Developmental Screening Research Articles

Early onset and increasing disparities in neurodevelopmental delays from birth to age 6 in children from low socioeconomic backgrounds.

To analyze the complex relationship between socioeconomic status (SES) and neurodevelopmental achievements by investigating the temporal dynamics of these associations from birth to age 6. This retrospective cohort study was conducted over 6 years using population-based data from the National Health Insurance Service and integrated data from the National Health Screening Program for Infants and Children. Participants were children born between 2009 and 2011 in Korea without neurodevelopmental delays with potential developmental implications. We analyzed results from the Korean Developmental Screening Test, administered at age 6, which covered overall assessment and six domains of gross and fine motor function, cognition, language, sociality, and self-care. The secondary outcome was to determine when neurodevelopmental outcomes began after birth and how these differences changed over time. Of 276,167 individuals (49.2% males), 66,325, 138,980, and 60,862 had low, intermediate, and high SES, respectively. Neurodevelopmental delays observed across all developmental domains were more prevalent in the low-SES group than in the high-SES group. Disparities in neurodevelopment according to these statuses were apparent as early as age 2 and tended to increase over time (interaction, P < 0.001). The cognition and language domains exhibited the most substantial disparities between SES levels. These disparities persisted in subgroup analyses of sex, birthweight, head circumference, birth data, and breastfeeding variables. Low SES was significantly associated with an increased risk of adverse neurodevelopmental outcomes in preschool children, particularly those affecting cognitive and language domains. These differences manifested in early childhood and widened over time.

61 The HEADS-ED under 6: Validation of a mental health and developmental screening and triage tool

Abstract Background The HEADS-ED screening and triage tool was developed for children 6 years to young adults as a communimetric mental health (MH) and addictions screener to help clinicians identify and communicate areas of need and recommended clinical care. Few clinician-administered tools identify both MH and developmental needs in young children under 6. From a review of milestone tools and in consultation with paediatricians, psychiatrists, and family physicians, the HEADS-ED Under 6 is a MH and developmental screening and triage tool that was developed to screen and flag functional impairment and action required in several areas, including: Home &amp; caregivers, Eating &amp; sleeping, Activities &amp; peers, Development /speech/language/motor, Safety, Emotions &amp; behaviours and Discharge &amp; current resources (see http://heads-ed.com for more background and access to both tools available in English and French). Objectives Our objectives were to examine: 1) feasibility of implementing the new HEADS-ED Under 6 screening and triage tool in community and hospital settings, 2) clinical utility of the tool to assist with clinical decision making, and 3) validity of the tool against a comprehensive assessment. Design/Methods We conducted two implementation and validation studies to examine uptake of the tool and how the tool assists in clinical referral decisions to more specialized and intensive services at 2 sites. For our initial validation study, we piloted and validated the tool at a community MH agency in Ontario for children under the age of 6 from November 2019- March 2021 (N=566). For our cross-validation study, we examined how the tool was implemented within a regional coordinated access service housed in a paediatric hospital in Ontario from June 2021- August 2023 (N=589). Results For our initial validation study, the HEADS-ED Under 6 was widely used by intake workers (95%, N = 536/566) to communicate children’s MH and developmental needs (Figure 1) and assisted in recommending services of varying intensity. The tool showed good concordance with the InterRAI Early Years assessment in similar domains requiring no action (61.1% to 81.6%), requiring action but not immediate (49.2% to 88.0%) and requiring immediate action (66.7% to 100%) for children under 4 years old (p's &amp;lt;.001). Three clinical domains (Eating &amp; sleeping, Development/speech/language/motor, and Emotions &amp; behaviours) also independently predicted an urgent care recommendation (p's &amp;lt; .001). For our cross-validation study, the tool was used for all 589 intake appointments, and 96.4% (N = 568/589) had a level of need documented. HEADS-ED Under 6 clinical domains (.24-.38) and total scores (.52) were significantly correlated with level of need (p&amp;lt;.001). Higher HEADS-ED Under 6 total scores helped intake workers decide on more intense services based on level of need (p&amp;lt;.001; Figure 2). ROC analyses (AUC = .807, SE = 68.5% sensitivity, 79.5% specificity) confirmed a total score of 6 or above helped triage to more targeted and intense services. Conclusion The HEADS-ED Under 6 is a brief, straight-forward, and valid screening and triage tool that can be used by intake workers, physicians, and paediatricians to guide their interview in several areas of MH and development, communicate the severity of the child’s MH and developmental needs, and assist with determining level of need for services. When a HEADS-ED Under 6 total score reaches ≥6, clinicians should advocate for more intensive services when making MH service referrals.

