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Ramella-Roman JC, Mahendroo M, Raoux C, Latour G, Schanne-Klein MC. Quantitative Assessment of Collagen Remodeling during a Murine Pregnancy. ACS PHOTONICS 2024; 11:3536-3544. [PMID: 39310300 PMCID: PMC11413848 DOI: 10.1021/acsphotonics.4c00337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/23/2024] [Accepted: 07/29/2024] [Indexed: 09/25/2024]
Abstract
Uterine cervical remodeling is a fundamental feature of pregnancy, facilitating the delivery of the fetus through the cervical canal. Yet, we still know very little about this process due to the lack of methodologies that can quantitatively and unequivocally pinpoint the changes the cervix undergoes during pregnancy. We utilize polarization-resolved second harmonic generation to visualize the alterations the cervix extracellular matrix, specifically collagen, undergoes during pregnancy with exquisite resolution. This technique provides images of the collagen orientation at the pixel level (0.4 μm) over the entire murine cervical section. They show tight and ordered packing of collagen fibers around the os at the early stage of pregnancy and their disruption at the later stages. Furthermore, we utilize a straightforward statistical analysis to demonstrate the loss of order in the tissue, consistent with the loss of mechanical properties associated with this process. This work provides a deeper understanding of the parturition process and could support research into the cause of pathological or premature birth.
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Affiliation(s)
- Jessica C. Ramella-Roman
- Biomedical
Engineering Department, Florida International
University, Miami, Florida 33174, United States
| | - Mala Mahendroo
- Department
of Obstetrics and Gynecology, University
of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Clothilde Raoux
- Laboratory
for Optics and Biosciences (LOB), École Polytechnique, CNRS,
Inserm, Institut Polytechnique de Paris, Palaiseau 91120, France
| | - Gaël Latour
- Laboratory
for Optics and Biosciences (LOB), École Polytechnique, CNRS,
Inserm, Institut Polytechnique de Paris, Palaiseau 91120, France
- Université
Paris-Saclay, Gif-sur-Yvette 91190, France
| | - Marie-Claire Schanne-Klein
- Laboratory
for Optics and Biosciences (LOB), École Polytechnique, CNRS,
Inserm, Institut Polytechnique de Paris, Palaiseau 91120, France
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Singh M, Shobhane H, Tiwari K, Agarwal S. To Study the Correlation of Maternal Serum Vitamin D Levels and Infant Serum Vitamin D Levels With Infant Birth Weight: A Single-Centre Experience From the Bundelkhand Region, India. Cureus 2024; 16:e68696. [PMID: 39371764 PMCID: PMC11452918 DOI: 10.7759/cureus.68696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2024] [Indexed: 10/08/2024] Open
Abstract
BACKGROUND Vitamin D deficiency during pregnancy can have severe effects on both the mother and the newborn child. The main aim of this study was to assess the impact of maternal vitamin D levels on the birth weight of the newborn by analysing the vitamin D levels in pregnant women at full term and their newborn. MATERIAL AND METHODS The cross-sectional, hospital-based study was conducted with 150 consecutive women in labour presenting with a singleton term pregnancy at a large tertiary centre in the Bundelkhand region, India. Maternal and infant blood samples were obtained at the time of delivery. Umbilical cord blood was collected from infants, while maternal venous blood was drawn simultaneously. All relevant data were gathered, including the assessment of 25-hydroxy vitamin D3 levels in both mother and infant. The birth weight of the infant was measured, and statistical analysis was performed to find an association between maternal vitamin D level to birth weight and vitamin D level of the infant. RESULT Most pregnant women had low vitamin D levels in this study. The results revealed a significant positive correlation between maternal serum vitamin D levels and infant birth weight (p < 0.001), suggesting that lower maternal vitamin D levels were associated with low birth weight in infants. Additionally, infant serum vitamin D levels showed a positive correlation with maternal vitamin D levels (p < 0.001), indicating that higher maternal vitamin D levels tend to have infants with higher vitamin D levels at birth. CONCLUSION These findings suggest a potential correlation of maternal vitamin D status to birth weight and vitamin D level of newborns, and further research is needed to confirm and better understand this relationship. Additionally, other factors such as maternal nutrition, genetics, lifestyle factors, and environmental influences may contribute to birth weight outcomes.
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Affiliation(s)
- Mayank Singh
- Pathology, Maharani Laxmi Bai Medical College, Jhansi, IND
| | - Hema Shobhane
- Obstetrics and Gynecology, Maharani Laxmi Bai Medical College, Jhansi, IND
| | - Kapil Tiwari
- Pathology, Maharani Laxmi Bai Medical College, Jhansi, IND
| | - Shristy Agarwal
- Obstetrics and Gynecology, Maharani Laxmi Bai Medical College, Jhansi, IND
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Moloney RA, Palliser HK, Pavy CL, Shaw JC, Hirst JJ. Zuranolone therapy protects frontal cortex neurodevelopment and improves behavioral outcomes after preterm birth. Brain Behav 2024; 14:e70009. [PMID: 39236116 PMCID: PMC11376442 DOI: 10.1002/brb3.70009] [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: 03/26/2024] [Revised: 07/30/2024] [Accepted: 08/11/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Preterm birth is associated with brain injury and long-term behavioral abnormalities, for which there are limited prevention options. When born preterm, infants prematurely lose placental neurosteroid (allopregnanolone) support. This increases the risk of excitotoxic damage to the brain, which increases the risk of injury, causing long-term deficits in behavior, myelination, and alterations to neurotransmitter pathways. We propose that postnatal restoration of neurosteroid action through zuranolone therapy will reduce neurological impairments following preterm birth. METHODS Guinea pig dams underwent survival cesarean section surgery to deliver pups prematurely (GA64) or at term (GA69). Between birth and term equivalence age, preterm pups received vehicle (15% β-cyclodextrin) or the allopregnanolone analogue zuranolone (1 mg/kg/day). Behavioral analysis was performed at postnatal day (PND) 7 and 40, before tissue collection at PND 42. Immunostaining for myelin basic protein (MBP), as well as real-time polymerase chain reaction to characterize oligodendrocyte lineage and neurotransmitter pathways, was performed in frontal cortex tissues. RESULTS Zuranolone treatment prevented the hyperactive phenotype in preterm-born offspring, most markedly in males. Additionally, preterm-related reductions in MBP were ameliorated. Several preterm-related alterations in mRNA expression of dopaminergic, glutamatergic, and GABAergic pathways were also restored back to that of a term control level. CONCLUSION This is the first study to assess zuranolone treatment as a neuroprotective therapy following preterm birth. Zuranolone treatment improved behavioral outcomes and structural changes in the preterm offspring, which continued long term until at least a late childhood timepoint. Clinical studies are warranted for further exploring the neuroprotective possibilities of this treatment following preterm birth.
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Affiliation(s)
- Roisin A Moloney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Hannah K Palliser
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Carlton L Pavy
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Julia C Shaw
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Jonathan J Hirst
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
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Maalouf Y, Provost S, Gaudet I, Dodin P, Paquette N, Gallagher A. Executive and attentional functioning interventions in preterm children: a systematic review. J Pediatr Psychol 2024:jsae068. [PMID: 39186682 DOI: 10.1093/jpepsy/jsae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 08/08/2024] [Accepted: 08/08/2024] [Indexed: 08/28/2024] Open
Abstract
OBJECTIVE This systematic review, performed in accordance with the PRISMA guidelines, seeks to summarize the interventions that have been developed in order to improve executive functioning and attention in children born prematurely. METHODS The PICOS framework helped guide the structure and relevant terms selected for the study. Electronic systematic searches of the databases PubMed (NLM), Ovid Medline, Ovid All EBM Reviews, Ovid Embase, and Ovid PsycINFO were completed in March 2022. This review focuses on interventions that target attention and executive functioning in prematurely born children between birth and 12 years old, with outcome measures assessed between 3 and 12 years old, even if the age range in the study can exceed our own parameters. Data extraction included sample characteristics, country of recruitment, type of intervention, description of the intervention group and control group, outcome measures, and overall results. An assessment of the quality of methodology of studies was performed through an adaptation of the Downs and Black checklist for both randomized and nonrandomized studies in healthcare interventions. An assessment of the risk of bias was also presented using the Cochrane risk of bias tool for randomized trials 2.0. RESULTS A total of 517 premature children received an intervention at some point between birth and early adolescence. Eleven different interventions were assessed in 17 studies, with rating of the quality of methodology and outcomes ranging from lower quality studies (44% quality rating) to robust studies (96% quality rating) in terms of reporting standards, external and internal validity, and power. Five of those studies focused on interventions administered in the neonatal intensive care unit or shortly postdischarge (e.g., the Mother-Infant Transaction Program and the Newborn Individualized Developmental Care and Assessment Program, documented in two articles each [11%] or the Infant Behavioral Assessment and Intervention Program assessed in one study [about 5%]), while 12 articles reported on interventions administered between the ages of 1.5-12 years old [mostly computerized cognitive training programs such as Cogmed (23%) and BrainGame Brian (17%)]. Of the 17 articles examined, 12 (70%) showed positive short-term outcomes postintervention and 3 (17%) demonstrated positive long-term results with small to large effect sizes (0.23-2.3). Among included studies, 50% showed an overall high risk of bias, 21.4% showed some concerns, and 28.6% were low risk of bias. CONCLUSIONS Due to the heterogeneity of the programs reviewed, the presented findings should be interpreted as descriptive results. A careful and individualized selection from the various available interventions should be made based on the target population (i.e., age at intervention administration and outcome testing) before implementing these program protocols in clinical settings.
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Affiliation(s)
- Yara Maalouf
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, CHU Sainte-Justine University Hospital Center, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Sarah Provost
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, CHU Sainte-Justine University Hospital Center, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Isabelle Gaudet
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, CHU Sainte-Justine University Hospital Center, Montréal, QC, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Philippe Dodin
- Library, CHU Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Natacha Paquette
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, CHU Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Anne Gallagher
- Neurodevelopmental Optical Imaging Laboratory (LIONlab), Research Center, CHU Sainte-Justine University Hospital Center, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
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Décaillet M, Denervaud S, Huguenin-Virchaux C, Besuchet L, Fischer Fumeaux CJ, Murray MM, Schneider J. The impact of premature birth on auditory-visual processes in very preterm schoolchildren. NPJ SCIENCE OF LEARNING 2024; 9:42. [PMID: 38971881 PMCID: PMC11227572 DOI: 10.1038/s41539-024-00257-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 06/19/2024] [Indexed: 07/08/2024]
Abstract
Interactions between stimuli from different sensory modalities and their integration are central to daily life, contributing to improved perception. Being born prematurely and the subsequent hospitalization can have an impact not only on sensory processes, but also on the manner in which information from different senses is combined-i.e., multisensory processes. Very preterm (VPT) children (<32 weeks gestational age) present impaired multisensory processes in early childhood persisting at least through the age of five. However, it remains largely unknown whether and how these consequences persist into later childhood. Here, we evaluated the integrity of auditory-visual multisensory processes in VPT schoolchildren. VPT children (N = 28; aged 8-10 years) received a standardized cognitive assessment and performed a simple detection task at their routine follow-up appointment. The simple detection task involved pressing a button as quickly as possible upon presentation of an auditory, visual, or simultaneous audio-visual stimulus. Compared to full-term (FT) children (N = 23; aged 6-11 years), reaction times of VPT children were generally slower and more variable, regardless of sensory modality. Nonetheless, both groups exhibited multisensory facilitation on mean reaction times and inter-quartile ranges. There was no evidence that standardized cognitive or clinical measures correlated with multisensory gains of VPT children. However, while gains in FT children exceeded predictions based on probability summation and thus forcibly invoked integrative processes, this was not the case for VPT children. Our findings provide evidence of atypical multisensory profiles in VPT children persisting into school-age. These results could help in targeting supportive interventions for this vulnerable population.
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Affiliation(s)
- Marion Décaillet
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland.
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Solange Denervaud
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cléo Huguenin-Virchaux
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Laureline Besuchet
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Céline J Fischer Fumeaux
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Micah M Murray
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
| | - Juliane Schneider
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Oluwafemi O, Manoharan S, Xie L, Pro G, Patel RS, Delclos GL, Gelfand A, Messiah SE, Lopez DS, Patel J. Assessing the Role of Asthma on the Relationship between Neurodevelopmental Disabilities and Adverse Birth Outcomes. Pediatr Neurol 2024; 156:131-138. [PMID: 38776595 DOI: 10.1016/j.pediatrneurol.2024.04.023] [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: 04/13/2023] [Revised: 03/07/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Investigating asthma as an effect modifier between adverse birth outcomes and neurodevelopmental disabilities (NDDs) across different races is crucial for tailored interventions and understanding variable susceptibility among diverse populations. METHODS Data were collected through the National Survey of Children's Health. This cross-sectional study included 131,774 children aged 0 to 17 years. Study exposures comprised adverse birth outcomes including preterm birth and low birth weight. Weighted prevalence estimates and odds ratios with 95% confidence intervals (CIs) among children with and without adverse birth outcomes were calculated for NDDs including attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, seizure, and several others including behavior problems. Adjusted odds ratios were stratified by asthma status and separate interactions were assessed for each outcome. RESULTS Of 131,774 participants, 10,227 were born low birth weight (9.12%; 95% CI: 8.77% to 9.49%), 14,058 were born preterm (11.35%; 95% CI: 10.94% to 11.76%), and 16,166 participants had asthma (11.97%; 95% CI: 11.58% to 12.37%). There were 68,100 males (51.11%), 63,674 females (48.89%), 102,061 non-Hispanic Whites (NHW) (66.92%), 8,672 non-Hispanic Blacks (NHB) (13.97%), and 21,041 participants (19.11%) categorized as other. NHB children with adverse birth outcomes had higher prevalence of several NDDs compared to NHW children. CONCLUSIONS Asthma was not shown to be an effect modifier of the association between adverse birth outcomes and NDDs. Nevertheless, these results suggest that NDDs are more prevalent within US children with adverse birth outcomes, with higher rates among NHB compared to NHW children. These findings support screening for NDDs in pediatric health care settings among patients with adverse birth outcomes, particularly among those from ethnic minority backgrounds.
