Psychomotor Development Of Infants Research Articles

"Effect of Breastfeeding Practices on Psychomotor Development of Infants"

"Effect of Breastfeeding Practices on Psychomotor Development of Infants"

Correlation Between Hypothyroidism During Pregnancy and Glucose and Lipid Metabolism in Pregnant Women and Its Influence on Pregnancy Outcome and Fetal Growth and Development.

Purpose:To observe the correlation between hypothyroidism during pregnancy and glucose and lipid metabolism in pregnant women and its influence on a pregnancy outcome and fetal growth and development.MethodsAbout 152 patients with hypothyroidism during pregnancy in our hospital from June 2017 to June 2020 were selected as the observation group and divided into the overt hypothyroidism (OH) group, the subclinical hypothyroidism (SCH) group, and the low T4 group. Another 60 pregnant women with normal antenatal examination and normal thyroid function were selected as the normal group. The glucose and lipid metabolism indexes of each group were compared. The pregnant women in the OH group and the SCH group were given levothyroxine intervention, and the pregnancy outcome and infant development of the two groups were compared.ResultsThe fasting blood glucose and hemoglobin A1c, triglyceride and low-density lipoprotein of the OH group and the SCH group were higher than the low T4 group and the normal group, and the OH group was higher than the SCH group (p < 0.05). The incidence of premature delivery and premature rupture of membranes at term (PROM at term) in the hypothyroidism non-control group was higher than the hypothyroidism control group (p < 0.05). The mental development index and the psychomotor development index in the hypothyroidism non-control group were lower than the hypothyroidism control group (p < 0.05).ConclusionPregnant women with hypothyroidism during pregnancy are more prone to glucose and lipid metabolism disorder, which increases the risk of premature delivery and PROM at term, and has certain influence on the intellectual development and psychomotor development of infants.

Explanatory factors of the psychomotor development of infants aged 1-24 months in N'Djamena (Chad)

Introduction: Psychomotor development (PMD) reflects the cerebral maturation through sensory, motor and psychological acquisitions of an individual. Its evaluation allows an early diagnosis of delays in order to take care of them. The objective of this study was to determine the profile and explanatory factors of PMD of infants in N'Djamena. Methods: This was a cross-sectional study conducted at the “Notre Dame des Apôtres” Hospital in N'Djamena. It involved 428 infants aged 1 to 24 months received in preventive consultation between October 2017 and June 2018. The Denver II scale was used for the assessment of PMD. Data were analyzed with SPSS 21.0 software. Results: the sex ratio was 1.06. The most represented age group was under 3 months (35.5%). The items of gross motor skills were 95% completed, fine motor skills 93.8%, language 84.6% and sociability 68.8% at the 90th percentile. Development was advanced in 56.8% normal in 32.1% and delayed in 2.1%. Statistically significant differences in PMD were observed according to age group (p= 0.000), vaccination status (p= 0.002), feeding mode (p= 0.000), maternal exchange (p= 0.000) and pregnancy follow-up (p= 0.03). Conclusion: The psychomotor development of N'Djamenese infants is similar to that of other African children, although some variations are noted. It is influenced by certain factors related to the infant and the mother.

Psychomotor development in infants and young children with Down syndrome-A prospective, repeated measure, post-hoc analysis.

Children with Down syndrome (DS) show delayed acquisition of cognitive and functional skills compared to typically developing children. The objective of this study was to accurately describe early development of infants and young children (children hereafter) with DS based on a large recent sample. We carried out repeated measure analysis of the global development quotient (GDQ) and developmental age using data from the Assessment of Systematic Treatment with Folinic Acid and Thyroid Hormone on Psychomotor Development of Down Syndrome Young Children (ACTHYF) study (NCT01576705). Because there was no statistically significant difference in the primary endpoint between active treatment and placebo, data from all treatment groups were pooled for post-hoc analysis. Data of 141 children with DS aged 6-18 months at inclusion were analyzed. Mean GDQ decreased over the study period, especially in the youngest age classes ([6-9] and [9-12] months), indicating that acquisition of skills occurred at a slower pace compared to typically developing children. Strongest deficits were observed for motor and hearing and language skills. Only GDQ at baseline correlated significantly with evolution of GDQ. Future studies should aim at elucidating the mechanisms underlying motor and language development. Early pharmacological interventions together with early childhood therapies might be necessary to improve the developmental trajectory of children with DS.

