Neurological Development Of Infants Research Articles

Visual Acuity Thresholds in Preterm Newborns: An Experimental Study.

Purpose: Visual acuity plays a role in mediating neurological development in infants by enabling the differentiation of shapes and discriminating objects. Given the rapid structural development of the brain in the first days of life, this aspect is particularly significant for preterm infants, who typically experience this developmental phase while hospitalized in the neonatal intensive care unit (NICU). Therefore, this study aimed to assess visual acuity thresholds in preterm infants during hospitalization and to evaluate possible correlations between visual acuity and clinical parameters. Methods: A cross-sectional study was conducted in an NICU in Northeast Brazil. The visual acuity thresholds were tested using the Teller Acuity Cards II, comprised of 17 gray cards, with one 4 mm diameter peephole at the center and presented with about 35% reflectance. Preterm infants were positioned supine, at 30° elevation on the laps of their caregivers. The evaluator presented both sides of the cards and observed the eye fixation and reactions on both sides. Results: A total of 42 preterm infants with corrected gestational age between 30 to 36 weeks and 6 days were included. Visual acuity ranged from 0.23 to 0.64 cycle per degree. The mean visual acuity threshold was 0.32 cycles per degree for preterm infants at around 32 weeks of corrected gestational age. The visual acuity was not correlated with gestational age (p = 0.18), and neither were birth weight (p = 0.83) or duration of respiratory support (p = 0.98). However, days of phototherapy were inversely correlated with visual acuity (p = 0.04). Conclusions: Despite the challenges of hospitalization, it was possible to carry out a psychophysical test to assess visual acuity in preterm infants. The visual acuity showed no correlation with clinical parameters such as gestational age, birth weight, and duration of respiratory support. However, there was an inverse correlation between the number of days in phototherapy and visual acuity. Understanding the visual acuity levels in preterm infants during their NICU stay can contribute to tailoring interventions and care strategies that specifically address their visual developmental needs. This knowledge may guide healthcare professionals in optimizing the NICU environment to provide appropriate visual stimuli that support neurological development.

Live‐streaming webcam technology in the neonatal unit: A systematic review and thematic analysis

AbstractBackgroundAdmission of a baby for neonatal care represents a deeply traumatic time for parents. Webcam technology facilitating live‐streaming of the baby when the parents are unable to be physically present has been introduced to support bonding and parental engagement in care.AimThis systematic review explores the impact and experiences of webcam technology upon parents of babies in the neonatal unit and neonatal health care professionals.Study DesignA systematic search of Embase, Medline and Scopus was conducted using the keywords ‘video technology’, ‘newborn’ and ‘neonatal intensive care.’ Studies written in English and exploring live‐stream technology were included. Thematic analysis per group (parents and health care professionals) was undertaken to identify similarities between themes across published studies.ResultsTen studies were included. Six studies explored the impact of webcam technology on parents only, two on both parents and health care professionals and two on health care professionals only. Thematic analysis per group identified three themes for parents, including parental well‐being, parent‐infant bonding and quality of care. Two themes were identified for neonatal health care professionals, including quality of care and feasibility of webcam technology.ConclusionsWebcam technology has many documented benefits for parental well‐being. However, new technology requires adequate staff training, support and plans for ongoing maintenance. Further research is required to explore the long‐term impacts on breast‐milk production and infant neurological development.Relevance to Clinical PracticeThe use of webcam technology in neonatal units can potentially improve the mental health and well‐being of the parents and promote bonding between the infant, their parents and wider family members. Specialist roles to support advancing technology in the neonatal unit may allow parents and professionals to integrate webcams into practice and enhance care.

