Medicine › Pediatrics, Perinatology and Child Health

Infant Development and Preterm Care

Works Count: 50515

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This cluster of papers focuses on the mortality, neurodevelopmental outcomes, and long-term sequelae of preterm birth, with an emphasis on interventions such as family-centered care and kangaroo mother care in neonatal intensive care units. It also explores the cognitive and behavioral outcomes, as well as the challenges associated with developmental surveillance and executive functioning in individuals born preterm.

Keywords

Preterm Birth; Neurodevelopmental Outcomes; Infant Mortality; Family-Centered Care; Neonatal Intensive Care Unit; Cognitive Function; Developmental Surveillance; Kangaroo Mother Care; Executive Functioning; Behavioral Outcomes

Early skin-to-skin contact for mothers and their healthy newborn infants

2016-11-25

Elizabeth R. Moore , Nils Bergman , Gene Cranston Anderson +1 more

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Generalized Linear Models

2005-11-14

Peter McCullagh , J. A. Nelder

The Denver II: A Major Revision and Restandardization of the Denver Developmental Screening Test

1992-01-01

William K. Frankenburg , Josiah B. Dodds , P. Archer +2 more

Since the Denver Developmental Screening Test was first published 23 years ago, it has been utilized worldwide and restandardized in more than a dozen countries. Concerns raised through the years … Since the Denver Developmental Screening Test was first published 23 years ago, it has been utilized worldwide and restandardized in more than a dozen countries. Concerns raised through the years by test users about specific items and features of the Denver Developmental Screening Test, coupled with a need for more current norms, have prompted a major revision and restandardization of the test. For the revision, 336 potential items were administered to more than 2000 children. The average number of times each item was administered was 540. Using regression analysis, composite norms for the total sample and norms for subgroups (based on gender, ethnicity, maternal education, and place of residence), were used to determine new age norms. The final selection of the 125 Denver II items was based on the following criteria: ease of administration and scoring, item appeal to child and examiner, item test-retest and inter-rater reliability, minimal "refusal" scores, minimal "no opportunity" scores, minimal subgroup differences, and a smooth step-like progression of ages at which 90% of children could perform the tasks. The major differences between the Denver II and the Denver Developmental Screening Test are: 1) an 86% increase in language items; 2) two articulation items; 3) a new age scale; 4) a new category of item interpretation to identify milder delays; 6) a behavior rating scale; and 7) new training materials.

Neonatal Behavioral Assessment Scale

2005-01-01

T. Berry Brazelton , J. Kevin Nugent

Contributors vii Foreword ix Martin Bax 1. Introduction 1 T. Berry Brazelton 2. Standard administration of the NBAS 7 3. Manual for scoring the NBAS Items 41 4. Research Uses … Contributors vii Foreword ix Martin Bax 1. Introduction 1 T. Berry Brazelton 2. Standard administration of the NBAS 7 3. Manual for scoring the NBAS Items 41 4. Research Uses for the NBAS 67 5. Clinical Uses of the NBAS 84 I. Introduction 84 II. The Combined Physical and Behavioral Neonatal Examination: A Parent-Centered Approach to Pediatric Care 92 Constance Helen Keefer III. A Model for Intergrating the NBAS into Nursing Practice 102 Donna J. Karl, Judy A. Beal and Patricia N. Rissmiller IV. Using the NBAS with Families: A Psychotherapeutic Approach 108 Hanne Munck V. Family Administered Neonatal Activities (FANA) 111 Ida Anne Cardone and Linda Gilkerson VI. Parents' Perceptions as Guides for Conducting NBAS Clinical Sessions 117 Dieter Wolke VII. Using the NBAS with High-Risk Infants 126 Jean Gardner Cole Appendices 123 1. NBAS Scoring Form 133 2. Mother and Baby Scales (MBAS) 135 References 138

Apgar Scores as Predictors of Chronic Neurologic Disability

1981-07-01

Karin B. Nelson , Jonas H. Ellenberg

Apgar scores were recorded at one and five minutes for approximately 49,000 infants, and at ten, 15, and 20 minutes for babies who did not achieve a score of 8 … Apgar scores were recorded at one and five minutes for approximately 49,000 infants, and at ten, 15, and 20 minutes for babies who did not achieve a score of 8 or higher at five minutes. These children were followed to the age of 7 years. Low Apgar scores were risk factors for cerebral palsy, but 55% of children with later cerebral palsy had Apgar scores of 7 to 10 at one minute, and 73% scored 7 to 10 at five minutes. Of 99 children who had Apgar scores of 0 to 3 at ten, 15, or 20 minutes and survived, 12 (12%) had later cerebral palsy; 11 of the 12 were also mentally retarded (in ten, IQ &lt; 50) and half had seizure disorders. Eight children who survived after having very low late Apgar scores and who did not have cerebral palsy had lesser but significant disabilities. Of the children who had Apgar scores of 0 to 3 at ten minutes or later and survived, 80% were free of major handicap at early school age.

Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction

1990-09-01

H.F.R. Prechtl

Reducing Premature Infants' Length of Stay and Improving Parents' Mental Health Outcomes With the Creating Opportunities for Parent Empowerment (COPE) Neonatal Intensive Care Unit Program: A Randomized, Controlled Trial

2006-10-17

Bernadette Mazurek Melnyk , Nancy Fischbeck Feinstein , Linda J. Alpert‐Gillis +7 more

Although low birth weight premature infants and parents are at high risk for adverse health outcomes, there is a paucity of studies that test early NICU interventions with parents to … Although low birth weight premature infants and parents are at high risk for adverse health outcomes, there is a paucity of studies that test early NICU interventions with parents to prevent the development of negative parent-infant interaction trajectories and to reduce hospital length of stay. Our objective was to evaluate the efficacy of an educational-behavioral intervention program (ie, Creating Opportunities for Parent Empowerment) that was designed to enhance parent-infant interactions and parent mental health outcomes for the ultimate purpose of improving child developmental and behavior outcomes.A randomized, controlled trial was conducted with 260 families with preterm infants from 2001 to 2004 in 2 NICUs in the northeast United States. Parents completed self-administered instruments during hospitalization, within 7 days after infant discharge, and at 2 months' corrected age. Blinded observers rated parent-infant interactions in the NICU.All participants received 4 intervention sessions of audiotaped and written materials. Parents in the Creating Opportunities for Parent Empowerment program received information and behavioral activities about the appearance and behavioral characteristics of preterm infants and how best to parent them. The comparison intervention contained information regarding hospital services and policies.Parental stress, depression, anxiety, and beliefs; parent-infant interaction during the NICU stay; NICU length of stay; and total hospitalization were measured.Mothers in the Creating Opportunities for Parent Empowerment program reported significantly less stress in the NICU and less depression and anxiety at 2 months' corrected infant age than did comparison mothers. Blinded observers rated mothers and fathers in the Creating Opportunities for Parent Empowerment program as more positive in interactions with their infants. Mothers and fathers also reported stronger beliefs about their parental role and what behaviors and characteristics to expect of their infants during hospitalization. Infants in the Creating Opportunities for Parent Empowerment program had a 3.8-day shorter NICU length of stay (mean: 31.86 vs 35.63 days) and 3.9-day shorter total hospital length of stay (mean: 35.29 vs 39.19 days) than did comparison infants.A reproducible educational-behavioral intervention program for parents that commences early in the NICU can improve parent mental health outcomes, enhance parent-infant interaction, and reduce hospital length of stay.

Every Newborn: progress, priorities, and potential beyond survival

2014-05-19

Joy E. Lawn , Hannah Blencowe , Shefali Oza +7 more

NIH Toolbox for Assessment of Neurological and Behavioral Function

2013-03-11

Richard Gershon , Molly V. Wagster , Hugh C. Hendrie +3 more

At present, there are many studies that collect information on aspects of neurologic and behavioral function (cognition, sensation, movement, emotion), but with little uniformity among the measures used to capture … At present, there are many studies that collect information on aspects of neurologic and behavioral function (cognition, sensation, movement, emotion), but with little uniformity among the measures used to capture these constructs. Further, available measures are generally expensive, normed on homogenous nondiverse populations, not easily administered, do not cover the lifespan (or have easily linked pediatric and adult counterparts for the purposes of longitudinal comparison), and not based on the current thinking in the neuroscience community. There is also a paucity of measurement tools to gauge normal children in the motor and sensation domain areas, and many of these measures rely heavily on proxy reporting. Investigators have expressed the need for brief assessment tools that could address these issues and be used as a form of "common currency" across diverse study designs and populations. This ability to assess functionality along a common metric and "crosswalk" across measures is essential to the process of being able to pool data, which is often necessary when a large and diverse sample is needed. When individual studies employ unique assessment batteries, comparisons between studies and combining data from multiple studies can be problematic. The contract for the NIH Toolbox for the Assessment of Neurological and Behavioral Function (www.nihtoolbox.org) was initiated by the NIH Blueprint for Neuroscience Research (www.neuroscienceblueprint.nih.gov) to develop a set of state-of-the-art measurement tools to enhance collection of data in large cohort studies and to advance the biomedical research enterprise.

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Individualized Developmental Care for the Very Low-Birth-Weight Preterm Infant

1994-09-21

Heidelise Als

To investigate the effectiveness of individualized developmental care in reducing medical and neurodevelopmental sequelae for very low-birth-weight infants.Randomized controlled trial.Newborn intensive care unit.Thirty-eight singleton preterm infants, free of known congenital … To investigate the effectiveness of individualized developmental care in reducing medical and neurodevelopmental sequelae for very low-birth-weight infants.Randomized controlled trial.Newborn intensive care unit.Thirty-eight singleton preterm infants, free of known congenital abnormalities, weighing less than 1250 g, born before 30 weeks' gestation, mechanically ventilated within 3 hours of delivery and for more than 24 hours in the first 48 hours, randomly assigned to a control or an experimental group.Caregiving by nurses specifically trained in individualized developmental care; observation and documentation of the infants' behavior within 12 hours of admission, and subsequently every 10th day; developmental care recommendations and ongoing clinical support for the nurses and parents based on regular observation of the infant by developmental specialists; and the availability of special caregiving accessories.Medical outcome, including average daily weight gain; number of days the infant required mechanical ventilation, oxygen, gavage tube feeding, and hospitalization; severity of retinopathy of prematurity, bronchopulmonary dysplasia, pneumothorax, and intraventricular hemorrhage; pediatric complications; age at discharge; and hospital charges. Neurodevelopmental outcome, including Assessment of Preterm Infants' Behavior scale and quantified electroencephalography (2 weeks after due date); and Bayley Scales of Infant Development and Kangaroo Box Paradigm (9 months after due date).The infants in the experimental group had a significantly shorter duration of mechanical ventilation and supplemental oxygen support; earlier oral feeding; reduced incidence of intraventricular hemorrhage, pneumothorax, and severe bronchopulmonary dysplasia; improved daily weight gain; shorter hospital stays; younger ages at hospital discharge; and reduced hospital charges compared with the infants in the control group. At 2 weeks after their due dates, these infants also showed improved autonomic regulation, motor system functioning, self-regulatory abilities, and visual evoked potential measures; and at 9 months, they had improved Bayley Mental and Psychomotor Developmental Index scores, as well as Kangaroo Box Paradigm scores.Very low-birth-weight preterm infants may benefit from individualized developmental care in the neonatal intensive care unit in terms of medical and neurodevelopmental outcome.

Prolonged Duration of Initial Empirical Antibiotic Treatment Is Associated With Increased Rates of Necrotizing Enterocolitis and Death for Extremely Low Birth Weight Infants

2008-12-29

C. Michael Cotten , Sarah Taylor , Barbara J. Stoll +5 more

Our objectives were to identify factors associated with the duration of the first antibiotic course initiated in the first 3 postnatal days and to assess associations between the duration of … Our objectives were to identify factors associated with the duration of the first antibiotic course initiated in the first 3 postnatal days and to assess associations between the duration of the initial antibiotic course and subsequent necrotizing enterocolitis or death in extremely low birth weight infants with sterile initial postnatal culture results.We conducted a retrospective cohort analysis of extremely low birth weight infants admitted to tertiary centers in 1998-2001. We defined initial empirical antibiotic treatment duration as continuous days of antibiotic therapy started in the first 3 postnatal days with sterile culture results. We used descriptive statistics to characterize center practice, bivariate analyses to identify factors associated with prolonged empirical antibiotic therapy (> or =5 days), and multivariate analyses to evaluate associations between therapy duration, prolonged empirical therapy, and subsequent necrotizing enterocolitis or death.Of 5693 extremely low birth weight infants admitted to 19 centers, 4039 (71%) survived >5 days, received initial empirical antibiotic treatment, and had sterile initial culture results through the first 3 postnatal days. The median therapy duration was 5 days (range: 1-36 days); 2147 infants (53%) received prolonged empirical therapy (center range: 27%-85%). Infants who received prolonged therapy were less mature, had lower Apgar scores, and were more likely to be black. In multivariate analyses adjusted for these factors and center, prolonged therapy was associated with increased odds of necrotizing enterocolitis or death and of death. Each empirical treatment day was associated with increased odds of death, necrotizing enterocolitis, and the composite measure of necrotizing enterocolitis or death.Prolonged initial empirical antibiotic therapy may be associated with increased risk of necrotizing enterocolitis or death and should be used with caution.

