The Assessment of Psychomotor Development in Full-Term Children at 12 Months of Age with Munich Functional Development Diagnostics Depending on the Feeding Method: A Cross-Sectional Study.

BACKGROUND: Psychomotor development is the most important outcome determining the proper growth and development of children. Optimizing childcare and modifying risk factors can provide the child with the best conditions to realize their developmental potential. The study aimed to assess the impact of the feeding method on the psychomotor development of full-term children at 12 months of age with Munich Functional Developmental Diagnostics (MFDD). METHODS: The study included 242 full-term children who were examined at 12 months of age by a child neurologist using MFDD. The children were divided into two groups depending on the feeding method: breastfed (146) vs. formula-fed (93). We analysed selected obstetric and neonatal risk factors as well as MFDD scores within the groups. RESULTS: The only axis on the MFDD scale on which we observed a difference between the groups was social skills. No differences were noted between the groups in the analysis of the gross and fine motor skills, with regard to perception or active and passive speech. CONCLUSIONS: The full-term, exclusively breastfed infants over their first 6 months of age or longer have greater social skills in comparison with the formula-fed infants when measured on the MFDD axis.

Relationship between Apgar score and umbilical cord blood acid-base balance in full-term and late preterm newborns born in medium and severe conditions.

OBJECTIVES: Application of Apgar scores (AS) and umbilical cord blood acid-base analysis is a base for the prediction of future neurological development in children. In clinical practice we often observe huge discrepancy between clinical and biochemical status of newborn. Because many obstetricians consider both assessments as substitute and measure of their proceeding's outcome, we decided to scientifically measure actual correlation between them among newborns born with Apgar less than 8 points. MATERIAL AND METHODS: This was an observational retrospective study. The study included 141 newborns born in general medium and severe condition (Apgar < 8 points in first minute of life). Acid-base analysis of umbilical cord vein blood immediately after birth was performed. We correlated gasometer parameters with Apgar scores of newborns. RESULTS: The clinical condition of a newborn at 1, 5, and 10 minutes after birth correlates positively and significantly with pH values (0.25; 0.24; and 0.26; respectively) and bicarbonate levels (0.21; 0.27; 0.28; respectively) in the umbilical cord vein, however correlation was low. Subsequently we qualified newborns to four groups depending on the degree of invasiveness of respiratory support after delivery, and the groups were compared in terms of parameters of acid-based balance. No significant differences were observed between groups in terms of acid-base balance parameters. CONCLUSIONS: There is low, but significant correlation between clinical condition of a newborn after birth with most of acid-base parameters from umbilical vein blood. The assessment of the newborn's condition after birth using the Apgar score, (but not acid-base parameters) determines the degree of invasiveness of respiratory support activities for newborns after birth.

Principal Component Analysis of Munich Functional Developmental Diagnosis.

OBJECTIVES: Munich Functional Developmental Diagnosis (MFDD) is a scale for assessing the psychomotor development of children in the first months or years of life. The tool is based on standardized tables of physical development and is used to detect developmental deficits. It consists of eight axes on which the following skills are assessed: crawling, sitting, walking, grasping, perception, speaking, speech understanding, social skills. METHODS: The study included 110 children in the first year of life examined with the MFDD by the same physician. The score obtained on a given axis was coded as a negative value (defined in months) below the child's age-specific developmental level. Next, we examined the dimensionality of the scale and the intercorrelation of its axes using polychoric correlation and principal component analysis. RESULTS: Correlation matrix analysis showed high correlation of MFDD axes 1-4, and MFDD 6-8. The PCA identified three principal components consisting of children's development in the areas of large and small motor skills (axis 1-4), perception (axis 5), active speech, passive speech and social skills (axis 6-8). The three dimensions obtained together account for 80.27% of the total variance. CONCLUSIONS: MFDD is a three-dimensional scale that includes motor development, perception, and social skills and speech. There is potential space for reduction in the number of variables in the scale.

Cerebral palsy and obstetric-neonatological interventions.

Cerebral palsy is a disease that puts a great mental burden on caregivers and generates very high social costs. Children with CP require many years of rehabilitation and medical care. The etiology of the disease is undoubtedly multifactorial, and the pathogenesis is associated with focal damage to the central nervous system. One can find descriptions of well-documented interventions in the literature that reduce the risk of CP in certain groups of pregnant and neonatal patients, and interventions that have a potentially protective effect. In this review, we have analyzed the available literature in terms of prenatal and postnatal interventions that may have an impact on reducing the incidence of this condition in children.

Factors associated with gestational weight gain: a cross-sectional survey.

BACKGROUND: The aim of this study was to describe the dietary patterns in pregnant women and determine the association between diet factors, pre-pregnancy body mass index, socio-demographic characteristics and gestational weight gain. METHODS: The analysis was conducted on a group of 458 women. Cut-off values of gestational weight gain adequacy were based on recommendations published by the US Institute of Medicine and were body mass index-specific. Logistic regression analysis was used to assess the risk of the occurrence of inadequate or excessive gestational weight gain. Dietary patterns were identified by factor analysis. RESULTS: Three dietary patterns characteristic of pregnant women in Poland were identified: 'unhealthy', 'varied' and 'prudent'. The factor associated with increased risk of inadequate gestational weight gain was being underweight pre-pregnancy (OR = 2.61; p = 0.018). The factor associated with increased risk of excessive weight gain were being overweight or obese pre-pregnancy (OR = 7.00; p = 0.031) and quitting smoking (OR = 7.32; p = 0.019). The risk of excessive weight gain was decreased by being underweight pre-pregnancy (OR = 0.20; p = 0.041), being in the third or subsequent pregnancy compared to being in the first (OR = 0.37; p = 0.018), and having a high adherence to a prudent dietary pattern (OR = 0.47; p = 0.033). CONCLUSIONS: Women who were overweight or obese pre-pregnancy and those who quit smoking at the beginning of pregnancy should be provided with dietary guidance to prevent excessive gestational weight gain.