15 Predictive validity of two developmental screening tools at the 18-month visit and neurodevelopmental consultation at an average age of 8 years

Abstract Background The Canadian Paediatric Society (CPS) recommends an enhanced 18-month well-baby visit incorporating a developmental screening tool to stimulate discussion with parents, and notes that a widely used tool is the Nipissing District Developmental Screen (NDDS). For early detection of autism spectrum disorder, the CPS notes that a commonly used screening tool is the Infant Toddler Checklist (ITC). Objectives To examine the predictive validity of the ITC and NDDS at the 18-month visit using later neurodevelopmental consultation as the criterion measure; and examine whether positive developmental screening was associated with health care utilization (HCU). Design/Methods Using a prospective design, parents completed the ITC and the NDDS at the 18-month visit in primary care practices. Seven types of HCU were collected from health administrative databases, via linkage using the child’s health insurance number, including: neurodevelopmental consultation, special paediatric consultation, scheduled primary care visit billings, unscheduled primary care or minor visit billings, other non-primary care visit billings, hospitalizations, and emergency department visits. Covariates included child and family characteristics. We calculated screening test properties (using neurodevelopmental consultation as the criterion) and used multivariable negative binomial regression to estimate rate ratios (RR) for each of the 7 types of HCU. Results For both the ITC (n=1460) and NDDS (n=802) cohorts, mean age at screening was 18 months and mean age at follow up was 8 years. Of the ITC cohort, 11% were screen positive, 2.6% had a neurodevelopmental consultation. A positive ITC had 40% sensitivity (95% CI 24%-57%), 90% specificity (95% CI 88%-91%), 10% false positive rate (95% CI 9%-12%). A positive ITC was associated with 6 of 7 types of HCU, including neurodevelopmental consultation (RR=2.78, 95% CI 1.37-5.67). Of the NDDS cohort, 36% were screen positive, 2.5% had a neurodevelopmental consultation. A positive NDDS had a sensitivity of 50% (95% CI 27%-73%), specificity of 65% (95% CI 61%-68%), false positive rate of 35% (95% CI 31%-40%). A positive NDDS was associated with only 1 of 7 types of HCU: unscheduled primary care or minor visit billings 1.24 (95% CI 1.01, 1.53, p=0.04). Conclusion The predictive validity of the ITC was stronger than the NDDS due to high specificity and low false positive rates. The low sensitivity of the ITC is similar to other screening tools used at 18 months, highlighting the importance of ongoing developmental surveillance. The false positive rate of the NDDS is unacceptably high for a screening tool.

Missed Opportunities for Intervening Early in Preschoolers with Developmental Concern: Perspectives From Head Start Parents, Teachers, and Healthcare Providers.

The purpose of this study was to discover the care meanings of facilitators and barriers to detection and intervention for developmental delay among Head Start preschool-aged children, as viewed by parents, teachers, and primary care providers. We used a qualitative focus group design and broad cultural lens to understand similarities and differences in family and professional care, as Head Start programs educate preschoolers living in poverty who are disproportionately from ethno-racial minoritized groups. We sought the perspectives of 15 Head Start parents equally representing Black, Latino(a), and White parents, 17 teachers, and 11 healthcare providers to discover facilitators and barriers to adherence with professional recommendations. We found that silos in professional communications, parent distrust, knowledge deficits, and stigma were barriers to obtaining developmental recommendations. Participants also identified missed opportunities to facilitate interagency coordination, parental advocacy of a child's developmental needs, and professional alliances to take collaborative actions for early identification and treatment. Furthermore, a subculture of poverty adversely influenced adherence to developmental recommendations, and ethno-racial biases affected Black and Latino(a) families' follow-through. Our findings highlight how the lack of coordination between sectors resulted in the dismissal of parental concerns or denial of services by 1 system or the other, thus, at the very least reducing the child's chances for earlier intervention and treatment. We also identified potential benefits to children when the barriers of poverty and ethnoracial bias are addressed by professionals with coordinated actions, and new systems are developed for sharing developmental screening results and partnering to coordinate care across the preschool and primary healthcare settings.

