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Neonatal respiratory instability and infant development.

This study examines the relationships between neonatal sleep respiratory instability and infant development. A group of 122 full-term healthy infants was observed during a nap within the first and fourth weeks of life. During each nap, a continuous polygraphic recording was obtained of respiratory activity and extraocular movements. The relative frequency and average duration of apneic pauses (greater than or equal to 2 sec) in each testing session for an infant were employed to calculate a measure of respiratory instability (PSA4) previously found to be related to the occurrence of prolonged sleep apnea. 28 of the infants in this study were maintained at home on apnea monitors. The Bayley Scales of Infant Development were administered to each infant at approximately 9 months of age. Comparisons of infants with high versus low PSA4 values and of monitored versus unmonitored infants were not strongly distorted by imbalances in birth weight, sex, race, birth order, method of feeding, Sudden Infant Death Syndrome (SIDS) sibship, parental education, age at developmental assessment, and developmental tester. Those with increased respiratory instability (PSA4 greater than or equal to -0.04) within the first week of life averaged significantly lower in mental and psychomotor development. Utilization of home apnea monitors was not significantly associated with developmental scores.

Child Development

Fetal malnutrition: an experimental study of its consequences on infant development in two caregiving environments.

Infants from low socioeconomic status families were randomly assigned to an instructional day-care program designed to prevent socioculturally caused mental retardation or to a nonintervention control group. This assignment procedure resulted in an equal distribution of full-term, full-birth-weight, fetally malnourished babies in 2 environments varying in intellectually supportive characteristics. The condition of fetal malnourishment was defined by infants having low ponderal indices (PI). At 3 months of age low-PI infants showed lower Bayley Mental Development Index (MDI) scores than normal-PI infants, independent of the environment. In the control group low-PI infants still had lower MDI scores than normal-PI infants at 18 months of age. However, at that time in the day-care group, low-PI infants scored as well as normal-PI infants. These findings were replicated when the infants were 24 months of age with Stanford-Binet intelligence tests. Observations of mothers' involvement with their infants showed that, although all groups had similar amounts of maternal involvement when the babies were 6 months of age, the mothers of low-PI infants in the control group showed less involvement with their infants at 18 months of age than the other mothers. We suggest that this longitudinal study provides experimental evidence for a transactional model of development which emphasizes both newborn infant characteristics and environmental quality as cocontributors to the process of development.

Child Day Care Centers

Effects of thyroxine on infant development of undernourished rats.

The rehabilitative effects of exogenous thyroxine on infant development of undernourished animals were examined. Thyroxine injection accelerated the rate of body growth, age at eye opening, tooth eruption, and several emitted behaviors in undernourished infant animals. The data indirectly support previous findings that undernutrition induces hypothyroidism and that exogenous thyroxine might be an effective rehabilitative agent.

Age Factors

The infant development distress (IDD) syndrome: a predictor of impaired development?

A group of eight infants with a disorder termed the IDD syndrome and another group of eight matched healthy infants taken into study at the same time have been followed-up for 6.75 years. The follow-up technique and some findings are described. Three IDD syndrome children are still severely disturbed. Three others show recovery from severe developmental disturbance. But one child who was grossly abused after being taken into the study has been well since the third follow-up. The comparison children have not experienced comparable problems. A qualified affirmative to the question of predictive power is given and discussed.

Child

Effect of maternal education and ethnic background on infant development.

We examined the influence of maternal education and ethnic background on the four main areas of development (as measured by the Brunet-Lezine adaptation of Gesell's developmental schedule) of their infants. 173 babies were examined at the ages 0f 3, 6, 9, and 12 months in the Kiryat Yovel area of Jerusalem, an area where Jew from North Africa, Asia, Europe, and Israel are represented at different educational levels but all share the saem maternal and child care services. The mean development quotients (dqs) of the infants of highly educated mothers were higher in all four areas of development that those of infants whose motherw were of low education. Further, North African infants of middle educated mothers had higher DQs than those of middle education European mothers, especially in motor and adaptive areas. It was concluded from this study that higher education of mothers will be expressed in higher DQs of their babies. This was true in all ethnic groups. However, where educational groups were comparable, North African babies have shown better development than all other groups, while European babies were the least developed.

Adaptation, Psychological

Medical correlates of infant development.

Attempts to correlate developmental outcome with medical complications affecting the fetus and infant have focused on the prenatal, intrapartum, and postnatal periods. The time beyond the newborn stage has not been explored in detail. The aim of this study was to relate events occurring during the gestational and neonatal periods as well as the infancy periods to later performance by the use of four medical scales. A total of 126 preterm infants were followed up prospectively from birth to 2 years of age. Medical complications occurring during the prenatal, intrapartum, and postnatal periods as well as the first nine months of life were recovered. No relationship was found between obstetric and neonatal events and developmental outcome. Significant correlations were seen between medical events of later infancy and development at 2 years of age.

