Lo Studio SCoPre (Sviluppo Cognitivo e Prematurità): dati preliminari sullo sviluppo dei “Late Preterms” in età scolare

Background. In Italy, children born Late Preterm (LPs, 34-36 weeks of gestational age) represent about 4% of all births. LPs have a higher risk of mortality, repeated hospitalizations in early life, chronic illnesses and functional limitations, compared to children born at term. Moreover, LPs are more likely to experience difficulties in their neurodevelopment, which may impair adaptation, especially at school. This study explores the developmental and behavioural outcomes of LPs compared to those of “Very Preterm” (VPs) or “Full Term” (FTs) peers. Methods. The paediatricians involved, recruited, among their patients, all VPs and LPs aged 7-10 years and a number of FTs twice that of the LPs. Mothers of children filled in a protocol consisting of a medical history form and three questionnaires. Results. 554 questionnaires were collected and processed (39 VPs, 183 LPs and 332 FTs). The three groups were significantly different in terms of birth weight (p < .001), twin pregnancy (p < .001), type of delivery (p <.001), type of pregnancy (p < .001) and gender (p < .05). FTs show better school achievements than VPs and LPs (p < .001). The LPs showed more symptoms of anxiety (p < .05) and aggressive behaviours (p < .001) than the FTs and, together with VPs, social problems (p < .001). VPs score significantly lower than FTs in the fine motor (p < .05) and in the general coordination abilities (p = .01). Mothers of the LPs reported a lower mental and physical wellbeing than mothers of FTs (p = .06). Conclusions. These data show that preterm children are more vulnerable that counterparts born at term in some developmental areas. Particularly, LPs present more difficulties in school achievements and in some behaviour, compared to FTs, often similarly to VPs. Mothers of the LPs perceive more mental and physical discomfort than mothers of FTs

Early protein intake influences neonatal brain measurements in preterms: an observational study

Introduction: To limit extrauterine growth restriction, recent guidelines on nutrition of preterm neonates recommended high protein intake since the first day of life (DOL). The impact of this nutritional strategy on the brain is still controversial. We aimed to evaluate the effects of protein intake on early cerebral growth in very low birth weight newborns. Materials and Methods: We performed serial cranial ultrasound (cUS) scans at 3-7 DOL and at 28 DOL in very low birth weight newborns consecutively observed in the neonatal intensive care unit. We analyzed the relation between protein intake and cerebral measurements at 28 DOL performed by cUS. Results: We enrolled 100 newborns (gestational age 29 ± 2 weeks, birth weight 1,274 ± 363 g). A significant (p < 0.05) positive correlation between enteral protein intake and biparietal diameter (r = 0.490**), occipital-frontal diameter (r = 0.608**), corpus callosum (length r = 0.293*, genu r = 0.301*), caudate head (right r = 0.528**, left r = 0.364**), and cerebellum (transverse diameter r = 0.440**, vermis height r = 0.356**, vermis width r = 0.377**) was observed at 28 DOL. Conversely, we found a significant negative correlation of protein intake given by parenteral nutrition (PN) with biparietal diameter (r = -0.524**), occipital-frontal diameter (r = -0.568**), body of corpus callosum (r = -0.276*), caudate head (right r = -0.613**, left r = -0.444**), and cerebellum (transverse diameter r = -0.403**, vermis height r = -0.274*, vermis width r = -0.462**) at 28 DOL. Multivariate regression analysis showed that measurements of occipital-frontal diameter, caudate head, and cerebellar vermis at 28 DOL depend positively on protein enteral intake (r = 0.402*, r = 0.305*, and r = 0.271*) and negatively by protein parenteral intake (r = -0.278*, r = -0.488*, and r = -0.342*). Conclusion: Brain development in neonatal life depends on early protein intake. High protein intake affects cerebral structures' measurements of preterm newborn when administered by PN. Positive impact on brain development encourages the administration of recommended protein intake mainly by enteral nutrition

Cross-cultural adaptation, reliability and predictive validity of the Italian version of Developmental Coordination Disorder Questionnaire (DCDQ)

Background: Developmental coordination disorder (DCD) is a motor disorder of unclear etiology that severely interferes with a child's ability to perform daily motor tasks. As a useful alternative to a time-consuming motor test and specialist evaluation, parents or teachers can complete motor questionnaires. A tool used worldwide to screen motor performance in 4- to 14-year-old children is the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07). Aims: To describe how we translated the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) and adapted it to the Italian population and to test its preliminary psychometric properties in Italian children. Methods: Parents of a clinical group of 26 children (5-11 years old) with a diagnosis of DCD and 52 matched controls completed the DCDQ translated into Italian and adapted for cross-cultural purposes according to current guidelines. Twenty-four parents of typically developing children randomly selected completed the questionnaire twice to examine test -retest reliability. Results: The internal consistency value (Cronbach alpha) for the Italian DCDQ was 0.94. The Italian DCDQ achieved moderate-to-high test -retest reliability(ICC) for 14/15 items and a good diagnostic performance for identifying children with DCD (sensitivity 88% and specificity 96%). Conclusions: The Italian DCDQ is a valid screening tool for assessing motor performance in 5- to 11-year-old children that merits research in a larger sample. (C) 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved

Gender-biased attitudes and attributions among young italian children. Relation to peer dyadic interaction

In the present study, we examined gender-based social cognitions (i.e., global liking and trait attributions) related to observed dyadic peer interactions with same- and other-gender peers in a sample of young children from a large city in central Italy (N = 151; M age = 56.54 months). A multi-method procedure was used including observations of naturally occurring peer interactions and child reports of gender cognitions. Results showed that children interacted more in same-gender dyads than in other-gender dyads (i.e., gender segregation) and viewed same-gender peers more positively than other-gender peers (i.e., gender bias). However, this ingroup bias was found to be stronger for girls than for boys. In addition, findings revealed that for girls only, global liking and positive attributions were related to observed peer dyadic interactions. Specifically, girls who reported higher liking towards same-gender peers were observed to interact more in same-gender dyads. Moreover, the more girls reported liking same-gender peers and the more they viewed them as having positive characteristics, the less girls interacted in other-gender dyads. This result was consistent with our hypothesis about the relationship between gender cognitions and children’s peer interactions. Overall, these findings extend knowledge about the development of gender biases as early as preschool age and the role of gender cognitions on social interactions among young children

Zinc levels in neonatal life influence long-term neurodevelopment

Many preclinical studies demonstrated a key role of zinc (Zn) intake in neurodevelopmental processes. Brion at al. recently published a cohort study on Journal of Perinatology, demonstrating that Zn supplementation improved head circumference. However, they concluded that there is still urgent need of studies regarding the effects of early life Zn supplementation and Zn deficiency on NDV. To make our contribution in addressing this issue, we herein show our data regarding the relationship between serum Zn levels in preterm newborns and long-term effects on NDV. We found a significantly (p < 0.05) positive correlation between total composite motor score and serum Zn levels at 28 DOL (r = 0.467). In order to improve NDV of preterm newborns, optimization of early nutritional strategies, including Zn supplementation, represent an important toll to be considered