Diverse weaning foods and diet patterns at multiple time points during infancy period and their association with neurodevelopmental outcomes in 6-year-old children.

Understanding the impact of early-life nutritional choices on neurodevelopment in children is a growing area of research. To investigate the association between dietary patterns at multiple timelines and neurodevelopmental outcomes in 6-year-old children. This administrative observational study utilized a merged data from the national health insurance database and the health screening program for children. Information on the diet patterns from infancy to 3 years of age was obtained from parent-administered questionnaires. Dietary pattern clusters of the participants were identified using Polytomous Latent Class Analysis. The outcome was neurodevelopment using the Korean Developmental Screening Test (K-DST) at the age of 6 years. The study identified four distinct clusters among with the 133,243 eligible children (49.6% male, birth weight 3.22 kg, head circumference 42.7 cm at 4 months). The control cluster (53.4%) exhibited a diet including breast milk feeding and a variety of dietary patterns at the age of 1 year. In contrast, cluster 1 (36.0%) showed a skewed dietary pattern at the same age. Cluster 2 (6.6%) displayed diverse dietary patterns at one year but primarily consumed formula at four months, while cluster 3 (4.0%) had reduced dietary diversity and formula feeding. Compared with the control cluster, the adjusted odds ratio for unfavorable development was 1.209 (95% CI, 1.156-1.266) in cluster 1, 1.418 (95% CI, 1.312-1.532) in cluster 2, and 1.741 (95% CI, 1.593-1.903) in cluster 3. These findings remained consistent across individual domains of the K-DST. Dietary patterns during infancy and early childhood may be associated with neurodevelopment at the age of 6 years.

Parent screening questionnaires to detect cognitive and language delay at 2 years in high-risk infants: an analysis from the Victorian Infant Collaborative Study 2016–2017 cohort

ObjectiveTo determine the accuracy of two developmental screening questionnaires to detect cognitive or language delay, defined using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), in children born...

Developmental profile of Filipino children born during the SARS-COV-2 pandemic: pilot study.

The Philippines experienced one of the longest restriction periods during the COVID-19 pandemic. This study aimed to provide a developmental profile of 18-25 month-old children and identify factors associated with their development during their early years being born and raised during the pandemic. The study population was recruited through convenience sampling among families living in proximity to the daycare centers in Cainta, Rizal, Philippines. 116 children qualified to participate and underwent developmental screening using the Early Childhood Care and Development (ECCD) Checklist and their parents were interviewed related to demographic and social factors. The mean score of the children's Overall Development is 106.47 (SD = 13.43) indicating that children's skills were within the expected range of 80-119. Girls had significantly higher mean scores compared to boys [M Girl = 111.23, SD Girl = 9.95 vs. M Boy = 101.18, SD Boy = 14.83 t(114) = -4.32 p < 0.001]. Mean scores were highest among children whose mothers completed a high school education (M High School = 107.76, SD HighSchool = 12.47) compared to those who have some or have completed an elementary education (M SomeElem = 72.50, SD SomeElem = 6.36 and M Elem = 103.58, SD Elem = 13.86 respectively) [F(2, 113) = 8.18, p < 0.001]. Unadjusted linear regression shows a modest increase in mean scores as the number of household members increased [ꞵ = 0.86, (CI: 0.02, 1.70), t-score (1, 113) = 2.03, p = 0.045]. The developmental skills of 18-25 month-old children born and raised during the COVID-19 pandemic in an urban municipality in the Philippines are within average scores. Both hindering and protective demographic factors were identified as associated with the children's developmental evaluation scores. It is important to acknowledge these factors and continue monitoring the children's development and address needs among children who may need further support.

