Risk For Development Of Disorders Research Articles

Medicines regulator seeks expert advice on risk of developmental disorders in children fathered by men on valproate

Medicines regulator seeks expert advice on risk of developmental disorders in children fathered by men on valproate

Nursing Care in Complex Congenital Heart Disease and Respiratory Distress Syndrome for Baby in NICU

Background: Neonates are at high risk for health problems. Without proper treatment, those problems might lead to either disability or death. Congenital heart disease causes respiratory distress syndrome (breathing distress syndrome), with symptoms of dyspnea, cyanosis, and respiratory arrest due to pathological changes in the heart that disrupt the blood flow cycle throughout the body. This study aimed to discover nursing care for Baby MH with complex congenital heart disease and respiratory distress syndrome. Methods: This research used a case study design—data collection from assessment to evaluation in the NICU in December 2022. The patient was observed for 4 days. Data collection techniques were carried out through interviews, observation, and documentation. Data analysis was carried out using narrative analysis. Results: Baby MH looks dyspnea with minimal epigastria retraction and hypersecretion in the mouth with CPAP installed. The nursing diagnoses in the case of Baby MH are ineffective breathing patterns, decreased cardiac output, activity intolerance, risk of shock, risk of hypothermia, risk of developmental disorder, and risk of attachment disorders. The interventions provided are based on the Indonesian Nursing Intervention Standards, consisting of observational, therapeutic, and collaborative interventions. Conclusion: Nursing problems in baby MH after the treatment showed that the problem of ineffective breathing patterns had not been resolved, but the decreased cardiac output was partially handled while the activity intolerance had not been resolved. However, no shock occurred, and the risk of hypothermia was partially resolved.

Literature Review : Feeding Comfort With Stunting Problems in Toddlers

The poor practice of complementary feeding (MPASI) is one of the most common problems in developing countries. This can lead to poor absorption of nutrients, especially protein, which is associated with problems related to physical growth disorders such as stunting in children under the age of 5 years. This study used a cross-sectional design intending to clarify the relationship between complementary feeding practices and the risk of stunting in children aged 6 to 12 months from Central Lombok. It was an analytical observational study. A total of 206 children with an average age of 9.3 months were selected as the subjects of this study using cluster sampling. Most of them are women. This study analyzed four parameters of the practice of giving complementary foods, namely the age of the first time complementary foods, types of complementary foods, the frequency of complementary foods, and the frequency of complementary foods. This study found a significant relationship between the frequency of complementary feeding (p=0.047, 95%CI) and the number of complementary foods given (p = 0.020, 95% CI) with the risk of developmental disorders in children. On the other hand, other parameters such as age at initiation of complementary foods and solid food texture were not significantly associated with the risk of growth retardation. One of the factors that directly affect stunting in children under the age of 2 years is intake factors such as breast milk (ASI) and breast milk supplements (MPASI).

Risk of developmental disorders in the next generation due to paternal aging focusing on sperm epimutation.

Risk of developmental disorders in the next generation due to paternal aging focusing on sperm epimutation.

Maternal prepregnancy weight and gestational weight gain in association with autism and developmental disorders in offspring.

Objective:Maternal prepregnancy BMI and gestational weight gain (GWG) are examined in relation to autism spectrum disorder (ASD) and other developmental disorders (DD) in offspring in a multisite case-control study.Methods:Maternal prepregnancy BMI, obtained from medical records or self-report, was categorized as underweight, normal weight, overweight, obesity Class 1, or obesity Class 2/3. GWG was standardized for gestational age (GWG z score), and the rate (pounds/week) was categorized per adherence with clinical recommendations. Logistic regression models, adjusting for demographic factors, were used to assess associations with ASD (n = 1,159) and DD (n = 1,617), versus control children (n = 1,633).Results:Maternal obesity Class 2/3 was associated with ASD (adjusted odds ratio [AOR] = 1.87, 95% CI: 1.40–2.51) and DD (AOR = 1.61, 95% CI: 1.22–2.13). GWG z score was not associated with DD (AOR = 1.14, 95% CI: 0.95–1.36), but the GWG z score highest tertile was associated with higher odds of ASD, particularly among male children (AOR = 1.47, 95% CI: 1.15–1.88).Conclusions:Results indicate that maternal prepregnancy severe obesity increases risk of ASD and DD in children and suggest high gestational-age-adjusted GWG is a risk factor for ASD in male children. Because maternal BMI and GWG are routinely measured and potentially modifiable, these findings could inform early interventions for high-risk mother-child dyads.

