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PubMed2006

Neonatal behavior and infant cognitive development in rhesus macaques produced by assisted reproductive technologies.

Assisted reproductive technologies (ART) used in fertility clinics include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), followed by embryo transfer into the biological or a surrogate mother. Over 1,000,000 liveborn offspring--an estimated 1 in 150 United States newborns--have been produced worldwide by ART since 1978. IVF appears to produce healthy children in singleton pregnancies, though concerns remain regarding preterm deliveries, multiple pregnancies, as well as the longer-term consequences of all ART procedures. Clinical studies remain difficult to interpret and subject to confounding variables, as developmental problems may be due to a parent's reproductive conditions rather than, or in addition to, an ART procedure. Also, because of expense and time commitments, the United States ART clinical population is not fully representative of society diversities. This socio-economic skewing might compensate for negative effects, masking small, or modest developmental deficits. Embryo splitting (ES), an ART procedure used only with animals, can produce genetically identical offspring. ES involves dividing four- to eight-cell embryos into separate blastomeres and implanting them into empty zona pellucida, followed by embryo transfer. Although these ART techniques have produced nonhuman primate offspring, there has been no research on behavioral safety. Here, we report the first study of behavioral development by rhesus macaques infants produced through ES, ICSI, and IVF. We assessed neonatal reflexes, self-feeding ability, recognition memory, object concept attainment, simple discrimination learning and reversal, and learning set (LS) acquisition. Although the sample sizes are small, we found no overall ART group delayed development. Surprisingly, the ES and ICSI monkeys appeared to be accelerated in attaining age milestones involving sensory-motor behaviors and a difficult Well Hiding object concept task. We conclude that macaque monkeys may provide an excellent model for the study of early human development by offspring of parents with conditions requiring ART pregnancies, as well as a model for the behavioral study of genetic-environment interactions using identical twins produced by ES.

Analysis of Variance↗
PubMed2005

The development of infant learning about specific face-voice relations.

This study examined the development of infants' ability to perceive, learn, and remember the unique face-voice relations of unfamiliar adults. Infants of 2, 4, and 6 months were habituated to the faces and voices of 2 same-gender adults speaking and then received test trials where the faces and voices were synchronized yet mismatched. Results indicated that 4- and 6-month-olds, but not 2-month-olds, detected the change in face-voice pairings. Two-month-olds did, however, discriminate among the faces and voices in a control study. Results of a subsequent intermodal matching procedure indicated that only the 6-month-olds showed matching and memory for the face-voice relations. These findings suggest that infants' ability to detect the arbitrary relations between specific faces and voices of unfamiliar adults emerges between 2 and 4 months of age, whereas matching and memory for these relations emerges somewhat later, perhaps between 4 and 6 months of age.

Child Development↗
PubMed1999

Polyunsaturated fatty acids and infant visual development: a critical appraisal of randomized clinical trials.

At the Consensus and Controversies Conference held in Barcelona in November 1996, one of the sessions focused on an evaluation of the effects of dietary polyunsaturated fatty acids (PUFA) on infant visual development. The intervention trials in preterm and term infants were reviewed and discussed in detail. Results of these trials, particularly those in term infants, were inconsistent; much discussion occurred concerning the causes of these diverse results. We attempt to reflect, rather than report exactly, the discussion relating to these issues and address the clinical trials according to recently published guidelines for conduct and reporting of randomized clinical trials (RCT). Compared with these recent guidelines, the published papers of RCT involving PUFA and visual function are often incomplete, making it difficult to assess if we can have a high degree of confidence in the reported effects (or lack of effects). Despite this, valuable data relating to the effect of diet on the visual development of infants were obtained. Our evaluation of the trials to date suggests that the definitive answer to the degree to which dietary long-chain PUFA is likely to influence visual development may only be resolved with impeccably conducted RCT.

Fatty Acids, Unsaturated↗
PubMed1989

Iron deficiency anemia: adverse effects on infant psychomotor development.