In Utero Exposure to Maternal COVID-19 and Offspring Neurodevelopment Through Age 24 Months

In utero exposure to maternal infections has been associated with abnormal neurodevelopment among offspring. The emergence of a new, now endemic infection (SARS-CoV-2) warrants investigating developmental implications for exposed offspring. To assess whether in utero exposure to maternal COVID-19 is associated with abnormal neurodevelopmental scores among children ages 12, 18, and 24 months. Data were ascertained from the ASPIRE (Assessing the Safety of Pregnancy in the Coronavirus Pandemic) trial, a prospective cohort of pregnant individuals aged 18 years or older who were enrolled before 10 weeks' gestation and their children. Individuals were recruited online from May 14, 2020, to August 23, 2021, using the Society for Assisted Reproductive Technology and BabyCenter, an online media platform. Participants from all 50 states and Puerto Rico completed activities remotely. In utero exposure to COVID-19. Birth mothers completed the Ages & Stages Questionnaires, Third Edition, a validated screening tool for developmental delays, at 12, 18, and 24 months' post partum. A score below the cutoff in any domain (communication, gross motor, fine motor, problem-solving, and social skills) was considered an abnormal developmental screen (scores range from 0 to 60 in each domain, with higher scores indicating less risk for neurodevelopmental delay). The cohort included 2003 pregnant individuals (mean [SD] age, 33.3 [4.2] years) enrolled before 10 weeks' gestation and who completed study activities; 1750 (87.4%) had earned a college degree. Neurodevelopmental outcomes were available for 1757 children at age 12 months, 1522 at age 18 months, and 1523 at age 24 months. The prevalence of abnormal screens for exposed vs unexposed offspring at age 12 months was 64 of 198 (32.3%) vs 458 of 1559 (29.4%); at age 18 months, 36 of 161 (22.4%) vs 279 of 1361 (20.5%); and at age 24 months, 29 of 151 (19.2%) vs 230 of 1372 (16.8%). In an adjusted mixed-effects logistics regression model, no difference in risk of abnormal neurodevelopmental screens was observed at age 12 months (adjusted risk ratio [ARR], 1.07 [95% CI, 0.85-1.34]), age 18 months (ARR, 1.15 [95% CI, 0.84-1.57]), or age 24 months (ARR, 1.01 [95% CI, 0.69-1.48]). Supplemental analyses did not identify differential risk based on trimester of infection, presence vs absence of fever, or breakthrough infection following vaccination vs primary infection. In this cohort study of pregnant individuals and offspring, exposure to maternal COVID-19 was not associated with abnormal neurodevelopmental screening results through 24 months' post partum. Continued study of diverse groups of children is needed because, among other factors, evidence suggests sensitivity of the developing fetal brain to maternal immune activation.

Raising Awareness of the Impact of Stunting on Toddler Development Through Parental Education

In 2023, the prevalence of stunting in Indonesia remains at 21.5%, showing only a marginal decrease of 0.1% from the previous year and still exceeding the WHO standard of 20%. Stunting adversely affects children, leading to impaired physical and cognitive development, increased risk of developmental disorders, and a higher likelihood of metabolic diseases in adulthood.This study utilized a multi-stage approach: data and area analysis, educational and developmental screening, and evaluation. Participants included 44 parents with their toddlers, 5 cadres, and 3 village officials. Knowledge among participants improved significantly, with 76% demonstrating enhanced understanding. Statistical analysis revealed a significant increase in knowledge post-intervention (p=0.000). Developmental assessments showed that 11% of toddlers were classified as "doubtful" and 23% as having "deviant" results. Parents of these children received education on age-appropriate stimulation, and cases were reported to local health workers. The goal is for the acquired knowledge to be widely applied, with ongoing routine screening for early detection and timely management of developmental issues.

