The Importance of Monitoring Neurodevelopmental Outcomes for Preterm Infants: A Comparison of the AIMS, GMA, Pull to Sit Maneuver and ASQ-3

The Assessment of Postural-Motor, Coordination, and Reflex Functions in Children and Adolescents with a History of Premature Verticalization and Ontogeny Disorders in Their First Year of Life

(1) Background: Contracting diseases or being exposed to adverse environmental factors in the first year of life may impair the development of body posture and motor coordination. The purpose of this study was to evaluate the correlation between data on the speed of passive verticalization, the number of risk factors and the quality of development in the first year of life, and the results of the functional examination of these individuals in adolescence. (2) Methods: Two groups of 60 volunteers, aged 9-14 years, were examined by performing functional tests and the retrospective analysis of their development up to the age of 1 year. The first group consisted of patients diagnosed with postural defects. The control group consisted of healthy people of the same age who volunteered for this study. (3) Results: Statistical analysis showed statistically significant differences between groups in terms of posture (p = 0.001), motor coordination (p = 0.001), and accumulated primitive reflexes (p = 0.001), as well as a high correlation between these disorders and the quality of development in the first year of life. In the first group, for the ages of 3-6 months (r = 0.96; p = 0.001), 6-9 months (r = 0.871; p = 0.001), and 9-12 months (r = 0.806; p = 0.001), no significant correlations were found with the age of 0-3 months. In the second group, the results were as follows: 0-3 months (r = 0.748; p = 0.001), 3-6 months (r = 0.862 p = 0.001), 6-9 months (r = 0.698; p = 0.001), and 9-12 months (r = 0.740; p = 0.001). In the group of adolescents with posture defects, we observed an earlier time of passive verticalization and sitting, as well as more frequent use of loungers, seats, and walkers (p = 0.026). (4) Conclusions: The analysis of this study's data indicates that the development of body posture and motor coordination may be impaired due to accelerated and passive verticalization in the first year of life.

Early interventions with parental participation and their implications on the neurodevelopment of premature children: a systematic review and meta-analysis

The occurrence of preterm birth is correlated with the potential emergence of disabilities in children. Early intervention programs are designed to promote better developmental outcomes. These interventions employ family-centered methodologies, wherein parents are instructed to facilitate neurodevelopment, thereby promoting heightened involvement of the child in their daily activities. The objective of this investigation was to evaluate the efficacy of early family-based interventions on motor, cognitive, and language development. A systematic review and meta-analysis was conducted utilizing the databases PubMed, Medline, PEDro, Scopus, CINAHL Complete, SciELO, and Open Grey. The search terms utilized included NDT (neuro-developmental treatment), Bobath, neurodevelopmental therapy, parents administered, family administered, physical therapy modalities, early intervention (educational), early intervention, premature infant, preterm, and premature. Randomized clinical trials and observational studies written in English or Spanish were taken into consideration. The initial search resulted in 420 articles. After removing duplicates and applying the selection criteria, 12 articles were selected for the systematic review and 5 articles were selected for the meta-analysis. The meta-analysis revealed a significant association between early intervention and enhanced cognitive function (p = 0.01) in this study. Additionally, the meta-analysis indicated improvements resulting from early family-based intervention (p = 0.02) in motor function. Early motor interventions that emphasize parent involvement and education in neurodevelopment show significant outcomes in motor and cognitive areas at 2 years of age in very premature or extremely premature infants. However, inconclusive effects have been found in the language area, which is the least studied domain. Due to the methodological heterogeneity observed, further research is needed to establish conclusive decisions regarding the administration of these interventions and the determination of key evaluation periods.

Gestational Age and Neurodevelopmental Delay in Term Births at 6 and 12 Months: The Japan Environment and Children's Study (JECS)

BACKGROUND

In the recent years, a high risk of developmental delay not only in very low birth weight infants and late preterm infants but also in early term infants (37-38 weeks) have increasingly been reported. However, in Japan, there are virtually no studies regarding the development delays in early term infants.

