Intra-uterine exposure to selective serotonin reuptake inhibitors (SSRIs), maternal psychopathology, and neurodevelopment at age 2.5years-Results from the prospective cohort SMOK study

Background: Selective serotonin reuptake inhibitors (SSRIs) are prescribed in 2-8% during pregnancy. Whether prenatal exposure to SSRIs has long-term effects on the children's development is unknown. Aim: The aim of this study was to determine the effect of prenatal exposure to SSRIs on children's cognitive, motor, and behavioral outcomes at 2.5 years, adjusted for maternal depression and anxiety. Methods: In a prospective, longitudinal cohort-study we included 111 pregnant women treated either or not with an SSRI. We examined cognitive and motor development of their children at 2.5 years, using the Bayley Scale of Infant and Toddler Development, 3rd Edition, and measured emotional and behavioral problems using the parent-rated Child Behavior Checklist (CBCL). Maternal depression and anxiety was determined during pregnancy and at the children's assessment. Differences of normed cognitive, motor, and behavioral scores between SSRI-exposed and non-SSRI-exposed children were tested using multiple linear regression analyses. Results: We examined 102 children. SSRI-exposed children had lower scaled scores on cognition and gross motor development than non-SSRI-exposed children: 9.0 +/- 1.4 (mean +/- SD) versus 9.9 +/- 1.7 [P = 0.004], and 7.9 +/- 2.2 versus 9.0 +/- 2.5 [P = 0.01], respectively. Differences remained significant after adjusting for maternal depression and anxiety and other confounders in various models (mean difference for cognition 0.8 to 0.9 points, for gross motor 1.1 to 1.2 points). Only after adjusting for severity of maternal anxiety, differences in gross motor scores lost significance. Conclusions: Prenatal exposure to SSRIs is associated with poorer cognitive and gross motor development of the children at 2.5 years. Effects on gross motor development disappeared after correction for severity of maternal anxiety

The Predictive Value of Amplitude-Integrated Electroencephalography in Preterm Infants for IQ and Other Neuropsychological Outcomes at Early School Age

Background: Amplitude-integrated electroencephalography (aEEG) is used increasingly in neonatal intensive care and seems helpful in predicting outcomes at the age of 2 years, Objectives:To determine whether early aEEG patterns in preternn infants are equally useful in predicting outcomes at early school age. Methods: We recorded aEEG in 41 pre-terms (gestational age 26.0-32.9 weeks) at a median postnatal age of 9.7 h (IQR 7.0-25.3) and in 43 preternns on median day 8 (IQR 7-9). We assessed aEEG by pattern recognition and calculated the means of the aEEG amplitude centiles. At a median of 739 years, i.e., early school age, we assessed their motor, cognitive, and behavioral outcomes. Results: Depressed aEEG patterns were not associated with poorer outcomes. Cyclicity directly after birth was associated with a higher total IQ (mean 104 vs. 97, p = 0.05) and higher scores on visual perception (mean percentile 57.1 vs. 40.1, p 0,049) and visual memory (mean percentile 34.5 vs. 19.1, p = 0090). We found some associations between the aEEG amplitude centiles and cognitive outcomes, but none for motor or behavioral outcomes. There was an increased risk of abnormal scores on long-term verbal memory in cases of the lower 5th and 50th aEEG amplitude centiles directly after birth. The odds ratios were 0.65 (95% CI 0,42-0.99, p = 0.040) and 0.71 (95% CI 0.52-0.96, p = 0.025), respectively. Conclusions: In relatively healthy preternn infants the value of aEEG in predicting neuropsychological outcomes at early school age is limited. The presence of cyclicity directly after birth tends to be associated with better cognition. (C) 2018 The Author(s) Published by S. Karger AG, Base

Visuospatial Perception in Children Born Preterm With No Major Neurological Disorders

Objective: Many investigations have found deficits in visuospatial perception in children born preterm, however, it is not clear whether the deficits are specific to visuospatial perception or the consequences of deficits in other functional areas, whic

Prenatal exposure to persistent organic pollutants and cognition and motor performance in adolescence