Predictors of Early Intervention Referral after a Positive Developmental Screen in Community Primary Care Clinics

BackgroundPrimary care physicians (PCPs) may rely upon factors other than screening test scores in making referral decisions to developmental services. This study investigated which patient, provider, and screening test factors predict a PCP’s IDEA Part C Early Intervention (EI) referral after a positive screening test result. MethodsChild demographics, developmental screening test results and EI referral decisions were collected via medical record review of 2,756 15-, 18-, 24- and 30-month well-child checks conducted at 7 community primary care clinics in 4 Oregon counties, in 2020-2021. A provider survey collected PCP demographic and professional characteristics. We tested the association of receipt of EI referral with screening test (Ages & Stages-3 [ASQ-3] and Modified Checklist for Autism in Toddlers – Revised [MCHAT-R]) scores, provider demographic information, child demographic data (sex, language, race/ ethnicity), using multivariable logistic regression. Results54.1% of children with positive MCHAT-R screens, and 42% of children with positive ASQ-3 screens received EI referrals. Multivariable analyses showed that MCHAT-R score, ASQ-3 Communication and Gross Motor scores were associated with referral after a positive screen. Child sex, race, ethnicity, and language, and provider demographics had no multivariable association with referral. Referral rates varied substantially by site and individual provider. ConclusionThe majority of toddlers with positive developmental screens were not receiving EI referrals from their PCP during the COVID-19 pandemic. Screening test thresholds and clinical thresholds for EI referral differ substantially, and some portions of the ASQ-3 do not seem to impact provider referral decisions. These findings may help inform physician training on developmental screening in primary care, specifically during times of unprecedented healthcare challenges.

Neurodevelopmental outcomes among children with congenital gastrointestinal anomalies using Korean National Health Insurance claims data.

This study investigated neurodevelopment and risk factors in children surgically treated for congenital gastrointestinal anomalies (CGIA), excluding those with known high-risk factors such as low birth weight or chromosomal anomalies. Data of children born between 2008 and 2015 who underwent surgical treatment for CGIA were retrieved from the Korean National Health Insurance Database. CGIA included esophageal atresia, duodenal atresia, jejunoileal atresia, anorectal malformations, and congenital megacolon. Neurodevelopmental impairment (NDI) was defined as Korean Ages and Stages Questionnaire scores below the determined cut-off or Korean Developmental Screening Test scores < 2 standard deviations at 3 years of age. Children with CGIA had a significantly higher risk of NDI than controls (6.2% vs. 2.7%, p < 0.001). Growth failure was correlated with NDI. Longer durations of oxygen support (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.013-1.063), mechanical ventilation (aOR, 1.053; 95% CI, 1.018-1.089), and number of surgeries (aOR, 1.137; 95% CI, 1.016-1.273) were significantly associated with NDI. These findings emphasize that cautious yet proactive neurodevelopmental monitoring is crucial in affected children, ensuring timely intervention and that excessive concern among families is unnecessary.

Standardization of the Denver Developmental Screening Test for children in Seoul: a validity study

Standardization of the Denver Developmental Screening Test for children in Seoul: a validity study

Special Education Law and Services for Pediatricians.

Rates of developmental screening have increased, and understanding how to discuss delays with families is imperative. Knowledge of federal and state law regarding special education is needed. Families often need support to understand the complexity of early intervention and school district-based services. The Individuals with Disabilities Education Act is the law that mandates services for children from birth to age 21 years who require them. Early intervention provides services for children age 0 to 3 years who have a delay or a condition with a high probability of delay. School-based services for children age 3 to 21 years provide children with disabilities with a free and appropriate public education in the least restrictive environment. While details of the laws are state and location specific, understanding the general principles of the law is important to support children and families navigate this very complex system and receive needed support. [Pediatr Ann. 2024;53(10):e366-e371.].

Improving Accessibility and Delivery of Healthcare Services to Underserved Children through Technology: A Comprehensive Approach of Literature Review

