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PubMed1983

Phencyclidine: effects on the fetus and neonate.

As phencyclidine hydrochloride (PCP) has become one of the more frequently abused drugs in the United States, there has been increasing interest in its effect on the fetus and neonate of the pregnant abuser. Two groups of women enrolled in a comprehensive perinatal addiction program were studied: 7 women abused PCP prior to and during pregnancy, and these women were compared to a group of 27 drug-free women. No differences between the two groups were seen in maternal age, gravidity, gestational age or Apgar scores. At birth, there was no difference in birth weight, length, or head circumference between the two groups of neonates. The most characteristic features of the PCP-exposed infants were the sudden outbursts of agitation and rapid changes in level of consciousness, similar to responses described in adults intoxicated with PCP. Scores on the Brazelton Neonatal Behavioral Assessment Scale revealed a significant increase in lability of states and poor consolability in PCP-exposed infants. 3-month scores on the Bayley Scales of Infant Development revealed no significant difference between the two groups of infants.

Adult↗

PubMed1999

Predictors of development in premature infants from low-income families: African Americans and Hispanics.

OBJECTIVE: The goal of the study was to determine the factors that affect the motor and mental development of premature Latino and African American infants from low socioeconomic backgrounds. STUDY DESIGN: A prospective study of 41 low birth weight (LBW) African American infants along with 82 LBW Hispanic infants examined the factors that influence mental and motor development at 8 months of age. Multiple regression analysis was performed to correlate perinatal, environmental, and demographic variables with mental and motor development using the Bayley scales of infant development. The perinatal variables included birth weight, gestational age, and days of hospitalization. The demographic and environmental variables chosen were: income, education, the home environment, social support, mother-infant interaction, and maternal confidence. RESULTS: The results indicated that, for African American infants, motor development was correlated with the mother's education and the number of days the infant spent in the hospital Mental development for African American infants was predicted by the home environment. For Hispanic infants, the home environment predicted motor scores while the mother-infant interaction was correlated with the mental scores. CONCLUSION: Factors contributing to the development of premature infants vary according to ethnicity, and social variables may be more predictive of development than medical factors.

Black or African American↗

PubMedDate not supplied

Toxocara canis infection in preschool age children: risk factors and the cognitive development of preschool children.

Risk factors for Toxocara canis (T. canis) infection were evaluated in a prospective study of disadvantaged preschool children. In addition, the hypothesis that T. canis exposure is associated with lower intelligence was tested. Seropositivity was tested at 2 years, 3 years, and at 4 years 10 months (4-10). Intelligence was measured at age 4-10 by the Full Scale IQ of the Wechsler Preschool and Primary Scales of Intelligence (WPPSI). Pica and ownership of a dog were unrelated to seropositivity. Seropositive children had lower scores on the Mental Development Index (MDI) of the Bayley Scales of Infant Development at age 1 year (prior to likely exposure). They also had less favorable scores on a measure of the quality of childrearing. These findings suggest that, for disadvantaged children, lower initial intelligence and less advantageous child rearing are risk factors for T. canis exposure. Seropositive children also had higher blood lead levels, probably as a result of the common pathway of hand to mouth transmittal. Seropositivity at 3 years, at age 4-10, or, cumulatively, at any of the age 2, 3, or 4-10 assessments was associated with the WPPSI IQ after adjustment for sociodemographic factors. Exposure at age 4-10-years was significantly associated with reduced IQ scores (p = 0.030). However, when the age 1 year MDI score was controlled, the estimate became nonsignificant. We, thus, can neither confirm nor deny a relationship of T. canis and intelligence, but the importance of considering prior developmental status is emphasized.

Animals↗

PubMed1995

The effect of pain on infant behaviors.

