Infant Faces Research Articles

Tiny Lungs, Big Differences: Navigating the Varied COVID-19 Landscape in Neonates vs. Infants via Biomarkers and Lung Ultrasound.

Due to their susceptibilities, neonates and infants face unique SARS-CoV-2 challenges. This retrospective study will compare the illness course, symptoms, biomarkers, and lung damage in neonates and infants with SARS-CoV-2 infection from February 2020 to October 2023. This study was conducted at two hospitals in Timisoara, Romania, using real-time multiplex PCR to diagnose and lung ultrasonography (LUS) to assess lung involvement. Neonates had a more severe clinical presentation, an increased immune response, and greater lung involvement. Neonates had more PCR-positive tests (p = 0.0089) and longer hospital stays (p = 0.0002). In neonates, LDH, CRP, and ferritin levels were higher, indicating a stronger inflammatory response. Reduced oxygen saturation in neonates indicates respiratory dysfunction. The symptoms were varied. Infants had fever, cough, and rhinorrhea, while neonates had psychomotor agitation, acute dehydration syndrome, and candidiasis. This study emphasizes individualized care and close monitoring for neonatal SARS-CoV-2 infections. Newborn lung ultrasonography showed different variances and severity levels, emphasizing the need for targeted surveillance and therapy. Newborns have high lung ultrasound scores (LUSS), indicating significant lung involvement. Both groups had initial lung involvement, but understanding these modest differences is crucial to improving care for these vulnerable populations.

Exploring Risk Factors and Perinatal Outcomes of Preterm Birth in a Tertiary Care Hospital: A Comprehensive Analysis.

Background Preterm birth before 37 weeks of gestation is a global public health challenge, particularly in India, where the prevalence varies regionally. Understanding risk factors, such as maternal age and complications like hypertensive disorders, is vital. India's diverse healthcare landscape and regional disparities further complicate this issue. Preterm infants face increased mortality and morbidity risks like respiratory distress and intraventricular hemorrhage. This study in a tertiary care hospital aimed to analyze risk factors, assess perinatal outcomes, and contribute to the understanding of preterm birth in this complex context, providing valuable insights for maternal and child health strategies. Methods This retrospective cohort study was conducted at the Venkateshwara Institute of Medical Science, Rajabpur, over one year, extracting data from electronic health records. The study aimed to analyze risk factors associated with preterm delivery and assess perinatal outcomes. The study included diverse pregnancies, both singleton and multiple gestations, and employed sample size calculations to ensure statistical validity. Trained medical personnel collected extensive data on maternal characteristics, obstetric history, antenatal care, perinatal outcomes, and mode of delivery. Statistical analysis, utilizing SPSS (IBM, Chicago, USA), involved descriptive statistics, comparative analysis, chi-square tests, t-tests, Mann-Whitney U tests, and multivariate logistic regression models. Findings with a p-value <0.05 were considered significant. Results The study included 2042 deliveries, with a preterm birth prevalence of 14.2%. Multiparous women had higher preterm birth rates than primigravida (72.92% vs. 27.08%). Maternal age, history of preterm delivery, hypertensive disorders, inadequate antenatal care compliance, previous cesarean section, multiple gestations, antepartum hemorrhage (APH), polyhydramnios, oligohydramnios, and premature rupture of membranes (PROM) were significantly associated with preterm birth. Apgar scores at one minute and five minutes, neonatal complications, and mortality rates were notably worse among preterm births. Vaginal delivery rates were significantly lower in the preterm group (36.3%) compared to full-term deliveries (48.8%), with a higher rate of emergency cesarean sections (19.7% vs. 10.8%). Conclusion This study provides valuable insights into the risk factors and perinatal outcomes of preterm delivery at a tertiary care hospital, with precise values illustrating the extent of associations. The findings such as history of preterm delivery, hypertensive disorders, and inadequate antenatal care compliance as the most commonly associated conditions with preterm birthand management of such associated conditions may help reduce the rate of premature birth.

