The effects of motor and intellectual functions on the effectiveness of comprehensive rehabilitation in young children with cerebral palsy

Association between maternal hypertensive disorders of pregnancy and child neurodevelopment at 3 years of age: a retrospective cohort study

Hypertensive disorders of pregnancy (HDP) affect up to 10% of women during pregnancy and influence child neurodevelopment, including mental and motor function. We assessed whether HDP, including gestational hypertension, preeclampsia, superimposed preeclampsia, and eclampsia, correlate with motor and mental developmental abnormalities in 3-year-old children, using data obtained between April 2004 and March 2013 through a mandatory population-based health checkup of mothers and children in Kobe city, Japan. The primary outcome was motor and mental developmental abnormalities at 3 years of age; parental-reported questionnaires and physician's medical examinations were evaluated. The association between maternal HDP and child neurodevelopmental abnormality was evaluated using a logistic regression model. Of the 43,854 participating children, 1120 were born to women with HDP and 42,734 were born to women without HDP. The prevalence of motor developmental abnormality was 1.7% in the exposed group and 0.95% in the control group; the prevalence of mental developmental abnormality was 2.41% in the exposed group and 1.22% in the control group. Children born to mothers with HDP did not have an increased risk of motor developmental abnormality at the age of 3 years [adjusted odds ratio (OR) 1.17, 95% confidence interval 0.72-1.91], but had an increased risk of mental developmental abnormality (adjusted OR 1.80, 95% confidence interval 1.21-2.69). Maternal HDP were associated with mental development abnormality in 3-year-old children. These findings may be clinically relevant; mental abnormality in children born to women with HDP could be detected during early stages, which would facilitate early intervention.

Association between birth weight and neurodevelopment at age 1-6 months: results from the Wuhan Healthy Baby Cohort

OBJECTIVE

The association between birth weight and infants' neurodevelopment is not well understood. We aimed to examine the impact of birth weight on neurodevelopment of infants at age 1-6 months using data from the Wuhan Healthy Baby Cohort (WHBC) study.

SETTING AND PARTICIPANTS

This is a prospective cohort study of 4026 infants from the WHBC study who were born at the Women and Children's Hospital of Wuhan, China between October 2012 and September 2013 and who had complete healthcare records within 6 months after birth. Participants were categorised into three groups according to their birth weight: low birth weight (LBW; birth weight <2500 g), normal birth weight (2500 g ≤ birth weight <4000 g) and macrosomia (birth weight ≥4000 g).

MAIN OUTCOME MEASURES

The main outcomes were development quotient (DQ) and clinical diagnosis of neurodevelopmental delay. Both adjusted regression coefficients and ORs were estimated for LBW and macrosomia.

RESULTS

Of the 4026 infants, 166 (4.12%) were of LBW and 237 (5.89%) were with macrosomia. Adjusted regression coefficients of LBW and macrosomia for gross motor DQ were -11.18 (95% CI -11.36 to 10.99) and 0.49 (95% CI 0.36 to 0.63), fine motor DQ -6.57 (95% CI -6.76 to -6.39) and -2.73 (95% CI -2.87 to -2.59), adaptability DQ -4.87 (95% CI -5.05 to -4.68) and -1.19 (95% CI -1.33 to -1.05), language DQ -6.23 (95% CI -6.42 to -6.05) and 0.43 (95% CI 0.29 to 0.57), and social behaviour DQ -6.82 (95% CI -7.01 to -6.64) and 1.10 (95% CI 0.96 to 1.24). Adjusted OR of LBW for clinical diagnosis of 'neurodevelopmental delay' in gross motor was 2.43 (95% CI 1.65 to 3.60), fine motor 1.49 (95% CI 1.01 to 2.19) and adaptability 1.56 (95% CI 1.06 to 2.31). LBW has no significant effects on 'neurodevelopmental delay' in language and social behaviour, and macrosomia has no significant effects on clinical diagnosis of 'neurodevelopmental delay' in all domains.

CONCLUSION

Both LBW and macrosomia are associated with infants' DQ, and LBW increases the risk of being diagnosed with 'neurodevelopmental delay' in gross motor, fine motor and adaptability among infants aged 1-6 months.