Risk factors analysis for early childhood caries

Aim. To study the dominant antenatal and postnatal risk factors for development early childhood caries (12 – 47 months).Materials and methods. In order to study the dental morbidity of the child population aged 1 to 3 years, permanently living in Moscow, an epidemiological examination of 510 children was carried out. To determine the dental status of the subjects, clinical research methods were carried out. To assess antenatal and postnatal risk factors for the development of caries in children aged 1 to 3 years, a questionnaire survey was conducted between parents or legal representatives. The survey participants answered 5 questions that are important for understanding the causes of early tooth decay.Conclusions. With growing up, the prevalence of caries increases. The prevalence of Early Childhood Caries among the boys and the girls aged 12-23 months and 24-35 months depends on the sex of the child. A statistically significant difference in the intensity of caries in different age groups was revealed; the older the age group, the higher the intensity of caries. The risk of caries in children in the group with the pathological course of the mother's pregnancy is higher than in the group with the normal course of pregnancy. A statistically significant relationship was found between the prevalence of caries in children and the age at which toothbrushing began.

The Brain and Early Experience Study: Protocol for a Prospective Observational Study (Preprint)

BACKGROUND Children raised in conditions of poverty (or near-poverty) are at risk for nonoptimal mental health, educational, and occupational outcomes, many of which may be precipitated by individual differences in EF skills that first emerge in early childhood. OBJECTIVE The Brain and Early Experience (BEE) study considers prenatal and postnatal experiences that may mediate the association between poverty and EF skills, including their neural substrates. This manuscript describes (1) the study rationale and aims; (2) research design issues, including sample size determination, the recruitment strategy, and participant characteristics; and (3) a summary of developmental assessment points, procedures, and measures used to test the study hypotheses. METHODS This is a prospective longitudinal study examining multiple pathways by which poverty influences normative variations in executive function (EF) skills in early childhood. It is funded by the National Institute of Child Health and Human Development with Institutional Review Board approval. Recruitment is completed with a sample of N = 203 and data collection is expected to continue from September of 2018 to February 2024. RESULTS Analysis plans and validation data supporting the recruitment strategy is provided. Conclusions: BEE Study data and analyses will help elucidate the complex interplay between prenatal and postnatal risk factors that may undermine critical neurocognitive developmental outcomes in early childhood. CONCLUSIONS Findings will help elucidate the complex interplay between prenatal and postnatal risk factors affecting critical neurocognitive developmental outcomes in early childhood.

ASSOCIATION OF CARDIOVASCULAR RISK IN CHILDREN BORN WITH LOW BIRTH WEIGHT

INTRODUCTION: Most studies of early programming focus on very LBWor extremely LBW, even though the majority of all LBWchildren are 2 born only with marginally LBW. The pathogenesis behind CVD is multifactorial, and for health care providers to be able to assess the risk of each individual, we need to know more about this common subgroup. AIM:Being born with LBWaffects later cardiovascular risk. RESUILT: In Marginally LBW group, 4.7(0.6) patients had Fasting glucose(mmol/L), 2.7(2.3-3.8) patients had Fasting insulin(µU/mL), 0.57(0.4-0.8) patients had HOMA-IR, 4.4(0.7) patients had Cholesterol(mmol/L), 0.50(0.2) patients had Triglyceride(mmol/L), 2.7(0.6) patients had LDL(mmol/L), 1.5(0.3) patients had HDL(mmol/L), 0.82(0.2) patients had ApoB(g/L), 1.4(0.2) patients had ApoA1 (g/L), 0.51(0.3) patients had ApoB/ApoA1and 0.24(0.1-0.7) patients had hs-CRP(mg/L). In Controls group, 3.5(0.5) patients had Fasting glucose(mmol/L), 2.8(LD-3.5) patients had Fasting insulin(µU/mL), 0.60(LD-0.7) patients had HOMA-IR, 5.5(0.8) patients had Cholesterol(mmol/L), 0.57(0.2) patients had Triglyceride(mmol/L), 2.9(0.7) patients had LDL(mmol/L), 1.4(0.3) patients had HDL(mmol/L), 0.71(0.2) patients had ApoB(g/L), 1.4(0.2) patients had ApoA1 (g/L), 0.57(0.1) patients had ApoB/ApoA1and 0.18(0.1-0.5) patients had hs-CRP(mg/L). CONCLUSION: Some risk factors originating from the fetal environment cannot be changed after birth, good cardiovascular health can be restored by inuencing postnatal risk factors before adulthood. There were no signicant differences in insulin, insulin resistance, hs-CRPor blood lipids between the marginally LBWchildren and controls.

