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ObjectiveTo describe the neuropsychological development screening of 0‒2 years in Tongzhou from 2017 to 2021 so as to understand the status and trend of developmental delay （DD）. MethodsAnnual report data of 21 community health service centers in Tongzhou District from 2017 to 2021 were clustered， Chi square test was used to analyze the differences in positive rate and DD rate of children aged 0‒2 years with different ages and household registration， and Chi square trend test was used to analyze the linear trend of each age group and household registration. The Gesell test results in 762 children with developmental delay were analyzed， and Chi square test was used to compare the age distribution differences in gross motor， fine motor， language and personal-social behaviors. ResultsThe DD rate of children aged 0‒2 years in 2017‒2021 was 0.43％. A decreasing trend of DD rate in the 0‒ age group was observed （χ2=14.135， P<0.001）， while an increasing trend of DD rate in the 1‒ and <3 age groups was observed （χ2=5.375， P=0.020； χ2=5.558， P=0.018）. The DD rate of children aged 0‒2 years with Beijing household registration was higher （χ2=12.504， P<0.001）. The DD rate of gross motor was the highest in the 0‒ age group （64.60%）， the DD rate of language was the highest in the <3 age group （85.97%）， and a statistically significant difference of gross motor and language was separately found in the three age groups （χ2=183.061， P<0.001； χ2=78.450， P<0.001）. ConclusionAge and Beijing household registration are the influencing factors of DD for children aged 0‒2， and 0‒ years and <3 years are the critical periods for guidance and intervention to promote the development of gross motor and language abilities.
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ObjectiveTo compare the neuropsychological development of infants with different types of morphologic cranial deformities. MethodsA total of 954 children aged 0 to 18 months who came to Beijing Children's Hospital from January, 2020 to August, 2021 for cranial measurement and neuropsychological development measurement were selected. They were divided into brachycephaly group, plagiocephaly group, asymmetric brachycephaly group, scaphocephaly group and normal group according to the cranial measurement. The development quotient (DQ) was calculated from Children Neuropsychological Development Scale (0-6). ResultsThere were 449 cases in the normal group, 94 cases in the brachycephaly group, 201 cases in the plagiocephaly group, 82 cases in the asymmetric brachycephaly group and 128 cases in the scaphocephaly group. The detection rate of Developmental Edge and Delay (DQ < 85) for gross motor area was the most in brachycephaly group (60.6%), and it was the most for fine motor (64.6%), language (45.1%), adaption (51.2%) and social behavior areas (48.8%) in the asymmetrical brachycephaly group. The DQ was different among the five groups for all the areas except the language area (F > 14.835, P < 0.001); compared with the normal group, DQ decreased for all the four areas in all the groups except the scaphocephaly group; DQ of the areas of gross motor, fine motor and adaption was more in the plagiocephaly group than in the asymmetric brachycephaly group (P < 0.05), while DQ of the areas of gross motor and fine motor was more in the plagiocephaly group than in the brachycephaly group (P < 0.05). Linear regression analysis showed that, DQ negative linear correlated with the cephalic ratio and cranial vault asymmetry index (|B| > 0.967, P < 0.05). ConclusionAmong four kinds of cranial malformation in infants, the neuropsychological development of the scaphocephaly group is almost normal, and somehow delays for brachycephaly, plagiocephaly and asymmetric brachycephaly, especially in the aspects of gross motor, fine motor, adaption and social behavior. The more serious the cranial deformity, the greater the risk of developmental delay in each functional area.
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OBJECTIVES@#To study the physical and neuropsychological development of children with Citrin deficiency (CD).@*METHODS@#A total of 93 children, aged 1.9-59.8 months, who were diagnosed with CD by @*RESULTS@#For the 93 children with CD, the incidence rate of failure to thrive was 25% (23 children) and the proportion of small for gestational age was 47% (44 children). For the 100 cases of CD, the incidence rates of growth retardation, underweight, emaciation, overweight, and microcephalus were 23% (23 cases), 14% (14 cases), 4% (4 cases), 8% (8 cases), and 9% (9 cases), respectively. The incidence rate of neuropsychological developmental delay was 25% (25 cases), and the incidence rates of development delay in the five domains of adaptability, gross motor, fine motor, language, and social ability were 7% (7 cases), 15% (15 cases), 7% (7 cases), 9% (9 cases), and 7% (7 cases), respectively.@*CONCLUSIONS@#Physical and neuropsychological developmental delay can be observed in children with CD, and physical and neuropsychological development should be regularly assessed.
