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Bradshaw J, Shi D, Federico A, Klaiman C, Saulnier C. The Pull-to-Sit Task: Examining Infant Postural Development in Autism Spectrum Disorder. J Pediatr 2023; 253:225-231.e2. [PMID: 36202237 PMCID: PMC11009487 DOI: 10.1016/j.jpeds.2022.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To evaluate the predictive relationship between early trajectories of postural and head control during a pull-to-sit task and later autism diagnostic and developmental outcomes. STUDY DESIGN Using a prospective longitudinal design, postural skills of 100 infants at elevated and low familial likelihood of autism spectrum disorder (ASD) were evaluated using a pull-to-sit task monthly from age 1 month to 6 months. At age 24 months, infants were seen for a developmental and diagnostic evaluation completed by examiners masked to participant group. Latent growth curve models were used to compare early trajectories of pull-to-sit performance in infants later diagnosed with ASD and typically developing infants and to predict developmental outcomes. RESULTS Pull-to-sit trajectories did not differ in infants with an elevated likelihood of ASD or infants with ASD compared with low-likelihood and typically developing infants, but infants with ASD were more likely to exhibit a head lag by age 4 months. In addition, pull-to-sit trajectories were predictive of social and speech skills 2 years later. CONCLUSIONS These findings highlight the link between very early pull-to-sit skills and later social and language outcomes. Atypical postural development and persistent presence of head lag may be important early indicators of social and language vulnerabilities, including ASD.
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Affiliation(s)
- Jessica Bradshaw
- Department of Psychology, University of South Carolina, Columbia, SC.
| | - Dexin Shi
- Department of Psychology, University of South Carolina, Columbia, SC
| | - Alexis Federico
- Department of Psychology, University of South Carolina, Columbia, SC
| | - Cheryl Klaiman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
| | - Celine Saulnier
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Neurodevelopmental Assessment & Consulting Services, Atlanta, GA
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Meether M, Bush CN, Richter M, Pineda R. Neurobehaviour of very preterm infants at term equivalent age is related to early childhood outcomes. Acta Paediatr 2021; 110:1181-1188. [PMID: 32985000 PMCID: PMC8299513 DOI: 10.1111/apa.15595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/18/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022]
Abstract
AIM To describe neurodevelopmental outcomes during early childhood among infants born very preterm and define the relationships between neurobehaviour of very preterm infants and neurodevelopmental outcomes at 4 years. METHODS Forty-eight infants born ≤32 weeks gestation had neurobehaviour assessed at term equivalent age using the NICU Network Neurobehavioral Scale (NNNS). Outcomes at 4 years were assessed with the Ages and Stages Questionnaire (ASQ-3), the Sensory Profile-Short Form (SF) and the Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P). RESULTS At 4 years, 23 (48%) children had at least one below average score on the ASQ-3, 15 (31%) had a below average total score on the Sensory Profile-SF, and 3 (6%) had an abnormal total score on the BRIEF-P. Children with lower fine motor scores at 4 years had poorer orientation (P = 0.03) and self-regulation (P =0.03), hypertonia (P = 0.01), and more sub-optimal reflexes (P = 0.02) as neonates. Children with lower gross motor scores at 4 years of age had more sub-optimal reflexes (P = 0.03) and lethargy (P = 0.046) as neonates. Children with tactile sensitivity at 4 years of age had poorer orientation (P = 0.01) and tolerance of handling (P = 0.03) as neonates. Children with decreased responsiveness at 4 years of age had low arousal (P = 0.02) as neonates, and those with poor auditory filtering at age 4 years had hypotonia (P = 0.03) as neonates. CONCLUSION Early neurobehaviour is related to neurodevelopmental outcome in early childhood.
