Maternal postpartum behaviors and mother-infant relationship during the first year of life

OBJECTIVE: To assess the hypothesis that maternal postpartum behaviors toward the newborn may predict the quality of the maternal-infant relationship during the first year. DESIGN: Prospective, non-randomized, longitudinal cohort study of 174 maternal-infant dyads. METHODS: A Postpartum Parenting Behavior Scale (PPBS) was formulated to measure clearly defined observed maternal behaviors toward the infant shortly after birth. The quality of the maternal-infant relationship was assessed at 6 months after birth with the Nursing Child Assessment Satellite Training (NCAST) Feeding Scale and at 12 months after birth with the NCAST Teaching Scale and Ainsworth Strange Situation. RESULTS: The PPBS score correlated significantly with the Feeding Scale score (r =.27, P <.005) and with the Teaching Scale score (r =.23, P <.01). Mothers whose infants were later classified as securely attached in the Ainsworth Strange Situation had higher PPBS scores than mothers of infants classified as insecurely attached (mean +/- SD: 5.18 +/- 1.51 vs 4.63 +/- 1.69, respectively, P <.05). In regression models adjusting for social and demographic factors, the PPBS remained a significant predictor of the Feeding Scale score, the Teaching Scale score, and security of attachment. CONCLUSIONS: Maternal behaviors in the immediate postpartum period may aid in predicting quality of the maternal-infant relationship during the subsequent 12 months, suggesting the potential for early identification of suboptimal parenting.     

Heterogeneous growth and mental development of intrauterine growth-retarded infants during the first 3 years of life

Postnatal growth and development were studied in two groups of term infants with intrauterine growth retardation (IUGR) and one group of infants with normal birth weight up to 3 years of age (total sample, 205 infants). Infants with IUGR were classified as having low ponderal index (IUGR-LPI) or adequate ponderal index (IUGR-API). At birth, the two groups of infants with IUGR had similar birth weight, but length and head circumference measurements were significantly different. Overall, the IUGR-API infants remained lighter and shorter and had smaller head circumferences up to 30 months of age. The IUGR-LPI infants experienced catch-up growth in weight during the first months, because of greater fat deposition. At 24 months of age, the IUGR-API infants scored below the others on mental items. At 3 years of age the IUGR-API infants had the lowest values on seven of eight developmental measures and on the composite score; at these two time periods, the group with normal birth weight scored the highest, and the IUGR-LPI infants obtained intermediate values. It is concluded that infants with IUGR tend to follow postnatal growth and developmental patterns that are associated with their physical characteristics at birth.     

婴幼儿出生至2岁身长和体重生长轨道变化的随访研究

目的 研究2岁内正常儿童身长、体重发生追赶生长或减速生长的状况及影响儿童身长变化的因素。方法 回顾性收集1996年8月至2008年12月,前瞻性收集2009年1月至2010年3月重庆医科大学附属儿童医院儿童保健科门诊体检儿童的资料。均以首次体检年龄<2月龄±15 d;﹤1岁,随访≥6次（至少每2个月随访1次）;～2岁,随访≥2次（至少每6个月随访1次）的原则进行随访。由专人测量儿童身长和体重,并于首次体检时询问并记录父母亲的身高。根据随访年龄,分为<2、～4、～6、～8、～10、～12、～18和～24月龄组。以首次体检（<2月龄±15 d）身长测量值为基础值计算百分位值,并计算其Z值。以～24月龄身长百分位值代表2岁时身长百分位值。生长参数参照2000年美国CDC儿童生长资料,本研究将追赶生长或减速生长定义为身长或体重百分位较前次年龄段百分位上升或下降≥1条主百分位线,且身长发生百分位线变化后能沿着新生长轨道生长,观察儿童生长轨道变化情况,采用Logistic回归分析儿童身长与儿童基础身长Z值及父母亲身高的相关性。结果 共有331名儿童(3 421人次测量数据)进入分析,其中男172例,女159例。①<2岁儿童179/331名（54.1%）的身长发生246人次追赶生长,229人次追赶生长1条百分位线,17人次追赶生长2条百分位线;56/331名（16.9%）儿童的身长出现63人次减速生长,均减速生长1条百分位线;各月龄组平均身长在P50～P75。②3～6、～12和～24月龄组儿童身长变化与母亲身高、儿童基础身长相关（均P<0.05）,～12月龄组身长变化同时还与父亲身高相关（P<0.05）。③<2岁儿童309人次体重发生追赶生长,232人次追赶生长1条百分位线,77人次追赶生长2条百分位线;641人次体重发生减速生长,596人次减速生长1条百分位线,45人次减速生长2条百分位线。各月龄组平均体重的百分位值不稳定。结论 儿童出生时的体格生长水平反映胎儿期生长,但不完全决定生后生长情况。判断2岁内儿童身长变化需综合考虑基础身长、父母亲身高遗传等因素。     