Gap Effect for Manual Responses in Chimpanzees (Pan troglodytes): Temporal Aspects of Attentional Disengagement, Cognitive aging, and the Test for Attentional Bias Toward Infant Faces

This study examined factors influencing the gap effect, a phenomenon where the saccadic latency is faster when the fixation point disappears than when it overlaps with the target. The gap effect has been used in basic attentional research, as well as in developmental, neurophysiological, and comparative research. This effect is found not only in oculomotor tasks but also in manual response tasks in humans. In this study, we conducted a gap-overlap task using manual spatially orienting responses in chimpanzees and examined several factors that influence this effect. The results confirmed the gap effect for manual orienting responses in chimpanzees. Response times for gap trials showed a floor effect at around the gap with 200 ms and more. The duration of the fixation point did not affect the gap effect, although it did affect the chimpanzees’ response times. The presence or absence of auditory stimuli at the fixation point offset did not affect the gap effect. We also analyzed the data from two geriatric individuals (51 years old) who participated in this study and confirmed the usefulness of this effect for studying comparative cognitive-aging studies. In a second task we examined attentional bias for infant faces, an effect which has been reported in humans. However, while a gap effect was observed overall, there was no significant difference in the gap effect among stimulus types.

PremieFeed: Investigating Preterm Infant Feeding Behaviors, Growth, and Caregiver Experiences in the First Weeks After NICU Discharge.

This study aimed to longitudinally investigate the preterm infant feeding regimens, feeding behaviors, effect on infant growth, and caregiver perceptions and experiences with feeding in the first 4 weeks following hospital discharge. Preterm infants face high nutritional risk due to their underdeveloped gastrointestinal systems and feeding coordination. Caregivers of preterm infants were recruited to participate in a weekly telephone survey for the first 4 weeks following the infant's hospital discharge. Responses for infant feeding behaviors and caregiver experiences were scored on a 3-point Likert scale. Growth and feeding data were collected from the infant's first neonatal intensive care unit (NICU) developmental follow-up visit. Twenty-four caregivers completed the study. Changes in feeding regimens were common (8/24 infants; 33%), with the percentage of infants receiving any human milk feedings decreasing from 70% at hospital discharge to 54% at 4 weeks post-discharge. Poor infant feeding skills were weakly associated with poor caregiver feeding experiences, and 46% of caregivers reported contacting their healthcare provider with feeding-related questions. Thirty-eight percent of infants required nutritional intervention at NICU developmental follow-up visit. Infants who received fortified feedings during the first 4 weeks after hospital discharge grew an average of 2.5 g/day faster than infants who did not receive fortified feedings. The postdischarge period for preterm infants is characterized by feeding regimen changes, a decrease in human milk use, and caregiver questions about feeding. Future studies should further investigate the period after hospital discharge to enable better feeding support for preterm infants and their caregivers.

Health Consequences of Natural Disasters: An Overview of Recent Literature on Floods

Disasters, whether arising from natural forces or human activities, engender substantial harm, loss, and, in severe cases, fatalities. The enduring repercussions extend across individuals, animals, societies, ecosystems, and geographical locations. The consequences of disasters on public health are particularly pronounced, manifesting in a spectrum of medical outcomes. This review delves into the specific impact of floods on distinct age groups, scrutinizing the varying vulnerabilities within each demographic. Infants, young children, teenagers, adults, and the elderly encounter distinctive challenges during and post-flood events, encompassing respiratory ailments, waterborne diseases, infections, hunger, physical injuries, and psychological disorders. Floods not only compromise healthcare services but also precipitate shortages in medication and suboptimal treatment. Health issues resulting from floods exhibit divergence among neonates, infants, children, adolescents, and older individuals. The susceptibility to physical injuries, infections, respiratory disorders, healthcare disruptions, mental health issues, malnutrition, and waterborne diseases varies with the unique vulnerabilities of each age group. Disruptions to routine life disproportionately impact children and adolescents, whereas infants and older individuals exhibit heightened susceptibility. Extreme flood events pose the potential for fatalities, with the risk contingent on both the severity of the flood and the age group affected. Older adults, newborns, and infants face a higher likelihood of mortality attributable to flood-related causes. Mitigating the adverse health effects of floods necessitates robust disaster planning, improved infrastructure, and targeted health interventions tailored to the age-related vulnerabilities of the population.

