Predictors of early life milestones: Results from the Copenhagen Perinatal Cohort.

BACKGROUND: Pre- and postnatal factors have been found to be predictors of age at attaining milestones in infancy; however, the degree to which such factors are predictors of milestones in the subsequent years is less investigated. The aim was to conduct a systematic evaluation of a broad range of possible predictors of milestone attainment during the second and third years to identify factors that explain significant inter-individual variance. METHODS: Mothers of 4009 children from the Copenhagen Perinatal Cohort (1959-61) were interviewed by a physician about 20 developmental milestones at a three-year examination. Milestones were related to: Language, Walking, Eating, Dressing, Social interaction, and Toilet training. Information on possible predictors was collected during pregnancy and at a 1- and 3-year follow-up. RESULTS: Several pre- and postnatal factors were significantly associated with the timing of milestone attainment; especially parental social status, paternal age, sex, gestational age, birth weight, birth length, weight increase in the first year of life, and motor development during the first year of life. The significant predictors explained 16.2% of the variance in the Overall mean of milestones and 20.3% of the variance in milestones related to Walking. The most influential individual factor for the timing of milestone attainment was previous motor development during the first year of life. Additionally, sex was an important factor as girls were generally faster at attaining milestones. Parental social status was a consistent, but relatively week predictor. CONCLUSION: A notable amount of variance in the timing of milestones during the first three years of life can be explained by perinatal and early postnatal factors. The study provides evidence of developmental continuity as the main predictor of milestones in the second and third years was the speed of development during the first year.

Predictors of motor developmental milestones during the first year of life.

Studies suggest that both pre- and postnatal factors are predictors of age of attaining milestones in infancy. However, no studies evaluate the comparative strength of these predictors and the amount of the variance in development they explain. This study aimed to conduct a systematic evaluation of a broad selection of possible predictors of age at milestone attainment and to identify factors that explain significant inter-individual variance. Mothers of 5765 children of the Copenhagen Perinatal Cohort (1959-61) recorded 12 developmental milestones prospectively during the child's first year of life. Information on possible predictors was collected during pregnancy and at follow-up and was categorized into the domains: Family background, Pregnancy and delivery, Postnatal influences, and Postnatal growth. The domain Pregnancy and delivery contributed most of the explained variance in Overall mean of milestones (14.4%), with especially gestational age (ß = -0.15; p ≤ 0.001) and birth weight (ß = -0.16; p ≤ 0.001) being important predictors. CONCLUSION: Several individual factors, especially gestational age, birth weight, breastfeeding, having lived in a full-time institution, and weight and head increase in the first year, were significantly associated with milestone attainment in the first year of life. Variables within the domain of Pregnancy and delivery explained the largest proportion of variance in milestone attainment compared to the other domains. What is known: • Younger age at attainment of motor developmental milestones positively predicts cognitive outcomes in adulthood. • Both pre- and postnatal factors have been associated with age of attaining milestones in infancy. What is new: • First study to provide a systematic evaluation of a broad selection of predictors of infant milestone attainment. • Variables within the domain of Pregnancy and delivery, especially gestational age and birth weight, explained the largest proportion of variance in milestone attainment. • The variance explained by the predictors decreased time-dependently with later milestones.

Maternal, prenatal and postnatal risk factors for early child physical abuse: a French nationwide cohort study.

