Early Childhood Neurodevelopment Research Articles

Prenatal exposure to ambient fine particulate matter and early childhood neurodevelopment: A population-based birth cohort study

Although previous studies have reported the adverse effect of air pollution exposure during pregnancy on neurodevelopment in children, epidemiological evidence is limited, and the results are inconsistent. This study aimed to explore the association between prenatal ambient fine particulate matter (PM2.5) exposure and early childhood neurodevelopment in a large birth cohort study of 4009 maternal-child pairs. Prenatal daily PM2.5 exposure concentrations at 1 km spatial revolution were estimated using high-performance machine-learning models. Neurodevelopmental outcomes of children at ages 2, 6, 12, and 24 months were assessed using the Ages and Stages Questionnaire (ASQ). Distributed lag nonlinear models were used to identify critical windows of prenatal PM2.5 exposure. General linear mixed models with binomially distributed errors were used to estimate the effect of prenatal PM2.5 exposure on suspected developmental delay (SDD) in five developmental domains based on the longitudinal design. Prenatal PM2.5 exposure was significantly associated with decreased scores for all neurodevelopmental domains of children at ages 2, 6, and 24 months. Each 10-μg/m3 increase in PM2.5 exposure was significantly associated with increased risk of SDD for all subjects (RR: 1.52 95% CI: 1.19, 2.03), specifically, in problem-solving domain for girls (RR: 2.23, 95% CI: 1.22, 4.35). Prenatal PM2.5 exposure in weeks 18 to 34 was significantly associated with both ASQ scores and SDDs. Our study proposed that prenatal PM2.5 exposure affected early childhood neurodevelopment evaluated with the ASQ scale. PM2.5 exposure might increase the risk of SDD for boys and girls, specifically in the problem-solving domain for girls.

Exposure to prenatal phthalate mixtures and neurodevelopment in the Conditions Affecting Neurocognitive Development and Learning in Early childhood (CANDLE) study

BackgroundFindings from epidemiological studies of prenatal phthalate exposure and child cognitive development are inconsistent. Methods for evaluating mixtures of phthalates, such as weighted quantile sum (WQS) regression, have rarely been applied. We developed a new extension of the WQS method to improve specificity of full-sample analyses and applied it to estimate associations between prenatal phthalate mixtures and cognitive and language outcomes in a diverse pregnancy cohort. MethodsWe measured 22 phthalate metabolites in third trimester urine from mother-child dyads who completed early childhood visits in the Conditions Affecting Neurodevelopment and Learning in Early childhood (CANDLE) study. Language and cognitive ability were assessed using the Bayley Scales of Infant Development (age 3) and the Stanford Binet-5 (age 4–6), respectively. We used multivariable WQS regression to identify phthalate mixtures that were negatively and positively associated with language score and full-scale IQ, in separate models, adjusted for maternal IQ, race, marital status, smoking, BMI, socioeconomic status (SES), child age, sex, and breastfeeding. We evaluated effect modification by sex and SES. If full sample 95% WQS confidence intervals (which are known to be anti-conservative) excluded the null, we calculated a p-value using a permutation test (ppermutation). The performance of this new approach to WQS regression was evaluated in simulated data. We compared the power and type I error rate of WQS regression conducted within datasets split into training and validation samples (WQSSplit) and in the full sample (WQSNosplit) to WQS regression with a permutation test (WQSpermutation). Individual metabolite associations were explored in secondary analyses. ResultsThe analytic sample (N = 1015) was 62.1% Black/31.5% White, and the majority of mothers had a high school education or less (56.7%) at enrollment. Associations between phthalate mixtures and primary outcomes (language score and full-scale IQ) in the full sample were null. Individual metabolites were not associated with IQ, and only one metabolite (mono-benzyl phthalate, MBzP) was associated with Bayley language score (β = −0.68, 95% CI: −1.37, 0.00). In analyses stratified by sex or SES, mixtures were positively and negatively associated with outcomes, but the precision of full-sample WQS regression results were not supported by permutation tests, with one exception. In the lowest SES category, a phthalate mixture dominated by mono-methyl phthalate (MMP) and mono-carboxy-isooctyl phthalate (MCOP) was associated with higher language scores (βlow SES = 2.41, full-sample 95%CI: 0.58, 4.24; ppermutation = 0.04). Performance testing in simulated data showed that WQSpermutation had improved power over WQSSplit (90% versus 56%) and a lower type I error rate than WQSNosplit (7% versus 47%). ConclusionsIn the largest study of these relationships to date, we observed predominantly null associations between mixtures of prenatal phthalates and both language and IQ. Our novel extension of WQS regression improved sensitivity to detect true associations by obviating the need to split the data into training and test sets and should be considered for future analyses of exposure mixtures.

