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PubMed2002

Assessment of infant physiology and neuronal development using magnetic resonance imaging.

Previous work has demonstrated both that there are substantial individual differences in the rate of physiological development,and that infants with risk factors for Sudden Infant Death Syndrome (SIDS) develop more slowly, suggesting that their increased vulnerability may be due to delayed neuronal development associated with compromised development in fetal or early neonatal life. This project aims to test the hypothesis that individual differences in the rate of physiological development of infants correlate with measurable differences in the rate of brain development as assessed by magnetic resonance imaging (MRI). Sixty infants were recruited to this study in three different groups that are known to have differing rates of physiological development. MRI was performed successfully in 49 cases at 6 weeks of age without sedation. Forty-one of these cases had full follow-up (15 normal; 19 IUGR; 11 'high risk'). Postnatal physiological development was assessed by measuring age-related deep body temperature patterns during sleep. Neuronal development was assessed by subjective analysis of MRI images and objective measurements relating to myelination using T1 and diffusion weighted (23 cases) MRI images. As expected the normal group acquired the adult temperature pattern earlier, but this was not statistically significant. All MRI scan appearances were within normal limits. Ranking cases subjectively in order of maturity revealed no significant pattern. The normal group had a significantly higher myelination score than the IUGR and 'high risk' groups (P = 0.001). This trend was also shown by the diffusion weighted myelination score but did not reach statistical significance. No significant differences were seen in both the subjective and objective MRI measurements and development of nocturnal temperature patterns. The results suggest there may be differences in neurodevelopment between the different groups at 6 weeks of age but these are not linked to late development of temperature patterns. It is therefore unlikely that this related to a global delay in maturation.

Brain↗

PubMed2001

Necrotizing tracheobronchitis in patent ductus arteriosus-dependent cyanotic congenital heart disease.

We report 2 patients with necrotizing tracheobronchitis (NTB) associated with patent ductus arteriosus-dependent cyanotic congenital heart disease. The pathologic findings suggest that hypotension and decreased tracheo-bronchial perfusion were the major contributing factors in the development of NTB. Necrotizing tracheobronchitis developed in infants with pulmonary atresia and Ebstein's anomaly with pulmonary stenosis. Both infants required prostaglandin E1 infusion from early infancy, and presented with sudden onset of dyspnea and hypercapnea. In one infant, NTB developed prior to mechanical ventilation. In the other infant, NTB developed after 4 days of mechanical ventilation. Care of both infants involved minimal pressures and FiO(2), adequate humidification, and optimal temperature of inspired gases; these factors probably did not play a role in the development or worsening of NTB. Both infants had hypotension and hypoxemia. These factors could have contributed to the development of NTB because of decreased perfusion pressure and tissue hypoxia. As the area of necrosis and its severity correlated with the area of blood supply served by the specific feeding arteries, we speculate that tissue hypoperfusion was the major cause of NTB.

Bronchitis↗

PubMed1980

The effect of premature rupture of the membranes on the surface activity of amniotic fluid and on the pulmonary function of the newborn.

In 30 patients with rupture of the membranes at 29 to 37 weeks gestation amniotic fluid was collected immediately and within 72 h. The concentration of lung surfactant was estimated by surface tension measurements in the Wilhelmy-balance. In 19 cases the results of the first surface tension measurement predicted lung immaturity, in 17 of these surfactant concentration increased, the last surface tension measurement being consistent with complete pulmonary maturation. None of these infants developed RDS. However, the two newborn infants, in whom serial surface tension measurements had shown no increase of surfactant concentration developed symptoms of RDS. In 11 patients with apparently mature surfactant values immediately after membrane rupture, further amniotic fluid surface tension measurements showed an increase in the concentration of surface active material. The respiratory compliance was measured in 11 healthy neonates and in the two newborn with RDS. The results reflected those of surfactant concentration obtained in amniotic fluid. Premature rupture of the membranes would seem to constitute a stimulus for fetal lung maturation.