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Child , Humans , Infant , Citrullinemia , Mitochondrial Membrane Transport Proteins , Retrospective StudiesABSTRACT
Objective To explore the relationship between the catch-up situation of physical development and neuropsychological development in 2-year-old SGA children. Methods A longitudinal follow-up observation was conducted in 185 SGA children who were recruited between January 1, 2016 and January 1, 2017.The height, weight, head circumference and other physical development indicators were measured by unified methods at the age of 24 months.Gesell development scale was used to evaluate the neuropsychological development of catch-up and non-catch-up children. Results In 179 out of 185 SGA children who received physical development examination 56.98%(102/179) had achieved catch-up growth.The rate of abnormal/suspected-abnormal neuropsychological development in the full-term SGA children without Shanghai household registration was higher(P < 0.05).After adjusting the factors of household registration and gestational age, there was no significant difference in neuropsychological development between the catch-up and non-catch-up children(P>0.05). Conclusion SGA children, whose physical development did not reach the catch-up growth at the age of 2 years are not obviously backward in neuropsychological development.Catch-up growth for the children with intrauterine growth retardation mainly shows the positive significance in height and weight.The significance of catch-up growth in neuropsychological development remains to be studied.
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Resumen La deficiencia de hierro (DFe) es la patología nutrimental infantil de mayor prevalencia en el mundo y afecta la maduración cerebral y el consiguiente desarrollo cognitivo, lingüístico, motor y comportamental de quienes la padecen. El informe que se presenta tuvo como objetivo estudiar, en profundidad, literatura acerca del efecto de la DFe sobre el desarrollo neuropsicológico en lactantes. Para ello, se analizaron 51 estudios originales realizados en humanos, 49 de los cuales fueron obtenidos a través de Pubmed y 2, de Scielo. Cabe resaltar que, con el fin de discutir los hallazgos de estos artículos, se incluyeron investigaciones sobre el efecto de la DFe que utilizan modelo animal, así como estudios en humanos con desarrollo típico. Esta búsqueda se realizó a conveniencia. El reconocimiento de sus implicaciones facilitaría el trabajo terapéutico, así como la inclusión de programas de estimulación temprana junto con el manejo de la deficiencia nutrimental.
Abstract Iron is involved in various aspects related to brain function, including oxygen transport, neurotransmitters metabolism, DNA synthesis, ATP production, dendritic growth, axonal development and transport, myelin production, glial development, in plasticity markers such as the brain-derived growth factor, and in synaptic plasticity. Human development (biological, cognitive, social) is associated with a bidirectional and dynamic interaction between gene activity, neural activity and environment. An environmental variable is nutrition, and it is known that the central nervous system is extremely vulnerable to nutritional deficiencies during pregnancy and in the first two years of life, period in which an accelerated maturational dynamism occurs. Therefore, a disturbance of these by an iron deficiency would result in neuropsychological alterations, with varied expressions depending on the age at which it occurs and the severity and duration of the nutritional disease. Iron deficiency is defined as the depletion of iron reserves in the body by various factors (nutritional, physiological, pathological, etc.). Three stages of the illness have been established: iron depletion, iron deficiency without anemia and iron deficiency anemia. The first is associated with a decrease in iron reserves without reaching the deficiency; it may be due to a reduction in iron intake and or absorption, excessive loss or an increase in iron requirements. At this stage, there are no functional consequences in the organism. The second stage, is characterized by biochemical changes that reflect a pathologically reduced concentration of serum ferritin with a normal hemoglobin concentration. Finally, iron deficiency anemia is defined by the combination of low concentration of serum ferritin and hemoglobin. Given that iron deficiency is the most prevalent childhood nutritional disorder in the world (affecting 43 % of children aged 6-59 months) and that it impacts brain maturation and the consequent cognitive, linguistic, motor and behavioral development of those who suffer from it, in this paper, the literature on the effect of iron deficiency on neuropsychological development in infants is analyzed in depth. The review was performed considering the short, medium and long lasting effects of iron deficiency without anemia, iron deficiency anemia, chronic iron deficiency during the first two years of life and the presence of treatment. To contextualize, the analysis of the relationship between iron and brain functioning is included and the variables that modulate the expression of its effect are addressed. To carry out the search of literature regarding the effect of iron deficiency on neuropsychological development in infants, Pubmed and SciELO were consulted. No date or language restriction was established. Different combinations of terms were used: "iron deficiency infant", "iron deficiency fetal", "iron deficiency neonatal", "iron deficiency long lasting". The analyzed reports fulfilled the following inclusion criteria: a) primary sources, b) establish a value of hemoglobin and at least one of iron (i.e, serum ferritin, mean corpuscular volume, free erythrocyte, protoporphyrin, transferrin saturation) to define the children of each group, c) human sample, d) description of the measures used for the evaluation, e) studies examined after this stage, had to determine that the sample evaluated presented iron deficiency during the first two years of life. In this paper, 51 original articles conducted in humans were analyzed, of which 49 were obtained through Pubmed and 2 from SciELO. It should be noted that, in order to discuss the findings of these reports, literature was included on the effect of iron deficiency using animal models, as well as studies in humans with typical development. The search for these was done at convenience. The recognition of its implications would facilitate the therapeutic work, as well as the inclusion of early stimulation programs together with the management of nutritional deficiency.