Prenatal triclosan exposure and neurodevelopment at 2 years of age in Shandong, China

Background Triclosan (TCS) has been widely detected in pregnant women. Limited epidemiological studies suggest that prenatal exposure to TCS may interfere with the neurodevelopment of school-age children. However, there is a lack of evidence for effects on children in early childhood, especially in China. Methods Based on Laizhou Wan Birth Cohort in Shandong, China, TCS concentrations were measured in urine among 489 pregnant women during their hospital admission for delivery. Neurodevelopment of their children was assessed using the Gesell Development Schedules (adopted by the Chinese Pediatric Association and widely used for assessing early child development in China, including gross motor, fine motor, adaptive, language, and social domains) at 2 years of age (n=294). Linear regression and generalized linear models were used to analyze the association between prenatal TCS exposure and the toddlers’ developmental quotient scores (DQs).Results The median of maternal TCS concentrations was 0.24μg/L and 0.67μg/g creatinine. Although no association was found between prenatal TCS exposure and DQs in the five domains, adverse associations were detected after gender stratification. We found an inverse association between prenatal TCS concentrations and DQs in the language domain among boys. Specifically, for every 10-fold increase in TCS concentrations, DQs decreased by 2.13 points (β= -2.13; 95% CI: -4.06 to -0.19, p=0.03). Besides, prenatal TCS concentrations were adversely associated with DQs in the adaptive domain among boys (p-trend=0.01) and DQs in the gross motor domain among girls (p-trend=0.03) by the trend across TCS quartiles. Conclusions Based on a Chinese population, our findings suggest that prenatal TCS exposure might have adverse effects on neurodevelopment at the age of 2 in a gender-dependent manner. Further studies to replicate our findings are needed and further investigations are required to examine the potential mechanisms underlying the association between early-life TCS exposure and neurodevelopment in early childhood.

Relationships between dietary diversity and early childhood developmental outcomes in rural China.

The period from birth to 2years of age is highly sensitive with respect to the relationship between nutrition and neurodevelopment, but data regarding the association between dietary diversity and early childhood neurodevelopment are limited. We sought to examine the association of two feeding indicators—minimum dietary diversity (MDD) and minimum meal frequency (MMF)—with the neurodevelopment of children aged 6–23 months, using data from a cross‐sectional survey conducted in six rural counties in China. Data on 1,534 children were analysed using logistic regression to explore the associations between dietary diversity and early neurodevelopment, with adjustments for the age, sex and prematurity of the child; the age, sex and educational level of the caregiver; and family size, income and simulative care practices and resources. We found that 32.4% of children had suspected developmental delays based on the Chinese version of the Ages and Stages Questionnaires Version 3, whereas 77.0% and 39.2% failed to meet the MDD and MMF, respectively. Meeting the MDD was associated with a 39% lower risk of developmental delays (AOR = 0.61, 95% CI [0.43, 0.86]). There was a significant association between MDD and reduced likelihood of developmental delays in gross motor, fine motor, problem‐solving and personal social subscales, whereas MMF was only associated with a lower risk of developmental delays in the gross motor subscale (AOR = 0.63, 95% CI [0.42, 0.94]). We observed an inverse dose–response relationship between the number of food groups consumed and the risk of developmental delays (P < .001).

General anesthesia for cesarean delivery and childhood neurodevelopmental and perinatal outcomes: a secondary analysis of a randomized controlled trial