In a double-blind, placebo-control prospective cohort study of 196 infants from birth to 15 months of age, assessment was made at 12 months of age of the relationship between iron status and psychomotor development, the effect of a short-term (10-day) trial of oral iron vs placebo, and the effect of long-term (3 months) oral iron therapy. Development was assessed with the mental and psychomotor indices and the infant behavior record of the Bayley Scales of Infant Development in 39 anemic, 30 control, and 127 nonanemic iron-deficient children. Anemic infants had significantly lower Mental and Psychomotor Developmental Index scores than control infants or nonanemic iron-deficient infants (one-way analysis of variance, P less than .0001). Control infants and nonanemic iron-deficient infants performed comparably. No difference was noted between the effect of oral administration of iron or placebo after 10 days or after 3 months of iron therapy. Among anemic infants a hemoglobin concentration less than 10.5 g/dL and duration of anemia of greater than 3 months were correlated with significantly lower motor and mental scores (P less than .05). Anemic infants failed specifically in language capabilities and body balance-coordination skills when compared with controls. These results, in a design in which intervening variables were closely controlled, suggest that when iron deficiency progresses to anemia, but not before, adverse influences in the performance of developmental tests appear and persist for at least 3 months despite correction of anemia with iron therapy. If these impairments prove to be long standing, prevention of iron deficiency anemia in early infancy becomes the only way to avoid them.

Anemia, Hypochromic↗
PubMed1995

Milestone development in infants exposed to methylmercury from human milk.

Breastfeeding seems to confer an advantage to the infant with regard to neurobehavioral development, possibly in part due to essential nutrients in human milk. However, human milk may be contaminated by environmental neurotoxicants, such as methylmercury. At the Faroe Islands where maternal consumption of pilot whale meat and blubber may well cause a considerable transfer of these neurotoxicants into human milk, 583 infants were followed by district health nurses during the first 12 months after birth. Three developmental milestones that are usually reached between between 5 and 12 months of age, i.e., sitting, creeping and standing, were examined. Infants who reached milestone criteria early had significantly higher mercury concentrations in the hair at 12 months of age. This association is contrary to what would be expected from possible neurotoxic effects of mercury. However, early milestone development was clearly associated with breastfeeding which was again related to increased hair-mercury levels. Milestone development was not associated with indicators of prenatal methylmercury exposure, such as the maternal hair-mercury concentration at parturition. The relationship between early milestone development and high hair-mercury levels in the infant therefore seems to be due to confounding caused by the duration of breastfeeding. No other potential confounder played any role in this regard. This study therefore suggests that, if methylmercury exposure from human milk had any adverse effect on milestone development in these infants, the effect was compensated for or overruled by advantages associated with nursing.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed2001

Continuous insulin infusion: promoting growth in low birth weight infants.

Development of improved technologies in neonatal care has yielded increasing numbers of surviving low birth weight (LBW) infants who have challenged methods of supportive care. As researchers and practitioners have focused on respiratory, cardiac, and other body system requirements, nutritional support has been low on the priority list. Support for growth and maximized neurologic development, rather than simply for survival, has been the challenge in care of small and sick newborns. Use of insulin to enhance glucose tolerance in LBW infants, and thereby maximize growth, is a management modality that can be initiated early in the infant's course and is facilitated by implementation of clear and consistent policies and procedures. Continuous insulin infusions have been demonstrated to enhance glucose uptake and utilization--facilitating neonatal growth and in turn enhancing brain growth and developmental outcome.

Drug Monitoring↗
PubMed1990

Speech and language development after infant tracheostomy.

This study describes the speech/language development of 31 children who had been fitted with an endotracheal tube. Intubation in all cases occurred prior to 13 months of age and remained in situ for more than 3 months. These children were chosen from a pool of 130 potential subjects. Individuals diagnosed as having a primary neurological disorder, developmental delays, or mental retardation were excluded from the study. Demographic, birth, and medical factors that might also affect language outcome were documented. Standardized outcome measures were used to assess speech, language, and cognitive development of the children seen for testing. For the entire group of children, the overall measures of language functioning at follow-up were within normal limits and commensurate with cognitive ability. However, when a breakdown of results based on the children's ages was done, a clear pattern of language disability was noted in the expressive language of the oldest group of children tested. These findings raise questions about this group of children who were previously thought to develop speech and language skills normally.

