Critical Developmental Period Research Articles

Ten-year outcomes of congenital cataract surgery performed within the first six months of life.

To investigate the long-term outcomes of congenital cataract surgery performed within the first 6 months of life. 11 ophthalmic surgical sites in Japan. Retrospective chart review. Medical charts were retrospectively reviewed for 216 eyes of 121 patients. The age at surgery was 2.9 ± 1.7 months, with follow-up duration 13.0 ± 2.3 years. The cohort consisted of 83 cases with bilateral aphakia, 12 with bilateral pseudophakia, 20 with unilateral aphakia, and 6 with unilateral pseudophakia. Surgical intervention within the critical period of visual system development (10 weeks for bilateral and 6 weeks for unilateral cases) led to significantly better final visual acuity than surgery conducted after this time frame. The incidence of secondary glaucoma was similar between groups while the occurrence of visual axis opacification was more frequent with earlier surgery. A forward stepwise multiple regression analysis revealed that the final visual acuity was significantly associated with laterality of cataract (better outcomes in bilateral cases), phakic status (with pseudophakia outperforming aphakia), presence of systemic and ocular comorbidities, and development of secondary glaucoma. Secondary glaucoma was significantly more prevalent in aphakic eyes than pseudophakic eyes. In patients with genuine congenital cataract, surgery within the critical period of visual development results in better final visual acuity, albeit with an increased risk of visual axis opacification. The use of IOL with sophisticated surgical techniques shows promise even in congenital cataract surgery.

The Impact of Administration of Fenofibrate During Suckling on Glucose Homeostasis and Programming of Metabolic Function in Adolescent Sprague Dawley Rats

Fenofibrate, a PPAR α agonist used in the treatment of hyperlipidaemia is known to prevent diabetes and its complications. It is cautiously used during pregnancy and in neonates due to its potential for teratogenesis. The suckling period is a critical window for developmental programming. Drugs with antimetabolic syndrome activities have been used during critical developmental periods to program for protection against metabolic syndrome or its components. We evaluated the long-term metabolic effects of fenofibrate when administered during suckling and whether it would prevent the poor metabolic outcomes associated with high fructose intake in adolescent rats. A total of 119, 6-day-old (male and female) Sprague Dawley pups were randomly allocated to four groups and either orally gavaged with 10ml.kg-1 DMSO (0.5%), 100mg.kg-1 fenofibrate, 20% (w/v) fructose or both fructose and fenofibrate till 21 days after birth (PND) 21. Following weaning onto standard commercial rat cubes, the groups were split up further into two based on their drinking fluid: either fructose (20%, w/v) or tap water till PND 63 when they were subjected to an overnight fast before being terminated. Blood was taken for hormone analysis. The kidneys, pancreas, liver and visceral fat pad were weighed. Hepatic tissue was stored at -20ºC until quantification of hepatic fat content. Although the rats gained weight significantly (p<0.0001) throughout the study period, there were no significant differences in terminal body weights across the groups (p>0.05). The interventions did not significantly (p>0.05) alter concentrations of blood glucose, adiponectin and insulin. In both sexes, the HOMA-IR, liver lipids and visceral masses were similar in the different treatment groups. Fenofibrate administered to suckling rats did not adversely impact health of the study rats. It may therefore be safe for use in neonates.

Self-Regulation and Academic Learning in Preschoolers with Autism Spectrum Disorder: Links to School Engagement and Levels of Autism Characteristics.

Children with autism spectrum disorder often demonstrate self-regulation challenges and academic difficulties. Although self-regulation has been well documented as an important factor for academic achievement in neurotypical children, little is known about how it is related to academic learning in autistic children, especially during preschool, a critical developmental period for both emergent academic skills and self-regulatory abilities. It is also unclear whether school engagement or autism characteristics influence the relation between self-regulation and academic learning in autistic children during preschool. Thirty-two autistic preschoolers participated in this study. Direct measures and parent reports were used to measure three dimensions of self-regulation, including executive function, effortful control, and emotion regulation. Classroom-based data from multiple academic programs were used to reflect their average rates of achieving new literacy and mathematics learning goals. Teachers reported the participants' levels of school engagement, and their autism characteristics were measured directly. Emotion regulation was significantly linked to the rate of meeting literacy learning goals in autistic preschoolers, whereas multiple executive function skills, including inhibitory and attentional control and working memory, were associated with their mathematics learning rate. Emotion regulation demonstrated a stronger association with literacy learning when autistic children were more engaged in classroom activities. Levels of autism characteristics did not mediate or moderate the association between self-regulation and academic learning. Future interventions and teaching should consider fostering self-regulation and facilitating school engagement for autistic preschoolers besides targeting their learning performance on specific academic content to promote their current and future academic success.

