Correlation analysis between sleep-wake patterns and cognition development in newborns

Early postoperative systemic inflammatory response is an important determinant for adverse 2-year neurodevelopment-associated outcomes after the Norwood procedure

Background and aims Arsenic exposure during pregnancy may increase the risk for intellectual deficits in children, but limited data exists from prospective epidemiologic studies, particularly at low arsenic exposure levels. We investigated the association between prenatal urinary arsenic concentrations and childhood cognitive abilities in the Health Outcomes and Measures of the Environment (HOME) Study. Methods We used anion exchange chromatography coupled with inductively coupled plasma mass spectrometry detection to measure arsenic species content in pregnant women’s urine. The summation of inorganic arsenic (iAs), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) refers to ∑As. We longitudinally assessed children’s cognitive function (n = 260) longitudinally at 1, 2, and 3 years using Bayley Scales of Infant and Toddler Development, at 5 years using Wechsler Preschool and Primary Scale of Intelligence, and at 8 years using Wechsler Intelligence Scale for Children. Results We observed a modest decrease in mental development index and full-scale intelligence quotient at ages 3 and 5 years with each doubling of ∑As (median and IQR of 3.63 and 2.40-5.86 µg/L) with estimated score (ß) differences and 95% confidence interval (CI) of -1.8 from -4.1 to 0.5 and -2.5 from -5.1 to 0.0, respectively. This trend was stronger among children whose mothers had lower iAs methylation capacity and low urinary arsebonetaine concentrations. Conclusions Our findings suggest that exposure levels relevant to the general US population may adversely affect children’s cognitive abilities. Keywords arsenic; neurodevelopment; cognitive; Bayley Scale of Infant Development; Wechsler Preschool and Primary Scale of Intelligence; in utero exposure; Mental development index; Full scale intelligence quotient.

Background It is well known that white matter injuries observed at birth are associated with adverse neurodevelopmental outcomes later in life. Whether white matter developmental variations in healthy newborns are also associated with changes in later neurodevelopment remains to be established. Purpose To evaluate whether developmental variations of white matter microstructures identified by MRI correlate with neurodevelopmental outcomes in healthy full-term infants. Materials and Methods In this prospective study, pregnant women were recruited and their healthy full-term newborns underwent a brain MRI including diffusion tensor imaging at approximately 2 weeks of age. These infants were tested at approximately 2 years of age with the Bayley Scales of Infant Development (BSID). Voxel-wise correlation analyses of fractional anisotropy (FA), measured with diffusion tensor MRI, and neurodevelopmental test scores, measured by using BSID, were performed by using tract-based spatial statistics (TBSS), followed by region-of-interest (ROI) analyses of correlations between mean FA in selected white matter ROIs and each BSID subscale score. Results Thirty-eight full-term infants (20 boys, 18 girls) underwent MRI examination at 2 weeks of age (14.3 days ± 1.6) and BSID measurement at 2 years of age (732 days ± 6). TBSS analyses showed widespread clusters in major white matter tracts, with positive correlations (P ≤ .05, corrected for the voxel-wise multiple comparisons) between FA values and multiple BSID subscale scores. These correlations were largely independent of several demographic parameters as well as family environment. Gestational age at birth appeared to be a confounding factor as TBSS-observed correlations weakened when it was included as a covariate; however, after controlling for gestational age at birth, ROI analyses still showed positive correlations (P ≤ .05, R = 0.35 to 0.48) between mean FA in many white matter ROIs and BSID cognitive, language, and motor scores. Conclusion There were significant associations between white matter microstructure developmental variations in healthy full-term newborns and their neurodevelopmental outcomes. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Hu and McAllister in this issue.

Objective To investigate the assistant method for improving and promoting nervous movement functional recovery on neonate hypoxie ischemic encephalopathy. Methods Eighty-five patients with neonate hypoxic ischemic encephalopathy were divided into two groups: observed group (45 cases) and control group(40 cases). Observed group added early exercises intervention on basis of routine synthetic drug treatment, compared to control group which just purely synthetic drug treatment with neonatal behavior neurological assessment (NBNA), mental development index (MDI) and psychomotor development index (PDI). Results NBNA at 14 days [(38.84±1.56)scores] in observed group was significantly higher than that in control group [(36.12±2.23)scores]. PDI at 6, 12 months and MDI at 12 months in observed group were significantly higher than those in control group. Conclusion Early exercises intervention can promote nervous movement functional recovery on neonate hypoxic ischemic encephalopathy, prevent or lessen brain injury sequels, elevate life quality for patients with neonate hypoxic ischemic encephalopathy. Key words: Infant, newborn; Hypoxia-ischemia, brain

ObjectivesTo review the current available literature on neurodevelopment in Hypoplastic Left Heart Syndrome (HLHS) and discuss suggestions for early diagnosis and intervention.MethodsA search of MEDLINE found 87 results. After screening...

ObjectivesResearch increasingly indicates the importance of the nutritional programming that occurs in the first 2–3 years of life. Quality nutrition during this brief window has been shown to have large...