Child Development

Infant development in father-absent families.

In a sample of 55 black infants (age 5-6 months) living in the inner city in lower socioeconomic circumstances, 27 infants were being reared by their mothers in single-parent families. Male infants who had experienced minimal interaction with their fathers were significantly lower on the Bayley Mental Developmental Index and in measures of social responsiveness, secondary circular reactions, and preferences for novel stimuli. Female infants in this sample appeared unaffected by the father's presence or absence. After weighing alternative interpretations of the findings, we conclude that the father is a significant component in the early environment and that both observational studies and conceptual development of the role of the father in infancy are needed.

Child Development

The discriminative efficiency of the Bayley Scales of Infant Development.

This study was designed to determine the discriminative efficiency of the Bayley Mental and Motor Scales for classifying infants as neurologically suspicious and neurologically normal. The two groups employed in the study were formed on the basis of the results from comprehensive neurological examinations performed at ages 1 and 7. Three discriminant function analyses were conducted, one for each scale separately and a third incorporating both scales using a stepwise procedure. Efficiency was measured in terms of number of correct and incorrect classifications, false positive and false negative errors, and validity coefficients. Comparisons among the analyses were examined by means of relative discrimination power and incremental validity. The findings suggested that the Motor Scale provides the most accurate identification of infants with suspected neurological impairments. A statistically significant likelihood discriminant function derived from both scales yielded some additional discriminative power. The law of parsimony, however, dictated the use of the single Motor Scale.

Child

Effects of maternal nutrition on fetal growth and infant development.

The results of a food supplementation study conducted in four chronically malnourished rural villages in Guatemala were analyzed to determine possible effects on the study children's early mental and physical development. One of two food supplements, atole and fresco, were given to pregnant and lactating mothers and the infants born to them up to three years of age. The level of supplement received was noted and the subsequent course of the children's development observed. Food supplementation of pregnant mothers was found to correlate with higher weights of their babies at birth. No other major maternal variables--home diet, body height and/or weight, morbidity, obstetric characteristics, or socioeconomic status--could account for this association. At 36 months of age the children who had received a large amount of food supplementation showed a far lower prevalence of growth retardation than did those who received smaller quantities. Again, this correlation could not be attributed to any other major maternal variables. In regard to mental development, food supplementation was found to correlate with better performance in psychological tests beginning at six months of age. At 36 months the correlations were significant in five different tests. The results of this analysis have wide-ranging implications for public health. Given the recognized association between low birthweight and infant mortality, they point especially to the importance of maternal nutrition during pregnancy in programs aimed at reducing this serious problem.

Child, Preschool

Toxicity to bilirubin in neonates: infant development during first year in relation to maximum neonatal serum bilirubin concentration.

Neurologic and developmental performance during the first year of life was correlated with maximum neonatal serum bilirubin levels for 27,000 infants in the Collaborative Perinatal Project. The infants were grouped by race and by five birth weight/gestational age categories to control for the effect of these factors on hyperbilirubinemia and developmental outcome. Low mean eight-month motor scores and delayed one-year motor development were associated with serum bilirubin levels in the range of 10 to 14 mg/dl and above. This relationship was strongest for low-birth-weight/short-gestational-period infants. A persistent association of developmental outcome with hyperbilirubinemia was found over and above the variation of maturity within the birth weight/gestational age categories.

Bilirubin

Relationships between prenatal medical and nutritional measures, pregnancy outcome, and early infant development in an urban poverty setting. I. The role of nutritional intake.

Repeated nutritional assessments were made on 118 low-income women who registered at an urban hospital clinic prior to the twenty-eighth week of pregnancy and then on 122 comparable women who were provided with protein-mineral supplementation. Demographic and background information were obtained. Medical assessments were carried out throughout pregnancy, labor, delivery, and the postpartum period. The infants were assessed both medically and with Brazelton Neonatal Behavioral Assessment Scales. In spite of their low-income status, the subjects did not appear nutritionally deprived. Few significant relationships were obtained between maternal nutritional intake and measures of maternal or infant medical status or infant psychological status. A limited number of consistent relationships were obtained when the supplemented and nonsupplemented groups were compared. Although consistent infant medical and psychological benefits were not noted, mothers in the supplemented group developed fewer parameters of pre-eclampsia and had fewer complications during labor and delivery.

Adolescent