Association of both prenatal and early childhood multiple metals exposure with neurodevelopment in infant: A prospective cohort study

BackgroundImpaired neurodevelopment of children has become a growing public concern; however, the associations between metals exposure and neurocognitive function have remained largely unknown. ObjectivesWe systematically evaluated the associations of multiple metals exposure during pregnancy and childhood on the neurodevelopment of children aged 2–3 years. MethodsWe measured 22 metals in the serum and urine among703 mother-child pairs from the Guangxi Birth Cohort Study. The neurocognitive development of children was assessed by the Gesell Development Diagnosis Scale (GDDS; Chinese version). Multiple linear regression models were used to evaluate the relationship between the metals (selected by elastic net regression) and the outcomes. The Bayesian kernel machine regression (BKMR) was used to evaluate the possible joint effect between the multiple metal mixture and the outcomes. ResultsPrenatal aluminum (Al) exposure was negatively associated with the fine motor developmental quotient (DQ) (β = −1.545, 95%CI: 2.231, −0.859), adaption DQ (β = −1.182, 95%CI: 1.632, −0.732), language DQ (β = −1.284, 95% CI: 1.758, −0.809), and social DQ (β = −1.729, 95% CI: 2.406, −1.052) in the multi-metal model. Prenatal cadmium (Cd) exposure was negatively associated with gross motor DQ (β = −2.524, 95% CI: 4.060, −0.988), while postpartum Cd exposure was negatively associated with language DQ (β = −1.678, 95% CI: 3.227, −0.129). In stratified analyses, infants of different sexes had different sensitivities to metal exposure, and neurobehavioral development was more significantly affected by metal exposure in the first and second trimester. BKMR analysis revealed a negative joint effect of the Al, Cd, and selenium (Se) on the language DQ score; postpartum Cd exposure played a major role in this relationship. ConclusionPrenatal exposure to Al, Ba, Cd, molybdenum (Mo), lead (Pb), antimony (Sb), and strontium (Sr), and postpartum exposure to cobalt (Co), Cd, stannum (Sn), iron (Fe), nickel (Ni), and Se are associated with neurological development of infants. The first and second trimester might be the most sensitive period when metal exposure affects neurodevelopment.

Metoclopramide for Milk Production in Lactating Women: A Systematic Review and Meta-Analysis.

BackgroundBreastfeeding is recognized as the optimal form of nutrition for the physical and neurological development of infants and is considered the most significant way to prevent child mortality. This study aimed to assess the effectiveness of metoclopramide for enhancing milk production in lactating women.MethodsWe searched the Cochrane Central Register of Controlled Trials and MEDLINE for randomized controlled trials comparing metoclopramide with a placebo, no treatment, or other galactagogue drugs. We included breastfeeding women with term or preterm infants.ResultsWe retrieved 164 records from our search of the electronic databases and 20 records from other sources. Eight trials involving 342 lactating women that used metoclopramide were included in this review after assessing the eligibility criteria. The meta-analysis of these trials revealed that metoclopramide did not increase the milk volume of the intervention groups compared to that of the control groups. There was a significant increase in the serum concentrations of prolactin when the mothers were administered metoclopramide. No significant adverse events were reported.ConclusionMetoclopramide did not improve milk production in lactating women. Therefore, we do not recommend using metoclopramide to increase milk production in lactating women.

Developmental consequences of children born from mothers with telbivudine treatment during late pregnancy: A prospective study with 3-year follow-up