BackgroundIn 2016, the U.S. Food and Drug Administration expressed concern that neurodevelopment may be negatively affected by anesthesia or sedation exposure in pregnancy or before three years of age. We examined the association between general anesthesia at the time of cesarean delivery and early childhood neurodevelopment. MethodsA secondary analysis of a multicenter randomized controlled trial assessing magnesium for prevention of cerebral palsy in infants at risk for preterm delivery. Exposure was general compared to neuraxial anesthesia. The primary outcome was motor or mental delay at two years of age, assessed by Bayley Scales of Infant Development II (BSIDII). Secondary outcomes included BSIDII subdomains and perinatal outcomes. Multivariable logistic regression models were performed to control for confounders. ResultsOf 557 women undergoing cesarean delivery, 119 (21%) received general anesthesia. There were no differences in the primary composite outcome of developmental delay (aOR 0.93, 95% CI 0.61 to 1.43) or the BSIDII subdomains of mild, moderate, or severe mental delay, or mild or moderate motor delay. Severe motor delay was more common among infants exposed to general anesthesia (aOR 1.98, 95% CI 1.06 to 3.69). Infants exposed to general anesthesia had longer neonatal intensive care stays (51 vs 37 days, P=0.010). ConclusionsGeneral anesthesia for cesarean delivery was not associated with overall neurodevelopmental delay at two years of age, except for greater odds of severe motor delay. Future studies should evaluate this finding, as well as the impact on neurodevelopment of longer or multiple anesthetic exposures across all gestational ages.

37 Growth and neurodevelopment in early childhood of preterm infants with complex congenital heart defects following open cardiac surgery

Abstract Background Compared with those born at term gestation, infants with complex congenital heart defects (CCHD) who were delivered before 37 weeks of gestational age and received neonatal open cardiac surgery (OHS) have poorer neurodevelopmental outcomes in early childhood. Specific details related to the neurodevelopmental outcome of these infants remain unpublished. Objectives To describe the growth, disability, functional, and neurodevelopmental outcome in early childhood of preterm infants (born at &amp;lt;37+0 weeks gestation) with CCHD and neonatal OHS. Design/Methods We studied all infants with CCHD who received OHS within 6 weeks of corrected age between 1996 and 2016. In the Western Canadian Complex Pediatric Therapies Follow-up Program, comprehensive neurodevelopmental assessments at a corrected age of 18-24 months were done by multidisciplinary teams at the original referral sites. In addition to demographic and clinical data, standardized age-appropriate outcome measures included physical growth with calculated Z-scores, disabilities including cerebral palsy, visual impairment, sensorineural hearing loss; adaptive function (Adaptive Behavioural Assessment System-II); and cognitive, language, and motor skills (Bayley Scales of Infant and Toddler Development-III). Results From 1996 to 2016, 115 preterm infants (34±2 weeks gestation, 2339±637g, 64% males) with CCHD had OHS with 11(10%) deaths before first discharge and 21 (18%) by 2 years. Prior to the first surgery, 7 (6%) neonates had cerebral injuries. Overall, 7 had necrotizing enterocolitis; none had retinopathy of prematurity. All 94 surviving infants received comprehensive evaluation at 2 years corrected age; Eighteen (19%) had congenital syndromes who had worse functional and neurodevelopmental outcomes compared to those (n=76) without syndromal abnormalities (SA) (Table). Conclusion For preterm neonates with CCHD and early OHS, the mortality was significant, but the short-term neonatal morbidity was not increased. Compared with published preterm outcomes, the early outcome suggests more cerebral palsy but not sensorineural hearing loss, and greater neurodevelopmental delay. This information is important for management care of the infants, parental counselling and the decision-making process.

Adverse effects of prenatal mercury exposure on neurodevelopment during the first 3 years of life modified by early growth velocity and prenatal maternal folate level

Background and aimsPrevious studies have suggested that mercury exposure and folate levels during pregnancy may influence early childhood neurodevelopment. Rapid catch-up growth in children is associated with an increased risk of pathological nervous system development. We evaluated whether the association between prenatal folate and mercury-related neuropsychological dysfunction was modified by growth velocity during childhood. MethodsThe Mothers and Children's Environmental Health (MOCEH) birth cohort study began in 2006 and by 2010, 1751 women had been enrolled before the second trimester of their pregnancy along with their partners. Participants visited the research center at birth and 6, 12, 24, and 36 months. We measured mercury levels in maternal and cord blood and folate in maternal serum. Questionnaires to evaluate the environment and health of their child were administered and anthropometric factors including body weight and height were measured. Certified investigators used the Bayley test to measure neurobehavioral outcomes. We calculated postnatal growth change as the change in infant weight for-age z-score between birth and 3 years. Multiple linear regression and mixed models were used to examine the association between mercury exposure and children's neurodevelopment as well as the modifying effects of folate and growth velocity. ResultsA total of 30.6% of children experienced rapid growth during the first 3 years of life. Median values of mercury in the low folate group were significantly higher in rapid growers (3.41 μg/L in maternal blood and 5.63 μg/L in cord blood) than in average/slow growers (3.05 μg/L in maternal blood and 5.19 μg/L in cord blood). Rapid growers were also significantly associated with decreased psychomotor development scores during the first 3 years of life and with having mothers who had low prenatal folate levels, even after adjusting for potential confounders. ConclusionPrenatal mercury exposure adversely affects infant neurodevelopment and is associated with rapid growth during the first 3 years of life. This effect was limited to children whose mothers had low prenatal folate levels, suggesting a protective effect of folate against developmental neurotoxicity due to mercury exposure and rapid catch-up growth.

