The impact of ever breastfeeding on children ages 12 to 36 months: A secondary data analysis of the standardization study of the Dominican system for evaluating early childhood development

Extensive research has shown that breastfeeding offers many benefits to children, including advantages in lifelong health, physical development, cognitive function, behavior, and brain development, compared to those not breastfed. In the Dominican Republic, the prevalence of exclusive breastfeeding among infants aged 0-6 months remains low, and the lack of a surveillance system has made it challenging to measure the impact of breastfeeding on early childhood development (ECD). This study aims to address the effect of ever breastfeeding on ECD. We conducted secondary data analysis from the Dominican System for Measuring Early Childhood Development (SIMEDID), a screening tool adapted and validated to the Dominican context that measures four areas of development: gross-motor, fine-motor, language, and socioemotional development. The data from SIMEDID can be cross-analyzed with other datasets generated by the National Institute for Early Childhood Comprehensive Care (INAIPI) that include information about breastfeeding. The children were evaluated during the standardization study of SIMEDID. To determine the breastfeeding impact, we: 1) conducted an analysis of covariance using ECD scores as dependent variables and ever breastfed as the independent variable, with age and sex as covariates (previously confirmed with an analysis of variance indicating the relevance of age and sex at birth in ECD); 2) analyzed the relative risk (RR) of developmental delay by breastfeeding status. We studied a sample of 699 Dominican children aged 12-36 months who receive services at INAIPI (the government institution responsible for administering comprehensive early childhood services). The results show that ever breastfed children had higher scores in overall ECD than those who were not; higher scores in language and fine motor development primarily drove this effect. The never breastfed group had a greater risk of developmental delay in fine motor and socioemotional development. These findings underscore the importance of promoting and supporting breastfeeding to improve child neurodevelopmental outcomes. This is particularly relevant in low-resource settings, where mothers may need additional support. Moreover, the study's results provide evidence of SIMEDID's validation, which can help inform future research and evidence-based decision-making toward optimal ECD in similar contexts.

A review of dairy food intake for improving health among black infants, toddlers, and young children in the US

Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children. Among breastfeeding mother-child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns. For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk - which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age. For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being - with important impacts on their taste perception, microbiome composition, and immune function. According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups still provide significant challenges to achieving adequate nutrition during these early life stages. For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US. For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, dairy-based infant formulas are considered the next best option for meeting nutritional needs. Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development. Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities - some of which may have lifelong consequences on physical and mental health. A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life. However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children. Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed. This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population.

Children perceive illusory faces in objects as male more often than female

Face pareidolia is the experience of seeing illusory faces in inanimate objects. While children experience face pareidolia, it is unknown whether they perceive gender in illusory faces, as their face evaluation system is still developing in the first decade of life. In a sample of 412 children and adults from 4 to 80 years of age we found that like adults, children perceived many illusory faces in objects to have a gender and had a strong bias to see them as male rather than female, regardless of their own gender identification. These results provide evidence that the male bias for face pareidolia emerges early in life, even before the ability to discriminate gender from facial cues alone is fully developed. Further, the existence of a male bias in children suggests that any social context that elicits the cognitive bias to see faces as male has remained relatively consistent across generations.

Bodyweight and human capital development: Assessing the impact of obesity on socioemotional skills during childhood in Chile

This article analyzes the effect of bodyweight on socioemotional skills for children aged two to 12 years in Chile. Using an instrumental variable approach and a representative survey, we show that both BMI and obesity are causality related to children's socioemotional development, even after assuming that our instrument is imperfect. Although we did not find significant differences between boys and girls, we do identify heterogeneous effects by age: the weight penalty for girls starts earlier than for boys. Our findings suggest that early interventions for childhood obesity not only might generate positive impacts on children's health, but also a greater accumulation of non-cognitive human capital in the future.

Development of children born after in vitro maturation with a prematuration step versus natural conception: a prospective cohort study

PURPOSE

IVM preceded by a prematuration step (capacitation [CAPA]-IVM) improves the acquisition of oocyte developmental competence and can enhance embryo quality. There is currently no follow-up data on babies born from CAPA-IVM. This study investigated developmental outcomes in children born after CAPA-IVM versus natural conception.