The role of temperature on the development of circadian rhythms in honey bee workers.

Circadian rhythms in honey bees are involved in various processes that impact colony survival. For example, young nurses take care of the brood constantly throughout the day and lack circadian rhythms. At the same time, foragers use the circadian clock to remember and predict food availability in subsequent days. Previous studies exploring the ontogeny of circadian rhythms of workers showed that the onset of rhythms is faster in the colony environment (~2 days) than if workers were immediately isolated after eclosion (7-9 days). However, which specific environmental factors influenced the early development of worker circadian rhythms remained unknown. We hypothesized that brood nest temperature plays a key role in the development of circadian rhythmicity in young workers. Our results show that young workers kept at brood nest-like temperatures (33-35 °C) in the laboratory develop circadian rhythms faster and in greater proportion than bees kept at lower temperatures (24-26 °C). In addition, we examined if the effect of colony temperature during the first 48 h after emergence is sufficient to increase the rate and proportion of development of circadian rhythmicity. We observed that twice as many individuals exposed to 35 °C during the first 48 h developed circadian rhythms compared to individuals kept at 25 °C, suggesting a critical developmental period where brood nest temperatures are important for the development of the circadian system. Together, our findings show that temperature, which is socially regulated inside the hive, is a key factor that influences the ontogeny of circadian rhythmicity of workers.

Critical developmental periods of vulnerability in dystonia

Dystonia is a heterogenous movement disorder characterised by involuntary muscle contractions, leading to abnormal postures and movements. Despite being the third most common movement disorder, the pathophysiological mechanisms causing dystonia are incompletely understood. Isolated dystonia is often caused by pathogenic mutations in single genes. An emerging body of evidence suggests that at least some forms of isolated dystonia have a strong developmental component, with pathogenic effects acting within discrete periods of increased vulnerability during neurodevelopment. The extent to which this is a common feature of genetically distinct forms of dystonia, and which developmental mechanisms might be disrupted during these periods, remains unclear. During critical periods of development, neuronal activity is instructive in the maturation of neuronal circuits, and inappropriate levels of activity during this period can lead to permanent defects. This review, with an intentional focus on our work, outlines evidence implicating disruptions to neuronal activity during critical developmental periods as a potential mechanism underlying inherited motor disorders in general, and dystonia in particular.

Fitness Costs of Early Life Adversity in Primates

As arguably the most critical period of mammalian development, early life can be defined as the period from conception to reproductive maturity (Tung et al., 2016). The importance of adequate nutrition and proper maternal care for maximizing the survival and development of offspring has been demonstrated through research findings in various species (Lu et al., 2018). However, these ideal growth conditions are difficult to achieve for wild offspring, who often have to overcome various energetically or socially challenging conditions that limit their development in early life. This paper will focus on the effect that environmental and social adversities have on the fitness of wild and captive non-human primates as measured by lifespan and reproductive success. Current research suggests that early life adversity in non-human primates reduces individual fitness by decreasing lifespan, fertility, and offspring survival. This paper will explore and discuss the various factors that contribute to this fitness reduction. These factors include but are not limited to: increased risk of physical illness and behavioral disorders, social isolation, maternal death, intergenerational effects, reduced female fertility, maternal stress, delayed sexual maturation, and lower adult body size.