This study investigates the use of technology to improve healthcare accessibility and delivery for children in underprivileged communities through article review comprehensively. A literature review with qualitative method that involved four distinct steps. In the initial stage, the search was conducted using Google Scholar (GS) and Scopus website. The second stage was filtering, which entails selecting the journals that will be examined. The last stage was analysis the articles, this analysis uses a 4-step PRISMA process to identify 123 articles published from 2019 to 2024 in Scopus journal. The review was evaluated the efficacy of telemedicine, mobile health applications, and wearable devices in monitoring and addressing children's health, while considering genetic predispositions and underlying medical issues that influence growth patterns. The research emphasizes the importance of a comprehensive strategy in evaluating child growth and development, utilizing health data to tailor interventions. Online systems, such as mobile phones and PDAs, can support healthcare workers in underserved rural areas. The integration of technology is essential for addressing unique challenges in underserved areas and ensuring access to high-quality healthcare services for all children. Current monitoring methods include regular check-ups, growth charts, and developmental screenings, with advancements in technology providing new tools like mobile health apps and wearable devices. Involving various stakeholders in the evaluation process is crucial, with participatory research focusing on community empowerment, ownership, and capacity building. Online systems offer efficient and accessible ways to track health data but may come with privacy concerns and data breach risks. The study focuses on the effectiveness of online systems for monitoring child health indicators, discussing data collection methods, sampling strategies, and ethical considerations. Findings reveal the need to address areas such as limited social interaction and incorporate interactive activities and group projects into online curriculum. Understanding the impact of online learning on students' health and well-being is crucial for tailoring approaches to ensure comprehensive support. The research findings have significant implications for child health policy and practice, emphasizing the importance of social connection and mental well-being in online learning environments.

Keun Lee (October 10, 1942 – May 14, 2024): A pioneering pediatrician in the field of developmental screening tests in Korea and a beloved teacher at Ewha Womans University College of Medicine

Keun Lee (October 10, 1942 – May 14, 2024): A pioneering pediatrician in the field of developmental screening tests in Korea and a beloved teacher at Ewha Womans University College of Medicine

Neurodevelopmental outcome in preterm infants

Background and objectives. Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. It is one of the world's critical health problems because it may be a significant cause of long-term neurodevelopmental disability. The purpose of this work was to evaluate the impact of premature birth and brain injuries on neurological development and to identify problems as soon as possible in order to prevent or minimize sequelae as much as possible. Materials and methods. Between June 2022 and July 2024, 374 infants were examined at “Prof. Dr. Panait Sarbu” Clinical Hospital of Obstetrics and Gynecology. Each baby's gross and fine motor development was assessed, cognitive acquisitions were evaluated using an adapted Denver Developmental Screening Test, and where needed, physical therapy, head ultrasound/MRI, EEG, or genetic tests were recommended. Results. From the 374 infants evaluated (M/F: 142/232), 72 were excluded considering the normal term of birth. Of the other 302, 23 did not present for follow-up checks after one or two appointments, and 54 completed all evaluations up to 21-24 months (the study is ongoing). 5/54 had poor neurodevelopmental outcomes, almost all due to very preterm birth. From the remaining 225 babies, with a few exceptions with variable neurological damage (13/225), no motor or cognitive development abnormalities have been observed in the evaluations carried out so far. Conclusions. In our cohort, almost all babies who completed or did not the follow-up program had normal development (261/279), but in some cases, prematurity, brain lesions, or genetic causes remain associated with a poor long-term outcome. Establishing a follow-up system for premature infants is necessary because early management during the period of higher brain plasticity may prevent neurological complications and improve the quality of life.

PEDS Developmental Screening Tool Construct Validity for Northern Sotho and Zulu Versions: A Validation Study

ABSTRACT Validation of the translated PEDS test is necessary to improve early detection of developmental delays. This study aimed to determine the construct validity of the translated Northern Sotho and Zulu PEDS tests. This validation study determined whether the translated PEDS tests are valid when compared to the reference English PEDS test. Stratified convenience sampling was used to recruit a collective of 546 research participants from a government healthcare facility in South Africa. A higher referral rate (43%) was found for Zulu participants when compared to Northern Sotho participants (17%). There were significant correlations of the Zulu and Northern Sotho PEDS tests when compared to the reference English PEDS test. Pearson correlations for the Zulu PEDS test ranged from 0.815 (very strong association) to 1.000 (perfect association) and for Northern Sotho from 0.496 to 0.854 (both, very strong association). Equivalence percentages for the Zulu PEDS ranged from 90.9% to 100.0% and for the Northern Sotho PEDS from 92.3% to 100.0%. The translated PEDS test has been found to have construct validity.

