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- Domellöf, Erik, 1970-, et al.
(author)
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Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages
- 2020
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In: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 8:311
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Journal article (peer-reviewed)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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2. |
- Timby, Niklas, et al.
(author)
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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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In: American Journal of Clinical Nutrition. - : Oxford University Press. - 0002-9165 .- 1938-3207. ; 113:3, s. 586-592
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Journal article (peer-reviewed)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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3. |
- Yeung, Edwina, et al.
(author)
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Maternal age is related to offspring DNA methylation : a meta-analysis of results from the pace consortium
- 2024
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In: Aging Cell. - : John Wiley & Sons. - 1474-9718 .- 1474-9726. ; 23:8
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Journal article (peer-reviewed)abstract
- Worldwide trends to delay childbearing have increased parental ages at birth. Older parental age may harm offspring health, but mechanisms remain unclear. Alterations in offspring DNA methylation (DNAm) patterns could play a role as aging has been associated with methylation changes in gametes of older individuals. We meta-analyzed epigenome-wide associations of parental age with offspring blood DNAm of over 9500 newborns and 2000 children (5–10 years old) from the Pregnancy and Childhood Epigenetics consortium. In newborns, we identified 33 CpG sites in 13 loci with DNAm associated with maternal age (PFDR < 0.05). Eight of these CpGs were located near/in the MTNR1B gene, coding for a melatonin receptor. Regional analysis identified them together as a differentially methylated region consisting of 9 CpGs in/near MTNR1B, at which higher DNAm was associated with greater maternal age (PFDR = 6.92 × 10−8) in newborns. In childhood blood samples, these differences in blood DNAm of MTNR1B CpGs were nominally significant (p < 0.05) and retained the same positive direction, suggesting persistence of associations. Maternal age was also positively associated with higher DNA methylation at three CpGs in RTEL1-TNFRSF6B at birth (PFDR < 0.05) and nominally in childhood (p < 0.0001). Of the remaining 10 CpGs also persistent in childhood, methylation at cg26709300 in YPEL3/BOLA2B in external data was associated with expression of ITGAL, an immune regulator. While further study is needed to establish causality, particularly due to the small effect sizes observed, our results potentially support offspring DNAm as a mechanism underlying associations of maternal age with child health.
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4. |
- Afeiche, Myriam C., et al.
(author)
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The dietary inflammatory index is associated with subclinical mastitis in lactating european women
- 2022
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In: Nutrients. - : MDPI. - 2072-6643. ; 14:22
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Journal article (peer-reviewed)abstract
- Subclinical mastitis (SCM) is an inflammatory state of the lactating mammary gland, which is asymptomatic and may have negative consequences for child growth. The objectives of this study were to: (1) test the association between the dietary inflammatory index (DII®) and SCM and (2) assess the differences in nutrient intakes between women without SCM and those with SCM. One hundred and seventy-seven women with available data on human milk (HM) sodium potassium ratio (Na:K) and dietary intake data were included for analysis. Multivariable logistic regression was used to examine the association between nutrient intake and the DII score in relation to SCM. Women without SCM had a lower median DII score (0.60) than women with moderate (1.12) or severe (1.74) SCM (p < 0.01). A one-unit increase in DII was associated with about 41% increased odds of having SCM, adjusting for country and mode of delivery, p = 0.001. Women with SCM had lower mean intakes of several anti-inflammatory nutrients. We show for the first time exploratory evidence that SCM may be associated with a pro-inflammatory diet and women with SCM have lower intakes of several antioxidant and anti-inflammatory nutrients.
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5. |
- Alm, Stina, et al.
