Pikkulasten normaali unen kehitys ja siihen vaikuttavat tekijät

Ensimmäisen kahden elinvuoden aikana unen laadussa tapahtuu moninaisia muutoksia. Viimeistään 2-3 kuukauden iässä pisimmät unijaksot alkavat sijoittua yöhön ja päiväunet vähenevät. Noin puolen vuoden ikään mennessä nukahtamisviive lyhenee alle 30 minuuttiin, mikä heijastelee vuorokausirytmin kypsymistä. Lyhyet yöheräämiset ovat yleisiä koko ensimmäisen ikävuoden ajan ja vähenevät vasta toisella ikävuodella itsesäätelyn kehityksen myötä. Pitkittynyt yövalvominen on epätyypillistä kaikissa ikäryhmissä. Pienten lasten uniongelmat ovat yleisiä. Erilaiset ulkoiset tekijät, kuten somaattiset sairaudet, perheen vuorokausirytmi, valaistusolosuhteet ja iltarutiinit, vanhemmuus sekä muutokset kasvuympäristössä vaikuttavat helposti lapsen nukkumiseen. Hoitosuunnitelmaa laadittaessa tulisikin ensimmäisenä kiinnittää huomiota unenhuoltoon jo ennen kuin varsinaisia interventioita suunnitellaan.publishedVersionPeer reviewe

Exposure to electronic media was negatively associated with speech and language development at 18 and 24 months

Aim: This study evaluated early speech and language development at 18 and 24 months, and associated factors, based on parental reports. Method: We followed up the CHILD-SLEEP birth cohort of 1667 Finnish-speaking families, who were randomly recruited in 2011–2013 during routine visits to maternity clinics in the Pirkanmaa Hospital District of Finland. The women were approximately 32 weeks’ pregnant at enrolment. Parents reported the size of their child's expressive vocabulary, word combinations, intelligibility, finger-pointing and adherence to instructions. A subsample was studied using the Expressive Language subscale of the Bayley Scales of Infant and Toddler Development, Third Edition. Results: The children's vocabulary was smaller than previously reported. At 18 months of age, 68.8% of the 997 children had a vocabulary of 20 words or less and 35.7% used about five words at most. At 24 months, 32.4% of the 822 children had a vocabulary of 50 words or less and 18.4% used about 20 words at most. Longer child and parental exposure to electronic media was negatively associated with the size of the child's expressive vocabulary. Conclusion: Vocabulary size at 18 and 24 months was smaller than previously reported and negatively associated with exposure to electronic media.Aim This study evaluated early speech and language development at 18 and 24 months, and associated factors, based on parental reports. Method We followed up the CHILD-SLEEP birth cohort of 1667 Finnish-speaking families, who were randomly recruited in 2011-2013 during routine visits to maternity clinics in the Pirkanmaa Hospital District of Finland. The women were approximately 32 weeks' pregnant at enrolment. Parents reported the size of their child's expressive vocabulary, word combinations, intelligibility, finger-pointing and adherence to instructions. A subsample was studied using the Expressive Language subscale of the Bayley Scales of Infant and Toddler Development, Third Edition. Results The children's vocabulary was smaller than previously reported. At 18 months of age, 68.8% of the 997 children had a vocabulary of 20 words or less and 35.7% used about five words at most. At 24 months, 32.4% of the 822 children had a vocabulary of 50 words or less and 18.4% used about 20 words at most. Longer child and parental exposure to electronic media was negatively associated with the size of the child's expressive vocabulary. Conclusion Vocabulary size at 18 and 24 months was smaller than previously reported and negatively associated with exposure to electronic media.Peer reviewe

Sleep disturbances and depressive and anxiety symptoms during pregnancy : associations with delivery and newborn health

Background Sleep disturbances and mood symptoms are common in late pregnancy; according to the literature, they can affect delivery and newborn outcomes. This study evaluated the effect of sleep and mood symptoms on delivery and newborn health, because there are insufficient and partly contradictory studies on the topic. Methods A cohort of 1414 mothers in their third trimester was enrolled in this prospective cross-sectional questionnaire study. Validated questionnaires were assessed for the measurement of sleep disturbances and depressive and anxiety symptoms. The data on delivery and newborn outcomes were obtained from hospital medical records. Results Sleep disturbances were very common. A higher insomnia score (beta = - 0.06, p = 0.047) and longer sleep need (beta = 0.07, p = 0.047) were related to delivery at a lower gestational age. In addition, a higher insomnia score (beta = - 28.30, p = 0.010) and lower general sleep quality (beta = - 62.15, p = 0.025) were associated with lower birth weight, but longer sleep duration and longer sleep need with a higher birth weight (beta = 28.06, p = 0.019; beta = 27.61, p = 0.028, respectively). However, the findings regarding birth weight lost their significance when the birth weight was standardized by gestational weeks. Concerning Apgar scores and umbilical artery pH, no associations were found. Snoring was associated with a shorter duration of the first phase of delivery (beta = - 78.71, p = 0.015) and total duration of delivery (beta = - 79.85, p = 0.016). Mothers with higher insomnia, depressive, or anxiety symptoms were more often treated with oxytocin (OR 1.54 95% CI 1.00-2.38, p = 0.049, OR 1.76, 95% CI 1.02-3.04, p = 0.049 and OR 1.91, CI 95% 1.28-2.84, p < 0.001, respectively) and those with higher depressive and anxiety symptoms were delivered more often with elective cesarean section (OR 4.67, 95% CI 2.04-12.68, p < 0.001 and OR 2.22, 95% CI 1.03-4.79, p = 0.042). Conclusions Maternal sleep disturbances and mood symptoms during pregnancy are associated with delivery and newborn health. However, nearly, all the outcomes fell within a normal range, implying that the actual risks are low.Peer reviewe