METHODS

This prospective cohort study was conducted at a fertility clinic in Vietnam in August/September 2019. Children born after CAPA-IVM were propensity score-matched with those born after natural conception. All parents were asked to complete the Developmental Red Flags and Ages & Stages Third Edition (ASQ-3) questionnaires.

RESULTS

A total of 46 parents (23 in each group) of 55 babies (31 CAPA-IVM and 24 natural conception) were included in the study. Baseline characteristics, including mother's age and body mass index, gestational age at delivery, and birth weight, were comparable. The mean age of children at the end of follow-up was 15 months. The overall proportion of children with any abnormal ASQ-3 score was 6.5% in the CAPA-IVM group and 20.8% in the natural conception group (p = 0.24). The proportion of children with a developmental red flag did not differ significantly between the CAPA-IVM and natural conception groups (9.7% vs. 4.2%; p = 0.80).

CONCLUSIONS

The use of CAPA-IVM did not have any significant impact on childhood physical and mental development compared with children born as a result of natural conception.

Chronic social stress during early development elicits unique behavioral changes in adulthood

Purpose

Chronic social stress is known to induce inflammation in the brain, and early-life stress affects the brain and social behavior in adulthood. To study the relationship between social stress in childhood development and social behavior in adulthood, we subjected mice to a sequential early-life social stresses and characterized their adult behavioral phenotypes.

Methods

C57BL/6 mice were sequentially subjected to maternal separation (MS), social defeat (SD), and social isolation (SI) in that order. The body weights of the MS/SD/SI mice were measured. Behavioral tasks related to anxiety, depression, locomotion, learning/memory, and repetitive/compulsive-like behavior were conducted. Social behaviors suggesting sociability, social interaction, aggression, and social fear were investigated.

Results

MS/SD/SI mice weighed less than the control mice. At 7 and 8 weeks of age. These mice displayed normal behaviors in anxiety-, depression-, and learning/memory-related tasks, but they exhibited increased locomotor activity and a low level of repetitive/compulsive-like behavior. Notably, they exhibited increased social interaction, impaired empathy-related fear, reduced predator fear, and increased defensive aggressiveness.

Conclusion

Social stress during childhood development resulted in behavioral alterations, and MS/SD/SI mice generated by mimicking child abuse or maltreatment showed unique abnormalities in social behaviors. MS/SD/SI mice might be useful not only to study the relationship between social stress and brain inflammation but also psychosocial behaviors observed in individuals with brain disorders, such as psychopaths.

The nature of coordination and control problems in children with developmental coordination disorder during ball catching: A systematic review

The aim of this review was to examine what is presently known about the nature of motor coordination and control problems in children with developmental coordination disorder (DCD) during ball catching and to provide directions for future research. A systematic literature search was conducted using four electronic databases (PubMed, Embase, PsycINFO and Web of Science), which identified 15 eligible studies. The results of the included studies were discussed, structured around the target population characteristics, the task used to measure motor coordination and control aspects, and the type of outcome. Children with DCD experience difficulties with both motor coordination and control during ball catching. They have been suggested to apply four compensation strategies to overcome these difficulties: a later initiation of the reaching phase, an earlier initiation of the grasping phase, a higher degree of coupling of the joints both intra- and inter-limb, and fixating the joints. However, despite these compensation strategies, children with DCD still caught fewer balls than typically developing children in all studies. This was especially due to a higher amount of grasping errors, which indicates a problem with the timing of the grasping phase. Directions for future research and practical implications were discussed.

Early Parenting Characteristics Associated with Internalizing Symptoms Across Seven Waves of the Longitudinal Study of Australian Children

The aim of this study was to identify whether parenting style during a child's toddler years predicts the course of the child's internalising symptoms throughout early to middle childhood. The current study uses data from waves 1 to 7 (acquired biennially) of the infant cohort (N = 4494) of Growing up in Australia: the Longitudinal Study of Australian Children (LSAC), a population-based longitudinal study. Latent class growth analysis identified four distinct longitudinal trajectories of internalizing symptoms: Low stable (66% of the children), High increasing (7%), Low increasing (17%) and High decreasing (10%). Multinomial logistic regression indicated that low self-efficacy and socioeconomic disadvantage during the toddler years were significant predictors of unfavourable (i.e., increasing) trajectories of internalizing symptoms across later childhood. Parenting hostility was a significant predictor of the low increasing trajectory. Additionally, male children were more likely than females to follow unfavourable trajectories. However, low parenting warmth was not predictive of increasing symptoms across time. Our findings highlight the importance of parenting factors in a child's early years, particularly the potentially detrimental outcomes associated with parental hostility and low self-efficacy.

