive association between ASQ and later CA/SP was found in different social, cultural, and economic settings. Additional studies are necessary to determine the impact factors in the predictive capacity of DSQs. Systematic Review Registration: PROSPERO, identifier: CRD42020183883.
Collapse
Affiliation(s)
- Luisa Schonhaut
- Departamento de Pediatría, Clínica Alemana, Santiago, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Andres Maturana
- Departamento de Pediatría, Clínica Alemana, Santiago, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Departamento de Desarrollo Académico e Investigación, Clínica Alemana, Santiago, Chile
| | - Olenkha Cepeda
- Departamento de Desarrollo Académico e Investigación, Clínica Alemana, Santiago, Chile
| | - Pamela Serón
- Departamento Medicina Interna y Centro de excelencia CIGES, Universidad de La Frontera, Temuco, Chile
| |
Collapse
|
3
|
Øksendal E, Brandlistuen RE, Wolke D, Helland SS, Holte A, Wang MV. Associations Between Language Difficulties, Peer Victimization, and Bully Perpetration From 3 Through 8 Years of Age: Results From a Population-Based Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2698-2714. [PMID: 34133886 DOI: 10.1044/2021_jslhr-20-00406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background and Purpose Schoolchildren with language difficulties experience more peer victimization compared to their typically developing (TD) peers. Whether these children also bully their peers (bully perpetration) more than TD children is unclear. Furthermore, little is known about peer victimization and bully perpetration among preschool children with language difficulties and how it may be related to different paths of language difficulties. This study aimed to investigate associations between language difficulties, peer victimization, and bully perpetration from preschool to school age as well as the risk of peer victimization and bully perpetration for children with different developmental paths of language difficulties and mild language difficulties compared to TD children. Method The sample was drawn from the Norwegian Mother, Father and Child Cohort Study. Participants with completed questionnaires at 3, 5, and 8 years of age (n = 22,628) were included. Paths between latent variables of language skills at 3, 5, and 8 years of age, peer victimization at 5 and 8 years of age, and bully perpetration at 8 years of age were examined with structural equation modeling. Logistic regression was used to investigate peer victimization and bully perpetration for predefined paths of language difficulties. Results Poor language skills at 3 and 5 years of age were associated with peer victimization at 5 years of age. Poor language skills at 5 and 8 years of age were associated with peer victimization and bully perpetration at 8 years of age. The association between poor language skills at 5 years of age and bully perpetration at 8 years of age was stronger for girls. Persistent paths of language difficulties at 3, 5, and 8 years of age showed the highest risk of peer victimization and bully perpetration. Conclusions Language difficulties are associated with peer victimization and bully perpetration. The risk of peer victimization and bully perpetration differs according to different developmental paths of language difficulties from preschool to school age.
Collapse
Affiliation(s)
- Elise Øksendal
- Department of Research and Development, The Norwegian National Service of Special Needs (Statped), Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Norway
| | | | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Siri Saugestad Helland
- Regional Centre for Child and Adolescent Mental Health (RBUP), Eastern and Southern Norway
| | - Arne Holte
- Department of Psychology, University of Oslo, Norway
| | - Mari Vaage Wang
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
4
|
McLeigh JD, Tunnell K, Lazcano C. Developmental Status of Young Children in Foster Care. J Dev Behav Pediatr 2021; 42:389-400. [PMID: 33743005 DOI: 10.1097/dbp.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Children in foster care (CFC) may be at higher risk for developmental problems. This study sought to determine (1) the percentage of CFC with developmental problems seen at an integrated primary care clinic and (2) whether the presence of various risk factors was associated with increased odds of developmental problems in general and across developmental domains. METHOD This cross-sectional study used the Ages and Stages Questionnaire, Third Edition, demographic, and health-related data retrieved from electronic health records. The study included 796 children aged 1 to 66 months seen at an integrated primary care clinic exclusively serving CFC. Frequencies and percentages of children with developmental problems were calculated, and relationships between developmental status and potential risk factors were accessed using χ2 and bivariate logistic regression analyses. RESULTS Overall, 68.5% had scores indicative of developmental concern (DC), and 39.8% had scores indicating developmental delay (DD). After adjusting for other risk factors, analysis suggested that being male (odds ratio [OR] 2.169, 95% confidence interval [CI] 1.595-2.950) and exhibiting trauma symptoms (OR 1.51, 95% CI 0.993-2.295) were associated with higher odds of exhibiting DC, whereas being in a kinship placement (OR 0.55, 95% CI 0.359-0.842) was associated with lower odds. Odds were higher for exhibiting DD for children who were male (OR 1.716, 95% CI 1.278-2.303), born prematurely (OR 2.165, 95% CI 1.438-3.259), experienced physical abuse (OR 1.541, 95% CI 1.040-2.283), and presented trauma symptoms (OR 1.441, 95% CI 0.975-2.130). CONCLUSION The findings suggest that early screening is vital for CFC to identify developmental impairment so that appropriate education and interventions can be offered.