Awareness, knowledge and practice of healthcare professionals following implementation of a Pregnancy Prevention Program for sodium valproate in Ireland: a multi-stakeholder cross-sectional study

ABSTRACT Objectives To establish awareness, knowledge, use and experience in practice of a sodium valproate pregnancy prevention program (PPP) in Ireland (“prevent”) among three healthcare professional (HCP) groups. Methods A cross-sectional study using anonymous online surveys was conducted among general practitioners (GPs), pharmacists, and specialist consultants. Descriptive analyses are presented. Results HCP response rates were 5.8% for GPs (90/1544), 10.7% for pharmacists (219/2052), and 7.6% for specialists (17/224). Across HCP groups, there was high awareness (>90%) for specialist referral when female valproate patients are planning pregnancy, or become pregnant, but less awareness to refer annually for specialist review. While awareness of a possible teratogenic effect at any stage of pregnancy was high (>80%), most GPs (62.2%, 95% CI: 51.3, 71.9%) and community pharmacists (53.1%, 95% CI: 43.2, 62.8%) were unsure of the magnitude of risk for developmental disorders, while most specialists under-estimated this risk (46.7%, 95% CI: 24.8, 69.9%). Although >70% of the respondents identified valproate to be contraindicated in any woman of childbearing potential unless the conditions of the PPP are fulfilled, experience implementing key elements in practice varied. Conclusions Our findings suggest continued effort is needed to ensure optimal implementation of “prevent” into clinical practice in Ireland.

Intrauterine Hypoxia and Epigenetic Programming in Lung Development and Disease.

Clinically, intrauterine hypoxia is the foremost cause of perinatal morbidity and developmental plasticity in the fetus and newborn infant. Under hypoxia, deviations occur in the lung cell epigenome. Epigenetic mechanisms (e.g., DNA methylation, histone modification, and miRNA expression) control phenotypic programming and are associated with physiological responses and the risk of developmental disorders, such as bronchopulmonary dysplasia. This developmental disorder is the most frequent chronic pulmonary complication in preterm labor. The pathogenesis of this disease involves many factors, including aberrant oxygen conditions and mechanical ventilation-mediated lung injury, infection/inflammation, and epigenetic/genetic risk factors. This review is focused on various aspects related to intrauterine hypoxia and epigenetic programming in lung development and disease, summarizes our current knowledge of hypoxia-induced epigenetic programming and discusses potential therapeutic interventions for lung disease.

The Association Between Nutritional Status and Risk of Developmental Disorder in Children in Denpasar Bali Indonesia

BACKGROUND: Preschool age is an important period for growth and development. Malnutrition that occurs during this period can have negative impacts on growth, cognitive development, and academic performance in children. AIM: The objective of the study is to know the association between nutritional status and the risk of developmental disorder in preschool children in Denpasar. METHODS: An observational analytic study with a cross-sectional design and cluster sampling method was conducted on children under 5 years old who attended Early Childhood Education in Denpasar Bali in 2019. RESULTS: From 468 samples, the median age was 5 years old (range, 1–5), the majority of children were well-nourished (52.6%), and caretaken by parents (82.9%). Child development was prescreened using an Indonesian child development pre-screening questionnaire/Kuesioner Pra Skrining Perkembangan (KPSP) that had 75% sensitivity, 99.16% specificity, 85.71% positive predictive value,and 98.33% negative predictive value compared to Capute Scale test as a gold standard. It showed that the majority of participants had an appropriate developmental stage (91.3%), followed by doubtful (5.3%) and possible deviations (3.4%). The results of the bivariate analysis showed that malnutrition was significantly related to the risk of developmental delay (PR 2; confidence interval [CI] 95%, 1.05-3.97). The result of multivariate analysis for variables that were considered to be significant as a risk for developmental disorder showed that malnutrition was related to the possibility of developmental disorder (PR 2; CI 95%, 1.04–3.95). Caretakers other than parents and lack of physical activity were not significantly related to the risk of developmental disorder. CONCLUSION: Malnutrition was found to be significantly associated with the risk of developmental disorder in preschool children. Further prospective study by standard assessment tools is required to evaluate the association between nutritional status and developmental level in children.