Environmental Pollution and Population Disorders: A Brief Communication

Most diseases in society have a complicated epidemiology including various chemical influences such as biology, diet and environmental pollution (EP). “The most dangerous contaminants included particulate matter (PMs), nitrogen oxides, polycyclic aromatic hydrocarbons (PAHs), heavy metals, pesticides, hormones, and polychlorinated biphenyls (PCBs)”. Indeed, there are countless potential contaminants and most have never been assessed as toxic and health hazards, particularly when new chemicals are constantly being developed as a result of interactions with existing chemicals. The effects of these new substances on wellbeing are almost difficult to assess. Previous reports show a wide range of pollution-related diseases. EP has been linked to an elevated prevalence of some malignancies, an increase in all-cause mortality, coronary disease progression, recurring illnesses, “disrupted intellectual and psychomotor development in infants, type 2 diabetes, breathing and immune system as well as brain-degenerative disorders.” EP is a significant reason of mortality and morbidity around the globe, initiating high expenditures in health care. Ecological, biological and toxicological testing is needed to determine the environmental toxins and at what amounts are most dangerous to animals and humans. It will only be possible to enhance environmental security by interdisciplinary collaboration and public awareness-raising programs.

Neurodevelopmental Outcomes of Infants with Benign Enlargement of the Subarachnoid Space.

Objective:Benign enlargement of the subarachnoid space (BESS) is the most common cause of macrocephaly in infants. This study aimed to evaluate the neurodevelopmental outcomes in infants with BESS.Materials & Methods:In this follow-up study, all records of infants diagnosed with BESS in 2012-2016 were assessed. A clinical follow-up examination was carried out at 6, 12, 18, and 24 months of age to assess the macrocephaly outcomes. Denver Developmental Screening Test-II (DDST-II) was used for evaluating the psychomotor development of infants at 24 months of age. All data were entered in SPSS Version 13, and descriptive statistics were measured.Results:Out of 32 infants included in this study, 28 (87.5%) were boys. Five cases of prematurity history (15.6%), and 23 cases of macrocephaly in the family (71.9%) were recorded. The mean age of BESS diagnosis was 6.8 months (SD=3.2). subdural hematoma was reported in one infant (3.1%). Also, 28 infants showed macrocephaly at 18 months of age (83.3%). Seven patients had developmental delay, according to DDST-II (22%). The mean head circumference at birth and six months of age was significantly greater in infants with developmental delay compared to those with normal development. There was a significant difference between the mean head circumference at birth (P=0.05) and the mean head circumference at six months of age (P=0.02).Conclusion: Developmental delay is frequent in BESS infants, especially those with macrocephaly at birth and six months of age, and requires medical attention.

Perinatal Distress in Fathers: Toward a Gender-Based Screening of Paternal Perinatal Depressive and Affective Disorders.