Collapse
Affiliation(s)
- Jill D McLeigh
- Rees-Jones Center for Foster Care Excellence, Children's Health, Dallas, TX
- UT Health School of Public Health, Dallas, TX
- Center for Pediatric Population Health, UT Health School of Public Health and Children's Health System of Texas, Dallas, TX
| | - Karlyn Tunnell
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Cecilia Lazcano
- Rees-Jones Center for Foster Care Excellence, Children's Health, Dallas, TX
| |
Collapse
|
5
|
Breast milk protein content at week 3 after birth and neurodevelopmental outcome in preterm infants fed fortified breast milk. Eur J Nutr 2021; 60:3959-3969. [PMID: 33929587 DOI: 10.1007/s00394-021-02562-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/09/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Feeding supplemented mother milk during hospital stay improves neurodevelopment in preterm infants. Yet the composition of mother milk varies widely between subjects. The relationship between this variation and outcome is unknown. OBJECTIVE To determine whether the protein content in native breast milk (BM) correlates with 2-year infant outcome. DESIGN In a monocentric prospective observational study, LACTACOL, preterm infants born between 28 and 34 weeks of gestation, whose mothers decided to exclusively breastfeed, were enrolled during the first week of life. Samples of expressed breast milk obtained at several times of the day were pooled over a 24-h period, and such pool was used for macronutrient analysis, using mid-infrared analyzer. Age and Stages questionnaire (ASQ) was used to assess 2-year neurodevelopmental outcome. We analyzed the relationship between protein content in BM, and (i) infant neurodevelopment at 2-year (primary outcome), and (ii) growth until 2-year (secondary outcome). RESULTS 138 infants were enrolled. The main analysis concerned 130 infants (including 40 twin infants) and 110 mothers with BM samples collected at week 3 after birth. Native BM samples were ranked in three tertiles of protein content (g/100 ml): 0.91 ± 0.09 (lower), 1.14 ± 0.05 (middle) and 1.40 ± 0.15 (upper); 48, 47 and 35 infants were ranked, respectively, in these three tertiles. Infants in the upper tertile were more often singleton (P = 0.012) and were born with lower birth weight and head circumference Z-scores (P = 0.005 and 0.002, respectively). Differences in weight and head circumference were no longer observed at 2-year. ASQ score at age 2 did not differ between the three tertiles (P = 0.780). Sensitivity analyses with imputations, including all 138 infants, confirmed the main analysis as well as analyses based on fortified BM as exposure. CONCLUSIONS Protein content of BM (native or fortified) is not associated with preterm infant neurodevelopment at 2-year. Higher protein content was associated with a lower birth weight.