Manipulation of phasic arousal by auditory cues is associated with subsequent changes in visual orienting to faces in infancy

This eye-tracking study investigated the effect of sound-induced arousal on social orienting under different auditory cue conditions in 5-month-old (n = 25; n = 13 males) and 10-month-old infants (n = 21; n = 14 males) participating in a spontaneous visual search task. Results showed: (1) larger pupil dilation discriminating between high and low volume (b = 0.02, p = 0.007), but not between social and non-social sounds (b = 0.004, p = 0.64); (2) faster visual orienting (b = − 0.09, p < 0.001) and better social orienting at older age (b = 0.94, p < 0.001); (3) a fast habituation effect on social orienting after high-volume sounds (χ2(2) = 7.39, p = 0.025); (4) a quadratic association between baseline pupil size and target selection (b = − 1.0, SE = 0.5, χ2(1) = 4.04, p = 0.045); (5) a positive linear association between pupil dilation and social orienting (b = 0.09, p = 0.039). Findings support adaptive gain theories of arousal, extending the link between phasic pupil dilation and task performance to spontaneous social orienting in infancy.

Machine Learning-Derived Active Sleep as an Early Predictor of White Matter Development in Preterm Infants.

White matter dysmaturation is commonly seen in preterm infants admitted to the neonatal intensive care unit (NICU). Animal research has shown that active sleep is essential for early brain plasticity. This study aimed to determine the potential of active sleep as an early predictor for subsequent white matter development in preterm infants. Using heart and respiratory rates routinely monitored in the NICU, we developed a machine learning-based automated sleep stage classifier in a cohort of 25 preterm infants (12 females). The automated classifier was subsequently applied to a study cohort of 58 preterm infants (31 females) to extract active sleep percentage over 5-7 consecutive days during 29-32 weeks of postmenstrual age. Each of the 58 infants underwent high-quality T2-weighted magnetic resonance brain imaging at term-equivalent age, which was used to measure the total white matter volume. The association between active sleep percentage and white matter volume was examined using a multiple linear regression model adjusted for potential confounders. Using the automated classifier with a superior sleep classification performance [mean area under the receiver operating characteristic curve (AUROC) = 0.87, 95% CI 0.83-0.92], we found that a higher active sleep percentage during the preterm period was significantly associated with an increased white matter volume at term-equivalent age [β = 0.31, 95% CI 0.09-0.53, false discovery rate (FDR)-adjusted p-value = 0.021]. Our results extend the positive association between active sleep and early brain development found in animal research to human preterm infants and emphasize the potential benefit of sleep preservation in the NICU setting.

Maternal psychological risk and the neural correlates of infant face processing: A latent profile analysis.

Maternal psychological factors, including anxiety, depression, and substance use, may negatively affect parenting. Previous works with mothers have often assessed each of these factors in isolation despite their frequent co-occurrence. Psychological factors have also been associated with neural processing of facial stimuli, specifically the amplitude (i.e., size) and latency (i.e., timing) of the face-specific N170 event-related potential. In the current study, 106 mothers completed measures assessing maternal psychological factors-anxiety, depression, and substance use. A latent profile analysis was used to identify profiles of psychological factors and assess profile associations with the N170 elicited by infant faces and with parental reflective functioning (PRF) as a measure related to caregiving. Two profiles (termed high and low psychological risk) were identified, with the higher risk profile associated with delayed N170 latency responses to infant faces. An exploratory analysis evidenced an indirect effect between the higher psychological risk profile and lower PRF through delayed N170 latency responses to infant faces. Taken together, maternal psychological risk across multiple indicators may together shape neural processing of infant faces, which may have downstream consequences for caregiving.

Facilitators, barriers, and key influencers of breastfeeding among low birthweight infants: a qualitative study in India, Malawi, and Tanzania

BackgroundLow birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through infection prevention, growth improvements, and enhancements in neurodevelopment. However, limited data exist on the feeding experiences of LBW infants, their caregivers and key community influencers. The qualitative component of the Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand practices, facilitators, and barriers to optimal feeding options in the first six months for LBW infants in low-resource settings.MethodsThis study was conducted in four sites in India, Malawi, and Tanzania from July 2019 to August 2020. We conducted 37 focus group discussions with mothers and family members of LBW infants and community leaders and 142 in-depth interviews with healthcare providers, government officials, and supply chain and donor human milk (DHM) experts. Data were analyzed using a framework approach.ResultsAll participants believed that mother’s own milk was best for LBW infants. Direct breastfeeding was predominant and feeding expressed breast milk and infant formula were rare. DHM was a new concept for most. Adequate maternal nutrition, lactation support, and privacy in the facility aided breastfeeding and expression, but perceived insufficient milk, limited feeding counseling, and infant immaturity were common barriers. Most believed that DHM uptake could be enabled through community awareness by overcoming misconceptions, safety concerns, and perceived family resistance.ConclusionThis study fills an evidence gap in LBW infant feeding practices and their facilitators and barriers in resource-limited settings. LBW infants face unique feeding challenges such as poor latching and tiring at the breast. Similarly, their mothers are faced with numerous difficulties, including attainment of adequate milk supply, breast pain and emotional stress. Lactation support and feeding counseling could address obstacles faced by mothers and infants by providing psychosocial, verbal and physical support to empower mothers with skills, knowledge and confidence and facilitate earlier, more and better breast milk feeding. Findings on DHM are critical to the future development of human milk banks and highlight the need to solicit partnership from stakeholders in the community and health system.