Associations of acetaminophen use during pregnancy and the first year of life with neurodevelopment in early childhood.

Over-the-counter analgesic use during pregnancy, particularly acetaminophen, may be associated with negative developmental outcomes in children. Estimate associations of prenatal and early-life exposure to acetaminophen in early childhood with cognitive, motor, and language skills in two birth cohorts. The American Project Viva cohort (1217 mother-child pairs enrolled 1999-2002) assessed cognition at approximately 3years using the Peabody Picture Vocabulary Test and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). The Brazilian 2015 Pelotas Birth Cohort (3818 mother-child pairs) assessed cognition at 2years using the INTERGROWTH-21st Neurodevelopment Assessment. We used linear regression to estimate associations of acetaminophen use during pregnancy (Project Viva and Pelotas) and infancy (Project Viva) with children's cognitive scores adjusted for maternal age, pre-pregnancy body mass index, education, parity, race/ethnicity, smoking and alcohol use during pregnancy, depression during pregnancy, antibiotic and ibuprofen use during pregnancy, household income, and child's sex. In Project Viva, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was associated with lower WRAVMA drawing scores (β -1.51, 95% CI -2.92, -0.10). However, in Pelotas, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was not associated with INTER-NDA motor scores (β 0.02; 95% CI -0.05, 0.09) and was associated with higher INTER-NDA total scores (β 0.08, 95% CI 0.01, 0.16). Other comparisons did not show evidence for any associations. Inconsistencies and lack of specificity of the findings did not clarify the research question considering that we still have a large variability and uncertainty to define the risk or safety in the use of acetaminophen related to cognition in early childhood. More studies using better exposure assessment and better confounding variables are needed to clarify these associations.

Early childhood developmental functional connectivity of autistic brains with non-negative matrix factorization.

Autism spectrum disorder (ASD) is associated with altered patterns of over- and under-connectivity of neural circuits. Age-related changes in neural connectivities remain unclear for autistic children as compared with normal children. In this study, a parts-based network-decomposition technique, known as non-negative matrix factorization (NMF), was applied to identify a set of possible abnormal connectivity patterns in brains affected by ASD, using resting-state electroencephalographic (EEG) data. Age-related changes in connectivities in both inter- and intra-hemispheric areas were studied in a total of 256 children (3-6 years old), both with and without ASD. The findings included the following: (1) the brains of children affected by ASD were characterized by a general trend toward long-range under-connectivity, particularly in interhemispheric connections, combined with short-range over-connectivity; (2) long-range connections were often associated with slower rhythms (δ and θ), whereas synchronization of short-range networks tended to be associated with faster frequencies (α and β); and (3) the α-band specific patterns of interhemispheric connections in ASD could be the most prominent during early childhood neurodevelopment. Therefore, NMF would be useful for further exploring the early childhood developmental functional connectivity of children aged 3-6 with ASD as well as with typical development. Additionally, long-range interhemispheric alterations in connectivity may represent a potential biomarker for the identification of ASD.

Prepregnancy obesity is associated with lower psychomotor development scores in boys at age 3 in a low-income, minority birth cohort.