Child↗
PubMedDate not supplied

Relationship between rhythmic behavior and canonical babbling in infant vocal development.

The onset of canonical babbling (CB) is a landmark event in infants' vocal development for spoken language. Previous research has suggested that the onset of CB coincides with the peak period of rhythmic activities. To examine this phenomenon in detail, 28 Japanese infants (14 girls, 14 boys) were observed longitudinally from the age of 5 to 9 months. In the experimental sessions, an audible or an inaudible rattle was placed into a hand of each tested infant. Then the number of times that the infant shook the rattle was counted. In the observational sessions, infants' spontaneous rhythmic activities under natural conditions were observed. The result shows that rhythmic activities reached their peak around the onset of CB. When the infants began to babble, they shook whichever rattle was in their hand, regardless of its audibility. After this period, they shook the audible rattles more frequently than the inaudible ones. These findings suggest that, around the onset of CB, infants learn to control their motor activities based on auditory feedback.

Child, Preschool↗
PubMed2002

Effect of breastfeeding on cognitive development of infants born small for gestational age.

UNLABELLED: Breastfeeding during infancy appears to result in enhanced cognitive development during childhood, but it is not known whether breastfeeding should be encouraged for infants born small for gestational age (SGA) whose growth might otherwise benefit from nutritional supplementation. To address this issue, duration of exclusive breastfeeding and cognitive development were evaluated prospectively for 220 term children born SGA and 299 term children born appropriate for gestational age (AGA). Cognitive development was assessed using the Bayley Scale of Infant Development at 13 mo and Wechsler Preschool and Primary Scales of Intelligence at 5 y of age. Infants born SGA were given supplemental foods significantly earlier than those born AGA. Growth of infants born SGA was not related to early nutritional supplementation. The salutary effect of exclusive breastfeeding on cognitive development was greater for children born SGA than for those born AGA. Based on a linear association between duration of exclusive breastfeeding and intelligence quotient (IQ), children born SGA and exclusively breastfed for 24 wk were predicted to have an 11-point IQ advantage over those breastfed for 12 wk, as opposed to a 3-point advantage for children born AGA with similar durations of breastfeeding. The IQ distribution of children born SGA and exclusively breastfed for more than 12 wk was not different from that of all children born AGA. CONCLUSION: Duration of exclusive breastfeeding has a significant impact on cognitive development without compromising growth among children born SGA. These data suggest that mothers should breastfeed exclusively for 24 wk to enhance cognitive development.

Breast Feeding↗
PubMed1996

Neonatal neutropenia and thrombocytopenia following maternal hypertension.

OBJECTIVE: To assess the relationship between the subtypes of hypertension in pregnancy and subsequent neonatal haematology. METHODOLOGY: Retrospective review of the haematology of newborns of hypertensive mothers at a tertiary neonatal unit. RESULTS: Over a 2 year period, 249 infants had full blood examinations. Nineteen (7.6%) were neutropenic and 35 (14.1%) thrombocytopenic, including 11 (4.4%) who were both neutropenic and thrombocytopenic. Neutropenia occurred only in infants whose mothers had severe pre-eclampsia and eclampsia or pre-eclampsia with pre-existing hypertension, whereas thrombocytopenia complicated all maternal hypertension subtypes. Two (10%) of the neutropenic infants developed nosocomial infection while seven (20%) of the thrombocytopenic infants bled. Thirteen (68%) of the neutropenic infants compared with 15 (43%) of the thrombocytopenic infants developed their haematological abnormality within 24 h of birth. All but two infants developed the haematological abnormality by the 5th day of life. CONCLUSION: Although haematological abnormalities in infants born to hypertensive mothers are uncommon, serious neonatal complications can occur and therefore early haematological screening of these infants is recommended.

Eclampsia↗
PubMed2006

Indoor heated swimming pools: the vulnerability of some infants to develop spinal asymmetries years later.