Experiences of Indonesian nurses in improving preterm oral feeding readiness in special care units: A qualitative descriptive study.

Many preterm infants face feeding difficulties during the transition from enteral to oral feeding due to organ immaturity, resulting in aspiration, airway instability, and oral feeding intolerance. These challenges can increase morbidity and mortality among preterm infants. Nurses play a vital role in providing interventions to minimize negative impacts and enhance the safety of preterm oral feeding. This study aimed to explore the experiences of Indonesian nurses in improving preterm oral feeding readiness. A qualitative descriptive study was conducted involving ten nurses working in intensive care units as participants through purposive sampling. Data were collected through semi-structured, in-depth interviews conducted from January to March 2023. Thematic analysis was applied for data analysis. Four key themes developed in this study: 1) comprehensive and holistic nursing assessment, 2) challenging and complex nursing issues, 3) the need for nutritional management skills, and 4) the necessity of collaborative support. Nurses play a pivotal role in enhancing oral feeding readiness among premature infants. Their responsibilities include assessing oral feeding readiness, addressing nursing challenges, and implementing multidisciplinary stimulation involving parents. This study provides a foundational framework for developing interventions to improve preterm oral feeding readiness.

Attentional bias to infant faces might be associated with previous care experiences and involvement in childcare in same-sex mothers

BackgroundAttentional bias toward infant faces is associated with parental sensitivity and supports the infant-caregiver attachment relationship, ultimately fostering child health outcomes. However, experience-related determinants of parents' attentional bias to infant faces have been poorly investigated. We examined attentional bias to infant versus adult faces in a sample of same-sex mothers (N = 76), and whether it varied depending on maternal involvement in childcare and the perceived quality of past experiences of care. MethodA Go/no-Go attentional task was used to compare the effects of infant and adult faces in retaining attention. Maternal involvement in childcare was measured using items addressing nurturing behaviors. Memories of past experiences of care were collected using the short-form version of the Parental Acceptance-Rejection scale. ResultsResults confirmed that infant faces induced greater attentional bias compared to adult faces. More involved mothers were more biased, in terms of attention, to infant versus adult faces. Attentional bias to infant versus adult faces increased as mothers felt more rejected by their own fathers during childhood. DiscussionOur findings suggested that attentional bias to infant faces might be associated with past experiences of care and direct commitment in childcare in same-sex mothers. Robust and accurate empirical findings on same-sex parent families are essential to inform social policies supporting these families’ well being.

The Effects of Head Pose and Face Roundness on Age Progression in Children Faces

Background: This paper analyzes the geometric changes in human face during childhood to estimate the related age; cranial changes are used as age-progression features within childhood stage (0-12) years. Infant face is close to the circular shape turning to an ellipse shape over age progression face oval is determined and drawn using face landmarks, were it’s robust against opening mouth, thinness, fatness or face occlusion by hair.&#x0D; Materials and Methods: The experiments depending on two types of face dataset. First one is the standard FG-NET dataset, which was provided with face landmark points numbered from 1 to 68 [14, 15]. Besides, an Internet-based collected data set of (3010) face images extracted from Daily Photo Project.&#x0D; Results: Drawn face ellipse provided set of measures that significantly modeled changes in forehead size and face roundness. Studied age period was between birth and 12 years old. Exaggerated head size at birth provides round face with big forehead, which starts shrinking as age progresses natural face.&#x0D; Conclusion: Face ellipse provided efficient measures and distances to represent face changes along childhood. Comparing with published researches in young-face age estimation, proposed face ellipse recorded encouraging results.&#x0D;

Longitudinal changes in attention bias to infant crying in primiparous mothers.

