scholarly journals Predictors of early life milestones: Results from the Copenhagen Perinatal Cohort

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Trine Flensborg-Madsen ◽  
Marie Grønkjær ◽  
Erik Lykke Mortensen

Abstract Background Pre- and postnatal factors have been found to be predictors of age at attaining milestones in infancy; however, the degree to which such factors are predictors of milestones in the subsequent years is less investigated. The aim was to conduct a systematic evaluation of a broad range of possible predictors of milestone attainment during the second and third years to identify factors that explain significant inter-individual variance. Methods Mothers of 4009 children from the Copenhagen Perinatal Cohort (1959–61) were interviewed by a physician about 20 developmental milestones at a three-year examination. Milestones were related to: Language, Walking, Eating, Dressing, Social interaction, and Toilet training. Information on possible predictors was collected during pregnancy and at a 1- and 3-year follow-up. Results Several pre- and postnatal factors were significantly associated with the timing of milestone attainment; especially parental social status, paternal age, sex, gestational age, birth weight, birth length, weight increase in the first year of life, and motor development during the first year of life. The significant predictors explained 16.2% of the variance in the Overall mean of milestones and 20.3% of the variance in milestones related to Walking. The most influential individual factor for the timing of milestone attainment was previous motor development during the first year of life. Additionally, sex was an important factor as girls were generally faster at attaining milestones. Parental social status was a consistent, but relatively week predictor. Conclusion A notable amount of variance in the timing of milestones during the first three years of life can be explained by perinatal and early postnatal factors. The study provides evidence of developmental continuity as the main predictor of milestones in the second and third years was the speed of development during the first year.

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 664-669
Author(s):  
Michael K. Georgieff ◽  
Judy C. Bernbaum

To document the incidence of and neonatal factors associated with abnormal shoulder girdle muscle tone in premature infants at follow-up, we studied 125 consecutively admitted infants weighing < 1,750 g treated in The Children's Hospital of Philadelphia intensive care nursery and subsequently seen in the Neonatal Follow-up Program up to 18 months of age. Fifty-seven infants (46%) displayed abnormal shoulder girdle muscle tone which presented clinically as scapular retractions. These infants had significantly lower birth weights (P < .001) and gestational age (P < .001) as well as a higher incidence of acute and chronic pulmonary disease (P < 0.01) and CNS insults (P < .05) when compared with infants without scapular retractions. The 57 infants with scapular retractions were further divided into two groups: 42 infants (74%) in whom scapular retractions were associated with generalized mild hypertonicity and 15 infants (26%) in whom scapular retractions compensated for trunk and neck hypotonicity. The infants with scapular retractions and hypotonicity had a significantly higher incidence of neonatal neurologic morbidity including seizures, major resuscitations, and birth asphyxia (P < .01) when compared with the infants with scapular retractions and hypertonicity. Shoulder girdle tone abnormalities in the first year of life inhibit crawling, sitting, and object manipulation and, therefore, may manifest as delays in motor development. Identification of infants with significant neonatal risk factors for tone abnormalities is important to allow for earlier therapeutic intervention.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Mitteregger ◽  
Martina Wehrli ◽  
Manuela Theiler ◽  
Jana Logoteta ◽  
Irina Nast ◽  
...  

Abstract Background Children with severe congenital heart disease (CHD) are a group of children at risk for neurodevelopmental impairments. Motor development is the first domain to show a delay during the first year of life and may significantly contribute to parental concerns, stress, and difficulties in early child-parent attachment. Thus, the aim of the study was to better understand the wishes and concerns of parents of children with CHD and explore their experience of their children’s neuromotor development in the first year of life. Methods In this qualitative study, fourteen families were recruited. Their children were aged 1–3 years and had undergone open heart surgery within the first 6 months of life. Semi-structured interviews were audio-recorded and transcribed. The data was explored within an expert group, and a qualitative content analysis was conducted using VERBI MAXQDA software 2020. The study was conducted in accordance with the COREQ checklist. Results Parents of children with CHD reported several burdens and needs. Parental burdens concerned the child’s motor development, their own physical and psychological strain, and difficulties in communication with healthcare professionals. The needs, parents reported included supporting their child’s motor development, a medical coordinator, and better communication between healthcare professionals and parents. During the first phase of their children’s illness, parents underwent a dynamic transitional phase and expressed the need to rely on themselves, to trust their children’s abilities, and to regain self-determination in order to strengthen their self-confidence. Conclusions It is essential to involve parents of children with CHD at an early stage of decision-making. Parents are experts in their children and appreciate medical information provided by healthcare professionals. Interprofessional teamwork, partnering with parents, and continuous support are crucial to providing the best possible care for children and their families. Family-centred early motor intervention for CHD children might counteract the effect of parental overprotection and improve children’s motor development and thus strengthen child-parent interaction. In future work, we aim to evaluate a family-centred early motor intervention for children with CHD developed on the basis of this qualitative study. Trial registration Not applicable.


2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
F Bevilacqua ◽  
B Ragni ◽  
L Valfrè ◽  
A Conforti ◽  
A Braguglia ◽  
...  