In Western society, with the gradual transition from the patriarchal family to the contemporary nuclear one (both parents work and contacts with the extended family are limited), fatherhood has been increasingly linked to more expectations and responsibilities in childcare and family life (Quilici, 2010; Biehle and Mickelson, 2012; Crespi and Ruspini, 2015). At biological level, neural plasticity and hormonal changes that occur in men may also increase the risk of psychological distress during the transition to parenthood (Poromaa et al., 2017; Baldoni, 2020). Research has clearly demonstrated that during the perinatal period the emotional states of mothers and fathers influence each other showing a significant correlation between paternal and maternal perinatal depressive disorders (Baldoni and Ceccarelli, 2010; Paulson and Bazemore, 2010; Musser et al., 2013). Thus, in the last decades there has been an increased interest in men's perinatal mental health (Baldoni, 2010; Garfield, 2015; Gutierrez-Galve et al., 2015; Field, 2018). In this scenario, Paternal Perinatal Depression (PPND) is considered a specific condition that affects many fathers between pregnancy and the first year after childbirth. PPND is associated with maternal depression (Baldoni et al., 2009; Paulson et al., 2016) and adverse outcomes in children and adolescents, including externalizing and internalizing symptoms (Ramchandani and Psychogiou, 2009; Baldoni, 2016; Sweeney and MacBeth, 2016). Specifically, a longitudinal study on 12,884 fathers has confirmed the influence of PPND on the psychophysical development of children evaluated from birth to 7 years of life (Ramchandani et al., 2005, 2008), with an increase, more significant in males, in emotional and behavioral control problems at 21 and 42 months and childhood psychiatric disorders and oppositional behaviors at 7 years. Other studies (Baldoni et al., 2009, 2011) conducted with the CARE-Index (Crittenden, 1979–2007) documented the influence of depression and poor paternal sensitivity on the psychomotor development of infants (assessed with the Bailey scales). Two recent metanalyses showed a PPND prevalence in the word ranging from 10.4% (Paulson and Bazemore, 2010) to 8.4% (Cameron et al., 2016) and longitudinal studies found that pregnancy is the most sensitive period for the onset of symptoms in both men and women (Madsen and Juhl, 2007; Figueiredo and Conde, 2011). Therefore, the term Paternal Perinatal Depression (PPND) is gradually replacing Paternal Post-partum/Post-natal Depression (PPD), to consider and identify the possible onset of depressive symptoms in fathers since the prenatal period (Baldoni, 2010; Cameron et al., 2016; Bruno et al., 2020). Although these terms are commonly used in research, these diagnoses are not even mentioned in the current DSM-5. The manual only specifies the criteria for a major depressive episode “with peripartum onset” referring to the mother only, which is defined as the most recent episode occurring during pregnancy as well as in the 4 weeks following delivery. Anyhow, fathers are not usually the focus of the prevention and screening of perinatal affective disorders, and PPND remains underestimated and undertreated compared to maternal depression. A possible explanation is that men tend to show a less clear clinical picture than women do and thus the use of screening questionnaires developed for mothers may be not appropriate. Given that perinatal depression risks and psychological responses differ significantly based on gender (Habib, 2012), it would be useful to rethink perinatal psychological disorders considering the wide array of paternal affective symptoms and the limitations of current tools developed to assess maternal depression. Hence, the aim of this opinion article is to emphasize the need to consider male-specific responses to perinatal distress following an integrative and gender-based perspective. Secondly, we have commented on the limits of research on PPND based on current self-reported measurements.

Slow-wave activity and sigma activities are associated with psychomotor development at 8 months of age.

The electrophysiological properties of non-rapid eye movement sleep (NREM) EEG are homeostatically modulated on global and local use-dependent levels. Furthermore, the local NREM quality reflects age-dependent brain maturation and individual, age-independent, and psychomotor potential. Cortical maturation and its electrophysiological marker, Slow-wave activity (SWA), as well as sleep spindles are known to change in topography and quality during the early years of life, but their associations with psychomotor development in infants are unknown. Therefore, we aimed to evaluate the local properties of SWA and spindles (sigma power) and ascertain whether they correlate with psychomotor development in 8-month-old infants. Ambulatory polysomnographies were recorded in 56 infants at 8 months of age to calculate the local SWA and sigma powers. The associations between the SWA and sigma powers and psychomotor development (Bayley-III) were examined in 36 of these infants. In both hemispheres, the highest SWA and sigma powers were found occipitally and centrally, respectively, with higher powers in the right hemisphere than in the left. The Bayley-III correlated with local SWA and sigma powers: the occipital SWA and centro-occipital sigma correlated with cognitive scales, and the frontal and occipital SWA and centro-occipital sigma correlated with language and fine motor scales. Most of the correlations were unilateral. In 8-month-old infants, the NREM sleep quality shows local differences that are mostly attributable to the topical phase of brain maturation. The local NREM parameters correlate with psychomotor development.

