Developmental Delay In Infants Research Articles

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 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.

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.

Risk of Global Developmental Delay in Infants Born from Mothers with COVID-19: A Cross-Sectional Study.

To investigate the risk of global developmental delay in infants born from mothers with COVID-19. A cross-sectional study was conducted between March and November 2021, with 54 infants of both sexes aged between 1 and 12 months. Twenty-seven infants born from mothers diagnosed with COVID-19 during pregnancy composed the COVID-19 group, whereas infants born from mothers not exposed to COVID-19 composed the control group. Medical records and child health booklets provided neonatal and prenatal data. The Survey of Wellbeing of Young Children screened the risk of global developmental delay during a phone interview or home visit. Chi-squared, Mann-Whitney test, and binary logistic regression were applied. The risk of motor developmental delay was identified in 15 infants (12 in the COVID-19 group), while 36 were at risk of behavioral alteration (22 in the COVID-19 group). The COVID-19 group presented a 6.3-fold risk of motor developmental delay. Motor developmental delay was also significantly associated with socioemotional alterations (odds ratio = 6.4, p = 0.01). Regarding families of infants in the COVID-19 group, 63% of the mothers presented risk of depression, 51.9% risk of substance abuse, 40.7% risk of food insecurity, and 7.4% risk of domestic violence. The inflexibility subscale of the survey was a statistically relevant variable for the socioemotional domain. Infants born from mothers with COVID-19 were at high risk of motor developmental delay and socioemotional alterations. Although, this study fills an important gap in the literature regarding the influence of maternal exposure to COVID-19 on infant development, new studies screening families with infants at risk of developmental delay may significantly impact maternal and child health-related indicators, such as physical health, emotional development and social behavior.

The Use of the Alberta Infant Motor Scale (AIMS) as a Diagnostic Scale for Infants with Autism.

This retrospective cohort study included all children registered at one health care organization in Israel born between 2011 and 2017 (N = 240,299). Early childhood MDD was defined as having at least one recorded developmental physiotherapy (DPT) visit before the age of 2 years. Reasons for referral to DPT and the results of using AIMS as an appropriate tool for revealing developmental delays in infants with ASD are presented. ASD diagnosis was reported in 1821 children (prevalence rate 0.75%). Of those, 388 (odds ratio 4.1, 95% CI 3.6-4.6) children were referred to DPT. Children with ASD mostly received DPT for motor delays (46.19%), torticollis (19.52%), developmental delay (15.48%), and preterm birth (7.38%). The use of AIMS as an early detection tool suggests that more than 87% of children with ASD and MDD present with a developmental delay or risk for one when using this scale. The prevalence of ASD among children referred to DPT for MDD is higher than its prevalence within the general population. The most common reasons for a child with ASD to be referred for DPT services are MMDs. AIMS was found to be a sensitive tool to pinpoint relevant candidates for ASD screening among children treated in DPT. Possible effects of the study: The use of AIMS as a relevant assessment scale for this group of clients is recommended. Training DPTs in identifying initial ASD signs and developing their clinical reasoning abilities will increase the chance of implementing early intervention with this group of clients.

Mediterranean diet during pregnancy and infant neurodevelopment: A prospective birth cohort study.

Embryonic neural development is associated with intrauterine nutritional status. However, few cohort studies estimated the relationship between maternal dietary patterns during pregnancy and offspring's early neurodevelopment. To examine the impact of the Mediterranean diet (MD) during pregnancy on infant neurodevelopment, including the potential mediating role of cord blood metabolites. Among 1,471 mother-child pairs in a prospective birth cohort study in Hefei, China, we investigated the associations between maternal MD score [calculated based on a validated food frequency questionnaire (FFQ)] and child neurodevelopment at infancy [assessed using Ages and Stages Questionnaires, Third Edition (ASQ-3)]. The cord blood metabolic markers (including C-peptide, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, total cholesterol, and triglycerides) were measured. The MD score was negatively associated with communication domain developmental delays in infants [relative risk (RR) with 95% CI: 0.34 (0.16, 0.72)]. Compared with girls, boys born from mothers with lower MD scores during pregnancy were inclined to the failure of the communication domain [RRs with 95% CI for boys: 0.34 (0.14, 0.84); for girls: 0.26 (0.06, 1.18)]. Mediation analysis showed that the association between the maternal MD score and failure of communication domain mediated by C-peptide was 19.4% in boys but not in girls. Adhering to the MD during pregnancy was associated with a decreased risk of poor neurodevelopment, possibly mediated by lower levels of cord blood C-peptide.