ABSTRACT We prospectively investigated the neurological development in infants born from mothers treated with telbivudine (LdT) in the third trimester for prevention of hepatitis B virus (HBV) mother-to-infant transmission. Mothers with high HBV load were assigned to either the LdT group (n = 81, 600 mg of LdT each day from gestational week 28 to delivery) or the Control group (n = 39, untreated). Their infants were followed for 36 months to assess physical and neurological developments with Gesell Developmental Schedule tools. At 12 months after birth, the mean scores in the LdT group for gross motor, fine motor, adaptive, linguistic, and personal social domains were similar to those in the Control group. At 36 months, infants in the LdT group had higher mean scores for gross motor than the Control group (98.42 ± 9.69 vs. 94.54 ± 7.48, P = 0.03). In the LdT group, the rates of normal development were higher for gross motor (96.30% vs. 82.05% P = 0.01) and lower for adaptive (74.07% vs. 92.31% P = 0.02). Multivariate regression analyses showed that exposure to LdT during pregnancy was independently associated with infant’s development in gross motor (OR 6.49, 95% CI 1.37–30.20, P = 0.02) and adaptive (OR 0.18, 95% CI 0.05–0.71, P = 0.01) at 36 months. These results suggest that prenatal LdT exposure might affect neurological development in long-term observation. Abbreviations: LdT: telbivudine; HBV: hepatitis B virus; HBsAg: hepatitis B surface antigen; HBeAg: hepatitis Be antigen; HbsAb: hepatitis B surface antibody; ALT: alanine aminotransferase; NA: nucleoside/nucleotide analog; LAM: lamivudine; MTCT: mother-to-child transmission; GDS: Gesell Developmental Schedule; OR: odds ratio; CI: confidence interval; DQ: developmental quotient; RMB: renminbi; BMI: body mass Index; HBIG: hepatitis B immunoglobulin.

Vitamin B12 quantification in human milk – Beyond current limitations using liquid chromatography and inductively coupled plasma – Mass spectrometry

Vitamin B12 plays a key role in human biological functions and is vital in the neurological development of infants. The assessment of the vitamin B12 intake in exclusively breastfed babies depends on the reliability of its determination in milk. In this report, we present a new accurate and robust method for quantification of vitamin B12 in human milk. A highly specific sample preparation is applied, associated with chromatographic separation and detection by ICP-MS. Excellent sensitivity and accuracy are reported, with recovery values well within acceptability limits (80–120%), within- and between-day variability are lower than 10% and 15% respectively. Strong correlation with a microbiological assay was observed (r2 = 0.9) within the validation range (40–1000 pmol/L, corresponding to 54 to 1355 ng/L). The method can be used to routinely monitor vitamin B12 in clinical or population observational studies, determine infant’s intake or assess efficacy of mother’s supplementation.

Early visual training and environmental adaptation for infants with visual impairment

AimTo evaluate the effectiveness of early visual training and environmental adaptation on visual function and neurological development in infants with visual impairment.MethodThis was a pilot intervention clinical trial study. Thirty infants (mean age 5.9mo, SD 2.1mo, range 4–11mo; 16 males, 14 females) with peripheral visual impairment (PVI, n=15) or cerebral visual impairment (CVI, n=15) participated in a 6‐month visual intervention programme. Thirty matched infants (mean age 6mo, SD 1.4mo, range 4–9mo; 18 males, 12 females) served as a comparison group. Primary outcome measures were visual acuity, contrast sensitivity, and qualitative ocular motor functions. Secondary outcomes were scores on the Griffiths Mental Developmental Scales (GMDS).ResultsThe treatment group showed a significant improvement in all the primary outcomes (p<0.01). The comparison group improved only in visual acuity and contrast sensitivity (p<0.01). The treatment group showed greater improvement than the comparison group in visual fixation (p=0.033) and smooth pursuit (p<0.01). The CVI subgroup showed greater improvement in visual acuity than the PVI subgroup (p<0.01). GMDS subscales of hand–eye coordination (p=0.01) and performance (p<0.01) increased in the treatment group, while the total score of the comparison group decreased, driven by language (p=0.039) and hand–eye coordination (p=0.025) subscales.InterpretationResults suggest that, in infants with visual impairment, visual function and certain developmental outcomes improve in response to early visual training and environmental adaptation, in an interactive context. What this paper adds Early visual training and environmental adaptation are associated with enhanced visual acuity and smooth pursuit.Early visual training and environmental adaptation are associated with an improvement of neurological developmental outcome.Performance, hand–eye coordination, and language scores in Griffiths Mental Developmental Scales increase after visual training.After training, visual acuity improves more in infants with cerebral rather than anterior visual impairment.Type and complexity of visual impairment contribute to determine infants’ response to training.

