Delay In Infants Research Articles

Gross motor delays in infants and young boys with Duchenne muscular dystrophy

Background Duchenne muscular dystrophy (DMD), an X-linked progressive neurodegenerative disorder, is being added to required universal screening programs for newborns in the United States. It is estimated that this will result in around 880 patients presenting at clinics in infancy. Very little is known about the early gross motor abilities in infants and young boys with DMD. Objective Describe the early gross motor skill acquisition in boys in our clinic with DMD. Methods Between the years 2016 and 2024, 90 boys with DMD under the age of 6 years (2 months – 5 years 10 months at their first visit) were evaluated as part of their standard of care during regularly scheduled clinic visits using the using the Bayley Scales of Infant & Toddler Development, Third Edition (Bayley-III). Forty-seven boys were seen in clinic longitudinally with two to six follow up visits for a total of 129 assessments. Results Ninety four percent of the boys with DMD seen in our clinic demonstrated delays in gross motor skills across the age span when compared with normative controls. None of the boys reached a ceiling on the Bayley-III despite being older than the intended age range of the test. Conclusions Our clinic data showed an almost universal gross motor delay in infants and toddlers that did not diminish over time.

Parental childhood vaccine hesitancy and the National Vaccination Programme, in Portugal

Abstract Background Despite the invaluable contribution of vaccination to Public Health, vaccine hesitancy is increasing in the European Union. Several factors are associated with parental childhood vaccine hesitancy (PCVH). In Portugal, there are no known studies specifically addressing vaccine delay in infants. Objectives We aimed to estimate the proportion of parental childhood vaccine hesitancy (PCVH) up to 12 months of age in Portugal, and to determine vaccination (confidence and information) and National Vaccination Programme (NVP) associated factors. Methods We performed a cross-sectional study on a convenience sample, using an anonymous online questionnaire directed to parents of children up to 17 months old, living in Portugal. We performed an exploratory factor analysis, followed by logistic regression. We obtained crude (OR) and parental vaccination status’ adjusted odds ratios (aOR). Results PCVH proportion was estimated at 1.8% (95%CI: 1.0%-3.0%; n = 790). The exploratory factor analysis resulted in five dimensions: 1. vaccine confidence; 2. access to enough/reliable information about vaccines; 3. access to NVP; 4. vaccination schedule; 5. trust in healthcare professionals’ information about vaccines. Vaccine confidence (aOR=0.29, 95%CI: 0.14-0.54), vaccination schedule (aOR=0.31, 95%CI: 0.15-0.58) and trust in information about vaccines provided by health professionals (aOR=0.30, 95%CI: 0.16-0.53) were protective dimensions of PCVH. Conclusions The low proportion of PCVH observed is consistent with the high immunisation coverage in Portugal. Vaccination schedule, trust in vaccines, and in the information provided by healthcare professionals are factors associated with lower vaccine hesitancy. This highlights the importance of trust and healthcare professionals in maintaining high vaccination coverage in Portugal. Key messages • Parental childhood vaccine hesitancy (PCVH) proportion was 1.8%. Vaccine confidence, vaccination schedule and trust in information provided by health professionals were protective factors of PCVH. • Trust in vaccines and in healthcare professionals seem to play a key role in keeping a high immunisation coverage in Portugal.

The Sensitivity and Specificity of the Korean-Infant and Toddler Checklist in Screening for Developmental Language Delay in Infants and Toddlers

Objectives: This study aimed to investigate the validity of the Korean-infant and toddler checklist (K-ITC) in screening for developmental language delay through analysis of sensitivity and specificity.Methods: Participants were 39 infants with developmental language delay aged 6-24 months, and 39 typically developing infants matched for chronological age. Total scores and scores from three domains (social, speech, and symbolic) of the K-ITC were compared between the two groups using independent samples t-tests. Receiver operating characteristic (ROC) analysis was conducted to assess the sensitivity and specificity of each score, confirming the validityResults: Infants with developmental language delay scored significantly lower than typically developing infants on the social and speech domains of the K-ITC, but not on the symbolic domain. ROC analysis indicated significant area under the curve (AUC) values for total scores and scores from each domain, with sensitivity of 95% for total scores and 87.18% for domain scores, and specificity of 64.10% for total scores. Sensitivity was notably higher compared to specificityConclusion: This study confirms that the K-ITC exhibits high sensitivity as a screening tool for developmental language delay in infants, demonstrating validity in significantly identifying developmental delays in infants and toddlers.

