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| 2. |
- Andersson, Ola, et al.
(författare)
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Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age : A Randomized Clinical Trial
- 2015
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Ingår i: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 169:7, s. 631-638
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Prevention of iron deficiency in infancy may promote neurodevelopment. Delayuci umbilical cord clamping (CC) prevents iron deficiency at 4 to 6 months of age, but long-term effects after 12 months of age have not been reported. OBJECTIVE To investigate the effects of delayed CC compared with early CC on neurodevelopment at 4 years of age. DESIGN, SETTING, AND PARTICIPANTS Follow-up of a randomized clinical trial conducted from April 16, 2008, through May 21, 2010, at a Swedish county hospital. Children who were included in the original study (n = 382) as full-term infants born after a low-risk pregnancy were invited to return for follow-up at 4 years of age. Wechsler Preschool and Primary Scale of Intelligence (WPPSI-111) and Movement Assessment Battery for Children (Movement ABC) scores (collected between April 18, 2012, and July 5, 2013) were assessed by a blinded psychologist. Between April 11, 2012, and August 13, 2013, parents recorded their child's development using the Ages and Stages Questionnaire, Third Edition (ASQ) and behavior using the Strengths and Difficulties Questionnaire. All data were analyzed by intention to treat. INTERVENTIONS Randomization to delayed CC (>= 180 seconds after delivery) or early CC (<= 10 seconds after delivery). MAIN OUTCOMES AND MEASURES The main outcome was full-scale IQ as assessed by the were development as assessed by the scales from the WPPSI-III and Movement ABC, development as recorded using the ASQ, and behavior using the Strengths and Difficulties Questionnaire. RESULTS We assessed 263 children (68.8%). No differences were found in WPPSI-III scores between groups. Delayed CC improved the adjusted mean differences (AMDs) in the ASQ personal-social (AMD, 2.8; 95% Cl, 0.8-4.7) and fine-motor (AMD, 2.1; 95% Cl, 0.2-4.0) domains and the Strengths and Difficulties Questionnaire prosocial subscale (AMD, 0.5; 95% Cl, >0.0-0.9). Fewer children in the delayed-CC group had results below the cutoff in the ASQ fine-motor domain (11.0% vs 3.7%; P =.02) and the Movement ABC bicycle-trail task (12.9% vs 3.8%; P =.02). Boys who received delayed CC had significantly higher AMDs in the WPPSI-III processing-speed quotient (AMD, 4.2; 95% Cl, 0.8-7.6; P =.02), Movement ABC bicycle-trail task (AMD, 0.8; 95% Cl, 0.1-1.5; P =.03), and fine-motor (AMD, 4.7; 95% Cl, 1.0-8.4; P =.01) and personal-social (AMD, 4.9; 95% Cl, 1.6-8.3; P =.004) domains of the ASQ. CONCLUSIONS AND RELEVANCE Delayed CC compared with early CC improved scores in the fine-motor at 4 years of age, especially in boys, indicating that optimizing the time to CC may affect neurodevelopment in a low-risk population of children born in a high-income country.
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| 3. |
- Domellöf, Erik, et al.
(författare)
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Formula feeding supplemented with milk fat globule membranes improves cognitive score in term infants at 12 months
- 2013
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Ingår i: Developmental Medicine & Child Neurology, 55 (Suppl. S2). - : Mac Keith Press. - 0012-1622. ; , s. 50-50
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Konferensbidrag (refereegranskat)abstract
- Introduction: Findings of enhanced cognitive development in breast‐fed compared with formula‐fed infants suggest that breast milk contains neurodevelopmentally beneficial components. Animal studies report positive behavioral effects of supplementation with components included in the bovine milkfat globule membrane fraction (MFGM). Behavioral effects of MFGM supplemented formula in human infants have not been studied. This study tested the hypothesis that infants fed an experimental formula (EF) supplemented with a bovine MFGM fraction would display a more favorable neurofunctional development than infants fed a standard formula (SF) at 12 months.Participants and Methods: Healthy term formula‐fed infants (n = 160) and a breast‐fed reference (BFR) group (n = 80) were included in a prospective double blind randomized trial before 2 months of age. Formula‐fed infants were randomized to receive EF or SF from inclusion until 6 months. At 12 months, cognitive, motor and verbal functions were tested using the Bayley Scales of Infant and Toddler Development‐III.Results: The cognitive score was significantly higher in the EF (105.8 ± 9.2) than SF (101.8 ± 8.0) group, but equal between the EF and BFR groups. No differences were found in motor or verbal score between the formula groups. The BFR group displayed higher verbal but not motor scores than the formula groups.Conclusion: In keeping with the hypothesis, feeding infants MFGM supplemented formula resulted in improved cognitive function at 12 months compared with a standard formula. The difference in cognitive score between the EF and SF groups is compliant with calculated differences between formula‐fed and breast‐fed infants in previous studies.