Collapse
|
6
|
Martínez-Nadal S, Schonhaut L, Armijo I, Demestre X. Predictive value of the Ages and Stages Questionnaire® for school performance and school intervention in late preterm- and term-born children. Child Care Health Dev 2021; 47:103-111. [PMID: 32978787 DOI: 10.1111/cch.12814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/10/2020] [Accepted: 09/19/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The new health supervision guidelines emphasize the importance of surveillance or a formal developmental screening test at 4 years, one of the most used tests is Ages & Stages Questionnaire. Nevertheless, there is still not enough evidence whether these tools will be useful to predict future school performance (SP). OBJECTIVES The objectives of this study were to evaluate the Ages & Stages Questionnaire 3rd edition 48-month interval (ASQ3-48) translated to Spanish for predicting the need for school intervention (SI) and poor SP at 8-9 years of age, in late preterm infants (LPIs) and term-born infants (Terms) and to compare the prevalence of SI and poor SP in the two groups. METHODS Data were collected from a cohort of 75 LPIs and 58 Terms assessed with ASQ3-48 and with a further assessment of academic results at 8-9 years, through a standardized school test of the Education Department of Catalonia. SI data were obtained through a parent report. Area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used. RESULTS The prevalence of poor SP was 12.8%, without statistically significant differences between LPIs and Terms. LPIs had higher SI than Terms (29.3% vs. 10.3%, P = 0.001). AUC for poor SP was 0.73 and for receiving SI was 0.56 without differences between the two groups. The sensitivity of the ASQ3-48 for poor SP was 41%, for specificity 92%, and for receiving SI 14% and 89%, respectively. Poor SP was related to having positive screening in the ASQ3-48 (OR 6.5 [95% CI, 1.9-22.2]) while having received SI was related to late prematurity (OR 3.6 [95% CI, 1.3-9.6]). CONCLUSIONS The ASQ3-48 shows acceptable predictive properties for poor SP but not for receiving SI. No differences were found in SP between LPI and Term cohorts, but LPIs are likelier to require SI.
Collapse
Affiliation(s)
| | - Luisa Schonhaut
- Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Iván Armijo
- Faculty of Psychology, Universidad del Desarrollo, Santiago, Chile
| | - Xavier Demestre
- Department of Pediatrics, Hospital de Barcelona, SCIAS, Barcelona, Spain
| |
Collapse
|
7
|
Frantz MF, Schaefer MP, Donelli TMS. Follow-Up de Nascidos Prematuros: Uma Revisão Sistemática da Literatura. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivou-se mapear estudos científicos sobre follow-up de prematuros na área da psicologia. Buscou-se no portal BVS artigos empíricos publicados até dezembro de 2017 pelos descritores prematur* AND follow up AND child AND psychology. A partir dos critérios adotados, analisou-se 48 artigos, nas categorias: faixa etária em que os prematuros foram avaliados; objetivos do estudo; tipo de avaliação realizada; e resultados encontrados. Destaca-se que a metade realizou o follow-up entre o nascimento e a adolescência, a maioria investigou o desenvolvimento neuropsicológico e encontrou associações entre a prematuridade, déficits cognitivos e psicológicos. Compreende-se que os estudos priorizam as repercussões no desenvolvimento de habilidades e competências, dando pouca atenção aos aspectos psíquicos e às interações criança-pais-ambiente.
Collapse
|
8
|
Mirzakhani H, Kelly RS, Yadama AP, Chu SH, Lasky-Su JA, Litonjua AA, Weiss ST. Stability of developmental status and risk of impairment at 24 and 36 months in late preterm infants. Infant Behav Dev 2020; 60:101462. [PMID: 32599336 DOI: 10.1016/j.infbeh.2020.101462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/06/2020] [Accepted: 06/20/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Few studies investigated whether late preterm infants might have developmental delays in several domains in early life and how stable the lag in developmental status might be. AIM We aimed to examine the stability of potential delays across developmental domains at 24 and 36 months of age in late preterm (34°-366 weeks) and term (≥37 weeks) children and whether the risk of delays remained high at 36 months. STUDY DESIGN, SUBJECTS, AND OUTCOME MEASURE We conducted a prospective cohort analysis of the children of pregnant women participating in the Vitamin Antenatal Asthma Reduction Trial (VDAART). 652 children who were prospectively followed up and had parent-completed Ages Stages Questionnaires (ASQ-3) questionnaires at both 24 and 36 months were analyzed to assess their domain-specific developmental status. RESULTS 6.61 % (42/635) of children had a late preterm birth. Developmental delays were stable between 24 and 36 months on all 5 domains for the children born preterm and on 4/5 domains for those born at term. The developmental domains with the status stability at 24 and 36 months in both late preterm and term children were the gross motor, communication, personal-social skills, and problem-solving. Late preterm children compared with term children remained at higher risk of delays at 36 months for gross motor, communication, and problem-solving skills (aOR = 4.54, 95 %CI: 1.81-10.79; aOR = 8.60, 95 %CI: 3.10-23.28 and aOR = 3.80, 95 %CI: 1.58-8.73, respectively). CONCLUSION Late preterm birth is associated with suboptimal development and stability in several domains at both 24 and 36 months and compared with term birth, requiring early monitoring and assessment of the developmental lag to avoid potential long-term implications.