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Neurologic and Developmental Disability at Six Years of Age after Extremely Preterm Birth

2005-01-05

Neil Marlow , Dieter Wolke , Melanie Bracewell +1 more

Birth before 26 weeks of gestation is associated with a high prevalence of neurologic and developmental disabilities in the infant during the first two years of life.We studied at the … Birth before 26 weeks of gestation is associated with a high prevalence of neurologic and developmental disabilities in the infant during the first two years of life.We studied at the time of early school age children who had been born at 25 or fewer completed weeks of gestation in the United Kingdom and Ireland in 1995. Each child had been evaluated at 30 months of age. The children underwent standardized cognitive and neurologic assessments at six years of age. Disability was defined as severe (indicating dependence on caregivers), moderate, or mild according to predetermined criteria.Of 308 surviving children, 241 (78 percent) were assessed at a median age of six years and four months; 160 classmates delivered at full term served as a comparison group. Although the use of test reference norms showed that cognitive impairment (defined as results more than 2 SD below the mean) was present in 21 percent of the children born extremely preterm (as compared with 1 percent in the standardized data), this value rose to 41 percent when the results were compared with those for their classmates. The rates of severe, moderate, and mild disability were 22 percent, 24 percent, and 34 percent, respectively; disabling cerebral palsy was present in 30 children (12 percent). Among children with severe disability at 30 months of age, 86 percent still had moderate-to-severe disability at 6 years of age. In contrast, other disabilities at the age of 30 months were poorly predictive of developmental problems at 6 years of age.Among extremely preterm children, cognitive and neurologic impairment is common at school age. A comparison with their classroom peers indicates a level of impairment that is greater than is recognized with the use of standardized norms.

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Comparison of Skin-to-Skin (Kangaroo) and Traditional Care: Parenting Outcomes and Preterm Infant Development

2002-07-01

Ruth Feldman , Arthur I. Eidelman , Lea Sirota +1 more

To examine whether the kangaroo care (KC) intervention in premature infants affects parent-child interactions and infant development.Seventy-three preterm infants who received KC in the neonatal intensive care unit were matched … To examine whether the kangaroo care (KC) intervention in premature infants affects parent-child interactions and infant development.Seventy-three preterm infants who received KC in the neonatal intensive care unit were matched with 73 control infants who received standard incubator care for birth weight, gestational age (GA), medical severity, and demographics. At 37 weeks' GA, mother-infant interaction, maternal depression, and mother perceptions were examined. At 3 months' corrected age, infant temperament, maternal and paternal sensitivity, and the home environment (with the Home Observation for Measurement of the Environment [HOME]) were observed. At 6 months' corrected age, cognitive development was measured with the Bayley-II and mother-infant interaction was filmed. Seven clusters of outcomes were examined at 3 time periods: at 37 weeks' GA, mother-infant interaction and maternal perceptions; at 3-month, HOME mothers, HOME fathers, and infant temperament; at 6 months, cognitive development and mother-infant interaction.After KC, interactions were more positive at 37 weeks' GA: mothers showed more positive affect, touch, and adaptation to infant cues, and infants showed more alertness and less gaze aversion. Mothers reported less depression and perceived infants as less abnormal. At 3 months, mothers and fathers of KC infants were more sensitive and provided a better home environment. At 6 months, KC mothers were more sensitive and infants scored higher on the Bayley Mental Developmental Index (KC: mean: 96.39; controls: mean: 91.81) and the Psychomotor Developmental Index (KC: mean: 85.47; controls: mean: 80.53).KC had a significant positive impact on the infant's perceptual-cognitive and motor development and on the parenting process. We speculate that KC has both a direct impact on infant development by contributing to neurophysiological organization and an indirect effect by improving parental mood, perceptions, and interactive behavior.

Randomised trial of early diet in preterm babies and later intelligence quotient

1998-11-28

Alan Lucas , Ruth Morley , Tim Cole

<h3>abstract</h3> Objectives: To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm. Design: Randomised, blinded nutritional intervention trial. Blinded follow up at … <h3>abstract</h3> Objectives: To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm. Design: Randomised, blinded nutritional intervention trial. Blinded follow up at 7 1/2 - 8 years. Setting: Intervention phase in two neonatal units; follow up in a clinic or school setting. Subjects: 424 preterm infants who weighed under 1850 g at birth; 360 of those who survived were tested at 7 1/2 - 8 years. Interventions: Standard infant formula versus nutrient enriched preterm formula randomly assigned as sole diet (trial A) or supplements to maternal milk (trial B) fed for a mean of 1 month. Main outcome measures: Intelligence quotient (IQ) at 7 1/2 - 8 years with abbreviated Weschler intelligence scale for children (revised). Results: There was a major sex difference in the impact of diet. At 7 1/2 - 8 years boys previously fed standard versus preterm formula as sole diet had a 12.2 point disadvantage (95% confidence interval 3.7 to 20.6; P<0.01) in verbal IQ. In those with highest intakes of trial diets corresponding figures were 9.5 point disadvantage and 14.4 point disadvantage in overall IQ (1.2 to 17.7; P<0.05) and verbal IQ (5.7 to 23.2; P<0.01). Consequently, more infants fed term formula had low verbal IQ (<85): 31% versus 14% for both sexes (P=0.02) and 47% versus 13% in boys P=0.009). There was a higher incidence of cerebral palsy in those fed term formula; exclusion of such children did not alter the findings. Conclusions: Preterm infants are vulnerable to suboptimal early nutrition in terms of their cognitive performance—notably, language based skills—at 7 1/2 - 8 years, when cognitive scores are highly predictive of adult ones. Our data on cerebral palsy generate a new hypothesis that suboptimal nutritional management during a critical or plastic early period of rapid brain growth could impair functional compensation in those sustaining an earlier brain insult. Cognitive function, notably in males, may be permanently impaired by suboptimal neonatal nutrition.

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The Denver Developmental Screening Test

1967-08-01

William K. Frankenburg , Josiah B. Dodds

Cognitive and Behavioral Outcomes of School-Aged Children Who Were Born Preterm

2002-08-14

Adnan Bhutta , Mario A. Cleves , Patrick H. Casey +2 more

The cognitive and behavioral outcomes of school-aged children who were born preterm have been reported extensively. Many of these studies have methodological flaws that preclude an accurate estimate of the … The cognitive and behavioral outcomes of school-aged children who were born preterm have been reported extensively. Many of these studies have methodological flaws that preclude an accurate estimate of the long-term outcomes of prematurity.To estimate the effect of preterm birth on cognition and behavior in school-aged children.MEDLINE search (1980 to November 2001) for English-language articles, supplemented by a manual search of personal files maintained by 2 of the authors.We included case-control studies reporting cognitive and/or behavioral data of children who were born preterm and who were evaluated after their fifth birthday if the attrition rate was less than 30%. From the 227 reviewed studies, cognitive data from 15 studies and behavioral data from 16 studies were selected.Data on population demographics, study characteristics, and cognitive and behavioral outcomes were extracted from each study, entered in a customized database, and reviewed twice to minimize error. Differences between the mean cognitive scores of cases and controls were pooled. Homogeneity across studies was formally tested using a general variance-based method and graphically using Galbraith plots. Linear meta-analysis regression models were fitted to explore the impact of birth weight and gestational age on cognitive outcomes. Study-specific relative risks (RRs) were calculated for the incidence of attention-deficit/hyperactivity disorder (ADHD) and pooled. Quality assessment of the studies was performed based on a 10-point scale. Publication bias was examined using Begg modified funnel plots and formally tested using the Egger weighted-linear regression method.Among 1556 cases and 1720 controls, controls had significantly higher cognitive scores compared with children who were born preterm (weighted mean difference, 10.9; 95% confidence interval [CI], 9.2-12.5). The mean cognitive scores of preterm-born cases and term-born controls were directly proportional to their birth weight (R(2) = 0.51; P<.001) and gestational age (R(2) = 0.49; P<.001). Age at evaluation had no significant correlation with mean difference in cognitive scores (R(2) = 0.12; P =.20). Preterm-born children showed increases in externalizing and internalizing behaviors in 81% of studies and had more than twice the RR for developing ADHD (pooled RR, 2.64; 95% CI, 1.85-3.78). No differences were noted in cognition and behaviors based on the quality of the study.Children who were born preterm are at risk for reduced cognitive test scores and their immaturity at birth is directly proportional to the mean cognitive scores at school age. Preterm-born children also show an increased incidence of ADHD and other behaviors.

Long-Term Developmental Outcomes of Low Birth Weight Infants

1995-01-01

Maureen Hack , Nancy K. Klein , H. Gerry Taylor

Advances in neonatal medicine have resulted in the increased survival of infants at lower and lower birth weight. While these medical success stories highlight the power of medical technology to … Advances in neonatal medicine have resulted in the increased survival of infants at lower and lower birth weight. While these medical success stories highlight the power of medical technology to save many of the tiniest infants at birth, serious questions remain about how these infants will develop and whether they will have normal, productive lives. Low birth weight children can be born at term or before term and have varying degrees of social and medical risk. Because low birth weight children are not a homogeneous group, they have a broad spectrum of growth, health, and developmental outcomes. While the vast majority of low birth weight children have normal outcomes, as a group they generally have higher rates of subnormal growth, illnesses, and neurodevelopmental problems. These problems increase as the child's birth weight decreases. With the exception of a small minority of low birth weight children with mental retardation and/or cerebral palsy, the developmental sequelae for most low birth weight infants include mild problems in cognition, attention, and neuromotor functioning. Long-term follow-up studies conducted on children born in the 1960s indicated that the adverse consequences of being born low birth weight were still apparent in adolescence. Adverse sociodemographic factors negatively affect developmental outcomes across the continuum of low birth weight and appear to have far greater effects on long-term cognitive outcomes than most of the biological risk factors. In addition, the cognitive defects associated with social or environmental risks become more pronounced as the child ages. Enrichment programs for low birth weight children seem to be most effective for the moderately low birth weight child who comes from a lower socioeconomic group. Continued research and attempts to decrease the rate of low birth weight and associated perinatal medical sequelae are of primary importance. Ongoing documentation of the long-term outcome of low birth weight children needs to be mandated, as does the implementation of environmental enrichment programs to help ameliorate the long-term consequences for infants who are born low birth weight.

The emergence of fetal behaviour. I. Qualitative aspects

1982-12-01

Johanna I.P. de Vries , Gerard H. A. Visser , H.F.R. Prechtl

National Sleep Foundation’s sleep time duration recommendations: methodology and results summary

2015-03-01

Max Hirshkowitz , Kaitlyn Whiton , Steven M. Albert +7 more

Development of Executive Functions Through Late Childhood and Adolescence in an Australian Sample

2001-08-01

Vicki Anderson , Peter J. Anderson , Elisabeth Northam +2 more

Abstract Although there have been significant theoretical advances in the field of child neuropsychology, developmental features of adolescence have received less attention. Progress in clinical practice is restricted due to … Abstract Although there have been significant theoretical advances in the field of child neuropsychology, developmental features of adolescence have received less attention. Progress in clinical practice is restricted due to a lack of well-standardized, developmentally appropriate assessment techniques. This article addresses these issues in relation to executive skills. These abilities are targeted for 2 reasons: first, because they are often considered to be mature during late childhood and adolescence, despite limited investigation in this age range; and second, because of their central importance to efficient day-to-day functioning. Using a normative sample of 138 children, aged 11.0 to 17.11 years, this article plots the development of executive skills through late childhood and early adolescence and interprets progress in these skills with reference to current neurological and cognitive theory.

Age‐associated memory impairment: Proposed diagnostic criteria and measures of clinical change — report of a national institute of mental health work group

1986-01-01

Thomas H. Crook , Raymond T. Bartus , Steven H. Ferris +3 more

(1986). Age‐associated memory impairment: Proposed diagnostic criteria and measures of clinical change — report of a national institute of mental health work group. Developmental Neuropsychology: Vol. 2, No. 4, pp. … (1986). Age‐associated memory impairment: Proposed diagnostic criteria and measures of clinical change — report of a national institute of mental health work group. Developmental Neuropsychology: Vol. 2, No. 4, pp. 261-276.

Development and Psychometric Evaluation of the Pediatric Anesthesia Emergence Delirium Scale

2004-04-20

Nancy Sikich , Jerrold Lerman

Emergence delirium has been investigated in several clinical trials. However, no reliable and valid rating scale exists to measure this phenomenon in children. Therefore, the authors developed and evaluated the … Emergence delirium has been investigated in several clinical trials. However, no reliable and valid rating scale exists to measure this phenomenon in children. Therefore, the authors developed and evaluated the Pediatric Anesthesia Emergence Delirium (PAED) scale to measure emergence delirium in children.A list of scale items that were statements describing the emergence behavior of children was compiled, and the items were evaluated for content validity and statistical significance. Items that satisfied these evaluations comprised the PAED scale. Each item was scored from 1 to 4 (with reverse scoring where applicable), and the scores were summed to obtain a total scale score. The degree of emergence delirium varied directly with the total score. Fifty children were enrolled to determine the reliability and validity of the PAED scale. Scale validity was evaluated using five hypotheses: The PAED scale scores correlated negatively with age and time to awakening and positively with clinical judgment scores and Post Hospital Behavior Questionnaire scores, and were greater after sevoflurane than after halothane. The sensitivity of the scale was also determined.Five of 27 items that satisfied the content validity and statistical analysis became the PAED scale: (1) The child makes eye contact with the caregiver, (2) the child's actions are purposeful, (3) the child is aware of his/her surroundings, (4) the child is restless, and (5) the child is inconsolable. The internal consistency of the PAED scale was 0.89, and the reliability was 0.84 (95% confidence interval, 0.76-0.90). Three hypotheses supported the validity of the scale: The scores correlated negatively with age (r = -0.31, P <0.04) and time to awakening (r = -0.5, P <0.001) and were greater after sevoflurane anesthesia than halothane (P <0.008). The sensitivity was 0.64.These results support the reliability and validity of the PAED scale.