Whether maternal obesity and gestational weight gain (GWG) are associated with early-childhood development in low-income, urban, minority populations, and whether effects differ by child sex remain unknown. This study examined the impact of prepregnancy BMI and GWG on early childhood neurodevelopment in the Columbia Center for Children's Environmental Health Mothers and Newborns study. Maternal prepregnancy weight was obtained by self-report, and GWG was assessed from participant medical charts. At child age 3 years, the Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Intelligence were completed. Sex-stratified linear regression models assessed associations between prepregnancy BMI and pregnancy weight gain z-scores with child PDI and MDI scores, adjusting for covariates. Of 382 women, 48.2% were normal weight before pregnancy, 24.1% overweight, 23.0% obese, and 4.7% underweight. At 3 years, mean scores on the PDI and MDI were higher among girls compared to boys (PDI: 102.3 vs. 97.2, P = 0.0002; MDI: 92.8 vs. 88.3, P = 0.0001). In covariate-adjusted models, maternal obesity was markedly associated with lower PDI scores in boys [b = -7.81, 95% CI: (-13.08, -2.55), P = 0.004], but not girls. Maternal BMI was not associated with MDI in girls or boys, and GWG was not associated with PDI or MDI among either sex (all-P > 0.05). We found that prepregnancy obesity was associated with lower PDI scores at 3 years in boys, but not girls. The mechanisms underlying this sex-specific association remain unclear, but due to elevated obesity exposure in urban populations, further investigation is warranted.

Prenatal and early postnatal phthalate exposure and child neurodevelopment at age of 7 years – Polish Mother and Child Cohort

Phthalates are among the most frequently investigated environmental chemicals influencing children's health and particularly their neuropsychological development. However, the reported effects of these compounds on child behavior, cognitive and psychomotor outcomes are not fully consistent. The aim of this study is to evaluate the associations between prenatal and early postnatal phthalate exposures and child neurodevelopment at age of 7 years. A total of 134 mother-child pairs from Polish Mother and Child Cohort (REPRO_PL) constitute the basis for current analysis. Eleven phthalate metabolites were measured in urine samples collected from mothers in the 3rd trimester of pregnancy and from children at the age of 2 years. Child neuropsychological development at early school age (7 years) was assessed by both the Strengths and Difficulties Questionnaire (SDQ) filled by mothers and the Polish adaptation of the Intelligence and Development Scales (IDS) performed by psychologists. Mono-ethyl phthalate (MEP) concentration during pregnancy was significantly associated with increased risk of peer relationship problems in SDQ (OR = 2.7, p = 0.03). The results of the IDS analyses focused on child's cognitive and psychomotor development are not fully conclusive. Negative associations were evident between some phthalates in early childhood period and fluid intelligence and cognition (MEP: β = −5.2; p = 0.006; β = −4.2; p = 0.006; mono-n-butyl phthalate (MnBP): β = −4.9; p = 0.03; β = −4.0; p = 0.03; respectively), while positive associations have been found in the prenatal period (mono-2-ethyl-5-oxo-hexyl phthalate (oxo-MEHP): β = 3.6; p = 0.03 for fluid intelligence; β = 2.9; p = 0.03 for cognition). Further studies are required in order to elucidate which are the most critical periods of phthalate exposure on children's neurodevelopmental outcomes.

Associations of body composition with brain size in very preterm infants

Background: For very preterm infants, faster weight gain during the neonatal hospitalization is associated with better neurodevelopment in early childhood. Body composition analysis distinguishes lean from fat mass, and may provide information about components of weight gain that contribute to improved brain growth and development. Currently, little is known about the relationship between body composition and brain size in very preterm infants. Purpose: To assess associations of lean and fat mass with brain …

Early Childhood Neglect, Toxic Stress, and Neurodevelopment

Several and recent neuroscientific studies have accumulated empirical evidence about the maturation and neurodevelopmental processes that occur in the human brain during the first months and years of life. This immaturity gives the human brain under construction greater plasticity and learning capacity, but also leads to greater vulnerability to harmful and toxic agents from the environment. Therefore, it is considered that the care quality received in early childhood and child abuse in the form of emotional neglect, directly influence the architecture and functionality of the developing brain, both of which would elicit physiological responses of chronic and sustained (toxic) stress, being a key risk factor for the development of both physical and mental illness (anxiety and depression) in adolescence and adulthood. In this sense, a prevention model is proposed in which the first caregivers (family and school) act appropriately contributing to improve school success.