Evaluating Vaccination Delay in Infants during COVID-19 Outbreak in Yazd

Background: One of the potential consequences of COVID-19 is the interruption of childhood vaccination. The aim of this study is to investigate the frequency of vaccination delay in children during the COVID-19 outbreak in Yazd, Iran. Methods: In this cross-sectional study in 2020, 667 children living in Yazd were enrolled through multi-stage sampling method. Date of birth, vaccination dates of 2-, 4-, and 6- months of age, gender, family size, birth order and municipal area were extracted from the Integrated System Information Block (SIB) system. Data were analyzed using SPSS software version 22. Results: among 667 infants, 322 (48.3%) were girls and 345 (51.7%) were boys. In total, 53.5% of children had delay in vaccination at 2-month of age, 54%, at 4-month, and 45% at 6-month regarding vaccination appointment. Moreover, the dangerous delay was 3% in vaccination rounds for 2-month-olds, 5.4% for 4-month-olds, and 1.7% for 6-month-olds. At all the three appointments, there was a statistically significant difference between both the family size (P-value: 0.025, 0.017 and 0.004, respectively) and birth order (P-value: 0.015, 0.007 and 0.013, respectively) regarding vaccination delay. Conclusion: Despite the high frequency of one or more than one day delay for 2-, 4-, and 6-month-old infants regarding vaccination appointments, dangerous delay in the mentioned times was relatively infrequent. Meanwhile, family size and birth order were two influential factors respecting vaccination delay in children. It is essential to raise awareness among families, particularly those with larger size and higher number of children about the importance of timely vaccination.

Effect of Early Intervention Programs on Developmental Delays in Infants and Toddlers in Malawi

Purpose: The aim of the study was to analyze the effect of early intervention programs on developmental delays in infants and toddlers in Malawi. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Early intervention programs in Malawi for developmental delays in infants and toddlers have shown significant positive outcomes. These programs, integrated into community healthcare services, focus on early identification, assessment, and tailored interventions. They improve motor skills, language development, cognitive abilities, and social-emotional skills. Parental involvement is crucial, with caregivers educated to support developmental progress at home. Unique Contribution to Theory, Practice and Policy: Ecological systems theory, social learning theory & bioecological model of development may be used to anchor future studies on effect of early intervention programs on developmental delays in infants and toddlers in Malawi. Enhance the involvement of parents and caregivers in EIPs through structured training and support. Advocate for increased funding and resource allocation to support the expansion and sustainability of EIPs. Policy recommendations should focus on securing public and private investments in early childhood development, prioritizing programs that demonstrate evidence-based effectiveness.

Disruption of myelin structure and oligodendrocyte maturation in a macaque model of congenital Zika infection

Zika virus (ZikV) infection during pregnancy can cause congenital Zika syndrome (CZS) and neurodevelopmental delay in infants, of which the pathogenesis remains poorly understood. We utilize an established female pigtail macaque maternal-to-fetal ZikV infection/exposure model to study fetal brain pathophysiology of CZS manifesting from ZikV exposure in utero. We find prenatal ZikV exposure leads to profound disruption of fetal myelin, with extensive downregulation in gene expression for key components of oligodendrocyte maturation and myelin production. Immunohistochemical analyses reveal marked decreases in myelin basic protein intensity and myelinated fiber density in ZikV-exposed animals. At the ultrastructural level, the myelin sheath in ZikV-exposed animals shows multi-focal decompaction, occurring concomitant with dysregulation of oligodendrocyte gene expression and maturation. These findings define fetal neuropathological profiles of ZikV-linked brain injury underlying CZS resulting from ZikV exposure in utero. Because myelin is critical for cortical development, ZikV-related perturbations in oligodendrocyte function may have long-term consequences on childhood neurodevelopment, even in the absence of overt microcephaly.