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| 4. |
- Domellöf, Erik, et al.
(författare)
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Improved fine motor performance in children born preterm : a longitudinal study of upper-limb kinematics from 4 to 8 years
- 2015
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Konferensbidrag (refereegranskat)abstract
- Introduction:Although children born preterm (PT) are at known risk for impaired neuromotor development, longitudinal studies using detailed measurements of motor performance are rare. This study investigated developmental changes in goal-directed upper-limb kinematics from 4-8 years old in a sample of children born fullterm (FT) and PT without known developmental disabilities.Participants and Methods:3D kinematic recordings of performance with either arm/hand during a goal-directed unimanual precision task were carried out at 4 and 8 years in 37 children (13 very PT, V-PT, < 32 GW; 5 moderately PT, M-PT, 33-35 GW; 19 FT).Results:Repeated measures ANOVA revealed significant main effects for group and occasion, and interaction effects between group and occasion, for distal movement duration (p < .0001) and segmentation in terms of movement units (MUs, p < .0001). From initially having displayed less proficient movement organization at 4 years than both children born FT and M-PT, the children born V-PT showed a marked catch-up at 8 years, where no significant group differences remained. The mean between-occasion difference was substantial for both duration and segmentation in V-PT relative the other groups, although with noticeably higher within-group variability (MSD = 1.2 s/7.8 MUs) than M-PT (MSD = 0.5 s/2.5 MUs) and FT (MSD = 0.5 s/4.2 MUs).Conclusion:The children born PT, V-PT in particular, generally displayed a considerable gain in fine motor performance from preschool to school age. Compared with the FT and M-PT groups, however, the rate of improvement appears more heterogeneous in the V-PT group
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| 5. |
- Domellöf, Erik, 1970-, et al.
(författare)
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Relations Among Upper-Limb Movement Organization and Cognitive Function at School Age in Children Born Preterm
- 2013
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Ingår i: Journal of Developmental and Behavioral Pediatrics. - : Lippincott Williams & Wilkins. - 0196-206X .- 1536-7312. ; 34:5, s. 344-352
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore relations between aspects of upper-body spatiotemporal movement organization and intelligence in children born preterm at school age.Methods: Three-dimensional (3D) kinematic recordings of arm and head movements during a unimanual precision task were related to performance on the Wechsler Intelligence Scale for Children, 4th edition, in a sample of 32 children born preterm (gestational age, mean: 31.5 weeks [range: 22-35 weeks]; birth weight, mean: 1699 g [range: 404-2962 g]) at 6 years to 8 years with no diagnosed cognitive, sensory, or motor impairments compared with 40 age-matched control children born fullterm.Results: In the children born preterm, upper-limb movement duration and segmentation of movement trajectories were significantly associated with full-scale intelligence quotient independent of gestational age (GA) and sex. These effects pertained to the preferred side, characterized by more effective movement organization being linked with increased intelligence scores. The same relations were not seen in the controls. Within the children born preterm, a significant effect of GA was also found for some aspects of upper-limb movement organization. Full-scale intelligence quotient was within normal limits for both groups but significantly lower in the preterm (mean: 94.5 [range: 72-120]) compared with the fullterm (mean: 101.7 [range: 76-119]) born children.Conclusions: The findings demonstrate that, independent of GA, the spatiotemporal organization of upper-limb movements is partly associated with cognitive performance in children born preterm.
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| 6. |
- Domellöf, Erik, 1970-, et al.