Residential exposure to green space and early childhood neurodevelopment

BackgroundA few studies reported that exposure to high levels of residential surrounding green spaces was associated with better cognitive development in primary school children. However, no studies have been conducted to examine such association in early childhood. ObjectivesWe investigated the association between residential exposure to green space and early childhood neurodevelopment, and further explored the mediation effects of traffic-related air pollution and maternal physical activity on this association. MethodsWe enrolled 1312 pregnant women between January 2012 and October 2015 and their children were followed up until an age of 2 years. We measured residential exposure to green space by calculating averaged normalized difference vegetation index (NDVI) within a 300 meter buffer area surrounding residential address at birth. The neurodevelopment, which included mental development index (MDI) and psychomotor development index (PDI), was assessed using Bayley Scales of Infant Development for each child at about 24 months. The associations of residential exposure to NDVI with early childhood MDI score and PDI score were evaluated using multiple linear regression models. The mediation effects of traffic-related air pollution and maternal physical activities on those associations were estimated by causal mediation analyses. ResultsExposure to higher levels of residential surrounding green spaces was associated with increased early childhood PDI score (adjusted changes for one SD increment of NDVI: 3.28 (95% CI: 2.15, 4.41)) and MDI score (adjusted changes for one SD increment of NDVI: 1.97 (95% CI: 0.63, 3.30). These associations were more pronounced in children of mothers whose pre-pregnancy BMI were lower than 24 kg/m2. Further mediation analyses indicated that reduced levels of traffic-related air pollution explained 13.6% to 28.0% of the association between exposure to green space and early childhood PDI score. ConclusionExposure to higher levels of residential surrounding green spaces was associated with better early childhood neurodevelopment. The association between exposure to green space and early childhood psychomotor development might be partly explained by reduced levels of traffic-related air pollution.

Prenatal Bisphenol A exposure and early childhood neurodevelopment in Shandong, China.

Several epidemiological studies suggest that prenatal exposure to BPA may interfere with the neurodevelopment of pre-school and school-age children. However, a limited number of studies are available for effects during children at a younger age, especially in China. Based on Laizhou Wan Birth Cohort (LWBC), BPA concentrations were measured in urine among 506 pregnant women during their hospital admission for delivery and neurodevelopment of their children was assessed using the Gesell Development Schedules at 12 months (n = 368) and 24 months (n = 296). Linear regression and generalized linear models were used to analyze the association between prenatal BPA exposure and the children's developmental quotient scores (DQs). The median of maternal BPA concentration was 0.48 μg/L or 1.05 μg/g creatinine. Maternal BPA concentrations were adversely associated with children DQs at 12 months of age, with a 10-fold increase in prenatal BPA concentrations correlated to 1.43-point decrease in DQs in the adaptive domain (β = -1.43; 95% CI: -2.30 to -0.56, p = 0.001). When stratified by gender, prenatal BPA concentrations were adversely associated with the adaptive domain DQs among boys (p-trend = 0.012) and girls (p-trend = 0.028) and the social domain DQs (p-trend = 0.019) only among girls. At 24 months of age, the significant adverse association was only found in the language domain among girls (β = -1.69; 95% CI: -3.23 to -0.15, p = 0.032). Based on a Chinese population, we found potential impacts of prenatal BPA exposure on childhood neurodevelopment at 12 and 24 months of age, especially among girls.

Determinants of neurodevelopment in early childhood - results from the Copenhagen prospective studies on asthma in childhood (COPSAC2010 ) mother-child cohort.

The objective of this study was to identify possible pre- and postnatal factors influencing neurodevelopment of the young child. We used data from the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010 ) mother-child cohort, but excluded those with a neurological diagnosis, born <37weeks of gestation and birthweights <2500g, resulting in 650 children analysed. Neurodevelopment was assessed as age of achievement of early milestones, language scores at 1 and 2years and cognitive score at 2 ½ years of age. Neurodevelopmental scores were not associated with breastfeeding, persistent wheeze, eczema and number of sick days (p>0.05 in all tests). Early age at milestone achievement was associated with male sex (p=0.05), lower maternal age (p=0.02), higher gestational age (p<0.001) and paternity leave (p=0.01). A higher 1-year language score was associated with female sex (p=0.02) and maternal smoking during pregnancy (p=0.01) and a higher 2-year language score with female sex (p<0.001) and being first born (p=0.01). A higher cognitive score was associated with female sex (p=0.02). Neurodevelopmental scores were unrelated to breastfeeding, persistent wheeze, eczema and number of sick days. Neurodevelopment in early childhood was mostly associated with gender.