Re-evaluation of the reduced heart weights in male rats in a 28-day oral repeated-dose toxicity study of tetramethylammonium hydroxide

We recently conducted a detailed hazard assessment of tetramethylammonium hydroxide (TMAH), a priority chemical substance under the Japan Chemical Substances Control Law. During this assessment, there was debate regarding the reduced heart weight observed in the treated male groups in the 28-day rat oral repeated-dose toxicity study. This finding was not observed in females in this study and in both sexes of oral toxicity studies for tetramethylammonium chloride (TMAC) or tetramethylammonium hydrogen phthalate (TMAHP). Unpublished individual data from the oral TMAH developmental and reproductive toxicity (DART) screening study were also obtained; no effect on heart weight was observed. In addition, background data on rat heart weight from six 28-day oral toxicity studies conducted in the same facility, year, strain, age, and breeder as the TMAH study were obtained from the Japan Existing Chemical Substances Database (JECDB). These investigations suggest that the statistically significant lower heart weight in the treated males in the 28-day toxicity study is likely caused by an incidental skewing of individuals with heavier heart weights toward control male groups and is not due to TMAH treatment. Thus, it is worthwhile to include as much relevant data as possible to confirm or refute unexpected findings in toxicity studies.

Association of Maternal Short Sleep Duration With Neurodevelopmental Delay in Offspring: A Prospective Cohort Study.

To investigate how short sleep duration (SSD) during pregnancy is related to neurodevelopmental delays in offspring, we aimed to inform pregnancy sleep guidelines and promote maternal health and child development. To identify the associations between SSD during pregnancy and offspring neurodevelopmental delay and to determine whether fetal glucose metabolism plays a role in SSD and neurodevelopmental delays. This cohort study followed 7059 mother-child pairs from the Maternal & Infants Health in Hefei cohort, and collected sleep data during pregnancy via the Pittsburgh Sleep Quality Index at weeks 24 to 28 and 32 to 36. Neurodevelopmental outcomes from 6 to 36 months postpartum were assessed via the Denver Developmental Screening Test-II and the Gesell Development Diagnosis Scale. Cox proportional hazard regression was used to analyze the link between maternal SSD and neurodevelopmental delay risk. Mediation analysis was used to evaluate the role of cord blood serum C-peptide levels. Three hospitals and children's health centers in Hefei were involved. The stratified analysis revealed a significant association between mothers with SSD during midpregnancy and neurodevelopmental delay in boys (adjusted HR 2.05, 95% CI 1.29, 3.25). Cord blood marker analysis revealed a positive relationship between cord blood serum C-peptide levels and neurodevelopmental delay in offspring (RR 0.04, 95% CI 0.00, 0.08). The proportion of the association between SSD and neurodevelopmental delay mediated by cord blood C-peptide was 11.05%. Maternal SSD during pregnancy was continuously associated with an increased incidence of neurodevelopmental delay with sex differences among offspring. This association may be mediated in part by increased higher levels of cord C-peptide.

Risk of Developmental Delay in Infants Born to Perinatal COVID-19-Positive Mothers at a Tertiary Care Hospital: A Cross-Sectional Study

Purpose: Prenatal and perinatal experiences of the mother are known to influence infant development. Maternal exposure to coronavirus disease 2019 (COVID-19) during pregnancy has been associated with increased morbidity and mother-baby separation. However, the developmental outcomes of infants born to COVID-19-positive mothers remain unclear. This study represents an initial exploratory effort to assess the developmental risks faced by infants born to mothers who tested positive for COVID-19. Methods: This cross-sectional study involved telephonic interviews and developmental screenings of 45 infants, aged 9 to 15 months, who were born to perinatal COVID-19-positive mothers between July 2020 and May 2021. The Ages &amp; Stages Questionnaire was used for the developmental assessment. The impacts of maternal, infant and separation-related factors on development were analyzed. Results: Within the study population, 28.8% (13 of 45 infants) presented with a risk of developmental delay. The gross motor and problem-solving domains were the most frequently impacted. Among the factors studied, prolonged separation period (exceeding 7 days), advanced maternal age, and gestational age (preterm birth) were associated with higher proportions of infants at risk of developmental delay; however, these associations were not statistically significant.Conclusion: This study suggests that infants born to mothers who tested positive for COVID-19 during the perinatal period face a risk of developmental delay. Factors such as maternal age, gestational age at birth, metabolic disease during pregnancy, and infant-mother separation could exacerbate this risk. Future research should prioritize objective assessments of development and long-term follow-up to monitor developmental outcomes in this population.