Gross Motor Outcomes of Children Born Prematurely in Northern Ontario and Followed by a Neonatal Follow-Up Programme

Scaling patterns of cortical folding and thickness in early human brain development in comparison with primates

Across mammalia, brain morphology follows specific scaling patterns. Bigger bodies have bigger brains, with surface area outpacing volume growth, resulting in increased foldedness. We have recently studied scaling rules of cortical thickness, both local and global, finding that the cortical thickness difference between thick gyri and thin sulci also increases with brain size and foldedness. Here, we investigate early brain development in humans, using subjects from the Developing Human Connectome Project, scanned shortly after pre-term or full-term birth, yielding magnetic resonance images of the brain from 29 to 43 postmenstrual weeks. While the global cortical thickness does not change significantly during this development period, its distribution does, with sulci thinning, while gyri thickening. By comparing our results with our recent work on humans and 11 non-human primate species, we also compare the trajectories of primate evolution with human development, noticing that the 2 trends are distinct for volume, surface area, cortical thickness, and gyrification index. Finally, we introduce the global shape index as a proxy for gyrification index; while correlating very strongly with gyrification index, it offers the advantage of being calculated only from local quantities without generating a convex hull or alpha surface.

Physiotherapy Intervention on Premature Infants-A Pilot Study

Background and Objectives: Considering the fact that prematurity echoes in terms of motor development even up to the age of adolescence, through the presence of deficiencies, the importance of starting kinetotherapeutic treatment as soon as possible is highlighted, even in the absence of brain damage or obvious motor delays. Therefore, the objectives of this study are to analyze the factors that influence the level of motor development of premature babies up to 9 months and identify the motor development curve of premature babies according to the three stages of motor development: the position of symmetrical support on the elbows at 3 months, sitting with support at 6 months, and verticalization at 9 months. Materials and Methods: This prospective pilot study was conducted within a rehabilitation facility located in Targu Mureș, Romania, spanning a duration of 2 years from June 2021 to 2023. Results: The study involved a population of 78 children, all premature infants, selected from the patient pool of the rehabilitation facility, specifically chosen based on adherence to the predetermined inclusion and exclusion criteria outlined in the study protocol. Two physiotherapists specialized in child recovery were involved in the study, and one performed the assessments and the other applied the Bobath therapy. Conclusions: Early physiotherapy interventions can have a positive influence in terms of reducing differences in motor development between preterm and full-term infants. This study identified several factors that influence the motor development of premature infants. Among these, the most prominent biological factors were gestational age and birth weight.

Postural Control Measurements to Predict Future Motor Impairment in Preterm Infants: A Systematic Review

Preterm infants are more likely to demonstrate developmental delays than fullterm infants. Postural measurement tools may be effective in measuring the center of pressure (COP) and asymmetry, as well as predicting future motor impairment. The objective of this systematic review was to evaluate existing evidence regarding use of pressure mats or force plates for measuring COP and asymmetry in preterm infants, to determine how measures differ between preterm and fullterm infants and if these tools appropriately predict future motor impairment. The consulted databases included PubMed, Embase, Scopus, and CINAHL. The quality of the literature and the risk of bias were assessed utilizing the ROB2: revised Cochrane risk-of bias tool. Nine manuscripts met the criteria for review. The postural control tools included were FSA UltraThin seat mat, Conformat Pressure-Sensitive mat, Play and Neuro-Developmental Assessment, and standard force plates. Studies demonstrated that all tools were capable of COP assessment in preterm infants and support the association between the observation of reduced postural complexity prior to the observation of midline head control as an indicator of future motor delay. Postural measurement tools provide quick and objective measures of postural control and asymmetry. Based on the degree of impairment, these tools may provide an alternative to standardized assessments that may be taxing to the preterm infant, inaccessible to therapists, or not sensitive enough to capture motor delays.

Maternal fluoride exposure, fertility and birth outcomes: The MIREC cohort

OBJECTIVE

Fluoride exposure >1.5 mg/L from water has been associated with adverse pregnancy and birth outcomes. Little is known, however, about the effect of fluoride at levels consistent with water fluoridation (i.e., 0.7 mg/L) on pregnancy and birth outcomes. We examined the relationship between maternal fluoride exposure, fertility, and birth outcomes in a Canadian pregnancy cohort living in areas where municipal drinking water fluoride concentrations ranged from 0.04 to 0.87 mg/L.

METHODS

Using data from the Maternal-Infant Research on Environmental Chemicals (MIREC) study, we estimated fluoride exposure during pregnancy using three different metrics: (1) maternal urinary fluoride concentrations standardized for specific gravity (MUF_SG) and averaged across all three trimesters (N = 1566), (2) water fluoride concentration (N = 1370), and (3) fluoride intake based on self-reported consumption of water, coffee, and tea, adjusted for body weight (N = 1192). Data on fertility, birth weight, gestational age, preterm birth, and small-for-gestational age (SGA) were assessed. We used multiple linear regression to examine associations between fluoride exposure, birth weight and gestational age, and logistic regression to examine associations with fertility, preterm birth, and SGA, adjusted for relevant covariates.

RESULTS

Median (IQR) MUF_SG was 0.50 (0.33-0.76) mg/L, median water fluoride was 0.52 (0.17-0.64) mg/L, and median fluoride intake was 0.008 (0.003-0.013) mg/kg/day. MUF_SG, water fluoride concentrations, and fluoride intake were not significantly associated with fertility, birth weight, gestational age, preterm birth, or SGA. Fetal sex did not modify any of the associations.

CONCLUSION

Fluoride exposure during pregnancy was not associated with fertility or birth outcomes in this Canadian cohort.

Home-based early stimulation program targeting visual and motor functions for preterm infants with delayed tracking: Feasibility of a Randomized Clinical Trial

AIMS

To verify the feasibility of a home-based early stimulation program targeting visual and motor functions in preterm infants with delayed visual tracking.

METHOD

We applied a randomized controlled trial. We included thirty low-risk preterm infants, from both genders, with delayed visual tracking, gestational between 28-37 weeks, and age at entrance between 1-2 months of corrected age, and absence of visual impairments. Infants were divided into two groups as follows: a) standard care group (SC) that received general orientation about sensory and motor development (16 infants); b) experimental group, that received a four-week home-based early stimulation program targeting visual and motor functions (ESPVM) applied by the caregivers (14 infants). The feasibility outcomes were retention and loss rates, adherence, adverse events, and stress signals. We obtained preliminary data by comparing visual tracking, motor development, and sensory behavior between groups at the end of the intervention.

RESULTS

Retention rate was high, 90 % of the caregivers provided ESPVM at least 22 days, and 70 % provided SC at least 17 days. No adverse events were reported. At the end of intervention, the ESPVM group presented higher frequencies of complete visual tracking for cards 7 (ESPVM = 57.3 %, SC = 6.3 %, p = 0.006) and 8 (ESPVM = 64.3 %, SC = 12.2 %, p = 0.013), and lower scores for total sensory profile (ESPVM: median = 58, range = 46-69; SC: median = 71, range = 54-90; p = 0.016). The groups were similar for motor development.

CONCLUSIONS

The protocol was feasible, and the results encourage a larger randomized controlled trial.