The growth of children in relation to the timing of obesity development

Objective: To examine whether there is an association between the timing of the development of obesity and children's growth. Research Methods and Procedures: This study investigated 141 prepubertal obese children (76 girls) and 72 healthy non‐obese children (39 girls). The target height standard deviation score (SDS), the percentage weight for height, and the height SDS (H‐SDS) at presentation and at the age of 2 years were calculated. Patients were classified, according to whether obesity developed before or after the age of 3 years, as presenting with early‐onset or late‐onset obesity, respectively. Results: Mean age (±SD) at presentation was 9.4 (2.1) years. At the age of 2 years, the H‐SDS of the children with early‐onset obesity was 1.3 (1.0) vs. 0.9 (1.3) for the late‐onset obese (p > 0.5) and 0.4 (1.0) for controls (p < 0.001), and the children with late‐onset obesity were also significantly taller than controls (p < 0.005). At presentation, children with early‐onset obesity were significantly taller than children with late‐onset obesity [1.1 (0.8) vs. 0.6 (1.0); p < 0.001] and controls [0.2 (0.8); p < 0.001]. There was no increase in H‐SDS after the age of 2 years in the late‐onset obese children (p > 0.05). H‐SDS values were below average in 21% of the children with late‐onset obesity and in only 4% of the children with early‐onset obesity. Discussion: These findings indicate that late development of obesity is not associated with increased stature in prepubertal children; however, it may be preceded by growth acceleration in the early years of life. Growth acceleration in early life may be a predictor for future obesity.     

Habilitation of Patients with Congenital Malformations Associated with Thalidomide: Psychiatric and Psychological Aspects

Nearly 100 cases of congenital malformations associated with thalidomide ingestion by the mother have been reported in Canada to the Department of National Health and Welfare. Depression and selfcastigation have been the specific psychiatric reactions noted, particularly in the mother. In most cases it is preferable psychologically for the parents and the child if the child is kept at home rather than placed in an institution. Parents should be fully informed concerning the child''s prognosis for future development. Most of the children followed up for about two years showed no intelligence defects. A prosthesis, if required, should be applied early (at three to six months) so that it may become a part of the child''s body-image, but it should not interfere with play activities. Assessment by a psychiatrist and a psychologist is indicated at about six months.     

Dietary thyroid hormone replacement ameliorates hearing deficits in hypothyroid mice

Thyroid hormone (TH) insufficiency causes variable hearing impairment and mental deficiency in humans. Rodents lacking TH have congenital hearing deficiency that has been attributed to physiologic, morphologic, and developmental abnormalities of the auditory system. We examined four genetically defined strains of hypothyroid mice for development of hearing and response to TH replacement initiated during late gestation and continued through six weeks of age. Auditory brain stem response studies showed variable hearing impairment in homozygous mutants of each strain at three weeks of age relative to normal littermates. Mutants from three of the strains still had hearing deficiencies at six weeks of age. TH-enriched diet significantly improved hearing in three-week-old mutants of each strain relative to untreated mutants. Differences in the level of hearing impairment between the Prop1 ^df and Pit1 ^dw mutants, which have defects in the same developmental pathway, were determined to be due to genetic background modifier genes. Further physiologic and morphologic studies in the Cga ^tm1Sac strain indicated that poor hearing was due to cochlear defects. We conclude that TH supplement administered during the critical period of hearing development in mice can prevent deafness associated with congenital hypothyroidism of heterogeneous genetic etiology.     

Adrenal steroidogenic defects in children with precocious pubarche.

The occurrence of nonclassical congenital adrenal hyperplasia among children with precocious pubarche is still a matter of debate. We studied the adrenal steroid response to ACTH stimulus (Synacthen, 0.25 mg i.v. bolus) in 26 Italian children (5 boys, 21 girls) who had presented pubic hair, without other signs of virilization, at ages ranging between 0.45 and 8.8 years. The control groups comprised 8 prepubertal children (5 boys, 3 girls) and 12 children at Tanner stage 2 for pubic hair development (1 boy, 11 girls). Two patients were diagnosed as having nonclassical congenital adrenal hyperplasia: 1 due to 21-hydroxylase deficiency, the other due to 3 beta-hydroxysteroid-dehydrogenase deficiency. The remainder, classified as having idiopathic precocious pubarche (PP), had adrenal androgens higher than normal prepubertal children and similar levels to those observed in early pubertal controls. In contrast to a recent report, we confirmed that mild adrenal enzymatic defects can occur in PP, and, consequently, the use of ACTH testing in children with PP seems to be recommended.     