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Objective To study the dose-response relationship between maternal thyroid hormone levels in the first twenty weeks of pregnancy and the infant physical and neuropsychological development.Methods In this prospective cohort study,a total of 945 women and their children were included.Maternal serum samples during first half of the pregnancy were collected and analyzed for levels of thyroid hormones by using the electro-chemiluminescence immunoassay.Maternal social demographic information was collected by using the a self-administered questionnaire.Physical measurements of newborns and neuropsychological evaluation of infants were performed by doctors of maternal and child health care.Results The differences in newborns' birth length and head circumference were significant among the newborns of mothers with different percentiles of maternal serum (thyroidstimulating hormone,TSH) levels (P＜0.05).Newboms with maternal TSH level ≥P95 or ＜P5 had significantly lower birth length and birth head circumference,compared with the newborns with maternal TSH level between P25-P75 (P＜0.05).Newborns' birth head circumferences showed an inverted U-shaped association with maternal serum TSH level (Y=33.940 + 0.003X-0.109X2,F=4.685,P=0.009).The difference in mental development index (MDI) of the infants at 18-30 months were significant among the infants of mothers with different percentiles of maternal serum TSH level (P＜0.05).Infants with maternal TSH level ≥P90 showed lower MDI (6.39,95％CI:2.29-10.49,P=0.002) compared with the infants with maternal TSH level between P25-P75.Infant's MDI at 18-30 months also showed an inverted U-shaped association with maternal serum TSH level (Y=103.249-1.524X-0.939X2,F=6.616,P=0.001).Conclusions Maternal TSH level was associated with newborn's birth length,birth head circumference and infant's MDI at 18-30 months.Newborn's birth head circumference and infant's MDI at 18-30 months showed an inverted U-shaped association with maternal serum TSH-Z score.
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Objective To study the dose-response relationship between maternal thyroid hormone levels in the first twenty weeks of pregnancy and the infant physical and neuropsychological development.Methods In this prospective cohort study,a total of 945 women and their children were included.Maternal serum samples during first half of the pregnancy were collected and analyzed for levels of thyroid hormones by using the electro-chemiluminescence immunoassay.Maternal social demographic information was collected by using the a self-administered questionnaire.Physical measurements of newborns and neuropsychological evaluation of infants were performed by doctors of maternal and child health care.Results The differences in newborns' birth length and head circumference were significant among the newborns of mothers with different percentiles of maternal serum (thyroidstimulating hormone,TSH) levels (P＜0.05).Newboms with maternal TSH level ≥P95 or ＜P5 had significantly lower birth length and birth head circumference,compared with the newborns with maternal TSH level between P25-P75 (P＜0.05).Newborns' birth head circumferences showed an inverted U-shaped association with maternal serum TSH level (Y=33.940 + 0.003X-0.109X2,F=4.685,P=0.009).The difference in mental development index (MDI) of the infants at 18-30 months were significant among the infants of mothers with different percentiles of maternal serum TSH level (P＜0.05).Infants with maternal TSH level ≥P90 showed lower MDI (6.39,95％CI:2.29-10.49,P=0.002) compared with the infants with maternal TSH level between P25-P75.Infant's MDI at 18-30 months also showed an inverted U-shaped association with maternal serum TSH level (Y=103.249-1.524X-0.939X2,F=6.616,P=0.001).Conclusions Maternal TSH level was associated with newborn's birth length,birth head circumference and infant's MDI at 18-30 months.Newborn's birth head circumference and infant's MDI at 18-30 months showed an inverted U-shaped association with maternal serum TSH-Z score.