Abstract Background Esophageal atresia (EA) prognosis have improved significantly over the past three decades. Research and clinical attention has shifted to neurodevelopmental outcomes and quality of life. Aim The aim of this study wasto examine neurodevelopmental outcomes and to identify clinical and sociodemographic risk factors in a cohort of infants with EA. Methods An observational prospective longitudinal study was conducted between 2009 and 2017. Neurodevelopment was assessed at 6 and 12 months by Bayley Scales of Infants and Toddler Development—3rd Edition. Clinical and sociodemographic variables included were gender, birthweight, gestational age, associated malformations, number of hospitalizations, surgeries and dilatations at 12 months, days of mechanical ventilation, parental age, education level, and socioeconomic status. Results Ninety-six infants were enrolled in the study at 6 months and 73 of them were evaluated also at 12 months. Analysis showed significant differences between motor development at 6 and 12 months (M6 = 95.39, SD = 15.71; M12 = 91.83, SD = 12.87; t = 0.245, P = 0.017); significant differences emerged also between cognitive development at 6 and 12 months (M6 = 91.80, SD = 11.70; M12 = 100.92, SD = 15.39; t = −5.10, p = .000). Infants with long-gap AE achieved the worst scores in cognitive (r = -.28, P < .01) and motor scales (r = -.36, P < .01) at 6 months and in motor scale at 12 months (r = −0.30, P < 0.05). More days of mechanical ventilation were related to a lower score in both the cognitive (6 months r = −0.26, P < 0.05; 12 months r = −0.26, P < 0.05) and motor scale (6 months: r = −0.38, P < 0.01; 12 months r = −0.42, P < 0.01). A major number of interventions in the first year of life were related to lower scores in the motor scale at 12 months (r = −0.43, P < 0.01). Conclusions Infants operated on for AE are at risk of neurodevelopmental impairment in the first year of life. Findings support the association between neurodevelopmental outcomes and clinical risk factors. Careful interdisciplinary follow-up is essential for early detection of neurodevelopmental delay.


Author(s):  
Bevilacqua Francesca ◽  
Ragni Benedetta ◽  
Conforti Andrea ◽  
Braguglia Annabella ◽  
Gentile Simonetta ◽  
...  

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 &lt; 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.


2011 ◽  
Vol 26 (S2) ◽  
pp. 305-305
Author(s):  
M.A. Kalinina ◽  
G.N. Schimonova

IntroductionThe study of clinical features and prognostic significance of autonomic disorders are among the most pressing problems of modern medicine.ObjectivesDynamically within 5 years were observed 50 children at high risk for schizophrenia and 40 children with hypoxic-ischemic encephalopathy of the general population. Aims. Evaluation of prognostic significance of autonomic disorders in infancy for mental health in older age groups.MethodsAll patients were examined by clinical methods and EEG, neurosonografia, original screening tables for early childhood.ResultsIn the first year of life in children at high risk for schizophrenia observed mental and motor development within the syndrome of PDD.In infancy the vagotonic orientation prevailed 72, 5%. By 3 years it changed to the amphotonic orientation reaching 76, 0% of children, while the 10, 0% acquired sympathotony, the rest remained vagotonic.The mental state of 37 children to 5 years qualified as schizotipical disorder (F 21.8). In 13 children it was diagnosed schizophrenia, children's type (F20.8). Frequent and sudden changes in the type of tonus correlated with the deterioration of the mental state of a different nature.In the control group at the first year of life prevailed vagotonic orientation, which gradually to age of one year changed by eutonic. During the first 3–5 months of infancy revealed some unstable circulatory, sleep disorders.ConclusionsThe instability of autonomic tone and an abundance of vegetative violations indicate the risk of mental pathology.


Author(s):  
T. V. Samsonova ◽  
S. B. Nazarov ◽  
A. A. Chistyakova ◽  
Yu. A. Ryl'skaya

At the first year of a child’s life begins a gradual transition to verticalization through the sequential development of anti-gravity postures. During the maintain of these poses occurs the active muscle contraction and appears a postural tremor.Purpose: To identify the features of postural tremor while holding the first antigravity postures in children with motor development disorders and to develop a new method for its diagnosing in children in the first six months of life. During the first year of life, the child gradually moves to verticalization through the sequential development of anti-gravity postures. To maintain these postures, the child actively contracts muscles, causing postural tremor.Objective. To reveal the features of postural tremor while holding the first antigravity postures in children with motor development disorders and to develop a new diagnostic method in the first six months of life. Children characteristics and research methods. The authors examined 33 children with impaired motor development and 10 children without neurological pathology at the age of 3–5 months. All children underwent neurological examination and study of postural tremor according to our method.Results. The authors established the features of postural tremor in children with impaired motor development at the age of 3-5 months compared with healthy children, manifested in amplitude increase. The authors presented their own for recording postural tremor in children of the first six months of life at the stage of mastering the first antigravity postures. There are presented the results of the analysis postural tremor in children of 3-5 months with impaired motor development in comparison with healthy children. The article presents a new method for diagnosing impaired motor development in children of the first six months of life using the results of postural tremor research. The high diagnostic value of the developed method is shown