Background: Prenatal exposure to persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), was found to be associated with poorer neurological development in children. Knowledge about the effects on outcomes until adolescence is limited. Objectives: To determine whether prenatal exposure to POPs, particularly hydroxylated PCBs (OH-PCBs), is associated with cognitive and motor development in 13- to 15-year-old children. Methods: This prospective observational cohort study is part of the Development at Adolescence and Chemical Exposure (DACE)-study, a follow-up of two Dutch birth cohorts. Maternal pregnancy serum levels of PCB-153 and three OH-PCBs were measured, in part of the cohort also nine other PCBs and three OH-PCBs, and in another part five polybrominated diphenyl ethers (PBDEs), dichloroethene (DDE), pentachlorophenol (PCP) and hexabroomcyclododecane (HBCDD). Of the 188 invited adolescents, 101 (53.7%) participated, 55 were boys. Cognition (intelligence, attention, verbal memory) and motor performance (fine motor, ball skills, balance) were assessed. Scores were classified into 'normal' (IQ > 85; scores > P15) and '(sub)clinical' (IQ Results: Several OH-PCBs were associated with more optimal sustained attention and balance. PCB-183 was associated with lower total intelligence (OR: 1.29; 95%CI:0.99-1.68; P =.060), and HBCDD with lower performance intelligence (OR: 3.62; 95%CI:0.97-13.49; P = .056). PCBs, OH-PCBs and PBDEs were negatively associated with verbal memory. Conclusions: Prenatal background exposure to several POPs can influence neuropsychological outcomes in 13- to 15-year-old Dutch adolescents, although exposure to most compounds does not have clinically relevant consequences at adolescence

The effect of enteral bolus feeding on regional intestinal oxygen saturation in preterm infants is age-dependent:a longitudinal observational study

Background The factors that determine the effect of enteral feeding on intestinal perfusion after preterm birth remain largely unknown. We aimed to determine the effect of enteral feeding on intestinal oxygen saturation (r(int)SO(2)) in preterm infants and evaluated whether this effect depended on postnatal age (PNA), postmenstrual age (PMA), and/or feeding volumes. We also evaluated whether changes in postprandial r(int)SO(2) affected cerebral oxygen saturation (r(c)SO(2)). Methods In a longitudinal observational pilot study using near-infrared spectroscopy we measured r(int)SO(2) and r(c)SO(2) continuously for two hours on postnatal Days 2 to 5, 8, 15, 22, 29, and 36. We compared preprandial with postprandial values over time using multi-level analyses. To assess the effect of PNA, PMA, and feeding volumes, we performed Wilcoxon signed-rank tests or logistic regression analyses. To evaluate the effect on r(c)SO(2), we also used logistic regression analyses. Results We included 29 infants: median (range) gestational age 28.1 weeks (25.1-30.7) and birth weight 1025 g (580-1495). On Day 5, r(int)SO(2) values decreased postprandially: mean (SE) 44% (10) versus 35% (7), P = .01. On Day 29, r(int)SO(2) values increased: 44% (11) versus 54% (7), P = .01. Infants with a PMA >= 32 weeks showed a r(int)SO(2) increase after feeding (37% versus 51%, P = .04) whereas infants with a PMA = 32 weeks when greater volumes of enteral feeding are tolerated. We speculate that at young gestational and postmenstrual ages preterm infants are still unable to increase intestinal oxygen saturation after feeding, which might be essential to meet metabolic demands. Trial registration: For this prospective longitudinal pilot study we derived patients from a larger observational cohort study: CALIFORNIA-Trial, Dutch Trial Registry NTR4153

The Effect of Maternal Antihypertensive Drugs on the Cerebral, Renal and Splanchnic Tissue Oxygen Extraction of Preterrn Neonates