Developmental assessment of infants with congenital heart disease: a cross-sectional study

BackgroundRecently, marked improvement of medical and surgical care for infants with congenital heart disease led to a growing population with a high risk of developmental delay. We aimed to identify developmental delay in these infants and its risk factors. So, we performed a cross-sectional study on 100 infants with congenital heart disease to assess their development by using Vineland Adaptive Behaviour Scale. We searched for risk factors for developmental delay in these infants. Correlations were conducted between the degree of developmental delay and the potential risk factors. To our knowledge, this study has not been conducted in developing countries before.ResultsThe median age of the study group is 12.5 months, but it is equivalent to 9.5 months by using Vineland Adaptive Behaviour Scale. There was a statistically significant developmental delay in infants who had risk factors such as prematurity, history of neonatal intensive care unit admission, anemia, stunted growth, underweight, central cyanosis, or abnormal electroencephalographic.ConclusionsDevelopmental delay is a common complication in infants with congenital heart disease. It has many risk factors; some of them could be modifiable as anemia, stunted growth, and underweight. Thus, early screening for developmental delay and its risk factors is of a great value. This could help in applying preventive measures and early intervention programs. Vineland Adaptive Behaviour Scale is a reliable tool in determination of developmental delay in infants with congenital heart disease.

Longitudinal association between maternal psychological stress during pregnancy and infant neurodevelopment: The moderating effects of responsive caregiving.

Little is known regarding the role of responsive caregiving in the association between maternal psychological stress and child neurodevelopment. We, therefore, herein investigated the relationship between maternal psychological stress during pregnancy and children's neurodevelopment with modifications in responsive caregiving. A total of 3,603 mother-child pairs were recruited from the Shanghai Maternal-Child Pairs Cohort, and we assessed maternal psychological stress using the Life Events Scale for Pregnant Women (LESPW) during early and late pregnancy. Early neurodevelopment of infants at 6 and 12 months of age was also evaluated using the Age and Stage Questionnaire, Third Edition (ASQ-3). The 2-month-old infant nursing-care questionnaire was designed based on the Five Elements of Parenting Care Framework released by the World Health Organization (WHO) and used to evaluate the levels of early responsive caregiving for infants. Multivariate logistic regression analysis was then applied to determine the association between maternal psychological stress during pregnancy and child development. The suspected developmental delay rate of infants aged 6 and 12 months ranged between 13.3% and 24.5%. After adjusting for confounders, we noted that high maternal subjective events stress during early pregnancy was associated with an increased risk of suspected developmental delay in problem-solving domains at 12 months of age [adjusted OR (aOR) = 1.51; 95% confidence interval (CI), 1.09-2.20]. High general negative objective events' stress during late pregnancy also constituted a risk factor for development in the personal-social domain at 12 months of age (aOR = 1.57; 95% CI, 1.13-2.19). Remarkably, we noted in infants with insufficient responsive caregiving that there were greater associations between the risk of general maternal negative objective events during late pregnancy and personal-social domain at 12 months of age (aOR = 2.06; 95% CI, 1.15-3.68). Similarly, there was a greater association between the risk for maternal subjective events during early pregnancy and problem-solving at 12 months of age (aOR = 1.55; 95% CI, 1.11-2.34). Maternal psychological stress during pregnancy was predominantly associated with suspected developmental delay in infants at 6 and 12 months of age, and these associations were modified by early responsive caregiving.

Perceptions of Healthcare Providers and Caregivers Regarding Procedures for Early Detection of Developmental Delays in Infants and Toddlers in Saudi Arabia.