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Affiliation(s)
- Margaret Meether
- Washington University Program in Occupational Therapy, St. Louis MO
| | - Cathy Niles Bush
- Synova Associates, LLC, Milwaukee, WI
- Tarry Medical Products, Danbury, CT
| | - Marinthea Richter
- University of Southern California, Chan Division of Occupational Science and Occupational Therapy
| | - Roberta Pineda
- Washington University Program in Occupational Therapy, St. Louis MO
- University of Southern California, Chan Division of Occupational Science and Occupational Therapy
- Keck School of Medicine, Department of Pediatrics
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Abstract
UNLABELLED Preterm birth is associated with medical problems affecting the neuroendocrine system, altering cortisol levels resulting in negative effects on newborn neurobehavior. Newborn neurobehavior is regulated by DNA methylation of NR3C1 and HSD11B2. AIM Determine if methylation of HSD11B2 and NR3C1 is associated with neurobehavioral profiles in preterm infants. PATIENTS & METHODS Neurobehavior was measured before discharge from the hospital in 67 preterm infants. Cheek swabs were collected for DNA extraction. RESULTS Infants with the high-risk neurobehavioral profile showed more methylation than infants with the low-risk neurobehavioral profile at CpG3 for NR3C1 and less methylation of CpG3 for HSD11B2. Infants with these profiles were more likely to have increased methylation of NR3C1 and decreased methylation of HSD11B2 at these CpG sites. CONCLUSION Preterm birth is associated with epigenetic differences in genes that regulate cortisol levels related to high-risk neurobehavioral profiles.
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Affiliation(s)
- Barry M Lester
- Brown Center for the Study of Children at Risk, Providence, RI, USA
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Carmen J Marsit
- Departments of Pharmacology & Toxicology & Community & Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - James Giarraputo
- Brown Center for the Study of Children at Risk, Providence, RI, USA
- Department of Neuroscience, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Katheleen Hawes
- Brown Center for the Study of Children at Risk, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Linda L LaGasse
- Brown Center for the Study of Children at Risk, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - James F Padbury
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA
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Pineda R, Neil J, Dierker D, Smyser C, Wallendorf M, Kidokoro H, Reynolds L, Walker S, Rogers C, Mathur A, Van Essen D, Inder T. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr 2014; 164:52-60.e2. [PMID: 24139564 PMCID: PMC3872171 DOI: 10.1016/j.jpeds.2013.08.047] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 07/17/2013] [Accepted: 08/22/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate associations between neonatal intensive care unit (NICU) room type (open ward and private room) and medical outcomes; neurobehavior, electrophysiology, and brain structure at hospital discharge; and developmental outcomes at 2 years of age. STUDY DESIGN In this prospective longitudinal cohort study, we enrolled 136 preterm infants born <30 weeks gestation from an urban, 75-bed level III NICU from 2007-2010. Upon admission, each participant was assigned to a bedspace in an open ward or private room within the same hospital, based on space and staffing availability, where they remained for the duration of hospitalization. The primary outcome was developmental performance at 2 years of age (n = 86 infants returned for testing, which was 83% of survivors) measured using the Bayley Scales of Infant and Toddler Development, 3rd Edition. Secondary outcomes were: (1) medical factors throughout the hospitalization; (2) neurobehavior; and (3) cerebral injury and maturation (determined by magnetic resonance imaging and electroencephalography). RESULTS At term equivalent age, infants in private rooms were characterized by a diminution of normal hemispheric asymmetry and a trend toward having lower amplitude integrated electroencephalography cerebral maturation scores (P = .02; β = -0.52 [CI -0.95, -0.10]). At age 2 years, infants from private rooms had lower language scores (P = .006; β = -8.3 [CI -14.2, -2.4]) and a trend toward lower motor scores (P = .02; β = -6.3 [CI -11.7, -0.99]), which persisted after adjustment for potential confounders. CONCLUSION These findings raise concerns that highlight the need for further research into the potential adverse effects of different amounts of sensory exposure in the NICU environment.