Microstate Analysis of Continuous Infant EEG: Tutorial and Reliability

Microstate analysis of resting-state EEG is a unique data-driven method for identifying patterns of scalp potential topographies, or microstates, that reflect stable but transient periods of synchronized neural activity evolving dynamically over time. During infancy – a critical period of rapid brain development and plasticity – microstate analysis offers a unique opportunity for characterizing the spatial and temporal dynamics of brain activity. However, whether measurements derived from this approach (e.g., temporal properties, transition probabilities, neural sources) show strong psychometric properties (i.e., reliability) during infancy is unknown and key information for advancing our understanding of how microstates are shaped by early life experiences and whether they relate to individual differences in infant abilities. A lack of methodological resources for performing microstate analysis of infant EEG has further hindered adoption of this cutting-edge approach by infant researchers. As a result, in the current study, we systematically addressed these knowledge gaps and report that most microstate-based measurements of brain organization and functioning except for transition probabilities were stable with four minutes of video-watching resting-state data and highly internally consistent with just one minute. In addition to these results, we provide a step-by-step tutorial, accompanying website, and open-access data for performing microstate analysis using a free, user-friendly software called Cartool. Taken together, the current study supports the reliability and feasibility of using EEG microstate analysis to study infant brain development and increases the accessibility of this approach for the field of developmental neuroscience.

UNDERSTANDING THE DEVELOPMENT OF THINKING IN CHILDREN OF PRIMARY SCHOOL AGE

The development of thinking in children of primary school age is a complex and fascinating process that has intrigued psychologists and educators for decades. This article aims to provide an overview of the key theoretical perspectives and empirical findings regarding cognitive development during the primary school years. By examining the interplay between biological, cognitive, social, and environmental factors, this article sheds light on how children's thinking abilities evolve and mature during this critical period of development.

Maternal hsa-miR-423-5p associated with the cognitive development of babies in pregnant women without mental disorders.

MicroRNAs (miRNAs) are small non-coding RNAs capable of regulating gene expression post-transcriptionally. MiRNAs are recognized as key regulators of diverse biological and developmental processes. During the pregnancy-puerperal cycle, numerous changes occur in the female body for the formation, growth, and development of the baby. After birth, there is a critical period in child development, as rapid gains in the physical, cognitive, and socio-emotional domains constitute the "building blocks" of children's later growth. The aim of this study was to investigate the association between maternal expression of hsa-miR-423-5p during the first and second trimesters of pregnancy and neurocognitive development at 90 days of life in infants. Methods: This is a longitudinal study included in a population-based cohort study, carried out in a city in southern Brazil. The Bayley III was used to assess the babies' cognitive development. Blood samples from mothers were obtained for RNA extraction from serum and analysis of miRNA expression by qRT-PCR. In total, 87 dyads (mother-baby) were included. The average gestational age was 15.86 weeks (SD ± 5.55). An association of maternal miRNA with infant cognitive development was found; as maternal miR-423-5p increases, infants' cognitive development increases by 2.40 (95% CI 0.37; 4.43, p = 0.021) points at 3 months of age. In this context, it is suggested to use this miRNA as a biomarker of child neurocognitive development detectable in the prenatal period, thus allowing the planning of early interventions.

Effect of music-based interventions on physiologic stability of hospitalized preterm infants. A pilot study.

Hospitalized preterm infants experience reduced meaningful auditory exposures during a critical period of brain development. Music-based interventions (MBI) may be beneficial, though it remains unclear which stimuli optimally enhance infant stabilization. We investigated the relationship between three conceptually-different MBIs and short-term responses in hospitalized preterm infants. This is a case-crossover pilot study including 21 preterm infants between 30 and 35 weeks postmenstrual age. Participants listened to three MBIs and 'no music'; each condition was provided three times in random order. We monitored physiologic and behavioral parameters around each exposure and analyzed results using linear mixed models. Respiratory rates decreased after each MBI compared with 'no music' (p = 0.02). The most notable decrease occurred following exposure to a low, repetitive musical pattern resembling a lullaby (p = 0.01). We noted no significant changes for the remaining parameters. Specific MBI characteristics may preferentially enhance physiologic stabilization in hospitalized preterm infants.

Exposure to the psychedelic substance 25 H-NBOMe disrupts maternal care in lactating rats and subsequently impairs the social play behavior of the offspring

Given the critical role of maternal care in the neurodevelopment of offspring, this study aimed to investigate the effects of the psychedelic substance 25 H-NBOMe on maternal behavior in lactating rats and its subsequent impact on the social and neurodevelopmental behavior of the offspring. We administered two different dosages of 25 H-NBOMe (0.3 mg/kg and 1.0 mg/kg; i,p,) to lactating rats and observed changes in maternal behaviors, such as nest-building and pup retrieval, and in offspring behaviors, including social play. Behavioral assessments were complemented by physiological measurements to rule out general health or nutritional decline. 25 H-NBOMe significantly disrupted maternal behaviors, including nest-building and pup retrieval, without affecting the weight of dams or offspring. Offspring of exposed dams exhibited reduced social play behavior. Higher doses led to more pronounced disruptions, while lower doses, despite not visibly affecting maternal behavior, still impacted offspring behavior, suggesting potential direct effects of 25 H-NBOMe. The study highlights the potential risks associated with the use of 25 H-NBOMe during lactation, emphasizing its detrimental impact on maternal care and offspring development. These findings contribute to understanding the neurobiological effects of psychedelic substances during critical developmental periods and underscore the importance of avoiding their use.