Maternal depression is associated with altered functional connectivity between neural circuits related to visual, auditory, and cognitive processing during stories listening in preschoolers

BACKGROUND

Maternal depression can influence the early activity of a mother reading stories to a young child, as depressed mothers are less likely to read to their children. Here, maternal depression association to neurobiological circuitry of narrative comprehension, visualization, and executive functions during stories listening was examined in 21 4-year-old girls and their mothers. Maternal depression scores were collected from the mothers, and functional MRI during stories listening was collected from the children.

RESULTS

Increased maternal depression was related to decreased functional connectivity between visualization and auditory regions and increased connectivity between the right visual cortex and dorsolateral prefrontal cortex in the children.

CONCLUSIONS

This study highlights the need to monitor maternal depression and provide interventions to ensure positive linguistic outcomes in children.

Evaluation of an Evidence-based and Community-responsive Fatherhood Training Program: Providers' Perspective

BACKGROUND AND OBJECTIVES

Studies on male involvement and pregnancy outcomes have often not incorporated the providers' perspectives, which are potentially critical to understanding program context, evolution, perceived impact, and sustainability. We sought to evaluate the 24/7 Dad® program from the viewpoint of the program providers.

METHODS

We conducted purposive sampling of 24/7 Dad program facilitators and administrators who were involved in recruitment, training, and follow up of program participants within a federal Healthy Start program (REACHUP) in Tampa, Florida, USA. Using a snowballing approach, we recruited six key informants who had administered the program for at least four years. We elicited and evaluated factors impacting the performance of the father involvement program using content analysis.

RESULTS

Under program participation and perceived impact, most providers thought that the program had created a safe space previously unavailable for men in the community. The most useful recruitment strategy was building partnerships with other organizations. The key informants noted an important evolutionary trend in the father involvement program over time as well as the nature of linkages to partner organizations within the area. Threats to program sustainability included the continued reluctance and scepticism to invest funds to address male issues, sub-optimal retention of participants who were living transient lives as well as geographical/transportation barriers.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

The involvement of fathers during pregnancy has significant implications for healthy babies. Our study results provide a clarion call to augment capacity and infuse more resources to improve paternal involvement in order to attain the United Nations Sustainable Goal (2015-2030) of ensuring healthy lives and the promotion of well-being for all at all ages.

Developmental outcomes at age four following maternal antiepileptic drug use

We investigated whether prenatal antiepileptic drug (AED) exposure was associated with adverse outcomes in the Before School Check (B4SC) assessments, particularly the assessments measuring neurodevelopment. Children exposed to AEDs were identified by linking women dispensed AEDs in the Pharmaceutical Collection to births recorded on the National Minimum Dataset (NMDS). Multinomial logistic regression was used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for outcomes of the parent-completed Parental Evaluation of Developmental Status (PEDS) questionnaire and Strengths and Difficulties Questionnaire (SDQ), after adjusting for gender, ethnicity, and socioeconomic deprivation. Between 2012 and 2016, 606 children with a mother who had been dispensed one or more AEDs during pregnancy had taken part in the B4SC. Prenatal exposure to sodium valproate (n = 161) or lamotrigine (n = 149) monotherapy was associated with an increased risk of having an abnormal SDQ - parent-completed (SDQP) score, ≥17 - indicating emotional or behavioral concerns (9.32% of children exposed to sodium valproate monotherapy had an abnormal score; aRR: 2.11; 1.23-3.63; lamotrigine 8.05%; aRR: 2.21; 1.21-4.02). Prenatal exposure to carbamazepine monotherapy (n = 201) was not associated with an increased risk of having an abnormal total SDQP score but was associated with increased risks in the individual domains of the SDQP. Prenatal exposure to AED polytherapy (n = 57) was associated with the highest risk of abnormal SDQP scores (17.54% of children exposed to polytherapy had abnormal scores; aRR: 2.75; 1.25-6.02). Prenatal exposure to sodium valproate and lamotrigine is associated with an increased risk of concerns about emotional and behavioral development being reported by parents in a neurodevelopmental screening program. Additional investigation is required into why significant differences between AEDs were not seen in this study.