Infant stimuli attract caregiver attention and motivate parenting behavior. Studies have confirmed the existence of attentional bias toward infant face stimuli; however, relatively little is known about whether attentional bias exists for infant cry stimuli, which are as important as faces in child-rearing situations. Furthermore, scarce longitudinal evidence exists on how attentional bias toward infant crying changes through the postpartum period. In the present study, we conducted an experiment to assess bias toward infant crying at two postpartum time points: at Time 1 (Mean = 75.24 days), 45 first-time mothers participated and at Time 2 (Mean = 274.33 days), 30 mothers participated. At both time points, the mothers participated in a Stroop task with infant crying and white noise as the stimuli. They were instructed to answer the color out loud as quickly and accurately as possible, while ignoring the sound. Four types of audio stimuli were used in this task (the cry of the mother's own infant, the cry of an unfamiliar infant, white noise matched to the cry of the mother's own infant, and white noise matched to the cry of an unfamiliar infant), one of which was presented randomly before each trial. Response time and the correct response rate for each condition were the dependent variables. For response time, the main effect of familiarity was significant, with longer response times when the participant's infant's cry was presented. In addition, response times were lower at Time 2 than at Time 1 in some conditions in which crying was presented. The results suggest that mothers may be less disturbed by infant crying as they gain more experience. Elucidating the characteristics of postpartum mothers' changes in cognitive performance related to infants' cries would be useful in fundamental and applied research to understand the process of parents' adaptation to parenting.

Community diversity and the other-race effect in infancy.

The other-race effect (ORE) is characterized by processing advantages for faces of one's own race over faces of another race and is observed at ~9 months of age. Environmental exposure to other races has an impact on the development of the ORE. In the current study, we examined the effects of community racial diversity on the ORE in 9- to 12-month-olds from across the United States. We hypothesized that community racial diversity would influence the amount of experience that infants have with individuals of other races and be an important factor in predicting the ORE across broad regions of the United States. We predicted that infants from more diverse communities would demonstrate successful processing of own- and other-race faces, while infants from less diverse communities would demonstrate successful processing of own-race but not other-race faces. This would indicate that the ORE is exhibited more strongly in infants from less diverse communities than in infants from more diverse communities. Participants completed familiarization and visual paired comparison (VPC) trials with own- and other-race faces in an online study. Our results showed that although the ORE was present, the effect was driven by community members who were the racial majority. Recognition biases were not observed in community racial or ethnic minority participants, potentially due to increased exposure to racial out-group members, which mitigated the development of the ORE in this subset of participants. This study has far-reaching implications in the study of infant face perception, child development, and social justice, as the ORE develops at a young age, and may lead to a complex pattern of racial biases contributing to systemic barriers in society.

Neural reactivity to infant emotion cues during pregnancy: Associations with peripartum anxiety and depressive symptoms

BackgroundPregnancy is marked by physiological and psychosocial changes for women, and event-related potentials (ERP) are comfortable and safe for examining brain function across pregnancy. The late positive potential (LPP) ERP, a measure of allocated attention to emotional stimuli, may provide insight into associations between internalizing symptoms and neural processing of infant emotion cues, which may be particularly salient in this life stage. MethodsWe developed a task to examine neural and behavioral responses to infant faces in pregnant women (N = 120, Mage=31.09, SD=4.81), the impact of auditory infant cries on the LPP to faces, and associations between the LPP and anxiety and depressive symptoms. Participants matched distressed, happy, and neutral infant faces and shapes as a comparison condition with interspersed auditory conditions (infant cry sounds vs. white noise) while electroencephalogram data were collected. Participants also completed self-report measures of anxiety and depressive symptoms. ResultsReaction time (RT) was faster for the infant cry vs. white noise condition and when matching shapes vs. infant faces. Depressive symptoms were associated with slower RTs to neutral infant faces. The LPP was enhanced overall to faces vs. shapes, but there was no main effect of auditory condition. Anxiety symptoms were associated with an enhanced LPP to infant distressed faces in the infant cry condition. ConclusionsResults support these methods for measuring neural and behavioral responses to infant emotional cues in pregnancy and provide evidence that combinations of auditory and visual stimuli may be particularly useful for capturing emotional processes relevant to anxiety.

Face inversion effect on perceived cuteness of infant faces.