(författare)
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Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages
- 2020
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Ingår i: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 8:311
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate cognitive and behavioral outcomes in relation to gestational age (GA) in school-aged children born preterm (PT). Results from the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV), and the Child Behavior Checklist (CBCL) were analyzed in 51 children (mean age: 7.8 years [range: 7.0–8.7]) born PT (mean GA: 31 weeks [range: 23–35]; birth weight, mean: 1,637 g [range:404–2,962]) with the majority (96%) having no diagnosed cognitive, sensory, or motor impairments. The control group included 57 age-matched typically developing children (mean age: 7.9 years [range: 6.2–8.7]) born full-term (FT). Children born PT, extremelyPT (GA < 28) in particular, showed significantly lower cognitive performance and higher behavioral problem scores compared with children born FT. GA was found to predict aspects of both cognitive functioning and behavioral problems within the PT group, with lower GA being related to both poorer cognitive outcomes and elevated affective and attention-deficit/hyperactivity problems. Global cognitive functioning did not independently predict aspects of behavioral outcomes. Findings demonstrate that, even in children born PT without severe perinatal and/or postnatal complications and receiving active perinatal care, a short gestation is an evident risk factor for long-term negative effects on mental health independent of cognitive functioning. Additional findings suggest that both reduced growth and lower parental educational level may contribute to increased risk for poorer cognitive and behavioral functioning in children born PT.
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| 7. |
- Johansson, Anna-Maria, et al.
(författare)
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Early risk factors and cognitive outcomes in children born preterm
- 2012
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Ingår i: Developmental Medicine and Child Neurology. - : John Wiley & Sons. ; , s. 24-24
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Konferensbidrag (refereegranskat)abstract
- Background: Research has consistently demonstrated a greater risk for learning-related problems in children born preterm. However, little research has explored the longterm effects of early risk factors (RFs) on cognitive outcome. Thus, the associations between RFs and cognitive functions are the main focus of the present research.Methods: A sample of 32 children born preterm (M GW=31.5, [22–35]; M age=7.7yrs) and 38 age and sex matched full-term born control group (M age=7.7) underwentWechsler Intelligence Scale for Children, 4th edition (WISC-IV) testing. A number of RF in the pre/perinatal period was identified from information in medical records.Results: The children born preterm had significantly lower scores than full-term controls on the WISC-IV in terms of full-scale IQ (FSIQ; M=94.5 and 102.1 respectively) and performance index (PIQ) (M=100 and 106.8 respectively). Within the preterm group, standardized birth weight (BW) was positively correlated with FSIQ and PIQ. Further, the total number of RF was negatively correlated with FSIQ and working memory index.Discussion: As previously shown, most of the children born preterm score within normal limits on the WISC-IV, they score significantly lower and demonstrate higher rates of sub-average IQ and PIQ than their full-term peers. Additionally, early RFs were associated with several measures of cognitive functioning. Thus, these results highlight the importance of including early medical history when analyzing outcomes of preterm birth. Further enquiries are necessary to look into the relationship between specific RFs and cognition in order to better predict outcomes.
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| 8. |
- Rönnqvist, Louise, 1957-, et al.
(författare)
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Cognitive performance and behavioral functions in relation to gestational age (GA) at birth
- 2015
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Ingår i: Developmental Medicine & Child Neurology. - : John Wiley & Sons. - 0012-1622 .- 1469-8749. ; 57:Suppl s4, s. 21-
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Tidskriftsartikel (refereegranskat)abstract
- Introduction:It is well established that a very preterm birth (PT) relates to increased behavioral problems. The aim of this study was to investigate effects and associations between different gestational ages (GA) at birth (term, late-to-extreme) and later functions. This study is part of an ongoing, longitudinal project.Participants and Methods:Test outcomes from WISC-IV and Achenbach’s Child-Behavior-Checklist (CBCL) in children tested at 7-8-years (M=7.7) were used to investigate group differences as effect of GA at birth. In total, 64 preterm born (PT), GA range 22-36, (divided into groups of 14 extremely-PT/EPT, 17 very-PT/VPT, and 33 moderately PT/MPT) and 64 term born (TB), were included. Additionally, associations between GA, birth weight (BW), and outcomes from WISC-IV and CBCL were investigated.Results:Multivariate analyses of variance (MANOVA) revealed significantly (p < .05) poorer WISC outcomes on Verbal Comprehension Index, Perceptual Reasoning Index, and on Full-Scale-IQ for children born EPT/VPT in comparison to MPT and TB born. Parents’ CBCL ratings reveled that EPT children had significantly higher prevalence of Attention problems, Thought problems, Aggressive and Somatic complaints. Including the PT-group only shown significant positive correlations between GA/BW respectively and full scale IQ. Higher GA/BW was related to increasing IQ scores. Significant negative correlations were seen between GA/BW respectively and TotProblem/CBCL-scale. Additionally, CBCL/DSM-Oriented Scales; Adhd-, Opposite-, and Conduct-Problems correlated significantly negative with GA/BW in the PT-born children.Conclusion:Our study provides further support for associations between increased risk of cognitive and behavior problems with decreasing GA/BW at birth.