Background Breastfeeding is recognized as a crucial determinant of child health and development, yet its multifaceted effects remain underexplored in many contexts. This cross-sectional study investigates the association between breastfeeding practices and various health and developmental outcomes in infants and young children, focusing on exclusive breastfeeding, partial breastfeeding, and formula feeding. Done at Khyber Teaching Hospital, Pakistan, the research aims to provide comprehensive insights into the nuanced impacts of breastfeeding on child well-being. Objectives This study aims to assess the association between breastfeeding duration and practices with the incidence of infectious diseases in infants and young children. It investigates the relationship between different breastfeeding practices: exclusive breastfeeding, partial breastfeeding, and formula feeding and cognitive development outcomes in early childhood. Additionally, the study evaluates the role of breastfeeding in the development of motor skills in infants and young children. Methodology A cohort of 390 participants, aged one month to three years, participated in the study. Data collection encompassed parental interviews, clinical assessments using standardized tools such as the Bayley Scales of Infant Development, and reviews of medical records. Statistical analyses, including frequency analysis and chi-square tests, were conducted to elucidate the relationships between breastfeeding practices and health outcomes. Results Exclusive breastfeeding exhibited a significantly lower incidence of infectious diseases compared to partial breastfeeding and formula feeding. Specifically, among exclusively breastfed children, incidences of colds, pneumonia, and diarrhea were 32%, 39.7%, and 40%, respectively. These rates were notably higher in partially breastfed and formula-fed children. Cognitive development outcomes also varied significantly across feeding groups. Exclusively breastfed children demonstrated superior cognitive performance, with 34.2% rated above average, compared to only 6.5% in the formula-fed group. Additionally, the prevalence of developmental delays was lowest among exclusively breastfed children (14.1%), contrasting with 62.8% in the partial breastfeeding group and 77.0% in the formula-feeding group. Conclusions The study underscores the pivotal role of exclusive breastfeeding in promoting optimal child health and development. Exclusive breastfeeding is associated with significantly reduced incidences of infectious diseases, superior cognitive development outcomes, and a lower prevalence of developmental delays. These findings highlight the importance of supportive interventions and policies aimed at encouraging exclusive breastfeeding practices, ultimately enhancing child well-being and developmental trajectories.

Introduction: Functional echocardiography is a rapidly expanding field in both research and clinical settings. Newer techniques facilitate comprehensive and objective assessments of myocardial performance not previously possible. Although work has been done to assess feasibility and obtain reference values for several new modalities in normal term and preterm infants, data is still lacking in several important disease states. Objectives: We aim to study the impact of several important conditions on neonatal myocardial function over the transitional period. We hypothesise that myocardial function is impaired in certain conditions and that novel echocardiography techniques could improve our ability to characterise disease severity and predict important outcomes. Methods: We recruited several cohorts of infants including: control preterm and term infants; preterm infants with haemodynamically significant ductus arteriosus and chronic lung disease; infants with hypoxic ischemic encephalopathy; monochorionic diamniotic twins with twin to twin transfusion; and infants with Down syndrome with structurally normal hearts. We performed three echocardiograms on Day 1 (6-12 hours), Day 2 (36-48 hours) and Day 5 – 7. We compared our results in disease patient cohorts with a cohort of healthy preterm and term infants. Results: We have characterised myocardial performance in: preterm infants with and without disease; healthy term infants; infants with hypoxic ischemic encephalopathy; monochorionic diamniotic twins with and without twin to twin transfusion syndrome; and infants with Down syndrome with structurally normal hearts. We have demonstrated changes in haemodynamic status and cardiac function in these conditions and provided a rationale for these changes, in addition to exploring markers of outcome predication. Conclusion: Several important neonatal conditions affect myocardial performance during the transitional period. An improved understanding of cardiac function can aid in our ability to predict outcome and monitor disease. In the future, functional echocardiography may act to guide intervention and improve our management of these patients.

Objective To explore the safety and efficacy of intrathecal administration of adipose stem cells derived from bioactive secretome (ASCBS) in treatment of whiter matter injury (WMI) in the preterm infants. Methods Sixty-three cases of WMI were recruited according to the uniform standards from multiple medical centers and they were divided into 3 gestational age (GA) subgroups, which were 21 cases in group A (GA 24-28+ 6), 20 cases in group B (GA 29-32+ 6), and 22 cases in group C (GA 33-36+ 6). The patients were randomly divided into treatment groups and control groups by tossing coins.The treatment groups received lumbar puncture followed with ASCBS intra-thecal injection once daily for 3 consecutive days.Follow-up study included Neonatal Behavioral Neurological Assessment (NBNA) at term-equivalent age and neurodevelopment at corrected age of 6-month.Neurodevelopment was assessed by using the Bayley Scales of Infant Development and Peabody Developmental Motor Scale.The survival rates, NBNA scores, mental development index (MDI), psychomotor develop index (PDI), total motor development quotient, gross motor development quotient and fine motor development among each subgroup were compared. Results Sixty-three cases were recruited, including 31 in the treatment group and 32 in the control group.Only 1 case in the treatment groups lost in the follow-up.No clinical side effects were found in the treatment groups.There was no significant diffe-rence in the survival rate and complication in the preterms in all subgroups of the treatment group and control group (all P>0.05). The gross and total motor development quotient in the treatment group A was higher than that in the control group A(gross motor development quotient: 98.330±6.282 in treatment group A, 90.330±3.777 in control group A, P=0.040; total motor development quotient: 97.330±4.803 in treatment group A, 91.000±4.472 in control group A, P=0.023). The rest findings showed no significant difference between groups. Conclusion The treatment of WMI in preterm infants with ASCBS is safe and can promote the motor development of preterm infants with GA in 24 -28 weeks. Key words: Stem cells; Infant, premature; White matter injury; Lipid stem cells bioactive secretion

