Early Infant Development Research Articles

Parent‐guided early intervention for preterm babies improves motor skills

Researchers have concluded, unsurprisingly, that preterm infants randomized to enhanced developmental support had better developmental outcomes than infants whose caregivers did not receive the training. The researchers started with the very safe hypothesis that enhanced developmental support provided by caregivers — mothers, mainly — would improve the outcomes of infants born preterm to families with low income. The used an intervention which included training was provided by a multidisciplinary team with specialized knowledge of early intervention and infant development. The training began in the Neonatal Intensive Care Unit (NICU) and continued after the infant was discharged.

The effect of the separation of mother-preterm newborn infants hospitalized during the COVID-19 pandemic on maternal depression and stress levels, infant development, and bonding quality on Chilean dyads.

Early infant development is a maturation process critically depends on the infant's interaction with primary caregivers. Hence, neonatal units prioritize their proximity. In COVID-19, parental visitation hours were limited, reducing caregivers time with their infants. This follow-up study analyzes and compares levels of maternal depression and stress, infant development, and bonding quality in preterm mother-infant dyads hospitalized, before and during the pandemic. Out of 66 dyads participated, 36 were admitted before COVID-19, and 30 during COVID-19. The assessed was two video-call sessions in which mothers completed selected questionnaires. No significant differences between mothers' levels of depression and stress. However, low birth weight was associated with greater difficulties in children's communication and interpersonal relationships. Furthermore, infants hospitalized in COVID-19 had a higher risk of experiencing delayed communication. No significant differences were observed in bonding quality. Lower infant gestational age and longer breastfeeding time were associated with better bonding quality in both groups. Psychosocial intervention is considered a valuable tool, capable of preventing maternal mental health difficulties and protecting bonding in premature infants and in highly complex healthcare settings. Nevertheless, it is essential to more actively address the socio-affective needs of newborns during their hospital stay to promote adequate development.

Early development of infants born prematurely who were conceived through assisted reproductive technologies

ObjectiveThis study aims to determine physical and psychomotor development characteristics during the first 24 months of life in prematurely born children conceived with assistive reproductive technologies and to determine specific risk factors for deviation from typical development. Patients and methodsThe study included 308 prematurely born children (154 conceived with assistive reproductive technologies – ART group and 154 conceived naturally – NC group) hospitalized at the Institute for the Health Care of Children and Adolescents of Vojvodina in Serbia. The physical and psychomotor development was monitored during the first two years of life. ResultsBirth weight was statistically significantly higher in the NC group than in the ART group, and IUGR was more often present in the ART group than in the NC group of newborns. The mean values of body weight, length, and head circumference of children from both groups did not differ statistically significantly at 18 months. At 12 and 18 months, children from the ART group significantly more often had below-average scores on the test for assessment of psychomotor development (corrected GDQ <90) than children from the NC group, but not at 24 months. Logistic regression analysis has shown that at 12 and 18 months, multiple pregnancy is an independent risk factor for lower GDQ. ConclusionAt the age of 12 months, prematurely born children conceived with ART do not differ in physical development from prematurely born children after natural conception. At 12 and 18 months, prematurely born children conceived with ART achieve lower global developmental scores than children conceived naturally, but not at 24 months of age. Multiple pregnancies are an independent risk factor for lower achievement on the test for assessment of psychomotor development in prematurely born children.

Growth and development of syphilis-exposed and -unexposed uninfected children during their first 18 months of life in Suzhou, China: a nested case-control study with propensity score matching.