Effects of Task Interference on Kinematics and Dual-Task Cost of Running in Early Childhood.

Children aged 3-8 are in a critical period for motor development and postural control. Running is a basic motor skill that children need to master in early childhood. While running, children are prone to dangerous events such as falls. This study investigates the kinematic characteristics of running by children associated with different interference tasks, i.e., normalized running, cognitive dual-tasks, and obstacle crossing tasks, and provides a theoretical foundation for the interference mechanism of children's dynamic postural control and for screening of motor disorders. Two hundred children aged 3-8 were recruited. The BTS Bioengineering infrared motion capture system was used to collect spatiotemporal and kinematic running data under three tasks. Repeated measures of variance analysis were used to compare the effects of different interference tasks and ages on children's running signs. The main and interaction effect tests were compared by the Bonferroni method. The results and conclusions are as follows: (1) Running characteristics of early childhood are influenced by interference tasks and age. With interference tasks, the overall characteristics of running by children aged 3-8 showed an increasing trend in running cycle time and a decreasing trend in stride length, step length, cadence, and speed. (2) Both cognitive and obstacle crossing tasks had costs, and cognitive task costs were greater than obstacle crossing costs. Children adopted a "task first" running strategy with different interference tasks. When facing cognitive tasks, their overall joint motion decreased, and they reduced joint motions to promote task completion. When facing obstacle crossing tasks, because of the characteristics of the task itself, children increased joint motions to cope with interference. (3) In terms of age, the running characteristics showed a nonlinear development trend in various indicators, with a degree of recurrence and high variability in adjacent age groups. (4) The dual-task interference paradigm of "postural-cognition" can be used as a motor intervention tool to promote the development of basic motor skills in early childhood.

Morphological features of the poultry thymus

This article reviews the literature on the morphological features of the poultry thymus. Since the preservation of livestock and disease prevention is a constant problem, the issue of poultry care will always remain in the forefront. Efforts to preserve the population and increase their productivity are directly related to strengthening poultry immunity and the state of their immune system. The study of the morphology of immune system organs allows us to objectively assess the effectiveness of methods for the prevention and treatment of various diseases, as well as to identify critical periods of development of the immune system and the body as a whole. When assessing the immune status of poultry, much attention is paid to the state of lymphoid organs, including the thymus. Currently, aspects related to the dynamics of development of immunocompetent organs during the postnatal period of ontogenesis and the time frame of their involution remain unresolved. Understanding the morphological features of the thymus and its changes is a key element in assessing the function of the immune system. It was found that with the growth and development of chicks, the absolute and relative weight of the thymus increases. However, at the onset of reproductive maturity, these values decrease significantly. Involution of the thymus mass occurs, the boundary between cortical and cerebral substances becomes less distinct, and the cellular composition of the thymus changes. The process of age-related involution is accompanied by a decrease in lymphoid tissue and T-lymphocytes. It is worth noting that the total number of circulating T-lymphocytes remains stable, as this population includes long-lived cells that do not require constant renewal. In this context, there is a change in the ratio of cortical and cerebral substances, the growth of connective tissue stroma and adipose tissue. It is noted that stress factors are one of the causes of early thymic involution, and the degree of development and morphological state of the thymus significantly affect the body's resistance to infections. Changes in the structure and morphometry of the chicken thymus can be an important criterion for the morphological diagnosis of immunodeficiencies in poultry.

Knowns and unknowns about the neurobiology of stuttering.

Stuttering occurs in early childhood during a dynamic phase of brain and behavioral development. The latest studies examining children at ages close to this critical developmental period have identified early brain alterations that are most likely linked to stuttering, while spontaneous recovery appears related to increased inter-area connectivity. By contrast, therapy-driven improvement in adults is associated with a functional reorganization within and beyond the speech network. The etiology of stuttering, however, remains enigmatic. This Unsolved Mystery highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering.