Polymorphic variants in Sweet and Umami taste receptor genes and birthweight

The first thousand days of life from conception have a significant impact on the health status with short, and long-term effects. Among several anthropometric and maternal lifestyle parameters birth weight plays a crucial role on the growth and neurological development of infants. Recent genome wide association studies (GWAS) have demonstrated a robust foetal and maternal genetic background of birth weight, however only a small proportion of the genetic hereditability has been already identified. Considering the extensive number of phenotypes on which they are involved, we focused on identifying the possible effect of genetic variants belonging to taste receptor genes and birthweight. In the human genome there are two taste receptors family the bitter receptors (TAS2Rs) and the sweet and umami receptors (TAS1Rs). In particular sweet perception is due to a heterodimeric receptor encoded by the TAS1R2 and the TAS1R3 gene, while the umami taste receptor is encoded by the TAS1R1 and the TAS1R3 genes. We observed that carriers of the T allele of the TAS1R1-rs4908932 SNPs showed an increase in birthweight compared to GG homozygotes Coeff: 87.40 (35.13–139.68) p-value = 0.001. The association remained significant after correction for multiple testing. TAS1R1-rs4908932 is a potentially functional SNP and is in linkage disequilibrium with another polymorphism that has been associated with BMI in adults showing the importance of this variant from the early stages of conception through all the adult life.

Clinical significance of electroencephalography power spectrum density and functional connection analysis in neonates with hypoxic-ischemic encephalopathy.

To investigate the effects of electroencephalography (EEG) power and functional connectivity analysis on cerebral cortex function in neonates with hypoxic-ischemic encephalopathy (HIE), and to identify the neurobiological indicators of neural development in HIE. We recruited 20 mild HIE neonates, 15 moderate HIE neonates, and 30 controls. EEG was performed about 72hr after birth. The power spectral density (PSD) and imaginary part of coherency (ICOH) were analyzed. Gesell developmental schedule (GDS) was used to evaluate the neural development in the mild and moderate HIE groups at 1year of age, and the correlation between the quantitative EEG results and the state of neural development was analyzed. Compared with the controls, FP1, FP2, C3, C4, Fz, Cz, Pz , F3, and P4 of moderate HIE neonates showed that the PSD of theta, alpha and beta bands decreased significantly. In terms of the mean whole-brain PSD, themoderate HIEgroupshowed a significant decrease in all frequency bands. ICOH of the moderate HIE group showed that functional connectivity was significantly less than that in the controls mainly in the delta band, and the functional connectivity of the delta, theta, alpha1, and alpha2 bands was markedly reduced compared with the mild HIE. GDS test at 1year old showed that two infants in the moderate HIE group had suspected neurological delay in gross motor and language. The developmental quotient(DQ) of gross motor, language, and personal-social ability in the moderate HIE group were significantly lower than in the mild HIE group. And there was a significant positive correlation between PSD in each EEG frequency band and GDS score in the moderate HIE group. PSD and ICOH can be used to evaluate brain function. PSD can detect the delayed neurological development in infants with moderate HIE, and can be a neurobiomarker of brain development in HIE.

Zika virus NS3 protease induces bone morphogenetic protein-dependent brain calcification in human fetuses.

The most frequent fetal birth defect associated with prenatal Zika virus (ZIKV) infection is brain calcification, which in turn may potentially affect neurological development in infants. Understanding the mechanism could inform the development of potential therapies against prenatal ZIKV brain calcification. In perivascular cells, bone morphogenetic protein (BMP) is an osteogenic factor that undergoes maturation to activate osteogenesis and calcification. We show that ZIKV infection of cultivated primary human brain pericytes triggers BMP2 maturation, leading to osteogenic gene expression and calcification. We observed extensive calcification near ZIKV+ pericytes of fetal human brain specimens and in vertically transmitted ZIKV+ human STAT2-knock-in mouse pup brains. ZIKV infection of primary pericytes stimulated BMP2 maturation, inducing osteogenic gene expression and calcification that were completely blocked by anti-BMP2/4 neutralizing antibody. Not only did ZIKV NS3 expression alone induce BMP2 maturation, osteogenic gene expression and calcification, but purified NS3 protease also effectively cleaved pro-BMP2 in vitro to generate biologically active mature BMP2. These findings highlight ZIKV-induced calcification where the NS3 protease subverts the BMP2-mediated osteogenic signaling pathway to trigger brain calcification.