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Affiliation(s)
- Roberta Pineda
- Department of Occupational Therapy, Washington University School of Medicine, St Louis, Missouri
,Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Jeff Neil
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
,Department of Neurology, Washington University School of Medicine, St Louis, Missouri
,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Donna Dierker
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, Missouri
| | - Chris Smyser
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
,Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Michael Wallendorf
- Department of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Lauren Reynolds
- Department of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Stephanie Walker
- Department of Occupational Therapy, Washington University School of Medicine, St Louis, Missouri
| | - Cynthia Rogers
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Amit Mathur
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - David Van Essen
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, Missouri
| | - Terrie Inder
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
,Department of Neurology, Washington University School of Medicine, St Louis, Missouri
,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
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Bolten M, Nast I, Skrundz M, Stadler C, Hellhammer DH, Meinlschmidt G. Prenatal programming of emotion regulation: neonatal reactivity as a differential susceptibility factor moderating the outcome of prenatal cortisol levels. J Psychosom Res 2013; 75:351-7. [PMID: 24119942 DOI: 10.1016/j.jpsychores.2013.04.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 04/23/2013] [Accepted: 04/29/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Hypothalamic-pituitary-adrenal (HPA) activation during pregnancy is linked to dysfunctional behavioral outcomes in the offspring. According to Belsky's differential susceptibility hypothesis, individuals vary regarding their developmental plasticity. Translating the differential susceptibility hypothesis to the field of fetal programming, we hypothesize that infants' temperament, as the constitutionally based reactivity to stimulation, moderates prenatal environmental effects on postnatal emotion regulation. METHODS Maternal HPA axis activity and stress-reactivity during pregnancy was estimated, by measuring cortisol concentrations in saliva, collected at 0, 30, 45 and 60 min after awakening and in blood, collected during a laboratory stress test (Trier Social Stress Test), respectively. Newborns reactivity to stimulation was evaluated between postnatal day 10 and 14 using the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Infant's self-quieting-activities, as an indicator of emotion regulation, were evaluated at the age of six months during the still face paradigm. RESULTS Maternal cortisol reactivity to stress during pregnancy was associated with infant's emotion regulation at the age of six months. Whereas cortisol levels after awakening in mid and late pregnancy were not associated with emotion regulation. Furthermore, regression analyses revealed that in interaction with neonatal reactivity, both, prenatal maternal HPA activity as well as prenatal maternal HPA reactivity to stress predicted emotion regulation. CONCLUSION The findings indicate that newborns' reactivity to stimulation is moderating the association between prenatal exposure to maternal glucocorticoids and emotion regulation in infancy. Data suggests that temperamental characteristics of the newborn are a relevant differential susceptibility factor with regard to prenatal effects on emotion regulation.
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Affiliation(s)
- Margarete Bolten
- Psychiatric University Clinics of Basel, Department of Child and Adolescent Psychiatry, Switzerland; sesam - Swiss Etiological Study of Adjustment Mental Health, National Centre of Competence in Research, Faculty of Psychology, University of Basel, Switzerland.
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Abstract
There is growing evidence that bisphenol A (BPA) may adversely affect humans. BPA is an endocrine disruptor that has been shown to be harmful in laboratory animal studies. Until recently, there were relatively few epidemiological studies examining the relationship between BPA and health effects in humans. However, in the last year, the number of these studies has more than doubled. A comprehensive literature search found 91 studies linking BPA to human health; 53 published within the last year. This review outlines this body of literature, showing associations between BPA exposure and adverse perinatal, childhood, and adult health outcomes, including reproductive and developmental effects, metabolic disease, and other health effects. These studies encompass both prenatal and postnatal exposures, and include several study designs and population types. While it is difficult to make causal links with epidemiological studies, the growing human literature correlating environmental BPA exposure to adverse effects in humans, along with laboratory studies in many species including primates, provides increasing support that environmental BPA exposure can be harmful to humans, especially in regards to behavioral and other effects in children.