Background: Identifying risk factors for early child physical abuse (CPA) is crucial for understanding its mechanisms and defining effective preventive interventions. We aimed to identify maternal, prenatal and postnatal factors associated with early CPA. Methods: This cohort study was based on comprehensive data from the Mother-Child EPI-MERES nationwide register and included all infants born alive in France between 2010 and 2019. Factors associated with early CPA (before age 1) were identified with a multilevel Cox regression model with random intercepts at the regional level. Findings: Among the 6,897,384 included infants, 2994 (40/100,000) had a diagnosis of early CPA, at a median age of 4 months. Independent factors most strongly associated with early CPA were maternal low financial resources (adjusted hazard ratio [aHR] 1.91; 95% confidence interval [95% CI] 1.67-2.18), maternal age <20 years versus 35-40 years (aHR 7.06; 95% CI 6.00-8.31), maternal alcohol use disorder (aHR 1.85; 95% CI 1.48-2.31), opioid use disorder (aHR 1.90; 95% CI 1.41-2.56), intimate partner violence (aHR 3.33; 95% CI 2.76-4.01), diagnosis of a chronic mental disorder (aHR 1.50; 95% CI 1.14-1.97) or somatic disorder (aHR 1.55; 95% CI 1.32-1.83), hospitalisation for a mental disorder (aHR 1.88; 95% CI 1.49-2.36), very preterm birth (aHR 2.15; 95% CI 1.68-2.75), and diagnosis of a chronic severe neurocognitive disorder in the infant (aHR 14.37; 95% CI 11.85-17.44). Interpretation: Independent risk factors of early CPA identified at the national level in France may help in understanding CPA mechanisms and developing effective prevention programs including risk-stratification tools to optimise the allocation of parenting interventions to parents who could most benefit from them. Funding: Ile-de-France regional council, L'Oréal-UNESCO For Women In Science France Young Talent Award, French National Observatory for Child Protection [ONPE], French Association of Ambulatory Paediatrics [AFPA], HUGO university hospitals network, Mustela Foundation and Sauver la Vie prizes.

Etiological Factors of Molar Incisor Hypomineralization: A Systematic Review and Meta-Analysis.

Molar incisor hypomineralization (MIH) is a defect of the dental enamel that predominantly affects first molars and permanent incisors. Identifying the significant risk factors associated with MIH occurrence is essential for the implementation of prevention strategies. The purpose of this systematic review was to determine the etiological factors associated with MIH. A literature search was carried out from six databases until 2022; it covered pre-, peri-, and postnatal etiological factors. The PECOS strategy, PRISMA criteria, and the Newcastle-Ottawa scale were used, and 40 publications were selected for qualitative analysis as well as 25 for meta-analysis. Our results revealed an association between a history of illness during pregnancy (OR 4.03 (95% CI, 1.33-12.16), p = 0.01) and low weight at birth (OR 1.23 (95% CI, 1.10-1.38), p = 0.0005). Furthermore, general illness in childhood (OR 4.06 (95% CI, 2.03-8.11), p = 0.0001), antibiotic use (OR 1.76 (95% CI, 1.31-2.37), p = 0.0002), and high fever during early childhood (OR 1.48 (95% CI, 1.18-1.84), p = 0.0005) were associated with MIH. In conclusion, the etiology of MIH was found to be multifactorial. Children with health disorders in the first years of life and those whose mothers underwent illnesses during pregnancy might be more susceptible to MIH.

Determinants of Infant Adiposity across the First 6 Months of Life: Evidence from the Baby-bod study.

Excess adiposity in infancy may predispose individuals to obesity later in life. The literature on determinants of adiposity in infants is equivocal. In this longitudinal cohort study, we investigated pre-pregnancy, prenatal and postnatal determinants of different adiposity indices in infants, i.e., fat mass (FM), percent FM (%FM), fat mass index (FMI) and log-log index (FM/FFMp), from birth to 6 months, using linear mixed-effects regression. Body composition was measured in 322, 174 and 109 infants at birth and 3 and 6 months afterwards, respectively, utilising air displacement plethysmography. Positive associations were observed between gestation length and infant FM, maternal self-reported pre-pregnancy body mass index and infant %FM, and parity and infant %FM and FMI at birth. Surprisingly, maternal intake of iron supplements during pregnancy was associated with infant FM, %FM and FMI at 3 months and FM/FFMp at 6 months. Male infant sex and formula feeding were negatively associated with all adiposity indices at 6 months. In conclusion, pre-pregnancy and pregnancy factors influence adiposity during early life, and any unfavourable impacts may be modulated postnatally via infant feeding practices. Moreover, as these associations are dependent on the adiposity indices used, it is crucial that researchers use conceptually and statistically robust approaches such as FM/FFMp.