A methodological pipeline to generate an epigenetic marker of prenatal exposure to air pollution indicators

ABSTRACT A barrier in the children’s environmental health field has been the lack of early-warning systems to identify risks of childhood illness and developmental disorders. We aimed to develop a methodology to identify an accessible biomarker measured in a small amount of blood to distinguish newborns at elevated risk from a toxic prenatal exposure, using air pollutants as a case study. Because air pollutants are associated with altered DNA methylation, we developed a pipeline using DNA methylation signatures measured in umbilical cord blood, which could be used as predictors of prenatal exposure. We used air pollution indicators, including modelled trimester-specific and pregnancy average NO2 and PM2.5, and DNA methylation signatures from Illumina arrays measured in two New York City-based longitudinal birth cohorts from the Columbia Centre for Children’s Environmental Health. We developed a screening plus three-part pipeline that incorporates selection, testing, and validation to identify whether DNA methylation can be used to predict exposure to prenatal air pollution indicators, NO2 and PM2.5. Applying this pipeline, we found that cord blood DNA methylation could be used to predict high vs. low average pregnancy NO2 (AUC = 0.60, 95% CI: 0.52–0.68, with validation AUC = 0.60). Similar results were found for high vs. low third trimester NO2. In this proof of concept study using air pollutants as an example, we provide an approach (with a generalizable analytic pipeline) that can be used for prediction of prenatal exposure to contaminants. This approach has potential to identify children at risk of developmental disorders and illness resulting from prenatal exposure.

De novo mutations in folate-related genes associated with common developmental disorders.

Folate deficiency is an environmental risk factor for several developmental disorders. De novo mutations (DNMs) also play important etiological roles in various developmental disorders. However, it remains unclear whether DNMs in folate-related genes (FRGs) contribute to developmental disorders. We obtained a list of 1,821 FRGs from folate metabolism pathways and the Comparative Toxicogenomics Database, along with data concerning DNMs in 15,404 cases and 3,391 controls from the Gene4Denovo database. We used a TADA-Denovo model to prioritize candidate disease-associated FRGs, and characterized these genes in terms of genic intolerance, functional networks, and expression patterns. Compared with the controls, FRGs were significantly enriched in likely damaging DNMs (ldDNMs) in patients with developmental disorders (1.54≤odds ratio≤3.39, P adj≤0.0075). Furthermore, FRGs with ldDNMs rather than with likely non-damaging DNMs (lndDNMs) overlapped significantly among the five developmental disorders included in the datasets. The TADA-Denovo model prioritized 96 candidate disease-associated FRGs, which were intolerant to genetic variants. Their functional networks mainly involved pathways associated with chromatin modification, organ development, and signal transduction pathways. DNMT3A, KMT2B, KMT2C, and YY1 emerged as hub FRGs from the protein-protein interaction network. These candidate disease-associated FRGs are preferentially expressed in the excitatory neurones during embryonic development, and in the cortex, cerebellum, striatum, and amygdala during foetal development. Overall, these findings show that DNMs in FRGs are associated with the risk of developmental disorders. Further research on these DNMs may facilitate the discovery of developmental disorder biomarkers and therapeutic targets, enabling detailed, personalized, and precise folate treatment plan.