This study aimed to explore current practices adopted by frontline healthcare providers for the early detection of developmental delays in infants and toddlers in Saudi Arabia, with a specific focus on motor and speech delays and caregivers' perceptions of early detection of developmental delays and their awareness of well-child visits. Two cross-sectional surveys were conducted and distributed. The first survey was performed among healthcare providers who worked directly with infants and toddlers in the first 3 years of life, and the second survey was performed among caregivers of infants and toddlers who received healthcare services. Participants were recruited via online groups, social media platforms, and clinics. Overall, 60% of the healthcare providers played a role in identifying medical conditions that could be associated with delays and disabilities. However, they did not consistently check for normal development or developmental delays. Furthermore, the healthcare providers reported low frequencies of documenting developmental growth. The caregivers' survey results showed that 67% were familiar with the concept of "well-child visits", and the most frequently discussed topic by the healthcare providers was motor development. Well-defined, government-supported standards are needed to encourage regular well-child visits and implement efficient practices for the early detection of developmental delays.

Early detection of developmental delay in infants born very preterm or with very low birthweight.

This study aimed to identify early clinical biomarkers from birth to 16 weeks corrected age to predict typical outcome and developmental delay in infants born very preterm or with very low birthweight. A prospective cohort of infants on the Sunshine Coast, Australia, was assessed using the Premie-Neuro Examination, the General Movement Assessment (GMA), the Alberta Infant Motor Scale, and the Infant Sensory Profile 2. At 24 months corrected age, delay was identified using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) and Neurosensory Motor Developmental Assessment (NSMDA). One hundred and four infants were recruited; 79 completed outcome assessments (43 females, 36 males; mean gestational age 30 weeks [SD 1 week 6 days], mean birthweight 1346 g [SD 323]). The incidence of developmental delay (motor or cognitive) was 6.3%. Suboptimal quality of fidgety general movements (temporal organization) at 16 weeks corrected age demonstrated the best predictive accuracy (Bayley-III motor: sensitivity 100% [95% confidence interval {CI} 3-100], specificity 75% [95% CI 63-84], area under the curve [AUC] 0.87); Bayley-III cognitive: sensitivity 100% [95% CI 3-100], specificity 75% [95% CI 64-84], AUC 0.88); NSMDA motor: sensitivity 100% [95% CI 40-100], specificity 81% [95% CI 70-90], AUC 0.91 [95% CI 0.86-0.95]). GMA trajectories that combined abnormal writhing general movements at 4 to 5 weeks corrected age with suboptimal quality of fidgety movement at 16 weeks corrected age were strongly predictive of developmental delay, superior to all other clinical tools, and perinatal and demographic variables investigated (p=0.01, Akaike information criterion method 18.79 [score corrected for small sample size], accounting for 93% of the cumulative weight). Only the GMA had sufficient predictive validity to act as a biomarker for both conditions: typical outcome and developmental delay (motor or cognitive). GMA trajectories that assessed both writhing general movements at 4 to 5 weeks corrected age and quality of fidgety movement at 16 weeks corrected age predicted adverse neurodevelopmental outcome, accurately differentiating between infants with typical outcomes and those at increased risk for motor or cognitive delay.

How well does the General Movement Assessment predict general developmental delay in infants born very preterm/low birthweight?

How well does the General Movement Assessment predict general developmental delay in infants born very preterm/low birthweight?

