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Following directions, ignoring distractions, and inhibiting inappropriate responses: many aspects of children’s everyday functioning are, in some way, dependent on self-regulation. Self-regulation refers to the ability to automatically or purposely control thoughts, feelings, and behaviors (Karoly, 1993; Nigg, 2017). During the first years of life, self-regulation shows a rapid development and children typically become competent in complex self-regulatory skills, such as executive functioning, around the preschool period (Garon et al., 2008; Hendry et al., 2016). The emergence of self-regulatory skills is crucial for positive child outcomes, including health and well-being across the lifespan (Kopp, 1982; Moffitt et al., 2011). However, not all children develop at the same rate and preschool age children often differ considerably in their self-regulatory skills (Hendry et al., 2016). Given the importance of self-regulatory skills, it is crucial to understand which factors can explain individual differences in self-regulation at such early age (Vink et al., 2020). The emergence of complex self-regulatory skills may be impeded by a host of risk factors, a number of which can already be present in the prenatal caregiving environment. For instance, parental mental health problems (for a meta-analysis, see Power et al., 2021), low parental SES (for a review, see Vukojević et al., 2017), and prenatal stress (Davis et al., 2011; Korja et al., 2017) appear to negatively impact child developmental outcomes, such as self-regulation. Consistent with the cumulative risk hypothesis (Appleyard et al., 2005; Evans et al., 2013), exposure to multiple prenatal risk factors at the same time increases the likelihood of self-regulation deficits in preschool age children (Camerota & Willoughby, 2020). Yet, relatively little work has identified the specific mechanisms linking prenatal exposure to multiple risk factors and child self-regulation later in life. In line with biopsychosocial theories (Calkins et al., 2016; Sameroff, 2009), the current study examines whether psychosocial processes (the development of parenting) and biobehavioral processes (brain maturation) simultaneously mediate the effect of prenatal risk on self-regulation in preschool age children. Psychosocial mechanisms From a psychosocial perspective, it is assumed that positive experiences embedded within the early caregiving environment promote children’s self-regulatory skills (Bernier et al., 2010). Young infants still strongly depend on external regulation from their caregiving environment, but increasingly become more independent and able to achieve complex self-regulatory skills (Kopp, 1982; Lobo & Lunkenheimer, 2020). As parenting behaviors represent the most intense and immediate environmental experiences during early childhood, various theories emphasize the importance of early parent-child interactions that promote positive child outcomes later in life (e.g., Bowlby, 1979; Bronfenbrenner, 1979). Subsequently, empirical work revealed that the experience of supportive, consistent, and appropriate stimulating parenting behaviors are positively related to the emergence of child self-regulatory skills (for reviews, see Fay-Stammbach et al., 2014; Karreman et al., 2006). In general, these positive parenting behaviors appear to be relatively stable across infancy and early childhood (e.g., Dallaire & Weinraub, 2005; Paschall & Mastergeorge, 2018). Prenatal risk factors increase the risk for non-optimal parenting during the first years of life (Guyon-Harris et al., 2021; Tambelli et al., 2014). For instance, prenatal mental health problems (for a review, see Berg-Nielsen et al., 2002) and adverse prenatal live events (Tambelli et al., 2014) are linked to impaired parenting in early childhood, such as problems with recognizing and responding appropriately to children’s signals and needs. Especially exposure to multiple prenatal risk factors appears to negatively affect the quality of parenting behaviors (Barker et al., 2011; Tambelli et al., 2014). Mothers exposed to cumulative risk (e.g., both depressive symptoms and psychosocial risk, such as low educational level and single motherhood) showed lack of reciprocity, more intrusiveness and more conflictual parent-child interactions compared to non-exposed mothers, as well as compared to mothers with solely depressive or solely psychosocial risk (Tambelli et al., 2014). With increasing age, it might become even harder for parents to recognize and appropriately respond to the needs of their children as a result of advances in child mobility and increases in children’s sense of autonomy (Bornstein, 2019). Therefore, exposure to multiple prenatal risk factors might affect children’s self-regulation directly, or indirectly, through a disruption of the quality and the development of parenting. Previous research on postnatal cumulative risk demonstrated that maternal behaviors indeed mediated relations between exposure to cumulative risk and behavioral outcomes in preschool age children, such as aggression and rule-breaking behaviors (Trentacosta et al., 2008), and measures of attention, inhibitory control, and delay ability (Lengua et al., 2007). However, studies examining the mediating effect of parenting quality in the relation between prenatal cumulative risk and child self-regulation are, to our knowledge, still lacking. Although a meta-analysis on the association between exposure to risk (i.e., maternal depression) and child self-regulation revealed that prenatal and postnatal exposure to maternal depressive symptoms had the same negative effect on child self-regulation (Power et al., 2021), the mechanisms underlying the adverse effects of risk factors might be different when considering