Collapse
Affiliation(s)
- Hooman Mirzakhani
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Aishwarya P Yadama
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Su H Chu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Golisano Children's Hospital at University of Rochester Medical Center, Rochester, NY, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Partners Center for Personalized Medicine, Partners Health Care, Boston, MA, USA
| |
Collapse
|
9
|
Miller LC, Neupane S, Joshi N, Shrestha M, Neupane S, Lohani M, Thorne-Lyman AL. Diet quality over time is associated with better development in rural Nepali children. MATERNAL AND CHILD NUTRITION 2020; 16:e12964. [PMID: 32048475 PMCID: PMC7296824 DOI: 10.1111/mcn.12964] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
Abstract
Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource‐poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal‐source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire‐3 [ASQ‐3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross‐sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross‐sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p = .04) or dairy products (aOR 0.95, p = .05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59–0.89). In adjusted linear regression analysis, both cumulative DDS (β [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long‐term diet quality.
Collapse
Affiliation(s)
- Laurie C Miller
- Department of Pediatrics, Friedman School of Nutrition Science and Policy, and Eliot-Pearson Department of Child Study and Human Development, Tufts University, Boston, Massachusetts
| | - Sumanta Neupane
- International Food Policy Research Institute, New Delhi, India
| | | | - Merina Shrestha
- Institute of Medicine, Tribhuvhan University, Kathmandu, Nepal
| | | | | | - Andrew L Thorne-Lyman
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Lind A, Nyman A, Lehtonen L, Haataja L. Predictive value of psychological assessment at five years of age in the long-term follow-up of very preterm children. Child Neuropsychol 2019; 26:312-323. [DOI: 10.1080/09297049.2019.1674267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Annika Lind
- Department of Psychology, University of Turku, Turku, Finland
- Turku Institute for Advanced Studies (TIAS), University of Turku, Turku, Finland
| | - Anna Nyman
- Department of Psychology, University of Turku, Turku, Finland
| | - Liisa Lehtonen
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Leena Haataja
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
12
|
Hanf M, Nusinovici S, Rouger V, Olivier M, Berlie I, Flamant C, Gascoin G, Van Bogaert P, Rozé JC. Cohort Profile: Longitudinal study of preterm infants in the Pays de la Loire region of France (LIFT cohort). Int J Epidemiol 2019; 46:1396-1397h. [PMID: 29106567 DOI: 10.1093/ije/dyx110] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Matthieu Hanf
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France.,INSERM UMR 1181 Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Versailles Saint Quentin University, Villejuif, France
| | - Simon Nusinovici
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France
| | - Valérie Rouger
- 'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France
| | - Marion Olivier
- 'Loire Infant Follow-up Team' (LIFT) Network, Nantes, Pays de Loire, France
| | - Isabelle Berlie
- Department of Paediatric Neurology, Angers University Hospital, Angers, France
| | - Cyril Flamant
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France.,Department of Paediatric Medicine, Nantes University Hospital, Nantes, France
| | - Géraldine Gascoin
- Department of Neonatal Medicine, Angers University Hospital, Angers, France
| | | | - Jean-Christophe Rozé
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France.,Department of Paediatric Medicine, Nantes University Hospital, Nantes, France
| |
Collapse
|
13
|
Reliability and agreement of ages and stages questionnaires®: Results in late preterm and term-born infants at 24 and 48 months. Early Hum Dev 2019; 128:55-61. [PMID: 30529873 DOI: 10.1016/j.earlhumdev.2018.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 11/21/2022]
Abstract
AIM To evaluate the reliability of the Ages and Stages Questionnaires (ASQ-3) 24 and 48 month intervals translated to Spanish by Brookes Publishing, and the agreement between both questionnaires, comparing late preterm (LPI) and term-born infants (terms). METHODS Two cohort samples of healthy LPI and terms that were born in a private hospital in Barcelona, Spain. Internal consistency was analyzed by Cronbach's alpha scores and Pearson product- moment correlation between the domain scores and the overall score. The agreement was analyzed using Pearson's correlations between the two questionnaires, and the odds ratio (OR) for positive screening at 48 months, given a positive screen in 24 month assessment. RESULTS A total of 473 evaluations were analyzed, representing 331 children. Cronbach's alpha scores for the motor domains on both intervals were low, but acceptable compared with the overall score; a strong positive correlation between the domain and overall score were obtained in the majority of the domains. The correlation between the 24 and 48 month total scores were positive, especially for LPI. Having at least 2 domains in the referral zone at 24 months was associated with an OR of 140 [95% CI 14.85; 3575.65] for positive screen at 48 months. CONCLUSION The Spanish ASQ-3 24 and 48 month intervals appear to be a reliable for developmental screening and for the follow-up of children, especially for LPI. Having two or more domains in the referral zone at 24 months screening is a significant predictor of developmental delay risk at 48-month questionnaire.