METHODS

This study used the data from the Japan Environment and Children's Study (JECS), a birth cohort study conducted in Japan. Data were selected for analysis from the records of 104,065 fetal records. The risk of neurodevelopmental delays at 6 months and 12 months after birth was evaluated using multivariate analysis for infants of various gestational ages, using the 40th week of pregnancy as a reference value. Neurodevelopment was evaluated at 6 months and 12 months after birth using the Ages and Stages Questionnaires, Japanese translation (J-ASQ-3).

RESULTS

The proportion of infants born at a gestational age of 37 to 38 weeks who did not reach the J-ASQ-3 score cutoff value was significantly higher in all areas at both 6 months and 12 months after birth, when compared to that of infants born at 40 weeks. The odds ratio decreased at 12 months after birth compared to that at 6 months after birth.

CONCLUSION

Early term infants in Japan are at an increased risk of neurodevelopmental delay at 12 months after birth.

Development of postural-motor, coordination, and reflex functions in children in the first year of life

OBJECTIVE

Aim: This paper discusses the development of postural-motor, coordination, and reflex functions in children during their first year of life. It proceeds in an orderly manner in stages in which the child actively acquires new psychomotor skills (developmental milestones). These milestones are permanent and have a lifelong impact on health and fitness..

PATIENTS AND METHODS

Materials and Methods: An analysis of data from literary sources on child development in the first year of life was carried out. The review was based on the PubMed online database using keywords related to child development in the first year of life, childcare principles, and infant rehabilitation. The discussion follows an orderly progression through stages where children actively acquire new psychomotor skills, known as developmental milestones. Attention has been paid to the balance organ, which plays a significant role in the development of brain coordination and the disappearance of primitive reflexes. The analysis revealed that the development of postural-motor, coordination, and reflex functions follows a predictable pattern. Key developmental milestones include the gradual disappearance of primitive reflexes and the acquisition of new motor skills. The balance organ plays a crucial role in brain coordination and motor development.

CONCLUSION

Conclusions: Monitoring child development in the first year of life by specialists and guidance for caregivers is important to ensure optimal life-long physical and mental development. The dexterity and physique of an adult result from the harmonious course of development during the first year of life.

Long-term neurodevelopmental effects of exclusively high cord lactate levels in term newborn

INTRODUCTION

Cord arterial blood gas analysis (ABGA) results are used as diagnostic criteria for hypoxic-ischemic encephalopathy in newborns with suspected perinatal asphyxia. This study evaluated the effect of cord ABGA lactate level on the long-term neurodevelopment of newborns without any clinical signs of perinatal asphyxia.

METHODS

This clinical observation study was designed among term babies born between 2018 and 2019 in our unit. Cases with a 5-min Apgar score <7 and signs of fetal distress in their antenatal follow-up were excluded. The cases (n = 1438) were divided into two groups those with high cord lactate levels (above 5 mmol/L, n = 92) and those with low lactate levels (below 2 mmol/L, n = 255). An Ages and Stages Questionnaire, Third Edition (ASQ-3) developmental screening questionnaire was sent to all parents. Patients with a chronological age between 24 and 42 months and for whom the parents fulfilled the questionnaire (low lactate group, n = 29, and high lactate group, n = 45) were evaluated.

RESULTS

No difference was observed between the two groups in terms of demographic characteristics such as age (p = .1669), male gender (p = .906), mother's working situation (p = .948), mother's education level (p = .828), father's education level (p = .507), and family's total income (p = .642). Mean ACQ-3 developmental screening test scores were significantly lower in the high lactate group compared to the low lactate group concerning; fine motor (40 vs. 60, p = .001), problem-solving (50 vs. 60, p = .002), and personal social development (45 vs. 60, p = .003). No difference was observed in terms of communication and gross motor total scores.

DISCUSSION

In general practice, routine cord ABGA is not generally recommended for patients with normal Apgar scores and no suspected hypoxia. However, in this study, we observed that cases with a normal 5-min Apgar score, no suspected perinatal asphyxia, and a cord lactate value of ≥5 fell behind their peers when evaluated with the ACQ-3 developmental screening questionnaire.

Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition

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.