Facial, body, and cry behaviors, heart rate, palmar sweating, and acoustic cry measures were compared across differing levels of infant pain. Eighty-eight infants were placed in a 16-cell matrix of 4 ages (0 to 3 mo., 4 to 6 mo., 7 to 9 mo., and 10 to 12 mo.) and levels of pain (LOP) (none, mild, moderate, severe) with 5 to 6 infants occupying each cell. Matrix placement was determined by agreement of > 75% among five pediatric clinical nurse specialists who viewed videotapes and read information about the infant's history, diagnosis, medical and/or surgical status, medications, and nutritional/fluid status. Coded infant behaviors and acoustic cry parameters were compared using a 2-level (LOP, age) MANOVA. Behaviors that differed across LOP were influenced by infant development. Facial expressions were clinically useful LOP indicators only for 0- to 3-month-old infants. Facial and body behaviors and cry measures that differed across LOP in younger infants did not differ in older infants due to the development of intentionality. Cry orientation and consolability may be useful clinical indicators of pain with older infants.

Age Factors↗

PubMed1987

Severe intracranial hemorrhage and hydrocephalus in low-birthweight infants treated with CSF shunts.

The high-risk low-birth-weight newborn not uncommonly develops intracranial hemorrhage and intraventricular hemorrhage (ICH/IVH) from the immature state of the germinal matrix. Posthemorrhagic hydrocephalus may develop. Infants with small hemorrhages (grades I, II of Papile), with or without hydrocephalus have been shown to develop normally in 80%-90% of cases. There is limited information in the literature about the management and outcome of infants with more severe hemorrhages (grades III, IV of Papile), due to the dismal outlook as to their outcome in most centers. The current status and concerns as to the management of these infants is reviewed, and the aspects of neurosurgical and neonatal follow-up and outcome are described. A significant number of these infants have severe handicaps, which are primarily motor. However, a group of infants is noted who have normal intellectual performance despite varying degrees of motor handicaps: 18% have normal intellectual and motor development. In the current series predictors of poorest outcome are the presence of grade IV hemorrhage and/or seizures. The vast majority of the grades III and IV hemorrhages develop hydrocephalus that is a complex management issue for the neurosurgeon.

Acute Disease↗

PubMed1994

Prevention of iron deficiency and psychomotor decline in high-risk infants through use of iron-fortified infant formula: a randomized clinical trial.

OBJECTIVE: To determine the efficacy of iron-fortified infant formula in preventing developmental delays and abnormal behavior. DESIGN: Double-blind, randomized, controlled trial. SETTING: Urban hospital clinic. PARTICIPANTS: A total of 283 healthy, bottle-fed infants from very low income families. Children with prematurity, low birth weight, and major anomalies and those who had received more than 2 weeks of evaporated-milk feedings were excluded. The groups were similar for sociodemographic background variables. Fifty-eight infants (20.5%) dropped out before any outcome data were gathered; 225, 204, 186, and 154 remained at 6-, 9-, 12-, and 15-month assessments, respectively. INTERVENTION: Iron-fortified formula (12.8 mg iron per liter) versus regular formula (1.1 mg iron per liter). MAIN OUTCOME MEASURES: Iron status was measured on venous blood by determination of hemoglobin, serum iron and iron-binding capacity, serum ferritin, and free erythrocyte protoporphyrin values. The Bayley Scales of Infant Development (mental and psychomotor indexes) and two factors of the Infant Behavior Record (test affect and task orientation) were the outcomes of interest. RESULTS: All measures of iron status were significantly different between groups (p < 0.001). Psychomotor development patterns differed between groups (F3,520, 3.4; p = 0.02) with time. Mean values were similar at 6 months but differed at 9 and 12 months of age (p < 0.001), with a decline of 6.4 points in the regular-formula group. By 15 months of age the differences were no longer significant (p = 0.23). Mental development and behavior were not affected. CONCLUSIONS: Iron-fortified formula significantly reduced iron deficiency in a high-risk group of infants and prevented a decline in psychomotor development quotients. This effect may be transient, and its long-term significance needs further study.

Developmental Disabilities↗

PubMed2004

Transplacental transmission of maternal B-cell lymphoma.

We report a case of maternal malignant lymphoma transferred to the fetus during pregnancy. A 29-year-old woman developed lymphoma at 29 weeks' gestation, and her infant developed malignant lymphoma at 8 months. Immunohistochemical examinations revealed lymphoid cells of similar characteristics in the maternal, placental, and infant tissues.

Adult↗

PubMedDate not supplied

Cutaneous complications of BCG vaccination in infants with immune disorders: two cases and a review of the literature.