Serum IgE levels during the first 6 years of life

OBJECTIVE: Total serum IgE percentiles were derived for a population-based sample of 4082 white children from Germany by weighted analysis of measurements from the Multicenter Allergy Study cohort. METHODS: The children of a prospective birth cohort were selected from a complete 1-year sample of newborns in 6 obstetric departments in 1990. Total IgE was determined at 1, 2, 3, 5, and 6 years of age in 1160 newborns of the cohort. By weighting these measurements for sex, atopic family history, and elevated cord blood IgE, total serum IgE percentiles were estimated for the original population-based sample of 4082 children. RESULTS: IgE levels increased by age (P <.0001). We found statistically significant higher total IgE values in boys than in girls at each age (P <.05). Within the group of atopic children, this sex difference was not statistically significant. CONCLUSION: Our estimates of total serum IgE levels for a large population-based sample were lower than most values previously reported. We suggest that for both clinical and epidemiologic and genetic studies, IgE values should be expressed with percentiles.     

Growth of Hong Kong infants during the first two years of life

Physical growth in weight, length and head circumference during infancy and early childhood (the first two years) of Hong Kong children born in the 1960's and 1970's have been compared with a widely used international reference standard (National Center for Health Statistics). During the first 3-6 months the mean growth curves closely follow the reference mean. Over the following 6-12 months however, there is a distinct downward deviation. From about 18 months onwards the growth trajectories once again closely parallel the reference. This 'faltering' of physical growth, which shows some similarities with that described by young children in poor parts of the world has been attributed by some to less than adequate nutrition during the weaning period. Yet over the past 20 years or so Hong Kong has very much become part of the developed world. This apparent paradox leads us to speculate that genetic influences might play an important role in the faltering of growth.     

Longitudinal analysis of growth over the first 3 years of life in Turner's syndrome

OBJECTIVE: To evaluate longitudinal growth in Turner's syndrome (TS) over the first 3 years of life. METHODS: Growth of 47 patients with TS was compared with that of 40 age-matched control girls by using an analysis according to the Infancy-Childhood-Puberty and bi-exponential models. RESULTS: A mean of 1.2 SDs were lost before birth and a total of 3.0 SDs were lost by age 3 years. According to the Infancy-Childhood-Puberty model, intrauterine growth retardation contributed -1.24 SDs, a 5-month delay in childhood growth spurt contributed -0.96 SDs, and slow childhood growth contributed an additional -0.8 SDs by age 3 years. The bi-exponential analysis disclosed a quasi-linear first exponent and a confining second exponent, which merged at age 18 months in control subjects and 24 months in patients with TS. The first exponent confers an average annual growth rate of 8.4 cm/y in control subjects and 6.7 cm/y in patients with TS. CONCLUSIONS: Intrauterine growth retardation and the initial 3 years of life contribute most of the deficit in the final height of patients with TS. These data provide a reference of standards for longitudinal growth in patients with TS at age 3 months to 3 years.     

Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy

Maternal intake of omega- 3 (ω-3) polyunsaturated fatty acids (PUFAs) during pregnancy has decreased, possibly contributing to a current increased risk of childhood allergy.
Aim:  To describe the effects of maternal ω-3 long-chain PUFA supplementation during pregnancy and lactation on the incidence of allergic disease in infancy.
Methods:  One hundred and forty-five pregnant women, affected by allergy themselves or having a husband or previous child with allergies, were included in a randomized placebo-controlled trial. Daily maternal supplementation with either 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo was given from the 25^th gestational week to average 3–4 months of breastfeeding. Skin prick tests, detection of circulating specific immunoglobulin E (IgE) antibodies and clinical examinations of the infants were performed.
Results:  The period prevalence of food allergy was lower in the ω-3 group (1/52, 2%) compared to the placebo group (10/65, 15%, p < 0.05) as well as the incidence of IgE-associated eczema (ω-3 group: 4/52, 8%; placebo group: 15/63, 24%, p < 0.05).
Conclusion:  Maternal ω-3 fatty acid supplementation may decrease the risk of food allergy and IgE-associated eczema during the first year of life in infants with a family history of allergic disease.     

Intracranial tumours during the first two years of life: presenting features

Between 1979 and 1994, 21 children (nine females, 12 males) with intracranial tumours diagnosed before the age of 2 years (range 2-23 months) were treated at the University Hospital of Wales. The commonest presenting symptoms were vomiting (n = 9) and unsteadiness (n = 8); the commonest presenting sign was enlarged occipitofrontal circumference (> 97th centile in 16 and > 90th centile in a further two). In five cases with signs of raised intracranial pressure, meningitis was the clinical diagnosis, and a lumbar puncture was performed. For cases with long delays in diagnosis, multiple other disorders had been considered and the significance of head enlargement had not been recognised. In very early childhood, intracranial tumours are uncommon and can mimic other disorders, especially meningitis. Early neuroimaging is advised when a child presents with recent onset of neurological symptoms and a disproportionately large head.     

Effects of oral zinc supplementation on zinc status and catch-up growth during the first 2 years of life in children with non-organic failure to thrive born preterm and at term

Background

We aimed to analyze the effect of oral zinc supplementation on serum insulin-like growth factor-1 (IGF-1) levels and catch-up growth in infants with non-organic failure to thrive (NOFTT) who were born preterm as compared to those born at term.

Reference data on gains in weight and length during the first two years of life

Serial data from studies of infants at the University of Iowa and from the Fels Longitudinal Study were used to develop sex-specific percentiles for increments in weight and recumbent length for selected intervals during the first 24 months of life. Weight increments are presented for 1-month intervals from birth to 6 months, 2-month intervals from birth to 12 months, and 3-month intervals from birth to 24 months. Length increments are presented for 2-month intervals from birth to 6 months, and for 3-month intervals from birth to 24 months of age. Weights and lengths at the target ages were obtained for the Iowa data by simple interpolation, and for the Fels data by fitting families of three-parameter mathematical functions to the serial data from ages 1 to 24 months. The tabular presentations are based on the Iowa data from birth to 3 months of age, on the combined Iowa and Fels data from 3 to 6 months of age, and on the Fels data from 6 to 24 months of age. We believe that these reference data will be useful in screening for deviations from normal growth and may aid in early detection of failure to thrive or excessive weight gain during early life.     

Seroepidemiology of cytomegalovirus infections during the first years of life in urban communities.

Using indirect haemagglutination assay, combined with a collection of blood samples on blotting cards, seroepidemiological surveys of cytomegalovirus infections during early infancy have been done in different populations (French and immigrant) in urban areas. The comparison of CMV antibody status of mothers and their children at 10 months and at 2 years of age enables possible factors of viral transmission to be defined. During the first year of life, seropositive mothers were the only source of infection and they remained the main source during the second year. Socioeconomic class and educational level are determinant factors in the incidence of viral transmission.