Evidence reported in an earlier paper suggests that infants introduced to indoor heated swimming pools in the first year of life show an association with spinal asymmetries including progressive adolescent idiopathic scoliosis (AIS) and in normal subjects vertical spinous process asymmetry. Indoor heated swimming pools may contain a risk factor that predisposes some infants to develop such spinal asymmetries years later. What the risk factor(s) may be and its possible portal of entry into the infant's body are unknown and possibilities are examined. New teenage controls were obtained after mothers of AIS patients mentioned that they had taken their child to an infant swim class. In a further group of 18 normal teenagers introduced to an indoor heated swimming pool in the first year of life, 15 had vertical spinous process asymmetry. This prevalence of 83% of those at risk confirms our previous observation of vertical spinous process asymmetry in 61% of teenagers who were introduced to indoor heated swimming pools in the first year of life. Subject to confirmation of our observations consideration should be given to chemical risk factors, possible portals of entry, toxicology, environmental epigenomics and disease susceptibility to altered spinal development. If the risk factor is confirmed there may ultimately be a place for the prevention of AIS in some subjects.

Adult↗
PubMed1996

Specific cognitive abilities in 2-year-old children with subependymal and mild intraventricular hemorrhage.

Subependymal and mild intraventricular hemorrhages (S/IVH) are likely to affect the subcortical and frontal cortex regions of the brain in premature infants. Damage to the subcortical and frontal areas has been associated with poorer performance in certain abilities, including visual attention, memory for location, and ability to change response set. This study investigated whether S/IVH, occurring at birth, affect these abilities in young children. Two-year-old premature children with S/ IVH, premature children with normal neonatal head ultrasound scans, and full term children with normal births were evaluated on a series of tasks. These tasks were a habituation/novelty preference task (visual attention), Piaget's invisible displacement task (memory for location), an object discrimination reversal task (ability to change response set), and the Bayley Scales of Infant Development (traditional infant test). Premature children with hemorrhage performed significantly less well on the task of ability to remember the last location of a hidden object and on the task of ability to reverse response set. Both groups of premature children performed.

Cerebral Hemorrhage↗
PubMed1983

Growth achievement in low-birth-weight premature infants: relationship to neurobehavioral outcome at one year.

Previously published studies present conflicting conclusions about the growth of small, premature infants. To provide further data on these infants, a well-defined group of 86 premature infants appropriate for gestational age, weighing less than 1501 gm at birth, was observed until 12 months after their expected dates of delivery. Length, weight, and head circumference were measured at one, three, six, nine, and 12 months postterm. At 12 months postterm, infants were evaluated by neurologic examination and the Bayley Scales of Infant Development. Premature infants with mean Bayley scores greater than or equal to 85 were found to be significantly larger than infants with mean Bayley scores less than 85 by three months postterm. Birthweight, gestational age, duration of hospitalization in the neonatal intensive care unit, pneumonia, hypoglycemia, perinatal neurologic impairment, acidosis, and hypoxemia were found to be associated with reduced growth at one year. Conflicting results in previous studies may be a result of failure to separate infants with good neurobehavioral outcome from those with poor outcome.

Body Height↗
PubMedDate not supplied

Current parent education on infant feeding in the neonatal intensive care unit: the role of the occupational therapist.

OBJECTIVES: The purpose of this study was to describe current trends in parent education on infant feeding in the neonatal intensive care unit (NICU) and to clarify the role of the occupational therapist in educating parents. METHOD: Questionnaires were mailed to 190 neonatologists across the United States who were asked to forward it to a NICU occupational therapist. The questionnaire gathered descriptive information about the structure of parent education in the NICU, the role of the occupational therapist in providing parent education, and demographics about respondents and their NICUs. The response rate was 53% (n = 100). RESULTS: All 100 hospitals responding provided parent education in some form, and most included a variety of topics and teaching methods. Occupational therapists were on the NICU team at 74 of the hospitals and were identified third most frequently as a provider of parent education. The occupational therapists were most frequently identified as responsible for teaching about positioning, infant development, and infant states and cues and were highly involved in educating parents about feeding. CONCLUSION: Current parent education programs in NICUs are comprehensive in scope. Occupational therapists' role in educating parents about infant care and feeding consists of a focus on certain topics where occupational therapists have specialized skills and education. Occupational therapists are recognized by their NICU colleagues as providers of parent education, but this study suggests that the occupational therapists' role may not be clearly understood by other NICU professionals.

Adult↗