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Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants

2015-11-24

Alicia J. Spittle , Jane Orton , Peter J. Anderson +2 more

Children's Brain Development Benefits from Longer Gestation

2011-01-01

Elysia Poggi Davis , Claudia Buß , L. Tugan Muftuler +5 more

Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was … Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.

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“Late-Preterm” Infants: A Population at Risk

2007-11-30

William A. Engle , Kay M. Tomashek , Carol Wallman

Late-preterm infants, defined by birth at 34(0/7) through 36(6/7) weeks' gestation, are less physiologically and metabolically mature than term infants. Thus, they are at higher risk of morbidity and mortality … Late-preterm infants, defined by birth at 34(0/7) through 36(6/7) weeks' gestation, are less physiologically and metabolically mature than term infants. Thus, they are at higher risk of morbidity and mortality than term infants. The purpose of this report is to define "late preterm," recommend a change in terminology from "near term" to "late preterm," present the characteristics of late-preterm infants that predispose them to a higher risk of morbidity and mortality than term infants, and propose guidelines for the evaluation and management of these infants after birth.

Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies

2012-12-04

T. Moore , Enid Hennessy , Jonathan P. Myles +4 more

Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between … Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks’ gestation. Design Prospective national cohort studies, EPICure and EPICure 2. Setting Hospital and home based evaluations, England. Participants 1031 surviving babies born in 2006 before 27 completed weeks’ gestation. Outcomes for 584 babies born at 22-25 weeks’ gestation were compared with those of 260 surviving babies of the same gestational age born in 1995. Main outcome measures Survival to age 3 years, impairment (2008 consensus definitions), and developmental scores. Multiple imputation was used to account for the high proportion of missing data in the 2006 cohort. Results Of the 576 babies evaluated after birth in 2006, 13.4% (n=77) were categorised as having severe impairment and 11.8% (n=68) moderate impairment. The prevalence of neurodevelopmental impairment was significantly associated with length of gestation, with greater impairment as gestational age decreased: 45% at 22-23 weeks, 30% at 24 weeks, 25% at 25 weeks, and 20% at 26 weeks (P<0.001). Cerebral palsy was present in 83 (14%) survivors. Mean developmental quotients were lower than those of the general population (normal values 100 (SD 15)) and showed a direct relation with gestational age: 80 (SD 21) at 22-23 weeks, 87 (19) at 24 weeks, 88 (19) at 25 weeks, and 91 (18) at 26 weeks. These results did not differ significantly after imputation. Comparing imputed outcomes between the 2006 and 1995 cohorts, the proportion of survivors born between 22 and 25 weeks’ gestation with severe disability, using 1995 definitions, was 18% (95% confidence interval 14% to 24%) in 1995 and 19% (14% to 23%) in 2006. Fewer survivors had shunted hydrocephalus or seizures. Survival of babies admitted for neonatal care increased from 39% (35% to 43%) in 1995 to 52% (49% to 55%) in 2006, an increase of 13% (8% to 18%), and survival without disability increased from 23% (20% to 26%) in 1995 to 34% (31% to 37%) in 2006, an increase of 11% (6% to 16%). Conclusion Survival and impairment in early childhood are both closely related to gestational age for babies born at less than 27 weeks’ gestation. Using multiple imputation to account for the high proportion of missing values, a higher proportion of babies admitted for neonatal care now survive without disability, particularly those born at gestational ages 24 and 25 weeks.

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Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study

2008-03-01

Béatrice Larroque , Pierre‐Yves Ancel , Stéphane Marret +7 more

Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening

2006-07-01

John C. Duby , Paul H. Lipkin , Michelle M. Macias +7 more

Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home and an appropriate responsibility … Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals. This statement provides an algorithm as a strategy to support health care professionals in developing a pattern and practice for addressing developmental concerns in children from birth through 3 years of age. The authors recommend that developmental surveillance be incorporated at every well-child preventive care visit. Any concerns raised during surveillance should be promptly addressed with standardized developmental screening tests. In addition, screening tests should be administered regularly at the 9-, 18-, and 30-month visits. (Because the 30-month visit is not yet a part of the preventive care system and is often not reimbursable by third-party payers at this time, developmental screening can be performed at 24 months of age. In addition, because the frequency of regular pediatric visits decreases after 24 months of age, a pediatrician who expects that his or her patients will have difficulty attending a 30-month visit should conduct screening during the 24-month visit.) The early identification of developmental problems should lead to further developmental and medical evaluation, diagnosis, and treatment, including early developmental intervention. Children diagnosed with developmental disorders should be identified as children with special health care needs, and chronic-condition management should be initiated. Identification of a developmental disorder and its underlying etiology may also drive a range of treatment planning, from medical treatment of the child to family planning for his or her parents.

Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants

2002-01-17

Maureen Hack , Daniel J. Flannery , Mark Schluchter +3 more

Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood.We compared a cohort of 242 survivors among very-low-birth-weight … Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood.We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status.Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a lower mean IQ (87 vs. 92) and lower academic achievement scores (P<0.001 for both comparisons). They had higher rates of neurosensory impairments (10 percent vs. <1 percent, P<0.001) and subnormal height (10 percent vs. 5 percent, P=0.04). The very-low-birth-weight group reported less alcohol and drug use and had lower rates of pregnancy than normal-birth-weight controls; these differences persisted when comparisons were restricted to the participants without neurosensory impairment.Educational disadvantage associated with very low birth weight persists into early adulthood.

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Toward a synactive theory of development: Promise for the assessment and support of infant individuality

1982-12-01

Heidelise Als

A theoretical model to understand and assess the individual infant is presented. Its focus is on the dynamic, continuous interplay of various subsystems within the organism: the autonomic system, the … A theoretical model to understand and assess the individual infant is presented. Its focus is on the dynamic, continuous interplay of various subsystems within the organism: the autonomic system, the motor system, the state organizational system, the attentional-interactive system, and the self-regulatory system. The organism forges ahead negotiating emerging developmental agenda while simultaneously seeking to attain a new level of modulated, functional competence. Developmentally salient aspects of the environment are actively sought as fuel in this process. This synactive model of development promises to be helpful in identifying specific ingredients of the early developmental process and in structuring specific supports for preventive and ameliorative work when difficulties in differentiation and regulation are identified. An assessment procedure to systematically identify difficult areas of modulation integration is briefly described and examples of environmental structuring are given.

Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children

2009-07-27

Cornelieke S.H. Aarnoudse-Moens , Nynke Weisglas‐Kuperus , Johannes B. van Goudoever +1 more

Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (<or=33 weeks' gestation) and/or very low birth weight (VLBW) (<or=1500 g) children. … Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (<or=33 weeks' gestation) and/or very low birth weight (VLBW) (<or=1500 g) children. Great variability in the published results, however, hinders the field in studying underlying dysfunctions and developing intervention strategies. We conducted a quantitative meta-analysis of studies published between 1998 and 2008 on academic achievement, behavioral functioning, and EF with the aim of providing aggregated measures of effect size for these outcome domains.Suitable for inclusion were 14 studies on academic achievement, 9 studies on behavioral problems, and 12 studies on EF, which compared a total of 4125 very preterm and/or VLBW children with 3197 term-born controls. Combined effect sizes for the 3 outcome domains were calculated in terms of Cohen's d. Q-test statistics were performed to test homogeneity among the obtained effect sizes. Pearson's correlation coefficients were calculated to examine the impact of mean birth weight and mean gestational age, as well as the influence of mean age at assessment on the effect sizes for academic achievement, behavioral problems, and EF.Combined effect sizes show that very preterm and/or VLBW children score 0.60 SD lower on mathematics tests, 0.48 SD on reading tests, and 0.76 SD on spelling tests than term-born peers. Of all behavioral problems stacked, attention problems were most pronounced in very preterm and/or VLBW children, with teacher and parent ratings being 0.43 to 0.59 SD higher than for controls, respectively. Combined effect sizes for parent and teacher ratings of internalizing behavior problems were small (<0.28) and for externalizing behavior problems negligible (<0.09) and not significant. Combined effect sizes for EF revealed a decrement of 0.57 SD for verbal fluency, 0.36 SD for working memory, and 0.49 SD for cognitive flexibility in comparison to controls. Mean age at assessment was not correlated with the strength of the effect sizes. Mathematics and reading performance, parent ratings of internalizing problems, teacher ratings of externalizing behavior, and attention problems, showed strong and positive correlations with mean birth weight and mean gestational age (all r values > 0.51).Very preterm and/or VLBW children have moderate-to-severe deficits in academic achievement, attention problems, and internalizing behavioral problems and poor EF, which are adverse outcomes that were strongly correlated to their immaturity at birth. During transition to young adulthood these children continue to lag behind term-born peers.

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Trends in the Prevalence of Developmental Disabilities in US Children, 1997–2008

2011-05-24

Coleen A. Boyle , Sheree L. Boulet , Laura A. Schieve +5 more

To fill gaps in crucial data needed for health and educational planning, we determined the prevalence of developmental disabilities in US children and in selected populations for a recent 12-year … To fill gaps in crucial data needed for health and educational planning, we determined the prevalence of developmental disabilities in US children and in selected populations for a recent 12-year period.We used data on children aged 3 to 17 years from the 1997-2008 National Health Interview Surveys, which are ongoing nationally representative samples of US households. Parent-reported diagnoses of the following were included: attention deficit hyperactivity disorder; intellectual disability; cerebral palsy; autism; seizures; stuttering or stammering; moderate to profound hearing loss; blindness; learning disorders; and/or other developmental delays.Boys had a higher prevalence overall and for a number of select disabilities compared with girls. Hispanic children had the lowest prevalence for a number of disabilities compared with non-Hispanic white and black children. Low income and public health insurance were associated with a higher prevalence of many disabilities. Prevalence of any developmental disability increased from 12.84% to 15.04% over 12 years. Autism, attention deficit hyperactivity disorder, and other developmental delays increased, whereas hearing loss showed a significant decline. These trends were found in all of the sociodemographic subgroups, except for autism in non-Hispanic black children.Developmental disabilities are common and were reported in ~1 in 6 children in the United States in 2006-2008. The number of children with select developmental disabilities (autism, attention deficit hyperactivity disorder, and other developmental delays) has increased, requiring more health and education services. Additional study of the influence of risk-factor shifts, changes in acceptance, and benefits of early services is needed.

Neurobehavioral Outcomes of School-age Children Born Extremely Low Birth Weight or Very Preterm in the 1990s

2003-06-24

Peter J. Anderson

The outcome into school age of regional cohorts of children born in the 1990s with birth weights less than 1000 g (extremely low birth weight, ELBW) or earlier than 28 … The outcome into school age of regional cohorts of children born in the 1990s with birth weights less than 1000 g (extremely low birth weight, ELBW) or earlier than 28 weeks' gestation (very preterm) is not known.To determine the cognitive, educational, and behavioral outcome of ELBW or very preterm infants born in the 1990s compared with normal birth weight (NBW) controls.Regional cohort study.Victoria, Australia.The ELBW or very preterm cohort was composed of 298 consecutive survivors born during 1991-1992. The NBW cohort was composed of 262 randomly selected children with birth weights of more than 2499 g.Cognitive ability, educational progress, and behavioral problems.The follow-up rates from birth to 8 years of age for survivors were 92.3% (275/298) for the ELBW or very preterm cohort and 85.1% (223/262) for the NBW cohort. The ELBW or very preterm children scored significantly below NBW controls on full-scale IQ (mean difference, -9.4; 95% confidence interval [CI], -12.1 to -6.7; P<.001) and indices of verbal comprehension (mean difference, -6.8; 95% CI, -9.5 to -4.2; P<.001), perceptual organization (mean difference, -9.9; 95% CI, -12.7 to -7.2; P<.001), freedom from distractibility (mean difference, -8.1; 95% CI, -10.8 to -5.5; P<.001), and processing speed (mean difference, -6.7; 95% CI, -9.4 to -4.0; P<.001). The ELBW or very preterm children performed significantly worse than the NBW cohort on tests of reading (mean difference, -6.7; 95% CI, -9.5 to -3.9; P<.001), spelling (mean difference, -5.6; 95% CI, -8.0 to -3.3; P<.001), and arithmetic (mean difference, -8.8; 95% CI, -11.3 to -6.2; P<.001). Attentional difficulties, internalizing behavior problems, and immature adaptive skills were more prevalent in the ELBW or very preterm cohort.School-aged ELBW or very preterm children born in the 1990s continue to display cognitive, educational, and behavioral impairments.

Long-Term Medical and Social Consequences of Preterm Birth

2008-07-16

Dag Moster , Rolv T. Lie , Trond Markestad

Advances in perinatal care have increased the number of premature babies who survive. There are concerns, however, about the ability of these children to cope with the demands of adulthood. Advances in perinatal care have increased the number of premature babies who survive. There are concerns, however, about the ability of these children to cope with the demands of adulthood.