Two infants, one with a T-cell-signaling defect resulting in a primary immunodeficiency syndrome and the other with severe combined immunodeficiency (SCID), are described. Both infants developed cutaneous infections secondary to their bacillus Calmette-Guérin (BCG) vaccinations. Both patients were from countries where BCG is routinely administered in infancy. The infant with the T-cell-signaling defect developed a disseminated infection involving the skin, while the infant with SCID developed a localized cutaneous infection at the site of his BCG immunization. These two cases resemble other reported cases of cutaneous BCG infection following routine vaccination in immunocompromised patients. Mycobacterium bovis infection should be considered in patients with cutaneous eruptions who have received BCG vaccination, especially those who are immunocompromised.

BCG Vaccine↗

PubMed1978

The birth and early development of a captive sifaka, Propithecus verreauxi coquereli.

We report here our observations on parturition and infant development up to five months in a captive sifaka, Propithecus verreauxi coquereli. Comparisons are made with other reports of Propithecus. In describing the acquisition of developmental landmarks, a distinction is made between the first sighting of a behavior pattern and its regular occurrence in the infant's repertoire. We describe the development of locomotor abilities, grooming, feeding, play, and social interactions. In general, maturation of Propithecus is slow relative to species of the genus Lemur.

Animals↗

PubMed1998

The ontogeny of long-term memory over the first year-and-a-half of life.

This research documents the development of long-term memory in human infants from 2 months through the end of the first year-and-a-half of life. In the initial study phase, we trained 6- to 18-month-old human infants in an operant task and tested them after increasing delays until they exhibited no retention for 2 successive weeks. In the second phase, their data were combined with data previously obtained from 2- to 6-month-olds in an equivalent task. The resulting function revealed that the duration of retention increases monotonically between 2 and 18 months of age. This increase was not due to age differences in original learning. This is the first systematic analysis of the course of long-term memory across an extended period of infant development that is based on standardized parameters of training and testing. It provides a reference function against which measures of retention from infants of different ages that are obtained in different memory tasks with different parameters can be meaningfully compared.

Age Factors↗

PubMed1995

Prediction of 12-month neurodevelopmental outcome from a 6-month neurologic examination in premature infants.

This study examined whether a neurologic examination at 6 months of age is predictive of neurodevelopmental outcome at 12 months in very-low-birth-weight (VLBW) infants. A neurologic examination and the Bayley Scales of Infant Development were performed at 6 and 12 months with VLBW infants and full-term (FT) controls. VLBW infants were categorized based on early medical complications. High-risk (HR) infants had diagnoses of bronchopulmonary dysplasia, pulmonary immaturity, grade III or IV intraventricular hemorrhage, and/or periventricular leukomalacia. VLBW infants with other diagnoses were placed in the low-risk (LR) group. Total neurologic scores (NS) improved over time for all three groups but improved more for HR infants, who had more abnormal NS at both time points; NS at 6 months predicted neurologic and developmental scores at 12 months for all three groups, but the relation between 6- and 12-month outcomes was strongest for the HR infants. The neurologic examination may be helpful in assessing VLBW infants' need for referral to early childhood intervention programs.

Brain↗

PubMed1995

A randomized clinical trial of home intervention for children with failure to thrive.

