Infant's sex, birth control policy and postpartum well-being: a prospective cohort study in Shanghai, China

Objectives: The Chinese government loosed its birth control policy and allowed the parents to have the second child if both of the parent were from one-child family from 2001. We explore the association between infant’s sex and mother’s postpartum well-being, which may be moderated by birth control policy status in China. Setting and Participants: We conducted a prospective cohort study in Shanghai City, one of the largest cities in China. A total number of 1730 childbearing women from 8 obstetric hospitals across Shanghai were included in the study at baseline, with 1503 women completing the survey 7 days postpartum in 2013. Measures: The General Well-Being Schedule (GWBS) was used to assess maternal well-being at baseline and follow-up investigation in the study. Women’s demographic, clinical characteristic, and well-being were measured at baseline. The maternal satisfaction and postpartum well-being were assessed in the follow-up survey. Results The results of multivariable linear regression analyses showed that women who gave birth to male infants were positively associated with the total score of maternal well-being, when the participated hospitals, maternal well-being at baseline, the socio-demographic characteristic, maternal and infant’s health outcome were added to the adjustments (β=1.462, P0.05). The results of multiple logistic regression model showed that having a male infant was a protective factor of ‘positive well-being’ (OR=0.622, P0.05). Conclusions: Our results emphasize the importance in conducting intervention to increase the general well-being, especially for those with a female infant in a son preference society such as China, and enhance the necessity of sustainability of newly relaxed two-child policy which allows more couples to have the second child in China

How do I fit through that gap? Navigation through apertures in adults with Developmental Coordination Disorder

During everyday life we move around busy environments and encounter a range of obstacles, such as a narrow aperture forcing us to rotate our shoulders in order to pass through. In typically developing individuals the decision to rotate the shoulders is body scaled and this movement adaptation is temporally and spatially tailored to the size of the aperture. This is done effortlessly although it actually involves many complex skills. For individuals with Developmental Coordination Disorder (DCD) moving in a busy environment and negotiating obstacles presents a real challenge which can negatively impact on safety and participation in motor activities in everyday life. However, we have a limited understanding of the nature of the difficulties encountered. Therefore, this current study considered how adults with DCD make action judgements and movement adaptations while navigating apertures. Fifteen adults with DCD and 15 typically developing (TD) controls passed through a series of aperture sizes which were scaled to body size (0.9-2.1 times shoulder width). Spatial and temporal characteristics of movement were collected over the approach phase and while crossing the aperture. The decision to rotate the shoulders was not scaled in the same way for the two groups, with the adults with DCD showing a greater propensity to turn for larger apertures compared to the TD adults when body size alone was accounted for. However, when accounting for degree of lateral trunk movement and variability on the approach, we no longer saw differences between the two groups. In terms of the movement adaptations, the adults with DCD approached an aperture differently when a shoulder rotation was required and then adapted their movement sooner compared to their typical peers. These results point towards an adaptive strategy in adults with DCD which allows them to account for their movement difficulties and avoid collision

Gait patterns in children with Developmental Coordination Disorder

Previous research has shown that adults with Developmental Coordination Disorder (DCD) show increased variability of foot placement measures and movement of the centre of mass (CoM) while walking. The current study considered the gait patterns of young and older children with DCD. Fourteen young children with DCD (7-12 years), 15 older children with DCD (12-17 years) and 29 age and gender matched typically developing children took part. Children were asked to walk up and down a flat 10m long pathway for one minute while the movement of their feet and trunk was recorded using motion analysis. The gait pattern of children with DCD was characterised by wider steps, elevated variability in the time spent in double support and stride time and greater medio-lateral velocity and acceleration compared to their peers. An elevated variability in medio-lateral acceleration was also seen in the young but not the older children with DCD. In addition, the young children showed a greater variability in velocity and acceleration in all three directions compared to the older children. The data suggest that the high incidence of trips and falls seen in children with DCD may be due to differences in the control of the centre of mass

Association between screen time and suspected developmental coordination disorder in preschoolers: A national population-based study in China