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Affiliation(s)
- Omobola Oluwafemi
- Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, Southwest Center for Occupational and Environmental Health, UTHealth Houston School of Public Health, Houston, Texas
| | - Sneha Manoharan
- Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; The University of North Texas Health Science Center, Fort Worth, Texas
| | - Luyu Xie
- Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas
| | - George Pro
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Southern Public Health and Criminal Justice Research Center at University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Rikinkumar S Patel
- Department of Child and Adolescent Psychiatry, Duke University School of Medicine, Durham, North Carolina
| | - George L Delclos
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, Southwest Center for Occupational and Environmental Health, UTHealth Houston School of Public Health, Houston, Texas
| | - Andrew Gelfand
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah E Messiah
- Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas
| | - David S Lopez
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas
| | - Jenil Patel
- Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Houston School of Public Health, Dallas, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, Southwest Center for Occupational and Environmental Health, UTHealth Houston School of Public Health, Houston, Texas.
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7
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Kūkoja K, Villeruša A, Zīle-Velika I. Relationship between Maternal Socioeconomic Factors and Preterm Birth in Latvia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:826. [PMID: 38793009 PMCID: PMC11123435 DOI: 10.3390/medicina60050826] [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: 03/28/2024] [Revised: 05/06/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Worldwide, preterm birth (PTB) stands as the primary cause of mortality among children under 5 years old. Socioeconomic factors significantly impact pregnancy outcomes, influencing both maternal well-being and newborn health. Understanding and addressing these socioeconomic factors is essential for developing effective public health interventions and policies aimed at improving pregnancy outcomes. This study aims to analyse the relationship between socioeconomic factors (education level, marital status, place of residence and nationality) and PTB in Latvia, considering mother's health habits, health status, and pregnancy process. Materials and Methods: A cross-sectional study was conducted using data from the Medical Birth Register (MBR) of Latvia about women with singleton pregnancies in 2022 (n = 15,431). Data analysis, involving crosstabs, chi-square tests, and multivariable binary logistic regression, was performed. Adjusted Odds ratios (aOR) with 95% confidence intervals (CI) were estimated. Results: Lower maternal education was statistically significantly associated with increased odds of PTB. Mothers with education levels below secondary education had over two times higher odds of PTB (aOR = 2.07, p < 0.001, CI 1.58-2.70) and those with secondary or vocational secondary education had one and a half times higher odds (aOR = 1.58, p < 0.001, CI 1.33-1.87) after adjusting for other risk factors. Study results also showed the cumulative effect of socioeconomic risk factors on PTB. Additionally, mothers facing two or three socioeconomic risk factors in Latvia exhibited one and a half times higher odds of PTB (aOR = 1.59, p = 0.021). Conclusions: The study highlights the cumulative impact of socioeconomic risk factors on PTB, with higher maternal education demonstrating the highest protective effect against it. This underscores the importance of education in promoting optimal foetal development. Since the influence of socioeconomic factors on PTB is not a widely studied issue in Latvia, further research is needed to improve understanding of this complex topic.
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Affiliation(s)
- Katrīne Kūkoja
- Institute of Social, Economic and Humanities Research, Vidzeme University of Applied Sciences, LV-4201 Valmiera, Latvia
- Department of Public Health and Epidemiology, Rīga Stradiņš University, LV-1010 Riga, Latvia;
| | - Anita Villeruša
- Department of Public Health and Epidemiology, Rīga Stradiņš University, LV-1010 Riga, Latvia;
| | - Irisa Zīle-Velika
- Department of Research and Statistics, Centre for Disease Prevention and Control, LV-1005 Riga, Latvia;
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Boonya-ananta T, Gonzalez M, Ajmal A, Du Le VN, DeHoog E, Paidas MJ, Jayakumar A, Ramella-Roman JC. Speculum-free portable preterm imaging system. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:052918. [PMID: 38282917 PMCID: PMC10821769 DOI: 10.1117/1.jbo.29.5.052918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/30/2024]
Abstract
Significance Preterm birth is defined as a birth before 37 weeks of gestation and is one of the leading contributors to infant mortality rates globally. Premature birth can lead to life-long developmental impairment for the child. Unfortunately, there is a significant lack of tools to diagnose preterm birth risk, which limits patient care and the development of new therapies. Aim To develop a speculum-free, portable preterm imaging system (PPRIM) for cervical imaging; testing of the PPRIM system to resolve polarization properties of birefringent samples; and testing of the PPRIM under an IRB on healthy, non-pregnant volunteers for visualization and polarization analysis of cervical images. Approach The PPRIM can perform 4 × 3 Mueller-matrix imaging to characterize the remodeling of the uterine cervix during pregnancy. The PPRIM is built with a polarized imaging probe and a flexible insertable sheath made with a compatible flexible rubber-like material to maximize comfort and ease of use. Results The PPRIM device is developed to meet specific design specifications as a speculum-free, portable, and comfortable imaging system with polarized imaging capabilities. This system comprises a main imaging component and a flexible silicone inserter. The inserter is designed to maximize comfort and usability for the patient. The PPRIM shows high-resolution imaging capabilities at the 20 mm working distance and 25 mm circular field of view. The PPRIM demonstrates the ability to resolve birefringent sample orientation and full field capture of a healthy, non-pregnant cervix. Conclusion The development of the PPRIM aims to improve access to the standard of care for women's reproductive health using polarized Mueller-matrix imaging of the cervix and reduce infant and maternal mortality rates and better quality of life.
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Affiliation(s)
- Tananant Boonya-ananta
- Florida International University, Department of Biomedical Engineering, Miami, Florida, United States
| | - Mariacarla Gonzalez
- Florida International University, Department of Biomedical Engineering, Miami, Florida, United States
| | - Ajmal Ajmal
- Florida International University, Department of Biomedical Engineering, Miami, Florida, United States
| | - Vinh Nguyen Du Le
- Florida International University, Department of Biomedical Engineering, Miami, Florida, United States
| | - Edward DeHoog
- Optical Design and Engineering, Long Beach, California, United States
| | - Michael J. Paidas
- Miller School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Miami, Florida, United States
| | - Arumugam Jayakumar
- Miller School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Miami, Florida, United States
| | - Jessica C. Ramella-Roman
- Florida International University, Department of Biomedical Engineering, Miami, Florida, United States
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, United States
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Moloney RA, Palliser HK, Dyson RM, Pavy CL, Berry M, Hirst JJ, Shaw JC. Ongoing effects of preterm birth on the dopaminergic and noradrenergic pathways in the frontal cortex and hippocampus of guinea pigs. Dev Neurobiol 2024; 84:93-110. [PMID: 38526217 DOI: 10.1002/dneu.22937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
Children born preterm have an increased likelihood of developing neurobehavioral disorders such as attention-deficit hyperactivity disorder (ADHD) and anxiety. These disorders have a sex bias, with males having a higher incidence of ADHD, whereas anxiety disorder tends to be more prevalent in females. Both disorders are underpinned by imbalances to key neurotransmitter systems, with dopamine and noradrenaline in particular having major roles in attention regulation and stress modulation. Preterm birth disturbances to neurodevelopment may affect this neurotransmission in a sexually dimorphic manner. Time-mated guinea pig dams were allocated to deliver by preterm induction of labor (gestational age 62 [GA62]) or spontaneously at term (GA69). The resultant offspring were randomized to endpoints as neonates (24 h after term-equivalence age) or juveniles (corrected postnatal day 40, childhood equivalence). Relative mRNA expressions of key dopamine and noradrenaline pathway genes were examined in the frontal cortex and hippocampus and quantified with real-time PCR. Myelin basic protein and neuronal nuclei immunostaining were performed to characterize the impact of preterm birth. Within the frontal cortex, there were persisting reductions in the expression of dopaminergic pathway components that occurred in preterm males only. Conversely, preterm-born females had increased expression of key noradrenergic receptors and a reduction of the noradrenergic transporter within the hippocampus. This study demonstrated that preterm birth results in major changes in dopaminergic and noradrenergic receptor, transporter, and synthesis enzyme gene expression in a sex- and region-based manner that may contribute to the sex differences in susceptibility to neurobehavioral disorders. These findings highlight the need for the development of sex-based treatments for improving these conditions.
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Affiliation(s)
- Roisin A Moloney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Hannah K Palliser
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Rebecca M Dyson
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Biomedical Research Unit, University of Otago, Wellington, New Zealand
| | - Carlton L Pavy
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Max Berry
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Biomedical Research Unit, University of Otago, Wellington, New Zealand
| | - Jonathon J Hirst
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
| | - Julia C Shaw
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, Australia
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Haile TG, Pereira G, Norman R, Tessema GA. Economic burden of adverse perinatal outcomes from births to age 5 years in high-income settings: a protocol for a systematic review. BMJ Open 2024; 14:e079077. [PMID: 38216187 PMCID: PMC10806659 DOI: 10.1136/bmjopen-2023-079077] [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: 08/21/2023] [Accepted: 12/07/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Adverse perinatal outcomes such as preterm, small for gestational age, low birth weight, congenital anomalies, stillbirth and neonatal death have devastating impacts on individuals, families and societies, with significant lifelong health implications. Despite extensive knowledge of the significant and lifelong health implications of adverse perinatal outcomes, information on the economic burden is limited. Estimating this burden will be crucial for designing cost-effective interventions to reduce perinatal morbidity and mortality. Thus, we will quantify the economic burden of adverse perinatal outcomes from births to age 5 years in high-income countries. METHODS AND ANALYSIS A systematic review of all primary studies published in English in peer-reviewed journals on the economic burden for at least one of the adverse perinatal outcomes in high-income countries from 2010 will be searched in databases-MEDLINE (Ovid), EconLit, CINAHL (EBSCO), Embase (Ovid) and Global Health (Ovid). We will also search using Google Scholar and snowballing of the references list of included articles. The search terms will include three main concepts-costs, adverse perinatal outcome(s) and settings. We will use the Consolidated Health Economics Evaluation Reporting Standards 2022 and 17 criteria from the critical appraisal of cost-of-illness studies to assess the quality of each study. We will report the findings based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 statement. Costs will be converted into a common currency (US dollar), and we will estimate the pooled cost and subgroup analysis will be done. The reference lists of included papers will be reviewed. ETHICS AND DISSEMINATION This systematic review will not involve human participants and requires no ethical approval. The results of this review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023400215.
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Affiliation(s)
- Tsegaye Gebremedhin Haile
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Richard Norman
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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11
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Laureano B, Irzan H, O'Reilly H, Ourselin S, Marlow N, Melbourne A. Myelination of preterm brain networks at adolescence. Magn Reson Imaging 2024; 105:114-124. [PMID: 37984490 DOI: 10.1016/j.mri.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/31/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
Prematurity and preterm stressors severely affect the development of infants born before 37 weeks of gestation, with increasing effects seen at earlier gestations. Although preterm mortality rates have declined due to the advances in neonatal care, disability rates, especially in middle-income settings, continue to grow. With the advances in MR imaging technology, there has been a focus on safely imaging the preterm brain to better understand its development and discover the brain regions and networks affected by prematurity. Such studies aim to support interventions and improve the neurodevelopment of preterm infants and deliver accurate prognoses. Few studies, however, have focused on the fully developed brain of preterm born infants, especially in extremely preterm subjects. To assess the long-term effect of prematurity on the adult brain, myelin related biomarkers such as myelin water fraction and g-ratio are measured for a cohort of 19-year-old extremely preterm born subjects. Using multi-modal imaging techniques that combine T2 relaxometry and neurite density information, the results show that specific brain regions associated with white matter injuries due to preterm birth, such as the posterior limb of the internal capsule and corpus callosum, are still less myelinated in adulthood. Furthermore, a weak positive relationship between myelin water fraction values and Full-Scale Intelligence Quotient (FSIQ) scores was found in multiple brain regions previously defined as less myelinated in the Extremely Preterm (EPT) cohort. These findings might suggest altered connectivity in the adult preterm brain and explain differences in cognitive outcomes.