(author)
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Erythrocyte transfusions increased the risk of elevated serum ferritin in very low birth weight infants and were associated with altered longitudinal growth
- 2020
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 109:7, s. 1354-1360
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Journal article (peer-reviewed)abstract
- Aim: There has been a lack of population‐based longitudinal data on serum ferritin in very low birth weight (VLBW) infants during hospitalisation. Our aim was to fill this gap in the knowledge and investigate risk factors for elevated serum ferritin and associations between erythrocyte transfusions and longitudinal growth.Methods: We retrospectively reviewed longitudinal data on 126 VLBW infants treated at Umeå University Hospital, Sweden, between 2010‐2013.Results: The infants’ mean gestational age and birth weight were 26.9 weeks and 899 grams. Most (91%) received erythrocyte transfusions and the majority had multiple erythrocyte transfusions. There was a significant correlation between serum ferritin and the volume of transfusions. Almost two‐thirds had at least one serum ferritin measurement of more than 350 µg/L, indicating iron overload. In those with complete anthropometric data (n=78) there was no significant effect of serum ferritin concentrations in relation to longitudinal growth, but there was a positive association between the erythrocyte transfusion dose and longitudinal growth in VLBW infants born before 25 weeks.Conclusion: This is the first population‐based study to investigate longitudinal data on serum ferritin in VLBW infants during hospitalisation. The unexpected positive finding in the subgroup born at less than 25 weeks needs further research with a larger cohort.
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- Alm, Stina, et al.
(author)
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Prevalence and risk factors for post discharge feeding problems in children born extremely preterm
- 2023
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In: Journal of Pediatric Gastroenterology and Nutrition - JPGN. - : Wolters Kluwer. - 0277-2116 .- 1536-4801. ; 76:4, s. 498-504
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Journal article (peer-reviewed)abstract
- Objectives: Preterm infants have a high risk of post discharge feeding problems, but there is a lack of population-based studies in infants born extremely preterm and little is known about underlying mechanisms.The objectives were to assess the incidence of post discharge feeding problems and underweight in a population-based cohort of infants born extremely preterm in Sweden (EXPRESS) and identify perinatal risk factors.Methods: Perinatal health data and prenatal/postnatal growth data was prospectively collected in the cohort. Data on clinical diagnoses related to feeding problems were obtained from the Swedish Patient Register, population prevalence data was also obtained. The main outcome was a composite of post discharge feeding problem diagnosis and/or underweight at 2.5 years of age.Results: In total, 66 children (19%) had post discharge feeding problems diagnosed before 2 years and/or underweight at 2.5 years of age. The risk of feeding problems when compared to the general population was significantly higher, with an odds ratio (OR) of 193 (95% CI 137.6-270.9). The strongest risk factors for feeding problems were the number of days on mechanical ventilation during the first eight postnatal weeks, OR of 1.59 (CI 95% 1.29-1.98), and the Clinical Risk Index for Babies-score, OR of 1.14 (CI 95% 1.03-1.26).Conclusions: Post discharge feeding problems and underweight are common in children born extremely preterm. The strongest perinatal risk factor for later feeding problems was early treatment with mechanical ventilation. Identifying infants at risk of post discharge feeding problems might be useful for targeting of nutritional support.
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8. |
- Berglund, Staffan K., et al.
(author)
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Hepcidin is a relevant iron status indicator in infancy : results from a randomized trial of early vs. delayed cord clamping
- 2021
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In: Pediatric Research. - : Nature Publishing Group. - 0031-3998 .- 1530-0447. ; 89:5, s. 1216-1221
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Journal article (peer-reviewed)abstract
- Background: We aimed to evaluate whether serum hepcidin is a useful indicator of iron status in infants.Methods: Term infants (n = 400) were randomized to delayed (≥180 s) or early (≤10 s) cord clamping (CC). Iron status was assessed at 4 and 12 months. In all cases with iron depletion or iron deficiency (ID) (as defined in “Methods”) (n = 30) and 97 randomly selected iron-replete infants, we analyzed hepcidin and explored its correlation to the intervention, iron status, and perinatal factors.Results: Serum hepcidin concentrations were significantly lower in the early CC group at both time points and in ID infants at 4 months. Median (2.5th–97.5th percentile) hepcidin in non-ID infants in the delayed CC group (suggested reference) was 64.5 (10.9–142.1), 39.5 (3.5–157.7), and 32.9 (11.2–124.2) ng/mL in the cord blood and at 4 and 12 months, respectively. The value of 16 ng/mL was a threshold detecting all cases of iron depletion/ID at 4 months. No similar threshold for ID was observed at 12 months. The strongest predictor of hepcidin at both ages was ferritin.Conclusions: Hepcidin is relevant as iron status indicator in early infancy and may be useful to detect ID. Levels <16 ng/mL at 4 months of age indicates ID.ImpactSerum hepcidin is a relevant indicator of iron status in early infancy.Normal reference in healthy infants is suggested in this study.Serum hepcidin may be useful in clinical practice to detect iron deficiency.