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Optimizing Care and Outcome for Late-Preterm (Near-Term) Infants: A Summary of the Workshop Sponsored by the National Institute of Child Health and Human Development

2006-09-01

Tonse N.K. Raju , Rosemary D. Higgins , Ann R. Stark +1 more

In 2003, 12.3% of births in the United States were preterm (< 37 completed weeks of gestation). This represents a 31% increase in the preterm birth rate since 1981. The … In 2003, 12.3% of births in the United States were preterm (< 37 completed weeks of gestation). This represents a 31% increase in the preterm birth rate since 1981. The largest contribution to this increase was from births between 34 and 36 completed weeks of gestation (often called the "near term" but referred to as "late preterm" in this article). Compared with term infants, late-preterm infants have higher frequencies of respiratory distress, temperature instability, hypoglycemia, kernicterus, apnea, seizures, and feeding problems, as well as higher rates of rehospitalization. However, the magnitude of these morbidities at the national level and their public health impact have not been well studied. To address these issues, the National Institute of Child Health and Human Development of the National Institutes of Health invited a multidisciplinary team of experts to a workshop in July 2005 entitled "Optimizing Care and Outcome of the Near-Term Pregnancy and the Near-Term Newborn Infant." The participants discussed the definition and terminology, epidemiology, etiology, biology of maturation, clinical care, surveillance, and public health aspects of late-preterm infants. Knowledge gaps were identified, and research priorities were listed. This article provides a summary of the meeting.

Procedural pain and brain development in premature newborns

2012-02-28

Susanne Brummelte , Ruth E. Grunau , Vann Chau +6 more

Abstract Objective: Preterm infants are exposed to multiple painful procedures in the neonatal intensive care unit (NICU) during a period of rapid brain development. Our aim was to examine relationships … Abstract Objective: Preterm infants are exposed to multiple painful procedures in the neonatal intensive care unit (NICU) during a period of rapid brain development. Our aim was to examine relationships between procedural pain in the NICU and early brain development in very preterm infants. Methods: Infants born very preterm (N = 86; 24–32 weeks gestational age) were followed prospectively from birth, and studied with magnetic resonance imaging, 3‐dimensional magnetic resonance spectroscopic imaging, and diffusion tensor imaging: scan 1 early in life (median, 32.1 weeks) and scan 2 at term‐equivalent age (median, 40 weeks). We calculated N‐acetylaspartate to choline ratios (NAA/choline), lactate to choline ratios, average diffusivity, and white matter fractional anisotropy (FA) from up to 7 white and 4 subcortical gray matter regions of interest. Procedural pain was quantified as the number of skin‐breaking events from birth to term or scan 2. Data were analyzed using generalized estimating equation modeling adjusting for clinical confounders such as illness severity, morphine exposure, brain injury, and surgery. Results: After comprehensively adjusting for multiple clinical factors, greater neonatal procedural pain was associated with reduced white matter FA (β = −0.0002, p = 0.028) and reduced subcortical gray matter NAA/choline (β = −0.0006, p = 0.004). Reduced FA was predicted by early pain (before scan 1), whereas lower NAA/choline was predicted by pain exposure throughout the neonatal course, suggesting a primary and early effect on subcortical structures with secondary white matter changes. Interpretation: Early procedural pain in very preterm infants may contribute to impaired brain development. ANN NEUROL 2012;

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Poor Predictive Validity of the Bayley Scales of Infant Development for Cognitive Function of Extremely Low Birth Weight Children at School Age

2005-08-01

Maureen Hack , H. Gerry Taylor , Dennis Drotar +7 more

The Bayley Scales of Infant Development, Second Edition (BSID II) are commonly used to assess outcomes of extremely low birth weight (ELBW) infants. We sought to assess the predictive validity … The Bayley Scales of Infant Development, Second Edition (BSID II) are commonly used to assess outcomes of extremely low birth weight (ELBW) infants. We sought to assess the predictive validity of the BSID II Mental Developmental Index (MDI) for cognitive function at school age.Of 330 ELBW infants admitted in 1992-1995, 238 (72%) survived to the age of 8 years, of whom 200 (84%) were tested at both 20 months' corrected age (CA) and 8 years. Mean birth weight was 811 g, mean gestational age was 26.4 weeks, 41% were boys, and 60% were black. Measures included the BSID II at 20 months' CA and the Kaufman Assessment Battery for Children (KABC) Mental Processing Composite (MPC) at 8 years' postnatal age. BSID II MDI and MPC scores were compared and the predictive validity calculated for all 200 ELBW children and for the 154 ELBW neurosensory-intact subgroup. Predictors of stability or change in cognitive scores were examined via logistic regression adjusting for gender and sociodemographic status.For all ELBW children, the mean MDI was 75.6 +/- 16 versus a mean KABC of 87.8 +/- 19. For the neurosensory-intact subgroup, the mean MDI was 79.3 +/- 16 and the mean KABC was 92.3 +/- 15. Rates of cognitive impairment, defined as an MDI or KABC of <70, dropped from 39% at 20 months' CA to 16% at 8 years for the total ELBW population and from 29% to 7% for the neurosensory-intact subgroup. The positive predictive value of having an MPC of <70 given an MDI of <70 was 0.37 (95% confidence interval [CI]: 0.27, 0.49) for all ELBW infants, 0.20 (95% CI: 0.10, 0.35) for the neurosensory-intact subgroup, and 0.61 (95% CI: 0.42, 0.77) for the neurosensory-impaired subgroup. The negative predictive values were 0.98, 0.99, and 0.85 for the 3 groups, respectively. Neurosensory impairment at 20 months' CA predicted lack of improvement of cognitive function (odds ratio: 6.9; 95% CI: 2.4, 20.2). Children whose cognitive scores improved between 20 months and 8 years had significantly better school performance than those whose scores stayed at <70, but they did less well than those whose scores were persistently >70.The predictive validity of a subnormal MDI for cognitive function at school age is poor but better for ELBW children who have neurosensory impairments. We are concerned that decisions to provide intensive care for ELBW infants in the delivery room might be biased by reported high rates of cognitive impairments based on the use and presumptive validity of the BSID II MDI.

Neurodevelopmental and Growth Impairment Among Extremely Low-Birth-Weight Infants With Neonatal Infection

2004-11-16

Barbara J. Stoll

Neonatal infections are frequent complications of extremely low-birth-weight (ELBW) infants receiving intensive care. To determine if neonatal infections in ELBW infants are associated with increased risks of adverse neurodevelopmental and … Neonatal infections are frequent complications of extremely low-birth-weight (ELBW) infants receiving intensive care. To determine if neonatal infections in ELBW infants are associated with increased risks of adverse neurodevelopmental and growth sequelae in early childhood. Infants weighing 401 to 1000 g at birth (born in 1993-2001) were enrolled in a prospectively collected very low-birth-weight registry at academic medical centers participating in the National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth outcomes were assessed at a comprehensive follow-up visit at 18 to 22 months of corrected gestational age and compared by infection group. Eighty percent of survivors completed the follow-up visit and 6093 infants were studied. Registry data were used to classify infants by type of infection: uninfected (n = 2161), clinical infection alone (n = 1538), sepsis (n = 1922), sepsis and necrotizing enterocolitis (n = 279), or meningitis with or without sepsis (n = 193). Cognitive and neuromotor development, neurologic status, vision and hearing, and growth (weight, length, and head circumference) were assessed at follow-up. The majority of ELBW survivors (65%) had at least 1 infection during their hospitalization after birth. Compared with uninfected infants, those in each of the 4 infection groups were significantly more likely to have adverse neurodevelopmental outcomes at follow-up, including cerebral palsy (range of significant odds ratios [ORs], 1.4-1.7), low Bayley Scales of Infant Development II scores on the mental development index (ORs, 1.3-1.6) and psychomotor development index (ORs, 1.5-2.4), and vision impairment (ORs, 1.3-2.2). Infection in the neonatal period was also associated with impaired head growth, a known predictor of poor neurodevelopmental outcome. This large cohort study suggests that neonatal infections among ELBW infants are associated with poor neurodevelopmental and growth outcomes in early childhood. Additional studies are needed to elucidate the pathogenesis of brain injury in infants with infection so that novel interventions to improve these outcomes can be explored.

Kangaroo mother care to reduce morbidity and mortality in low birthweight infants

2016-08-23

Agustín Conde‐Agudelo , José Luis Díaz-Rossello

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Neurologic and Developmental Disability after Extremely Preterm Birth

2000-08-10

Nicholas S Wood , Neil Marlow , Kate Costeloe +2 more

Small studies show that many children born as extremely preterm infants have neurologic and developmental disabilities. We evaluated all children who were born at 25 or fewer completed weeks of … Small studies show that many children born as extremely preterm infants have neurologic and developmental disabilities. We evaluated all children who were born at 25 or fewer completed weeks of gestation in the United Kingdom and Ireland from March through December 1995 at the time when they reached a median age of 30 months. Each child underwent a formal assessment by an independent examiner. Development was evaluated with use of the Bayley Scales of Infant Development, and neurologic function was assessed by a standardized examination. Disability and severe disability were defined by predetermined criteria.At a median age of 30 months, corrected for gestational age, 283 (92 percent) of the 308 surviving children were formally assessed. The mean (+/-SD) scores on the Bayley Mental and Psychomotor Developmental Indexes, referenced to a population mean of 100, were 84+/-12 and 87+/-13, respectively. Fifty-three children (19 percent) had severely delayed development (with scores more than 3 SD below the mean), and a further 32 children (11 percent) had scores from 2 SD to 3 SD below the mean. Twenty-eight children (10 percent) had severe neuromotor disability, 7 (2 percent) were blind or perceived light only, and 8 (3 percent) had hearing loss that was uncorrectable or required aids. Overall, 138 children had disability (49 percent; 95 percent confidence interval, 43 to 55 percent), including 64 who met the criteria for severe disability (23 percent; 95 percent confidence interval, 18 to 28 percent). When data from 17 assessments by local pediatricians were included, 155 of the 314 infants discharged (49 percent) had no disability.Severe disability is common among children born as extremely preterm infants.

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Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine

2016-06-14

Shalini Paruthi , Lee J. Brooks , Carolyn D’Ambrosio +7 more

Sleep is essential for optimal health in children and adolescents. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal … Sleep is essential for optimal health in children and adolescents. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. The recommendations are summarized here. A manuscript detailing the conference proceedings and the evidence supporting these recommendations will be published in the Journal of Clinical Sleep Medicine.

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Standards and indications for cardiopulmonary sleep studies in children. American Thoracic Society.

1996-02-01

Prevalence of selected developmental disabilities in children 3-10 years of age: the Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1991.

1996-04-19

Coleen A. Boyle , Marshalyn Yeargin‐Allsopp , Nancy Doernberg +3 more

Serious developmental disabilities affect approximately 2% of school-age children and are lifelong conditions that incur substantial financial and societal costs.January 1991-December 1991.The Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) monitors … Serious developmental disabilities affect approximately 2% of school-age children and are lifelong conditions that incur substantial financial and societal costs.January 1991-December 1991.The Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) monitors the prevalence of four serious developmental disabilities--mental retardation, cerebral palsy, vision impairment, and hearing impairment--among children 3-10 years of age in the five-county metropolitan-Atlanta area. Children who have at least one of the four developmental disabilities are ascertained through annual review of records at schools, hospitals, and other sources.During 1991, rates for mental retardation varied by age, race, and sex; rates ranged from 5.2 per 1,000 children to 16.6 per 1,000 children. Regardless of the absolute rate of mental retardation in each of the age-, race-, and sex-specific categories, severe mental retardation (i.e., an intelligence quotient of <50) accounted for one third of all cases. The overall crude rate of cerebral palsy was 2.4 per 1,000 children; however, the rate was higher among black children (3.1 per 1,000 children) than among white children (2.0 per 1,000 children). The rate of moderate to severe hearing impairment was 1.1 per 1,000 children, and the rate of vision impairment was 0.8 per 1,000 children. Rates of hearing impairment were higher among black males than among children in the other race and sex groups, whereas rates for vision impairment varied only slightly between these groups. The rates of the developmental disabilities were not adjusted for possible confounding factors (e.g., maternal education, family income, and various medical conditions). Consequently, the variation in rates may reflect social or other characteristics unique to the study population.MADDSP data will be used to direct early childhood intervention efforts to reduce the prevalence of these four developmental disabilities. MADDSP data also are being used to measure progress toward the year 2000 national objectives for the prevention of serious mental retardation.