Hearing outcome in infants following correction of maternal hypothyroidism during pregnancy

PurposeThere is significant prevalence of overt and subclinical hypothyroidism in pregnant women in rural areas. Maternal hypothyroidism is known to cause congenital hypothyroidism resulting in sensorineural hearing loss. Anti-Thyroperoxidase antibodies are known to cross placental barrier. There is no literature on hearing assessment in infants born to women whose hypothyroidism was corrected during pregnancy. Do these infants suffer hearing loss? Our study addresses this question. Methods140 infants born to women on treatment for hypothyroidism during pregnancy and 140 infants born to euthyroid women were evaluated for hearing by Brainstem Evoked Response Audiometrry at 1 and 4 months age. Anti-TPO antibodies were estimated at 4 months of age. ResultsThere was no clinical hearing deficit or delay in neurological development in infants born to women undergoing treatment for hypothyroidism during pregnancy. However wave V latency on BERA was slightly prolonged in them compared to infants born to euthyroid women. There was absence of wave V when maternal subclinical hypothyroidism persisted till parturition. However within 6–8months of age the wave V latencies corrected to normal. Anti-TPO antibodies were within normal range at 4months age. ConclusionMaternal hypothyroidism when corrected before parturition does not affect hearing in the infants clinically. The mild delay in wave V on BERA corrects within first year of life. However larger studies to assess hearing in infants born to women having overt hypothyroidism during first trimester of pregnancy may be desirable to assess whether hearing is adversely affected in them.

Developmental Consequences of Children Born from Mothers with Telbivudine Treatment During Late Pregnancy: A Prospective Study with 3-Year Follow-Up

Aims: We prospectively investigated the neurological development in infants born from mothers treated with telbivudine (LdT) in third trimester for prevention of hepatitis B virus (HBV) mother-to-infant transmission. Methods: Mothers with high HBV load were assigned to either LdT group (n=81, 600 mg of LdT each day from gestational week 28 to delivery) or control group (n=39, untreated). Their infants were followed for 36 months to assess physical and neurological development with Gesell Developmental Schedule (GDS) tools. Results: At 12 months after birth, the mean scores in LdT group for gross motor, fine motor, adaptive, linguistic and personal social domains were similar to those in control group. At 36 months, infants in LdT group had higher mean score for gross motor than control group (98.42±9.69 vs 94.54±7.48, p=0.03). In LdT group, the rates of normal development were higher for gross motor (96.30% vs 82.05% p=0.01) and lower for adaptive (74.07% vs 92.31% p=0.02). Multivariate regression analyses showed that exposure to LdT during pregnancy was independently associated with infant’s development in gross motor (OR 6.49, 95% CI 1.37-30.20, p=0.02) and adaptive (OR 0.18, 95% CI 0.05-0.71, p=0.01) at 36 months. Conclusions: Prenatal LdT exposure might affect neurological development in long-term observation. Trial Registration: The study was registered at clinicaltrials.gov (Clinical Trials. gov ID: NCT02301650). Funding Statement: This study was funded in part by the Beijing Municipal Science & Technology Commission [No. Z151100004015122], in part by the Beijing Municipal Administration of Hospitals Clinical medicine Development of special funding support [No.XMLX 201706], in part by the National Science and Technology Major Project of China [No.2017ZX10201201-001-006, No.2017ZX10201201-002-006, and 2018ZX10715-005-003-005)], in part by Beijing Science and Technology Commission [No. D161100002716002], in part by the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority [No.XXZ0302 and XXT28]. Declaration of Interests: No potential conflict of interest relevant to this article was reported. Ethics Approval Statement: The study was approved by the Institutional Review Board of Beijing Ditan Hospital (Approval number: JDL2014-076-01). Written informed consents were obtained from all participants.