A Prospective Study of Cranial Deformity and Delayed Development in Children

Plagiocephaly, the most common form of cranial deformity, has become more prevalent in recent years. Many authors have described a number of sequelae of poorly defined etiologies, although several gaps exist in their real scope. This study aimed to analyze the effects of physiotherapy treatments and cranial orthoses on the psychomotor development of infants with cranial deformities, complemented by protocolized postural exercises applied by the family. This prospective study on different developmental areas included a sample of 48 breastfeeding infants aged 6 to 18 months who presented with plagiocephaly (flat head syndrome). The Brunet–Lézine scale was used to perform three tests for assessing the psychomotor development of infants, thus offering a measure for global development. The results suggest that plagiocephaly is a marker for the risk of delayed development, particularly in motor and language areas. This delayed development could be improved with physiotherapy and orthopedic treatment, complemented by interventions by the infants´ relatives.

Animation of Free Time and Support for Psychomotor Development of Infants Aged Over 3 Months

This article constitutes a desk study regarding animation of free time and its influence on the psychomotor development of infants aged over 3 months. The article discusses the concept of free time of infants. The motor and psychological development of children between the age of three months to one year is presented. Moreover, different ways of spending free time by the parent and child are shown. The aim of this article is to raise awareness of the role of supporting early child development through appropriate selection of games and other activities in line with the individual stage of development of an infant. The article has been prepared based on a literature review (including PubMed, Research Gate, EBSCO) as well as analysis of selected offers of commercial animation activities available in the city of Poznan, taking into account the individual stages of development and their impact on the comprehensive development of infants. Moreover, a list of activities recommended for children which are adequate to specific periods of their development was also prepared.

Improved Mental and Motor Development During 3 Years of GH Treatment in Very Young Children With Prader-Willi Syndrome.

Infants and toddlers with Prader-Willi syndrome (PWS) have mental and motor developmental delay. Short-term data suggest a positive effect of GH on mental and motor development in infants and children with PWS. There are, however, no longer-term results about the effects of GH treatment on mental and motor development. To investigate the longer-term effects of GH on psychomotor development in infants and toddlers with PWS and the effect of age at start of GH treatment on psychomotor development. Prospective cohort study during 3 years of GH treatment. The PWS Reference Center in the Netherlands. All children were treated with GH 1 mg/m2/d (≈0.035 mg/kg/d). Mental and motor developmental age assessed with Bayleys Scales of Infant Development II and expressed as percentage of the expected development (100%). During 3 years of GH, mean (SEM) mental development increased from 58.1% (2.8) at baseline to 79.6% (3.7), and motor development increased from 41.9% (2.9) to 78.2% (3.9; both P < 0.01). A lower baseline psychomotor development and a younger age at start of GH treatment were associated with a higher increase in mental and motor development (P < 0.01). Mental and motor development increased significantly during 3 years of GH treatment, reducing the gap between infants with PWS and healthy peers. A younger age at start of GH treatment leads to greater improvement in psychomotor development.