Regional Development of the Brain in Early Life

1968-06-01

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Bayley Scales of Infant Development

2019-07-15

Elizabeth M. Lennon , Judith M. Gardner , Bernard Z. Karmel +1 more

Effects of Stress and Social Support on Mothers and Premature and Full-Term Infants

1983-02-01

Keith A. Crnic , Mark T. Greenberg , Arlene S. Ragozin +2 more

Developmental Neurobiology

1991-01-01

Marcus Jacobson

Bayley Scales of Infant Development

2008-01-01

Elizabeth M. Lennon , Judith M. Gardner , Bernard Z. Karmel +1 more

Cognitive Orientation to daily Occupational Performance Approach with children with Dravet syndrome using a telerehabilitation format: A single subject study

2025-06-24

Patrizia Ianes , Rose Martini , Yann Bertholom +7 more | Epilepsy & Behavior

Dravet syndrome (DS) is a severe form of epilepsy that affects a child's cognitive, language, behavioral, and physical abilities, leading to reduced adaptive functioning. Despite its impact, there is limited … Dravet syndrome (DS) is a severe form of epilepsy that affects a child's cognitive, language, behavioral, and physical abilities, leading to reduced adaptive functioning. Despite its impact, there is limited evidence supporting effective interventions for these children, particularly in addressing their occupational performance. To explore the effectiveness of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach in a telerehabilitation format for children with DS. A single-subject design with multiple baselines across goals was used with four children (aged 9-13 years) with DS, who received eight online CO-OP sessions. Five goals were set using the Canadian Occupational Performance Measure (COPM), three of which were targeted in the intervention. Activity performance was rated using the Performance Quality Rating Scale (PQRS) and analyzed using the 3SD band method. Children and parents rated perceived performance and satisfaction on the COPM. Secondary outcomes included parents' sense of competency, children's adaptive behavior, and quality of life. Significant improvements in PQRS scores were seen for 8 of the 12 trained goals and 3 of the 7 untrained (transfer) goals. COPM scores showed changes greater than 2 points in both children's and parents' perceived performance and satisfaction for trained and untrained goals. Improvements were also noted on the secondary measures for 3 of 4 participants. These findings provide preliminary evidence that the CO-OP approach in a telerehabilitation format improves both trained and untrained goals, with a positive effect on parent self-efficacy, adaptive functioning, and quality of life. Further research is needed to confirm these results.

Parental perceived stress among mothers of neonates admitted in neonatal intensive care unit at a teaching hospital of Gandaki province

2025-06-23

Nitu Kumari Singh , Rajmi Gurung | Journal of Gandaki Medical College-Nepal

Introduction: Neonatal Intensive Care Unit admission may be traumatic for mothers, causing psychological distress and altered parenting roles. This study aimed to assess the perceived parental stress (PPS) level and … Introduction: Neonatal Intensive Care Unit admission may be traumatic for mothers, causing psychological distress and altered parenting roles. This study aimed to assess the perceived parental stress (PPS) level and experience of mothers of neonates admitted to the NICU at a tertiary hospital in Gandaki Province. Methods: A mixed-method approach was used. For the quantitative study, 68 mothers of neonates admitted to the NICU were selected through total enumeration. A face-to-face interview using a structured questionnaire was conducted. PSS was measured using the PSS: NICU tool. For the qualitative study, ten mothers were selected purposively, and in-depth interviews were conducted using an interview guideline. The study was conducted at Gandaki Medical College Teaching Hospital and Research Center from May to June, 2024. Results: Of the total 68 mothers, 52(76.5%) had a low level of PPS. The highest mean stress score was in the “Baby’s Appearance and Behavior” subscale (31.97±16.96) out of a maximum 95 score, followed by “Relationship with Baby and Parental Role” (23.14±8.79) out of a maximum 50. Qualitative findings revealed deeper emotional struggles, including anxiety, helplessness, sleep disturbances, and fear of medical procedures. Conclusions: Despite low reported PPS levels, qualitative insights revealed emotional struggles and psychological burdens among mothers. Comprehensive support systems and emotionally responsive care are essential in NICUs to address these hidden stressors and enhance maternal coping.

Malessere giovanile percepito e prospettive future: un questionario tra gli studenti di scuola secondaria superiore della città metropolitana di Milano

2025-06-23

Antonella Bodini , Isabella Gagliardi , A Albizzati +3 more | Medico e Bambino pagine elettroniche

Introduction - Due to COVID-19, Italy experienced the longest period of school closures in Europe. This prolonged period of uncertainty may have affected adolescents, leaving them with a negative outlook … Introduction - Due to COVID-19, Italy experienced the longest period of school closures in Europe. This prolonged period of uncertainty may have affected adolescents, leaving them with a negative outlook on their future. Objective - To assess the feasibility of a shared approach that combines the clinical expertise of family paediatricians and the perspectives of parents in the early identification of potential disorders in children by using standard clinical practice tools. Study design - Within the NASCITA birth cohort, in addition to the family paediatrician’s clinical evaluation, the M-CHAT-R was completed by parents to assess the child’s language, social skills, behaviour and sensory areas. Parents were also asked to complete the PSI-SF to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. Results - The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the paediatrician’s assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR = 2.42, 95% CI: 1.20-4.86) and having sleep disorders (OR = 2.48, 95% CI 1.19-5.71) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed, OR = 3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). Conclusions - Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and may improve the identification of children at risk of developmental disorders.

Temporal and spatial trends of low birth weight and Kangaroo Mother Care initiation in Uganda, 2015–2023

2025-06-23

Emmanuel Mfitundinda , Richard Migisha , Joyce Owens Kobusingye +7 more | Research Square (Research Square)

<title>Abstract</title> Background Low birth weight (LBW) births account for > 80% of global neonatal deaths, with the highest prevalence in low-and middle-income countries. Kangaroo Mother Care (KMC) is a low-cost, … <title>Abstract</title> Background Low birth weight (LBW) births account for > 80% of global neonatal deaths, with the highest prevalence in low-and middle-income countries. Kangaroo Mother Care (KMC) is a low-cost, effective intervention for the survival of LBW babies in low-resource settings, including Uganda. However, the distribution of LBW births and their KMC initiation is not well documented in Uganda. We assessed trends and spatial distribution of LBW births and their KMC initiation, Uganda, 2015–2023. Methods We abstracted data on LBW, total deliveries, and LBW babies initiated on KMC during 2015–2023 from the District Health Information Software Version 2. We calculated LBW prevalence as the proportion of LBW births among total deliveries. Kangaroo Mother Care initiation coverage was computed as the proportion of LBW babies started on KMC. We stratified LBW and KMC initiation data by region, and health facility level. We used the Mann-Kendall test to assess the significance of trends. Results During 2015–2023, 605,876 of 10,952,463 births (5.5%) were LBW, with no significant change in the prevalence (p = 0.8). The highest prevalence of LBW was observed in Karamoja and West Nile (7.4%) in northern Uganda, with no trend (p = 0.14). Bukedi (p = 0.05) and Busoga (p = 0.003) subregions in eastern Uganda, had an increasing trend, whereas, Kigezi subregion in western Uganda, had a declining trend (p = 0.003). Among the 296,421 live LBW births during 2020–2023, 188,519 (64%) received KMC. Its coverage increased from 60% in 2020 to 68% in 2023 (p = 0.01). Ankole (p = 0.005), Bunyoro (p = 0.017), and West Nile subregions had increasing trends whereas Bukedi (p = 0.024) and Kampala (p < 0.001) had declining trends. Karamoja had low KMC coverage (60%) with no trend (p = 0.96). KMC initiation increased at Health Centre IIIs (sub-county level) (p = 0.006), but declined at national referral hospitals (p < 0.01). Conclusion There were regional disparities in trends of LBW births. While KMC initiation improved in certain regions and at lower-level health facilities, challenges persist in Karamoja and national referral hospitals. Further studies are needed to understand the determinants of LBW births, and initiation to KMC, to better guide region-specific interventions.

Quantitative assessment of comfort and physiological responses in neonates and infants during pram transport: a pilot study

2025-06-23

Anna Trivillin , Maria Elena Cavicchiolo , Edoardo Passarotto +7 more | European Journal of Pediatrics

On the typical development of the central sulcus in infancy: A longitudinal evaluation of its morphology and link to behaviour

2025-06-20

Amaia Dornier , A. Gérard , Yann Leprince +5 more | Developmental Neuroscience

Introduction: The progressive folding of the cortex is an important feature of neurodevelopment starting around the 14th week of gestation. The central sulcus (CS) is one of the first to … Introduction: The progressive folding of the cortex is an important feature of neurodevelopment starting around the 14th week of gestation. The central sulcus (CS) is one of the first to fold. Since it represents the anatomical boundary between primary somatosensory and motor functional regions, its developing morphology may inform on the acquisition of sensorimotor skills. We aimed to identify potential asynchronous morphological changes along the CS during infancy, with the hypothesis that this may reflect the differential onset in the emergence of motor milestones across body parts. Method: Based on 3T anatomical magnetic resonance imaging (MRI) and dedicated post-processing, we characterized the evolution in CS depth and curvature, along with their respective interhemispheric asymmetries in 33 typical infants (aged 1 and 3 months, 22 with longitudinal data) in relation to 23 young adults as a reference. Four regions of interest (ROIs) along the CS, supposed to correspond to different parts of the body and one centred on the hand knob (HK), were reproducibly examined and compared across groups. We also explored the relationship between the age-related changes in morphological features and the global motor scaled scores evaluated at 3 months of age with the Bayley Scales of Infant and Toddler Development. Results: No interhemispheric asymmetry in CS depth and curvature was observed. While all ROIs showed significant increases in CS depth and curvature between 3-month-olds and adults, the results were more variable between 1 and 3 months of age depending on cross-sectional and longitudinal analyses. The central-medial and central-lateral regions showed the most consistent increase in depth. Besides, motor development at 3 months of age was not significantly related to CS morphological changes, but a positive trend was observed for depth changes in the (HK-related) central-medial ROI. Conclusion: The rapid evolution of CS folding during infancy may reflect the intense but asynchronous maturation of the brain sensorimotor system, with the differential growth of cortical areas related to body parts and underlying white matter connections. Although it will have to be replicated on larger groups and at other ages, this longitudinal and multimodal study highlights the potential of characterizing CS features as key markers of early sensorimotor development, both at the cerebral and behavioural levels. Combining anatomical and functional neuroimaging could provide deeper insights into the relationship between CS morphology and somatotopic organization in typical infants, but also in infants at risk of developing motor disorders.

Network Coordinator Perceptions of Early Childhood Community Systems Building and Development Efforts

2025-06-19

Tuyet‐Mai H. Hoang , Brandie Bentley , Karen V. Jenkins +3 more | Children

Background: Networks for building and developing community systems to support early childhood rely on the volunteer efforts of organizations and the leadership of coordinators to unite relevant stakeholders. Aims: The … Background: Networks for building and developing community systems to support early childhood rely on the volunteer efforts of organizations and the leadership of coordinators to unite relevant stakeholders. Aims: The purpose of this study was to explore the perspectives of network coordinators from 10 different communities participating in the All Our Kids Early Childhood Networks (AOK Networks) to identify the successes and barriers involved in implementing effective early childhood systems. Methods: We conducted two focus group interviews with 10 participants who worked as network coordinators in public health district offices. A semi-structured focus group interview guide was used to examine community coordinators' perceptions related to lessons learned with community systems development efforts around early childhood outcomes. All interviews were audio recorded and transcribed verbatim. Thematic network analysis was used to analyze all focus group data. Results: Three salient themes were identified from interviews with network coordinators: (1) respective strengths of the AOK Networks system building efforts; (2) challenges for coordinators, such as burnout; and (3) the importance of the networks' role within the community. Conclusions: This study contributes to the existing literature by identifying supportive and hindering factors that impact the implementation process to sustain long-term impact of early child community systems building. The findings can be useful for other ongoing government partnerships and community-based programs that use networks and system building strategies across the US.

The Effect of the COVID-19 Pandemic and the Establishment of a Ronald McDonald House on Skin-to-Skin Times in the Neonatal Intensive Care Unit: A Retrospective Study

2025-06-19

Stephanie Schaible , Edda Hofstätter , Wanda Lauth +1 more | Children

Objectives: Kangaroo care is vital for the development of premature and low-birthweight infants. However, detailed data on skin-to-skin times, especially for extremely preterm infants in NICUs, is lacking. This study … Objectives: Kangaroo care is vital for the development of premature and low-birthweight infants. However, detailed data on skin-to-skin times, especially for extremely preterm infants in NICUs, is lacking. This study quantifies skin-to-skin times for these infants at the neonatology department in Salzburg, considering factors like the COVID-19 pandemic, the opening of Ronald McDonald House, and sibling presence. Methods: We retrospectively analyzed data from the first eight weeks of life of 93 extremely preterm infants (<28 gestational weeks, <1500 g birth weight) treated at the Salzburg NICU from 2019 to 2023. Skin-to-skin times were recorded to the minute. Results: The mean value skin-to-skin time per visiting day was 241 min (±83), skin-to-skin was performed on 79.0% (±16.8) of the days of stay examined. During the pandemic, skin-to-skin care was performed on 64% of visit days, after the pandemic on 91% (p < 0.001). Before the Ronald McDonald House opened, the skin-to-skin time per visiting day was 215 min (±57.9), afterwards it was 273 min (±97) (p = 0.001). For Primipara the Kangaroo-Care time per day of visit was 257 min (±93), for Multipara 217 min (±52) (p = 0.043). Conclusions: Skin-to-skin is crucial for extremely premature infants and can be implemented for many hours a day. It is an integral part of parent-child interaction in a neonatal intensive care unit. External factors such as infrastructure, pandemic restrictions or siblings have a significant impact on skin-to-skin.