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Affiliation(s)
- Beatriz Laureano
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK.
| | - Hassna Irzan
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; Dept. of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Helen O'Reilly
- Children's Disability Network Team, St. Michael's House, Dublin, Ireland
| | - Sebastian Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; Dept. of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Neil Marlow
- Institute for Women's Health, University College London, London, UK
| | - Andrew Melbourne
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; Dept. of Medical Physics and Biomedical Engineering, University College London, London, UK
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12
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Jamaluddine Z, Sharara E, Helou V, El Rashidi N, Safadi G, El-Helou N, Ghattas H, Sato M, Blencowe H, Campbell OMR. Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review. Arch Dis Child 2023; 108:956-969. [PMID: 37339859 DOI: 10.1136/archdischild-2022-324884] [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: 10/02/2022] [Accepted: 05/04/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Size at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps. METHODS We searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association. FINDINGS We screened 16 641 articles and identified 302 systematic reviews. The literature operationalised size at birth (birth weight and/or gestation) in 12 ways. There were 1041 meta-analyses of associations between size at birth and 67 outcomes. Thirteen outcomes had no meta-analysis.Small size at birth was examined for 50 outcomes and was associated with over half of these (32 of 50); continuous/post-term/large size at birth was examined for 35 outcomes and was consistently associated with 11 of the 35 outcomes. Seventy-three meta-analyses (in 11 reviews) compared risks by size for gestational age (GA), stratified by preterm and term. Prematurity mechanisms were the key aetiologies linked to mortality and cognitive development, while intrauterine growth restriction (IUGR), manifesting as small for GA, was primarily linked to underweight and stunting. INTERPRETATION Future reviews should use methodologically sound comparators to further understand aetiological mechanisms linking IUGR and prematurity to subsequent outcomes. Future research should focus on understudied exposures (large size at birth and size at birth stratified by gestation), gaps in outcomes (specifically those without reviews or meta-analysis and stratified by age group of children) and neglected populations. PROSPERO REGISTRATION NUMBER CRD42021268843.
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Affiliation(s)
- Zeina Jamaluddine
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Eman Sharara
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Vanessa Helou
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nadine El Rashidi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nehmat El-Helou
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hala Ghattas
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Hannah Blencowe
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Oona M R Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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13
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Long HL, Christensen L, Hayes S, Hustad KC. Vocal Characteristics of Infants at Risk for Speech Motor Involvement: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4432-4460. [PMID: 37850852 PMCID: PMC10715844 DOI: 10.1044/2023_jslhr-23-00336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/13/2023] [Accepted: 08/20/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE The purpose of this scoping review was to (a) summarize methodological characteristics of studies examining vocal characteristics of infants at high risk for neurological speech motor involvement and (b) report the state of the high-quality evidence on vocal characteristic trends of infants diagnosed or at high risk for cerebral palsy (CP). METHOD The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) extension for scoping reviews was followed for reporting our review. Studies measured prelinguistic vocal characteristics of infants under 24 months with birth risk or genetic conditions known to commonly present with speech motor involvement. Fifty-five studies met criteria for Part 1. Eleven studies met criteria for synthesis in Part 2. RESULTS A smaller percentage of studies examined infants with or at risk for CP compared to studies examining genetic conditions such as Down syndrome. The median year of publication was 1999, with a median sample size of nine participants. Most studies were conducted in laboratory settings and used human coding of vocalizations produced during caregiver-child interactions. Substantial methodological differences were noted across all studies. A small number of high-quality studies of infants with or at risk for CP revealed high rates of marginal babbling, low rates of canonical babbling, and limited consonant diversity under 24 months. Mixed findings were noted across studies of general birth risk factors. CONCLUSIONS There is limited evidence available to support the early detection of speech motor involvement. Large methodological differences currently impact the ability to synthesize findings across studies. There is a critical need to conduct longitudinal research with larger sample sizes and advanced, modern technologies to detect vocal precursors of speech impairment to support the accurate diagnosis and prognosis of speech development in infants with CP and other clinical populations.
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Affiliation(s)
| | | | - Sydney Hayes
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Katherine C. Hustad
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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14
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Adane HA, Iles R, Boyle JA, Gelaw A, Collie A. Maternal Occupational Risk Factors and Preterm Birth: A Systematic Review and Meta-Analysis. Public Health Rev 2023; 44:1606085. [PMID: 37937117 PMCID: PMC10625911 DOI: 10.3389/phrs.2023.1606085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/01/2023] [Indexed: 11/09/2023] Open
Abstract
Objective: This systematic review and meta-analysis aimed to summarize the evidence on the relationship between physical occupational risks (high physical workload, long working hours, shift work, whole-body vibrations, prolonged standing, and heavy lifting) and preterm birth. Methods: A systematic review and meta-analysis was conducted across six databases to investigate the relationship between physical occupational risks and preterm birth. Result: A comprehensive analysis of 37 studies with varying sample sizes found moderate evidence of positive associations between high physical workload, long working hours, shift work, whole-body vibration, and preterm birth. Meta-analysis showed a 44% higher risk (OR 1.44, 95% CI 1.25-1.66) for preterm birth with long working hours and a 63% higher risk (OR 1.63, 95% CI 1.03-2.58) with shift work. Conclusion: Pregnant women in physically demanding jobs, those working long hours or on shifts, and those exposed to whole-body vibration have an increased risk of preterm birth. Employers should establish supportive workplaces, policymakers implement protective measures, healthcare providers conduct screenings, and pregnant women must stay informed and mitigate these job-related risks. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], Identifier [CRD42022357045].
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Affiliation(s)
- Haimanot Abebe Adane
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Ross Iles
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jacqueline A. Boyle
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Asmare Gelaw
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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15
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Sun B, Wallace ER, Ni Y, Loftus CT, Szpiro A, Day D, Barrett ES, Nguyen RHN, Kannan K, Robinson M, Bush NR, Sathyanarayana S, Mason A, Swan SH, Trasande L, Karr CJ, LeWinn KZ. Prenatal exposure to polycyclic aromatic hydrocarbons and cognition in early childhood. ENVIRONMENT INTERNATIONAL 2023; 178:108009. [PMID: 37331181 PMCID: PMC10519343 DOI: 10.1016/j.envint.2023.108009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Epidemiological evidence for gestational polycyclic aromatic hydrocarbon (PAH) exposure and adverse child cognitive outcomes is mixed; little is known about critical windows of exposure. OBJECTIVE We investigated associations between prenatal PAH exposure and child cognition in a large, multi-site study. METHODS We included mother-child dyads from two pooled prospective pregnancy cohorts (CANDLE and TIDES, N = 1,223) in the ECHO-PATHWAYS Consortium. Seven urinary mono-hydroxylated PAH metabolites were measured in mid-pregnancy in both cohorts as well as early and late pregnancy in TIDES. Child intelligence quotient (IQ) was assessed between ages 4-6. Associations between individual PAH metabolites and IQ were estimated with multivariable linear regression. Interaction terms were used to examine effect modification by child sex and maternal obesity. We explored associations of PAH metabolite mixtures with IQ using weighted quantile sum regression. In TIDES, we averaged PAH metabolites over three periods of pregnancy and by pregnancy period to investigate associations between PAH metabolites and IQ. RESULTS In the combined sample, PAH metabolites were not associated with IQ after full adjustment, nor did we observe associations with PAH mixtures. Tests of effect modification were null except for the association between 2-hydroxynaphthalene and IQ, which was negative in males (βmales = -0.67 [95%CI:-1.47,0.13]) and positive in females (βfemales = 0.31 [95%CI:-0.52,1.13])(pinteraction = 0.04). In analyses across pregnancy (TIDES-only), inverse associations with IQ were observed for 2-hydroxyphenanthrene averaged across pregnancy (β = -1.28 [95%CI:-2.53,-0.03]) and in early pregnancy (β = -1.14 [95%CI:-2.00,-0.28]). SIGNIFICANCE In this multi-cohort analysis, we observed limited evidence of adverse associations of early pregnancy PAHs with child IQ. Analyses in the pooled cohorts were null. However, results also indicated that utilizing more than one exposure measures across pregnancy could improve the ability to detect associations by identifying sensitive windows and improving the reliability of exposure measurement. More research with multiple timepoints of PAH assessment is warranted.
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Affiliation(s)
- Bob Sun
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew Day
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Shanna H Swan
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leonardo Trasande
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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16
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Adane HA, Iles R, Boyle JA, Collie A. Maternal occupational risk factors and preterm birth: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0283752. [PMID: 37432928 DOI: 10.1371/journal.pone.0283752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/15/2023] [Indexed: 07/13/2023] Open
Abstract
INTRODUCTION Preterm birth, which accounts for 33.1% of neonatal death globally, is the main cause of under-five mortality. A growing number of studies indicate that occupational risk factors during pregnancy are linked to an increased likelihood of poor pregnancy outcomes. The effect of physical occupational risks on preterm birth has received very little attention, and previous reviews have produced inconclusive results. This systematic review aims to update the evidence on the relationship between maternal physical occupational risks and preterm birth. METHOD AND ANALYSIS We will search electronic databases including Ovid Medline, Embase, Emcare, CINAHL, Scopus, and Web of science to find peer-reviewed studies examining the relationship between six common maternal physical occupational risks (heavy lifting, prolonged standing, heavy physical exertion, long working hours, shift work, and whole-body vibrations) and preterm birth. Articles published in English after 1 January 2000 will be included without geographic restrictions. Two reviewers will screen titles and abstracts independently, and then select full-text articles that meet inclusion criteria. Methodological quality of the included studies will be evaluated using the Joanna Briggs Institute (JBI) critical appraisal method. The quality of evidence across each exposure and the outcome of interest will be examined by using the GRADE (Grade of Recommendations, Assessment, Development, Evaluation) method. Accordingly, a high level of evidence will lead to "strong recommendations". A moderate level of evidence will lead to "practice considerations". For all evidence levels below moderate, the message will be "not enough evidence from the scientific literature to guide policymakers, clinicians, and patients. If data permits, a meta-analysis will be conducted using Stata Software. In case where meta-analysis is not possible, we will perform a formal narrative synthesis. DISCUSSION AND CONCLUSION Evidence suggests that preterm birth is linked to a number of maternal occupational risk factors. This systematic review will update, compile, and critically review the evidence on the effect of maternal physical occupational risk on preterm birth. This systematic review will provide guidance to support decision-makers including maternal and child health services, other health care providers, and government policy agencies. TRIAL REGISTRATION PROSPERO registration number: CRD42022357045.
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Affiliation(s)
- Haimanot Abebe Adane
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ross Iles
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline A Boyle
- Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alex Collie
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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17
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Pattnaik P, Nafday S, Angert R. Neonatal Intensive Care Unit to Home Discharge Communication: A Quality Improvement Project. Pediatr Qual Saf 2023; 8:e669. [PMID: 37434592 PMCID: PMC10332829 DOI: 10.1097/pq9.0000000000000669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
Neonatal intensive care unit (NICU) graduates require complex services after discharge. The NICU discharge process at Children's Hospital at Montefiore-Weiler, Bronx, NY (CHAM-Weiler) lacked a system for routine primary care provider (PCP) notification. Here, we describe a quality improvement project to improve communication with PCPs to ensure communication of critical information and plans. Methods We assembled a multidisciplinary team and collected baseline data on discharge communication frequency and quality. We used quality improvement tools to implement a higher-quality system. The outcome measure was the successful delivery of a standardized notification and discharge summary to a PCP. We collected qualitative data through multidisciplinary meetings and direct feedback. The balancing measures comprised additional time spent during the discharge process and relaying erroneous information. We used a run chart to track progress and drive change. Results Baseline data indicated that 67% of PCPs did not receive notifications before discharge, and when PCPs did receive notifications, the discharge plans were unclear. PCP feedback led to proactive electronic communication and a standardized notification. The key driver diagram allowed the team to design interventions that led to sustainable change. After multiple Plan-Do-Study-Act cycles, delivery of electronic PCP notifications occurred more than 90% of the time. Surveys of pediatricians who received notifications indicated that the notifications were highly valued and aided in the transition of care for these at-risk patients. Conclusion A multidisciplinary team, including community pediatricians, was key to improving the rate of PCP notification of NICU discharge to more than 90% and transmitting higher-quality information.
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Affiliation(s)
- Priyam Pattnaik
- From the Department of Pediatrics, Division of Neonatology, Connecticut Children’s Medical Center, Hartford, Conn
| | - Suhas Nafday
- Department of Pediatrics, Division of Neonatology, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, N.Y
| | - Robert Angert
- Department of Pediatrics, Division of Neonatology, New York University Langone Medical Center, New York, N.Y
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18
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Michaelides O, Luciano M. Bioenvironmental Predictors of Childhood Reading and Speech Difficulties. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1740-1754. [PMID: 37059050 DOI: 10.1044/2023_jslhr-22-00476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE Reading and speech difficulties are common in childhood, yet it is not fully understood how much of their etiology is shared. This partly derives from methodological issues related to overlooking the potential co-occurrence between the two sets of difficulties. This study investigated the effects of five bioenvironmental predictors in a sample assessed for such co-occurrence. METHOD A combination of exploratory and confirmatory analyses was performed on longitudinal data from the National Child Development Study. Exploratory latent class analysis was performed on children's reading, speech, and language outcomes at ages 7 and 11 years. Membership in the obtained classes was modeled using a regression with sex and four early-life predictors: gestation period, socioeconomic status, maternal education, and the home reading environment. RESULTS The model yielded four latent classes that broadly reflected (1) average reading and speech, (2) excellent reading, (3) reading difficulties, and (4) speech difficulties. Early-life factors significantly predicted class membership. Male sex and preterm birth emerged as risk factors for both reading and speech difficulties. Protective effects against reading difficulties were identified for maternal education, and lower (but not higher) levels of socioeconomic status and the home reading environment. CONCLUSIONS Co-occurrence of reading and speech difficulties in the sample was low, and differential patterns of effect of the social environment were supported. Reading outcomes were under stronger malleable influence than speech outcomes.