Background: Drugs with antihypertensive action are frequently used in obstetrics for the treatment of preeclampsia (labetalol) and tocolysis (nifedipine) or for neuroprotection (MgSO4), and may affect the hemodynamics of preterm born neonates. Objective: The aim of this study was to assess whether maternal antihypertensive drugs affect multisite oxygenation levels of the neonate. Methods: Eighty preterm neonates of 32 weeks of gestational age were monitored using near-infrared spectroscopy. Mean cerebral, renal and splanchnic fractional tissue oxygen extractions (cFTOE, rFTOE and sFTOE) were calculated for the first 5 postnatal days. We determined the effect of various maternal antihypertensive drugs on cFTOE and rFTOE using multilevel analysis, and on sFTOE using Kruskal-Wallis and Mann-Whitney U tests. Results: Eleven infants were exposed to labetalol +/- MgSO4, 7 to nifedipine +/- MgSO4, 20 to MgSO4 only, and 42 to no maternal antihypertensive drugs. The infants exposed to labetalol +/- MgSO4 had a lower cFTOE on days 1 (0.14, p = 0.031), 2 (0.13, p = 0.035) and 4 (0.18, p = 0.046) than nonexposed infants on the corresponding days (0.22, 0.20 and 0.24, respectively). On day 2, cFTOE was also lower in infants exposed to nifedipine +/- MgSO4 (0.11, p = 0.028) and to MgSO4 only (0.15, p = 0.047). sFTOE was higher in infants exposed to labetalol +/- MgSO4 on days 1 (mu = 0.71) and 2 (mu = 0.82) than in nonexposed infants (mu = 0.26, p = 0.04 and mu = 0.55, p = 0.007, respectively). Maternal antihypertensive drugs did not affect rFTOE. Conclusions: Low neonatal cFTOE found with maternal antihypertensive drug exposure may relate to either increased cerebral perfusion or neurologic depression induced by the medication, or preferential brain perfusion associated with preeclampsia placental insufficiency. Concomitantly high sFTOE found with labetalol exposure supports the latter, while renal autoregulation may explain rFTOE stability. (C) 2016 The Author(s) Published by S. Karger AG, Base

Visuospatial and visuomotor deficits in preterm children:The involvement of cerebellar dysfunctioning

One of the more consistent findings in follow-up studies of preterm children is a deficit in visuospatial and visuomotor skills. Impairment of the dorsal visual stream and basal ganglia damage have been hypothesized to underlie this deficit. However, given recent findings of impaired cerebellar development in preterm children without lesions to this structure, and the involvement of the cerebellum in visuospatial and visuomotor functioning, we argue the cerebellum should be included in models relating impaired development of brain networks to visuospatial and visuomotor deficits in this population. Here, we review the current literature on impaired cerebellar development in preterm children, and suggest possible underlying mechanisms

Motor development in 3-month-old healthy term-born infants is associated with cognitive and behavioural outcomes at early school age

AIM To determine whether motor development at 3 months of age is associated with cognitive, motor, and behavioural outcomes in healthy children at early school age. METHOD In this cohort study, we included 74 term-born, healthy children (44 males, 30 females; median gestational age 40.1wks, range 38.0-42.6wks). From video recordings (median 12.9wks, range 9.3-18.6wks), we assessed the quality of fidgety movements, and calculated a motor optimality score. At school age (median 5y 11mo, range 5y 8mo-7y 6mo), we performed detailed cognitive, motor, and behavioural assessments. We examined whether aspects of motor development were associated with functional outcomes. RESULTS An age-adequate motor repertoire, in particular the presence of antigravity, midline leg, and manipulation movements, was related to poorer cognition, whereas variable finger postures was related to better cognition. Children with a monotonous concurrent motor repertoire had better ball skills but experienced more behavioural problems. The presence of antigravity movements tended to be associated with abnormal recognition (odds ratio [OR] 4.4, 95% confidence interval [CI], 0.9-21; R-2=0.17; p=0.070), where the absence of variable finger postures was associated with borderline and abnormal visual-spatial perception (OR 20, 95% CI, 1.7-238; R-2=0.39; p=0.018). INTERPRETATION Detailed aspects of motor development at 3 months of age are associated with cognition and behaviour, but not with motor outcome, in healthy children at early school age. Our findings suggest that early motor development may be the basis for later cognitive and behavioural performance. Since the associations were only moderate, possible environmental influences should be acknowledged

Difference rather than delay in development of elementary visuomotor processes in children born preterm without cerebral palsy: A quasi-longitudinal study

Follow-up studies of preterm children without serious neonatal medical complications have consistently found poor visuomotor and visuospatial skills. In the first round of current follow-up study, we found a deficit in elementary visuomotor processes in preterm children without Cerebral Palsy (CP). To determine whether the development of these processes was delayed or different, we carried out a quasi-longitudinal study in which kinematic characteristics of pointing movements in 7- to 11-year-old preterm born children without CP and in an age-matched full-term group were analyzed. Multi-level analysis suggested a difference rather than a delay in the preterm born group: we found a regression around 8 years of age in the control but not in the preterm group. To our knowledge, this study is the first to provide longitudinal data confirming this regression in the development of movement control in typically developing children. Our results are also consistent in suggesting that elementary visuomotor processes are less efficient in preterm born children without CP: their movements were either slower or less accurate. While these differences were subtle, they persisted until 11 years of age