OBJECTIVE: To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). DESIGN: Randomized clinical trial. PARTICIPANTS: The NOFTT sample included 130 children (mean age, 12.7 months; SD, 6.4) recruited from urban pediatric primary care clinics serving low income families. All children were younger than 25 months with weight for age below the fifth percentile. Eligibility criteria included gestational age of at least 36 weeks, birth weight appropriate for gestational age, and no significant history of perinatal complications, congenital disorders, chronic illnesses, or developmental disabilities. Children were randomized into two groups: clinic plus home intervention (HI) (n = 64) or clinic only (n = 66). There were no group differences in children's age, gender, race, or growth parameters, or on any of the family background variables. Most children were raised by single, African-American mothers who received public assistance. Eighty-nine percent of the families (116 of 130) completed the 1-year evaluation. INTERVENTIONS: All children received services in a multidisciplinary growth and nutrition clinic. A community-based agency provided the home intervention. Families in the HI group were scheduled to receive weekly home visits for 1 year by lay home visitors, supervised by a community health nurse. The intervention provided maternal support and promoted parenting, child development, use of informal and formal resources, and parent advocacy. MEASUREMENTS: Growth was measured by standard procedures and converted to z scores for weight for height and height for age to assess wasting and stunting. Cognitive and motor development were measured with the Bayley Scales of Infant Development, and language development was measured by the Receptive/Expressive Emergent Language Scale. Both scales were administered at recruitment and at the 12-month follow-up. Parent-child interaction was measured by observing mothers and children during feeding at recruitment and at the 12-month follow-up, and the quality of the home was measured by the Home Observation Measure of the Environment 18 months after recruitment. ANALYSES: Repeated-measures multivariate analyses of covariance were used to examine changes in children's growth and development and parent-child interaction. Analyses of covariance were used to examine the quality of the home. Independent variables were intervention status and age at recruitment (1.0 to 12.0 vs 12.1 to 24.9 months). Maternal education was a covariate in all analyses. When changes in developmental status and parent-child interaction were examined, weight for height and height for age at recruitment were included as covariates. RESULTS: Children's weight for age, weight for height, and height for age improved significantly during the 12-month study period, regardless of intervention status. Children in the HI group had better receptive language over time and more child-oriented home environments than children in the clinic-only group. The impact of intervention status on cognitive development varied as a function of children's ages at recruitment, with younger children showing beneficial effects of home intervention. There were no changes in motor development associated with intervention status. During the study period, children gained skills in interactive competence during feeding, and their parents became more controlling during feeding, but differences were not associated with intervention status. CONCLUSIONS: Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT: Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT:

Child Development↗

PubMed1997

Blood transfusion and chronic lung disease in preterm infants.

UNLABELLED: Frequent blood transfusions may produce changes in iron status which can give rise to oxygen-derived free-radical (ODFR) generation and oxidative injury. Preterm infants developing chronic lung disease (CLD) receive significantly more transfusions. A total of 73 very preterm infants had weekly estimations of serum iron, transferrin, transferrin saturation, ferritin, caeruloplasmin, bleomycin detectable ('free') iron (BDI), and thiobarbituric acid reacting substances (TBARS) made over the first 28 days. Thirty infants remained oxygen dependent at 36 weeks postmenstrual age and were termed as having CLD. They were significantly lighter and less mature at birth and received more than twice as many transfusions during the 1st month. They had significantly lower transferrin levels initially but similar total iron and transferrin saturations as non-CLD infants. Ferritin and caeruloplasmin levels rose to significantly higher levels over the 1st month in CLD infants, and ferritin levels were significantly related to the number of transfusions given. Infants with higher ferritin levels were more likely to show BDI, although this was not associated with increased lipid peroxidation as evidenced by higher TBARS. CONCLUSION: It is unlikely that oxidative injury from ODFRs induced by blood transfusion contributes to the risk of developing CLD in preterm infants.

Bronchopulmonary Dysplasia↗

PubMed1999

Early intervention promotes intellectual development of premature infants: a preliminary report. Early Intervention of Premature Infants Cooperative Research Group.

OBJECTIVE: To evaluate the effect of early intervention on the intellectual development of the premature infants. METHODS: Premature infants at gestational age of 28-36.9 weeks were randomly divided into two groups: intervention and conventional care groups. Normal newborn infants during the same period were included in the control group (routine care). Up to March 1996, 156 cases were over the age 1.5-2 years (corrected age), 52 in the intervention group, 51 in the conventional care group and 53 in the normal control group. Parents were taught to carry out the 0-2 year intervention program, which included motor, cognitive, speech development and social behavior. Every three months, height, weight and head circumference were measured. At the age of one and a half and two years, all infants in the three groups received infant development tests of Child Development Center of China (CDCC) scale. The examiner did not know which infant had received intervention. RESULTS: There was no significant difference in biological factors among the two premature groups and in cultural and social factors among the three groups. Intelligence tests at the age of one and a half and two years showed that the average mental development index (MDI) in the intervention group was 13.8 and 14.6 higher than those in the conventional care group and the differences were significant. The psychomotor development index (PDI) was 5.2 and 4.7 higher but the differences were not significant. The MDI and PDI in the intervention group and normal control were quite close, but at two years, the MDI and PDI in the intervention group were 5.7 and 7.3 higher than those in the normal control and the differences were significant (P < 0.05). Compared with the normal control, the MDI in conventional care group at one and a half and two years of age were 11.5 and 8.9 lower. The difference was very significant. There were four cases of mental retardation, whose mental development index (MDI) was less then 70 in the conventional care group, but none in the intervention group. CONCLUSIONS: Early intervention can promote intellectual development of the premature infants and may be beneficial to the prevention of mental retardation. Early and intensive intervention can produce better results. Bringing parent's initiative into full play through deepening their understanding of the importance of early intervention is the key to success.