The Effect of Home Visit Program Based on the Continued Kangaroo Mother Care on Maternal Resiliency and Development of Premature Infant: A Randomized Clinical Trial.

ABSTRACTBackground: Premature birth is a crisis for mothers and affects resilience. Premature babies are at risk for developmental disorders. The Kangaroo Mother Care (KMC) can reduce maternal stress and improve the growth of the baby. This study aimed at assessing the effect of home visit based on the continued KMC on maternal resiliency and development of premature infant.Methods: This randomized controlled trial conducted on 50 pairs of mothers and premature babies with gestational age of 26-32 weeks who were admitted to Neonatal Intensive Care Unit of Om-al-Banin Hospital, Mashhad, Iran in 2019. The KMC is practiced routinely for all eligible newborns in this hospital. The experimental group continued the KMC one month after discharge at home and received two home visits. Resiliency of the mothers was assessed in admission, discharge, and one month after discharge with the Connor and Davison questionnaire and the development of the newborns was assessed in two months of adjusted age with Ages and Stages Questionnaire (ASQ). Data analysis was performed using SPSS software version 16 and t-test, Mann-Whitney, ANOVA, Friedman, Chi-square, Fishers exact. The significance level was set at P<0.05.Results: The resiliency score of the mothers one month after discharge was112.50±5.50 and 76.40±5.60 in the experimental and control groups, which was significantly different (P<0.001). The ASQ development score of the newborns in two months of adjusted age was also significantly higher in the experimental than the control group (280.40±15.60vs223.80±22.00) (P<0.001).Conclusion: The results showed that the home visit program based on the continued KMC was effective in increasing maternal resilience and the development of premature infants. Trial Registration Number IRCT20181121041718N1.

Effect of gamma irradiation treatment at phytosanitary dose level on physiological and consumer traits of Indian ber. Part 1. Cultivar ‘Umran’

We, study the effect of γ-irradiation on postharvest physiology, decay loss, consumer testing parameters and chilling injury index of Indian ber cv. ‘Umran’. Fresh fruits of original cultivar ‘Umran’ were purchased from research orchard. Fruits irradiated at 0 (as control), 0.4 or 1.0 kGy doses, and then cold stored (10 °C and 95% RH) for 35 d. Weight loss (WL), respiration rate, ethylene production, ripening index, firmness, chilling injury index and consumer testing parameters were tested during storage at 7 d interval. The results indicated that the application of irradiation successfully extended the postharvest marketable life of jujube fruit without any risk of disorder development. In comparison with control, irradiated fruit with 1.0 kGy, showed a significant reduction (P < 0.05) in WL, firmness, decay and ripening index. Moreover, irradiation caused a significant effect on consumer liking traits and chilling injury. In addition, irradiation also reduces the respiration and ethylene production rate however, ethylene peaks was delayed by 7 days at 1.0 kGy dose. Overall, irradiation dose at 1.0 kGy recommended as a postharvest treatment for a longer shelf life of Indian jujube.

Positional plagiocephaly from structure to function: Clinical experience of the service of pediatric osteopathy in Italy

ObjectiveAim of the study is to evaluate disorders related to positional plagiocephaly and introduce a new model of early intervention based on the osteopathic integrated approach. MethodsWe review clinical experience of the “Program for Neurodevelopmental Follow-up and Pediatric Osteopathy”, a service dedicated to newborns at risk for developmental disorders. ResultsWe present clinical data of 310 newborns followed during first years of life. Data analysis examines perinatal history, general features and disorders that could be related to plagiocephaly. ConclusionsThe experience confirms that plagiocephaly is not only a problem regarding the shape of the head, it involves the functions. In our Service most babies (81%) with positional plagiocephaly showed isolated or associated disorders that had an impact on growth, behavior and development. The early intervention based on the osteopathic integrated approach is addressed not only to the cranial shape but consider the baby as a whole, and the environment where he lives.