IntroductionExcessive screen exposure (ESE) is a growing global public health concern. This study aims to investigate the potential association between ESE and suspected developmental coordination disorder (DCD) in Chinese pre-schoolers, with or without siblings.MethodA retrospective cohort study was conducted, involving 126,433 children from 551 cities in China. The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was employed to evaluate motor impairment in children, while parents provided information on their children’s screen time in the past year. A mixed and multi-level logistic regression model was used to analyze the associations of all screen exposure measurements from the past year with LDCDQ scores and the risk of suspected DCD.ResultsThe prevalence of excessive screen exposure was 67.6% (>1 h per day) and 28.9% (>2 h per day) in Chinese pre-schoolers. One hour’s increase in weekday daily screen time, weekend daily screen time, and screen time before sleep in the past year was associated with a decreased total score of the LDCDQ (β were −0.690, −0.398, and −1.587, p < 0.001) and an increased risk of suspected DCD by 15.3%, 9.1%, and 46.8% when adjusting for the child, family and maternal health characteristics. Excessive screen exposure decreased the total LDCDQ scores by 1.335 (>1 vs. ≤1 h) and 1.162 (>2 vs. ≤2 h) and increased risks of suspected DCD by 44.0% (>1 vs. ≤1 h) and 31.1% (>2 vs. ≤2 h) with statistical significance (each p < 0.05). The stratified analysis showed that the association between screen time and LDCDQ score was stronger in children without siblings than in those with siblings.ConclusionThe risk of suspected DCD was highest for screen time exposure before bed compared with average weekday and weekend exposures. Parents should be advised to prevent their children from using electronic screens unsupervised, especially in one-child families

Association of the onset of self-feeding with subsequent Developmental Coordination Disorder: A prospective cohort study in China

Background: Successful self-feeding reflects the readiness of early motor development and environmental impacts, and the onset of self-feeding as a developmental milestone might be a predictor of subsequent motor development in children. In this study, we explored the association between the onset of self-feeding and childhood risk of Developmental Coordination Disorder in children from one-child and two-child families. Methods: We conducted a data-linkage prospective cohort study from 38 kindergartens in 6 cities in China. A total of 11,727 preschoolers were included in the final analysis and were assessed with the Movement Assessment Battery for Children-second edition (MABC-2) Test. The information on early self-feeding onset was obtained from parents. The mixed and multi-level logistic models utilizing a random intercept were used to investigate the associations between the onset time of self-feeding and subsequent motor performance. Results: The results showed that, compared with those beginning self-feeding at or younger than 12 months of age, children starting self-feeding at 13-24 months, 25-36 months, and later than 36 months, showed a decrease in their total MABC-2 scores of 2.181, 3.026 and 3.874, respectively; and had an increased risk of suspected DCD by 36.0%, 101.6%, 102.6% respectively; they also had 30.2%, 46.6%, 71.2% increased prevalence of at risk of suspected DCD, when adjusting for both child and family characteristics (each p<0.05). Significant associations were observed in fine motor, gross motor, and balance subtests (each p<0.05) in groups with a delayed onset of self-feeding. However, the strength of the associations was mitigated in the fine motor and balance subtests in children with a sibling. Conclusion: The delayed onset time of self-feeding acts as an early behavioural marker for later childhood motor impairment. Moreover, children with a sibling may benefit from additional interaction and their motor developmental pattern may be affected by the presence of a sibling.

Level walking in adults with and without Developmental Coordination Disorder: An analysis of movement variability