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Affiliation(s)
| | - Michelle Luciano
- Department of Psychology, The University of Edinburgh, United Kingdom
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19
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Gunawardana S, Harris C, Greenough A. Use of impulse oscillometry to assess lung function in prematurely born children and young people: Comparisons with spirometry. Paediatr Respir Rev 2023; 45:52-57. [PMID: 36270894 DOI: 10.1016/j.prrv.2022.07.003] [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: 04/29/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
Premature birth is a risk factor for bronchopulmonary dysplasia (BPD); both of which are associated with obstructive airway disease throughout childhood. Impulse oscillometry (IOS) is an effort-independent, passive measure of tidal breathing, which could have benefits in assessing lung function amongst younger patients unable to perform valid spirometry. A literature search was conducted to investigate the use of IOS in prematurely born children and young people. IOS results correlate with those of spirometry. Reversibility of airway obstruction in children with BPD is variable. IOS could have benefits in assessing individual patient response and suitability for bronchodilator therapy. More work, however, is required to establish multi-ethnic reference ranges and standardise commercially available devices prior to its routine incorporation into clinical practice.
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Affiliation(s)
- Shannon Gunawardana
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK.
| | - Christopher Harris
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK; Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.
| | - Anne Greenough
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK; NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London, UK.
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20
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Wallace ER, Buth E, Szpiro AA, Ni Y, Loftus CT, Masterson E, Day DB, Sun BZ, Sullivan A, Barrett E, Nguyen RH, Robinson M, Kannan K, Mason A, Sathyanarayana S, LeWinn KZ, Bush NR, Karr CJ. Prenatal exposure to polycyclic aromatic hydrocarbons is not associated with behavior problems in preschool and early school-aged children: A prospective multi-cohort study. ENVIRONMENTAL RESEARCH 2023; 216:114759. [PMID: 36370819 PMCID: PMC9817935 DOI: 10.1016/j.envres.2022.114759] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Epidemiological study findings are inconsistent regarding associations between prenatal polycyclic aromatic hydrocarbon (PAH) exposures and childhood behavior. This study examined associations of prenatal PAH exposure with behavior at age 4-6 years in a large, diverse, multi-region prospective cohort. Secondary aims included examination of PAH mixtures and effect modification by child sex, breastfeeding, and child neighborhood opportunity. METHODS The ECHO PATHWAYS Consortium pooled 1118 mother-child dyads from three prospective pregnancy cohorts in six U.S. cities. Seven PAH metabolites were measured in prenatal urine. Child behavior was assessed at age 4-6 using the Total Problems score from the Child Behavior Checklist (CBCL). Neighborhood opportunity was assessed using the socioeconomic and educational scales of the Child Opportunity Index. Multivariable linear regression was used to estimate associations per 2-fold increase in each PAH metabolite, adjusted for demographic, prenatal, and maternal factors and using interaction terms for effect modifiers. Associations with PAH mixtures were estimated using Weighted Quantile Sum Regression (WQSR). RESULTS The sample was racially and sociodemographically diverse (38% Black, 49% White, 7% Other; household-adjusted income range $2651-$221,102). In fully adjusted models, each 2-fold increase in 2-hydroxynaphthalene was associated with a lower Total Problems score, contrary to hypotheses (b = -0.80, 95% CI = -1.51, -0.08). Associations were notable in boys (b = -1.10, 95% CI = -2.11, -0.08) and among children breastfed 6+ months (b = -1.31, 95% CI = -2.25, -0.37), although there was no statistically significant evidence for interaction by child sex, breastfeeding, or neighborhood child opportunity. Associations were null for other PAH metabolites; there was no evidence of associations with PAH mixtures from WQSR. CONCLUSION In this large, well-characterized, prospective study of mother-child pairs, prenatal PAH exposure was not associated with child behavior problems. Future studies characterizing the magnitude of prenatal PAH exposure and studies in older childhood are needed.
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Affiliation(s)
- Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Erin Buth
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Erin Masterson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Bob Z Sun
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alexis Sullivan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Ruby Hn Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA
| | - Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Maternal Voice Exposure and Its Effect on Premature Infants' Feeding Milestones: A Systematic Review. Adv Neonatal Care 2022; 23:E40-E49. [PMID: 36191331 DOI: 10.1097/anc.0000000000001029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Premature infants experience alterations in maternal stimulation (including auditory sensory alteration such as talking or singing to the infant in the neonatal intensive care unit) due to admission to the neonatal intensive care unit. Because of their physiological and neurobehavioral immaturity, infants are at an increased risk of delays in reaching feeding milestones (a key developmental milestone), which often need to be achieved before discharge. PURPOSE This systematic review evaluated the literature regarding the effect of maternal speech on achievement of feeding milestones in premature infants. DATA SOURCES A systematic search of CINAHL, PubMed, Web of Science, and Google Scholar from 2010 to 2021. STUDY SELECTION Studies were selected if they examined the effect of maternal voice interventions on premature infants' feeding milestones. DATA EXTRACTION Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. RESULTS Six studies were identified. This systematic review of the literature on the effects of maternal voice on feeding milestones in premature infants found equivocal results. IMPLICATIONS FOR PRACTICE Given the inconsistent results, this systematic review does not support a change in clinical practice. However, encouragement of maternal visits is highly recommended as the additional benefits of the mother's presence may extend beyond exposure to maternal voice. IMPLICATIONS FOR RESEARCH More research is needed including use of more homogenous samples, application of recommended decibel levels, and utilization of an adequately powered randomized controlled trial to further examine the effects of maternal voice on feeding milestones.
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22
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Lyall K, Ning X, Aschner JL, Avalos LA, Bennett DH, Bilder DA, Bush NR, Carroll KN, Chu SH, Croen LA, Dabelea D, Daniels JL, Duarte C, Elliott AJ, Fallin MD, Ferrara A, Hertz-Picciotto I, Hipwell AE, Jensen ET, Johnson SL, Joseph RM, Karagas M, Kelly RS, Lester BM, Margolis A, McEvoy CT, Messinger D, Neiderhiser JM, O’Connor TG, Oken E, Sathyanarayana S, Schmidt RJ, Sheinkopf SJ, Talge NM, Turi KN, Wright RJ, Zhao Q, Newschaffer C, Volk HE, Ladd-Acosta C, Environmental Influences on Child Health Outcomes OBOPCF. Cardiometabolic Pregnancy Complications in Association With Autism-Related Traits as Measured by the Social Responsiveness Scale in ECHO. Am J Epidemiol 2022; 191:1407-1419. [PMID: 35362025 PMCID: PMC9614927 DOI: 10.1093/aje/kwac061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/07/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
Prior work has examined associations between cardiometabolic pregnancy complications and autism spectrum disorder (ASD) but not how these complications may relate to social communication traits more broadly. We addressed this question within the Environmental Influences on Child Health Outcomes program, with 6,778 participants from 40 cohorts conducted from 1998-2021 with information on ASD-related traits via the Social Responsiveness Scale. Four metabolic pregnancy complications were examined individually, and combined, in association with Social Responsiveness Scale scores, using crude and adjusted linear regression as well as quantile regression analyses. We also examined associations stratified by ASD diagnosis, and potential mediation by preterm birth and low birth weight, and modification by child sex and enriched risk of ASD. Increases in ASD-related traits were associated with obesity (β = 4.64, 95% confidence interval: 3.27, 6.01) and gestational diabetes (β = 5.21, 95% confidence interval: 2.41, 8.02), specifically, but not with hypertension or preeclampsia. Results among children without ASD were similar to main analyses, but weaker among ASD cases. There was not strong evidence for mediation or modification. Results suggest that common cardiometabolic pregnancy complications may influence child ASD-related traits, not only above a diagnostic threshold relevant to ASD but also across the population.
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Affiliation(s)
- Kristen Lyall
- Correspondence to Dr. Kristen Lyall, 3020 Market Street, Suite 560, Philadelphia, PA 19104 (e-mail: )
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23
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Ilyes SG, Chiriac VD, Gluhovschi A, Mihaela V, Dahma G, Mocanu AG, Neamtu R, Silaghi C, Radu D, Bernad E, Craina M. The Influence of Maternal Factors on Neonatal Intensive Care Unit Admission and In-Hospital Mortality in Premature Newborns from Western Romania: A Population-Based Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060709. [PMID: 35743972 PMCID: PMC9229487 DOI: 10.3390/medicina58060709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Neonatal mortality is a global public health issue, disproportionately affecting low- and middle-income nations. Although Romania is a high-income nation, according to the European Union’s most recent demographic data, it had the second-highest infant death rate in 2019. Although significant progress has been made in the last three decades in lowering newborn mortality, more initiatives to accelerate progress are required to meet the 2030 Sustainable Development Goals (SDG) objective. Therefore, we aimed to develop an observational study to determine the influence of maternal factors on in-hospital neonatal intensive care unit admission and mortality in premature infants born in western Romania. While newborn mortality has decreased globally, the pace of decline is far less than what is desired. Materials and Methods: A retrospective study comprising 328 premature patients and 422 full-term newborns, was developed at a tertiary obstetrics and gynecology clinic in western Romania, comprising the period of the last 24 months before the COVID-19 pandemic and the first 24 months of the pandemic. Results: The following variables were identified as statistically significant risk factors for neonatal intensive care unit admission: age > 35 years, OR = 1.59; twin births, OR = 1.14; low gestational age, OR = 1.66; preeclampsia, OR = 2.33; and peripartum infection, OR = 2.25. The same risk factors, with the exception of twin births, were significantly associated with in-hospital neonatal mortality. Except for a longer duration of maternal hospitalization and neonatal therapy with surfactant, steroids, and antibiotics, the COVID-19 pandemic did not cause significant differences in the evolution and outcomes of preterm newborns. Conclusions: The major maternal risk factors for NICU admission were advanced age, twin pregnancy, low gestational age, preeclampsia, and peripartum infection. Additionally, these characteristics contributed to a high likelihood of death, despite adequate access to medical care and advanced life support for the neonates. Understanding the causes of morbidity and death in neonates admitted to the neonatal intensive care unit enables better prioritization and planning of health services, resource reallocation, and care quality improvement.
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Affiliation(s)
- Stelian-Gabriel Ilyes
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Veronica Daniela Chiriac
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
- Correspondence: ; Tel.: +40-729-098-886
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Valcovici Mihaela
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - George Dahma
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Adelina Geanina Mocanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Carmen Silaghi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Daniela Radu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
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Lim J, Yoon SJ, Shin JE, Han JH, Lee SM, Eun HS, Park MS, Park KI. Growth Pattern With Morbidities From Birth to 5 Years of Age in Very Low Birth Weight Infants: Comparison of the Korean National Network and National Health Insurance Service. J Korean Med Sci 2022; 37:e162. [PMID: 35607740 PMCID: PMC9127431 DOI: 10.3346/jkms.2022.37.e162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Long-term growth data of very low birth weight (VLBW) infants are currently collected in the Korean Neonatal Network (KNN) and National Health Insurance Service (NHIS) database. However, variance in the number of infants, check-up time, and check-up parameters led to decreased credibility of cumulated data. We aimed to compare the data on serial growth outcomes by major morbidities from birth to 5 years in VLBW infants between the KNN and NHIS databases. METHODS We combined the NHIS and KNN data of VLBW infants born between 2013 and 2015. The check-up times in the NHIS database were at 4-6, 9-12, 18-24, 30-36, 42-48, and 54-60 months of age, whereas in the KNN were at 18-24 months of corrected age and at 36 months of age. RESULT Among 8,864 VLBW infants enrolled based on the birth certificates from the Statistics Korea, 6,086 infants (69%) were enrolled in the KNN, and 5,086 infants (57%) participated in the NHIS health check-up. Among 6,068 infants, 3,428 infants (56%) were enrolled at a corrected age of 18-24 months and 2,572 infants (42%) were enrolled at a chronological age of 33-36 months according to the KNN follow-up registry. However, based on the national birth statistics data, the overall follow-up rate of the KNN at 36 months of age was as low as 29%. The NHIS screening rate was lower at first (23%); however, it increased over time to exceed the KNN follow-up rate. Growth failure (weight under 10th percentile) at corrected ages of 18-24 months and 36 months were more common in the NHIS than KNN (42% vs. 20%, 37% vs. 34.5%). Infants with bronchopulmonary dysplasia and periventricular leukomalacia showed similar rates of growth failure at 2 years but varying rates at 3 years between the KNN and NHIS. CONCLUSION By integrating the KNN and NHIS data indirectly at continuous time points according to morbidities, we found that there are discontinuities and discrepancies between the two databases among VLBW infants. Establishing an integrated system by patient level linking the KNN and NHIS databases can lead to better understanding and improved neonatal outcomes in VLBW infants in Korea.
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Affiliation(s)
- Joohee Lim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - So Jin Yoon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Eun Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Ho Han
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
| | - Ho Seon Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kook In Park
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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25
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Winchester P, Nilsson E, Beck D, Skinner MK. Preterm birth buccal cell epigenetic biomarkers to facilitate preventative medicine. Sci Rep 2022; 12:3361. [PMID: 35232984 PMCID: PMC8888575 DOI: 10.1038/s41598-022-07262-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/11/2022] [Indexed: 11/09/2022] Open
Abstract
Preterm birth is the major cause of newborn and infant mortality affecting nearly one in every ten live births. The current study was designed to develop an epigenetic biomarker for susceptibility of preterm birth using buccal cells from the mother, father, and child (triads). An epigenome-wide association study (EWAS) was used to identify differential DNA methylation regions (DMRs) using a comparison of control term birth versus preterm birth triads. Epigenetic DMR associations with preterm birth were identified for both the mother and father that were distinct and suggest potential epigenetic contributions from both parents. The mother (165 DMRs) and female child (136 DMRs) at p < 1e-04 had the highest number of DMRs and were highly similar suggesting potential epigenetic inheritance of the epimutations. The male child had negligible DMR associations. The DMR associated genes for each group involve previously identified preterm birth associated genes. Observations identify a potential paternal germline contribution for preterm birth and identify the potential epigenetic inheritance of preterm birth susceptibility for the female child later in life. Although expanded clinical trials and preconception trials are required to optimize the potential epigenetic biomarkers, such epigenetic biomarkers may allow preventative medicine strategies to reduce the incidence of preterm birth.