Amniotic Fluid↗

PubMed2001

Developmental pathways of children with and without familial risk for dyslexia during the first years of life.

Comparisons of the developmental pathways of the first 5 years of life for children with (N = 107) and without (N = 93) familial risk for dyslexia observed in the Jyväskylä Longitudinal study of Dyslexia are reviewed. The earliest differences between groups were found at the ages of a few days and at 6 months in brain event-related potential responses to speech sounds and in head-turn responses (at 6 months), conditioned to reflect categorical perception of speech stimuli. The development of vocalization and motor behavior, based on parental report of the time of reaching significant milestones, or the growth of vocabulary (using the MacArthur Communicative Development Inventories) failed to reveal differences before age 2. Similarly, no group differences were found in cognitive and language development assessed by the Bayley Scales of Infant Development and the Reynell Developmental Language Scales before age 2.5. The earliest language measure that showed lower scores among the at-risk group was maximum sentence length at age 2. Early gross motor development had higher correlation to later language skills among the at-risk group rather than the control children. The most consistent predictor of differential development between groups was the onset of talking. Children who were identified as late talkers at age 2 were still delayed at the age 3.5 in most features of language-related skills-but only if they belonged to the group at familial risk for dyslexia. Several phonological and naming measures known to correlate with reading from preschool age differentiated the groups consistently from age 3.5. Our findings imply that a marked proportion of children at familial risk for dyslexia follow atypical neurodevelopmental paths. The signs listed previously comprise a pool of candidates for early predictors and precursors of dyslexia, which await validation.

Child↗

PubMed1984

The Pennsylvania Infant and Family Development Project, II: The development of reciprocal interaction in the mother-infant dyad.

In order to assess stability and change in mother-infant interaction, 74 mother-infant dyads were observed at home under naturalistic conditions when infants were 1, 3, and 9 months. Both conceptually and empirically guided data-reduction procedures indicated that 4 summary constructs underlie 15 behavioral categories coded: reciprocal interaction, noninvolvement, distress, and basic care. Mean levels of reciprocal interaction remained unchanged over time, with individual differences being stable. Mean levels of noninvolvement increased from 1 to 3 months only, and remained stable across all time periods, while mean levels of distress and basic care declined linearly across the 9-month periods, with individual dyads displaying little stability. A final analysis assessed stability and change in the 9 component variables comprising the reciprocal interaction construct. Significant change was discerned with respect to several of these components, as well as a good deal of instability. These findings led to the conclusion that, in the face of sameness in mother-infant interaction across the first 9 months, there is also much change.

Adult↗

PubMedDate not supplied

Clinical dilemma in triplet pregnancy: when is it appropriate to intervene for a jeopardized fetus?

OBJECTIVE: To determine gestational age-specific risks of intervening to "rescue" a compromised fetus in triplet pregnancies. STUDY DESIGN: We analyzed retrospectively triplet pregnancies managed at New England Medical Center (July 1992-May 2000; n=97 pregnancies). For each week in gestation, we compared the chance of at least one of three infants developing complications of prematurity in Scenario A (delivery at that gestation to rescue the jeopardized fetus) with the chance of at least one of two infants from Scenario B (allowing the jeopardized fetus to die in utero to prolong pregnancy) developing that complication later in gestation. RESULTS: We observed a decreased risk of at least one infant developing a specific complication in Scenario B than in Scenario A for all complications studied. CONCLUSIONS: Comparison of triplet outcomes with the two surviving older newborns identifies important changes in risk between 25 and 32 weeks. These data enable physicians and parents to weigh acceptable risks with benefits.

Adult↗

PubMed1997

Effects of medical risk and socioeconomic status on the rate of change in cognitive and social development for low birth weight children.