Research has demonstrated that attractiveness evaluations of adult faces were less accurate when faces were inverted than upright. It remains unknown, however, whether a similar effect applies to perceived cuteness of infants, which is assumed to be based on elemental facial features called the "baby schema." In this research, we studied the face inversion effect on perceived cuteness of infant faces in a rating task and a two-alternative forced-choice (2AFC) task. We also examined beauty as a control dimension. Although the rating task revealed no inversion effect, the 2AFC task showed poorer discrimination performance with inverted faces than with upright faces in both evaluations. These results indicate that infant cuteness and beauty dimensions are correlated well with each other, and their perception not only relies on elemental features that are not strongly affected by inversion but is also affected by holistic facial configurations when a detailed comparison is required.

Breastfeeding needs of mothers of preterm infants in China: a qualitative study informed by the behaviour change wheel

BackgroundAlthough breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiological immaturity of preterm infants, Chinese mothers of preterm infants face unique challenges of maternal-infant separation after birth. Moreover, little is known about Chinese mothers’ specific needs in coping with the difficulties posed by these challenges. This study utilized the Behaviour Change Wheel to investigate the breastfeeding needs of Chinese preterm mothers that may facilitate its practice in the future.MethodA qualitative descriptive design was implemented in Wuhan in 2022. Based on purposeful sampling, 13 preterm mothers were recruited from a NICU in a Grade III Class A hospital in Wuhan, China. Face-to-face semi-structured interviews were conducted to collect data using the interview guide developed by the Theoretical Domains Framework. Theoretical Thematic Analysis was used to review the data in 6 steps to identify themes.ResultsFive major themes emerged: (1) capability: ability to interpret infants’ cues and identify problems, and need for breastfeeding knowledge and skills training; (2) physical opportunity: cleanliness and quietness in household environment, private lactation spaces and breastfeeding tools in workplaces and hospitals; (3) social opportunity: family support, peer support, and authoritative support from healthcare providers; (4) reflective motivation: information on health impacts of breastfeeding; (5) automatic motivation: maternal-infant bonding, free of aversive stimulus.ConclusionPreterm mothers’ needs to enable breastfeeding were diverse, including increasing their capability, physical and social opportunities, and reflective and automatic motivation. People, resources and environments associated with these needs should be engaged together to stablish a conducive structural environment for breastfeeding. The policy change for “zero separation” and implementation of kangaroo care should also be implemented in Chinese neonatal intensive care units. Future studies are needed to design effective interventions according to mothers’ specific needs.

In the mind of the beholder: The effects of familiarisation on the perception of atypical infant facial configurations.

Infant facial attractiveness is an important facilitator for adult-infant caregiving behaviour. Disruption to typical infant facial configurations can, however, attenuate their perceived attractiveness, as rated by adult observers. Previous research has either focused on how ratings are affected by observer characteristics (e.g., male/female), or alterations to infant faces, either experimentally, or naturalistically induced, such as the presence of a cleft lip. Little research has however been conducted on the effects of observer experience on adult ratings of infant facial attractiveness. Such effects could inform clinical work and policies aimed at promoting positive perception of facial malformations. The present study thus explored the effects of familiarisation on how typical and atypical infant facial configurations are evaluated by adults. We recruited two groups of female participants and compared their subjective attractiveness ratings of infant faces (24 typical and 24 cleft-affected), at baseline, and at one-week post-test. Between the two assessments, one group (n = 41) underwent a week-long training phase, where they were familiarised with cleft lip/palate-related visual and informational stimuli, while the control group (n = 44) received no training. Significantly higher ratings were provided for faces of typically developing versus cleft-affected infants by both groups of participants at baseline. At post-test, this pattern of ratings was repeated in participants belonging to the control group, while familiarised participants showed an increase, compared to baseline, in their ratings of cleft-affected faces and no difference between their evaluation of the latter and that of typically developing faces. These findings extend our understanding of the observer's experience in the evaluation of infant faces, beyond the effects of the structural characteristics of the observed faces. Results also highlight familiarity as a potentially protective influence against the negative consequences of alterations to typical facial configurations, suggesting avenues for intervention in supporting adult caregivers in the context of neonatal facial malformations.