Testing the face validity of an instrument to measure interprofessional collaboration between midwives and obstetricians in antenatal care (InCo_AC) using cognitive interviews

2025-06-18

Katja Stahl , Fanny Schmeißner , Tom Stargardt | Journal of Interprofessional Care

Antenatal care constitutes an integral component of high-quality maternity care, prominently contingent upon the proficient interprofessional collaboration between midwives and obstetricians, the main care providers. Evaluation of interprofessional collaboration requires … Antenatal care constitutes an integral component of high-quality maternity care, prominently contingent upon the proficient interprofessional collaboration between midwives and obstetricians, the main care providers. Evaluation of interprofessional collaboration requires valid and reliable measurement tools. We report on the development of a questionnaire measuring interprofessional collaboration between midwives and obstetricians in antenatal care, with an emphasis on testing face validity and enhancing item quality through cognitive interviews. Nine cognitive interviews with six midwives and six obstetricians were conducted. Directed content analysis was employed to analyze and code the data. Tourangeau's model of cognitive processing was used to identify problems. Seventy-three percent of the 52 problems identified were related to the comprehension process, 15% to the decision process, 10% to the response process, and one to the retrieval process. Additionally, three instances of problems with item order emerged as an issue during the interviews. The questionnaire was revised based on the interview results. By employing cognitive interviewing, the study succeeded in identifying problems that may not have been detected otherwise, thus enhancing item quality and face validity of a newly developed questionnaire. The pilot version is now ready for piloting and psychometric testing to assess the instrument's construct validity and reliability.

An Examination of Acoustic Neuroprotection in the Neonate

2025-06-18

Peyton Lewis Chumley , Katherine M. Dudding , David E. Vance | Advances in Neonatal Care

Background: Hearing loss in neonates is more than 100 times that of the general pediatric population. Research suggests that there is a large amount of toxic noise exposure for these … Background: Hearing loss in neonates is more than 100 times that of the general pediatric population. Research suggests that there is a large amount of toxic noise exposure for these neonates in the neonatal intensive care unit and in the transport environments. Thus, acoustic neuroprotection, or auditory protection and support of neurodevelopment, is an important concept, particularly for neonates. Purpose: A systematic review of the literature was conducted to determine the possibility of successfully supporting acoustic neuroprotection and decreasing the ambient noise level to the recommendations of the American Academy of Pediatrics. Methods/Search Strategy: Across 3 databases (PubMed, Cochrane, and Science Direct), 21 articles were identified.Following PRISMA guidelines, the search was expanded to articles less than 20 years old due to lack of current studies. Inclusion criteria for articles were: infants less than 1 year old; written in English or translated to English; published within last 20 years unless seminal research; a unit quality improvement project; a literature review; a peer-reviewed article. Exclusion criteria were duplicated articles and qualitative studies. Decibel levels were extracted from articles in various neonate environments and then compared to standard recommendations. Results: Overall, the reviewed studies provided evidence that current interventions are unsuccessful in decreasing the amount of toxic noise exposure. Implications for Research and Practice: There are no “gold standard” interventions for protection of neonatal auditory systems, leading to inconsistent usage of current interventions and an overall lack of intervention focused research. More research is needed, particularly randomized controlled trials.

Comparison of the predictive validity of the Alberta Infant Motor Scale and Infant Neurological International Battery in low-birth-weight infants: a prospective longitudinal study

2025-06-18

Amitesh Narayan , Pratima Anand , Shreekanth D. Karnad +1 more | Physiotherapy Quarterly

Introduction This study aims to test the predictive validity of the Infant Neurological International Battery (INFANIB) and the Alberta Infant Motor Scale (AIMS) against the Peabody Developmental Motor Scale-2 (PDMS-2) … Introduction This study aims to test the predictive validity of the Infant Neurological International Battery (INFANIB) and the Alberta Infant Motor Scale (AIMS) against the Peabody Developmental Motor Scale-2 (PDMS-2) at 4, 8 and 12 months of age in low birth weight (LBW) infants. Methods Motor development in 18 LBW infants was examined prospectively at 4, 8 and 12 months. A professional investigator assessed the motor development of these infants using the AIMS, INFANIB and PDMS-2. The validity of the results was assessed using Friedman and Wilcoxon signed-rank tests on the total raw scores of PDMS-2, AIMS and INFANIB at the three distinct age points. The chi-square test was used to calculate the association between INFANIB and AIMS with PDMS-2 for normal and LBW infants at each age point. Results The INFANIB and AIMS scores were both associated with PDMS-2 at all three age points. However, INFANIB demonstrated a higher predictive validity for PDMS-2 in LBW infants than AIMS. Conclusions The INFANIB has greater predictive validity than AIMS for assessing motor outcomes in LBW infants at 4, 8 and 12 months.

Early‐Onset Neonatal Infection and Attention Deficit Hyperactivity and Autism Spectrum Disorder: A Nationwide Cohort Study

2025-06-18

Mads Andersen , Niels Bjerregård Matthiesen , May Murra +2 more | Paediatric and Perinatal Epidemiology

ABSTRACT Background Early‐onset neonatal infections are among the most common neonatal diseases. However, the long‐term outcomes of the infections are not well understood. Objective To study the association between early‐onset … ABSTRACT Background Early‐onset neonatal infections are among the most common neonatal diseases. However, the long‐term outcomes of the infections are not well understood. Objective To study the association between early‐onset neonatal infection and attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods A nationwide register‐based cohort study was conducted, including near‐term and term children born between 1997 and 2013 with follow‐up until 2021. An early‐onset infection was defined as an invasive bacterial infection occurring within the first week of life, including both physician‐assigned diagnoses and positive bacterial cultures. ADHD and ASD were defined by diagnoses or prescriptions of relevant medication. Associations between sepsis and the neurodevelopmental disorders were investigated using multivariable Cox regression to estimate adjusted hazard ratios (HR), whereas associations with meningitis were examined using person‐time incidence rate ratios (IRR). Sibling‐matched analyses were also conducted for associations with sepsis. Results A total of 981,869 children were included, with 8154 defined as having sepsis and 152 defined as having meningitis. Among these, only 257 children had culture‐positive sepsis, whereas 32 had culture‐positive meningitis. The incidence rate of ADHD and ASD for children with sepsis was 4.5 per 1000 and 3.3 per 1000 person‐years, respectively. Sepsis was associated with an increased adjusted likelihood of both ADHD (HR 1.28, 95% CI 1.17, 1.39) and ASD (HR 1.43, 95% CI 1.30, 1.58). However, sibling‐matched analyses especially attenuated the association with ADHD (HR 1.12, 95% CI 0.93, 1.34). Point estimates suggested that children with meningitis also had an increased likelihood of both ADHD (IRR 1.77, 95% CI 0.88, 3.17) and ASD (IRR 2.05, 95% CI 0.89, 4.04). Conclusions Early‐onset sepsis was associated with an increased likelihood of ASD, whereas the majority of the association with ADHD could be explained by unmeasured shared familial confounding.

Small Wins for Small Babies: Celebrating Weekly Successes Helps Parents Cope With the <scp>NICU</scp> Hospitalisation

2025-06-18

Béatrice Boutillier , Fanny Labelle , Emilie Lancastre +6 more | Acta Paediatrica

ABSTRACT Aim To describe the implementation and evaluation of an intervention to celebrate babies' weekly achievements in the neonatal unit (prolonged hospitalisations) and examine parental perspectives. Methods In a feasibility … ABSTRACT Aim To describe the implementation and evaluation of an intervention to celebrate babies' weekly achievements in the neonatal unit (prolonged hospitalisations) and examine parental perspectives. Methods In a feasibility study, 92 parents reported the lack of optimism in the NICU, that clinicians often focused on what was going wrong; they recommended weekly celebration of accomplishments. The formats recommended were both physical (certificate given to parents) and virtual (text message). Inclusion criteria were baby > 1 week of life, likely survival, predicted hospitalisation > 1 month and parental consent. Parental perspectives were investigated using mixed methods with a questionnaire after discharge. Results The parents of 93 babies received weekly certificates (100% participation). The length of stay was on average 104 days, for a total of 1182 certificates/text messages received. 45% answered the questionnaire. The overall evaluation of parents was 9.1 of10; 88% reported it helped them cope with hospitalisation. Parental answers to open‐ended questions were all positive and invoked gratitude, empowerment, patience and hope. Conclusion Weekly text messages and certificates celebrating babies' accomplishments were appreciated and helped parents cope. It is possible to instil healthy optimism in the NICU.

Physical activity and perinatal depression

2025-06-17

Priscila Marconcin , Gérson Ferrari , Adilson Marques | Routledge eBooks

Statistical learning to identify and characterise neurodevelopmental outcomes at 2 years in babies born preterm: model development and validation using population-level data from England and Wales

2025-06-17

Sadia Haider , Athanasios Tsanas , G. David Batty +6 more | EBioMedicine

Parental holding during therapeutic hypothermia: Benefit or burden?

2025-06-17

Lauren C. Weeke , Marije Hogeveen | Pediatric Research

NEURAL CORRELATES OF INFANT SELECTIVE MOTOR CONTROL EMERGENCE WITHIN 5 MONTHS OF LIFE: IMPLICATIONS FOR CEREBRAL PALSY

2025-06-17

Alexander Drobyshevsky , Vasiliy Yarnykh , Andrea C. Pardo +2 more | medRxiv (Cold Spring Harbor Laboratory)

ABSTRACT Background Selective motor control (SMC)—the ability to isolate joint movements—is a critical component of early motor development and a strong predictor of later motor outcomes in individuals with cerebral … ABSTRACT Background Selective motor control (SMC)—the ability to isolate joint movements—is a critical component of early motor development and a strong predictor of later motor outcomes in individuals with cerebral palsy (CP). While SMC is thought to emerge as descending control from the cortex increases, the neural mechanisms supporting this process in early infancy are not well defined. This study utilizes multimodal MRI to investigate the relationship between microstructural changes in the corticospinal tract (CST) and the development of SMC in preterm infants during the first five postnatal months. Methods Fifteen preterm infants (<32 weeks GA, <1500g) underwent MRI between 3– 21 weeks corrected age, including macromolecular proton fraction (MPF) mapping to quantify myelination, diffusion tensor imaging (DTI) to assess fractional anisotropy (FA), and g-ratio estimation. SMC was measured using BabyOSCAR, a clinical tool that captures an infant’s capacity to perform isolated joint movements. Regions of interest included the posterior limb of the internal capsule (PLIC; CST) and the corpus callosum. One infant with spastic CP was included for exploratory comparison. Results In infants with typical development, SMC scores increased with age and were strongly correlated with MPF in the PLIC (R² = 0.81), suggesting close alignment between CST myelination and emerging motor control. MPF in the CST increased rapidly (from 24% to 80% of adult values), outpacing both FA and corpus callosum. In the infant with CP, ipsilesional CST myelination and contralesional SMC scores were substantially lower than expected for their age. Elevated MPF values in the rubrospinal tract suggested compensatory reorganization. In contrast, the infant with early motor delay demonstrated typical MPF, FA, and SMC scores and achieved independent walking by age two, indicating a transient delay rather than evolving CP. Conclusion Rapid CST myelination during early infancy closely parallels the development of selective motor control. Measures of MPF provide a sensitive structural correlate of this emerging capacity and may help identify early disruptions in motor system development. These findings provide a neurobiological framework for the early detection of motor impairment and more precise timing of intervention in infants with or at an increased chance of CP.

Developmental-Centered Care in Preterm Newborns: Scoping Review

2025-06-16

Jina Mariont Velasco Arias , Aida Maris Peres , Francisco Miguel Escandell Rico +3 more | Children

Background/Objectives: Preterm newborns often require specialized care and management. However, exposure to multiple stimuli during hospitalization can adversely affect their neurological development. Developmental-centered care integrates evidence-based practices and neuroprotective strategies … Background/Objectives: Preterm newborns often require specialized care and management. However, exposure to multiple stimuli during hospitalization can adversely affect their neurological development. Developmental-centered care integrates evidence-based practices and neuroprotective strategies to create an optimal care environment that minimizes harmful stimuli in the neonatal intensive care unit (NICU) and supports the neurological development of preterm infants. To identify interventions related to developmental-centered care that support preterm newborns in the NICU. Methods: A scoping review was conducted following the guidelines of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A comprehensive search was performed in MEDLINE, CINAHL, and Web of Science databases. The results were categorized based on the general characteristics of the studies and the main interventions related to developmental-centered care. Results: Out of 163 potentially relevant sources identified, 19 studies met the inclusion criteria. A total of 52 interventions were identified and classified into three thematic categories related to the benefits of the kangaroo care method, the family-centered care model, and the neonatal individualized developmental care and assessment program. Conclusions: The findings underscore the importance of integrating developmental-centered care practices, such as skin-to-skin contact, specialized feeding, and active parental involvement, into clinical practice to support neurodevelopment and improve health outcomes in preterm infants.

Little Bookworms: Examining participation in a NICU reading program and parental attachment and anxiety

2025-06-16

Amy Henry , Carina Stanton , Erin J. Plosa +1 more | Journal of Neonatal-Perinatal Medicine

Background In recent years, bedside reading programs have multiplied as an accessible means of enhancing parent/caregiver engagement in the neonatal intensive care unit (NICU). However, little is yet known about … Background In recent years, bedside reading programs have multiplied as an accessible means of enhancing parent/caregiver engagement in the neonatal intensive care unit (NICU). However, little is yet known about the relationship between program participation and parent/caregiver well-being. Therefore, the aim of this study was to investigate potential relationships between a parent-led, bedside NICU reading program and parent/caregiver attachment, anxiety, and satisfaction. Methods A sample of 60 NICU parents/caregivers participated in a parent-led, bedside reading program in 2024. They completed pre- and post-intervention self-reported measures of anxiety and attachment; upon discharge, participants also completed a Program Perceptions and Experiences survey. Results Parent-reported anxiety was observed to decrease significantly between the pre- and post-intervention time points. Overall, postnatal attachment scores, and more specifically, Quality of Attachment sub-scale scores, were seen to significantly increase in mothers between the pre- and post-intervention periods. Conversely, no significant differences in attachment were found in fathers across time points. Program Perceptions and Experiences survey responses indicated participants enjoyed the reading program and perceived that it enhanced their feelings of attachment towards their infants. Conclusions Participants reported significant decreases in anxiety and significant increases in postnatal attachment over time, with more pronounced change observed in mothers compared to fathers. Though these results may also align with improving medical status and movement towards discharge, participants’ positive reflections on the program, combined with the minimal time and resources required to implement it, suggest that parental bedside reading interventions for NICU parents/caregivers may be a useful avenue of family-centered intervention.