Emerging themes in food security: environmental justice, extended families and the multiple roles of grandmothers

BACKGROUND

Pre- and perinatal nutritional status defines the development of adult metabolism and energy balance in humans. Young children in poor households are disproportionately more vulnerable to food insecurity given the cumulative impact of chronic stress on susceptibility to chronic diseases as an adult. Qualitative studies focusing on the experience of food insecurity in Latin America are scarce. In Argentina, although socioeconomic indicators improved in the aftermath of the 2001ecomomic crisis, the disadvantaged provinces in the north continue to bear the burden of historical inequities. The study was conducted among Primary Health Care patients in the city of San Salvador de Jujuy, Argentina. It analyzes environmental and household level stressors through the narratives of mothers with young children living with food insecurity, from the perspectives of eco-developmental conceptual frameworks.

METHODS

We conducted 11 semi-structured interviews with mothers of children < 1 to 6 years of age who participated in maternal-child health programs in Primary Health Care clinics and lived in food insecure households. Interviews focused on the environmental context and the resources and processes for obtaining and preparing daily meals.

RESULTS

The Eco-bio-developmental (EBD) framework and the vulnerability-assets approach, provided a basis for conceptualizing the significance of findings. Our results indicated the need to understand pathways in the association of stressors, vulnerability and ill health, as well as the mitigating role of social relationships. For example, understanding the link between the stress of being exposed to environmental contaminants and the capacity to overcome food insecurity, or developing strategies to integrate the support provided by kinship networks like extended families into food security programs. The results also indicate the importance of developing support mechanisms for vulnerable family members like grandmothers in food insecure households who play instrumental roles as providers and caretakers of younger relatives.

CONCLUSION

The empirical evidence generated by this study may inform community based strategies and public health policies to address food insecurity in vulnerable population groups who face health effects from multiple stressors.

Reading, Mathematics and Fine Motor Skills at 5 Years of Age in US Children who were Extremely Premature at Birth

Objectives The prevalence of extreme prematurity at birth has increased, but little research has examined its impact on developmental outcomes in large representative samples within the United States. This study examined the association of extreme prematurity with kindergarteners' reading skills, mathematics skills and fine motor skills. Methods The early childhood longitudinal study-birth cohort, a representative sample of the US children born in 2001 was analyzed for this study. Early reading and mathematics skills and fine motor skills were compared among 200 extremely premature children (EPC) (gestational age <28 wks or birthweight <1000 g), 500 premature children (PC), and 4300 term children (TC) (≥37wks or ≥2500 g). Generalized linear regression analyses included sampling weights, children's age, race, sex, and general health status, and parental marital status and education among singleton children. Results At age 5 years, EPC were 2.6(95 % CI 1.7-3.8) times more likely to fail build a gate and were 3.1(95 % CI 1.6-5.8) times more likely to fail all four drawing tasks compared to TC (p values <0.001). Fine motor performance of PC (failed to build a gate, 1.3[95 % CI 1.0-1.7]; failed to draw all four shapes, 1.1[95 % CI 0.8-1.6]) was not significantly different from TC. Mean early reading scale score (36.8[SE:1.3]) of EPC was 4.0 points lower than TC (p value < 0.0001) while mean reading score (39.9[SE:1.4]) of PC was not significantly different from TC (40.8[SE:1.1]). Mean mathematics scale score were significantly lower for both EPC (35.5[SE:1.0], p value < 0.001) and PC (39.8[SE:0.8], p value = 0.023) compared to TC (41.0[SE:0.6]). Conclusions for Practice Extreme prematurity at birth was associated with cognitive and fine motor delays at age 5 years. This suggests that based on a nationally representative sample of infants, the biological risk of extreme prematurity persists after adjusting for other factors related to development.