Hypertensive Disorders of Pregnancy and Risk of Early Brain Abnormalities on Magnetic Resonance Imaging at Term among Infants Born at ≤32 Weeks’ Gestational Age

To evaluate the proximal effects of hypertensive disorders of pregnancy (HDP) on a validated measure of brain abnormalities in infants born at ≤32 weeks' gestational age (GA) using magnetic resonance imaging (MRI) at term-equivalent age. In a multisite prospective cohort study, 395 infants born at ≤32 weeks' GA, underwent 3T MRI scan between 39 through 44 weeks' postmenstrual age. A single neuroradiologist, blinded to clinical history, evaluated the standardized Kidokoro global brain abnormality score as the primary outcome. We classified infants as HDP-exposed by maternal diagnosis of chronic hypertension, gestational hypertension, preeclampsia, or eclampsia. Linear regression analysis identified the independent effects of HDP on infant brain abnormalities, adjusting for histologic chorioamnionitis, maternal smoking, antenatal steroids, magnesium sulfate, and infant sex. Mediation analyses quantified the indirect effect of HDP mediated via impaired intrauterine growth and prematurity and remaining direct effects on brain abnormalities. 170/395 infants (43%) were HDP-exposed. Adjusted multivariable analyses revealed HDP-exposed infants had 27% (95% CI 5-53%) higher brain abnormality scores than those without HDP exposure (p=0.02), primarily driven by increased white matter injury/abnormality scores (p=0.01). Mediation analyses showed HDP-induced impaired intrauterine growth significantly (p=0.02) contributed to brain abnormality scores (22% of the total effect). Maternal hypertension independently increased the risk for early brain injury and/or maturational delays in infants born at ≤32 weeks' GA with an indirect effect of 22% resulting from impaired intrauterine growth. Enhanced prevention/treatment of maternal hypertension may mitigate the risk of infant brain abnormalities and potential neurodevelopmental impairments.

Nocturnal enuresis in early adolescence and neurodevelopmental delay in infancy: A population‐based study

AbstractAimThe neurodevelopmental delay hypothesis may explain the mechanism of nocturnal enuresis (NE), but whether the hypothesis holds in early adolescence remains unknown, considering NE frequency. Therefore, we aimed to identify whether neurodevelopmental delays in infancy were associated with the frequency of NE in early adolescence.MethodsData were extracted from the Tokyo Early Adolescence Survey, in which 4478 children (mean age: 10.2 years) and their parents participated. Twelve developmental delays (eight motor, four verbal) were extracted from the Maternal and Child Health Handbook. The NE frequency was obtained from a parent‐answered questionnaire, which divided children into three categories according to DSM‐5 criteria (none, infrequent [<1 time a week], and frequent [≥2 times a week]). Multinomial logistic regression analysis was performed to determine whether delayed developmental milestones in infancy were predictive of frequent/infrequent NE in early adolescence.ResultsDevelopmental delays, particularly those related to motor development but not verbal, such as holding their head up (odds ratio [95% confidence interval] = 2.1 [1.1–4.2]), crawling (2.1 [1.0–4.4]), walking with support (4.0 [1.9–8.4]), walking independently (5.8 [2.2–15.4]), and drawing a circle (5.0 [2.0–12.3]), were significantly associated with an increased risk of frequent NE in early adolescence (all ps < 0.05). However, an association with infrequent NE was not found.ConclusionThis population‐based epidemiological study revealed that motor developmental delays increased the risk of frequent NE in early adolescence, but not of infrequent NE. This finding reinforces the neurodevelopmental delay hypothesis, which provides a biological explanation for the involuntary nature of enuresis. All children in early adolescence with frequent NE should be evaluated and treated by a medical expert.