Collapse
|
14
|
Prospective follow-up of a cohort of preterm infants<33 WG receiving ketamine for tracheal intubation in the delivery room: Neurological outcome at 1 and 2 years. Arch Pediatr 2018; 25:295-300. [PMID: 29628409 DOI: 10.1016/j.arcped.2018.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/23/2018] [Accepted: 03/04/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Although ketamine analgesia is effective in reducing pain and facilitating the tracheal intubation of newborns in the delivery room, no data on the neurological effects of this treatment are available. This study compared the neurodevelopmental outcomes at 2 years of age in a cohort of preterm newborns having received ketamine prior to tracheal intubation at birth (the ketamine group) and in a control group. METHODS We included newborns delivered at less than 33 weeks gestational age (WGA) having undergone tracheal intubation at birth. The Ages and Stages Questionnaire (ASQ) was completed at 1 and 2 years of age. The development quotient (DQ) was calculated from the revised Brunet-Lezine score assessed at a corrected age of 2 years. RESULTS There were no statistically significant differences between the ketamine group (n=54 at 1 year and n=51 at 2 years) and the control group (n=16 at 1 and 2 years) in terms of the mean±standard deviation DQ at the age of 2 (98±12 vs. 103±9, respectively; P=0.17) and the ASQ score at the age of 2 (221±44 vs. 230±39, respectively; P=0.55). DISCUSSION This prospective cohort of 51 preterm newborns having received ketamine at birth did not reveal any differences in terms of neurological development at the age of 2 (relative to a control group and the literature data). These preliminary results must be confirmed in a randomized trial with longer follow-up.
Collapse
|
15
|
Agarwal PK, Shi L, Daniel LM, Yang PH, Khoo PC, Quek BH, Zheng Q, Rajadurai VS. Prospective evaluation of the Ages and Stages Questionnaire 3rd Edition in very-low-birthweight infants. Dev Med Child Neurol 2017; 59:484-489. [PMID: 27882544 DOI: 10.1111/dmcn.13307] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2016] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the predictive and concurrent diagnostic agreement of the Ages and Stages Questionnaire 3rd Edition (ASQ-3) with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) in infants born preterm and very-low-birthweight (PT/VLBW; ≤1250g). METHOD We evaluated 141 PT/VLBW infants (68 males, 73 females) born at the KK Women's and Children's Hospital between January 2010 and December 2011, to determine predictive and concurrent diagnostic agreement between the ASQ-3 at 9, 12, 18, and 24 months corrected age and Bayley-III at 24 months. Cut-offs on the ASQ-3 at 24 months were estimated by receiver operating characteristic curves. RESULTS Sixty (43%) and 25 (18%) failed in any domain of the ASQ-3 and Bayley-III (<70) respectively. A negative predictive value (NPV) >98% was achieved for the motor domain from 9 months, and >90% for the communication domain and the overall results at 24 months. Optimal referral ASQ-3 score at 24 months to achieve 100% NPV was 243. INTERPRETATION In PT/VLBW infants, ASQ-3 screening at 24 months can reduce the need for costly psychometric assessments in children with normal results. Clinicians can be assured of normal motor development at 9 months using the ASQ-3, but should continue to screen children on other domains.