Neurodevelopmental outcomes of very preterm infants born following early foetal growth restriction with absent end-diastolic umbilical flow

This study aims to assess the impact of time of onset and features of early foetal growth restriction (FGR) with absent end-diastolic flow (AEDF) on pregnancy outcomes and on preterm infants’ clinical and neurodevelopmental outcomes up to 2 years corrected age. This is a retrospective, cohort study led at a level IV Obstetric and Neonatal Unit in Bologna, Italy. Pregnant women were eligible if having singleton pregnancies, with no major foetal anomaly detected, and diagnosed with early FGR + AEDF (defined as FGR + AEDF detected before 32 weeks gestation). Early FGR + AEDF was further classified according to time of onset and specific features into very early and persistent (VEP, FGR + AEDF first detected at 20–24 weeks gestation and persistent at the following scans), very early but transient (VET, FGR + AEDF detected at 20–24 weeks gestation and progressively improving at the following scans) and later (LA, FGR + AEDF detected between 25 and 32 weeks gestation). Pregnancy and neonatal outcomes and infant follow-up data were collected and compared among groups. Neurodevelopment was assessed using the revised Griffiths Mental Developmental Scales (GMDS-R) 0–2 years. A regression analysis was performed to identify early predictors of preterm infants’ neurodevelopmental impairment. Fifty-two pregnant women with an antenatal diagnosis of early FGR + AEDF were included in the study (16 VEP, 14 VET, 22 LA). Four intrauterine foetal deaths occurred, all in the VEP group (p = 0.010). Compared to LA infants, VEP infants were born with lower gestational age and lower birth weight, had lower arterial cord blood pH and were at higher risk for intraventricular haemorrhage and periventricular leukomalacia (p < 0.05 for all comparisons). At 12 months, VEP infants had worse GMDS-R scores, both in the general quotient (mean [SD] 91.8 [12.4] vs 104.6 [8.7] in LA) and in the performance domain (mean [SD] 93.3 [15.4] vs 108.8 [8.8] in LA). This latter difference persisted at 24 months (mean [SD] 68.3 [17.0] vs 92.9 [17.7] in LA). In multivariate analysis, at 12 months corrected age, PVL was found to be an independent predictor of impaired general quotient, while the features and timing of antenatal Doppler alterations predicted worse scores in the performance domain. Conclusion: Timing of onset and features of early FGR + AEDF might impact differently on neonatal clinical and neurodevelopmental outcomes. Shared awareness of the importance of FGR + AEDF features between obstetricians and neonatologists may offer valuable tools for antenatal counselling and for tailoring pregnancy management and neonatal follow-up in light of specific antenatal and neonatal risk factors.What is Known:• Foetal growth restriction (FGR), together with antenatal umbilical Doppler abnormalities, is known to affect maternal and neonatal outcomes.• Infants born preterm and growth-restricted face the highest risk for neurodevelopmental impairment, especially when FGR occurs early during pregnancy (early FGR, before 32 weeks gestation).What is New:• The timing of onset and features of FGR and antenatal umbilical Doppler abnormalities impact differently on maternal and neonatal outcomes; when FGR and Doppler abnormalities occur very early, at the limit of neonatal viability, and persist until delivery, infants face the highest risk for neurodevelopmental impairment.• Shared knowledge between obstetricians and neonatologists about timing of onset and features of FGR would provide a valuable tool for informed antenatal counselling in high-risk pregnancies.

Supraventricular Tachycardia in the Setting of Neonatal COVID-19 Infection: A Case Report.

COVID-19 infection, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may present with a wide range of clinical presentations and a variety of symptoms in neonates. The cardiovascular manifestations that have been described in the setting of COVID-19 infection in neonates are tachycardia and hypotension, but information regarding cardiac arrhythmias is scarce, while the effect of SARS-CoV-2 on myocardial function is still not well established. We present a case of a neonate admitted with fever and nasal congestion. The neonate was tested positive for SARS-CoV-2. Supraventricular tachycardia (SVT) was diagnosed during his hospitalization in the neonatal intensive care unit. The neonate was under treatment with intravenous fluid repletion, intravenous broad-spectrum antibiotics, and continuous hemodynamic monitoring. SVT resolved spontaneously, while the team was preparing application of further supportive measures with a bag of ice on the infant's face. The neonate was discharged in good condition on day 14 post-admission, with no further recurrence of SVT. Follow-up visits were scheduled with the cardiologist. SVT in full-term or premature neonates can be a clinical manifestation of COVID-19 infection. Both neonatologists and neonatal nurse practitioners should be prepared to deal with cardiological manifestations of COVID-19 infection in neonates.