With the successful implementation of Prevention of Mother-to-Child Transmission (PMTCT) policies, the proportion of infants with exposure to both syphilis and antibiotic medication in utero has increased in China, but there is limited evidence about the early growth and development of such infants. We conducted a retrospective nested case-control study based on data from the China PMTCT program conducted in Suzhou from 2016 to 2021. Propensity score matching (PSM) was employed to extract 826 syphilis-exposed but uninfected (SEU) infants and 1,652 syphilis-unexposed uninfected (SUU) infants from a total of 712,653 infants. Maternal characteristics were collected through questionnaires, such as parity, age, education level, smoking and drinking habits during pregnancy. Infantile characteristics were retrieved from medical records or via questionnaires, such as gestational age, gender, mode of delivery, Apgar scores, birth weight and length, outdoor time, vitamin D intake, and feed pattern. Mixed effects models, adjusting for potential influencing factors, were used to investigate the early infantile growth pattern of SEU and SUU infants. All statistical analysis were conducted using R (version 4.2.0). Length and weight were slightly higher in SEU infants than in the SUU infants at some time points (months 0 and 18 for length, p-values <0.05; months 0, 6, and 18 for weight, p < 0.05). In the mixed effects model, SEU group was found to be associated with higher weight [exponentiated beta exp.(β) = 1.15, 95% Confidence Interval (CI) = 1.06, 1.25], length [exp(β) = 1.42, 95% CI = 1.14, 1.77], and BMI z-score [exp(β) = 1.09, 95% CI = 1.00, 1.19]. With the effective prevention of congenital syphilis under the PMTCT program, SEU infants have non-inferior growth patterns during their first 18 months of life compared with SUU controls in Suzhou, China.

Non-Nutritive Suck Assessment Tool Development to Characterize Sucking Patterns in Infant with Various Hunger Levels

Sucking abilities are critical in early infant development, and the patterns of non-nutritive suck (NNS) have been found to potentially predict neurodevelopmental issues in the future. Proper NNS assessments are essential to ensure valid conclusions. Previous studies have shown that the level of infant arousal significantly affects NNS patterns. However, the author did not find any studies that observed the influence of infant hunger levels on NNS patterns. Therefore, this study aimed to develop an NNS assessment tool to characterize NNS patterns in infants with various hunger levels. The NNS assessment was conducted using a pressure transducer connected to a pacifier. The results showed that the level of hunger significantly affected the intra-burst frequency and the sucking pressure. The more hungry the infant, the more frequent the intra-burst frequency became, while the sucking pressure tended to decrease. The intra-burst frequency of infant sucking was 2.3, 2.46, and 2.5 Hz on average for a relative hunger index of 0.67, 0.83, and 1.0, respectively. The NNS pressure of infant sucking was 6.31, 4.51, and 2.62 kPa on average for a relative hunger index of 0.67, 0.83, and 1.0, respectively. This study's results suggest that during NNS assessments, the measurement time should consider the next feeding schedule for the infant.

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.

“DINO Vs. DINI” educational game to increase children's cognitive abilities—what are its level elements?

Games designed for children have the potential to serve as educational tools, incorporating learning components that promote engagement and facilitate the child's cognitive and developmental progress, tailored to their specific age group. The significance of Early Childhood Cognitive Abilities is in their association with everyday tasks and functions. The promotion of cognitive development in individuals with AUD necessitates the provision of many opportunities for cognitive stimulation. Children must attain fundamental competencies commensurate with their chronological age in cognitive development. The objective of developing this educational game is to assist early childhood education (PAUD) teachers and parents in delivering instruction through imaginative and inventive simulations. This study employs the Research and Development (R&amp;D) technique, utilizing a 4D model. The instructional game incorporates many level features that assess difficulty, accuracy, memory, and thinking abilities. This educational game encompasses four distinct learning modules tailored for early infant development. These modules include word completion exercises, counting activities, picture guessing tasks, color identification exercises, and competitive elements. The utilization of educational games is anticipated to facilitate the enhancement of children's cognitive capacities, thereby preparing them for the subsequent stages of their primary education.

Chemical Synthesis of Human Milk Oligosaccharides: para-Lacto-N-hexaose and para-Lacto-N-neohexaose.

