ABSTRACT
BACKGROUND: To evaluate if treating maternal periodontal disease, a pro-inflammatory condition, during pregnancy (intervention) compared to after pregnancy (control) reduces the likelihood of offspring screening positive for autism spectrum disorder (ASD). METHODS: In a follow-up study to the MOTOR randomized trial, we compared rates of positive screens on the Modified Checklist for Autism in Toddlers (M-CHAT) among n = 306 two-year-old toddlers and correlated findings to maternal and cord blood pro-inflammatory interleukin-6 (IL-6). RESULTS: Toddlers in the intervention group had decreased risk of a positive M-CHAT screen (adjusted RR = 0.53, 95% CI 0.29-0.99). Toddlers screening positive compared to negative had higher mean IL-6 in cord blood (1.58 ± 1.14 vs. 1.09 ± 0.72 p = 0.001) and maternal IL-6 change from baseline (1.30 ± 0.61 vs 0.96 ± 0.62 p = 0.03). CONCLUSIONS: Treating periodontal disease during pregnancy reduced risk of a positive ASD screen. M-CHAT positivity was associated with increased IL-6 in maternal and cord blood. CLINICAL TRIAL: Trial Registration numbers: Clinicaltrials.gov NCT03423836.
Subject(s)
Autism Spectrum Disorder , Periodontal Diseases , Periodontitis , Humans , Infant , Autism Spectrum Disorder/diagnosis , Follow-Up Studies , Interleukin-6 , Mass Screening , Checklist , Periodontitis/diagnosisABSTRACT
Investigating safe and effective interventions in pregnancy that lower offspring adiposity is important given the burden of obesity and subsequent metabolic derangements. Our objective was to determine if docosahexaenoic acid (DHA) given during pregnancy to obese mothers results in lower offspring adiposity. This study was a long-term follow-up of a randomized trial of mothers with gestational diabetes or obesity who were randomized to receive DHA supplementation at 800 mg/day or placebo (corn/soy oil) starting at 25-29 weeks gestation. Anthropometric measures were collected at birth and maternal erythrocyte DHA and arachidonic (AA) levels were measured at 26 and 36 weeks gestation. At two- and four-year follow-up time points, offspring adiposity measures along with a diet recall were assessed. A significant increase in erythrocyte DHA levels was observed at 36 weeks gestation in the supplemented group (p < 0.001). While no significant differences by measures of adiposity were noted at birth, two or four years by randomization group, duration of breastfeeding (p < 0.001), and DHA level at 36 weeks (p = 0.002) were associated with body mass index z-score. Our data suggest that DHA supplementation during pregnancy in obese mothers may have long-lasting effects on offspring measures of adiposity.
Subject(s)
Adiposity , Diet , Docosahexaenoic Acids/administration & dosage , Maternal Nutritional Physiological Phenomena , Adult , Arachidonic Acid/administration & dosage , Arachidonic Acid/blood , Body Mass Index , Breast Feeding , Child Development , Child, Preschool , Diabetes, Gestational/drug therapy , Dietary Supplements , Docosahexaenoic Acids/blood , Double-Blind Method , Female , Follow-Up Studies , Gestational Age , Humans , Infant , Mothers , Nutrition Assessment , Pregnancy , Pregnancy Outcome , Socioeconomic Factors , Young AdultABSTRACT
OBJECTIVE: To determine if antenatal treatment of maternal periodontitis affects early childhood neurodevelopment. STUDY DESIGN: We evaluated neurodevelopment of 331 24-month-old children born to women who participated in a randomized trial of antenatal (167) or postpartum (164) treatment of periodontitis. Children within groups defined by maternal treatment were designated as high risk for abnormal neurodevelopment (n = 96; birth at ≤34(6)/7 weeks' gestation or small for gestational age following birth at term) or low risk (n = 235; appropriate birth weight and ≥37 weeks' gestation). We measured neurodevelopment using the Bayley Scale of Infant and Toddler Development III (BSID III) and neurological examination. Treatment effect was analyzed using a chi-square or Fisher exact test. Between-group mean scores were compared using Student t test. RESULTS: There were no differences in the incidence of neuromotor or sensory (visual or hearing) impairment or scores on the BSID III between groups. Low-risk children in the antenatal treatment group had higher language scores than those in the postpartum treatment group (92.9 versus 89.2; p = 0.05). CONCLUSION: Antenatal treatment of maternal periodontitis does not appear to affect neurodevelopment at 24 months of age. The slight improvement in language development in low-risk children may be an artifact or not clinically relevant.