Risk Factors and Bronchopulmonary Dysplasia Severity. Data From the Spanish Bronchopulmonary Dysplasia Research Network

GEIDIS is a national based research-net registry of patients with bronchopulmonary dysplasia (BPD) from public and private Spanish hospitals. It was created to provide data on the clinical characterization and follow up of infants with BPD until adulthood. The purpose of this observational study was to analyze the characteristics and the impact of perinatal risk factors on BPD severity. The study included 1,780 patients diagnosed with BPD. Of the total sample, 98.6% were premature (less than 37 weeks) and 89,4% less than 30 weeks of gestation. The median gestational age was 27.1 weeks (25.8–28.5) and median birth weight 890 g (740–1,090 g). 52.3% (n=931) were classified as mild (type 1), 25.1% (n=447) were moderate (type 2), and 22.6% (n=402) severe BPD (type 3). Most pre-and postnatal risk factors for type 2/3 BPD were associated with the length of exposure to mechanical ventilation (MV). Independent prenatal risk factors were male gender, oligohydramnios, and intrauterine growth restriction. Postnatal risk factors included the need for FiO2 of > 0.30 in the delivery room, two or more doses of surfactant administration, nosocomial pneumonia, and the length of exposure to MV. Conclusions: In this national based research-net registry of BPD patients the length of MV is the most important risk factor associated with type 2/3 BPD. Among type 3 BPD patients, those who required an FiO2 > .30 at 36 weeks’ postmenstrual age had a higher morbidity, during hospitalization and at discharge, compared to those with nasal positive pressure but FiO2 < .30.

Validation of the DIGIROP-birth model in a Chinese cohort

Background We aimed to validate the predictive performance of the DIGIROP-Birth model for identifying treatment-requiring retinopathy of prematurity (TR-ROP) in Chinese preterm infants to evaluate its generalizability across countries and races. Methods We retrospectively reviewed the medical records of preterm infants who were screened for retinopathy of prematurity (ROP) in a single Chinese hospital between June 2015 and August 2020. The predictive performance of the model for TR-ROP was assessed through the construction of a receiver-operating characteristic (ROC) curve and calculating the areas under the ROC curve (AUC), sensitivity, specificity, and positive and negative predictive values. Results Four hundred and forty-two infants (mean (SD) gestational age = 28.8 (1.3) weeks; mean (SD) birth weight = 1237.0 (236.9) g; 64.7% males) were included in the study. Analyses showed that the DIGIROP-Birth model demonstrated less satisfactory performance than previously reported in identifying infants with TR-ROP, with an area under the receiver-operating characteristic curve of 0.634 (95% confidence interval = 0.564–0.705). With a cutoff value of 0.0084, the DIGIROP-Birth model showed a sensitivity of 48/93 (51.6%), which increased to 89/93 (95.7%) after modification with the addition of postnatal risk factors. In infants with a gestational age < 28 weeks or birth weight < 1000 g, the DIGIROP-Birth model exhibited sensitivities of 36/39 (92.3%) and 20/23 (87.0%), respectively. Conclusions Although the predictive performance was less satisfactory in China than in developed countries, modification of the DIGIROP-Birth model with postnatal risk factors shows promise in improving its efficacy for TR-ROP. The model may also be effective in infants with a younger gestational age or with an extremely low birth weight.

The risk of forming neurological disease in extremely premature infants: a review of literature and clinical cases