Long-term outcomes after surgery for catastrophic epilepsy in infants: institutional experience and review of the literature.

Uncontrolled epilepsy is associated with serious deleterious effects on the neurological development of infants and has been described as "catastrophic epilepsy." Recently, there has been increased emphasis on early surgical interventions to preserve or rescue neurodevelopmental outcomes in infants with early intractable epilepsy. The enthusiasm for early treatments is often tempered by concerns regarding the morbidity of neurosurgical procedures in very young patients. Here, the authors report outcomes following the surgical management of infants (younger than 1 year). The authors performed a retrospective review of patients younger than 1 year of age who underwent surgery for epilepsy at Miami (Nicklaus) Children's Hospital and Jackson Memorial Hospital between 1994 and 2018. Patient demographics, including the type of interventions, were recorded. Seizure outcomes (at last follow-up and at 1 year postoperatively) as well as complications are reported. Thirty-eight infants (median age 5.9 months) underwent a spectrum of surgical interventions, including hemispherectomy (n = 17), focal resection (n = 13), and multilobe resections (n = 8), with a mean follow-up duration of 9.1 years. Hemimegalencephaly and cortical dysplasia were the most commonly encountered pathologies. Surgery for catastrophic epilepsy resulted in complete resolution of seizures in 68% (n = 26) of patients, and 76% (n = 29) had a greater than 90% reduction in seizure frequency. Overall mortality and morbidity were 0% and 10%, respectively. The latter included infections (n = 2), infarct (n = 1), and immediate reoperation for seizures (n = 1). Surgical intervention for catastrophic epilepsy in infants remains safe, efficacious, and durable. The authors' work provides the longest follow-up of such a series on infants to date and compares favorably with previously published series.

Preliminary evaluation of pre-speech and neurodevelopmental measures in 7-11-week-old infants with isolated oral clefts.

The purpose of this research study was to evaluate the earliest markers of vocal functioning and neurological development in infants with isolated oral cleft of the lip and/or palate (iCL/P). Participants were recruited through advertisements and clinic visits at a local mid-western university. A total of eight participants (four unaffected and four with iCL/P), ranging in age from 7.29 to 11.57 weeks, were enrolled and completed demographic and pre-speech measures. A subset of six males (four unaffected and two with iCL/P) successfully completed a structural magnetic resonance imaging scan. Patterns of disrupted vocal control and reduced myelinated white matter were found in participants with iCL/P. The findings of this study provide a foundation from which to build further research on the neuronal development of infants with oral clefts: the need to evaluate measures of cortical development, inclusion of information on anesthesia exposure and airway obstruction, and suggestions for avoiding identified pitfalls/blocks to obtaining data are discussed. Research in children with isolated oral clefts has demonstrated higher rates of learning disorders connected to subtle differences in brain structure. There is no work evaluating the potential impact of exposure to anesthesia on development. This is the first known attempt to evaluate brain structure and function in infants with isolated oral clefts before exposure to anesthesia. Potential trends of early vocal issues and structural brain differences (less myelinated white matter) were identified in infants with isolated oral clefts compared to unaffected controls. Differences in brain structure and function in infants with isolated oral clefts may be present before surgery.

Favorable outcome after nine minutes of shoulder dystocia preceded by a tight nuchal cord

Abstract Objectives A case report involving a tight nuchal cord and concomitant shoulder dystocia with a review of the literature. We demonstrate that favorable outcomes may result with correct application of maneuvers and adequate management after delivery. Case presentation A 41 years old woman was admitted with spontaneous rupture of membranes. The first stage of labor was unremarkable. During the second stage, an intentionally-cut tight nuchal cord was followed by 9 min of shoulder dystocia that was finally relieved by delivery of the anterior shoulder. APGAR scores were 0, 3, 4, 7 at 1, 5, 10 and 20 min respectively. The neonate was placed under therapuetic hypothermia and was discharged after 13 days. At 5 months and 1.5 years of age, the infant met age appropriate developmental milestones with no neurologic sequela. Conclusions Shoulder dystocia can result in fatal outcomes for the neonate. Adequate management highlights the need for prompt recognition of this complication and application of appropriate maneuvers. Therapeutic hypothermia decreases mortality and improves neurological development in infants who experience hypoxic ischemic encephalopathy (HIE).