Incense smoke: clinical, structural and molecular effects on airway disease

Background

A modest number of prospective studies of the composition of the intestinal microbiota and eczema in early life have yielded conflicting results.

Objective

To examine the relationship between the bacterial diversity of the gut and the development of eczema in early life by methods other than stool culture.

Methods

Fecal samples were collected from 21 infants at 1 and 4 months of life. Nine infants were diagnosed with eczema by the age of 6 months (cases) and 12 infants were not (controls). After conducting denaturating gradient gel electrophoresis (DGGE) of stool samples, we compared the microbial diversity of cases and controls using the number of electrophoretic bands and the Shannon index of diversity (H') as indicators.

Results

Control subjects had significantly greater fecal microbial diversity than children with eczema at ages 1 (mean H' for controls = 0.75 vs. 0.53 for cases, P = 0.01) and 4 months (mean H' for controls = 0.92 vs. 0.59 for cases, P = 0.02). The increase in diversity from 1 to 4 months of age was significant in controls (P = 0.04) but not in children who developed eczema by 6 months of age (P = 0.32).

Conclusion

Our findings suggest that reduced microbial diversity is associated with the development of eczema in early life.     

Does mixing age groups in early childhood education settings support children’s language development?

As early childhood education programming expands across the globe, there is an increased need to understand how features of these programs influence children’s development. The composition of children’s age within a classroom is one such feature, although it is much less studied than other features. Theoretical and empirical evidence suggests that children’s development may be influenced by the age range of their classmates. This study examines the relations between classroom age variability on children’s vocabulary development for 2,743 children between the ages of two years, nine months, and six years, 11 months enrolled in early childhood education settings in Denmark. Findings indicate a significant nonlinear relationship between the range of child age within a classroom and children’s vocabulary development, such that classrooms with a maximum age range of 24 months were associated with the greatest gains in vocabulary growth. Results give direction to policy efforts focused on expansion of early childhood education programming.     

Cancer Risk in Children and Adolescents with Birth Defects: A Population-Based Cohort Study

Objective

Birth defects are an increasing health priority worldwide, and the subject of a major 2010 World Health Assembly Resolution. Excess cancer risk may be an added burden in this vulnerable group of children, but studies to date have provided inconsistent findings. This study assessed the risk for cancer in children and young adolescents with major birth defects.

Methods and Findings

This retrospective, statewide, population-based, cohort study was conducted in three US states (Utah, Arizona, Iowa). A cohort of 44,151 children and young adolescents (0 through 14 years of age) with selected major, non-chromosomal birth defects or chromosomal anomalies was compared to a reference cohort of 147,940 children without birth defects randomly sampled from each state’s births and frequency matched by year of birth. The primary outcome was rate of cancer prior to age 15 years, by type of cancer and type of birth defect. The incidence of cancer was increased 2.9-fold (95% CI, 2.3 to 3.7) in children with birth defects (123 cases of cancer) compared to the reference cohort; the incidence rates were 33.8 and 11.7 per 100,000 person-years, respectively. However, the excess risk varied markedly by type of birth defect. Increased risks were seen in children with microcephaly, cleft palate, and selected eye, cardiac, and renal defects. Cancer risk was not increased with many common birth defects, including hypospadias, cleft lip with or without cleft palate, or hydrocephalus.

Conclusion

Children with some structural, non-chromosomal birth defects, but not others, have a moderately increased risk for childhood cancer. Information on such selective risk can promote more effective clinical evaluation, counseling, and research.     

An additional human chromosome 21 causes suppression of neural fate of pluripotent mouse embryonic stem cells in a teratoma model

Background

Down syndrome (DS), caused by trisomy of human chromosome 21 (HSA21), is the most common genetic cause of mental retardation in humans. Among complex phenotypes, it displays a number of neural pathologies including smaller brain size, reduced numbers of neurons, reduced dendritic spine density and plasticity, and early Alzheimer-like neurodegeneration. Mouse models for DS show behavioural and cognitive defects, synaptic plasticity defects, and reduced hippocampal and cerebellar neuron numbers. Early postnatal development of both human and mouse-model DS shows the reduced capability of neuronal precursor cells to generate neurons. The exact molecular cause of this reduction, and the role played by increased dosage of individual HSA21 genes, remain unknown.