Motivational interviewing pilot randomized trial targeting ethnically-, linguistically-, and racially-diverse mothers’ Neonatal Intensive Care Unit (NICU) bedside presence

2025-06-16

Melissa A. Faith , Sarah Sobalvarro , Allison Schimmel‐Bristow +5 more | Journal of Pediatric Psychology

Abstract Objective We evaluated feasibility, acceptability, and fidelity of motivational interviewing (MI) designed to increase neonatal intensive care unit (NICU) presence among ethnically/linguistically/racially diverse mothers. We also assessed study design … Abstract Objective We evaluated feasibility, acceptability, and fidelity of motivational interviewing (MI) designed to increase neonatal intensive care unit (NICU) presence among ethnically/linguistically/racially diverse mothers. We also assessed study design feasibility to inform a larger, future randomized controlled trial. Method We randomized 95 mothers to receive MI (intervention condition) or treatment as usual (control condition) during their baby’s Level IV NICU admission. Eligibility criteria included mothers’ adult age, English- and/or Spanish-language proficiency, and having a NICU-hospitalized infant. Using single-blind methodology, we assigned mothers to receive MI (n = 47) or treatment-as-usual (n = 42). Mothers rated intervention satisfaction, the extent to which MI motivated their NICU presence, and their openness to additional MI intervention. We evaluated MI fidelity to further assess MI feasibility. Results Of 131 eligible mothers, 72.5% enrolled. Motivational interviewing-arm mothers received 1–6 weekly MI sessions. Regarding MI-arm mothers, 100% agreed to subsequent MI intervention, and 90% reported strong MI satisfaction. Eighty-seven percent of mothers reported that MI motivated them to be present in the NICU. Motivational interviewing interventionists achieved expert proficiency for 72.7% of coded MI sessions and basic competency for the remaining 27.3% of coded sessions. Mothers’ MI perceptions did not differ by ethnic or linguistic groups. Conclusions Motivational interviewing was feasible and highly acceptable across all ethnic/linguistic/racial groups, making MI a promising intervention to increase maternal NICU presence among mothers from traditionally marginalized groups. Future research should evaluate the extent to which MI can increase maternal NICU presence and enhance infant (e.g., medical/developmental) and maternal (e.g., postpartum depression, infant bonding) outcomes.

Early detection of infants with neurodevelopmental concerns indicative of cerebral palsy in a lower middle‐income country (India)

2025-06-15

Katherine Benfer , Asis Kumar Ghosh , Sayak Chowdhury +7 more | Developmental Medicine & Child Neurology

To determine reproducibility and diagnostic accuracy of screening tools for neuromotor concerns indicative of cerebral palsy (CP) at 18 months corrected age by using the General Movements Assessment (GMA) and/or … To determine reproducibility and diagnostic accuracy of screening tools for neuromotor concerns indicative of cerebral palsy (CP) at 18 months corrected age by using the General Movements Assessment (GMA) and/or Hammersmith Infant Neurological Examination (HINE) in West Bengal, India. This prospective substudy tested psychometrics of screening tools nested within an overarching randomized control trial. A total of 785 infants with birth/infant-detectable risk factors, aged 12 to 40 weeks corrected age (n = 422 male, mean corrected age 22.6 weeks, SD = 10.2), were recruited. Infants were screened for 'high-risk CP' using the GMA (absent/abnormal fidgety, 12-17 weeks corrected age) and/or HINE (3 months < 56, 6 months < 59, 9 months < 62, 18-40 weeks corrected age). 'Neuromotor concerns indicative of CP' were classified at 18 months corrected age by a physician from a videoed neurological examination and semi-structured movement protocol. We analysed the results (1) using Gwet's AC1 and (2) for sensitivity and specificity. Interrater reproducibility was strong (Gwet's AC1 = 0.89, p < 0.001). A total of 165 out of 749 assessments were screened as 'high-risk CP' (22.0%; 95% confidence interval 19.2-25.1). The screening programme (GMA/HINE) was 80.1% accurate (GMA [only] sensitivity = 87.8%, specificity = 44.4%; HINE [only] sensitivity = 94.0%, specificity = 60.0%). The GMA and/or HINE are reliable and accurate tools for screening high-risk populations in India, and may be useful in other low- and middle-income countries to identify infants with neuromotor concerns indicative of CP who could be triaged to early intervention.

INTERVENÇÃO FISIOTERAPÊUTICA POR MEIO DE ESTIMULAÇÃO PRECOCE EM RECÉM-NASCIDOS PRÉ TERMO: REVISÃO DE LITERATURA

2025-06-15

Jéssica Fabiana Martins Rangel Barreto , Pâmela Camila Pereira , Fernanda de Souza Silva | Aracê.

Introduction: The Early Stimulation Program is a clinical-therapeutic service for children aged 0 to 3 years, aimed at promoting essential sensory-motor experiences to enhance neuropsychomotor development. Physiotherapy for newborns includes … Introduction: The Early Stimulation Program is a clinical-therapeutic service for children aged 0 to 3 years, aimed at promoting essential sensory-motor experiences to enhance neuropsychomotor development. Physiotherapy for newborns includes stimulating motor development through neuromuscular facilitation techniques, mobilization exercises, and therapeutic positioning, as well as preventing musculoskeletal complications such as contractures and dysplasia. Objective: To analyze physiotherapeutic intervention through early stimulation in preterm newborns. Methodology: A systematic review was conducted using electronic databases such as BVS, LILACS, SciELO, PubMed, PEDro, and the CAPES Portal. Final Considerations: Early physiotherapeutic intervention shows positive results in the motor development of preterm newborns, proving to be an essential tool to reduce risks and improve quality of life from the very first days of life.

Assessing the Benefits of a Novel Postural Supporting Device on the Postural Development of Preterm Neonates in the Neonatal Intensive Care Unit: A Feasibility Study

2025-06-15

Dhwani Chanpura , Neha Mukkamala , Nalina Gupta | Cureus

[Expert consensus on follow-up and health management of preterm infants after discharge (2025)].

2025-06-14

| PubMed

Neurological Outcomes in Late Preterm Infants: An Updated Review of Recent Research and Clinical Insights

2025-06-14

Alexandru Necula , Roxana Stoiciu , Razvan Radulescu Botica +2 more | Diagnostics

Research on late preterm infants is limited compared with extremely low birth weight infants, despite their vulnerability to brain injury. Early intervention is crucial, as these infants often face higher … Research on late preterm infants is limited compared with extremely low birth weight infants, despite their vulnerability to brain injury. Early intervention is crucial, as these infants often face higher risks of cerebral palsy and developmental delays. This review examines methods to predict neurological outcomes and evaluates standard care protocols for neurologically affected late preterm infants. It also explores the potential for developing a comprehensive care bundle that integrates family involvement and delineates the responsibilities for continuous developmental monitoring. A total of 21 studies, primarily cohort studies, were included. This review synthesizes recent research on neurological development in late preterm infants, highlighting key markers and methods to improve neurological monitoring and long-term outcomes. Late preterm infants are at an increased risk for neurodevelopmental impairments, such as cerebral palsy and cognitive delays, particularly when growth restrictions or low birth weight are present. Early interventions, including specialized neurological assessments and targeted rehabilitation, show potential for improving these outcomes. Late preterm infants face increased neurodevelopmental risks despite low perinatal mortality. Early identification, standardized assessments, and targeted follow-up are essential. Emerging interventions show promise, but further research and equitable care access are needed to improve long-term outcomes.

Early neuromotor and sensory development in premature infants: An 18-month longitudinal follow-up study

2025-06-13

Müberra Tanrıverdi , Güleser Güney Yılmaz | Infant Behavior and Development

Effectiveness of Sensory Stimulation for Improving Sleep Quality in Preterm Infants in the Neonatal Intensive Care Unit: A Systematic Review

2025-06-13

Shunran Li , Ying Lin , Lei Fan +5 more | Nursing in Critical Care

ABSTRACT Background Sleep is crucial for preterm infants; however, their immaturity and hospital‐related disturbances can lead to poor sleep quality. Recently, sensory stimulation has been used to promote sleep quality; … ABSTRACT Background Sleep is crucial for preterm infants; however, their immaturity and hospital‐related disturbances can lead to poor sleep quality. Recently, sensory stimulation has been used to promote sleep quality; however, comprehensive evidence regarding its effectiveness is lacking. Aim The review aimed to evaluate sensory stimulation's effectiveness and different interventions on the sleep quality of preterm infants in the neonatal intensive care unit ( NICU ). Study Design A systematic review and meta‐analysis of randomized controlled trials. Different databases and grey literature were searched from inception to March 2024. Randomized controlled trials examining the effects of sensory stimulation on sleep quality among preterm infants. The Cochrane risk of bias tool (ROB 2.0) evaluated bias risk. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach evaluated evidence certainty for each meta‐analysis outcome. RevMan version 5.3 was used to perform meta‐analysis. The study was registered with the Prospective Register of Systematic Reviews. Results Twenty studies involving 1297 premature infants met the inclusion criteria. Sensory stimulation could improve sleep duration and quiet sleep efficiency (QS%), but it had no significant effect on the active sleep efficiency (AS%). In the subgroup analysis based on sensory type and number, auditory and multi‐sensory stimulation significantly extended sleep duration. Auditory and tactile stimulation did not significantly affect QS%, but tactile stimulation had favourable effects on AS%. Multi‐sensory stimulation also had beneficial effects on QS%. Conclusions Sensory stimulation is beneficial for improving the sleep quality of preterm infants, but the evidence quality is moderate to very low. Intervention types may have affected their effects. Future research should explore the specificity of sensory stimulation and multidisciplinary collaboration strategies, and high‐quality, low‐heterogeneity clinical trials are needed. Relevance to Clinical Practice Evidence from this study suggests integrating sensory stimulation protocols into standard care regimens for preterm infants. Furthermore, NICU nurses should implement systematic sleep assessments to identify sleep disturbances and administer targeted sensory stimulation. Trial Registration: This review was registered on the Prospective Register of Systematic Reviews (PROSPERO protocol number: CRD42024520762)

Digital play and rehabilitation for children and adolescents in hospitals, outpatient departments and rehabilitation centres: A scoping review

2025-06-13

Lærke Winther , Camilla Milther , Sanne Miri Schroll +5 more | Journal of Pediatric Rehabilitation Medicine

Purpose The growing interest among children in digital play provides new rehabilitation opportunities in hospital settings. There are, however, no published reviews on digital play interventions for the functional rehabilitation … Purpose The growing interest among children in digital play provides new rehabilitation opportunities in hospital settings. There are, however, no published reviews on digital play interventions for the functional rehabilitation of children and adolescents across diagnoses and outcomes in hospital and rehabilitation settings. This scoping review aimed to identify and map the characteristics of digital play for functional rehabilitation in hospital and rehabilitation settings for children and adolescents to inform researchers and clinicians. Methods Studies including participants aged ≤18 years investigating digital play and functional rehabilitation in hospital and rehabilitation settings were included. Reviews, text and opinion papers, conference papers, case studies, and studies with fewer than five participants were excluded. Five scientific databases were searched. The final search was conducted in October 2022. Four authors performed the study selection and data extraction. Results Of 13,663 references, 90 studies met the inclusion criteria. Digital play for rehabilitation was used in clinical settings, including hospitals, outpatient departments, and rehabilitation centres. Some interventions were conducted in human movement laboratories or at home. The relevant studies involved a wide range of disease categories, primarily neurological. A conceptual framework comprising five categories for gaming technologies utilizing digital play and rehabilitation was proposed: (1) traditional gaming platforms, (2) extended reality, (3) robotics and assistive technology, (4) sensors, and (5) rehabilitation systems. One hundred eighty different outcome measures used to evaluate the interventions were identified, almost one-third of which were unvalidated. The studies generally failed to report limitations and barriers to implementation. Conclusion This scoping review gives a practical overview to assist and inspire healthcare professionals and researchers in digital play and rehabilitation, elucidating technology for rehabilitation within specific clinical contexts. In addition, this scoping review facilitates the exploration of implementation prospects associated with various technologies. Digital play and rehabilitation are primarily initiated in outpatient departments targeting children with neurological diseases. Future studies should investigate the potential of using digital play for the early rehabilitation of hospitalized children with various diseases.