Subject(s)
Child Development , Nervous System/growth & development , Periodontitis , Pregnancy Complications/therapy , Psychomotor Disorders , Subgingival Curettage/adverse effects , Adolescent , Adult , Chi-Square Distribution , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Language Tests , Neonatal Screening , Neurologic Examination , Periodontitis/etiology , Periodontitis/therapy , Pregnancy , Psychomotor Disorders/diagnosis , Psychomotor Disorders/epidemiology , Psychomotor Disorders/etiology , Psychomotor Performance , United States/epidemiologyABSTRACT
OBJECTIVE: The aim of the present study was to examine the effects of early and high intravenous (IV) amino acid (AA) supplementation on growth, health, and neurodevelopment of extremely-low-birth-weight (ELBW) infants throughout their first 2 years of life. METHODS: Infants were prospectively randomized in a double-masked fashion and treated for 7 days with either IV AA starting at 0.5 g · kg (-1) · day(-1) and increased by 0.5 g · kg(-1) every day to 3 g · kg(-1)· day(-) or starting at 2 g · kg (-1) · day(-1) of IV AA and advanced by 1 g · kg(-1) every day to 4 g · kg (-1) · day(-1). Plasma AA concentrations were determined by reverse-phase high-performance liquid chromatography. Survivors were longitudinally assessed with Bayley II Scales of Infant Development and physical, social, and global health. RESULTS: Forty-three of 51 survivors were studied. Mental Developmental Index (MDI) and Psychomotor Developmental Index were similar between groups; however, the early and high AA group had a lower MDI at 18 months. This difference disappeared at 2 years of age. The early and high AA group z score means for weight, length, and head circumferences were significantly lower than the standard AA group at most visits. Cumulative and single plasma AA concentrations correlated negatively with MDI and postnatal growth. CONCLUSIONS: ELBW infants who received early and high IV AA during the first week of life were associated with poor overall growth at 2 years.
Subject(s)
Amino Acids/administration & dosage , Dietary Supplements , Infant, Extremely Low Birth Weight/growth & development , Child Development/drug effects , Child, Preschool , Double-Blind Method , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Injections, Intravenous , Male , Prospective StudiesABSTRACT
OBJECTIVES: The goals were to assess postdischarge growth and developmental progress of very low birth weight (birth weight: <1500 g) premature infants in a predominantly Hispanic population and to identify predictors for neurodevelopmental impairment at 3 years of age. METHODS: A cohort of 135 very low birth weight infants (gestational age: 23 to 35 weeks) were monitored to 3 years of age. Maternal and neonatal characteristics, anthropometric z scores, and developmental performance (using corrected age until 24 months) were analyzed collectively and according to gestational age groups. Specific criteria for failure to thrive and microcephaly were used. RESULTS: A characteristic pattern of poor weight gain in the first 12 months was followed by accelerated weight gain starting at 18 months, whereas head growth decreased at 18 months, with recovery beginning at 30 months of age. Infants born at gestational age of Subject(s)
Developmental Disabilities/epidemiology
, Failure to Thrive/ethnology
, Growth Disorders/epidemiology
, Hispanic or Latino/statistics & numerical data
, Infant, Very Low Birth Weight
, Analysis of Variance
, Body Height
, Body Weight
, Child Development/physiology
, Cohort Studies
, Developmental Disabilities/etiology
, Developmental Disabilities/physiopathology
, Failure to Thrive/physiopathology
, Female
, Follow-Up Studies
, Gestational Age
, Growth Disorders/etiology
, Growth Disorders/physiopathology
, Humans
, Incidence
, Infant, Newborn
, Logistic Models
, Male
, Monitoring, Physiologic/methods
, Patient Discharge
, Pregnancy
, Probability
, Risk Assessment
, Texas