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Key Words
- 17-beta estradiol
- 8-OHdG
- 8-hydoxydeoxyguanosine
- A European population representative sample (Chianti, Italy)
- AGD
- ANA
- BADGE
- BASC-2
- BMI
- BPA
- BRIEF-P
- Behavior Rating Inventory of Executive Function-Preschool
- Behavioral Assessment System for Children
- Bisphenol A
- C-reactive protein
- CAD
- CBCL
- CHAMACOS
- CHD
- CMV
- CRP
- CVD
- Child Behavior Checklist
- DBP
- DHEAS
- Development
- E2
- ECN
- EFS
- EH
- EPIC-Norfolk Study
- ER
- Endocrine-disrupting chemicals
- Epidemiology
- FAI
- FDA
- FSH
- FT
- Food and Drug Administration
- HDL
- HOMES
- HRV
- HbA1c
- Human
- IL-6
- ISCI
- IVF
- InCHIANTI
- LDL
- LH
- MDA
- MGH
- MaGiCAD
- Massachusetts General Hospital (United States)
- Metabolic disease
- NECAT
- NHANES
- NICU Network Neurobehavioral Scale
- NNNS
- National Health and Nutrition Examination Survey (United States)
- OHAT
- Office of Health Assessment and Translation
- PCOS
- PFOA
- PFOS
- PIVUS
- Reproduction
- SBP
- SCE
- SFF
- SHBG
- SRS
- Social Responsiveness Scale
- T
- T3
- T4
- TDI
- TSH
- The Center for the Health Assessment of Mothers and Children of Salinas, Salina, CA
- The European Prospective Investigation into Cancer and Nutrition Cohort Study, consisting of over 500,000 people (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden and the United Kingdom)
- The Health Outcomes and Measures of the Environment Study (United States)
- The Metabolomics and Genomics in Coronary Artery Disease Study (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden and the United Kingdom)
- The New England Children's Amalgam Trial (United States)
- The Study for Future Families, USA
- The Vasculature in Uppsala Seniors Study (Uppsala, Sweden)
- Thyroid
- UCSF
- USEPA
- United Sates Environmental Protection Agency
- University of California, San Francisco
- VCL
- anogenital distance
- antinuclear antibodies
- bisGMA
- bisphenol A
- bisphenol A diglycidyl ether
- bisphenol A-glycidyl methacrylate
- body mass index
- cardiovascular disease
- coronary artery disease
- coronary heart disease
- curvilinear velocity (μm/s)
- cytomegalovirus
- dehydroepiandrosterone sulfate
- diastolic blood pressure
- embryo cell number
- embryo fragmentation score
- endometrial hyperplasia
- estrogen receptor
- follicle-stimulating hormone
- free androgen index (total T divided by SHBG)
- free testosterone
- hCG
- heart rate variability
- hemoglobin A1c
- high-density lipoprotein
- human chorionic gonadotropin
- in vitro fertilization
- interleukin-6
- intracytoplasmic sperm injection
- low-density lipoprotein
- luteinizing hormone
- malondialdehyde
- perfluorooctane sulfonate
- perfluorooctanoic acid
- polycystic ovary syndrome
- reverse transcription polymerase chain reaction
- rtPCR
- sex hormone binding globulin
- sister chromatid exchange
- systolic blood pressure
- thyroid stimulating hormone
- thyroxine
- tolerable daily intake
- total testosterone
- triidothyronine
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Affiliation(s)
- Johanna R Rochester
- The Endocrine Disruption Exchange (TEDX), P.O. Box 1407, Paonia, CO 81428, United States.
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Abstract
A review of the research on the NICU Network Neurobehavioral Scale (NNNS) is presented. The NNNS has good psychometric properties and reliability. Standardized norms are available for it. It was found to be sensitive to a wide variety of medical, exposure, and demographic variables and has robust predictive validity. It will be useful for nurses for detecting neurobehavioral problems and management of the young infant.
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Affiliation(s)
- Ed Tronick
- University of Massachusetts, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts, USA.
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