Early Subclinical Status Epilepticus May Contribute to Developmental Delays in Infants With Tuberous Sclerosis Complex

We present a case of a newborn with a prenatally discovered cardiac rhabdomyoma leading to early genetic diagnosis of tuberous sclerosis complex (TSC). This early diagnosis prompted a presymptomatic electroencephalography (EEG) that revealed subclinical seizures meeting the definition for status epilepticus on day 1 of life. Antiseizure medications (ASMs), including vigabatrin, were started. The EPISTOP and PREVeNT trials demonstrated that early life initiation of vigabatrin may reduce the degree of refractory epilepsy and epileptic spasms (ES) in this population (TSC). Although neonatal seizures are a known entity in TSC, continuous neonatal EEG monitoring is not standard at birth. This case supports early consideration for neonatal EEG monitoring to identify and treat neonatal seizures, reduce risk for infantile spasms, and potentially improve neurodevelopmental outcomes.

Early childhood development and its association with women's empowerment in the context of urban poverty in Ethiopia

BackgroundEmpowered women, with increased access to and control over resources, stronger social networks, greater decision-making power, and a more positive gender attitude, significantly contribute to better family well-being. While there is ample evidence regarding the association between child nutrition and women's empowerment, studies examining the association between early childhood development (ECD) and women's empowerment are scarce. AimsThe aim of this study was to estimate the prevalence of ECD delays among 12–36 months old and investigate its association with women's empowerment among the urban poor in Ethiopia. MethodsThe study included a sample of 432 women who were unemployed or had irregular employment during the data collection period, along with their children in urban Ethiopia. The ECD was assessed using the Age and Stage Questionnaire (ASQ-3), a tool designed to accurately identify developmental delays in infants and young children and categorized as on track, needs monitoring, and possible delays. Women's empowerment was measured using a multidimensional index that captured access to and control over resources, decision-making power, and social capital, and then categorized into lowest, medium, and highest empowerment levels. The association between ECD domains and women's empowerment was analyzed using ordinal logistic regression, after adjusting for confounders. ResultsThe study found a high prevalence of delays in ECD domains, with fine motor domain accounting for the largest delay (40.6 %). Children of less empowered mothers are more likely to have the highest development delays in communication (OR=2.22; 95 % CI: 1.36; 3.62), gross motor (OR=1.69; 95 % CI: 1.04; 2.76), problem solving (OR=1.85; 95 % CI: 1.15; 2.98), and personal-social (OR=2.59; 95 % CI: 1.62; 4.15) skills compared to children of more empowered mothers. ConclusionsThe study highlights the significance of women's empowerment in promoting ECD, especially in developing countries where ECD programs are fragmented and lacks coordination. Therefore, targeted interventions that improve women's empowerment could lead to improved ECD outcomes.

Prenatal tobacco smoke exposure and risk for cognitive delays in infants born very premature

Prenatal tobacco smoke exposure (TSE) and prematurity are independent risk factors for abnormal neurodevelopment. The objectives were to compare differences in Bayley-III cognitive, language, and motor scores at 2 years corrected age (CA) in 395 infants born very preterm (≤ 32 weeks gestation) with and without prenatal TSE. We performed multivariable linear regression analyses to examine associations between prenatal TSE and neurodevelopmental outcomes and a mediation analysis to estimate direct effects of prenatal TSE on outcomes and indirect effects through preterm birth. In total, 50 (12.6%) infants had prenatal TSE. Infants with prenatal TSE had lower mean [95% CI] Cognitive score (82.8 [78.6, 87.1]) vs. nonexposed infants (91.7 [90.1, 93.4]). In children with and without prenatal TSE, there were significant differences in mean [95% CI] Language scores (81.7 [76.0, 87.4] vs. 92.4 [90.2, 94.6], respectively) and mean [95% CI] Motor scores (86.5 [82.2, 90.7] vs. 93.4 [91.8, 95.0], respectively); scores remained significant after controlling for confounders. Preterm birth indirectly mediated 9.0% of the total effect of prenatal TSE on Cognitive score (P = NS). However, 91% of the remaining total effect was significant and attributable to TSE’s direct harmful effects on cognitive development (β = − 5.17 [95% CI − 9.97, − 0.38]). The significant association is largely due to TSE’s direct effect on cognitive development and not primarily due to TSE’s indirect effect on preterm birth.