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RESUMEN La problemática del muy bajo peso al nacer (MBP) ha sido abordada desde hace varios años, sin embargo, las investigaciones están enfocadas desde diferentes perspectivas y contextos, no siempre se ha considerado su repercusión a corto y a largo plazo, así como la interacción de los diferentes factores que se relacionan con este riesgo biológico. Por ello en esta revisión bibliográfica se realiza una valoración de estudios ejecutados a nivel internacional y en Cuba dedicados al desarrollo neuropsicológico de niños con muy bajo peso al nacer. Se concluye que el muy bajo peso al nacer repercute en el desarrollo neuropsicológicos desde edades tempranas, hasta la adolescencia; por ello es necesario una visión integradora que tenga en cuenta el riesgo biológico, las particularidades individuales y el contexto social en que se desenvuelve el niño desde los primeros momentos, lo que posibilitará, perfeccionar la atención a corto y largo plazo al grupo de riesgo.
ABSTRACT The problems of very low birth weight (MBP) have been dealt with for many years, however, research on the matter is approached from different perspectives and contexts, not always have its short and long term repercussions being considered as well as the interaction of different factors related to this biological risk. Therefore, this bibliographical review makes an assessment of international and Cuban studies devoted to very low birth weight children's neuropsychological development. It was reached the conclusion that very low birth weight affects neuropsychological development from early ages to adolescence; for that reason, it is necessary to have an integrated approach of the problem that takes into account the biologicals risk, individual characteristics and the social context in which the child develops from the beginning, which will make the improvement of short and long term care to this risk group possible.
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Objective To observe neuropsychological development status in children after surgical treatment of congenital heart diseases(CHDs)and analyze the risk factors. Methods 89 children who received outpatient review in Fuwai Hospital from September 2015 to March 2016 after surgical treatment of CHDs were recruited in this study and 90 normal children were recruited as the control group. The children with CHDs were divided into simple CHDs group(RACHS- 1 score≤2)and com-plex CHDs group(RACHS- 1 score≥3)according to RACHS- 1 classification. Neuropsychological development status was meas-ured according to pediatric-psychological mental test scale developed by Capital institute of pediatrics,Beijing and statistical a-nalysis was compared. Results The measurements of neuropsychological development showed the normal children behaved better than the children with CHDs(P < 0. 05). The simple CHDs group achieved better distribution of development quotient than complex CHDs group(P = 0. 032)and there was no difference between the normal control group and simple CHDs group (P = 0. 420). Multivariate regression analysis indicated that younger age at cardiac surgery,lower preoperative blood urea ni-trogen(BUN),higher preoperative creatinine(Cr)and prolonged duration of cardiopulmonary bypass(CPB)accounted for low-er scores in the test scale(P < 0. 05). Conclusion Distinct neuropsychological difficulties could be present especially in chil-dren with complex CHDs. Younger age at cardiac surgery,preoperative BUN,Cr and CPB duration were perioperative factors that were associated with long-time neuropsychological development.
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Objective To explore the neuropsychological development in twin premature infants,and to analyze the risk factors for the retardation of development.Methods The premature infants hospitalized in the Neonatal Ward First Affiliated Hospital of Kunming Medical University from Jun.2010 to Jun.2012 were divided into study groups of twin premature infants and a control group of singleton premature infants.The neuropsychological development of 88 premature infants was evaluated at corrected gestational age of 1 year old by Bayley scales of infant development.According to normal lab findings of the Bayley scales of infant development,the premature infants were then divided into abnormal neuropsychological development group [mental development index(MDI) ≤79 scores] and normal neuropsychological development group (MDI ＞ 79 scores),and the data of 2 groups were statistically analyzed.Results The frequency distribution of MDI score in study group showed a skewed distribution,of which 59％ (27/46 cases) had abnormal neuropsychological development (MDI ≤ 79 scores); However,the frequency distribution of MDI score in control group showed an approximate normal distribution,of which only 12％ (5/42 cases) for abnormal neuropsychological development.Head circumference,body length,body weight,MDI,psycho-motor development index of twin premature infants of one-year old were lower than those of the singleton premature infants of the same age,and the differences were statistically significant (all P ＜0.05).The single factor analysis demonstrated that the risk factors for abnormal neuropsychological development (MDI ≤ 79 scores) of twin premature infants were gestational age,birth weight,mother' s gcstational age,the cultural degree of parents,mode of feeding,neonatal hyperbilirubinemia,neonatal hypoglycemia and neonatal sepsis.Multiple regression analysis showed that neonatal hyperbilirubinemia was the independent risk factor for abnormal neuropsychological development of twin premature infants.Conclusions At same gestational age,neuropsychological development of twin premature infants lagged behind singleton premature infants.Neonatal hyperbilirubinemia may be the risk factors for neuropsychological development of twin premature infants,so the earlier management of neonatal hyperbilirubinemia may be beneficial for the neuropsychological development of twin premature infants.