Collapse
Affiliation(s)
- Pratibha K Agarwal
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - Luming Shi
- Department of Epidemiology, Singapore Clinical Research Institute, Singapore
| | - Lourdes M Daniel
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | - Phey Hong Yang
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | - Poh Choo Khoo
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - Bin Huey Quek
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - Qishi Zheng
- Department of Epidemiology, Singapore Clinical Research Institute, Singapore
| | - Victor S Rajadurai
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
16
|
Charkaluk ML, Rousseau J, Calderon J, Bernard JY, Forhan A, Heude B, Kaminski M. Ages and Stages Questionnaire at 3 Years for Predicting IQ at 5-6 Years. Pediatrics 2017; 139:peds.2016-2798. [PMID: 28360034 DOI: 10.1542/peds.2016-2798] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To assess the predictive value of the 36-month Ages & Stages Questionnaire (ASQ) score for IQ score at age 5 to 6 years in the general population and to identify factors associated with IQ <85 once the ASQ score is taken into account. METHODS Data were collected from 939 children enrolled in a population-based prospective cohort study. Developmental outcomes at 36 months were assessed via the ASQ and at 5 to 6 years via the Wechsler Preschool and Primary Scale of Intelligence. The ASQ threshold was identified via the receiver operating characteristic curve. Additional predictive factors to obtain an IQ <85 were investigated, and their interaction with ASQ score was studied. RESULTS Sixty-nine children (7.3%) had an IQ <85. A 36-month ASQ score threshold of 270 was optimal to identify children with an IQ <85 at 5 to 6 years, with a 0.77 ± 0.11 sensitivity and 0.68 ± 0.03 specificity. Maternal educational level and occupational activity at the time of ASQ completion were associated with the risk of an IQ <85 at a given ASQ level. In the multivariate model, no interaction between the studied factors and ASQ score reached significance. CONCLUSIONS In the general pediatric population, 36-month ASQ parental reports could be used to identify children at later risk of cognitive delay. Low maternal education level should also be considered as a major risk factor for lower IQ in preschool children regardless of ASQ score.
Collapse
Affiliation(s)
- Marie-Laure Charkaluk
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France; .,Université Catholique de Lille, Lille, France.,Service de Néonatologie, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique Lillois/Faculté de Médecine et Maïeutique, Lille, France
| | - Jessica Rousseau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France
| | - Johanna Calderon
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jonathan Y Bernard
- Inserm UMR 1153, Developmental Origins of Health and Disease (ORCHaD) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Centre,Villejuif, France.,Paris Descartes University, Paris, France; and.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Anne Forhan
- Inserm UMR 1153, Developmental Origins of Health and Disease (ORCHaD) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Centre,Villejuif, France.,Paris Descartes University, Paris, France; and
| | - Barbara Heude
- Inserm UMR 1153, Developmental Origins of Health and Disease (ORCHaD) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Centre,Villejuif, France.,Paris Descartes University, Paris, France; and
| | - Monique Kaminski
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France
| | | |
Collapse
|
17
|
Schonhaut B L, Pérez R M, Castilla F AM, Castro M S, Salinas A P, Armijo R I. [Predictive value of Ages & Stages Questionnaires for cognitive performance at early years of schooling]. REVISTA CHILENA DE PEDIATRIA 2017; 88:28-34. [PMID: 28288224 DOI: 10.1016/j.rchipe.2016.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 08/18/2016] [Indexed: 06/06/2023]
Abstract
UNLABELLED The Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. PATIENTS AND METHOD Diagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation. RESULTS 123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. Conclusion ASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country.
