Paternal sperm concentration and growth and cognitive development in children born with a gestational age more than 32 weeks after assisted reproductive therapy

Summary Data on neurodevelopmental outcomes of infants born with esophageal atresia (EA) are still scarce and controversial. The aims of our study were to evaluate motor and cognitive development during the first year of life, in patients operated on of EA and to investigate potential risk factors for motor and cognitive development both at 6 and 12 months. This is an observational prospective longitudinal study in a selected cohort of type C and D EA infants enrolled in our follow-up program from 2009 to 2017. In order to exclude possible confounding factors, the following exclusion criteria were applied: (i) gestational age ≤ 32 weeks and/or birth weight ≤ 1500 g; (ii) genetic syndrome or chromosomal anomaly known to be associated with neurodevelopmental delay; (iii) neurologic disease; (iv) esophageal gap ≥three vertebral bodies. Patients were evaluated at 6 and 12 months of life (corrected age for infants with a gestational age of 32–37 weeks) with the Bayley Scales of Infant and Toddler Development—3rd Edition. In our selected cohort of EA infants, 82 were evaluated at 6 months and 59 were reevaluated at 12 months. Both Motor and Cognitive average scores were within the norm at both time points. However, we report increased number of infants with motor delay with time: 14% at 6 months and 24% at 12 months. Multiple regression analysis for Motor scores at 6 [F(4,74) = 4.363, P = 0.003] and 12 months [F(6,50) = 2.634, P = 0.027] identified (i) low birth weight, (ii) longer hospital stay and (iii) weight < fifth percentile at 1 year as risk factors. Interestingly, average Cognitive scores also increased with time from 85.2% at 6 months and 96.6% at 12 months. Multiple regression models explaining variance of Cognitive scores at 6 [F(4, 73) = 2.458, P = 0.053] and 12 months [F(6, 49) = 1.232, P = 0.306] were nonsignificant. Our selected cohort of EA patients shows, on the average, Motor and Cognitive scores within the norm both at 6 and 12 months. Nevertheless, the percentage of infants with Motor scores below the average increases regardless gestational age. None of clinical and sociodemographic variables taken into consideration was able to predict cognitive development both at 6 and 12 months whereas risk factors for Motor development change during the first year of life. Healthcare providers should pay particular attention to patients with low birth weight, longer hospital stays and weight under fifth percentile at 1 year. Future studies should include long-term outcomes to reveal possible catch up in motor development and/or possible findings in Cognitive scores.

Download Full-text

Babies at Double Hazard: Early Development of Infants at Biologic and Social Risk

PEDIATRICS ◽

10.1542/peds.70.5.670 ◽

1982 ◽

Vol 70 (5) ◽

pp. 670-676 ◽

Cited By ~ 8

Author(s):

Sibylle K. Escalona

Keyword(s):

Social Class ◽

Cognitive Development ◽

Brain Damage ◽

Psychosocial Development ◽

Gestational Age ◽

Neonatal Intensive Care ◽

Cognitive Status ◽

Full Term ◽

Social Risk ◽

The Impact

From the population of a neonatal intensive care unit, 114 infants and their families were followed from birth to age 3½ years. Infants showing massive brain damage at birth and/or severe mental retardation at 7 months of age were excluded from this analysis. The remainder were predominantly poor and nonwhite. The group showed normal cognitive development through age 15 months. By 28 months of age and thereafter, a severe decline in cognitive status proved to be associated with social class. In addition, serious behavioral maladjustment led to improverished cognitive development. The incidence of maladjustment was unrelated to social class. The impact of maladjustment on test scores was significant in all classes, but greater for the higher rather than the lower socioeconomic social groups. Neither neurologic pathology (excepting severe brain damage) nor gestational age (small for gestational age [SGA] vs appropriate for gestational age [AGA]) had a significant effect on IQ scores at 3½ years of age. It is suggested that environmental deficits and stresses impair early cognitive and psychosocial development for both full-term and premature infants, but that the latter group is more vulnerable to environmental insufficiencies than are full-term babies.

Download Full-text

Age and the Disvalue of Death

Global Health Priority-Setting ◽

10.1093/oso/9780190912765.003.0014 ◽

2019 ◽

pp. 239-262

Author(s):

Joseph Millum ◽

Espen Gamlund ◽

Emery Ngamasana ◽

Carl Tollef Solberg

Keyword(s):

Cognitive Development ◽

South African ◽

Gestational Age ◽

Current Practice ◽

Well Being ◽

Older Children ◽

Perinatal Deaths ◽

Neonatal Deaths ◽

A Value ◽

Key Questions

Summary measures of health or well-being must assign a value to averting death and relate it to the value of preventing or curing morbidity. The authors address two key questions about how to value the prevention of death: (1) how the age at which someone dies affects how bad their death is and (2) at what age death starts to be bad for the decedent. Current practice includes, by default, views about both questions that the authors think are mistaken. Regarding (1), the authors argue in favor of gradualism: the value assigned to preventing mortality should gradually increase during early cognitive development, so that the prevention of perinatal deaths is assigned a lower value than the prevention of the deaths of older children. Regarding (2), value should be assigned to preventing deaths from the point of the onset of sentience—at around 28 weeks gestational age—so that the prevention of stillbirths is also valued. The authors tentatively suggest a function for calculating the disvalue of death at different ages and apply this and alternative functions to South African data on interventions to prevent stillbirths and neonatal deaths.

Download Full-text

Effect of breastfeeding on cognitive development of infants born small for gestational age

Acta Paediatrica ◽

10.1111/j.1651-2227.2002.tb01713.x ◽

2007 ◽

Vol 91 (3) ◽

pp. 267-274 ◽

Cited By ~ 56

Author(s):

MR Rao ◽

ML Hediger ◽

RJ Levine ◽

AB Naficy ◽

T Vik

Keyword(s):

Cognitive Development ◽

Gestational Age ◽

Small For Gestational Age

Download Full-text

Intrauterine environment and cognitive development in young twins

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174413000287 ◽

2013 ◽

Vol 4 (6) ◽

pp. 513-521 ◽

Cited By ~ 4

Author(s):

E. E. Antoniou ◽

T. Fowler ◽

E. Thiery ◽

T. R. Southwood ◽

S. van Gestel ◽

...

Keyword(s):

Birth Weight ◽

Cognitive Development ◽

Umbilical Cord ◽

Gestational Age ◽

Intelligence Quotient ◽

Shared Environment ◽

Intrauterine Environment ◽

Intelligence Scale ◽

Iq Scores ◽

Cord Length

Intrauterine factors important for cognitive development, such as birth weight, chorionicity and umbilical cord characteristics were investigated. A total of 663 twin pairs completed the Wechsler Intelligence Scale for Children-Revised and scores were available for Performance, Verbal and Total Intelligence Quotient (IQ). The intrauterine factors examined were birth weight, placental weight and morphology, cord knots, cord length and cord insertion. IQ scores for the varying levels of the intrauterine markers adjusting for gender and gestational age were calculated. The heritability of IQ and the association between IQ and intrauterine environment were examined. Twins with lower birth weight and cord knots had lower IQ scores. The aetiology of IQ is largely distinct from that of birth weight and cord knots, and non-shared environment may influence the observed relationships.

Download Full-text