Several studies have shown that Developmental Coordination Disorder (DCD) is a condition that continues beyond childhood. Although adults with DCD report difficulties with dynamic balance, as well as frequent tripping and bumping into objects, there have been no specific studies on walking in this population. Some previous work has focused on walking in children with DCD but variation in the tasks and measures used has led to inconsistent findings. The aim of the current study therefore was to examine the characteristics of level walking in adults with and without DCD. Fifteen adults with DCD and 15 typically developing (TD) controls walked barefoot at a natural pace up and down an 11 m walkway for one minute. Foot placement measures and velocity and acceleration of the body were recorded, as well as measures of movement variability. The adults with DCD showed similar gait patterns to the TD group in terms of step length, step width, double support time and stride time. The DCD group also showed similar velocity and acceleration to the TD group in the medio-lateral, anterior-posterior and vertical direction. However, the DCD group exhibited greater variability in all foot placement and some body movement measures. The finding that adults with DCD have a reduced ability to produce consistent movement patterns is discussed in relation to postural control limitations and compared to variability of walking measures found in elderly populations

Association of gestational age at birth with subsequent suspected Developmental Coordination Disorder in early childhood

Importance. It remains unknown whether children born at different degrees of prematurity, early-term and post-term might have a higher risk of developing Developmental Coordination Disorder (DCD) compared to completely full-term children (39-40 gestational weeks). Objective. To differentiate between suspected DCD in children with different gestational ages based on a national representative sample in China. DESIGN, SETTING, AND PARTICIPANTS We conducted a retrospective cohort study in China from 2018 to 2019. A total of 152,433 children from 2,403 public kindergartens in 551 cities of China aged 3-5 years old were included in the final analysis. The association between gestational age and motor performance was investigated. A multi-level regression model was developed to determine the strength of association for different gestational ages associated with suspected DCD when considering kindergartens as clusters. Main outcomes and measures. Children’s motor performance was assessed using the Little Developmental Coordination Disorder Questionnaire (LDCDQ), completed by parents. Gestational age was determined according to the mother’s medical records. Results. Of the 152,433 children aged 3-5 years old, 80,370 (52.7%) were male, and 72,063 (47.3%) were female. There were 45,052 children aged 3 years old (29.6%), 59,796 aged 4 years old(39.2%), and 47,585 children aged 5 years old (31.2%). The LDCDQ total scores for very-preterm (β=-1.74, 95%CI: -1.98, 1.50; p<0.001), moderately-preterm (β=-1.24, 95%CI: -1.60, -0.89; p<0.001), late-preterm (β=-0.92, 95%CI: -1.08, -0.76; p<0.001), early-term (β=-0.36, 95%CI: -0.46, -0.25; p<0.001) and post-term children (β=-0.47, 95%CI: -0.67, -0.26; p<0.001) were significantly lower than full-term children when adjusting for child, family and maternal health characteristics. The very-preterm (OR=1.35, 95%CI: 1.23,1.48; p<0.001), moderately-preterm (OR=1.18, 95%CI: 1.02, 1.36; p<0.001), late-preterm (OR =1.24, 95%CI: 1.16,1.32; p<0.001), early-term (OR =1.11, 95%CI: 1.06,1.16; p<0.001) and post-term children (OR =1.167, 95%CI: 1.07, 1.27; p<0.001) were more likely to fall in the suspected Developmental Coordination Disorder (DCD) category on the LDCDQ compared with completely full-term children after adjusting for the same characteristics. The associations between different gestational ages and suspected DCD were stronger in boys and older (5 year old) children (each p<0.05). Conclusions and relevance. We found significant associations between every degree of prematurity at birth, early-term and post-term birth with suspected DCD when compared with full-term birth. Our findings have important implications for understanding motor development in children born at different gestational ages. Long-term follow-up and rehabilitation interventions should be considered for early- and post-term born children

Effects of midwife-led maternity services on postpartum wellbeing and clinical outcomes in primiparous women under China’s one-child policy