Nutritional Status, Physical and Psychomotor Development of Premature Infants: A Prospective Observational Comparative Study

Background. The development of premature infants is slower than that of term ones, often due to nutritional status disorders in preterm infants. Objective. Our aim was to study the nutritional status, physical, and psychomotor development of infants. Methods. Nutritional status — the composition (the ratio of fat and fat-free tissues) and the value of lean body mass (LBM) — was assessed by plethysmography and densitometry; physical development — by measuring the mass and length of the body, the circumference of the head and chest, calculating the body mass index (BMI); psychomotor development — assessing compliance with the schedule of neuropsychological development of infants (GNOM). The examination was carried out at 12–14 and 16–18 weeks of the corrected age for preterm and actual age for full-term infants. Initially, the diet of infants was assessed by determining the amount, content of macronutrients and energy in the breast milk and/or milk formula and complementary food consumed. The diet was considered to be balanced if the diet parameters diverged not more than 10% of the norm. Results. The study included 23 preterm infants with extremely low (ELBW), 20 — with very low (VLBW), 34 — with low body weight (LBW), and 33 full-term infants. At 12–14 weeks of the corrected age, the magnitude of LBM in infants with ELBW — 3,397 (3,096; 3,608) and with VLBW — 3,824 (3,797; 3,899) was lower than in infants with LBW — 4,497 (4,034; 4,651) and full-term infants — 4,511 (3,887; 4,647) (Kruskal–Wallis test, p = 0.048). Protein balanced diet was in 2 (9%) infants with ELBW, energy balanced diet — in 1 (4%) infant. Among infants with ELBW, 17/23 (74%) referred to the risk group, 6/23 (26%) — to the developmental disorder group. Compared with infants with ELBW and VLBW, infants with LBW and full-term infants had a higher LBM and, correspondingly, higher body weight and BMI. Improvement of the nutritional status after 4–6 weeks due to correction of protein and energy consumption in infants with ELBW was accompanied by some increase in lean body mass, while its proportion was much higher and the proportion of fat mass was lower, which was accompanied by an improvement in the psychomotor development in individual infants: 5/23 (22%) became age-appropriate, and in the risk group of developmental disorders, the proportion of infants decreased from 17 (74%) to 13/23 (57%). The obtained results testify to the influence of nutritional status on the physical and psychomotor development of infants. Conclusion . The importance of dynamic assessment of the nutritional status of premature infants with individualized correction of their diet for improving the physical and psychomotor development of the child during the first year of life is shown.

Assessment of neurodevelopment in children of different gestational age with neonatal seizures

To assess psychomotor development in infants with neonatal seizures (NS) born with different gestational age, by means of Bayley-III scales of infant and toddler development, in their corrected age of 1 year. The study included 52 infants, who had NS and were born with different gestational age: 28 weeks or less (n=26) - group I, 29-32 weeks (n=16) - group II, 33-36 weeks (n=3) - group III, 37-41 weeks (n=7) - group IV. The infants' neurodevelopment was evaluated in their corrected age of 1 year by means of N. Bayley scales of infant and toddler development, third edition: Cognitive, Language, Motor, Social-Emotional, and Adaptive Behavior. Only 17 (32,7%) of 52 examined infants did not demonstrate any developmental delay on each of five Bayley-III scales. Significant developmental delay (composite score <70) on at least one scale was revealed in 23 (44,2%) patients, including 12 (46,2%) in group I, 5 (31,3%) in group II, 6 (60%) of 10 in the combined group III-IV. In most cases, neurodevelopmental delays were attributed to only one domain and could be indicated as partial. The conclusion about global developmental retardation (the composite scores 55 or less on all five scales) was done in 3 patients, each of whom had a co-morbidity of cerebral palsy and epilepsy.

Association between prenatal exposure to organochlorine pesticides and the mental and psychomotor development of infants at ages 6 and 18 months: The Hokkaido Study on Environment and Children’s Health