Using Hierarchical Linear Models (HLM) analysis, this study evaluated the effects of medical risk at birth and socioeconomic status (SES) on the rate of change in cognitive and social development over the first three years of life in premature children with low birth weight (LBW). Children with LBW (n = 79) with both high (HR) (n = 37) and low (LR) (n = 42) medical risk were compared to healthy full-term (FT) (n = 49) children. Children were assessed longitudinally at 6, 12, 24, and 36 months for cognitive development with the Bayley Scales of Infant Development and the McCarthy Scales for Children's Abilities, and for social initiative and responsiveness with observational measures. The HR LBW group had slower rates of increases in cognitive scores than did the LR LBW and FT groups and showed more deceleration in cognitive development by 36 months of age. Children with LBW, regardless of medical risk, had lower social initiating scores and slower rates of increase in initiating across the first 36 months than did FT children. As predicted, the groups did not show different rates of change for measures of social responsiveness. Higher SES was predictive of better cognitive and social development for all children. The difficulties encountered by children with LR and HR LBW in developing social initiating skills are discussed in relation to the link between learning to take initiative and early executive function skills.

Child Development↗

PubMed1985

Kernicterus in term infants.

Kernicterus is a frequent occurrence in Chinese term infants. In a previous study, the mean level of serum bilirubin of 152 kernicteric infants was 35.4 mg/dl (605.3 mumol/l) and the range was 22.3-50 mg/dl. More recently, three further term infants developed kernicterus and one exhibited bilirubin level of only 23.3 mg/dl. Features of haemolysis were lacking in 56.8% of these infants. Evidence of brain damage occurred in 26.5% in a former series and in 5.5% of the more recent study of those infants who developed bilirubinaemia exceeding 20 mg/dl. Such a high risk favours the present practice of exchange transfusion for rising bilirubin beyond 20 mg/dl (342 mumol/l) in Chinese term infants.

ABO Blood-Group System↗

PubMed1994

Intracranial abnormalities and neurodevelopmental status after venovenous extracorporeal membrane oxygenation.

Computed tomography scans of the head and early neurodevelopmental assessment (Bayley Scales of Infant development) were recorded for 24 surviving infants who received venovenous extracorporeal membrane oxygenation and were compared with those of infants treated with venoarterial bypass matched by diagnosis and oxygenation index before extracorporeal membrane oxygenation. A comparable neuroradiographic and early neurodevelopmental outcome was documented for survivors of venoarterial and venovenous extracorporeal membrane oxygenation.

Brain↗

PubMed1987

Correlation of echoencephalographic findings and neurodevelopmental outcome: intracranial hemorrhage and ventriculomegaly in infants of birth weight 1,000 grams or less.

Echoencephalograms were obtained for 118 of 121 successive infants who were admitted to the Stanford intensive care nursery, weighed 1,000 g or less at birth, and survived long enough for at least one study to be performed. Eighty-eight of these infants survived and were followed up for 1 to 3 years; psychometric testing (Bayley Scales of Infant Development, Stanford-Binet Intelligence Scale, or both) was performed on 81% of these infants. Subependymal-intraventricular hemorrhages or intraparenchymal hemorrhages were associated with impaired development, but ventriculomegaly was not. The absence of echoencephalographic abnormalities did not exclude the possibility of impaired development in many infants. Periventricular leukomalacia was not observed. These data support independent scoring of subependymal-intraventricular hemorrhages, intraparenchymal hemorrhages, and ventriculomegaly, rather than use of combined scales for prognostic purposes.

Brain Damage, Chronic↗

PubMed2001

Maternal consumption of pulque, a traditional central Mexican alcoholic beverage: relationships to infant growth and development.