Mesenchymal stromal/stem cells and bronchopulmonary dysplasia.

Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants, leading to chronic respiratory disease. There has been an improvement in perinatal care, but many infants still suffer from impaired branching morphogenesis, alveolarization, and pulmonary capillary formation, causing lung function impairments and BPD. There is an increased risk of respiratory infections, pulmonary hypertension, and neurodevelopmental delays in infants with BPD, all of which can lead to long-term morbidity and mortality. Unfortunately, treatment options for Bronchopulmonary dysplasia are limited. A growing body of evidence indicates that mesenchymal stromal/stem cells (MSCs) can treat various lung diseases in regenerative medicine. MSCs are multipotent cells that can differentiate into multiple cell types, including lung cells, and possess immunomodulatory, anti-inflammatory, antioxidative stress, and regenerative properties. MSCs are regulated by mitochondrial function, as well as oxidant stress responses. Maintaining mitochondrial homeostasis will likely be key for MSCs to stimulate proper lung development and regeneration in Bronchopulmonary dysplasia. In recent years, MSCs have demonstrated promising results in treating and preventing bronchopulmonary dysplasia. Studies have shown that MSC therapy can reduce inflammation, mitochondrial impairment, lung injury, and fibrosis. In light of this, MSCs have emerged as a potential therapeutic option for treating Bronchopulmonary dysplasia. The article explores the role of MSCs in lung development and disease, summarizes MSC therapy's effectiveness in treating Bronchopulmonary dysplasia, and delves into the mechanisms behind this treatment.

Prenatal exposure to per- and polyfluoroalkyl substances and DNA methylation in the placenta: A prospective cohort study

Epidemiological studies regarding the relationship between per- and polyfluoroalkyl substances (PFAS) and DNA methylation were limited. We investigated the associations of maternal PFAS concentrations with placental DNA methylation and examined the mediating role of methylation changes between PFAS and infant development. We measured the concentrations of 11 PFAS in maternal plasma during early pregnancy and infant development at six months of age. We analyzed genome-wide DNA methylation in 16 placental samples using reduced representation bisulfite sequencing. Additionally, we measured DNA methylation levels using bisulfite amplicon sequencing in 345 mother-infant pairs for five candidate genes, including carbohydrate sulfotransferase 7 (CHST7), fibroblast growth factor 13 (FGF13), insulin receptor substrate 4 (IRS4), paired like homeobox 2Ap (PHOX2A), and plexin domain containing 1 (PLXDC1). We found that placental DNA methylation profiles related to PFOA mainly enriched in angiogenesis and neuronal signaling pathways. PFOA was associated with hypomethylation of IRS4 and PLXDC1, and PFNA was associated with PLXDC1 hypomethylation. There were positive associations of CHST7 methylation with PFTrDA and IRS4 methylation with PFDoA and PFTrDA. PLXDC1 hypomethylation mediated the association between PFOA and suspected developmental delay in infants. Future studies with larger sample sizes are warranted to confirm these findings.

Ophthalmic symptoms, clinical signs and diagnostic delay in infants diagnosed with brain tumours in Denmark between 2007 and 2017.