Different neural substrates for precision stepping and fast online step adjustments in youth

Humans can navigate through challenging environments (e.g., cluttered or uneven terrains) by modifying their preferred gait pattern (e.g., step length, step width, or speed). Growing behavioral and neuroimaging evidence suggests that the ability to modify preferred step patterns requires the recruitment of cognitive resources. In children, it is argued that prolonged development of complex gait is related to the ongoing development of involved brain regions, but this has not been directly investigated yet. Here, we aimed to elucidate the relationship between structural brain properties and complex gait in youth aged 9–18 years. We used volumetric analyses of cortical grey matter (GM) and whole-brain voxelwise statistical analyses of white matter (WM), and utilized a treadmill-based precision stepping task to investigate complex gait. Moreover, precision stepping was performed on step targets which were either unperturbed or perturbed (i.e., unexpectedly shifting to a new location). Our main findings revealed that larger unperturbed precision step error was associated with decreased WM microstructural organization of tracts that are particularly associated with attentional and visual processing functions. These results strengthen the hypothesis that precision stepping on unperturbed step targets is driven by cortical processes. In contrast, no significant correlations were found between perturbed precision stepping and cortical structures, indicating that other (neural) mechanisms may be more important for this type of stepping.

The influence of mortality and socioeconomic status on risk and delayed rewards: a replication with British participants

Here, we report three attempts to replicate a finding from an influential psychological study (Griskevicius et al., 2011b). The original study found interactions between childhood SES and experimental mortality-priming condition in predicting risk acceptance and delay discounting outcomes. The original study used US student samples. We used British university students (replication 1) and British online samples (replications 2 and 3) with a modified version of the original priming material, which was tailored to make it more credible to a British audience. We did not replicate the interaction between childhood SES and mortality-priming condition in any of our three experiments. The only consistent trend of note was an interaction between sex and priming condition for delay discounting. We note that psychological priming effects are considered fragile and often fail to replicate. Our failure to replicate the original finding could be due to demographic differences in study participants, alterations made to the prime, or other study limitations. However, it is also possible that the previously reported interaction is not a robust or generalizable finding.

Parental perception and factors associated with treatment strategies for primary nocturnal enuresis

OBJECTIVE

The aim was to investigate the factors influencing parents seeking reasonable managements for their child and their overall outlook toward primary nocturnal enuresis (PNE).

STUDY DESIGN

We recruited 93 children with PNE from enuresis clinics and requested their parents to complete questionnaires regarding their child's medical history and behavior, their methods for coping with PNE, and their perception of enuresis. Logistic regression models were applied to investigate factors influencing the parents to adopt a positive approach toward enuresis and to subsequently seek a medical consultation.

RESULTS

One-third of the parents had an encouraging attitude toward children with PNE, whereas slightly less than half reacted with anger. The more educated the father or the younger the child with NE, the larger the possibility of the parents utilizing a positive approach, such as encouragement, for coping with NE. Factors that influenced parents to seek medical consultation for NE were socioeconomic status, maternal educational level, and the age and birth order of their child.

DISCUSSION

From our results, angry and frustrated parents (43.0%) were significantly more likely to punish their child for bedwetting than were parents who approached NE positively (comfort and encouragement; 33.3%). A lack of encouragement may negatively affect the self-esteem of children with NE. Moreover, an individual's self-esteem or confidence, both of which can help them eliminate NE, determines the person's behavioral response to bedwetting. In our study, approximately 50% of the parents who approached NE positively (comfort and encouragement) or inconsistently (ambivalence) reported that they comforted their child after bedwetting.

CONCLUSIONS

Nearly half the parents reacted angrily to children with NE, and some parents even punished their child. The parents' socioeconomic background, education, and the age and birth order of the child were the factors associated with their seeking active treatment for NE. A father's education and young age of the child were factors that influenced parents who preferred positive approaches, such as encouragement, for coping with NE.