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Affiliation(s)
- Paul Winchester
- Department of Pediatrics, St. Franciscan Hospital, School of Medicine, Indiana University, Indianapolis, IN, 46202-5201, USA
| | - Eric Nilsson
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA
| | - Daniel Beck
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA
| | - Michael K Skinner
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA.
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Wallace ER, Ni Y, Loftus CT, Sullivan A, Masterson E, Szpiro AA, Day DB, Robinson M, Kannan K, Tylavsky FA, Sathyanarayana S, Bush NR, LeWinn KZ, Karr CJ. Prenatal urinary metabolites of polycyclic aromatic hydrocarbons and toddler cognition, language, and behavior. ENVIRONMENT INTERNATIONAL 2022; 159:107039. [PMID: 34902794 PMCID: PMC8748410 DOI: 10.1016/j.envint.2021.107039] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Animal and epidemiological studies suggest that prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) may negatively impact toddler neurodevelopment. METHODS We investigated this association in 835 mother-child pairs from CANDLE, a diverse pregnancy cohort in the mid-South region of the U.S. PAH metabolite concentrations were measured in mid-pregnancy maternal urine. Cognitive and Language composite scores at ages 2 and 3 years were derived from the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3). Behavior Problem and Competence scores at age 2 were derived from the Brief Infant and Toddler Social Emotional Assessment (BITSEA). We used multivariate linear or Poisson regression to estimate associations with continuous scores and relative risks (RR) of neurodevelopment delay or behavior problems per 2-fold increase in PAH, adjusted for maternal health, nutrition, and socioeconomic status. Secondary analyses investigated associations with PAH mixture using Weighted Quantile Sum Regression (WQS) with a permutation test extension. RESULTS 1- hydroxypyrene was associated with elevated relative risk for Neurodevelopmental Delay at age 2 (RR = 1.20, 95% CI: 1.03,1.39). Contrary to hypotheses, 1-hydroxynaphthalene was associated with lower risk for Behavior Problems at age 2 (RR = 0.90, 95% CI: 0.83,0.98), and combined 1- and 9-hydroxyphenanthrene was associated with 0.52-point higher (95% CI: 0.11,0.93) Cognitive score at age 3. For PAH mixtures, a quintile increase in hydroxy-PAH mixture was associated with lower Language score at age 2 (βwqs = -1.59; 95% CI: -2.84, -0.34; ppermutation = 0.07) and higher Cognitive score at age 3 (βwqs = 0.96; 95% CI: 0.11, 1.82; ppermutation = 0.05). All other estimates were consistent with null associations. CONCLUSION In this large southern U.S. population we observed some support for adverse associations between PAHs and neurodevelopment.
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Affiliation(s)
- Erin R Wallace
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Alexis Sullivan
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erin Masterson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Fran A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicole R Bush
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Ariff S, Maznani I, Bhura M, Memon Z, Arshad T, Samejo TA, Zaidi S, Umer M, Ahmed I, Habib MA, Soofi SB, Bhutta ZA. Understanding Perceptions and Practices for Designing an Appropriate Community-Based Kangaroo Mother Care Implementation Package: Qualitative Exploratory Study. JMIR Form Res 2022; 6:e30663. [PMID: 34994692 PMCID: PMC8783273 DOI: 10.2196/30663] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background Low birth weight (LBW) is a common outcome of preterm birth, which increases the risk of an infant’s morbidity and mortality. Approximately 20 million infants are born with LBW globally per year. Since a significant number of births in Pakistan take place at home, it is important to focus on the use of kangaroo mother care (KMC), the practice of skin-to-skin contact, in communities to prevent neonatal mortality and morbidity. Objective We employed a formative research approach to understand the context of communities and facilities with regard to neonatal care and KMC practice. The broader aims were to inform the design and delivery of culturally appropriate platforms to introduce KMC in communities, and develop effective recruitment and retention strategies of KMC in rural areas of the Dadu district in the Sindh province of Pakistan. Methods We conducted focus group discussions, in-depth interviews, and key informant interviews with families of LBW babies, community members, health care providers, and hospital administrators to identify barriers, enablers, and a knowledge base for KMC interventions. Results Newborn care practices in communities were found to be suboptimal. The community was generally unaware of the KMC intervention for the care of LBW babies. However, facility health care providers, the community, and family members were willing to provide KMC to improve outcomes. We found significant support from the community members and health care providers for KMC practices. Mothers were also ready to provide intermittent KMC. The administrative staff at the hospitals accepted the introduction of KMC practices for LBW babies. Conclusions KMC as a method of treating LBW babies is widely accepted in the community. This formative research provides strategically valuable information that will be helpful for developing effective implementation strategies by identifying common community practices for LBW babies, along with identifying the barriers and enablers to KMC practice.
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Affiliation(s)
- Shabina Ariff
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Ikram Maznani
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Maria Bhura
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Zahid Memon
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Tayyaba Arshad
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Tariq Ahmed Samejo
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Shujaat Zaidi
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Muhammad Umer
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Imran Ahmed
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Muhammad Atif Habib
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Sajid Bashir Soofi
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
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Westaway JAF, Huerlimann R, Kandasamy Y, Miller CM, Norton R, Watson D, Infante-Vilamil S, Rudd D. To Probiotic or Not to Probiotic: A Metagenomic Comparison of the Discharge Gut Microbiome of Infants Supplemented With Probiotics in NICU and Those Who Are Not. Front Pediatr 2022; 10:838559. [PMID: 35345612 PMCID: PMC8957066 DOI: 10.3389/fped.2022.838559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/09/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Preterm birth is associated with the development of both acute and chronic disease, and the disruption of normal gut microbiome development. Recent studies have sought to both characterize and understand the links between disease and the microbiome. Probiotic treatment may correct for these microbial imbalances and, in turn, mitigate disease. However, the criteria for probiotic supplementation in NICU's in North Queensland, Australia limits its usage to the most premature (<32 weeks gestation) and small for gestational age infants (<1,500 g). Here we use a combination of amplicon and shotgun metagenomic sequencing to compare the gut microbiome of infants who fulfill the criteria for probiotic-treatment and those who do not. The aims of this study were to determine if probiotic-supplemented preterm infants have significantly different taxonomic and functional profiles when compared to non-supplemented preterm infants at discharge. METHODS Preterm infants were recruited in North Queensland, Australia, with fecal samples collected just prior to discharge (36 ± 0.5 weeks gestation), to capture potential changes that could be probiotic induced. All samples underwent 16S rRNA gene amplicon sequencing, with a subset also used for shotgun metagenomics. Mixed effects models were used to assess the effect of probiotics on alpha diversity, beta diversity and taxonomic abundance, whilst accounting for other known covariates. RESULTS Mixed effects modeling demonstrated that probiotic treatment had a significant effect on overall community composition (beta diversity), characterized by greater alpha diversity and differing abundances of several taxa, including Bifidobacterium and Lactobacillus, in supplemented infants. CONCLUSION Late preterm-infants who go without probiotic-supplementation may be missing out on stabilizing-effects provided through increased alpha diversity and the presence of commensal microbes, via the use of probiotic-treatment. These findings suggest that late-preterm infants may benefit from probiotic supplementation. More research is needed to both understand the consequences of the differences observed and the long-term effects of this probiotic-treatment.
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Affiliation(s)
- Jacob A F Westaway
- College of Public Health, Medical and Veterinary Science, James Cook University, Cairns, QLD, Australia.,Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Townsville, QLD, Australia
| | - Roger Huerlimann
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Townsville, QLD, Australia.,Marine Climate Change Unit, Okinawa Institute of Science and Technology (OIST), Onna, Japan.,Center for Sustainable Tropical Fisheries and Aquaculture, James Cook University, Townsville, QLD, Australia
| | - Yoga Kandasamy
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, QLD, Australia.,Neonatology, Townsville University Hospital, Townsville, QLD, Australia
| | - Catherine M Miller
- College of Public Health, Medical and Veterinary Science, James Cook University, Cairns, QLD, Australia
| | - Robert Norton
- Microbiology, Pathology Queensland, Herston, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - David Watson
- Maternal-Fetal Medicine, Townsville University Hospital, Townsville, QLD, Australia
| | - Sandra Infante-Vilamil
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Townsville, QLD, Australia.,Center for Sustainable Tropical Fisheries and Aquaculture, James Cook University, Townsville, QLD, Australia
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, QLD, Australia
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29
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Westaway JAF, Huerlimann R, Kandasamy Y, Miller CM, Norton R, Staunton KM, Watson D, Rudd D. The bacterial gut microbiome of probiotic-treated very-preterm infants: changes from admission to discharge. Pediatr Res 2022; 92:142-150. [PMID: 34621029 PMCID: PMC9411061 DOI: 10.1038/s41390-021-01738-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Preterm birth is associated with the development of acute and chronic disease, potentially, through the disruption of normal gut microbiome development. Probiotics may correct for microbial imbalances and mitigate disease risk. Here, we used amplicon sequencing to characterise the gut microbiome of probiotic-treated premature infants. We aimed to identify and understand variation in bacterial gut flora from admission to discharge and in association with clinical variables. METHODS Infants born <32 weeks gestation and <1500 g, and who received probiotic treatment, were recruited in North Queensland Australia. Meconium and faecal samples were collected at admission and discharge. All samples underwent 16S rRNA short amplicon sequencing, and subsequently, a combination of univariate and multivariate analyses. RESULTS 71 admission and 63 discharge samples were collected. Univariate analyses showed significant changes in the gut flora from admission to discharge. Mixed-effects modelling showed significantly lower alpha diversity in infants diagnosed with either sepsis or retinopathy of prematurity (ROP) and those fed formula. In addition, chorioamnionitis, preeclampsia, sepsis, necrotising enterocolitis and ROP were also all associated with the differential abundance of several taxa. CONCLUSIONS The lower microbial diversity seen in infants with diagnosed disorders or formula-fed, as well as differing abundances of several taxa across multiple variables, highlights the role of the microbiome in the development of health and disease. This study supports the need for promoting healthy microbiome development in preterm neonates. IMPACT Low diversity and differing taxonomic abundances in preterm gut microbiota demonstrated in formula-fed infants and those identified with postnatal conditions, as well as differences in taxonomy associated with preeclampsia and chorioamnionitis, reinforcing the association of the microbiome composition changes due to maternal and infant disease. The largest study exploring an association between the preterm infant microbiome and ROP. A novel association between the preterm infant gut microbiome and preeclampsia in a unique cohort of very-premature probiotic-supplemented infants.
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Affiliation(s)
- Jacob A. F. Westaway
- grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Science, James Cook University, 1/14-88 McGregor Road, Smithfield, QLD 4878 Australia ,grid.1011.10000 0004 0474 1797Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, 1 James Cook Drive, Douglas, QLD 4811 Australia
| | - Roger Huerlimann
- grid.1011.10000 0004 0474 1797Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, 1 James Cook Drive, Douglas, QLD 4811 Australia ,grid.250464.10000 0000 9805 2626Marine Climate Change Unit, Okinawa Institute of Science and Technology (OIST), 1919-1 Tancha, Onna-son Okinawa, 904-0495 Japan ,grid.1011.10000 0004 0474 1797College of Science and Engineering, James Cook University, 1 James Cook Drive, Douglas, QLD 4811 Australia
| | - Yoga Kandasamy
- grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, QLD 4811 Australia ,grid.417216.70000 0000 9237 0383Department of neonatology, Townsville University Hospital, 100 Angus Smith Drive, Douglas, QLD 4814 Australia
| | - Catherine M. Miller
- grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Science, James Cook University, 1/14-88 McGregor Road, Smithfield, QLD 4878 Australia ,grid.1011.10000 0004 0474 1797Australian Institute for Tropical Health and Medicine, James Cook University, 1/14-88 McGregor Road, Smithfield, QLD 4878 Australia
| | - Robert Norton
- Department of Microbiology, Pathology Queensland, 100 Angus Smith Drive, Douglas, QLD 4814 Australia
| | - Kyran M. Staunton
- grid.1011.10000 0004 0474 1797Australian Institute for Tropical Health and Medicine, James Cook University, 1/14-88 McGregor Road, Smithfield, QLD 4878 Australia
| | - David Watson
- grid.417216.70000 0000 9237 0383Department of Maternal-Fetal Medicine, Townsville University Hospital, 100 Angus Smith Drive, Douglas, 4814 Australia
| | - Donna Rudd
- grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, QLD 4811 Australia
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Al-Hindi MY, Almahdi BH, Alasmari DA, Alwagdani RK, Hunjur WM, Khalel AF, AlQurashi MA. Screening for Neurodevelopmental Delay for Preterm Very Low Birth Weight Infants at Tertiary Care Center in Saudi Arabia. Cureus 2021; 13:e20092. [PMID: 34877230 PMCID: PMC8642145 DOI: 10.7759/cureus.20092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/29/2022] Open
Abstract
Background Preterm infants are more susceptible to death, short-term complications, and long-term complications such as neurodevelopmental impairments. However, definitive assessment tools are not available in a resource-limited setting. Hence a screening tool is needed the Arabic-speaking population. Method Infants born at a gestational age of <32 weeks or a very low birth weight (VLBW) of less than 1500 g were recruited into a cross-sectional study. We identified infants (n = 61) admitted to the neonatal ICU at King Abdulaziz Medical City and reached 18 up to 24 months of corrected gestational age (CGA). The developmental assessment was done at 18, 20, 22, and 24 CGAs using the Ages and Stages Questionnaire third edition - Arabic version (ASQ3-A). The primary outcomes are early detection rate of neurodevelopmental delay (NDD), defined as a delay in one or more of the following: communication, gross motor, fine motor, problem-solving, and personal-social skills as per ASQ3-A. Results Sixty-one out of 92 eligible infants (36 excluded) completed the sufficient assessment. Twenty-six infants (42.6%) had at least one NDD in one of the following domains: communication skills: (11.5%), gross motor: (11.5%), fine motor: (19.7%), problem-solving skills: twelve infants (19.7%), and personal-social skills: twenty infants (23%). Perinatal events and periventricular leukomalacia (PVL) were significant independent predictors for the NDD. Conclusion This single-center study in Saudi Arabia screened preterm, VLBW infants based on ASQ3-A, twenty infants (42.6%) had an abnormal NDD at a corrected age of 18-24 months. Perinatal events and PVL were independent predictors of NDD. We recommend that all preterm VLBW infants in Saudi Arabia be evaluated by a neurodevelopmental screening tool, ASQ3-A, especially in resource-limited settings to start early intervention. Also, more extensive multicenter studies are to be carried out with definitive diagnostic tools to have a national benchmark for the long-term neurodevelopmental impairment.