OBJECTIVES: To document the consumption during pregnancy of pulque, a traditional central Mexican alcoholic beverage, and its relationship to subsequent infant size, physical growth and performance on the Bayley Scales of Infant Development. DESIGN: Prospective cohort study. SETTING: Six villages in rural, central Mexico in 1984-1985. SUBJECTS: Seventy mother-infant pairs. RESULTS: Most women (72.9%) consumed pulque during pregnancy, and 28.6% consumed more than 150 g ethanol week(-1) from the beverage. Individuals who consumed pulque showed no compensating decrease in energy obtained from other foods. Pulque consumption possessed curvilinear relationships with both infant length (at 1 and 6 months) and Bayley mental performance (at 6 months). Heavy pulque intakes were associated with smaller infant size and poorer mental performance. In modest quantities, pulque consumption may have been beneficial due to its micronutrient content. CONCLUSIONS: Intakes of alcohol from pulque were common among pregnant women in these rural, central Mexican villages. Given current scientific knowledge of the adverse effects of ethanol on foetal development, public health interventions are needed to reduce heavy pulque consumption during pregnancy in some areas of rural Mexico.

Adult↗

PubMed2004

[Effect of early nutrition on growth parameters and psychomotor development of children of very low birth weight].

OBJECTIVE: The aim of the study was to evaluate influence of early nutrition on growth parameters and psychomotor development of children with very low birth weight (VLBW). DESIGN: A prospective clinical study. SETTING: Institute for Care of Mother and Child, Prague. METHODS: Thirty nine children of birth weight 1,000-1,499 were followed up to one year of their corrected age in a prospective study. The group was divided in two groups according to type of nutrition: 17 children (group A) were fed with milk of own mother - "preterm milk", 22 children (group B) were orally fed with mature milk from the Bank of mother milk - "term milk", which was fortified with BMF preparation (Nutricia, Netherlands). Both groups were comparable in basic anthropometric parameters (weight, lenght, circumference of head and thotax) and in psychosocial characteristics of their mothers. Growths parameters were monitored in weekly intervals for approximatelly eight weeks. In the period between 11th and 15th month of corrected age, the children were evaluated by a clinical psychologist on a blind basis in mental a motor development by using Bayley Scales of Infant Development (BSID-II). Statistical analysis was performed by chi-square test and t-test. RESULTS: No statistically significant differences between the two groups in evaluating the growth parameters were observed. The psychological examination demonstrated statistically significant differences in the motor development. The psychomotor developmental index (PVI) proved to be 84.4 +/- 14.6 in the group A and 94.3 +/- 12.5 in the group B (t-test = 2.28, p<0.05). There was not any statistically significent difference in metal development between the two groups. The mean mentel developmental index (MVI) was 98.2 +/- 10.2 in the A group and 101.0 +/- 13.3 in the group B. CONCLUSION: Result of the study indicate favorable effect of fortification of breast milk in VLBW newborns, especially in view of the observed favorable influence of fortfication on motor development of the children.

Breast Feeding↗

PubMed2005

Sex differences in high-risk premature infants' asymmetric movement development.

High-risk premature infants are likely to show altered patterns in the development of reflexes and postural reactions. This study used the Modified-Measure of Behavioral Laterality (M-MOBL) neonatal assessment to explore differences in reflex and postural reactions among 26 male and female high-risk, premature infants born between 23 and 26 weeks gestational age. M-MOBL scores at 33-36.5 weeks were compared to those at 36.5-40 weeks of age, shortly before hospital discharge. The M-MOBL data were analyzed using the categorical method (CATMOD) repeated measures analysis of variance (ANOVAs) to compare the development of asymmetric movement patterns in: (1) non-injured and CNS-injured high-risk, premature infants, (2) control and experimental infants who received multi-sensory stimulation, and (3) males and female infants. Consistent with previously published reports of a right-(R) bias for healthy, full-term infant's movements, we found that high-risk premature females showed R-sided biases by 35-37 weeks post-conceptional age (PCA) for head turning responses and reflexes evoked by upper-body stimulation (i.e., palmar grasp, asymmetric tonic neck reflex (ATNR), incurvation). High-risk premature males however showed no significant difference in strength and coordination between the R-side and the left (L), as measured by the M-MOBL, in most of these upper-body movements tested at 35-37 weeks PCA. Neither premature males nor females showed asymmetries in foot and leg reflexes (placing, plantar grasp, Babinski). Healthy, full-term males did not show asymmetries in these reflexes either. However, full-term females showed an R-bias. With further research, the M-MOBL may become a useful instrument for early identification of infants with atypical CNS development who later exhibit atypical laterality patterns.