Temporal profiles of plasma proteome during childhood development

Human blood plasma proteome reflects physiological changes associated with a child's development as well as development of disease states. While age-specific normative values are available for proteins routinely measured in clinical practice, there is paucity of comprehensive longitudinal data regarding changes in human plasma proteome during childhood. We applied TMT-10plex isobaric labeling-based quantitative proteomics to longitudinally profile the plasma proteome in 10 healthy children during their development, each with 9 serial time points from 9months to 15years of age. In total, 1828 protein groups were identified at peptide and protein level false discovery rate of 1% and with at least two razor and unique peptides. The longitudinal expression profiles of 1747 protein groups were statistically modeled and their temporal changes were categorized into 7 different patterns. The patterns and relative abundance of proteins obtained by LC-MS were also verified with ELISA. To our knowledge, this study represents the most comprehensive longitudinal profiling of human plasma proteome to date. The temporal profiles of plasma proteome obtained in this study provide a comprehensive resource and reference for biomarker studies in childhood diseases. Biological significance: A pediatric plasma proteome database with longitudinal expression patterns of 1747 proteins from neonate to adolescence was provided to the research community. 970 plasma proteins had age-dependent expression trends, which demonstrated the importance of longitudinal profiling study to identify the potential biomarkers specific to childhood diseases, and the requirement of strictly age-matched clinical samples in a cross-sectional study in pediatric population.

Parents have different perceptions of bed-wetting than children from six to 15 years of age

AIM

Enuresis is a common childhood disorder that negatively affects children's social and psychological well-being. This study investigated the psychological and emotional problems of children in Taiwan who wet the bed between the ages of six and 15 by comparing feedback from the children, their parents and a control group.

METHODS

This case study featured 93 children with primary nocturnal enuresis from enuresis clinics, and their parents, and 98 nonenuretic controls and parents from the local community. All the parents completed the Behavioural and Emotional Rating Scale (BERS) and all the children completed the Teenage Self-Concept Scale (TSCS). T-scores were used for statistical comparisons and high scores related to higher self-concept.

RESULTS

The parents and their children displayed different perceptions of enuresis, with more behavioural and emotional problems in enuretic children. Older children and children with more severe enuresis reported more difficulties, and low maternal education was also a risk factor.

CONCLUSION

Parental attitudes and perceptions towards bed-wetting were different from their children's. The children's age, enuresis severity and their mothers' educational level were potential risk factors that affected well-being. Health practitioners need to facilitate communication between enuretic children and their parents in addition to monitoring their psychological well-being.

Mitral balloon valvuloplasty during pregnancy:The long term up to 17 years obstetric outcome and childhood development

Background & Objectives : We report 17 years outcome of subsequent pregnancies of women with severe Mitral Stenosis (MS) who underwent Mitral Balloon Valvuloplasty (MBV) during pregnancy and the follow up of the children born of such pregnancies.

METHODS

Twenty three pregnant patients suffering from severe MS (NYHA-New York Heart Association class III/IV) who underwent MBV by Inoue balloon catheter technique during second trimester were enrolled. The study was performed between January 1992 and December 2008 at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, during which time, details about the obstetric outcome and childhood development were recorded. Mean follow up period was 10± 5.5 years (range 1-17 years).

RESULTS

MBV was successful in all patients with improvement in their NYHA class to I/II. All patients were followed until term and had uneventful course after MBV. Twenty two (95.6%) patients delivered 23 babies including a twin birth. These children exhibited normal growth and development according to their age. Nineteen patients had further pregnancies and gave birth to 38 live & healthy babies with one still birth and no unfavorable maternal outcome. Of these, 97.4% were singleton pregnancies while 2.6% were twin pregnancies. Spontaneous abortions were recorded in 21.5% and there was one still birth (2.5%) and one ectopic pregnancy (2.5%). Conclusion : Mitral Balloon Valvuloplasty is a safe and useful procedure during pregnancy, with no short or long term adverse affects on the mothers and their obstetric future. The children born of subsequent pregnancies exhibited normal physical and mental development.

Anti-equality: social comparison in young children

Young children dislike getting less than others, which might suggest a general preference for equal outcomes. However, young children are typically not averse to others receiving less than themselves. These results are consistent with two alternatives: young children might not have any preferences about others receiving less than themselves, or they might have preferences for others receiving less than themselves. We test these alternatives with 5- to 10-year-old children. We replicate previous findings that children will take a cost to avoid being at a relative disadvantage, but also find that 5- and 6-year-olds will spitefully take a cost to ensure that another's welfare falls below their own. This result suggests that the development of fairness includes overcoming an initial social comparison preference for others to get less relative to oneself.