To investigate ophthalmic onset manifestations and the impact of diagnostic delay on the prognosis in infants (<1 year) diagnosed with a brain tumour. A retrospective population-based nationwide study of infants diagnosed with a brain tumour between 2007 and 2017 in Denmark. Data was retrieved from the Danish Childhood Cancer Registry, the National Danish Health registries, and medical files. Primary outcome measures included symptoms, clinical findings, time to diagnosis and survival. Thirty-seven infants were diagnosed with a brain tumour in Denmark between 2007 and 2017. In total, 19/37 infants (51%, 95% CI: 34-68) had ophthalmic manifestations at any time prior to or at diagnosis; and in 6/37 (16%, 95% CI: 6-32) ophthalmic manifestations were the initial symptom. The most common ophthalmic manifestations were strabismus (n = 7), sunset eyes (n = 6), nystagmus (n = 4), reduced pupillary light reflex (n = 4), and/or decreased vision (n = 4). The median number of symptoms per infant at the time of diagnosis was three (range 0-9). The median diagnostic delay was 26 days (range 0-283, IQR: 6;90). 5-year survival rate was 75% (95% CI: 61-90) and all children with diagnostic delay > 100 days (n = 9, 24%) were still alive at the end of follow-up (median 6.3 years, range 2.2-10.2). We provide an overview of symptoms and clinical signs in a nation-wide series of infants with CNS tumours and demonstrate that ophthalmic manifestations are frequently observed in infants prior to diagnosis, but, often in combination with other clinical signs. The diagnostic delay was substantial for a large part of the infants, but this was not associated with increased mortality.

Clinical outcomes and antibody transfer in a cohort of infants with in utero or perinatal exposure to SARS-CoV-2 (Coronascope Study).

In this cohort, the majority of infants born to mothers with COVID-19 during pregnancy were healthy infants with a normal cUS, no hearing loss, and normal neurodevelopment in the first year of life. Only half of the infants had a positive serological result during the follow-up. • Hearing loss and neurodevelopmental delay in infants born to mothers with COVID-19 during pregnancy has been suggested, although data is inconsistent. Maternal antibody transfer seems to be high, with a rapid decrease during the first weeks of life. • Most infants born to mothers with COVID-19 during pregnancy had normal hearing screening, cranial ultrasound, and neurodevelopmental status at 12months of life. Antibodies against SARS-CoV-2 were only detected in 50% of the infants at two months of life.

Cytomegalovirus infection during pregnancy.

Cytomegalovirus (CMV) infection during pregnancy is a global silent problem. Additionally, it is the leading cause of congenital infections, non-genetic sensorineural hearing loss, and neurodevelopmental delays in infants. However, this has barely been recognized globally. This condition lacks adequate attention, which is further emphasized by the lack of awareness among healthcare workers and the general population. The impact of CMV infection is often overlooked because of the asymptomatic nature of its presentation in infected pregnant women and newborns, difficulty in diagnosis, and the perception that infants born to women with pre-existing antibodies against CMV have normal neonatal outcomes. This article highlights the latest information on the epidemiology, transmission, clinical manifestations, and development of CMV infection and its management. We reviewed the pathophysiology and clinical manifestations of CMV infection in pregnant women, diagnostic methods, including screening and prognostic markers, and updates in treatment modalities. Current advancements in research on vaccination and hyperimmunoglobulins with worldwide treatment protocols are highlighted.

Growth retardation in children with allergies: A review

The increase in the prevalence of food allergies among children in recent years is evident with onset in infancy and childhood in most cases. The full value of the elimination diet, the time before diagnosis, and the severity of allergic inflammation can affect the nutritional status of the children and, ultimately, their linear growth. Age-correspondent height is one of the most important indicators of a child's health and well-being, especially in the first few years of life when energy and nutrient requirements per body weight are highest. Insufficient nutrient intake in children with food allergies can impair growth, and developmental delay in infancy and early childhood can have long-term sequelae. It is essential to understand the frequency of developmental retardation in kids with food allergies, the most prevalent allergen that causes it, and whether or not growth retardation may be reversed with effective diet therapy. Based on the studies presented in the article, the following key provisions were identified: of the entire spectrum of food allergens, cow milk protein allergy (CMPA) has the most significant effect on growth; the impact of CMPA on the formation of improper eating habits is also high; careful management of a child with CMPA with adequate diet therapy and timely re-introduced dairy products to induce tolerance can reduce the adverse effect of CMPA on growth and nutrition; apparently, multiple food allergies also harm growth; a nutritionist should more often observe children with multiple food allergies; regular assessment of growth and diet with individual nutrition recommendations to date has shown the best results in achieving the growth target of children with food allergies.