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| 9. |
- Rönnqvist, Louise, et al.
(författare)
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Effects of twin-births on IQ, handedness, and brain volumes in 8-years-old preterm born twins and matched singletons: a pilot study
- 2016
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Ingår i: Developmental Medicine & Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 58:S6, s. 57-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children born preterm have a high prevalence of long-term cognitive and behavioral disturbances. Still, studies of how preterm-twin-births may effect brain maturation and thus, contribute to long-term effects on brain-behavioral development and functions are rare.Aim: To investigate whether brain volumes differ between twin (TPB) and singleton preterm born (SPB) and full-term born children (FTB) and associate to long-term cognitive and behavioral outcomes as well as to gestational age (GA), birth weight (BW) and head circumference (BHC) at birth.Method: A sample of 22 twin born preterm (Mean GA=32.1, BW=1781), 23 matched singletons preterm (Mean GA=31.8, BW=1751), and 22 full-term singletons were included. All children were investigated by means of their cognition functions (WISC-IV), handedness performance index and brain volumes (3 Tesla MRI) at early school ages (M=7.8y) in 40 children (9 TPB, 10 SPB, 21 FTB).Results: The FTB-children performed better than both TPB and SPB on cognitive performance, and showed higher IQ. Brain volumes, especially Gray matter were stronger associated with IQ in the twins. Furthermore it was found that the SPB singletons had smaller Total Brain volume and less Grey Matter than FTB. The twins showed a higher prevalence of non-right handedness associated to GA, than both SPB and FTB. Independently of birth status, GA, BW and BHC were found to correlate positively with IQ, Total Brain volume, and Gray-and White matter volumes.Conclusion: Discordant handedness in TPB children and associations to lower GA indicate effect of twin-births on early functional laterality. The overall associations found between low GA/BW and smaller BHC at birth in preterm born and associations with lower IQ and smaller brain volumes at 8-y indicate that a very preterm birth are a higher predictor for long-term effects on brain development and cognitive performance than twin-birth per se.
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| 10. |
- Timby, Niklas, et al.
(författare)
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Neurodevelopment and growth until 6.5 years of infants who consumed a low-energy, low-protein formula supplemented with bovine milk fat globule membranes : a randomized controlled trial
- 2021
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Ingår i: American Journal of Clinical Nutrition. - : Oxford University Press. - 0002-9165 .- 1938-3207. ; 113:3, s. 586-592
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We previously reported results from a randomized controlled trial in which we found that Swedish infants consuming an experimental low-energy, low-protein formula (EF) supplemented with bovine milk fat globule membranes (MFGMs) until 6 mo of age had several positive outcomes, including better performance in the cognitive domain of Bayley Scales of Infant and Toddler Development 3rd Edition at 12 mo of age, and higher plasma cholesterol concentrations during the intervention, than infants consuming standard formula (SF).OBJECTIVES: We aimed to evaluate neurodevelopment, growth, and plasma cholesterol status at 6 and 6.5 y of age in the same study population.METHODS: We assessed cognitive and executive functions using the Wechsler Intelligence Scale for Children 4th Edition (WISC-IV), Brown Attention-Deficit Disorder Scales for Children and Adolescents (Brown-ADD), and Quantified Behavior (Qb) tests, and behavior using the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF), at 6.5 y of age. Anthropometrics and plasma lipids were assessed at 6 y of age.RESULTS: There were no differences between the EF and SF groups in any of the subscales in WISC-IV or Brown-ADD at 6.5 y of age, in the proportion of children with scores outside the normal range in the Qb test, nor in clinical or borderline indications of problems in adaptive functioning from parental and teacher's scoring using the CBCL and TRF. There were no differences between the EF and SF groups in weight, length, or head or abdominal circumferences, nor in plasma concentrations of homocysteine, lipids, insulin, or glucose.CONCLUSIONS: Among children who as infants consumed a low-energy, low-protein formula supplemented with bovine MFGMs, there were no effects on neurodevelopment, growth, or plasma cholesterol status 6-6.5 y later.
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