2020 ◽  
Vol 77 (3) ◽  
pp. 324-329
Author(s):  
Danijela Pavicevic ◽  
Jelena Milosevic ◽  
Ivana Petrovic-Markovic ◽  
Zoran Milenkovic ◽  
Katarina Parezanovic-Ilic

Background/Aim. Craniosynostosis is a condition that occurs intrauterine or develops in the infant period, and represents premature fusion of cranial sutures. This fusion of sutures limits the normal cranium development and leads to disorder in the phase of rapid growth and development of the brain. Creation of craniosynostoses is associated with an increased incidence of developmental delay during the breastfeeding period. Craniosynostoses are treated by surgery. The role of a physiatrist is to postoperatively assess psychomotor development and implement habilitation treatment. The aim of this study was to determine distribution of the type of craniosynostoses according to the age and gender of patients, effectiveness of habilitation treatment and to estimate the somatosensory evoked potential in the preoperative and postoperative period in children who underwent craniosynostosis surgery in the first year of life. Methods. The study was designed as a retrospective research. The data were collected from medical records of 51 children with craniosynostoses and delay in psychomotor development who underwent surgical intervention. The children included in this study, during follow-up, were involved in the habilitation treatment. Results. An early diagnosis and surgical intervention had a favorable effect on the development of motor function in children with craniosynostoses. The importance of stimulation treatment in the postoperative period was also proved for achievement of an adequate degree of motor development in children in relation to age. The results of our study confirmed the results obtained in previously published studies that the children who did not undergo surgery and start with the habilitation treatment immediately after it, had delay in psychomotor development of moderate degree. Conclusion. Habilitation treatment significantly reduced the deviations in psychomotor development of children with craniosynostoses if it started immediately after the surgical procedure.


2021 ◽  
Vol 2 (3) ◽  
pp. 119-136
Author(s):  
Galina S. Lupandina-Bolotova ◽  
Aliya A. Revina ◽  
Dmitry A. Ignatov

Introduction. The development of a child in the first year of life provides the basis for their further harmonious growth. Motor development occurs in parallel with the ongoing gradual development of the nervous system. The transition to a new motor milestone is associated with the emergence of new skills; therefore, stimulation of motor development should occur in accordance with the next milestone of the nervous system development. Intervention in the natural process of the skills gaining without considering the developmental nervous system milestone leads to a change in the trajectory of motor progress of the child. Aim of the study was to assess the significance of individual elements of motor development for the function of balance and walking, as well as to identify the role of non-physiologic (contradicting motor ontogenesis) stimulation of motor skills in the evolvement of non-optimal motor patterns and impaired balance and walking function. Materials and methods. In total, 43 children aged ≥ 12 months admitted to the «Consultative Diagnostic Department» of the Federal State Autonomous Institution «National Medical Research Center for Children’s Health» of the Ministry of Health of Russia were examined within the framework of dispensary observation in the period from December 2016 to June 2019. The assessment of motor development was carried out according to the tests and questionnaires developed. The children were divided into two groups: the treatment group, in which the intervention was carried out, and the control group. Results. The frequency of realization of physiological patterns in children in the treatment group was 65.5%, and in the control group was 89.6%. The occurrence of the functional disorders of the musculoskeletal system was as follows: pathological functional kyphosis in the lumbar spine in children in the treatment group occurred in 73.1%, and in the control group in 26.9%; sitting on the sacrum occurred in 73.1% in the treatment group, and 26.9 % in the control group; impaired coordination in the treatment group occurred in 53.9%, and in 46.1% in the control group; decreased balance function in the treatment group occurred in 61.5%, and in 38.5% in the control group. Conclusion. Correct interaction with a child in the first year of life, in combination with physiological stimulation corresponding to the developmental milestones of the nervous system, allows the child to implement their motor skills in a timely manner, without disrupting the natural sequence of motor development, and minimizes the risks of functional disorders of the musculoskeletal system.


Author(s):  
Rajendra Kumar Kinagi ◽  
Rashmi Pareek

Rectal prolapse is protrusion of some or all layers of wall of rectum. In infants, the prolapse usually involves all layers of wall of rectum called as complete prolapse or Procidentia. In children its incidence is higher during first year of life. It has several causes such as constipation, diarrhoea, malnutrition, muscular weakness, worm infestation etc. but mostly it occurs due to straining associated with chronic constipation. Usually it is a self-limiting entity most of which resolves spontaneously within 1 year of life. It is managed by dietary modification, toilet training along with some sort of conservative treatment but sometimes it may require surgical treatment. In Ayurveda, it is described as Gudabhranshaand caused by excessive straining anddiarrhoea. There are several treatments available in Ayurveda which can help in early resolution of disease or reduce the chances of having surgery for correction. In this review article we assess the various treatment modalities available in Ayurveda along with contemporary medical science which can be used in the better management of Rectal Prolapse.


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