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Una forma de entender la estructura de las Funciones Ejecutivas (FE), es su estudio en el desarrollo temprano y el uso de métodos estadísticos avanzados que permiten entender la interrelación de los distintos componentes. Los hallazgos en la etapa adulta, apoyan la idea multifactorial de componentes relacionados, pero separables; mientras que evidencias recientes, en la etapa preescolar sugieren que la estructura de las FE, puede ser descrita por un solo factor. La estructura de las FE fue examinada en 128 niños de 3 a 6 años de edad, usando un análisis factorial confirmatorio. Los preescolares completaron una batería de tareas de FE, que evaluaban procesos de inhibición y memoria de trabajo, con sensibilidad adecuada para la edad. En la edad preescolar la estructura del funcionamiento ejecutivo puede ser diferenciada en dos procesos relacionados pero independientes: memoria de trabajo e inhibición. Las relaciones entre los componentes parecen cambiar en el desarrollo. La unidad estructural de las FE en edades muy tempranas, cambia a través del desarrollo, siendo cada vez más multifacética, que se relaciona con la maduración e integración de diferentes circuitos frontosubcorticales.
One way to understand the structure of executive functions (EF) is their study in early development and use of advanced statistical methods that allow us to understand the interrelationship of various components. The findings in the adult age, support the idea multifactorial of related components, but separable, while recent evidence in the preschool years suggest that the structure of the FE, can be described by a single factor. The structure of the EF was examined in 128 children aged 3 to 6 years of age, using a confirmatory factor analysis. Preschoolers completed a battery of EF tasks, assessing processes of inhibition and working memory with age-appropriate sensitivity. In the preschool the structure of executive functioning can be differentiated into two related but independent processes: working memory and inhibition. The relationships between the components seem to change in development. The structural unit of the FE at very early ages, it changes through the development, becoming more multifaceted, which is associated with the maturation and integration of different frontal-subcortical circuits.
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Objective To investigate the effect of early medical intervention in neuropsychological development of premature infant.Methods 94 premature infants were divided into experimental group and control group.The experimental group were treated with drug, cerebral circulation and early intervention rehabilitation training.The control group were treated with drug and cerebral circulation.Developmental evaluation were performed in 1 old.Results The developmental quotient (DQ) of experimental group was much higher than that of control group ( ( 101.80 ± 9.60 ) vs ( 86.10 ± 10.55 ), P ＜ 0.05 ).The cerebral palsy incidence of experimental group was much lower than that of control group, also lesser than control group( ( 3.07% vs 27.59%, P＜ 0.05 ).In the evaluation of neuropsychological development, much improved in experimental group (P＜ 0.05 ).Conclusion Early medical intervention could promote neuropsychological development of premature infant and reduce the sequelae.
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En una muestra de 243 infantes (119 niños y 124 niñas), de edades comprendidas entre 36 y 72 meses, pertenecientes a instituciones públicas y privadas, se evaluaron las propiedades psicométricas post adaptación y normalización del Cuestionario de Madurez Neuropsicológica Infantil CUMANIN. Los resultados encontrados permiten indicar que el instrumento posee una buena consistencia interna y es capaz de discriminar entre rangos de edad, obteniéndose rendimientos más altos a medida que la edad avanza. No se encontraron diferencias en puntajes por sexo. Factores tales como nivel socioeconómico y tipo de institución educacional a la que asiste el párvulo determinaron diferencias en los resultados obtenidos. Se concluye que el Cuestionario de Madurez Neuropsicológica Infantil CUMANIN es un instrumento válido y confiable para la evaluación del constructo madurez neuropsicológica en población preescolar.
In a sample of 243 children (119 males and 124 females) aged between 36 and 72 months, students from public and private institutions, was evaluated the psychometric properties of Child Neuropsychological Maturity Questionnaire CUMANIN, post their adjustment and normalization. These findings can indicate that the instrument has good internal consistency and is able to discriminate between age groups, resulting in higher yields as age advances. There were no differences in scores by gender Factors such as socioeconomic status and type of educational institution attended by the infant determined differences in the results. We concluded that the Child Neuropsychological Maturity Questionnaire CUMANIN is a reliable and valid instrument for the assessment of neuropsychological maturity construct in preschool population.