To compare at ages 3, 12, and 24 months the cognitive and psychomotor development of 29 infants with cleft lip and palate (CLP), 28 infants with cleft palate only (CPO), and a demographically matched comparison (COMP) group of 69 infants; to examine predictors of cognitive status at age 24 months in the cleft group. Infants were administered the Bayley Scales of Infant Development (BSID), mother-infant interactions were observed, and medical records were reviewed. CLP and CPO groups scored lower than the COMP group on the BSID, but did not differ from one another. Cleft group infants scored lower than COMP group infants on BSID items assessing nonverbal and expressive language skills. Quality of maternal interaction predicted the 2-year Mental Development Index (MDI) scores of infants with clefts. Infants with clefts show relative deficits in cognitive and psychomotor development. Cognitive deficits are apparent in nonverbal as well as verbal areas of performance.

Role of Intervention Strategies for At-risk Preterm Infants

Low Birth Weigth (LBW) is defined as a birth weight of a newborn infant less than 2.500 grams. In addition of being one of the main cause of death on neonatal, infants with LBW are at risk of morbidity and mortality, chronic disease, and stunted growth and development. Based on epidemiological study, infants with LBW have a higher risk of stunting than newborn infants with normal weight. Stunting is a problem of malnutrition that become a concern in the world, especially in developing country like Indonesia. Stunting can cause decreased intelligence, stunted growth and development, decreased body endurance, and low productivity. The long term effects of stunting are decreased cognitive development, learning ability, and productivity. There are several factors besides LBW that can cause stunting, including parental education, low family income, number of family members, and parent’s profession.

The parenting environment provided by mothers with schizophrenia is likely to contribute to the cognitive impairment observed in their offspring. To assess the relative contribution of maternal schizophrenia, obstetric factors and mothers' lifestyle to the cognitive development of infants in their first year. The Bayley Scales of Infant Development were administered to 19 infants of mothers with schizophrenia, 34 with non-psychotic depression in the mother, 29 with affective psychosis in the mother and 24 normal controls when the babies were two and seven months of age. At two months, infants of mothers with schizophrenia and of those with affective psychosis had lower mental development index (MDI) scores than controls. At seven months, infants of mothers with schizophrenia had lower MDI scores than all other groups. When infant birth weight and mothers' social class were taken into account there was no effect of maternal schizophrenia on infants' MDI scores. Infants of mothers with schizophrenia are likely to have impaired cognitive development. This may be due in part to environmental factors such as the mother's lifestyle.

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.

Objective To explore the efficacy and safety of systemic mild hypothermia in management of neonates with moderate or severe hypoxic-ischemic encephalopathy (HIE). Methods A retrospective case-control study was conducted on 75 neonates with moderate or severe HIE, who were admitted to the Neonatal Intensive Care Unit of Teaching Hospital of Fujian Medical University (Quanzhou Children's Hospital) from January 1, 2011 to May 31, 2015. The 75 neonates were divided into two groups, the conventional treatment group (33 cases, control group) and the mild hypothermia treatment group (42 cases, hypothermia group). Sequential management protocol for all subjects was followed, including amplitude-integrated electroencephalogram (aEEG) before treatment, aEEG and brain MRI at one week after birth, neonatal behavioral neurological assessment (NBNA) on the 14th day after birth, and determination of mental and psychomotor development index with Bayley Scales of Infant and Toddler Developmental at 18 months old. Adverse reactions, serious disability cases and deaths during the study were also recorded. Two sample-t test and Chi-square test were as statistical methods. Results There were six death cases in the control group, but on one died in the hypothermia group. In the survivals, The maximum voltage and minimum voltage in the hypothermia group were higher at 7-day old than that before treatment [maximum voltage: (31.3±2.4) vs (18.1±2.2) μV; minimum voltage: (13.5±2.1) vs (6.1±1.5) μV, t=8.591 and 5.314, both P 0.05). Conclusions Systemic mild hypothermia treatment is effective in reducing mortality rate and major disability rate in neonates with moderate or severe HIE and improves the neuromotor development when babies grow up to 18-month-old. Key words: Hypoxia-ischemia,brain; Hypothermia, induced; Infant,newborn