The effects of prolonged pacifier use on language development in infants and toddlers.

Pacifiers are a common soothing tool used by parents to calm and comfort infants and toddlers. While pacifiers can provide temporary relief, there is growing concern about the potential long-term effects of prolonged pacifier use on language and cognitive development. Previous studies have suggested that prolonged use of pacifiers may have negative consequences on language outcomes in infants and toddlers, especially during the first few years of life known to be a critical period for language development. Previous studies have shown that children who use pacifiers extensively have smaller vocabulary sizes at 1 and 2 years of age which can have subsequent effects on socioemotional. In addition, significant association between greater frequency of daytime pacifier use and worsening of cognitive outcomes was shown. Furthermore, research has shown a strong dose-response association between intense pacifier use up to 4 years of age and lower IQ at 6 years. Recently, the importance of oral motor movements and sensorimotor production for speech perception in infants as young as 6 months has been highlighted, raising important questions on the effect of oral motor movement restrictions at an early age. Together, these findings raise concern about the potential long-term effects of prolonged pacifier use on language and cognitive development at a critical time in child development. However, it is still debatable within the scientific field the potential relationship between pacifier use and language development in early life most likely due to the complexity of studying child development. This mini review aims to provide valuable insights for parents, caregivers, and healthcare professionals in making informed decisions and understand regarding pacifier use for infants and toddlers.

IMPLEMENTATION OF STUNTING REDUCTION REGULATIONS AND POLICIES IN EAST LOMBOK REGENCY, INDONESIA

Objective: This research aims to develop a theoretical model for implementing stunting management policies applicable in East Lombok Regency, Indonesia, and other districts with high stunting prevalence across Indonesia through the enactment of statutory regulations. The study focuses on community engagement, cross-sector collaboration, and capacity building. Theoretical framework: Drawing upon the Network Policy Model concept and supported by the Social-Ecological Model from USAID. Methodology: Employing a qualitative approach, the research utilizes a phenomenological study of stunting incidents, complemented by focus group discussions and interviews. Field observations are integrated to validate the data. Research is conducted in 11 intervention and 10 non-intervention sub-districts. Results: The 2023 intervention exhibited a significant decrease in stunting prevalence from 17.46% (2022) to 14.22% and wasting rate from 5.93% (2022) to 5.07%. Four aspects of success emerged: mapping of stunting areas, improved regulations, community involvement, and collaborative education programs. Conclusion: Successful stunting and wasting management in 11 sub-districts in East Lombok Regency began with intervention mapping. Government collaboration with SEAMEO RECFON, UNICEF, and universities was pivotal. Regulatory improvements included strengthening marriage regulations and school regulations. Community involvement and collaborative education programs were vital, ensuring comprehensive program implementation. Recommendation: The five recommendations from this research are strengthening community involvement by encouraging active participation, improving the governance structure, enhancing capacity building by continuing and expanding training initiatives for the organization's regional representatives, and fostering cross-sector collaboration by strengthening partnerships between regional organizations, NGOs, academic institutions, and international organizations; collaborative efforts can leverage diverse expertise, resources, and networks to accelerate efforts to reduce stunting and prevent wasting; promoting nutrition education and outreach: implement comprehensive nutrition education programs targeting schools, communities, and families. Emphasize the importance of a balanced diet, breastfeeding practices, and proper nutrition during critical periods of growth and development. Research Implications: The findings inform policymakers, program managers, and stakeholders involved in stunting reduction efforts in East Lombok Regency, facilitating evidence-based decision-making and program design for more effective and sustainable interventions. Originality/Value: This research contributes to the existing literature on stunting reduction by providing empirical evidence and insights using the Network Policy Model concept and the Social-Ecological Model. The study's contextual specificity, methodological rigor, stakeholder engagement, and multiple perspectives enrich the understanding of stunting management initiatives.