Organochlorine pesticides (OCPs) are environmental contaminants that persist in the environment and bioaccumulate through the food chain in humans and animals. Although previous studies have shown an association between prenatal OCP exposure and subsequent neurodevelopment, the levels of OCPs included in these studies were inconsistent. A hospital-based prospective birth cohort study was conducted to examine the associations between prenatal exposure to relatively low levels of OCPs and neurodevelopment in infants at 6 (n=164) and 18 (n=115)months of age. Blood samples were analyzed using gas chromatography/mass spectrometry techniques to quantify 29 OCPs. The Bayley Scales of Infant Development 2nd edition (BSID-II) was used to assess the Mental and Psychomotor Developmental Index. After controlling for confounders, we found an inverse association between prenatal exposure to cis-heptachlor epoxide and the Mental Developmental Index at 18 months of age. Furthermore, infants born to mothers with prenatal concentrations of cis-heptachlor epoxide in the highest quartile had Mental Developmental Index scores −9.8 (95% confidence interval: −16.4, −3.1) lower than that recorded for infants born to mothers with concentrations of cis-heptachlor epoxide in the first quartile (p for trend <0.01). These results support the hypothesis that prenatal exposure to OCPs, especially cis-heptachlor epoxide, may have an adverse effect on the neurodevelopment of infants at specific ages, even at low levels.

Association between maternal intake of n-6 to n-3 fatty acid ratio during pregnancy and infant neurodevelopment at 6 months of age: results of the MOCEH cohort study

Background & aimsLong-chain polyunsaturated fatty acids (LC-PUFAs) are essential for infant neurodevelopment. The nutritional adequacy of dietary LC-PUFAs depends not only on the LC-PUFAs intake but also on the n-6 to n-3 fatty acid ratio (n-6/n-3 PUFAs). This study aimed to identify the association between the maternal dietary n-6/n-3 PUFAs and motor and cognitive development of infants at 6 months of age.MethodsWe used data from 960 participants in the Mothers and Children's Environmental Health (MOCEH) study, which is a multi-center prospective cohort study. Dietary intake of pregnant women was assessed by a one-day 24-h recall method. Food consumption of infants was estimated based on the volume of breast milk and weaning foods. The duration of each feed was used to estimate the likely volume of milk consumed. Dietary intake of infants at 6 months was also assessed by a 24-h recall method. Cognitive and motor development of infants at 6 months of age was assessed by the Korean Bayley scales of infant development edition II (BSID-II) including the mental developmental index (MDI) and the psychomotor developmental index (PDI).ResultsMaternal intakes of n-6/n-3 PUFAs and linoleic acid (LA)-to-α-linolenic acid (ALA) ratio (LA/ALA) were 9.7 ± 6.3 and 11.12 ± 6.9, respectively. Multiple regression analysis, after adjusting for covariates, showed that n-6/n-3 PUFAs was negatively associated with both the MDI (β = −0.1674, P = 0.0291) and PDI (β = −0.1947, P = 0.0380) at 6 months of age. These inverse associations were also observed between LA/ALA and both the MDI and PDI (MDI; β = −0.1567; P = 0.0310, PDI; β = −0.1855; P = 0.0367). Multiple logistic regression analysis, with the covariates, showed that infants whose mother’s LA/ALA were ranked in the 2nd, 3rd, and 4th quartile were at approximately twice the risk with more than twice the risk of delayed performance on the PDI compared to the lowest quartile (1st vs. 2nd; OR = 2.965; 95% CI = 1.376 − 6.390, 1st vs. 3rd; OR = 3.047; 95% CI = 1.374 − 6.756 and 1st vs. 4th; OR = 2.551; 95% CI = 1.160 − 5.607).ConclusionsBoth the maternal dietary n-6/n-3 PUFAs and LA/ALA intake were significantly associated with the mental and psychomotor development of infants at 6 months of age. Thus, maintaining low n-6/n-3 PUFAs and LA/ALA is encouraged for women during pregnancy.