the timing of exposure to risk factors. Beside the effect of prenatal risk on parenting behaviors (Guyon-Harris et al., 2021; Tambelli et al., 2014), the prenatal period is a critical period for infant’s internal biobehavioral processes, such as neurocognitive development (for a review, see Ruiz et al., 2005). Therefore, it is now increasingly recognized that prenatal exposure to risk factors could alter child developmental outcomes through biobehavioral mechanisms as well (Power et al., 2021; Ruiz et al., 2005). Biobehavioral mechanisms From a biobehavioral perspective, there is growing evidence that self-regulation emerges as a function of brain maturation. For instance, the exchange of information between brain regions within functional networks (e.g., the orienting and executive attention network) appears to play an important role in child self-regulation (Posner & Rothbart, 2000; Rothbart et al., 2011). However, the infants’ brain still consists of an overabundance of neural connections, which hinders optimized communication between widespread brain regions. In order to make the exchange of information more efficient, postnatal brain development typically includes optimization of brain networks through the process of systematic pruning of unimportant connections and the strengthening of important connections (Huang et al., 2015; Yap et al., 2011). This process of increasing functional brain network efficiency possibly allows for more complex behaviors to arise during early childhood (Tau & Peterson, 2010). Prior research revealed associations between brain network efficiency and individual differences in young children’s self-regulation (Fekete et al., 2014; Xie et al., 2019). The efficiency of communication within brain networks can be measured using the synchronicity of oscillatory EEG rhythms, reflecting the communication between distinct brain regions. Small-worldness is one of the most frequently analyzed topological properties of functional brain network efficiency, which calculates the optimization of brain networks by using a graph-theoretical framework (Muldoon et al., 2016). In graph theory, brain networks consist of nodes and edges, respectively reflecting the distributed brain regions and neural connections between these regions (Bassett & Bullmore, 2006; Bullmore & Sporns, 2009). Small-world networks are generally characterized by a high clustering coefficient (dense interconnections between neighboring nodes) in combination with few edges between clusters of nodes, also referred to as short path lengths (Muldoon et al., 2016). In general, functional brain networks in young children become more efficient with age, indicated by increases in the levels of small-worldness (Gao et al., 2017; Hofstee et al., 2022). The prenatal stress literature has linked a wide variety of mothers’ prenatal risk factors with altered brain networks in young children, such as prenatal mental health problems (e.g., Posner et al., 2016; Soe et al., 2018) and increases in the number of stressful live events during pregnancy (e.g., Humphreys et al., 2020; Van den Bergh et al., 2018). As prenatal risk could undermine the emergence of efficient brain networks, there might be an indirect effect of prenatal risk through deficits in the development of efficient brain networks on child self-regulation later in life. Prior research on postnatal risk indeed revealed that variations in functional brain networks mediated the relation between cumulative risk and individual differences in child self-regulation (Pagliaccio et al., 2015). However, longitudinal studies examining the mediating role of brain network efficiency in the link between prenatal risk and self-regulation in early childhood are, to our knowledge, still lacking. The current study In sum, risk factors during pregnancy have been found to negatively affect the emergence of self-regulatory skills in young children (e.g., Korja et al., 2017; Van den Berg et al., 2009). Thus far, most interventions start in early childhood and tend to focus on promoting the parent-child relationship and the quality of parenting behaviors (Allen, 2011). However, if prenatal risk factors already compromise child developmental outcomes, such as self-regulation, then early interventions may be required during pregnancy as well (O’Donnell et al., 2014). In order to improve interventions that promote the emergence of complex self-regulatory skills in young children, more insight into the possible mechanisms underlying the association between exposure to multiple prenatal risk factors and child self-regulation is necessary. The majority of research on the mediating mechanisms of child self-regulation focuses on postnatal risk, rather than prenatal risk (e.g., Lengua et al., 2007; Pagliaccio et al., 2015), or did not examine psychosocial and biobehavioral processes within the same study, so their relative importance could not be determined (e.g., Camerota & Willoughby, 2020). In line with biopsychosocial theory (Calkins et al., 2016; Sameroff, 2009), the current study addresses important gaps in the literature by simultaneously examining (the development of) parenting quality and brain network efficiency as mediating mechanisms underlying the relation between prenatal risk and variations in child self-regulation. In addition, the current study adds to the literature by examining psychosocial and biobehavioral mechanisms using a longitudinal design, allowing for testing developmental changes in parenting behaviors and brain network efficiency over time. Given that evaluating single risk factors may underestimate the impact of prenatal risk on developmental outcomes, a combination of multiple prenatal risk factors will be created by using the approach of cumulative risk models (Appleyard et al., 2005; Evans et al., 2013).