Background: The Midwife-led maternity services have been implemented in China in response to the high rates of primiparous women and Caesarean Sections (CS) which may be related to China’s one-child policy. However, few studies in China have been reported on the effectiveness of Midwife-led Care at Delivery (MCD) and the Continuity of Midwife-led Care (CMC) on postpartum wellbeing and other clinical outcomes. Therefore, evidence-based clinical validation is needed to develop an optimal maternity service for childbearing women in China. Methods: A concurrent cohort study design was conducted with 1730 pregnant women recruited from 9 hospitals in Shanghai. Among the 1730 participants at baseline, 1568 participants completed the follow-up questionnaire, with a follow-up rate of 90.6%. Results: Compared with the routine Obstetrician-led Maternity Care (OMC), Midwife-led Care at Delivery (MCD) was associated with CS rate (OR were 0.16; 95%CI: 0.11 to 0.25) and a higher total score of postpartum wellbeing (βwere 2.70; 95%CI: 0.70 to 4.70) when adjusting for the baseline differences and other confounders during delivery or postpartum period. Moreover, continuity of Midwife-led Care (CMC) was associated with CS rate (OR were 0.30; 95%CI: 0.23 to 0.41), as well as increased rate of breastfeeding within the first 24 h (OR were 2.49; 95% CI: 1.47 to 4.23), higher postpartum satisfaction (β = 4.52; 95% CI: 1.60 to 12.68), lower anxiety (βwere 0.66; 95% CI: 0.16 to 1.17), increased self-control (βwere 0.39; 95% CI: 0.02 to 0.76) and a higher total score of postpartum wellbeing (βwere 3.14; 95% CI: 1.54 to 4.75). Conclusion: CMC is the optimal service for low-risk primiparous women under China’s one-child policy, and is worthwhile for a general implementation across China

Associative implicit learning in adult dyslexic readers

This thesis examined associative implicit learning in dyslexic young adults. Dyslexic adults' associative implicit learning has been examined from three perspectives: what, when, and how. More specifically, it has been investigated if dyslexics have deficit in learning more complex knowledge, such as longer chunks or abstract knowledge (i.e., 'what'); if learning occurs at different stages in dyslexics compared to non-dyslexics (i.e., when); how dyslexics learn, and especially the role of both implicit and explicit processes (i.e., 'how'). The empirical findings from 9 experiments in 5 studies are: i) implicit learning deficits in dyslexic people are more manifest in second-order learning than first-order learning, with both motor and perceptual stimuli; ii) when only zero and first-order information is required, dyslexic people developed abstract learning under implicit learning condition as well as, and as fast as nondyslexics; iii) dyslexic participants had different sequence learning profiles compared to matched controls: dyslexic participants' expression, but not learning per se was impaired under resource-demanding condition compared to controls. Moreover, implicit learning was found to correlate with word reading score, phonological awareness, and working memory. This thesis is the first comprehensive study to consider a wide range of associative implicit learning with different learning content on a dyslexic population. The findings contribute to the current framework of explanatory theories of dyslexia, suggesting a new route through which cerebellar dysfunction can lead to phonological impairment, and eventually lead to reading difficulties.This thesis examined associative implicit learning in dyslexic young adults. Dyslexic adults' associative implicit learning has been examined from three perspectives: what, when, and how. More specifically, it has been investigated if dyslexics have deficit in learning more complex knowledge, such as longer chunks or abstract knowledge (i.e., 'what'); if learning occurs at different stages in dyslexics compared to non-dyslexics (i.e., when); how dyslexics learn, and especially the role of both implicit and explicit processes (i.e., 'how'). The empirical findings from 9 experiments in 5 studies are: i) implicit learning deficits in dyslexic people are more manifest in second-order learning than first-order learning, with both motor and perceptual stimuli; ii) when only zero and first-order information is required, dyslexic people developed abstract learning under implicit learning condition as well as, and as fast as nondyslexics; iii) dyslexic participants had different sequence learning profiles compared to matched controls: dyslexic participants' expression, but not learning per se was impaired under resource-demanding condition compared to controls. Moreover, implicit learning was found to correlate with word reading score, phonological awareness, and working memory. This thesis is the first comprehensive study to consider a wide range of associative implicit learning with different learning content on a dyslexic population. The findings contribute to the current framework of explanatory theories of dyslexia, suggesting a new route through which cerebellar dysfunction can lead to phonological impairment, and eventually lead to reading difficulties

Description of the dependent variables used in this study including the phase during which these were measured.

<p>Description of the dependent variables used in this study including the phase during which these were measured.</p