Avaliação do desenvolvimento psicomotor pelos médicos de família: estudo observacional

Goals: To assess the current status of the evaluation of psychomotor development in children by family doctors during regular clinic visits in two primary healthcare groupings, ACES Gaia and Espinho/Gaia. Study design: Cross-sectional study. Location: ACES Gaia and Espinho/Gaia. Population: Family medicine specialists of ACES Gaia and Espinho/Gaia. Methods: We distributed a self-administered questionnaire written by the authors consisting of 18 multiple-choice questions about the evaluation of psychomotor development during well child consultations. Data were analyzed with Microsoft Excel 2010®. This study is reported according to the STROBE guidelines. Results: Completed questionnaires were received from 112 of the 193 specialists (58%) in these two healthcare groupings. The assessment of psychomotor development is performed by 99% and 84% take more than five minutes in doing so. The Modified Mary Sheridan Scale is used by 97% and 72% of respondents considered that they need more training on the use of this scale, while 50% have doubts related to referrals. A lack of time (76% of respondents) and a lack of material (66% of respondents) are considered to be the main difficulties encountered when assessing psychomotor development. Conclusions: Given the role that family doctors play in the assessment of the psychomotor development of infants and children, it is essential to provide these professionals with adequate time, training, and material conditions to complete this task.

Effects of prenatal phthalate exposure on thyroid hormone levels, mental and psychomotor development of infants: The Hokkaido Study on Environment and Children's Health

Di (2-ethylhexyl) phthalate (DEHP) is commonly used phthalates and concerns of adverse effects of prenatal DEHP exposure on neonatal thyroid hormone (TH) and neurodevelopment are increasing. However, there is no report regarding association between prenatal DEHP exposure and infant neurodevelopment including TH levels in Japanese population. Thus the aim of present study was to evaluate the associations between prenatal DEHP exposure and mental and psychomotor development of infants 6 and 18months along with investigating influence on neonatal free thyroxine (FT4) and thyroid stimulating hormone (TSH) levels in the prospective birth cohort study.Maternal blood samples collected between 23 and 41weeks of gestation was analyzed for mono (2-ethylhexyl) phthalate (MEHP), metabolite of DEHP levels. Neonatal FT4 and TSH were obtained from mass screening data. Infant neurodevelopment was assessed by Bayley Scale of Infant Development second edition at 6 and 18month of age. For the final analysis, 328 participants were included.The median levels of maternal MEHP was 10.6ng/ml, neonatal TSH and FT4 was 2.20 μU/ml and 2.03ng/ml, respectively. We did not find any associations between prenatal DEHP exposure and neonatal TH levels or infant mental and psychomotor development at 6 and 18month.In this study, prenatal DEHP exposure did not show adverse effects on infant TH levels or mental and psychomotor development in early life stage. However, our previous study revealed negative effects of prenatal DEHP exposure on sex hormone levels, continuous investigation on neurodevelopment in later life in association with prenatal DEHP exposure is necessary.

Describing normal development in an African setting: The utility of the Kilifi Developmental Inventory among young children at the Kenyan coast

The Kilifi Developmental Inventory (KDI) is a tool developed in Kenya for the assessment of psychomotor development in infants and young children. We developed age-appropriate standards against which the developmental progress of individual children could be tracked. The current report is based on three studies completed among 1428 children aged between 5 and 36months and living within rural and urban locations at the Coast of Kenya. We identified age-appropriate cut-offs and expected ranges of performance to facilitate the identification and monitoring of children with impaired psychomotor development.

Vitamin D supplementation should be routine in pregnancy: FOR: Recent research supports routine vitamin D supplementation in pregnancy.