Maternal stress or sleep during pregnancy are not reflected on telomere length of newborns

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Univaikeudet raskauden aikana - riskitekijä synnytyksen jälkeiselle masennukselle

In the general population, sleeping problems can precede an episode of depression. We hypothesized that sleeping problems during pregnancy, including insomnia symptoms, shortened sleep, and daytime tiredness, are related to maternal postnatal depressiveness. We conducted a prospective study evaluating sleep and depressive symptoms, both prenatally (around gestational week 32) and postnatally (around 3months after delivery) in the longitudinal CHILD-SLEEP birth cohort in Finland. Prenatally, 1667 women returned the questionnaire, of which 1398 women participated also at the postnatal follow-up. Sleep was measured with the Basic Nordic Sleep Questionnaire (BNSQ) and depressive symptoms with a 10-item version of the Center for Epidemiological Studies Depression Scale (CES-D). Altogether, 10.3% of the women had postnatal depressiveness (CES-D 10 points). After adjusting for main background characteristics and prenatal depressiveness (CES-D 10), poor general sleep quality (AOR 1.87, 95% CI 1.21-2.88), tiredness during the day (AOR 2.19, 95% CI 1.41-3.38), short sleep 6 and 7h, sleep latency >20min, and sleep loss 2h were associated with postnatal depressiveness (all pPeer reviewe

Finnish children who experienced narcolepsy after receiving the Pandemrix vaccine during the 2009-2010 H1N1 pandemic demonstrated high level of psychosocial problems

https://doi.org/10.1111/apa.16233ABSTRACT Aim We assessed psychosocial burdens in children who developed narcolepsy after receiving the Pandemrix H1N1 vaccine during the 2009-2010 pandemic. Parental quality of life was also assessed. Methods This multicentre study covered four of the five Finnish University Hospital Districts, which dealt with about 90% of the paediatric narcolepsy cases after the Pandemrix vaccination. The medical records of children diagnosed from 2010-2014 were reviewed. The questionnaires included the Youth Self Report (YSR), Children?s Depression Inventory (CDI), the Child Behaviour Checklist (CBCL) and questions on parental resources, stress and quality of life. Results We obtained the medical records of 94 children who were aged 5-17 years at the time of their narcolepsy diagnosis and questionnaire data for 73 of those children. Most children had strong narcolepsy symptoms 25% had CDI scores that suggested depression. In addition, 41% had total CBCL problem scores above the clinically significant limit and 48% were anxious, withdrawn and had somatic complaints. Sleep latency was weakly associated with the CBCL total problem score. Half of the children needed psychiatric interventions and parental stress was common. Conclusion Depression and behavioural problems were common in children with narcolepsy after the Pandemrix vaccination and their parents frequently reported feeling stressed.Peer reviewe

Lasten ja nuorten krooninen väsymysoireyhtymä

Kroonista väsymysoireyhtymää pidetään toiminnallisena häiriönä. Etiologia on todennäköisesti monitekijäinen. Oikea-aikainen diagnoosi parantaa potilaan ennustetta ja kuntoutumista. Tutkitusti tehokasta hoitoa ei vielä ole. Hoidosta vastaa lasten ja nuorten hoitoon perehtynyt moniammatillinen tiimi. Tavoitteena on arjen toimintakyvyn tukeminen tai palauttaminen pitkäkestoisen, kuuntelevan ja luottamuksellisen hoitosuhteen avulla.Peer reviewe

Prenatal and Postnatal Predictive Factors for Children's Inattentive and Hyperactive Symptoms at 5 Years of Age: The Role of Early Family-Related Factors

We examined several parent-reported prenatal and postnatal factors as potential risk factors for attention-deficit and hyperactivity disorder (ADHD) symptomatology in 5-year-old children. Our study is based on the CHILD-SLEEP birth cohort. Several parental questionnaires were collected prenatally (32nd pregnancy week) and postnatally (i.e. child aged 3, 8, and 24 months and at 5 years). At 5 years of age, ADHD symptoms were assessed using questionnaires. Our main results showed that being a boy, parental depressive symptoms, more negative family atmosphere or a child’s shorter sleep duration, and maternal authoritarian parenting style predicted inattentive/hyperactive symptoms. Maternal and paternal authoritative parenting style predicted less inattentive/hyperactive symptoms. Children with several risk factors together had the highest risk for inattentive/hyperactive symptoms. Our findings emphasise the need for early screening and treatment of parental mental health, and early evidence-based targeted parental support, to enable early intervention in those children at a risk of developing ADHD.Peer reviewe

Night Awakening in Infancy : Developmental Stability and Longitudinal Associations With Psychomotor Development

Fragmented sleep is common in infancy. Although night awakening is known to decrease with age, in some infants night awakening is more persistent and continues into older ages. However, the influence of fragmented sleep on development is poorly known. In the present study, the longitudinal relationship between fragmented sleep and psychomotor development (Bayley Scales of Infant and Toddler Development [Bayley-III]; Bayley, 2009) was investigated in infants with (>= 3 night awakenings, n = 81) and without fragmented sleep (Peer reviewe