Human milk oligosaccharides (HMO) have emerged as a very active area of research in glycoscience and nutrition. HMO are involved in the early development of infants and may help to prevent certain diseases. The development of chemical methods for obtaining individual HMO aids the global effort dedicated to understanding the roles of these biomolecules. Reported herein is the chemical synthesis of two common core hexasaccharides found in human milk, i. e. para-lacto-N-hexaose (pLNH) and para-lacto-N-neohexaose (pLNnH). After screening multiple leaving groups and temporary protecting group combinations, a 3+3 convergent coupling strategy was found to work best for obtaining these linear glycans.

Effect of prenatal exposure to organophosphates and pyrethroid pesticides on neonatal anthropometric measures and gestational age

Several studies have examined the association between prenatal exposure to organophosphate and pyrethroid pesticides and their impact on foetal growth and newborn anthropometry; however, the available evidence is limited and inconclusive. This study examined whether prenatal organophosphate and pyrethroid pesticide exposure was associated with anthropometric measures at birth (weight, length, head circumference), ponderal index, gestational age, and prematurity in 537 mother-child pairs. These were randomly selected from the 800 pairs participating in the prospective birth cohort GENEIDA (Genetics, early life environmental exposures and infant development in Andalusia). Six non-specific organophosphate metabolites (dialkylphosphates, DAPs), one metabolite relatively specific to chlorpyrifos (3,5,6-trichloro-2-pyridinol, TCPy) and a common metabolite to several pyrethroids (3-phenoxybenzoic acid, 3-PBA) were measured in maternal urine from the 1st and 3rd pregnancy trimesters. Information on anthropometric measures at birth, gestational age and prematurity was retrieved from medical records. The sum on a molar basis of DAPs with methyl (ƩDMs) and ethyl (ƩDEs) moieties and the sum of the 6 DAPs metabolites (ƩDAPs) was calculated for both trimesters of pregnancy. High urinary levels of dimethyl phosphate (DMP) during the 3rd trimester were associated with a decrease in birth weight (β = −0.24; 95% CI: 0.41; −0.06) and birth length (β = −0.20; 95% CI: 0.41; 0.02). Likewise, ΣDMs during 3rd trimester were near-significantly associated with decreased birth weight (β = −0.18; 95% CI: 0.37; 0.01). In turn, increased urinary TCPy during 1st trimester was associated with a decreased head circumference (β = −0.31; 95% CI: 0.57; −0.06). Finally, an increase in 3-PBA in the 1st trimester was associated with a decreased gestational age (β = −0.36 95% CI: 0.65–0.08), whereas increased 3-PBA at 1st and 3rd trimester was associated with prematurity. These results indicate that prenatal exposure to organophosphate and pyrethroid insecticides could affect normal foetal growth, shorten gestational age and alter anthropometric measures at birth.

Sex differences in infant vocalization and the origin of language

Seeking to discern the earliest sex differences in language-related activities, our focus is vocal activity in the first two years of life, following up on recent research that unexpectedly showed boys produced significantly more speech-like vocalizations (protophones) than girls during the first year of life.We now bring a much larger body of data to bear on the comparison of early sex differences in vocalization, data based on automated analysis of all-day recordings of infants in their homes. The new evidence, like that of the prior study, also suggests boys produce more protophones than girls in the first year and offers additional basis for informed speculation about biological reasons for these differences. More broadly, the work offers a basis for informed speculations about foundations of language that we propose to have evolved in our distant hominin ancestors, foundations also required in early vocal development of modern human infants.

Adverse Childhood Experiences: Associations with a Blunted Cortisol Stress Response During Pregnancy.