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Affiliation(s)
- Mohammed Y Al-Hindi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Research Office, King Abdullah International Medical Research Center, Jeddah, SAU.,Department of Pediatrics, Neonatology Division, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU
| | - Bashaer H Almahdi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Dinah A Alasmari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Raghad K Alwagdani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Wujud M Hunjur
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdullah F Khalel
- Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU
| | - Mansour A AlQurashi
- Department of Pediatrics, Neonatology Division, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Research Office, King Abdullah International Medical Research Center, Jeddah, SAU
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31
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Rocha R, Andrade L, Alves T, Sá S, Pereira PA, Dulce Madeira M, Cardoso A. Behavioral and brain morphological analysis of non-inflammatory and inflammatory rat models of preterm brain injury. Neurobiol Learn Mem 2021; 185:107540. [PMID: 34673263 DOI: 10.1016/j.nlm.2021.107540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/21/2021] [Accepted: 10/07/2021] [Indexed: 11/18/2022]
Abstract
Investigations using preclinical models of preterm birth have much contributed, together with human neuropathological studies, for advances in our understanding of preterm brain injury. Here, we evaluated whether the neurodevelopmental and behavioral consequences of preterm birth induced by a non-inflammatory model of preterm birth using mifepristone would differ from those after inflammatory prenatal transient hypoxia-ischemia (TSHI) model. Pregnant Wistar rats were either injected with mifepristone, and pups were delivered on embryonic day 21 (ED21 group), or laparotomized on the 18th day of gestation for 60 min of uterine arteries occlusion. Rat pups were tested postnatally for characterization of developmental milestones and, after weaning, they were behaviorally tested for anxiety and for spatial learning and memory. One month later, brains were processed for quantification of doublecortin (DCX)- and neuropeptide Y (NPY)-immunoreactive cells, and cholinergic varicosities in the hippocampus. ED21 rats did not differ from controls with respect to neonatal developmental milestones, anxiety, learning and memory functions, and neurochemical parameters. Conversely, in TSHI rats the development of neonatal reflexes was delayed, the levels of anxiety were reduced, and spatial learning and memory was impaired; in the hippocampus, the total number of DCX and NPY cells was increased, and the density of cholinergic varicosities was reduced. With these results we suggest that a preterm birth, in a non-inflammatory prenatal environment, does not significantly change neonatal development and adult neurologic outcome. On other hand, prenatal hypoxia and ischemia (inflammation) modifies developmental trajectory, learning and memory, neurogenesis, and NPY GABAergic and cholinergic brain systems.
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Affiliation(s)
- Ruben Rocha
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Center of Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; Pediatric Neurology Department, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, 4050-651 Porto, Portugal; Pediatric Emergency Department, Centro Hospitalar Universitário S. João, 4200-319 Porto, Portugal
| | - Leonardo Andrade
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Tânia Alves
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Susana Sá
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Center of Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Pedro A Pereira
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Center of Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - M Dulce Madeira
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Center of Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Armando Cardoso
- Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Center of Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.
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32
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Sharma A, Sah N, Kannan S, Kannan RM. Targeted drug delivery for maternal and perinatal health: Challenges and opportunities. Adv Drug Deliv Rev 2021; 177:113950. [PMID: 34454979 PMCID: PMC8544131 DOI: 10.1016/j.addr.2021.113950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/06/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022]
Abstract
Pre-existing conditions at reproductive age, and complications arising during pregnancy can be detrimental to maternal and fetal health. Current therapies to combat obstetric disorders are limited due to the inherent complexity of pregnancy, and can have harmful effects on developing fetus. Emerging research shows intricate signaling between the cells from mother and fetus at maternal-fetal interface, providing unique opportunities for interventions specifically targeted to the mother, fetus, or placenta. Advancements in nanotechnology, stem-cell biology and gene therapy have resulted in target-specific treatments with promising results in pre-clinical maternal and fetal disorder models. Comprehensive understanding of the effect of physicochemical properties of delivery systems on their uptake, retention and accumulation across placenta will help in the better diagnosis and treatment of perinatal disorders. This review describes the factors leading to obstetric complications along with their effect on pregnancy outcomes, and discusses key targeted therapeutic strategies for addressing conditions related to maternal and fetal health.
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Affiliation(s)
- Anjali Sharma
- Center for Nanomedicine, Department of Ophthalmology, Wilmer Eye Institute Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Nirnath Sah
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Sujatha Kannan
- Center for Nanomedicine, Department of Ophthalmology, Wilmer Eye Institute Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Hugo W. Moser Research Institute at Kennedy Krieger, Inc., Baltimore MD, 21205, USA
| | - Rangaramanujam M Kannan
- Center for Nanomedicine, Department of Ophthalmology, Wilmer Eye Institute Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA; Hugo W. Moser Research Institute at Kennedy Krieger, Inc., Baltimore MD, 21205, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore MD, 21218, USA.
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33
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Laverty C, Surtees A, O’Sullivan R, Sutherland D, Jones C, Richards C. The prevalence and profile of autism in individuals born preterm: a systematic review and meta-analysis. J Neurodev Disord 2021; 13:41. [PMID: 34548007 PMCID: PMC8454175 DOI: 10.1186/s11689-021-09382-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/16/2021] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Preterm birth (<37 weeks) adversely affects development in behavioural, cognitive and mental health domains. Heightened rates of autism are identified in preterm populations, indicating that prematurity may confer an increased likelihood of adverse neurodevelopmental outcomes. The present meta-analysis aims to synthesise existing literature and calculate pooled prevalence estimates for rates of autism characteristics in preterm populations. METHODS Search terms were generated from inspection of relevant high-impact papers and a recent meta-analysis. Five databases were searched from database creation until December 2020 with PRISMA guidelines followed throughout. RESULTS 10,900 papers were retrieved, with 52 papers included in the final analyses, further classified by assessment method (screening tools N=30, diagnostic assessment N=29). Pooled prevalence estimates for autism in preterm samples was 20% when using screening tools and 6% when using diagnostic assessments. The odds of an autism diagnosis were 3.3 times higher in individuals born preterm than in the general population. CONCLUSIONS The pooled prevalence estimate of autism characteristics in individuals born preterm is considerably higher than in the general population. Findings highlight the clinical need to provide further monitoring and support for individuals born preterm.
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Affiliation(s)
- Catherine Laverty
- School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
| | - Andrew Surtees
- School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
- Forward Thinking Birmingham, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Rory O’Sullivan
- School of Psychology, Loughborough University, Loughborough, LE11 3TU UK
| | - Daniel Sutherland
- School of Psychology, Loughborough University, Loughborough, LE11 3TU UK
| | - Christopher Jones
- School of Psychology, Loughborough University, Loughborough, LE11 3TU UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Birmingham, B15 2TT UK
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Powell M, Saade G, Thornton S, Pimenta JM, Haque N, Miller D, Beach KJ, Snidow J, Correa EO, Scott R. Safety and Outcomes in Infants Born to Mothers Participating in Retosiban Treatment Trials: ARIOS Follow-Up Study. Am J Perinatol 2021. [PMID: 34352924 DOI: 10.1055/s-0041-1733784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Retosiban, an oxytocin receptor antagonist, was developed for treating spontaneous preterm labor (sPTL) in women with intact membranes. This ARIOS follow-up study aimed to characterize clinical safety, morbidity, and mortality of infants exposed to retosiban or comparator over 2 years. STUDY DESIGN ARIOS prospectively assessed outcomes in infants whose mothers received at least one dose of retosiban or comparator (placebo/atosiban) in two Phase 3 sPTL trials. Both trials were terminated prematurely owing to poor enrolment. Infants could be enrolled into ARIOS from 28 days after estimated due date until hospital discharge or up to 9 months (corrected age). An internally developed questionnaire detailing medical conditions, mortality and resource use (Child Health Inventory; CHI), Ages and Stages Questionnaire-3 (ASQ-3), Modified Checklist for Autism in Toddlers-Revised with Follow-Up, and Child Behavior Checklist for Ages 1.5 to 5 were completed remotely by parents or legal guardians at prespecified intervals. Serious adverse events (SAEs) were primarily captured via CHI. No comparative statistical analysis was conducted between treatment arms. RESULTS A total of 49 (86%) infants who had received retosiban and 49 (78%) infants who had received a comparator were enrolled in ARIOS. No deaths occurred during the study. Nine infants experienced SAEs: 6/49 (12.2%) infants in the comparators group and 3/49 (6.1%) in the retosiban group. Of the nine SAEs, seven were due to infections, three, and four in the retosiban and comparators groups, respectively. Based on ASQ-3 score, the incidence of neurodevelopmental delay at 18 and 24 months were 0/18 (0%) and 2/25 (8%) with retosiban and 7/22 (31.8%) and 3/21 (14.3%) with comparator, respectively. CONCLUSION The current study showed no unexpected adverse outcome or impairment with retosiban based on safety monitoring and neurodevelopment assessments. No further follow-up is intended owing to the discontinuation of clinical development of retosiban. KEY POINTS · There is a need for an effective and safe treatment for sPTL.. · ARIOS was a follow-up study of two Phase 3 trials in sPTL.. · There were no safety concerns with retosiban treatment.. · Slow recruitment led to termination of the Phase 3 trials..
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Affiliation(s)
- Marcy Powell
- Pharma Research & Development, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - George Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, Texas
| | - Steve Thornton
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jeanne M Pimenta
- Epidemiology, GlaxoSmithKline, Stockley Park, Uxbridge, Middlesex, United Kingdom
| | - Nazneen Haque
- GlaxoSmithKline, Brentford, Middlesex, United Kingdom
| | - Diane Miller
- Pharma Research & Development, GlaxoSmithKline, Collegeville, Pennsylvania
| | - Kathleen J Beach
- Pharma Research & Development, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - Jerry Snidow
- Pharma Research & Development, GlaxoSmithKline, Research Triangle Park, North Carolina
| | - Erika Ochoa Correa
- Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | - Rhona Scott
- Clinical Development, GlaxoSmithKline, Stockley Park, Uxbridge, Middlesex, United Kingdom
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Russo S, Batista A, Esgalhado F, Palma dos Reis CR, Serrano F, Vassilenko V, Ortigueira M. Alvarez waves in pregnancy: a comprehensive review. Biophys Rev 2021; 13:563-574. [PMID: 34471439 PMCID: PMC8355272 DOI: 10.1007/s12551-021-00818-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022] Open
Abstract
Alvarez waves are local rhythmic contractions of the myometrium with high frequency and low intensity. They can be detected using internal or external tocography and electrohysterography. Some researchers correlate these small contractions with the initiation of labor, since they have been described as a pattern representing the uterine response to prostaglandin production. Other authors either do not validate a causality relation between Alvarez waves and labor or suggest that they have low predictive value for preterm labor. Alvarez waves' research has become a multidisciplinary subject with inputs ranging from medical science, biomedical engineering, and related areas. A comprehensive review is herein conducted to summarize the state of the art regarding Alvarez waves and their role in the initiation of labor, namely in preterm birth. The results show that a large number of studies have analyzed and characterized Alvarez waves without necessarily digging into their relationship with labor. Publications were categorized in three groups: (A) reports about morphology and characterization of Alvarez waves; (B) publications reporting a positive causality relation between Alvarez waves and labor; and (C) publications reporting an absence of causality regarding the previous hypothesis. Studies in group B outnumbered those in group C. A critical analysis is presented.