Geometrisk jordebok över Ödeshögs socken 1639-41 : Rumsliga föreställningar speglade i en karta / Den ovissa morgondagen : En undersökning av arbetarfamiljers utsatthet i Norrköping under perioden 1900-1910

Geometrisk jordebok över Ödeshögs socken 1639-41 : Rumsliga föreställningar speglade i en karta Av Charlotta Ekman. Kartor är ett källmaterial som inte har använts så ofta av historiker. Den främsta anledningen till. det är förmodligen att det handlar om bilder där man har en viss osäkerhet inför användandet. Informationen är kodad på ett sätt som skiljer sig från det traditionella källmaterialets skrivna text och siffror. Därmed krävs också en annan metod för att tillgängliggöra den kunskap som finns att hämta. Nu är kartorna visserligen inte helt outnyttjade. Inom bebyggelsehistoria är speciellt de utförliga skifteskartoma regelmässigt använda och för kulturmiljövården är de ett viktigt hjälpmedel för att lokalisera objekt. I dessa sammanhang är det dock bara kartornas rent geografiska fakta man utnyttjar. För namnforskning har också det språkliga innehållet använts. Jag menar att det finns möjligheter att komma åt mer. Speciellt de äldre kartorna, som går att spåra tillbaka till den enskilda personen bakom deras utförande, ger möjligheter till en djupare tolkning där man kan komma åt tankestrukturer. Det är inte bara till den geografiska omgivningens faktiska förändringar kartorna kan bli en källa utan också till de inställningar till den geografiska omgivningen som människor haft och de tolkningar de har gjort av den. Värderingar och attityder speglas omedvetet i allt material som produceras. I den här uppsatsen ska jag använda mig av en samling 1600-talskartor för att undersöka vilka spår man kan se av den tidens mentala föreställningar om den rumsliga omgivningen. Ett exempel på hur dessa kartor ser ut visas på en bild längst bak i texten.Den ovissa morgondagen : En undersökning av arbetarfamiljers utsatthet i Norrköping under perioden1900-1910 Av Sofia Seifarth. Nu började för mig förnedringens tid, fast det förstod jag inte då. Det var den ovissa brödkakans tid. Det hade det alltid varit, men jag hade aldrig hunnit få så skarp känning av det, alltid fanns det något åt mig. Det blev lössens och de smutsiga förklädenas tid och skolk från skolan. Det började blåsa tattarvind över dagarna.[---] Och ingen mat hade vi den flyttdagen. Inga grannar bjöd på något. Alla var ute på var sitt släp för brödet. Ingen hade heller något att bjuda, ty det var en torsdag. Ingen i Norrköpings förstäder hade något att bjuda på dagen före avlöningen.[---] Mor hade ett paket liggande i fönsterkarmen. Jag visste vad det var i det. Två lakan. Vi skulle genom hela stan, men lakanen skulle till pantbanken inne i stan och någon mat blev det ej förrän de var där. (Moa Martinsson) Bland annat så här skildrar Moa Martinsson sin barndoms verklighet i Norrköping runt sekelskiftet. Beskrivningarna vittnar om ett liv i utsatthet och tidvis stor misär. Hur var det egentligen att vara arbetare i Norrköping vid tiden för storindustrins genombrott? Jörn Svensson har i Norrköpings historia beskrivit situationen i staden på detta sätt: Den bräckliga ekonomiska grund varpå flertalet Norrköpingsfamiljers försörjning vilade, bragtes lätt att svikta. De lågavlönade kategorierna var ovanligt talrika och de depressiva tendenserna var starkare än inom den svenska industrin som helhet. Men hur såg familjesituationen ut för de utsatta familjerna? Hur klarade de försörjningen? Var man mer utsatt i vissa åldrar? Vad hände när man var gammal och inte kunde arbeta längre? Denna uppsats behandlar arbetares utsatthet i Norrköping 1900-1910, utifrån samtida familjebeskrivningar hämtade ur Brödraföreningen i Norrköpings protokoll