Prevalence of positional skull deformities in 530 premature infants with a corrected age of up to 6\u2009months: a multicenter study

BackgroundPositional deformities (PD) are common during early infancy. Severe cases may result in facial abnormalities and be associated with delayed neurological development in infants. The earlier the detection of PD, the better the intervention effect and the lower the cost of treatment. Currently, there are many studies on PD in Europe and the United States. However, in China, there is little data on the basic metrics and incidence of PD. Premature infants have a high risk of PD. However, there are few studies on PD in premature infants globally, and none in Asia. This study aimed to investigate PD and its characteristics inpremature infants to help its early detection and intervention and thus improve the quality of life for premature infants.MethodsWe analyzed 530 preterm infants who visited the outpatient departments at Xinqiao Hospital of Army Medical University and Maternal and Child Health Care Hospitals of Wanzhou and Yongchuan Districts in Chongqing from September 1, 2016, to August 31, 2017. The head shape data measured by a simple manual method were recorded. The diagonal difference (DD) between the transcranial diagonals and the cranial index (CI) was calculated. PD and its incidences indifferent gestational ages and corrected age groups were analyzed.ResultsAccording to previously defined international diagnostic criteria, the incidence of plagiocephaly, brachycephaly, and dolichocephaly were 51.1, 85.1, and 3.0% respectively, and those of right and left plagiocephalywere69.4 and 30.6%, respectively. The incidence of PD was highest among infants with a gestational age of < 32 weeks and decreased as the gestational age increased. As the corrected age (CA) increased, the incidence of plagiocephaly and dolichocephaly decreased, and the incidence of brachycephaly increased.ConclusionsPD incidence is high among preterm infants. As gestational age decreased, PD incidence and severity increased. Therefore, healthcare providers should implement early PD detection and intervention to prevent the adverse outcomes. The extremely high incidence of brachycephaly and extremely low incidence of dolichocephaly in this study are likely to be due to the variance of cranial metrics caused by cultural differences. The Chinese standards for infant cranial measurements must be established.

Maternal Intimate Partner Violence: Relationships with Language and Neurological Development of Infants and Toddlers.

Objectives This longitudinal study examined the influence of Intimate Partner Violence (IPV) experience of pregnant women participating in the Domestic Violence Enhanced Home Visitation Program on the language and neurological development of infants and toddlers. Methods A total of 210 infants and toddlers born to women reporting low, moderate, and high levels of IPV were included in the analysis. Logistic regression analysis was used to determine the bivariate association between maternal IPV and risk of language and neurological delay of infants and toddlers and between covariates and language and neurological delay. Generalized estimating equation models with logit link was used to predict the risk of language and neurological delay of infants and toddlers as a result of maternal IPV. Results Infants and toddlers born to women exposed to moderate levels of IPV had increased odds of language delay compared to infants and toddlers of women who experienced low levels of violence (OR 5.31, 95% CI 2.94, 9.50, p<0.001). Infants and toddlers born to women who experienced moderate and high levels of IPV were at higher risk of neurological delay respectively, compared to infants and toddlers of women who experienced low levels of IPV (OR 5.42, 95% CI 2.99, 9.82, p<0.001 and OR 2.57, 95% CI 1.11, 5.61, p=0.026). Conclusions for Practice Maternal IPV is associated with increased risk of language and neurological delay of infants and toddlers. These findings have implications for health care for women and infants exposed to IPV. Clinicians including pediatricians working with pregnant women should screen for IPV throughout pregnancy to identify women and children at risk. Interventions to reduce maternal IPV and early intervention services for infants and toddlers exposed to IPV are necessary for optimal maternal and child health.