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Affiliation(s)
- Sara Russo
- Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
| | - Arnaldo Batista
- Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
- UNINOVA, Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
| | - Filipa Esgalhado
- Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
- NMT, S.A., Parque Tecnológico de Cantanhede, Núcleo 04, Lote 3, 3060 -, 197 Cantanhede, Portugal
| | - Catarina R. Palma dos Reis
- Maternidade Alfredo da Costa, Rua Viriato 1, 1050-170 Lisboa, Portugal
- Nova Medical School / Faculty of Medical Sciences, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - Fátima Serrano
- Maternidade Alfredo da Costa, Rua Viriato 1, 1050-170 Lisboa, Portugal
- Nova Medical School / Faculty of Medical Sciences, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - Valentina Vassilenko
- Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
- NMT, S.A., Parque Tecnológico de Cantanhede, Núcleo 04, Lote 3, 3060 -, 197 Cantanhede, Portugal
| | - Manuel Ortigueira
- Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
- UNINOVA, Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Campus de Caparica, 2829-516 Caparica, Portugal
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Buys K, Gerber B. Maternal experiences of caring for preterm infants in a vulnerable South African population. Health SA 2021; 26:1549. [PMID: 34394963 PMCID: PMC8335761 DOI: 10.4102/hsag.v26i0.1549] [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: 09/24/2020] [Accepted: 05/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background Caring for a preterm infant is known to be a stressful experience as these infants are at a high risk of medical sequelae and developmental delays. Early intervention is imperative for the best developmental outcome for the infant. Such interventions are often delivered through the mother or primary caregiver; however, healthcare professionals are seldom aware of all the factors that influence maternal well-being, potentially influencing her ability to provide optimal care. Aim To explore the experiences of a group of vulnerable women, namely, isiXhosa-speaking mothers of preterm infants living in low socio-economic circumstances in the Western Cape province of South Africa, regarding having, caring for and feeding their preterm infants within the first 6 months of the infant’s life. Setting A follow-up clinic for preterm infants and their mothers at a public tertiary hospital in Cape Town, South Africa. Methods The study employed a qualitative, cross-sectional design that was explorative and contextual in nature. A discussion schedule was used to guide 15 in-depth interviews with mothers that were later thematically analysed. Results Social support and religion positively influenced maternal coping. The infant’s medical stability was the main concern for mothers and concerns regarding the infant’s development did not arise. Prematurity influenced mothers’ decisions to use traditional medicines and hospital care affected some traditional practices. Conclusion The study findings highlighted the influence of traditional and religious beliefs, the importance of the cultural education of medical staff members and a support system to improve maternal experiences. Contribution The findings provide insights into maternal experiences with implications for healthcare practitioners’ continued education in an ethnically diverse setting.
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Affiliation(s)
- Kristen Buys
- Department of Speech, Language and Hearing Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Berna Gerber
- Department of Speech, Language and Hearing Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Kwag Y, Kim MH, Oh J, Shah S, Ye S, Ha EH. Effect of heat waves and fine particulate matter on preterm births in Korea from 2010 to 2016. ENVIRONMENT INTERNATIONAL 2021; 147:106239. [PMID: 33341584 DOI: 10.1016/j.envint.2020.106239] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have reported that fine particulate matter (PM2.5) affects the incidence of premature births. In addition, recent studies have suggested that heat waves have a negative impact on birth outcomes. However, the combined effect of PM2.5 and heat waves on the incidence of premature birth is controversial. This study investigated the independent and combined effects of PM2.5 and heat wave exposures during the 1st and 2nd trimesters on premature birth. METHODS The National Statistical Office of Korea provided birth data from 2010 to 2016. Preterm birth was defined as birth between 22 and 36 weeks. To assess the exposure to PM2.5 and heat waves, we used PM2.5 data estimated by the Community Multiscale Air Quality Modeling System (CMAQ) and heat wave warning data provided by the Korea Meteorological Administration. A multivariate logistic regression was used to investigate the risk of preterm birth according to the exposure to PM2.5 and heat waves during the 1st and 2nd trimesters, and it was adjusted for residential area, year of birth, season of birth, parity, education level of the mother, age of the mother, and sex of the baby. RESULTS In the 2nd trimester, compared with the 0 h of heat wave exposure (≤67 percentile), 62.50-314.00 h (79-88 percentile) and>315.00 h of heat wave exposure (>88 percentile) were both significantly associated with preterm birth (OR for 79-88 percentile, 1.037, 95% CI, 1.003-1.073; OR for > 88 percentile, 1.174, 95% CI, 1.134-1.215). However, PM2.5 exposure was not significantly associated with preterm birth. On the other hand, in the analysis to evaluate the combined effect of PM2.5 and heat wave exposures of the 2nd trimester, compared with 0 h of heat wave exposure (≤67 percentile) and<11.64 μg/m3 (≤25 percentile) of PM2.5, 11.64-22.74 μg/m3 (≤25 percentile), 22.74-27.58 μg/m3 (26-50 percentile), and 27.57-32.39 μg/m3 (51-75 percentile) of PM2.5 exposure combined with>315.00 h of heat wave exposure (>88 percentile) were all significantly associated with preterm birth. In addition, the effect size was increased with an increase of PM2.5 exposure (OR for ≤ 25 percentile, 1.148, 95% CI, 1.095-1.203; OR for 26-50 percentile, 1.248, 95% CI, 1.178-1.323; OR for 51-75 percentile, 1.370, 95% CI, 1.245-1.507). CONCLUSION Our findings suggest that the combined effect of heat wave and PM2.5 exposure during the 2nd trimester on the risk of preterm birth was greater than that of each exposure alone. In other words, exposure to PM2.5 increases the impact of heat waves on the risk of preterm birth. These results indicate that control of prenatal exposure to fine particular matter and extreme temperatures is important for the prevention of preterm birth.
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Affiliation(s)
- Youngrin Kwag
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Min-Ho Kim
- Ewha University-Industry Collaboration Foundation Ewha Womans University, Seoul, Republic of Korea
| | - Jongmin Oh
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Surabhi Shah
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Shinhee Ye
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Republic of Korea.
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
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Gejo NG, W/Mariam MT, Kebede BA, Abdo RA, Anshebo AA, Halil HM, Woldu BF, Katiso NA. Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study. BMC Pregnancy Childbirth 2021; 21:35. [PMID: 33413150 PMCID: PMC7792126 DOI: 10.1186/s12884-020-03503-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. METHODS An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. RESULT The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. CONCLUSIONS The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.
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Affiliation(s)
- Negeso Gebeyehu Gejo
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.
| | - Melaku Tesfaye W/Mariam
- Department of Pharmacy, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Biruk Assefa Kebede
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Ritbano Ahmed Abdo
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Abebe Alemu Anshebo
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Hassen Mosa Halil
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Biruktawit Fekade Woldu
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Nuradin Abusha Katiso
- Department of Public health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
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Elhakham D, Wainstock T, Sheiner E, Sergienko R, Pariente G. Inter-pregnancy interval and long-term neurological morbidity of the offspring. Arch Gynecol Obstet 2020; 303:703-708. [PMID: 32935142 DOI: 10.1007/s00404-020-05788-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/02/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of our study was to evaluate the effect of IPI on long-term neurological morbidity of the offspring. METHODS In this retrospective cohort study, 144,397 singleton infants born to multiparous mothers, between the years 1991 and 2014 in a tertiary medical center, were evaluated for different perinatal outcomes and were followed until 18 years of age for long-term neurological morbidity according to three IPI groups: Short IPI (< 6 months), long IPI (> 60 months) and intermediate IPI (6-60 months). We used a Kaplan-Meier survival curve to compare cumulative incidence of long-term neurological morbidity, and a Cox regression analysis to control for confounders such as gestational age, birth weight and maternal age. RESULTS Offspring born to mothers with long IPI had higher rates of neurological morbidity (3.62% among offspring born after long IPI vs. 3.18% and 3.19% among offspring born after short and intermediate IPI, respectively, p = 0.041). The cumulative incidence of long-term neurological morbidity was significantly higher in the long IPI group (Kaplan-Meier log-rank test p < 0.001). Being born after a long IPI was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted hazard ratio 1.2; 95% confidence interval 1.1-1.4; p < 0.001). CONCLUSION Long IPI is independently associated with an increased risk of long-term neurological morbidity of the offspring.
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Affiliation(s)
- David Elhakham
- Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Wainstock
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O Box 151, 84101, Beer-Sheva, Israel.
| | - Ruslan Sergienko
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gali Pariente
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O Box 151, 84101, Beer-Sheva, Israel
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Pek JH, Yap BJ, Gan MY, Seethor STT, Greenberg R, Hornik CPV, Tan B, Lee JH, Chong SL. Neurocognitive impairment after neonatal sepsis: protocol for a systematic review and meta-analysis. BMJ Open 2020; 10:e038816. [PMID: 32532785 PMCID: PMC7295426 DOI: 10.1136/bmjopen-2020-038816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/11/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The effect of neonatal sepsis on the developing brain is not well documented. We aim to perform evidence synthesis to determine the outcome of neurodevelopmental impairment and intellectual disability among survivors of neonatal sepsis. The data gathered will inform on the long-term neurocognitive outcomes of neonates with sepsis and the measures used to document their developmental disability. METHODS AND ANALYSIS We will perform a search based on the following parameters: neonates and infants less than 90 days old diagnosed with sepsis who had neurocognitive outcomes or measures of developmental disability reported. We will search PubMed, Cochrane Central, Embase and Web of Science for articles in English language published between January 2010 and December 2019. Clinical trials and observational studies will be included. Two independent reviewers will screen studies for eligibility. Data extraction will then be performed using a standardised form. The quality of evidence and risk of bias will be assessed using Cochrane Collaboration's tool and Risk of Bias in Non-randomised Studies of Intervention (ROBINS-I). The results will be synthesised qualitatively and pooled for meta-analysis. ETHICS AND DISSEMINATION No formal ethical approval is required as there is no collection of primary data. This systematic review and meta-analysis will be disseminated through conference meetings and peer-reviewed publications. PROSPERO REGISTRATION NUMBER Registration submitted CRD42020164334.
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Affiliation(s)
- Jen Heng Pek
- Department of Emergency Medicine, Sengkang General Hospital, Singapore
| | - Bei Jun Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ming Ying Gan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Rachel Greenberg
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Christoph Paul Vincent Hornik
- Division of Quantitative Sciences, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Bobby Tan
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Jan Hau Lee
- Children's Intensive Care Unit, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore
| | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
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Abstract
BACKGROUND Cerebral palsy (CP) is a non-progressive, everlasting neurological disorder of movement, posture, and physical activities, with a prevalence of 2.2-3.3/1,000. CP is a condition that occurs globally, with a similar prevalence in both developed and undeveloped countries. However, the etiology differs according to the socioeconomic status of the countries. The objective is to determine the pattern and the contributing factors of CP among Sudanese children. METHODS This was a retrospective hospital-based study conducted over a period of three years in a pediatric referral hospital in Khartoum, Sudan. One hundred and eight patients of CP were enrolled, of whom 59 (54.6%) were males and 49 (45.4%) were females. RESULTS Spastic quadriplegic CP was the most common type. Most cases were from lower social classes. Prenatal, antenatal, and unclassified CP were found in 45 (41.7%), 31 (28.7.%), 23 (21.3%), and 9 (8.3%) cases, respectively. Birth asphyxia, neonatal jaundice, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus infections (TORCH), and sepsis (acquired) were the main causative factors. CONCLUSION Spastic quadriplegia is the most common type of CP. Most of the cases had a direct positive relationship with socioeconomic status. The prenatal period was the most common period for the development of CP.
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Affiliation(s)
- Karimeldin Salih
- Pediatrics, College of Medicine, University of Bisha, Bisha, SAU
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D'Silva AM, Hyett JA, Coorssen JR. First Trimester Protein Biomarkers for Risk of Spontaneous Preterm Birth: Identifying a Critical Need for More Rigorous Approaches to Biomarker Identification and Validation. Fetal Diagn Ther 2020; 47:497-506. [PMID: 32097912 DOI: 10.1159/000504975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/25/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Spontaneous preterm birth is the leading cause of perinatal morbidity and mortality worldwide and continues to present a major clinical dilemma. We previously reported that a number of protein species were dysregulated in maternal serum collected at 11-13+6 weeks' gestation from pregnancies that continued to labour spontaneously and deliver preterm. OBJECTIVES AND METHODS In this study, we aimed to validate changes seen in 4 candidate protein species: alpha-1-antitrypsin, vitamin D-binding protein (VDBP), alpha-1beta-glycoprotein and apolipoprotein A-1 in a larger cohort of women using a western blot approach. RESULTS Serum levels of all 4 proteins were reduced in women who laboured spontaneously and delivered preterm. This reduction was significant for VDBP (p = 0.04), which has been shown to be involved in a plethora of essential biological functions, including actin scavenging, fatty acid transport, macrophage activation and chemotaxis. CONCLUSIONS The decrease in select proteoforms of VDBP may result in an imbalance in the optimal intrauterine environment for the developing foetus as well as to a successful uncomplicated pregnancy. Thus, certain (phosphorylated) species of VDBP may be of value in developing a targeted approach to the early prediction of spontaneous preterm labour. Importantly, this study raises the importance of a focus on proteoforms and the need for any biomarker validation process to most effectively take these into account rather than the more widespread practice of simply focussing on the primary amino acid sequence of a protein.