Postnatal Exposure to Secondhand Smoke Measured with Urinary Cotinine and Neurodevelopment at 36 Months after Considering Outdoor Fine Particle (PM2.5)

Background/ObjectiveNeurodevelopment of infants have been associated with exposure to secondhand smoke (SHS) and air pollution (AP), respectively. There has been very few previous studies of combined effect of AP and SHS on early neurodevelopment. We aim to investigate the combined effect of postnatal AP and SHS exposure on neurodevelopment of infants at 36 months of age.MethodsThis study is a part of the Mothers and Children Environmental Health (MOCEH) study, a Korean multi-center prospective birth cohort study initiated in 2006. We measured infants&amp;#8217; urinary cotinine at 24 months and 36 months of age to represent postnatal SHS exposure. PM2.5 (particulate matter&amp;lt;2.5 in diameter) level from conception was modelled using the Community Multiscale Air Quality Modeling. The exposure estimations of PM2.5 of each subject were assigned in district level. Infant&amp;#8217;s mental developmental index (MDI) and psychomotor developmental index (PDI) were measured using the Bayley Scales of Infant Development at 36 months of age. General linear model was used to assess the relationship between combined exposure of PM2.5 and SHS and neurodevelopment.ResultsMDI score of 36 months aged infants was marginally associated with log-transformed urinary cotinine level at 24 months [&amp;#946;&amp;#61; -1.94, 95%confidence interval (CI): -3.92, 0.04] after adjusting for log-transformed urinary cotinine level at 36 months and PM2.5 level after birth. The association was statistically significant when the effect of PM2.5 level at early pregnancy was considered, &amp;#946;&amp;#61; -2.02 (95%CI: -4.01, -0.03). The effect was pronounced in the metropolitan city, &amp;#946;&amp;#61; -7.92 (95%CI: -13.15, -2.70). No association was found in PDI score.ConclusionsThese findings suggest that infants&amp;#8217; postnatal exposure to SHS combined with exposure to PM2.5 may result in delayed neurodevelopment in early childhood. Therefore, we should take care of both indoor and outdoor air pollution with regards to the neurodevelopment of infants.

Prenatal Exposure to Ambient Air Pollution and Early Childhood Neurodevelopment: A Longitudinal Birth Cohort Study in an Urban Region of the Southeastern U.S.

Background: Animal studies indicate that air pollution may be neurotoxic, but evidence in humans is limited. We analyzed associations between prenatal air pollution and childhood neurodevelopment in a large birth cohort in Shelby County, TN.Methods: We included mother-child dyads who completed a preschool visit in the Conditions Affecting Neurocognitive Development and Early Childhood (CANDLE) study. Primary outcomes were internalizing and externalizing behavior scores (Child Behavior Checklist) and full-scale IQ score as a measure of general cognition. Prenatal exposures to nitrogen dioxide (NO2) and particulate matter less than 10 microns (PM10) at maternal residences were estimated using a national annual average universal kriging model (land-use regression with spatial smoothing). We also measured distance to nearest major roadway as a proxy for traffic-related pollution. In regression models, we adjusted for confounding by individual and neighborhood socioeconomic status, maternal IQ, and other determinants of child neurodevelopment; and tested for effect modification by child sex, maternal race, and prenatal nutrition.Results: The study population (N&amp;#61;1009) was predominantly low-income and 69% African American; mean child age at assessment was 4.4 years. Mean NO2 and PM10 exposures were 12.9 ppb and 20.9 &amp;#956;g/m3, respectively. In fully adjusted models, a 5 ppb increase in prenatal NO2 was associated with 13% higher externalizing behavior score (95% CI: 0.5, 28%) and 2.8 times higher odds (95% CI: 1.0, 7.9) of an externalizing score above the clinical threshold. Full-scale IQ scores averaged 2.5 points (95% CI: 0.1, 4.8) lower per 5 ug/m3 increase in PM10. We found no statistically significant evidence of associations with road proximity or interaction by demographics or nutrition.Conclusions: Our findings support the hypothesis that air pollution impairs neurodevelopment. We observed the most consistent associations between NO2 and externalizing behaviors.

Brain Development Bags: Designing Tools to Engage Parents in Early Childhood Neurodevelopment Through Play

Background The physical and mental development of a child is greatly affected by early life experiences. Eighty percent of brain volume is formed from birth to three years of age with 700-1000 neuronal connections forming every second. During this critical time period of brain development, children are exceedingly responsive to environmental stimuli. Research shows that active engagement and a responsiveness to a child’s needs by a caregiver positively shapes the brain architecture and builds neuronal connections necessary for the development of cognitive skills. This model for increased cognitive performance, called …

Brain Development Bags: Designing Tools to Engage Parents in Early Childhood Neurodevelopment Through Play

Brain Development Bags: Designing Tools to Engage Parents in Early Childhood Neurodevelopment Through Play