Results

We have subcutaneously injected mouse pluripotent ES cells containing a single freely segregating supernumerary human chromosome 21 (HSA21) into syngeneic mice, to generate transchromosomic teratomas. Transchromosomic cells and parental control cells were injected into opposite flanks of thirty mice in three independent experiments. Tumours were grown for 30 days, a time-span equivalent to combined intra-uterine, and early post-natal mouse development. When paired teratomas from the same animals were compared, transchromosomic tumours showed a three-fold lower percentage of neuroectodermal tissue, as well as significantly reduced mRNA levels for neuron specific (Tubb3) and glia specific (Gfap) genes, relative to euploid controls. Two thirds of transchromosomic tumours also showed a lack of PCR amplification with multiple primers specific for HSA21, which were present in the ES cells at the point of injection, thus restricting a commonly retained trisomy to less than a third of HSA21 genes.

Conclusion

We demonstrate that a supernumerary chromosome 21 causes Inhibition of Neuroectodermal DIfferentiation (INDI) of pluripotent ES cells. The data suggest that trisomy of less than a third of HSA21 genes, in two chromosomal regions, might be sufficient to cause this effect.     

Cytogenetic analysis of the 2B3-4 — 2B11 region of the X chromosome of Drosophila melanogaster

Puffing patterns have been studied both in homozygotes t10/t10, a gene located in the area of the early ecdysone puff 2B5, and in a yellow (y) control stock, at the end of the third instar and during prepupal development. In mutants t10 at the end of the third instar puffing develops normally in general, however, 21 puffs (5 early and 16 late ones) underdevelop or do not develop at all, some larval intermoult puffs regressing slower. The next cycle of puffs (mid prepupal) in mutants t10 proceeds normally, but in the late prepupal cycle 21 puffs underdevelop again or are not formed at all. A model for the induction of early ecdysone puffs is proposed, assigning a key role to the 2B5 puff product in stimulating other early puffs. It is suggested that defects in the activity of early puffs in the mutant t10 may cause underdevelopment of late puffs.Dedicated to Professor W. Beermann on the occasion of his 60th birthday     

Soil-transmitted helminth infection in pregnancy and long-term child neurocognitive and behavioral development: A prospective mother-child cohort in Benin

BackgroundAn estimated 30% of women in Sub-Saharan Africa suffer from soil-transmitted helminth infection during pregnancy (SHIP), which has been shown to increase risk of pre-term birth, low birth weight, and maternal anemia. A previous study in Benin found that SHIP was associated with impaired cognitive and gross motor development scores in 635 one-year-old children. The objective of the present study was to follow children prospectively to investigate whether the association between SHIP and child neurocognitive and behavioral development persisted at age six.Principal findingsOur prospective child cohort included 487 live-born singletons of pregnant women enrolled in the Malaria in Pregnancy Preventive Alternative Drugs clinical trial in Allada, Benin. SHIP was assessed at three antenatal visits (ANVs) through collection and testing of stool samples. Neurocognitive and behavioral development was assessed in six-year-old children by trained investigators using the Kaufman Assessment Battery for Children 2^nd edition and the parent-reported Strengths and Difficulties Questionnaire (SDQ). Multiple linear regression models generated coefficients and 95% confidence intervals and potential mediating factors were tested. Prevalence of SHIP was 13% at the 1^st ANV, 9% at the 2^nd ANV, and 1% at delivery. SHIP was not associated with low neurocognitive scores in children at six years. Higher SDQ internalizing scores, indicating increased emotional impairments in children, were associated with helminth infection at the 2^nd ANV/delivery 1.07 (95% CI 0.15, 2.00) and at least once during pregnancy 0.79 (95% CI 0.12, 1.46) in adjusted models. Mediation analysis did not reveal significant indirect effects of several mediators on this association.ConclusionsOur study shows that while SHIP is not associated with impaired long-term neurocognitive development, infections may have significant negative impacts on emotional development in six-year-old children. SHIP remains a critical public health issue, and adequate prevention and treatment protocols should be enforced in low- and middle-income countries.     