Adverse Childhood Experiences (ACEs) are associated with a range of negative physical and mental health outcomes, yet there is limited research focused on the effect of ACEs on stress responses during pregnancy. Expectant mothers experience an increase in cortisol levels as pregnancy progresses, with this increase having important implications for fetal and early infant development. Little is known about the impact of ACEs on maternal cortisol levels. This study explored the relationship between maternal ACEs and cortisol response among expectant mothers nearing or in the third trimester of pregnancy. 39 expectant mothers were exposed to a Baby Cry Protocol via an infant simulator, with salivary cortisol collected at five points in time (N = 181). Stepwise, multilevel model creation resulted in a random intercept and random slope model with an interaction term for total number of ACEs and week of pregnancy. The repeated measures data showed that cortisol levels decreased across collection times, from arrival at the lab, through the Baby Cry Protocol, to recovery. Predictive margins for the interaction term showed that while exposure to a greater number of ACEs was associated with higher cortisol levels early in the third trimester, the expected increase in cortisol late in pregnancy was blunted for expectant mothers who were exposed to a greater number of ACEs. These findings findings suggest the importance of ACEs screening and intervention efforts as part of prenatal care.

Craniosynostosis in Patients With X-Linked Hypophosphatemia: A Review.

Craniosynostosis is a rare condition of skull development, manifesting during fetal and early infant development, and is usually congenital. Craniosynostosis secondary to metabolic disorders, such as X-linked hypophosphatemia (XLH), is less common and is typically diagnosed later than congenital craniosynostosis. XLH is a rare, progressive, and lifelong hereditary phosphate-wasting disorder characterized by loss of function of the phosphate-regulating endopeptidase homologue, X-linked gene, which is associated with premature fusion of cranial sutures due to abnormal phosphate metabolism (hypophosphatemia) and altered bone mineralization or elevated levels of fibroblast growth factor 23. This targeted literature review of 38 articles seeks to provide an overview of craniosynostosis in individuals with XLH. The objectives of this review are to increase awareness of the prevalence, presentation, and diagnosis of craniosynostosis in XLH; examine the spectrum of craniosynostosis severity in XLH; discuss the management of craniosynostosis in those with XLH; recognize the complications for patients with XLH; and identify what is known about the burden of craniosynostosis for individuals with XLH. The presentation of craniosynostosis in individuals with XLH tends to manifest slightly later than congenital craniosynostosis and can vary in severity and appearance, making diagnosis difficult and resulting in inconsistent clinical outcomes. Consequently, craniosynostosis in patients with XLH is an underreported and potentially underrecognized condition. There have been no studies investigating the effects of craniosynostosis on the quality of life of people with XLH. Despite a growing awareness among researchers and experienced clinicians, there are still improvements to be made in general awareness and timely diagnosis of craniosynostosis in XLH. The XLH community would benefit from further study into the prevalence of craniosynostosis, the effect of XLH medical therapy on the development of craniosynostosis, and the effects of craniosynostosis on quality of life. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Development of a speech emotion recognizer for large-scale child-centered audio recordings from a hospital environment

In order to study how early emotional experiences shape infant development, one approach is to analyze the emotional content of speech heard by infants, as captured by child-centered daylong recordings, and as analyzed by automatic speech emotion recognition (SER) systems. However, since large-scale daylong audio is initially unannotated and differs from typical speech corpora from controlled environments, there are no existing in-domain SER systems for the task. Based on existing literature, it is also unclear what is the best approach to deploy a SER system for a new domain. Consequently, in this study, we investigated alternative strategies for deploying a SER system for large-scale child-centered audio recordings from a neonatal hospital environment, comparing cross-corpus generalization, active learning (AL), and domain adaptation (DA) methods in the process. We first conducted simulations with existing emotion-labeled speech corpora to find the best strategy for SER system deployment. We then tested how the findings generalize to our new initially unannotated dataset. As a result, we found that the studied AL method provided overall the most consistent results, being less dependent on the specifics of the training corpora or speech features compared to the alternative methods. However, in situations without the possibility to annotate data, unsupervised DA proved to be the best approach. We also observed that deployment of a SER system for real-world daylong child-centered audio recordings achieved a SER performance level comparable to those reported in literature, and that the amount of human effort required for the system deployment was overall relatively modest.