The Effect of Baby Gym on Improving Baby Development in Purwakarta Regency, Indonesia

Introduction: Infancy is a critical period for physical, cognitive, and social-emotional development. Baby gym is a stimulation program designed to improve baby development through various physical, sensory, and social activities. This research aims to analyze the effectiveness of baby gym in improving baby development in Purwakarta Regency, Indonesia.
 Methods: Quasi-experimental research design with pre-test and post-test. A sample of 60 babies aged 6-12 months was divided into two groups: intervention (n=30) who participated in the baby gym program for 3 months and controls (n=30) who did not participate in the baby gym program. Infant development was measured using the Denver developmental screening test (DDST) before and after intervention.
 Results: There was a significant difference in the development of babies in the intervention group compared to the control group (p<0.05). The intervention group showed a higher increase in the DDST total score and gross motor, fine motor, language, and personal social subdomains.
 Conclusion: The baby gym program is effective in improving baby development in Purwakarta Regency, Indonesia.

Directionality explored: Black Adolescents' awareness of systemic racism and race-based experiences.

Increases in conversations about race and racial discrimination experiences during adolescence make this a critical developmental period to investigate adolescents' awareness of racism. We examined bidirectional associations between race-based experiences and awareness of systemic racism-operationalized as understanding systemic causes of racial disparities in education. Adolescents who self-identified as African American/Black were surveyed in Grade 6 (n = 317; Mage = 11.12; 48% girls) and Grade 8 (n = 247; Mage = 13.15; 56% girls). Cross-lagged panel analyses revealed that racial barrier messages, but not racial discrimination experiences, in Grade 6 positively predicted awareness of systemic racism in Grade 8. Adolescents' awareness of systemic racism in Grade 6 did not predict racial socialization or racial discrimination experiences in Grade 8.

Associations between problem technology use, life stress, and self-esteem among high school students

BackgroundAdolescence is a critical period for development, with many risk factors resulting in long-term health consequences, particularly regarding mental health. The purpose of this study was to examine the associations between problem technology use, life stress, and self-esteem in a representative sample of adolescents residing in Ontario, Canada.MethodsSelf-reported data were obtained from a cross-sectional sample of 4,748 students (57.9% females) in grades 9 to 12 (mean age: 15.9 ± 1.3 years) who participated in the 2019 Ontario Student Drug Use and Health Survey. Problem technology use was measured using the 6-item Short Problem Internet Use Test, life stress was assessed using an item from the British Columbia Adolescent Health Survey and self-esteem was assessed using a global measure from the Rosenberg Self-Esteem Scale. Ordinal logistic regression models were adjusted for age, sex, ethnoracial background, subjective socioeconomic status, body mass index z-score, tobacco cigarette smoking, alcohol consumption and cannabis use.ResultsWe found that 18.3% of participants reported symptoms of moderate-to-high problem technology use, although symptoms were more common in females than males (22% vs. 14.7%, respectively). Moderate-to-high problem technology use was associated with 2.04 (95% CI: 1.77–2.35) times higher odds of reporting high life stress and 2.08 (95% CI: 1.76–2.45) times higher odds of reporting low self-esteem compared to all other response options.ConclusionsFindings from this study show that problem technology use is strongly associated with higher life stress and lower self-esteem in adolescents. This study supports the importance of developing and implementing effective strategies that help to mitigate the adverse effects of problem technology use on adolescent mental health.

Use of Nicotine-Containing Products During Pregnancy: Effects on Fetal Development

Currently, the usage of tobacco products among adult females is prevalent, representing 10 out of 100 adult females (CDC, 2023). In addition, 4.0% of adult women have been reported as using e-cigarettes. This is mainly due to the addiction to nicotine, which releases dopamine in the brain, ultimately causing the user to want to consume more nicotine-containing products. When used during pregnancy, nicotine-containing products could be harmful to both the mother and the growing fetus. Nicotine consumption during pregnancy may impact the critical brain development period of the fetus, thus resulting in several serious birth defects. Among those who use nicotine-containing products, Nicotine Replacement Therapy (NRT) may be used to facilitate reducing addiction to nicotine. NRT can be used as an ideal therapy to help quit smoking tobacco or e-cigarettes as it replaces much of the nicotine in nicotine-containing products, thus decreasing motivation to use tobacco. Despite the reduced nicotine levels, NRT is reported to show that it may pose a threat when used during pregnancy. As a whole, a few studies have revealed the potential detrimental connection between the usage of nicotine-containing products - including tobacco, e-cigarettes, and NRT - during pregnancy and its effects on the fetus. In spite of this, there has been little research done on the subject, which may lead to further complications if the public is largely unaware. This literature review aims to investigate the effects of nicotine-containing products on the developing fetus.