Participação e autoconfiança materna no cuidado ao recém-nascido prematuro extremo

2025-06-13

Ana Catarina de Oliveira Santos , Érika da Silva Dittz | Deleted Journal

Esta pesquisa teve como objetivo conhecer os elementos que contribuem para um ambiente facilitador ou dificultador da participação e autoconfiança materna no cuidado ao recém-nascido prematuro extremo. Trata-se de um … Esta pesquisa teve como objetivo conhecer os elementos que contribuem para um ambiente facilitador ou dificultador da participação e autoconfiança materna no cuidado ao recém-nascido prematuro extremo. Trata-se de um estudo de métodos mistos, combinando abordagens qualitativa e quantitativa, realizado com 11 mães de bebês internados em uma unidade de terapia intensiva neonatal. Os dados foram coletados por meio de entrevistas semiestruturadas, da Escala de crenças dos pais de recém-nascidos prematuros (ECP) e de consultas aos prontuários dos recém-nascidos. A análise dos dados foi conduzida por meio de estatística descritiva simples e análise de conteúdo. A maioria das participantes demonstrou suficiência na capacidade de cuidado e destacou o acesso e a permanência nas unidades de terapia intensiva neonatal (UTIN), a comunicação efetiva, a inclusão materna no cuidado, o trabalho em equipe e o processo de ensino-aprendizagem como fatores facilitadores. A participação e a autoconfiança materna são construídas a partir da inter-relação entre as mães, o ambiente e os profissionais de saúde.

Brain volumes are related with motor skills at late childhood in children born extremely preterm

2025-06-13

Lina Broström , Hedvig Kvanta , Maria Örtqvist +2 more | PLoS ONE

Background This study had three aims. First, we wanted to explore if there was difference in motor performance at 12 years of age in children born extremely preterm (EPT < … Background This study had three aims. First, we wanted to explore if there was difference in motor performance at 12 years of age in children born extremely preterm (EPT < 28 weeks of gestation) and at term. Our second aim was to study whether the volumes of motor networks and regions differed between those groups when they underwent brain scans at 10 years of age. Third, we investigated whether there were differences in the motor networks and regions of the brain in children born EPT who did or did not have motor impairment at 12 years of age. Methods In a Swedish national study, a subgroup of 42 children born before 27 weeks and 25 term-born controls underwent MRI at age 10. A neuroradiologist performed MRI acquisitions, and analyses focused on brain regions associated with motor function. At age 12, motor function was assessed using the Movement Assessment Battery for Children – Second Edition (MABC-2), conducted by a licensed physiotherapist. Examiners were blinded to group status. Motor function and motor-related brain volumes were compared between the EPT and control group, and between children born EPT with and without motor impairments. Results Findings revealed significantly reduced motor performance and smaller motor region volumes in EPT children compared to controls (p < 0.001). Among EPT children, those with motor impairment especially in aiming and catching, had notably smaller brain volume in the basal ganglia (mean difference:1.2 cm 3 , p = 0.049), cerebellum (mean difference:14.4 cm 3 , p < 0.001), motor execution (mean difference:3.7 cm 3 , p = 0.049) network and motor imagery network (mean difference 5.6 cm 3 , p = 0.049) than their EPT peers without such impairments. Cerebellar volume remained significant different between the groups when adjusting for birth weight and sex in a linear regression model, p = 0.02 (η 2 = 0.17). Conclusion The results underscore the impact of extreme prematurity on motor function and brain structure, highlighting a specific link between reduced motor area volumes and impaired ball skills.

Moderate‐To‐Late Preterm Infants Benefit From the Early Collaborative Intervention: Primary Outcomes of an <scp>RCT</scp>

2025-06-13

Ulrika Birberg Thornberg , Felix Koch , Charlotte Sahlén Helmer +4 more | Acta Paediatrica

ABSTRACT Aim This study aimed to determine the longitudinal impact of the EArly Collaborative Intervention (EACI), a three‐session early intervention designed to enhance parent‐infant interaction, on the developmental outcomes of … ABSTRACT Aim This study aimed to determine the longitudinal impact of the EArly Collaborative Intervention (EACI), a three‐session early intervention designed to enhance parent‐infant interaction, on the developmental outcomes of preterm infants born between 30 + 0 and 35 + 6 weeks of gestation. Methods This randomised controlled blinded study recruited families in two neonatal intensive care units in Sweden. In this one‐year follow‐up, 87 infants (standard care = 37, standard care with EACI = 50) were included in the intention‐to‐treat analysis. The primary study outcomes were cognition, receptive and expressive communication, and fine and gross motor development measured with the Bayley‐III. Results At one year of age (mean age 13.1 months SD = 0.64), there was a statistically significant effect in the intention‐to‐treat analysis on receptive communication F (1, 85) = 4.61, p = 0.035, η 2 = 0.051. No statistically significant effects were found on the other Bayley‐III outcome measures. There were no significant differences between the groups regarding gestational age, birth weight, gender, parents' education, or age at assessment. Conclusion This new intervention indicates a small positive effect on moderate‐to‐late preterm infants' communication ability at one year of age. Though the attrition rate was relatively large, results are encouraging since clinical interventions supporting moderate‐to‐late preterm infants and parents are lacking. Trial Registration ClinicalTrials.gov : NCT02034617

Anxiety, Coping, and Self-Efficacy as a Psychological Adjustment in Mothers Who Have Experienced a Preterm Birth

2025-06-12

Agata Białas , Karolina Kamecka , Paweł Rasmus +3 more | Journal of Clinical Medicine

Background/Objectives: Research shows that mothers of premature infants can experience increased symptoms of anxiety, depression, and even a post-traumatic stress in comparison to mothers of healthy, full-term infants. The aim … Background/Objectives: Research shows that mothers of premature infants can experience increased symptoms of anxiety, depression, and even a post-traumatic stress in comparison to mothers of healthy, full-term infants. The aim of this study was to analyze and compare anxiety, coping, and self-efficacy in mothers who have and have not experienced a preterm birth, providing a basis for developing a targeted, mother-oriented support program that supports their adjustment to difficult situations. Methods: The study included 251 women, 112 of whom delivered infants prematurely (PTB group) and 139 who delivered infants at term (T-B group). Data were collected by using (1) The State-Trait Anxiety Inventory (STAI) Questionnaire, (2) the Generalized Self-Efficacy Scale (GSES), and (3) the Coping Inventory for Stressful Situations Questionnaire (CISS). Results: PTB women had higher results in anxiety in comparison to T-B women. Also, they were characterized by statistically significantly lower generalized self-efficacy and ability to cope with stress. PTB women more often presented the emotion-oriented coping style. Conclusions: A mother-oriented support program based on personal resources is a solution which could help mothers better adjust to difficult situations related to preterm birth child treatment and care.

Preuse Acceptance of a Family-Centered, Need-Based, and Interprofessional Perinatal Care Mobile Health Intervention: Exploratory Study

2025-06-12

Kristina Killinger , Verena Seyfried , Katharina Brusniak +4 more | JMIR Human Factors

Abstract Background The perinatal period is one of the most vulnerable times a woman experiences. Multidimensional, interprofessional, and personalized support is needed to improve outcomes in women’s and children’s health … Abstract Background The perinatal period is one of the most vulnerable times a woman experiences. Multidimensional, interprofessional, and personalized support is needed to improve outcomes in women’s and children’s health while strengthening partner relationships at the same time. Although a vast amount of support services already exist in Germany for psychosocial counseling during the perinatal period, groups who are especially at risk do not take advantage of them. Objective Family eNav is an app-based intervention developed by experts in the field of medical and psychosocial support to help young parents navigate through primary and secondary care services in Germany according to their needs. It also empowers patient and parenting perspectives through self-education and symptom monitoring for different settings, for example, mental health and preterm birth. While the intervention will be evaluated in a multicenter, randomized, controlled trial, the focus here lies on the conception of the app, demand among patients, and preuse acceptance. Methods During the conception phase, we conducted an explorative study with prospective users and experts in the perinatal psychosocial field to understand the need and preuse acceptance of the intervention. We interviewed 20 participants with a semistructured guide, analyzing their responses using systematic text condensation. Additionally, we conducted a short survey on general questions concerning digitalization within the health care system among the participants. Results We established two main themes: (1) access and barriers to health care and psychosocial services and (2) high preuse acceptance of app-based intervention. Health care and psychosocial providers indicated that there is a high demand for their services, which cannot always be met immediately, and at the same time, they are doubtful of reaching those individuals most in need. Prospective users and health and social care providers alike showed great interest in the perinatal navigator and suggested a variety of needs and content requirements to be included. Regionality, availability, and individualized content were underlined as success factors for high user acceptance. Barriers consisted of data protection concerns, as well as denial of their own needs. Conclusions Our findings show great acceptance for an app-based intervention on the part of both prospective users and service providers. Feedback on requirements and content, as well as possible barriers, was taken into consideration while developing the app.

Relationship Between Exclusive Breastfeeding and Infant Motor Development : A Scoping Review

2025-06-11

Melia Dwi Yitna Putri , Tamela Zahra | Lentera Perawat

Early childhood development is significantly influenced by nutrition and environmental factors. Exclusive breastfeeding has been associated with various health and developmental outcomes, including motor skill development. However, existing evidence on … Early childhood development is significantly influenced by nutrition and environmental factors. Exclusive breastfeeding has been associated with various health and developmental outcomes, including motor skill development. However, existing evidence on this relationship remains scattered and inconclusive. This scoping review aimed to systematically map the available evidence on the association between exclusive breastfeeding and motor skill development in children under five years of age. The review followed the PRISMA-ScR guidelines and utilized the Arksey and O’Malley framework, enhanced by Levac and colleagues. Inclusion criteria consisted of peer-reviewed articles published between January 2013 and December 2023, involving children aged 0–59 months, examining exclusive breastfeeding as the exposure, and assessing motor development as the outcome. Both observational and experimental studies were included. Literature searches were conducted in PubMed, Google Scholar, and ScienceDirect using predefined strategies and relevant MeSH terms. Data were extracted using a standardized charting form covering study characteristics, population, methods, key findings, and outcome measures. Two reviewers independently extracted data, and a third reviewer cross-validated for accuracy. A total of 21 studies met the inclusion criteria. Thematic analysis revealed three main patterns: (1) a positive association between the duration of exclusive breastfeeding and gross motor development; (2) inconsistent findings regarding fine motor skills; and (3) contextual factors such as socioeconomic status and maternal education moderated the relationship. In conclusion, while evidence suggests a potential link between exclusive breastfeeding and motor development, causality cannot be inferred due to the predominance of observational studies. Further longitudinal and interventional research is warranted. These findings highlight the broader developmental relevance of promoting exclusive breastfeeding.

The Impact of Aquatic Physiotherapy on the Motor Development of 5-Month-Old Infants: Parental Knowledge, Expectations, and Experiences

2025-06-11

Rosita Kiaulakytė , Lina Budrienė | Reabilitacijos mokslai slauga kineziterapija ergoterapija

Background. Early motor development is one of the most critical and intensive stages in a human’s life, significantly influenced by parents’ age, education, and knowledge. Aim. To assess parents’ knowledge … Background. Early motor development is one of the most critical and intensive stages in a human’s life, significantly influenced by parents’ age, education, and knowledge. Aim. To assess parents’ knowledge of infant developmental milestones, their expectations and experiences with aquatic physiotherapy, and the effect of aquatic physiotherapy on the rolling function of five-month-old infants. Methods. An anonymous 18-question survey was used to assess the knowledge and expectations of parents (n = 65) regarding infant development, the benefits and perceived need for aquatic physiotherapy. The Alberta Infant Motor Scale was used to evaluate the motor skills of infants (n = 33). Results. Parents with higher education, older age, or more children had more knowledge about infant motor development compared to younger, less-educated parents or those with fewer children. The older the parents, the more they emphasised the importance of motor development and the more likely they were to choose aquatic physiotherapy for their infants. Parents of older infants more often observed improved muscle tone and trunk control, while those with higher education more frequently noticed better social development in their child. The rolling-to-prone function of five-month-old infants who participated in aquatic physiotherapy was rated better compared to those who did not attend such sessions. Conclusions. Older parental age, higher education level, and a larger number of children in the family are statistically significantly associated with better parental knowledge about infant motor development. Compared to younger parents, older parents more often emphasise the importance of motor development and are more likely to choose aquatic physiotherapy to support it. Parents with higher education more frequently observe positive changes in their infant’s social development. Parents of older infants are more likely to report improvements in muscle tone and trunk control following aquatic physiotherapy sessions. Aquatic physiotherapy is associated with improved rolling function in infants. Keywords: infants; motor development; aquatic physiotherapy; parental knowledge

Efectos de la musicoterapia para la reducción del estrés en el pediátrico no complicado hospitalizado

2025-06-11

Gisselle Vásquez Cortés | Revista de Investigación en Musicoterapia

El estrés intrahospitalario en un paciente pediátrico puede afectar significativamente como se desarrolla el paciente. El uso de la musicoterapia suele ser un buen método para disminuir el estrés por … El estrés intrahospitalario en un paciente pediátrico puede afectar significativamente como se desarrolla el paciente. El uso de la musicoterapia suele ser un buen método para disminuir el estrés por ello se analizó los efectos de la musicoterapia en la reducción del estrés en pediátricos no complicados que se encontraran hospitalizados. La metodología utilizada fue de nivel descriptivo, correlacional, cuantitativo temporalidad prospectivo y transversal. Se aplicó el “Formulario observacional para medir el estrés en niños y niñas”, validado por constructo y expertos (Alpha de Cronbach: 0.92 antes y 0.95 después). Se compararon los resultados mediante la prueba de Chi cuadrada de McNemar. La intervención redujo significativamente conductas negativas como miedo, tristeza, irritabilidad e hiperactividad. Cambios significativos (p<0.05): inquietud (p=0.0005), hiperactividad (p=0.035), miedo (p=0.004), tristeza (p=0.002), rabietas (p=0.001), e irritabilidad (p=0.013). No se observaron cambios significativos en apetito, conducta agresiva o sueño (p>0.05).