Distinct breast milk microbiota, cytokine, and adipokine profiles are associated with infant growth at 12 months: an in vitro host-microbe interaction mechanistic approach.

Breast milk (BM) is important for adequate infant development, and it contains bioactive compounds, such as bacteria, cytokines and some adipokines which play a role in infant microbial, metabolic, and immunological maturation. However, little is known about its impact on growth and development in early life. The objective of this study was to evaluate the impact of milk microbiota, cytokine, and adipokine profiles on the risk of overweight at 12 months of life to find the possible mechanisms of host-microbe interactions. In this study, BM samples from 100 healthy women collected during 15 d after birth were included. BM microbiota was analysed by 16S rRNA gene sequencing, and cytokine and adipokine levels were measured by the Luminex approach. In addition, infant weight and length were recorded during the first 12 months and z-scores were obtained according to the WHO databases. Infants were classified as risk of overweight (ROW) and no-risk of overweight (NOROW) based on their body mass index z-score (BMIZ) and infant weight-for-length z-score (WLZ) at 12 months. In order to study host-microbe interactions, epithelial intestinal and mammary cell lines were exposed to milk microbes to assess the host response by interleukin (IL)-6 production as a potential inflammatory marker. BM was dominated by Staphylococcus and Streptococcus genera, and the most abundant cytokines were IL-6 and IL-18. Leptin levels were positively correlated with the pregestational body mass index (BMI). Higher relative abundance of the Streptococcus genus was associated with higher IL-10 and higher relative abundance of the Bifidobacterium genus was associated with lower IL-6 concentrations in milk. Infant WLZ at 12 months could be partially predicted by Streptococcus genus proportions and IL-10 and IL-18 levels in BM. BM microbiota significantly induced cytokine responses in mammary epithelial cells. Higher levels of IL-6 production were observed in mammary cells exposed to BM microbiota from mothers with ROW offspring compared to mothers with NOROW offspring. In conclusion, BM microbiota is related to the cytokine profile. IL-10 and IL-18 levels and the abundance of the Streptococcus genus could affect early infant development. Further research is needed to clarify the specific impact of BM microbiota and cytokines on infant growth and the risk of overweight.

A descriptive evaluation of early feeding development of infants in a local neonatal unit

PurposeA local neonatal unit undertook a descriptive evaluation of feeding development of infants receiving care so as to identify and maximise effective neonatal team care and support. MethodA retrospective data review examined infant feeding development from one local neonatal unit. Data were stratified according to gestational birth age and included infant health, post – menstrual age on introduction of oral feeding, oral feeding progression, method of feeding and re-admission to hospital in the first 12 months of life. ResultsA total of 150 infants met the criteria for inclusion in this retrospective review. Infants ranged in age from 23(+0) – 42(+2) gestational birth ages. Number of days on the neonatal unit ranged from 1 to 159 (mean = 25.87) days. Extremely preterm (EPT) infants experienced a significantly longer stay on the neonatal unit, had the highest number of respiratory problems, took significantly longer to achieve full oral feeding and tended to start oral feeding at a significantly later post - menstrual age compared with other infants. A high number of infants needed to access acute services post - discharge from the neonatal unit. ConclusionsAll infants regardless of gestational birth age were at risk of developing feeding problems and hospital re-admissions post neonatal discharge. EPT infants were significantly vulnerable to poor feeding outcomes. Parent and team working is necessary to identify and support complex infants.