Child Development↗

PubMed1981

Clinical manifestations of allergy related to breast and cows' milk feeding.

The frequency of allergic manifestations in the first year of life was studied. The prevalence of allergic signs affecting the skin and respiratory tract in infants who had been started on breast feeding was compared with the prevalence of such signs in infants started on cows' milk formulae. The relationship of allergy to family history was investigated. Eczema and rhinitis were found to be present as often in the initially breast-fed group as in the initially cows' milk-fed group. Bottle-fed infants developed asthma and bronchitis more often than their breast-fed counterparts. Infants of allergic parents exhibited more allergy than those from non-allergic families, and this difference was particularly pronounced for asthma or bronchitis. Breast feeding gave some protection against the development of respiratory tract allergies in infants of non-allergic parents. Among the infants with a positive family history of allergy, fewer with eczema or chronic rhinitis were found in the initially breast-fed group group but this did not achieve statistical significance.

Adult↗

PubMed1985

Intrauterine intracranial hemorrhage in an infant with isoimmune thrombocytopenia.

An infant with isoimmune thrombocytopenia and presumed intrauterine intracranial hemorrhage is presented. This infant developed focal seizures on day 6 of life which were controlled with phenobarbital. Presently, the infant is growing and developing normally. Previous cases have been described and are summarized in this paper. There is no known method for predicting or preventing this particular complication.

Blood Platelets↗

PubMed2002

The administration of programs for infants and toddlers.

In this article, models for providing training in infant and toddler mental health are described. The goal has been to outline programs in enough detail that they may serve as models for persons who wish to develop infant psychiatry training and services within their academic division or their clinical program. From an administrative and fiscal perspective, developing training experiences in infant mental health has many advantages. Consultation experience and clinical experience with infants and young children are training requirements of the psychiatry Residency Review Committee. There is also a workforce shortage of child and adolescent psychiatrists and clinicians who can work with children, and there is an even greater shortage of child psychiatrists and psychologists who can work with very young children. This shortage allows a division chief or program director a particular opportunity to earmark core training funding for this underserved area and to partner with affiliated institutions and programs that can help fund these training efforts. The author's program was helped immensely by a private foundation grant, but for the first 20 years it was able to be self-sufficient through a commitment to training and reimbursement for clinical services. Currently, there seems to be an awareness on the part of community and public sector programs that they not only need to pay for trainee time but also must include administrative and faculty time. Finally, experience has defined major important principles of this work with infants, toddlers, and their families. First, training and clinical service must be provided within a context of knowledge and experience in child development. Second, the principles and knowledge of infant mental health must be used. Third, an understanding of relationship-based interventions provided within the context of reflective supervision and mentorship must be provided.

Academic Medical Centers↗

PubMedDate not supplied

Factors determining development of allergy in infants.

For an infant to develop allergy (atopy), three main factors seem to be needed: genetic predisposition, allergen exposure, and contributory factors. The role of genetics seems to be mainly in transmitting a general atopic constitution and controlling the general IgE response. Together with environmental exposure, genetics possibly plays a role in determining the allergic shock organ and the specific offending allergen. Of the vast number of environmental allergens, food by far seems to be the major one in infancy, followed by indoor allergens then outdoor aeroallergens. Several intrinsic and extrinsic contributory factors can enhance the development of allergy, perpetuate its chronicity, or facilitate precipitation of symptoms. These factors can be immunologic defects, gastrointestinal diseases, infections, or nonspecific irritants such as tobacco smoke inhalation. Understanding all these factors is essential in formulating any program for allergy prevention in infants.

Age Factors↗