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Affiliation(s)
- Arlene M D'Silva
- Department of Molecular Physiology, The Molecular Medicine Research Group, School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Jon A Hyett
- Sydney Institute for Women, Children and their Families, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia,
| | - Jens R Coorssen
- Department of Health Sciences and Biological Sciences, Faculties of Applied Health Sciences and Mathematics and Science, Brock University, St. Catharines, Ontario, Canada
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Soleimani F, Azari N, Ghiasvand H, Shahrokhi A, Rahmani N, Fatollahierad S. Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis. BMC Pediatr 2020; 20:67. [PMID: 32054469 PMCID: PMC7017495 DOI: 10.1186/s12887-020-1953-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/30/2020] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this study was to review the effects of developmental care in neonatal intensive care unit (NICU) setting on mental and motor development of preterm infants. Method We searched PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane library until October 8th 2017, and included randomized controlled trials that assessed effects of developmental care in NICU on mental and motor development of preterm infants at 12 and 24 months of age, using the Bayley scale of infant development in this systematic review. In addition, data were pooled by random effects model and Standardized Mean Difference (SMD) with 95% confidence intervals (CI), calculated for meta-analysis. Results Twenty one studies were eligible to be included in this systematic review; however, only thirteen studies had data suitable for meta-analysis. According to statistical analysis, developmental care in NICU improved mental developmental index (MDI) (standardized mean difference [SMD] 0.55, 95% confidence interval [CI] 0.23–0.87; p < 0.05), and psychomotor developmental index (PDI) (SMD 0.33, [CI] 95% CI 0.08–0.57; p < 0.05) of BSID at 12 months of age and PDI at 24 months of age (SMD 0.15, 95% CI -0.02–0.32; p < 0.1) of preterm infants. However, the benefit was not detected at 24 months of age on MDI (SMD 0.15, 95% CI -0.05–0.35; p = 0.15). Conclusion Current evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants, especially at 12 months of age. However, because of clinical heterogeneity, more studies are needed to evaluate the effects of developmental NICU care in the development of preterm infants.
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Affiliation(s)
- Farin Soleimani
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nadia Azari
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hesam Ghiasvand
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Health Economics Group, Institute of Health Research, Medical School, Saint Luke's Campus, University of Exeter, Exeter, UK
| | - Amin Shahrokhi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nahid Rahmani
- Department of Physiotherapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shiva Fatollahierad
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Park B, Khanam R, Vinayachandran V, Baqui AH, London SJ, Biswal S. Epigenetic biomarkers and preterm birth. ENVIRONMENTAL EPIGENETICS 2020; 6:dvaa005. [PMID: 32551139 PMCID: PMC7293830 DOI: 10.1093/eep/dvaa005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 05/06/2023]
Abstract
Preterm birth (PTB) is a major public health challenge, and novel, sensitive approaches to predict PTB are still evolving. Epigenomic markers are being explored as biomarkers of PTB because of their molecular stability compared to gene expression. This approach is also relatively new compared to gene-based diagnostics, which relies on mutations or single nucleotide polymorphisms. The fundamental principle of epigenome diagnostics is that epigenetic reprogramming in the target tissue (e.g. placental tissue) might be captured by more accessible surrogate tissue (e.g. blood) using biochemical epigenome assays on circulating DNA that incorporate methylation, histone modifications, nucleosome positioning, and/or chromatin accessibility. Epigenomic-based biomarkers may hold great potential for early identification of the majority of PTBs that are not associated with genetic variants or mutations. In this review, we discuss recent advances made in the development of epigenome assays focusing on its potential exploration for association and prediction of PTB. We also summarize population-level cohort studies conducted in the USA and globally that provide opportunities for genetic and epigenetic marker development for PTB. In addition, we summarize publicly available epigenome resources and published PTB studies. We particularly focus on ongoing genome-wide DNA methylation and epigenome-wide association studies. Finally, we review the limitations of current research, the importance of establishing a comprehensive biobank, and possible directions for future studies in identifying effective epigenome biomarkers to enhance health outcomes for pregnant women at risk of PTB and their infants.
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Affiliation(s)
- Bongsoo Park
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Rasheda Khanam
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, International Center for Maternal and Newborn Health, Baltimore, MD 21205, USA
| | - Vinesh Vinayachandran
- School of Medicine, Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Abdullah H Baqui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, International Center for Maternal and Newborn Health, Baltimore, MD 21205, USA
| | - Stephanie J London
- Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
| | - Shyam Biswal
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Wallois F, Routier L, Bourel-Ponchel E. Impact of prematurity on neurodevelopment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:341-375. [PMID: 32958184 DOI: 10.1016/b978-0-444-64150-2.00026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.
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Affiliation(s)
- Fabrice Wallois
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France.
| | - Laura Routier
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
| | - Emilie Bourel-Ponchel
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
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Seleem MA, Amer RA, Romeh AH, Hamoda HM. Demographic and clinical characteristics of children seeking psychiatric services in the Nile Delta region: an observational retrospective study. Int J Ment Health Syst 2019; 13:66. [PMID: 31660063 PMCID: PMC6806528 DOI: 10.1186/s13033-019-0323-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/15/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Epidemiological studies, describing both community and clinical samples of youth in need for psychiatric help, are rare in the middle east. To our knowledge, this is the first study that aims to investigate the demographic and clinical characteristics of a sample of children suffering from emotional and behavioral problems seeking psychiatric services in the Nile Delta region and the largest clinical sample to date in Egypt. METHODS The files of all new cases who presented for care in the outpatient service for children and adolescents between August 2016 and July 2018 were reviewed. Ninety-six files were excluded due to missing data while another 18 files were found to be for adults (ages > 18 years old), so the sample included 886 cases. RESULTS The ages of our sample (n = 886) ranged from 18 months to 18 years with an average of 7.5 (± 3.8) years. Most of our cases were male, school aged children, living within low-income households and predominantly coming from rural areas. The most common diagnoses were attention deficit hyperactivity disorder (ADHD) (22.6%), intellectual disability (ID) (13.7%), depressive disorders (13.3%), and disruptive behavior disorders (DBD) (12.3%). Strong protective effects were found for family integrity and stability. Corporal punishment and physical and sexual abuse were noted to be significant risk factors for internalizing and externalizing disorders in children and adolescents. CONCLUSIONS Except for males being a majority in our sample of children seeking psychiatric consultation, demographic patterns and prevalence of psychiatric disorders are comparable to other tertiary clinical samples in other parts of the world.
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Affiliation(s)
- Mohammad A. Seleem
- Department of Psychiatry and Neurology, Faculty of Medicine, Tanta University, 31527 Tanta, Egypt
| | - Reham A. Amer
- Department of Psychiatry and Neurology, Faculty of Medicine, Tanta University, 31527 Tanta, Egypt
| | - Amr H. Romeh
- Department of Mental Health, Cwm Taf University Health Board, Wales, UK
| | - Hesham M. Hamoda
- Department of Psychiatry, Boston Children’s Hospital and Harvard Medical School, Boston, USA
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Domínguez-Martínez V, Cortés-Escárcega I. Adaptación cultural y validación de Parental Stressor Scale: Neonatal Intensive Care Unit en padres mexicanos. ENFERMERÍA UNIVERSITARIA 2019. [DOI: 10.22201/eneo.23958421e.2019.4.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introducción: La hospitalización de un recién nacido prematuro en la Unidad de Cuidados Intensivos Neonatales (UCIN), constituye un suceso estresante para los padres, como consecuencia de factores ambientales y psicosociales de la UCIN. Así, la identificación del grado de estrés de los padres a través de instrumentos adaptados y validados a su contexto, establecerá protocolos para disminuirlo durante la hospitalización de su hijo.
Objetivo: Adaptar culturalmente y validar la Escala de Estrés Parental: Unidad de Cuidados Intensivos Neonatales (PSS: NICU) para su aplicación en un grupo de madres y padres mexicanos.
Métodos: Estudio descriptivo y transversal, con una muestra intencional de 130 padres de recién nacidos prematuros hospitalizados en la Unidad de Cuidados Intensivos Neonatales. El estrés parental se midió utilizando la PSS: NICU, que fue adaptada y validada para su aplicación en padres mexicanos. La información se procesó con el paquete estadístico SPSS v.24.
Resultados: El instrumento adaptado al contexto cultural en población mexicana presentó una consistencia interna de .945, probando así su confiabilidad para su aplicación en padres mexicanos. El estrés parental total promedio fue de 2.48 + .986, considerado poco estresante.
Conclusiones: La adaptación cultural y validación de la PSS: NICU en población mexicana, resultó una herramienta válida y confiable para su aplicación en padres mexicanos. El factor más asociado con el incremento del nivel de estrés fue la alteración del rol parental, por lo que es importante establecer intervenciones dirigidas a mejorar la participación de los padres que apunten hacia el bienestar emocional de los mismos.
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Tu Y, Wang S, Shih H, Wu P, Yu W, Huang C. Epilepsy occurrence after neonatal morbidities in very preterm infants. Epilepsia 2019; 60:2086-2094. [DOI: 10.1111/epi.16340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/24/2019] [Accepted: 08/26/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Yi‐Fang Tu
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - Shan‐Tair Wang
- Institute of Gerontology College of Medicine National Cheng Kung University Tainan Taiwan
| | - Hsin‐I Shih
- Department of Emergency Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
| | - Po‐Ming Wu
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - Wen‐Hao Yu
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - Chao‐Ching Huang
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Department of Pediatrics College of Medicine Taipei Medical University Taipei Taiwan
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Seethapathy J, Boominathan P, Uppunda AK, Ninan B. Changes in Auditory Brainstem Response in very preterm and late preterm infants. Int J Pediatr Otorhinolaryngol 2019; 121:88-94. [PMID: 30878558 DOI: 10.1016/j.ijporl.2019.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/26/2019] [Accepted: 03/06/2019] [Indexed: 11/19/2022]
Abstract
AIM Aim of this study was to compare the absolute and interpeak latencies of Auditory Brainstem Responses (ABR) in very preterm and late preterm infants at 1 month and 3 months of corrected age. METHOD ology: ABR traces were obtained from 80 preterm infants (40 very preterm and 40 late preterm) at 1 month and 3 months of corrected age in a prospective, comparative cohort study. Auditory click stimuli at 70 dBnHL and 30 dBnHL, with repetition rate of 11.1/s were used. Absolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between preterm groups at 1 month and 3 months of corrected age. Wilcoxon Signed Ranks test was used to compare the ABR variables. Mann Whitney test was used to make inferences between groups. RESULTS There was a statistically significant difference in absolute latencies and interpeak latencies between very preterm and late preterm infants at 1 month of corrected age (p < 0.05). Absolute latency of peak I was similar among both groups of preterms. Absolute latencies of peak III, V and interpeak latencies I-III, III-V and I-V were prolonged in very preterm infants at 1 month of corrected age. However, these latencies were significantly reduced at 3 months of corrected age. This indicated accelerated maturation/myelination of the central auditory nervous system in very preterm infants. Absolute latencies of peak III and V and interpeak interval I-V was reduced in late preterm infants at 3 months of corrected age and this was statistically significant. This reduction in latency was considered to be a normal age dependent change. CONCLUSION Findings of the current study revealed that there was no deviation in the pattern of auditory maturation among preterms; it followed the typical 'caudal to rostral' form of maturation. Very preterm infants have less mature neuronal development compared with late preterm infants at 1 month of corrected age which catches up at 3 months of corrected age.
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Affiliation(s)
- Jayashree Seethapathy
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India.
| | - Prakash Boominathan
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
| | - Ajith Kumar Uppunda
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Binu Ninan
- Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
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Ghomi H, Yadegari F, Soleimani F, Knoll BL, Noroozi M, Mazouri A. The effects of premature infant oral motor intervention (PIOMI) on oral feeding of preterm infants: A randomized clinical trial. Int J Pediatr Otorhinolaryngol 2019; 120:202-209. [PMID: 30851536 DOI: 10.1016/j.ijporl.2019.02.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Given the increase in the birth and survival rate of the premature infants, a need for supportive health care services becomes more evident. The goal of the present study was to examine the effectiveness of the Premature Infant Oral Motor Intervention (PIOMI) in the feeding progression and early intervention. This study was a double-blind randomized clinical trial. METHODS This clinical trial included premature infants in the neonatal intensive care units (NICUs) of two hospitals in Tehran, who were randomly assigned into intervention and control group, each containing 15 infants. The PIOMI was administered to the intervention group in the course of 10 days. The infants in the control group received routine nursing services. Repeated measures ANOVA (RMA) were analyzed. The postmenstrual age and weight of the participants were examined at the time points of accomplishing one, four, and eight oral feedings a day and at the time of hospital discharge. RESULTS The intervention group reached the first oral feeding (with a mean of 7.2 days) and eight oral feeding (with a mean of 13.47 days) earlier than the control group. The length of hospital stay in intervention group was significantly shorter (P = 0.03). RMA wasn't statistically significant between groups for weight (F: 0.76, P: 0.39, ŋ: 0.03); but within-subjects test showed that change of the weight over time and for interaction of time and group was significant (F: 74.437, P < 0.001, ŋ: 0.727). The effect size of infants' age in the measurement times was 91%. CONCLUSION the results revealed that PIOMI is a fruitful method for premature infants. We suggest that PIOMI can be integrated in feeding rehabilitation programs of the premature infants born with gestational age of as young as 26-29 weeks, and applied at 29 weeks postmenstrual age (PMA). THE CLINICAL TRIAL REGISTRATION NUMBER IRCT20180410039260N1.
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Affiliation(s)
- Hadiseh Ghomi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
| | - Fariba Yadegari
- University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
| | - Farin Soleimani
- Pediatric Neurorehabilitation Research Center, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.
| | - Brenda Lessen Knoll
- School of Nursing, Illinois Wesleyan University, STV Hall, 203 Beecher St, Bloomington, IL, 61702, USA
| | - Mahdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Mazouri
- Department of Pediatrics, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
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