Female↗

PubMed1989

Effects of high-rise living on physical and mental development of children.

Effects of high-rise living on infants' development were investigated in 1987-1988 in a high-rise residential area in Tokyo, using questionnaires on the daily behaviors of a total of 1,045 infants, completed by mothers and kindergarten teachers. Infants of high-rise living showed a delayed independence in fundamental daily customs compared with those of low-rise living. This could be ascribed to an over-attachment of mothers of high-rise living with their infants resulting from a reduced number of outings.

Activities of Daily Living↗

PubMed2001

Percutaneous balloon mitral valvuloplasty during pregnancy: long-term follow-up of infant growth and development.

We have studied the long-term growth and development of seven infants who had been exposed during the foetal stage to ionising irradiation associated with percutaneous balloon mitral valvuloplasty between 1 April 1991 and 30 November 1993. We found that infants of mothers who underwent this procedure during the second and third trimester of pregnancy had normal long-term growth and development. This finding supports the argument that percutaneous balloon mitral valvuloplasty using the Inoue balloon technique should be the procedure of choice for pregnant women who have severe mitral stenosis refractory to medical therapy.

Adult↗

PubMed1994

Haptoglobin development in newborn infants from diabetic mothers.

Haptoglobin (Hp) development during the neonatal period has been studied in 325 newborn infants from normal pregnancies and in 242 infants from diabetic mothers. In infants from diabetic mothers Hp development is delayed as compared to infants from normal pregnancies. This delay is associated with a change in the pattern of relationship between Hp development and the polymorphism of acid phosphatase (ACP1) (an enzyme which shows phosphotyrosine phosphatase (PTPase) activity). In infants from normal pregnancies who show ACP1 phenotypes with the highest activity, the appearance of Hp is accelerated as compared to other infants. In contrast, infants from diabetic pregnancies who have ACP1 phenotypes with the highest activity, show delayed Hp development.

Acid Phosphatase↗

PubMed1989

Perceptual and intellectual development in infancy.

The conventional view of development in human infancy is that objective awareness of the surrounding world is gradually constructed during the first 2 years through the infant's actions on the environment. However, recent work on the perceptual abilities of young infants indicates that even newborns perceive objective properties of their surroundings, detecting depth and displaying perceptual constancies that have hitherto been attributed only to older infants. In consequence it is necessary to revise our model of infant development. Since evidence points to objective perception from birth there is no need to postulate developmental processes that lead to its construction during development. However, as infants gain new capabilities for acting on the world, they have to develop knowledge of how these actions relate to the perceived world. It is suggested that this sort of knowledge is constructed through active experience.

Child Development↗

PubMed2000

Brief report: effects of pediatric HIV infection on mental and psychomotor development.

OBJECTIVE: To examine the effect of HIV status on infants' mental and psychomotor functioning, controlling for confounding factors such as prenatal drug exposure and birth conditions. METHODS: Twenty HIV-infected and 25 seroreverted infants (ages 3-30 months old) were administered the Bayley Scales of Infant Development (BSID) and a neurological examination at two time points, 4 to 12 months apart. The majority were from ethnic minority, socioeconomically disadvantaged families; 67% of the infants were prenatally drug-exposed. RESULTS: HIV-infected infants had significantly lower scores on the BSID at baseline (mental development) and follow-up (motor development) compared to seroreverters. When HIV and neurological deficits were considered together, HIV+ children with neurological deficits scored significantly lower than HIV+ children without neurological deficits and seroreverters, with and without neurological diagnoses. Prenatal drug exposure was not associated with performance on the BSID. CONCLUSIONS: These data suggest that CNS involvement is a critical pathway by which HIV affects infants' neurodevelopment.

Analysis of Variance↗