Surgically Induced Interpregnancy Weight Loss and Prevalence of Overweight and Obesity in Offspring

Introduction

According to the fetal overnutrition hypothesis, obesity in pregnancy predisposes the offspring to obesity. Previous studies have suggested that after biliopancreatic surgery for obesity, the offspring is less likely to be obese. This study aims to further compare the BMI development of children born before and after maternal surgical weight loss.

Method

Women with at least one child born before and one child born after bariatric surgery were identified by record-linkage. Information about maternal BMI was extracted from medical records, as was information about the children''s BMI from birth to 10 years of age. We retrieved BMI data at four years of age for 340 children, born to 223 women (164 children born before surgery (BS), 176 children born after surgery (AS)). We evaluated prevalence of overweight/obesity and mean BMI in children born BS and AS at the ages of four, six and ten using GEE regression models. For 71 families, where we had complete data on mother and both children, we used a fixed-effects regression model to explore the association between differences in maternal BMI in w10 of the pre- and post-operative pregnancies with siblings'' BMI differences at age four.

Results

In no age group did we see a significantly reduced prevalence of overweight/obesity AS. For 10-year-old girls, the AS group had significantly higher rates of obesity. There was no association between differences in maternal BMI in early pregnancy and differences in siblings'' BMI at four years of age (β = −0.01, CI 95% = −0.11; 0.09).

Conclusions

We have been unable to demonstrate any effect of bariatric surgery on weight development in offspring. It seems unlikely that restrictive bariatric surgery conveys a protective effect in offspring with regards to obesity.     

Early puberty in short-haired Guinea pigs kept in laboratory animal facilities

Lab animals, such as Guinea pigs (Cavia porcellus), are crucial for scientific development, as they play an important role in the development and quality control chain of vaccines and drugs distributed by the Brazilian public health system. Investigating their biological and physiological parameters is fundamental to raise and keep these animals, so the handling of the facilities that hold them can be updated whenever new information comes up, with the well-being of the animals and alignment with the 3 Rs in mind. In the search for understanding reproductive aspects of Guinea pigs, the present study had the main goal of studying puberty by means of estrous cycle analysis in short-haired Guinea pigs. Guinea pigs have a vaginal occlusive membrane that covers the vaginal orifice. Its rupture takes place gradually and naturally, moments before labor and during estrus. The present study followed 42 females as for the presentation of the vaginal occlusive membrane. Once the membranes ruptured spontaneously, a swab was collected to study vaginal cytology. Membrane rupture was observed in 39 females; six females showed membrane rupture with less than 21 days of age (17 to 21 days). Twenty-three females were characterized as being in estrus due to cytology showing a prevalence of anucleated superficial cells. One of these females was younger than 21 days old. The opening of the vaginal occlusive membrane took place most frequently in intervals between 17 and 18 days, and the membrane remained open between one and three consecutive days. It was possible to follow three cycles of membrane opening on six females. The present study showed the need to adapt handling guidelines for C. porcellus kept in research animal facilities. The early age of puberty imposes the need of separate the female daughters from their fathers at 16 days old.     

The Urban Environment and Childhood Asthma (URECA) birth cohort study: design, methods, and study population

Background

The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA) study, which was established to investigate the immunologic causes of asthma among inner-city children.

Methods and Results

URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses) that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years.

Conclusion

The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.     

Forecasting youth adjustment at age 15 from school readiness profiles at 54 months

ABSTRACT

A person-oriented approach examined the extent to which patterns of school readiness across social and cognitive domains in 944 typically-developing 54-month-old children forecast academic achievement, social-emotional development, risk taking, and executive functioning at age 15. Prior work identified six distinct profiles of school readiness at 54 months that predicted group differences in achievement in first grade, as well as achievement and social-emotional outcomes in fifth grade. After controlling for demographics, early language skills, and home and school factors, the 54-month readiness profiles demonstrated different performance on risk-taking and executive function behaviors assessed at age 15. Children with attention problems at 54 months were most likely to believe that peers were engaging in risky behaviors and to have smoked more than 2 cigarettes by age 15. Children with low working memory and low to average social skills at 54 months were outperformed by their peers on working memory and executive function tasks at age 15. Results are discussed in terms of continuity in forms of developmental function.     