Introduction. Premature infants are at risk of developing central nervous system malformations; therefore, increased survival rates among infants with very low birth weight and extremely low birth weight have contributed to the rise in prevalence of neurologic deficit in extremely premature infants.Purpose. To summarize the literature data and demonstrate rare family clinical observations of preterm infants associated with adverse neurological outcomes as a result of exposure to various perinatal factors.Materials and methods. For the literature review, we used data from full-text scientific research from international scientific databases. The influence of ante-, intra-, and postnatal risk factors on the neurological outcome of the disease was studied in two male sibs born at 27 weeks of gestation with a weight of 980 and 970 grams, a body length of 34 and 33 cm, and an Apgar score of 5/7 and 6/7, respectively. The analysis of anamnestic data and results of clinical and laboratory-instrumental examination was performed; the catamnestic observation was 24 adjusted months of life.Results.The presented observations revealed a combination of various ante-, intra-and postnatal risk factors that lead to CNS damage in preterm infants. The obtained results indicate that prematurity and extremely low birth weight are not the only risk factors for neurological disorders, but the burdened neonatal period (congenital sepsis, bronchopulmonary dysplasia, lung atelectasis, neonatal convulsions, and 2-degree intraventricular hemorrhage verified by USC/MRI of the brain on both sides) contributed to the formation of neurogolic pathology in the second examined sibs. The results obtained can be considered preliminary, and a larger study is needed.Conclusion.Thus, the obtained results indicate that prematurity, extremely low birth weight and low Apgar score are not the only risk factors for the formation of neurological disorders. A combination of several significant ante-, intra-, and postnatal risk factors is necessary for the development of severe perinatal CNS damage, the formation of adverse neurological outcomes, and severe delay in motor and psycho - speech development in preterm infants. The prognosis of neurological outcome in a preterm baby requires long-term dynamic monitoring and a comprehensive approach using clinical and instrumental diagnostic methods. The results obtained can be considered preliminary, requiring additional more extensive research.

Validation of The DIGIROP-Birth Model in A Chinese Cohort

Background We aimed to validate the predictive performance of the DIGIROP-Birth model for identifying treatment-requiring retinopathy of prematurity (TR-ROP) in Chinese preterm infants to evaluate its generalizability across countries and races. Methods We retrospectively reviewed the medical records of preterm infants who were screened for retinopathy of prematurity (ROP) in a single Chinese hospital between June 2015 and August 2020. The predictive performance of the model for TR-ROP was assessed through the construction of a receiver-operating characteristic (ROC) curve and calculating the areas under the ROC curve (AUC), sensitivity, specificity, and positive and negative predictive values. Results Four hundred and forty-two infants (mean (SD) gestational age = 28.8 (1.3) weeks; mean (SD) birth weight = 1237.0 (236.9) g; 64.7% males) were included in the study. Analyses showed that the DIGIROP-Birth model demonstrated less satisfactory performance than previously reported in identifying infants with TR-ROP, with an area under the receiver-operating characteristic curve of 0.634 (95% confidence interval = 0.564–0.705). With a cutoff value of 0.0084, the DIGIROP-Birth model showed a sensitivity of 48/93 (51.6%), which increased to 89/93 (95.7%) after modification with the addition of postnatal risk factors. In infants with a gestational age < 28 weeks or birth weight < 1000 g, the DIGIROP-Birth model exhibited sensitivities of 36/39 (92.3%) and 20/23 (87.0%), respectively. Conclusions Although the predictive performance was less satisfactory in China than in developed countries, modification of the DIGIROP-Birth model with postnatal risk factors shows promise in improving its efficacy for TR-ROP. The model may also be effective in infants with a younger gestational age or with an extremely low birth weight.

Interplay of Prenatal and Postnatal Risk Factors in the Behavioral and Histological Features of a “Two-Hit” Non-Genetic Mouse Model of Schizophrenia

Schizophrenia is a multifactorial developmental neuropsychiatric disorder. This study examined the interplay of maternal infection and postweaning social isolation, which are prenatal and postnatal risk factors, respectively. Pregnant mice received poly I:C or saline injection on gestation day 9 and the pups were weaned at postnatal day 28. After weaning, male offspring were randomly assigned into group-rearing and isolation-rearing groups. In their adulthood, we performed behavioral tests and characterized the histochemical features of their mesocorticolimbic structures. The sociability and anxiety levels were not affected by either manipulation, but synergistic effects of the two hits on stress-coping behavior was observed. Either of the single manipulations caused defects in sensorimotor gating, novel object recognition and spatial memory tests, but the combination of the two hits did not further exacerbate the disabilities. Prenatal infection increased the number of dopaminergic neurons in midbrain, whereas postweaning isolation decreased the GABAergic neurons in cortex. Single manipulation reduced the dendritic complexity and spine densities of neurons in the medial prefrontal cortex (mPFC) and dentate gyrus. Our results support the current perspective that disturbances in brain development during the prenatal or postnatal period influence the structure and function of the brain and together augment the susceptibility to mental disorders, such as schizophrenia.