A Machine Learning Algorithm Predicting Infant Psychomotor Developmental Delay Using Medical and Social Determinants

Psychomotor developmental delay in infants includes failure to acquire abilities such as sitting, walking, grasping objects and communication at the ages when most infants have acquired these abilities. Known risk factors include a large number of aspects of family environment, socioeconomic position, problems in pregnancy and birth and maternal health. It is clinically useful to be able to screen for developmental delay so that healthcare interventions can be considered. The present research used machine learning (random forest) to create an algorithm predicting psychomotor delay in 9-month-old infants using information ascertainable at birth and in early infancy. The dataset was the UK longitudinal Millennium Cohort study. In total, 53 predictors measuring socioeconomic indicators, paternal, family and social support for the mother, beliefs about good parenting, maternal health, pregnancy and birth were included in the initial algorithm. Feature reduction showed that of the 53 variables, birthweight, gestational age at birth, pre-pregnancy BMI, family income and parents’ ages had the highest feature importance scores and could alone correctly predict developmental delay with over 99% sensitivity and 100% specificity. No features measuring aspects of early infant care or environment meaningfully added to algorithm performance. The relationships between delay and some of the predictors, particularly income, were nonlinear and complex. The results suggest that the risk of psychomotor developmental delay can be identified in early infancy using machine learning, and that the best predictors are factors present prior to and at birth.

Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure.

To investigate the association between prenatal opioid exposure (POE) and newborn infants' motor performance to aid in the early identification of developmental delays. Nineteen infants with POE requiring pharmacological treatment, 27 infants with POE without pharmacological treatment, and 25 infants without POE were assessed via the Test of Infant Motor Performance (TIMP). Infants in both groups with POE had lower TIMP scores than infants without POE. There was no difference between the TIMP scores of infants with POE who required pharmacological treatment and infants with POE who did not require pharmacological treatment. The TIMP can detect differences in motor performance of infants with POE. Regardless of whether infants required pharmacological treatment, POE was associated with lower motor performance. Those working in hospital or early intervention settings can use the TIMP to identify early delays in infants with POE and refer for intervention.

Gut Microbiome-Brain Axis as an Explanation for the Risk of Poor Neurodevelopment Outcome in Preterm Infants with Necrotizing Enterocolitis.

Necrotizing Enterocolitis (NEC) is characterized by an inflammation of intestinal tissue that primarily affects premature infants. It is the most common and devastating gastrointestinal morbidity of prematurity, but beyond intestinal morbidity, this condition has also been associated with an increased risk of neurodevelopmental delays that persist beyond infancy. Prematurity, enteral feeding, bacterial colonization, and prolonged exposure to antibiotics are all risk factors that predispose preterm infants to NEC. Interestingly, these factors are all also associated with the gut microbiome. However, whether or not there is a connection between the microbiome and the risk of neurodevelopmental delays in infants after NEC is still an emerging area of research. Furthermore, how microbes in the gut could impact a distant organ such as the brain is also poorly understood. In this review, we discuss the current understanding of NEC and the role of the gut microbiome-brain axis in neurodevelopmental outcomes after NEC. Understanding the potential role of the microbiome in neurodevelopmental outcomes is important as the microbiome is modifiable and thus offers the hope of improved therapeutic options. We highlight the progress and limitations in this field. Insights into the gut microbiome-brain axis may offer potential therapeutic approaches to improve the long-term outcomes of premature infants.