Proficiency deficiency: mastery of fundamental movement skills and skill components in overweight and obese children

The purpose of this observational study was to compare the mastery of 12 fundamental movement skills (FMS) and skill components between a treatment-seeking sample of overweight/obese children and a reference sample from the United States. Mastery of six locomotor and six object-control skills (24 components in each subdomain) were video-assessed by one assessor using the test of gross motor development-2 (TGMD-2). The 153 overweight/obese children (mean ± s.d. age = 8.3 ± 1.1 years, BMI z-score = 2.78 ± 0.69, 58% girls, 77% obese) were categorized into age groups (for the underhand roll and strike: 7-8 years and 9-10 years; all other FMS: 6-7 years and 8-10 years) and mastery prevalence rates were compared with representative US data (N = 876) using χ(2) analysis. For all 12 skills in all age groups, the prevalence of mastery was lower among overweight/obese children compared with the reference sample (all P < 0.05). This was consistent for 18 locomotor and upto 21 object-control skill components (all P < 0.05). Differences were largest for the run, slide, hop, dribble, and kick. Specific movement patterns that could be targeted for improvement include positioning of the body and feet, the control or release of an object at an optimal position, and better use of the arms to maintain effective force production during the performance of FMS. Physical activity programs designed for overweight and obese children may need to address deficiencies in FMS proficiency to foster the movement capabilities required for participation in health-enhancing physical activity.     

Stability of the Associations between Early Life Risk Indicators and Adolescent Overweight over the Evolving Obesity Epidemic

Background

Pre- and perinatal factors and preschool body size may help identify children developing overweight, but these factors might have changed during the development of the obesity epidemic.

Objective

We aimed to assess the associations between early life risk indicators and overweight at the age of 9 and 15 years at different stages of the obesity epidemic.

Methods

We used two population-based Northern Finland Birth Cohorts including 4111 children born in 1966 (NFBC1966) and 5414 children born in 1985–1986 (NFBC1986). In both cohorts, we used the same a priori defined prenatal factors, maternal body mass index (BMI), birth weight, infant weight (age 5 months and 1 year), and preschool BMI (age 2–5 years). We used internal references in early childhood to define percentiles of body size (<50, 50–75, 75–90 and >90) and generalized linear models to study the association with overweight, according to the International Obesity Taskforce (IOTF) definitions, at the ages of 9 and 15 years.

Results

The prevalence of overweight at the age of 15 was 9% for children born in 1966 and 16% for children born in 1986. However, medians of infant weight and preschool BMI changed little between the cohorts, and we found similar associations between maternal BMI, infant weight, preschool BMI, and later overweight in the two cohorts. At 5 years, children above the 90^th percentile had approximately a 12 times higher risk of being overweight at the age of 15 years compared to children below the 50^th percentile in both cohorts.

Conclusions

The associations between early body size and adolescent overweight showed remarkable stability, despite the increase in prevalence of overweight over the 20 years between the cohorts. Using consequently defined internal percentiles may be a valuable tool in clinical practice.     

Environmental stress and human life history strategy development in rural and peri-urban South India

Few studies have examined the role of early vs. later environment in the development of life history (LH) strategies, whether age at sexual debut mediates LH development, or whether LH indicators contribute to environmental stress in adulthood. In the current study, we addressed these gaps cross-culturally using data from Jenu Kurubas who live in the rural outskirts of Mysore (n = 133), India, and mixed-caste peri-urban residents in Mysore city (n = 222). Research took place from October 2016–July 2017. First, participants engaged in semi-structured interviews to formulate quantitative measures of current environmental stress (n = 60). Next, participants (n = 355) completed structured questionnaires that measured demographics; early and current environmental stress; and LH indicators including age at sexual debut, facets of impulsivity, education, and number of children. Structural equation modeling was used to test for the developmental cascade reported in Western studies of psychosocial acceleration (e.g., indirect effect of early environmental stress on number of children through age at sexual debut). Consistent with Western findings, environmental stress appeared to hasten sexual debut, decrease self-regulation and educational attainment, and increase current environmental stress in the peri-urban sample. Early environmental stress forecasted younger age at sexual debut in both samples; however, no other effects of early environmental stress nor any associations with current environmental stress were consistent between samples. Although age at sexual debut appeared to translate early environmental stress into greater numbers of children and current environmental stress in the peri-urban and rural samples, respectively, it was associated with different outcomes between the samples and forecasted adult environment only in the rural sample. Taken together, our findings indicate more research is needed to determine whether the developmental cascade suggested by most applications of LH theory to humans generalizes across cultures and rural and peri-urban environments.