Can a man also be afraid? Partner communication, anxiety and hope in parents of premature infants

ABSTRACT Premature birth can pose a great challenge on the performance of parental roles by parents of premature infants. Is the relationship of new parents affected by anxiety, which the literature enlists among the core consequences of an increased risk of developmental disorders and hospitalization in the early stages of their child’s life? The aims of this study were to determining the links between the levels of anxiety, hope and partner communication in parents of premature babies, and investigating the associations between their reported hope and anxiety. The research included 69 parents (46 mothers and 23 fathers) of infants born before 37-week gestation. All children were hospitalized throughout the entire study. The results suggest significant relationships between partner communication and anxiety in the investigated fathers. The higher their level of state anxiety, the less support they were willing to provide to their partners, and the higher their level of trait anxiety, the stronger their tendency to depreciate them. In addition, there were significant links between gestational week of birth and the level of anxiety reported by the mothers. The earlier the child was born, the higher was the level of state anxiety associated with the situation in mothers.

Prevention of aversive childhood experiences: social and health policy consequences

Prevention of aversive childhood experiences: social and health policy consequences Abstract. Neglect, as well as physical, psychological or sexual abuse increase the risk of developmental disorders and of long-term health consequences in adulthood. The prevention of maltreatment is therefore crucial. In Switzerland, a multi-layered prevention model mainly focuses on supporting the family. An improved social awareness of the importance of adequate childcare is in the interest of each individual as well as of the health care system and society as a whole.

Assessment of general movement among infants not at risk of developmental delay

Introduction. The functional assessment of general movements (GMs) is a common test for the developing nervous system. The high predictive validity of abnormal GMs for cerebral palsy has been documented among preterm infants. Aim. The present study examined whether term infants without any documented risk factors for neurodevelopment delay may benefit from an assessment of GMs. Material and Methods. One hundred and four infants ranging in age from 1–4 months were evaluated using Prechtl’s method, of which, thirty-eight were younger than two months of age and the remaining sixty-eight were older than two months of age (with available detailed neonatal characteristics). The following movements were considered among younger infants, writhing, poor repertoire and cramped synchronised, whereas fidgety, cramped synchronised, poor repertoire, chaotic and abnormal GMs were evaluated in older infants. Infants were classified as ‘normal’ or ‘abnormal’ groups based on their presenting GMs. We determined postural positional preference, following Kaplan recommendations, with features categorised as either ‘present’ or ‘absent’, as well as activity level and general muscle tone (‘normal’ or ‘abnormal’). Results. Cramped synchronised GMs were observed in seven (18.4%) younger infants and in eleven (16.7%) older infants. There was no difference in the clinical characteristics of children with normal vs. abnormal GMs. Abnormal muscle tone was associated with a higher OR (p = 0.0039) of presenting with abnormal GMs (4.6063; 95%CI: 1.6303–13.0149). Although the infants studied were not at risk for developmental disorders, almost one-fifth required follow-up neurological consultation. Conclusions. An assessment of GMs should be considered as a universal screening tool among healthy infants without risk factor(s) for developmental deficits.

Comparison of Child Development Between Aterm and Premature Birth at Age 2-3 Years Old

Objective: Premature births are at risk of developing language delays, motor balance and coordination. This study aims to analyze developmental differences in children with a history of premature birth and term. Methods: The data used was primary data through filling questionnaires and interviews to subjects. This study was observational analytic with retrospective cohort design. The population was all 2-3 years old children at Kabupaten Probolinggo. Sampling was using a simple sampling formula and obtained 100 children into 2 groups. First group was 50 children who aterm at birth. Second group was 50 children who premature at birth. Result: The result showed that there were there is significant different at child development between aterm and premature born childen (p&lt;0.05). The relative risk (RR) analysis showed that the value is significant enough. Children development was influenced by type of born (RR=1.647x) Conclusion: The development of 2-3 years old children is very important, especially children with a history of premature birth who have a risk of developmental disorders. Parents should give more attention in providing appropriate developmental stimulation according to the child's age.