A structural MRI study of global developmental delay in infants (

To use structural magnetic resonance imaging (3D-MRI) to evaluate the abnormal development of the cerebral cortex in infants with global developmental delay (GDD). The GDD group includes 67 infants aged between 112 and 699 days with global developmental delay and who underwent T1-weighted MRI scans in Shanxi Children's Hospital from December 2019 to March 2022. The healthy control (HC) group includes 135 normal developing infants aged between 88 and 725 days in Shanxi Children's Hospital from September 2020 to August 2021. Whole-brain T1-weighted MRI scans were carried out with a 3.0-T magnetic resonance scanner, which was later processed using InfantSurfer to perform MR image processing and cortical surface reconstruction. Two morphological features of the cortical surface of the 68 brain regions were computed, i.e., the cortical thickness (CT) and cortical surface area (SA), and compared between the GDD and HC groups. With regard to the CT, the HC group showed a rapid decrease at first and then a slow increase after birth, and the CT of the GDD group decreased slowly and then became relatively stable. The GDD group showed bilaterally higher hemispherical average CT than those in the HC group. In detail, for the left hemisphere, except in the entorhinal and temporal poles in which the average CT values of the two brain regions were lower than those of the HC group, the CT of the 26 brain regions in the GDD group was higher than those of the HC group (p < 0.05). For the right hemisphere, the CT of the entorhinal in the GDD group was lower than that in the HC group. Otherwise, the CT of the remaining 28 brain regions was higher than those in the HC group (p < 0.05). With regard to the SA, both groups showed a rapid increase after birth till 23 months and remained quite stable afterward. The GDD group shows lower SA bilaterally than that in the HC group. In detail, SA in the GDD group was lower in most cortical regions of both hemispheres than in the HC group (p < 0.05), except for the right temporal pole and entorhinal. When testing for brain asymmetry, we found that the HC group showed obvious asymmetry of CT and SA, while only a few cortical regions in the GDD group showed asymmetry.

Evaluation of Anomalies and Neurodevelopment in Children Exposed to ZIKV during Pregnancy.

Zika virus (ZIKV) infection in pregnancy is associated with birth and developmental alterations in infants. In this study, clinical records of 47 infants whose mothers had Zika during pregnancy or clinical manifestations compatible with Zika were reviewed. A description of the infants’ anomalies was established, and a neurodevelopmental assessment was performed on 18 infants, using the Evaluation of Infant Development (EDI for its initialism in Spanish) and DDST-II (Denver Developmental Screening Test II) tests. From his sample, 74.5% of the infants evaluated had major anomalies and 51.9% had minor anomalies. The incidence of major anomalies, related to trimester of pregnancy, was 84.2% for the first trimester, 77.8% for the second trimester, and 37.5% in the third trimester. A similar trend was observed in the frequency of infants without anomalies and was less evident in the incidence of minor anomalies (p = 0.016). Through neurodevelopmental assessments, EDI identified 27.8% of infants as having normal development, while 55.5% of affected infants had developmental delay, and 16.7% were at risk for developmental delay. The DDSST-II showed that 77.7% infants had delay in the gross motor and language area, 88.8% in the fine-adaptative motor area, and 72.2% in the personal–social area. In this work, children of mothers with ZIKV infection during pregnancy may have major or minor anomalies regardless of the trimester of pregnancy in which the infection occurred. The neurodevelopmental assessment shows that ZIKV can cause a developmental delay in infants with the fine-adaptative motor area being the most affected.

Pregnancy, Fetal, and Infant Outcomes Following Maternal Exposure to Glatiramer Acetate During Pregnancy and Breastfeeding.

Published data support the safety of glatiramer acetate in patients with multiple sclerosis who are pregnant or breastfeeding, but long-term data are limited. We aimed to assess pregnancy, fetal, and infant outcomes following maternal exposure to glatiramer acetate. In-utero glatiramer acetate-exposed postmarketing pregnancy reports from 2019 to 2021 were extracted from Teva's pharmacovigilance database. Pregnancy data acquired prior to knowledge of pregnancy outcome or detection of congenital malformation (prospective reports) were used to estimate pregnancy and infant outcome rates for glatiramer acetate 20- and 40-mg/mL exposure. A subgroup of cases completed follow-up questionnaires and were analyzed separately. Prospective cases with 702 fetuses had known outcomes with 647 (92.2%) live births, 47 (6.7%) spontaneous abortions, 4 (0.6%) induced abortions, 2 (0.3%) ectopic pregnancies, and 2 (0.3%) fetal deaths. Rates of major congenital malformation (1.1%), preterm births (7.2%), and low/very low birth weight (4.8%), and parameters of growth were within background rates. No infant developmental delay was reported. Overall, pregnancy and infant outcomes were similar across glatiramer acetate doses. Maternal exposure to glatiramer acetate does not appear to be related to adverse pregnancy, fetal, or infant outcomes. These data further support the safety of both glatiramer acetate 20-mg/mL and 40-mg/mL treatments during pregnancy and breastfeeding.