Molar-incisor hypomineralisation in Lebanon: association with prenatal, natal and postnatal factors.

BACKGROUND: Molar-incisor hypomineralisation is an enamel developmental defect highly prevalent in Lebanon. Literature suggests that perinatal conditions and childhood illnesses might be potential aetiological factors for this affection. AIMS: This case-control study aimed to investigate the association of MIH with prenatal, natal and postnatal factors amongst 7-9 years Lebanese children and to end up with recommendations to overcome its occurrence. METHODS: Self-administered, structured questionnaire including potential etiological factors was distributed to 659 MIH and non-MIH children's parents. The analysis of data was carried out using Statistical Package for Social Sciences Computer Software (SPSS 21.0, Inc., Chicago, IL, USA). For Statistical analysis, Pearson's chi-square, Fischer's exact test and multivariate regression model were used. A p value of less than 0.05 was considered statistically significant. RESULTS: Children whose mothers had consumed food and drinks canned during pregnancy had 2.9 (CI: 1.367 to 6.187) times more likely to have MIH. Those who had history of taking antibiotics had 2.15 (CI: 1.186 to 3.909) times higher odds of MIH than those who did not have while those who had fever episodes during the early childhood years were 2.057 (CI: 1.149 to 3.683) times more likely to develop MIH. CONCLUSION: During early childhood, careful handling of high fever, greater public awareness regarding misuse of antibiotics and education about bisphenol A and how to avoid it during pregnancy and breastfeeding are recommended to decrease the occurrence of MIH.

A good start in life is important-perinatal factors dictate early microbiota development and longer term maturation.

Maternal health status is vital for the development of the offspring of humans, including physiological health and psychological functions. The complex and diverse microbial ecosystem residing within humans contributes critically to these intergenerational impacts. Perinatal factors, including maternal nutrition, antibiotic use and maternal stress, alter the maternal gut microbiota during pregnancy, which can be transmitted to the offspring. In addition, gestational age at birth and mode of delivery are indicated frequently to modulate the acquisition and development of gut microbiota in early life. The early-life gut microbiota engages in a range of host biological processes, particularly immunity, cognitive neurodevelopment and metabolism. The perturbed early-life gut microbiota increases the risk for disease in early and later life, highlighting the importance of understanding relationships of perinatal factors with early-life microbial composition and functions. In this review, we present an overview of the crucial perinatal factors and summarise updated knowledge of early-life microbiota, as well as how the perinatal factors shape gut microbiota in short and long terms. We further discuss the clinical consequences of perturbations of early-life gut microbiota and potential therapeutic interventions with probiotics/live biotherapeutics.

The impact of pre- and perinatal factors on psychopathology in adulthood.

BACKGROUND: There is considerable evidence that pre- and post-natal factors are associated with a wide range of psychopathology in offspring during childhood and adolescence. OBJECTIVE: The main aims of the present study were to examine the associations between pre- and perinatal factors and psychopathology in offspring during adulthood, and to explore whether family factors (i.e., family cohesion, mother's social support, and father's social support) mediate these relationships. METHOD: Information on pre- and perinatal events was collected from biological mothers of the participants (N = 315) when they were between 14 and 18 years who were then followed up until they reached age 30. RESULTS: Maternal obstetric history and illness during first year were significant predictors of offspring anxiety disorder. Maternal emotional health predicted offspring affective disorder. Difficult delivery and breast feeding predicted disruptive disorder. The relationship between maternal obstetric history/emotional health and anxiety/affective disorder was no longer significant after controlling for family cohesion. LIMITATIONS: The information was based on maternal recall when their offspring were between 14 and 18 years which may be subjected to recall bias. CONCLUSION: The association between pre- and postnatal factors and psychopathology of offspring during adulthood is mediated by familial factors.