Study complications and follow-up outcomes of preterm infants hospitalized in Ardabil city hospital in 2016

Background: Preterm birth is one of the leading and direct causes of newborn mortality. The aim of this was to study complications and follow-up outcomes of preterm infants hospitalized in Ardabil city hospital in 2016. Methodology: This cross-sectional study was conducted on 73 preterm babies at Ardabil city hospital in 2016. The research-based checklist included demographics, and the outcome data were completed through the infant’s examination and by studying hospital files. Collected data were analyzed by statistical methods in statistical package for the social sciences v.19. Results: The rate of mortality was 21.2%, and the rate of developmental disorders (DD) was 26.2%. The main preterm infant’s problems were respiratory distress syndrome (RDS) and ICTER, respectively. There was a significant inverse relation between gestational age (GA) and birth weight with the rate of mortality and developmental disorders. The relationship between sex and mortality rate was not significant. There was a significant relation between DD with RDS, age of infants, weight and round head of infants in 6 months. Conclusion: Results showed that preterm infants are at risk for DD and mortality in comparison with full-term infants. Hence, specialized care for them is essential in the future.

Relative contributions of prenatal complications, perinatal characteristics, neonatal morbidities and socio-economic conditions of preterm infants on the occurrence of developmental disorders up to 7 years of age.

To investigate the relative contributions of prenatal complications, perinatal characteristics, neonatal morbidities and socio-economic conditions on the occurrence of motor, sensory, cognitive, language and psychological disorders in a large longitudinal preterm infant population during the first 7 years after birth. The study population comprised 4122 infants born at <35 weeks of gestation who were followed for an average of 74.0 months after birth. Developmental disorders, including motor, sensory, cognitive, language and psychological, were assessed at each follow-up visit from 18 months to 7 years of age. The investigated determinants included prenatal complications (prolonged rupture of membranes >24 hours, intrauterine growth restriction, preterm labour and maternal hypertension), perinatal characteristics (gender, multiple pregnancies, gestational age, birth weight, APGAR score and intubation or ventilation in the delivery room), neonatal complications (low weight gain during hospitalization, respiratory assistance, severe neurological anomalies, nosocomial infections) and socio-economic characteristics (socio-economic level, parental separation, urbanicity). Based on hazard ratios determined using a propensity score matching approach, population-attributable fractions (PAF) were calculated for each of the four types of determinants and for each developmental disorder. The percentages of motor, sensory, cognitive, language and psychological disorders were 17.0, 13.4, 29.1, 25.9 and 26.1%, respectively. The PAF for the perinatal characteristics were the highest and they were similar for the different developmental disorders considered (around 60%). For the neonatal and socio-economic determinants, the PAF varied according to the disorder, with contributions of up to 17% for motor and 27% for language disorders, respectively. Finally, prenatal complications had the lowest contributions (between 6 and 13%). This study illustrates the heterogeneity of risk factors on the risk of developmental disorder in preterm infants. These results suggest the importance of considering both medical and psycho-social follow-ups of preterm infants and their families.

Child development skills and language in toddlers with cleft lip and palate

IntroductionChildren born with cleft lip and palate (CLP) are exposed to several risk factors for developmental delay. MethodsThis cross-sectional and descriptive study compared the performance of gross motor, adaptive fine motor, social-personal and language skills in children with non-syndromic cleft lip and palate (age = 36–47 months, n = 30) matched as to chronological age and gender. The evaluation instruments were Denver Developmental Screening Test II and MacArthur Communicative Development Inventory – part D, employed for the receptive and expressive vocabulary checklist. Intergroup comparisons were performed using t tests and Chi-square tests. The Pearson correlation coefficient was used to verify the inter-category correlation (p ≤ 0.05). ResultsThere was statistically significant difference in gross motor, adaptive fine motor, and language skills, both in receptive and expressive aspects, in the comparison between groups. In the personal-social area, children with CLP presented performance below the expected, without statistically significant difference between groups. ConclusionsChildren with CLP are at risk for developmental disorders and should be monitored from early childhood to minimize the deleterious effects of this risk condition.