Collapse
Affiliation(s)
- Luisa Schonhaut B
- Servicio de Pediatría, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Marcela Pérez R
- Servicio de Pediatría, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Ana María Castilla F
- La Casa Azul, Centro Integral de Atención Psiquiátrica y Psicológica, Santiago, Chile
| | - Sonia Castro M
- Servicio de Pediatría, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Patricia Salinas A
- Servicio de Pediatría, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Iván Armijo R
- Facultad de Psicología, Universidad Gabriela Mistral, Santiago, Chile
| |
Collapse
|
18
|
Wood ME, Frazier JA, Nordeng HME, Lapane KL. Longitudinal changes in neurodevelopmental outcomes between 18 and 36 months in children with prenatal triptan exposure: findings from the Norwegian Mother and Child Cohort Study. BMJ Open 2016; 6:e011971. [PMID: 27625061 PMCID: PMC5030558 DOI: 10.1136/bmjopen-2016-011971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study sought to determine whether changes in neurodevelopmental outcomes between 18 and 36 months of age were associated with prenatal exposure to triptan medications, a class of 5-HT receptor agonists used in the treatment of migraine. METHOD Using data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort that includes nearly 40% of all pregnancies in Norway from 1999 to 2008, we identified 50 469 mother-child dyads who met inclusion criteria and were present for at least one follow-up assessment at 18 or 36 months postpartum. Neurodevelopment was assessed using the Child Behaviour Checklist, the Emotionality, Activity, and Shyness Questionnaire, and the Ages and Stages Questionnaire. We used generalised estimating equations to evaluate change from 18 to 36 months for children prenatally exposed to triptans, relative to contrast groups, and used marginal structural models with inverse probability of treatment and censoring weights to address time-varying exposure and confounding as well as loss to follow-up. RESULTS Among eligible participants (n=50 469), 1.0% used a triptan during pregnancy, 2.0% used triptans prior to pregnancy only, 8.0% reported migraine without triptan use and 89.0% had no history of migraine. Children with prenatal triptan exposure had greater increases in emotionality (r-RR 2.18, 95% CI 1.03 to 4.53) and activity problems (r-RR 1.70, 95% CI 1.02 to 2.8) compared to children born to mothers who discontinued triptan use prior to pregnancy. CONCLUSION Prenatal triptan exposure was associated with changes over time in externalising-type behaviours such as emotionality and activity, but not with internalising-type behaviours.
Collapse
Affiliation(s)
- Mollie E Wood
- The University of Oslo School of Pharmacy, Oslo, Norway
- The University of Massachusetts Medical School, Worcester, Massachusetts, USA
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Jean A Frazier
- The University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Hedvig M E Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
- The University of Oslo School of Pharmacy and the Norwegian Institute of Public Health, Oslo, Norway
| | - Kate L Lapane
- The University of Massachusetts Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
19
|
Wood ME, Frazier JA, Nordeng HME, Lapane KL. Prenatal triptan exposure and parent-reported early childhood neurodevelopmental outcomes: an application of propensity score calibration to adjust for unmeasured confounding by migraine severity. Pharmacoepidemiol Drug Saf 2016; 25:493-502. [PMID: 26554750 PMCID: PMC5071383 DOI: 10.1002/pds.3902] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/17/2015] [Accepted: 09/23/2015] [Indexed: 01/19/2023]
Abstract
PURPOSE Triptan medications are serotonin agonists used to treat migraine, a chronic pain condition highly prevalent in women of reproductive age. Data on the safety of triptans during pregnancy are scant. We sought to quantify the association of prenatal triptan exposure on neurodevelopment in 3-year-old children. METHODS Using data from the Norwegian Mother and Child Cohort Study, we used propensity score matching to examine associations between prenatal triptan exposure and psychomotor function, communication, and temperament. We used an external validation study to perform propensity calibration to adjust effect estimates for confounders unmeasured in the main study (migraine severity, type, and maternal attitudes towards medication use). RESULTS We identified 4204 women who reported migraine headache at baseline, of which 375 (8.9%) reported using a triptan greater than or equal to once during pregnancy. Children with prenatal triptan exposure had 1.37-fold greater unadjusted odds of fine motor problems (95% confidence interval (CI): 1.06-1.77), which decreased after propensity score matching (odds ratio (OR): 1.29, 95%CI 0.97-1.73) and was further attenuated after calibration (OR: 1.25, 95%CI 0.89-1.74). We observed no increased risk for gross motor or communication problems, and no differences in temperament. Adjustment for migraine severity using propensity score calibration had a moderate impact on effect estimates, with percent changes ranging from 2.4% to 50%. CONCLUSIONS Prenatal triptan exposure was not associated with psychomotor function, communication problems, or temperament in 3-year-old children. Adjustment for migraine severity reduced effect estimates and should be considered in future studies of the safety of triptans during pregnancy. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Mollie E Wood
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
- PharmacoEpidemiology and Drug Safety Research Group, Oslo, Norway
| | - Jean A Frazier
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Hedvig M E Nordeng
- School of Pharmacy, University of Oslo, Oslo, Norway
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- PharmacoEpidemiology and Drug Safety Research Group, Oslo, Norway
| | - Kate L Lapane
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|