Postnatal maternal distress, infant subcortical brain macrostructure and emotional regulation

BackgroundMaternal distress is associated with an increased risk for adverse emotional development in infants, including difficulties with emotion regulation. Prenatal maternal distress has been associated with alterations in infant brain development. However, less is known about these associations with postnatal maternal distress, despite this being an important modifiable risk factor that can promote healthy brain development and emotional outcomes in infants. Methods & resultsInfants underwent magnetic resonance imaging (MRI) and mothers completed standardized questionnaires concerning their levels of perceived distress 2–5 months postpartum. Infant emotion regulation was assessed at 8–11 months via maternal report. When examining the associations between maternal distress and infant macrostructure, maternal anxiety was associated with infant right pallidum volumes. Increased display of negative emotions at 8–11 months of age was associated with smaller hippocampal volumes and this association was stronger in girls than boys. ConclusionFindings suggest that postnatal maternal distress may be associated with early infant brain development and emphasize the importance of maternal mental health, supporting previous work. Furthermore, macrostructural properties of infant subcortical structures may be further investigated as potential biomarkers to identify infants at risk of adverse emotional outcomes.

Association of birthweight centiles and early childhood development of singleton infants born from 37 weeks of gestation in Scotland: A population-based cohort study.

BackgroundBirthweight centiles beyond the traditional thresholds for small or large babies are associated with adverse perinatal outcomes but there is a paucity of data about the relationship between birthweight centiles and childhood development among children born from 37 weeks of gestation. This study aims to establish the association between birthweight centiles across the whole distribution and early childhood development among children born from 37 weeks of gestation.Methods and findingsThis is a population-based cohort study of 686,284 singleton infants born from 37 weeks of gestation. The cohort was generated by linking pregnancy and delivery data from the Scottish Morbidity Records (2003 to 2015) and the child developmental assessment at age 2 to 3.5 years. The main outcomes were child’s fine motor, gross motor, communication, and social developmental concerns measured with the Ages and Stages Questionnaires—3 (ASQ-3) and Ages and Stages Questionnaire: Social & Emotional—2 (ASQ:SE-2), and for a subset of children with additional specialist tools such as the Modified Checklist for Autism in Toddlers (M-CHAT) if the ASQ3/SE indicate these are necessary. The ASQ score for each domain was categorised as “concern” and “no concern.”We used multivariate cubic regression splines to model the associations between birthweight centiles and early childhood developmental concerns. We used multivariate Poisson regression models, with cluster robust errors, to estimate the relative risks (RRs) of developmental concerns below and above the established thresholds. We adjusted for maternal age, early pregnancy body mass index (BMI), parity, year of delivery, gestational age at delivery, smoking history, substance misuse in pregnancy, alcohol intake, ethnicity, residential area deprivation index, maternal clinical conditions in pregnancy (such as diabetes and pre-eclampsia), induction of labour, and child’s sex.Babies born from 37 weeks of gestation with birthweight below the 25th centile, compared to those between the 25th and 74th centile, were at higher risk of developmental concerns. Those born between the 10th and 24th centile had an RR of 1.07 (95% CI: 1.03 to 1.12, p < 0.001), between the 3rd and 9th centile had an RR: 1.18 (95% CI: 1.12 to 1.25, p < 0.001), and <3rd centile had an RR of 1.37 (95% CI: 1.24 to 1.50, p < 0.001). There was no substantial increase in the risk of early childhood developmental concerns for larger birthweight categories of 75th to 89th (RR: 1.01; 95% CI: 0.97 to 1.05; p = 0.56), 90th to 96th (RR: 0.99; 95% CI: 0.94 to 1.05; p = 0.86), and ≥97th centiles (RR: 1.04; 95% CI: 0.97 to 1.12; p = 0.27), referent to birthweight between 25th and 74th centile.The percentage of developmental concerns attributable to birthweight between the 10th and 24th centile was more than that of birthweight <3rd centile (p = 0.023) because this group includes more of the population. Approximately 2.50% (95% CI: 1.26 to 3.61) of social skills concerns and 3.00% (95% CI: 1.33 to 4.67) of fine motor developmental concerns were attributable to birthweight between the 10th and 24th centile compared to 0.90% (95% CI: 0.48 to 1.26) and 2.30% (95% CI: 1.73 to 2.67) respectively for birthweight <3rd centile. We acknowledge the limitation of ASQ as a screening tool, the subjective nature of developmental assessments (particularly for speech) among young children, and inability to control for early childhood illness and upbringing factors may have an impact on our findings.ConclusionsWe observed that from 37 weeks of gestation birthweight below the 25th centile was associated with child developmental concerns, with an association apparent at higher centiles above the conventional threshold defining small for gestational age (SGA, 3rd or 10th centile). Mild to moderate SGA is an unrecognised potentially important contributor to the prevalence of developmental concerns. Closer surveillance, appropriate parental counselling, and increased support during childhood may reduce the risks associated with lower birthweight centiles.