Impact of maternal diet on human milk composition and neurological development of infants

Maternal nutrition has little or no effect on many nutrients in human milk; for others, human milk may not be designed as a primary nutritional source for the infant; and for a few, maternal nutrition can lead to substantial variations in human milk quality. Human milk fatty acids are among the nutrients that show extreme sensitivity to maternal nutrition and are implicated in neurological development. Extensive development occurs in the infant brain, with growth from ∼ 350 g at birth to 925 g at 1 y, with this growth including extensive dendritic and axonal arborization. Transfer of n-6 (omega-6) and n-3 (omega-3) fatty acids from the maternal diet into human milk occurs with little interconversion of 18:2n-6 to 20:4n-6 or 18:3n-3 to docosahexaenoic acid (DHA) and little evidence of mammary gland regulation to maintain individual fatty acids constant with varying maternal fatty acid nutrition. DHA has gained attention because of its high concentrations and roles in the brain and retina. Studies addressing DHA intakes by lactating women or human milk amounts of DHA at levels above those typical in the United States and Canada on infant outcomes are inconsistent. However, separating effects of the fatty acid supply in gestation or in the weaning diet from effects on neurodevelopment solely due to human milk fatty acids is complex, particularly when neurodevelopment is assessed after the period of exclusive human milk feeding. Information on infant fatty acid intakes, including milk volume consumed and energy density, will aid in understanding of the human milk fatty acids that best support neurological development.

Environmental mercury and its toxic effects.

Mercury exists naturally and as a man-made contaminant. The release of processed mercury can lead to a progressive increase in the amount of atmospheric mercury, which enters the atmospheric-soil-water distribution cycles where it can remain in circulation for years. Mercury poisoning is the result of exposure to mercury or mercury compounds resulting in various toxic effects depend on its chemical form and route of exposure. The major route of human exposure to methylmercury (MeHg) is largely through eating contaminated fish, seafood, and wildlife which have been exposed to mercury through ingestion of contaminated lower organisms. MeHg toxicity is associated with nervous system damage in adults and impaired neurological development in infants and children. Ingested mercury may undergo bioaccumulation leading to progressive increases in body burdens. This review addresses the systemic pathophysiology of individual organ systems associated with mercury poisoning. Mercury has profound cellular, cardiovascular, hematological, pulmonary, renal, immunological, neurological, endocrine, reproductive, and embryonic toxicological effects.

Fatty acid composition in the mature milk of Bolivian forager‐horticulturalists: controlled comparisons with a US sample

Breast milk fatty acid (FA) composition varies greatly among individual women, including in percentages of the long-chain polyunsaturated FAs (LCPUFA) 20:4n-6 (arachidonic acid, AA) and 22:6n-3 (docosahexaenoic acid, DHA), which are important for infant neurological development. It has been suggested that owing to wide variation in milk LCPUFA and low DHA in Western diets, standards of milk FA composition should be derived from populations consuming traditional diets. We collected breast milk samples from Tsimane women at varying lactational stages (6-82 weeks). The Tsimane are an indigenous, natural fertility, subsistence-level population living in Amazonia Bolivia. Tsimane samples were matched by lactational stage to samples from a US milk bank, and analysed concurrently for FA composition by gas-liquid chromatography. We compared milk FA composition between Tsimane (n = 35) and US (n = 35) mothers, focusing on differences in LCPUFA percentages that may be due to population-typical dietary patterns. Per total FAs, the percentages of AA, DHA, total n-3 and total n-6 LCPUFA were significantly higher among Tsimane mothers. Mean percentages of 18:2n-6 (linoleic acid) and trans FAs were significantly higher among US mothers. Tsimane mothers' higher milk n-3 and n-6 LCPUFA percentages may be due to their regular consumption of wild game and freshwater fish, as well as comparatively lower intakes of processed foods and oils that may interfere with LCPUFA synthesis.