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- Yasumitsu-Lovell, Kahoko
(författare)
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Pre/Peri/Earl-Life Exposures and Early Child Neurodevelopment: Results from the Japan Environment and Children's Study (JECS)
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Combinations of genetic and environmental factors contribute to aetiologies of neuropsychiatric problems and neurodevelopmental disorders (NDDs) in intricate manners. Among the environmental factors, exposures during the pre-/perinatal periods and early childhood are particularly important. Holistic assessment of additive risks during these periods on child neurodevelopment is crucial for prevention, early detection, and intervention. Equally, when concerns arise about a child’s development, comprehensive/ holistic assessment of neurodevelopment is extremely important as comorbidities are the rule rather than the exception. Aim: The overall aim of this thesis is to examine possible associations between pre-/perinatal and early-life exposures and child neurodevelopment up until 3 years of age. The thesis focuses on the association between pre-/perinatal optimality and child development at 1 month and 3 years of age (Study I), between birth month and gross motor development at age 6 and 12 months (Study II), and between child vitamin D and neurodevelopment at age 2 years (Study III). The fourth study assesses the ability of the ESSENCE-Q used at child age 2.5 years as a screening tool to identify child overall neurodevelopmental problems and relate findings to NDDs diagnosed before 3 years of age (Study IV). Methods: Medical records, blood samples, and self-administered parental questionnaires from the Japan Environment and Children’s Study (JECS), one of the world’s largest ongoing national birth cohort studies (more than 100,000 mother-child dyads), were utilised throughout the four studies. Results: Obstetric reduced optimality scale scores showed dose-response associations with NDDs at child age 3 years (Study I). Summer-born babies lagged behind winter-born babies regarding gross motor development at ages 6 and 12 months (Study II). Low vitamin D level was negatively associated with cognitive and communication development in boys (Study III). Parent-completed ESSENCE-Q was useful for screening out children without neurodevelopmental problems (Study IV). Conclusions: Child neurodevelopment by age 3 years was associated with negative pre-/perinatal factors, seasonality, and, in boys, with low vitamin D levels at age 2 years. These findings could be taken to indicate that better support should be provided for children who experienced adversities in their early life, as early as during the prenatal period. The ESSENCE-Q can probably be used for screening out children without major NDDs.
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| 2. |
- Yasumitsu-Lovell, Kahoko, et al.
(författare)
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Pre-/perinatal reduced optimality and neurodevelopment at 1 month and 3 years of age: Results from the Japan Environment and Children's Study (JECS)
- 2023
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Neurodevelopmental disorders (NDDs) in children are associated with a complex combination of genetic and/or environmental factors. Pre-/perinatal events are major known environmental suboptimal factors, and their individual and combined contributions vary. This study investigated the association between pre-/perinatal reduced optimality and child development observed by parents at 1 month, as well as NDDs at 3 years of age (i.e., motor delay, intellectual disability, developmental language disorder, and autism spectrum disorder), in the context of the Japan Environment and Children's Study. The study also assessed whether child development at 1 month predicted NDDs at 3 years of age. Associations between 25 pre-/perinatal factors and (a) developmental concerns at 1 month of age and (b) NDDs at 3 years were analyzed (n = 71,682). Binomial regression models were used to investigate risk ratios of the developmental outcome at each time point for total pre-/perinatal reduced optimality scale scores, as well as for individual pre-/perinatal factors of the reduced optimality scale. Finally, we assessed the ability of parental observations of offspring development at 1 month to predict NDDs at 3 years. Total reduced optimality scores were positively associated with 1-month developmental concerns and 3-year NDDs, with higher scores (i.e., a reduction in optimality) associated with an increased risk of both NDDs and earlier parental concerns. Neonatal transportation, epidural analgesia, advanced maternal age, cesarean section delivery, Apgar score <= 8, and hyperbilirubinemia were identified as individual risk factors for 3-year NDDs, overlapping with 14 risk factors for 1-month developmental concerns except Apgar score <= 8. Among six developmental items assessed at 1 month of age, concerns about gross motor function and difficulty holding/trouble calming down had the strongest associations with later-diagnosed motor delay and autism spectrum disorder, respectively. Five perinatal factors and advanced maternal age were associated with NDD at 3 years of age, as were early parental developmental concerns regarding their offspring's overall development, indicating the importance of careful follow-up of offspring born with pre-/perinatal reduced optimality. The results also implicated early parental concerns, as early as 1 month, may also be a useful indicator of later NDD status.
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| 3. |
- Yasumitsu-Lovell, Kahoko, et al.
(författare)
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Vitamin D deficiency associated with neurodevelopmental problems in 2-year-old Japanese boys
- 2023
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Ingår i: Acta Paediatrica. - 0803-5253. ; 113:1, s. 119-126
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Tidskriftsartikel (refereegranskat)abstract
- Aim: While associations between vitamin D deficiency and neurodevelopmental disorders have been found, large studies on child vitamin D, neurodevelopment, and sex differences among the general population are lacking. This study aimed to investigate the association between child serum 25-hydroxyvitamin D (25(OH)D)) levels and neurodevelopmental problems (NDPs).Methods: Serum 25(OH)D and NDPs were measured at age two among the subcohort study of the Japan Environment and Children's Study. NDPs were assessed with the Kyoto Scale of Psychological Development 2001 (Kyoto scale). Adjusted odds ratios (aORs) for the Kyoto-scale developmental quotient scores <70 were calculated, for postural-motor, cognitive-adaptive, and language-social domains and overall scores, adjusted for test month, latitude, small for gestational age, maternal age, and daycare attendance.Results: Among 2363 boys and 2290 girls, boys had higher 25(OH)D levels, but scored lower in the Kyoto scale. For boys in the vitamin D deficiency (<20 ng/mL) group, aORs of scoring the Kyoto-scale DQs <70 were 2.33 (p = 0.006) for overall DQs, 1.91 (p = 0.037) for cognitive-adaptive, and 1.69 (p = 0.024) for language-social domains. For girls, results were inconclusive.Conclusion: Only boys showed a clear and cross-modal association between vitamin D deficiency and NDPs.
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