A Case Report of Pregabalin Abuse During Pregnancy and Global Developmental Delay in Infants

A Case Report of Pregabalin Abuse During Pregnancy and Global Developmental Delay in Infants

Psychological Stress Due to Covid-19 on Pregnant Women in Post Partal Period

There is no indication that covid-19 has a long-term effect on pregnancy, the mother's psychiatric condition, or the infant's developmental delay. Between May 1st and July 31st 2020, 72 pregnant patients with covid-19 took part in a study that took place in different locations. Since giving birth these woman patients engaged in three-month follow-up surveys. The data was collected from Covid-19 medical history, maternal reports, quarantine questionnaires, mother-baby feeding separation, and assessing the mothers psychiatric illnesses.&#x0D; While there is no conclusive evidence of vertical transmission of SARS-COV-2, in order to reduce the risk of infection, healthcare professionals and researchers must focus more on the mental health of pregnant women, infant feeding, and closeness to the parents. This will aid in the early development of the new born, reducing stress on the mother.

Comprehensive genome sequencing analyses identify novel gene mutations and copy number variations associated with infant developmental delay or intellectual disability (DD/ID)

Comprehensive genome sequencing analyses identify novel gene mutations and copy number variations associated with infant developmental delay or intellectual disability (DD/ID)

Purification, Crystallization, and Preliminary Crystallographic Studies of Human As(III) S-Adenosylmethionine Methyltransferase (hAS3MT).

Exposure to environmental arsenic is associated with serious of health issues such as cancer, diabetes and developmental delays in infants and children. In human liver, As(III) S-adenosylmethionine methyl transferase (hAS3MT) (EC 2.1.1.137) was proposed to be an detoxification process by methylation of inorganic arsenite into pentavalent methyl MAs(V) and dimethyl arsenite DMAs(V). More recently the first product was shown to be highly toxic and potentially carcinogenic trivalent methylarsenite (MAs(III)). Our studies are designed to elucidate the mechanism of AS3MT and its contribution to arsenic-related diseases. Here, we report the first crystallization and preliminary X-ray diffraction analysis of the human AS3MT enzyme. The crystals belong to the monoclinic P1211 space group with unit cell parameters of a = 135.03 Å, b = 260.44 Å, c = 279.03 Å, α = 90.00°, β = 93.36°, γ = 90.00°.

Developmental delay in infants and toddlers with sickle cell disease: a systematic review.

To summarize developmental delay among infants and toddlers with sickle cell disease (SCD). This systematic review included studies that reported developmental outcomes of children with SCD between 0 months and 48 months of age and followed standards set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ten studies were included, describing 596 unique developmental assessments. The rate of developmental delay ranged from 17.5% to 50% and increased with age. Cognition was the only domain included in all studies and the most frequently identified delay. One study reported that more severe SCD genotypes predicted worse development, while five studies reported no difference in rates of developmental delay across genotypes. These findings emphasize the need for standardized screening to identify children with SCD at risk of delay at a young age to facilitate appropriate referrals for therapeutic intervention. Frequent and comprehensive developmental screening is necessary among all SCD genotypes.

Nuchal Translucency Thickness Measurement in Fetal Ultrasound Images to Analyze Down Syndrome

Down syndrome (DS) is a chromosomal condition associated with intellectual disability and developmental delay in infants. The most salient pre-natal marker to identify DS during the early stages of gestation is the Nuchal translucency (NT) thickness. Accurate NT measurement from ultrasound (US) images becomes challenging due to the presence of speckle noise, weak edges and other artifacts. This paper proposes a semi-automated approach for early identification and calibration of NT thickness by estimating the distance between the edges of NT. A comparative study is performed on six traditional filters to determine the effective denoising filter for US datasets. This paper also presents an evaluation of two popular segmentation algorithms, the Active Contour and Chan-Vese-based segmentation. The study reveals that Wiener filter outperformed other filters based on the performance metrics and achieved peak signal noise ratio of 42.88 dB and mean squared error of −3.45. The prime feature NT region has been segmented effectively using enhanced double region-based active contour segmentation and obtained Dice Similarity Index (DSI- 84%) and Jaccard Index (76%). This technique has been validated by using Bland Altman’s plot to determine the correlation between clinical and proposed method.