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9. |
- Berglund, Staffan K., et al.
(author)
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Iron deficiency in infancy : current insights
- 2021
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In: Current opinion in clinical nutrition and metabolic care. - : Wolters Kluwer. - 1363-1950 .- 1473-6519. ; 24:3, s. 240-245
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Research review (peer-reviewed)abstract
- PURPOSE OF REVIEW: Iron deficiency is the most common micronutrient deficiency and infants are at particular risk. The purpose of this review is to summarize recent studies that explored the metabolism of iron in infants as well as the risks and benefits of iron supplementation in different populations.RECENT FINDINGS: The ability of infants to regulate iron homeostasis is not fully known but most likely different from adults. Reducing iron deficiency has beneficial effects on neurodevelopment but iron overload may have adverse functional effects including diarrhea and even poor neurodevelopment. Recent studies have confirmed benefits of delayed cord clamping and supplementation of infants in risk groups while iron supplementation to pregnant women has shown limited effect in the offspring with regard to iron status and neurodevelopment. Further support is given to the recommendation that exclusive breast feeding, without supplementation, is safe for normal birth weight infants until 6 months whereafter an iron-rich diet should be given.SUMMARY: Iron deficiency negatively impacts global health but efforts to identify optimal interventions are progressing. Yet, questions remain, particularly regarding long-term risks, benefits and optimal interventions for low birth weight infants as well as the level of iron fortification in infant formula.
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10. |
- Bergman, Åke, et al.
(author)
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Analys av klorparaffiner i bröstmjölk och serum
- 2022
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Reports (other academic/artistic)abstract
- Klorparaffiner (CP) utgör en stor grupp av polyklorerade alkaner av olika kolkedjelängder och olika kloreringsgrad; kortkedjiga (C10 – C13, SCCP), medellånga (C14 – C17, MCCP) och långa (≥C18, LCCP). CP produceras i mycket stora volymer för användning som additiv (bl.a. som mjukgörare och flamskyddsmedel) i produkter, material och varor. De är globala miljöföroreningar som förekommer i abiotisk miljö, djur och människor. Hypotesen för den studie som nu genomförts är att CP uppvisar olika ackumulationsgrad i blod (serum eller plasma) jämfört med bröstmjölk. Därför har parade prover från 25 kvinnor som donerat blod och bröstmjölk analyserats med avseenden på CP i dessa båda matriser och halterna har jämförts med halter av en PCB-markör, CB-153, samt med 4,4’-DDE. Analyserna visar signifikanta haltskillnader, på fettviktsbasis, av SCCP och MCCP i serum på 22 respektive 6.2 gånger högre koncentrationer än de som uppmätts i bröstmjölken. Data visade även förhöjda halter av såväl vSCCPs (mycket korta CP) som LCCPs i serum jämfört med bröstmjölk men skillnaden i dessa båda fall är inte signifikant säkerställd. Medianhalterna av SCCP, MCCP och LCCP i serum respektive bröstmjölk är: 790, 520 och 16 ng/g fett respektive 36, 63 och 6,0 ng/g fett. 4,4’-DDE och CB-153 är jämförbara i de båda matriserna och ligger på 17 respektive 12 ng/g fett. SCCP är klassificerad som en POP i Stockholmskonventionen men inte MCCP trots höga halter i serum. CP är, oavsett kolkedjelängd, persistenta.
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