Today our society worldwide is undergoing some major behavioural changes that have increased the risk of vitamin D deficiency. The risk factors include the risks of skin cancer, the extensive use of sun block, the reduction in exposure to sun light and the failure of the administration of cod liver oil to reduce the incidence of rickets in children, the increasing sedentary lifestyle of children, the apparel choice of certain social groups, and the migration of dark-skinned ethnic groups to northern countries, where sunlight is insufficient for them. There has been recent research to support routine vitamin D supplementation of all women beginning early in pregnancy. Our research group has now completed three longitudinal studies suggesting that vitamin D deficiency is associated with preterm birth, depression during pregnancy and metabolic dysregulation in overweight and obese women during the first year postpartum (Prossner et al. Reprod Sci 2013;20:3; Hobel et al. Reprod Sci 2014;21:3; Pepkowitz et al. PAS 2014, abstract 3545.3). Important findings are that the cord blood levels are consistently 59–61% of the maternal levels (does this increase the risk of the fetus during the first year of life?). With the incidence of vitamin D deficiency (<20 ng/ml) and insufficiency (20–29 ng/ml) during pregnancy ranging 43%–55%, a significant number of newborns are vitamin D deficient at birth. Our findings in the study of obesity suggest that the incidence of vitamin D deficiency and inflammation is very high, indicating that overweight and obese women may have significant metabolic dysregulation and are at significant risk. Hence, our studies have led to a better understanding of what the requirements are during pregnancy to protect the mother and her fetus. We have proposed that the normal level of vitamin D during pregnancy should be at least 40 ng/ml. There are three important recent papers that support our recommendation, which is a life course perspective for women and children. One paper documents an association between maternal higher circulating levels of vitamin D (>30 ng/ml), just above the peak insufficient level, and improved psychomotor development in infants (Morales et al. Pediatrics 2012;130:e913–20). A more recent paper in a randomised, double-blind, placebo-controlled supplementation trial in New Zealand beginning at 27 weeks of gestation (1000 versus 2000 IU for the mothers and 400 versus 800 IU for the child), documented the importance and safety of vitamin D supplementation to significantly increase the proportion of infants with vitamin D levels >20 ng/ml (Grant et al. Pediatrics 2013;133:e143–53). The question remains as to the value and amount (dose) of supplementation beginning in early pregnancy. A recent paper on supplementation with 4000 IU/day in Pakistani women known to be vitamin D deficient found that this regimen was inadequate in achieving normalisation of maternal and neonatal vitamin D status (Hossain et al. J Clin Endocrinol Metab 2014; 99:2448–2455). Finally, to complete the life course perspective, a recent paper confirms the association between all-cause dementia and Alzheimer's disease suggesting that vitamin D supplementation may be important across the life course of individuals (Littlejohns Neurology 2014;83:1–9). The next debate will be whether or not routine vitamin D supplementation in women should begin during the preconception period. None declared.

Not living with both parents is associated with more health- and developmental problems in infants aged 7 to 11 months: a cross sectional study.

BackgroundIn Western countries, many children are affected by the separation of their parents. Our main objective was to assess the possible impact of parental separation family structure on certain aspects of somatic health in low-age children.MethodsWe conducted a cross-sectional study based on data collected in the framework of free preventive medicine consultations in the French Community of Belgium. The data was derived from assessments conducted, between 2006 and 2012, on children 7 to 11 months after birth during which information of 79701 infants was collected regarding the risk of sudden infant death, psychomotor development, and development in terms of height and weight. The main outcome measures were: episode of risk of sudden infant death, polysomnography, home monitoring, psychomotor development, and body mass index.ResultsThe parents of 6.6% of the infants were separated. We established multivariable models, based on the presence or absence of confounders. The adjusted ORs (95% CI) of symptoms perceived as frightening, notably at night, of a prescription for a polysomnography, of an abnormal polysomnography result, and of follow-up by home monitoring were thus respectively 1.3 (1.1–1.6), 1.1 (0.9–1.3), 1.8 (1.3–2.4), and 1.3 (1.1–1.6). The adjusted ORs (95% CI) for psychomotor delay and for a body mass index above the 97th percentile were respectively 1.3 (1.0–1.6) and 1.2 (1.1–1.3) in the event of separation.ConclusionsThis study confirms the possibility that not living with both parents is an independent risk factor for the somatic health and psychomotor development of infants. This observation should be verified because it would have a major impact on the actions of family doctors and other first-line healthcare providers, in particular with regard to information and targeted prevention.