4.4 Vitamins and Minerals Treat Antenatal Depression and Improve Birth and Infant Development: Results of the Double-Blind NutriMum RCT

Antenatal depression is associated with perinatal complications and poor emotional and behavioral infant development. The NUTRIMUM trial: 1) evaluated efficacy and safety of micronutrients (MN, vitamins/minerals) for antenatal depression; and 2) explored their effect on delivery and early infant development compared to controls and infants exposed to conventional treatment.

Hubungan Pengetahuan Ibu dengan Kemampuan Deteksi Dini Tumbuh Kembang Bayi 0 – 12 Bulan di Posyandu Anyeler 5 Desa Jarin Kecamatan Pademawu

The prevalence of malnutrition in Indonesia is still high compared to neighboring countries, the cause is the quantity and quality of food intake which can be judged from its consumption in terms of quality and diversity. This study aims to determine the relationship between mother's knowledge and the ability to detect early growth and development of children 0-12 months at the Anyelir 5 Posyandu, Jarin Village. This research method uses correlational analysis. The population is the total number of mothers of infants 0 -12 months in the Anyelir 5 Posyandu in Jarin Village as many as 72 people. The sample in this study were 61 mothers with babies 0-12 months. It is expected that health workers need to provide counseling to mothers about good weaning methods, appropriate weaning times and good weaning foods, analysis using Spearman Rank Correlation test obtained rho count value (0.00) &lt; 0.05, where Ha is accepted which means there is The relationship between mother's knowledge and the ability to detect early growth and development of infants 0-12 months at the Anyelir 5 Posyandu, Jarin Village, Pademawu District, Pamekasan Regency in 2012.

The Sleep Well Baby project: an automated real-time sleep-wake state prediction algorithm in preterm infants.

Study ObjectivesSleep is an important driver of early brain development. However, sleep is often disturbed in preterm infants admitted to the neonatal intensive care unit (NICU). We aimed to develop an automated algorithm based on routinely measured vital parameters to classify sleep–wake states of preterm infants in real-time at the bedside.MethodsIn this study, sleep–wake state observations were obtained in 1-minute epochs using a behavioral scale developed in-house while vital signs were recorded simultaneously. Three types of vital parameter data, namely, heart rate, respiratory rate, and oxygen saturation, were collected at a low-frequency sampling rate of 0.4 Hz. A supervised machine learning workflow was used to train a classifier to predict sleep–wake states. Independent training (n = 37) and validation datasets were validation n = 9) datasets were used. Finally, a setup was designed for real-time implementation at the bedside.ResultsThe macro-averaged area-under-the-receiver-operator-characteristic (AUROC) of the automated sleep staging algorithm ranged between 0.69 and 0.82 for the training data, and 0.61 and 0.78 for the validation data. The algorithm provided the most accurate prediction for wake states (AUROC = 0.80). These findings were well validated on an independent sample (AUROC = 0.77).ConclusionsWith this study, to the best of our knowledge, a reliable, nonobtrusive, and real-time sleep staging algorithm was developed for the first time for preterm infants. Deploying this algorithm in the NICU environment may assist and adapt bedside clinical work based on infants’ sleep–wake states, potentially promoting the early brain development and well-being of preterm infants.