Modulation of Alzheimer′s disease (AD) risk begins early in life. During embryo development and postnatal maturation, the brain receives maternal physiological influences and establishes epigenetic patterns that build its level of resilience to late-life diseases. The soluble epoxide hydrolase inhibitor N-[1-(1-oxopropyl)-4-piperidinyl]-N′-[4-(trifluoromethoxy)phenyl] urea (TPPU), reported as ant-inflammatory and neuroprotective against AD pathology in the adult 5XFAD mouse model of AD, was administered to wild-type (WT) female mice mated to heterozygous 5XFAD males during gestation and lactation. Two-month-old 5XFAD male and female offspring of vehicle-treated dams showed memory loss as expected. Remarkably, maternal treatment with TPPU fully prevented memory loss in 5XFAD. TPPU-induced brain epigenetic changes in both WT and 5XFAD mice, modulating global DNA methylation (5-mC) and hydroxymethylation (5-hmC) and reducing the gene expression of some histone deacetylase enzymes (Hdac1 and Hdac2), might be on the basis of the long-term neuroprotection against cognitive impairment and neurodegeneration. In the neuropathological analysis, both WT and 5XFAD offspring of TPPU-treated dams showed lower levels of AD biomarkers of tau hyperphosphorylation and microglia activation (Trem2) than the offspring of vehicle-treated dams. Regarding sex differences, males and females were similarly protected by maternal TPPU, but females showed higher levels of AD risk markers of gliosis and neurodegeneration. Taken together, our results reveal that maternal treatment with TPPU impacts in preventing or delaying memory loss and AD pathology by inducing long-term modifications in the epigenetic machinery and its marks., This research was funded by the Spanish Ministerio de Ciencia e Innovación and the Agencia Estatal de Investigación (MCIN/AEI/10.13039/501100011033, grants PID2019-106285RB and PDC2021-121096) and by the European Union “NextGenerationEU”/PRTR; CSIC (2019AEP038); CERCA program/Generalitat de Catalunya; and 2017SGR106 from AGAUR.

Prenatal detection of structural variants of uncertain significance, including copy number variants (CNV), challenges genetic counseling, and creates ambiguity for expectant parents. In Duchenne muscular dystrophy, variant classification and phenotypic severity of CNVs are currently assessed by familial segregation, prediction of the effect on the reading frame, and precedent data. Delineation of pathogenicity by familial segregation is limited by time and suitable family members, whereas analytical tools can rapidly delineate potential consequences of variants. We identified a duplication of uncertain significance encompassing a portion of the dystrophin gene (DMD) in an unaffected mother and her male fetus. Using long-read whole genome sequencing and alignment of short reads, we rapidly defined the precise breakpoints of this variant in DMD and could provide timely counseling. The benign nature of the variant was substantiated, more slowly, by familial segregation to a healthy maternal uncle. We find long-read whole genome sequencing of clinical utility in a prenatal setting for accurate and rapid characterization of structural variants, specifically a duplication involving DMD.

The aim of this study was to evaluate our prenatal risk stratification system for risk-adjusted management in fetuses with isolated congenital diaphragmatic hernia (CDH).Ninety-four infants prenatally diagnosed with isolated CDH treated between 1998 and 2017 at our institution were included in this retrospective single-center cohort study.The patients were prenatally classified into four risk groups: Group A (n = 54), which consisted of infants with neither liver-up nor a contralateral lung-to-thorax transverse area (L/T) ratio0.08. The infants in group A were divided into two subgroups: Group A-1 (n = 24) consisted of mild conditions; and Group A-2 (n = 30) consisted of severe conditions; Group B (n = 23), which consisted of infants with either liver-up or L/T ratio0.08; and Group C (n = 17), which consisted of infants with both liver-up and L/T ratio0.08. The rates of survival to discharge in Groups A-1, A-2, B, and C were 100.0%, 100.0%, 87.0%, and 58.8%, respectively. The rates of intact discharge were 91.7%, 90.0%, 52.1%, and 23.5%, respectively.Our prenatal risk stratification system demonstrated a significant difference in the severity of postnatal status and clinical outcomes between the groups.Case Series, Retrospective Review.LEVEL IV.

This study assessed prenatal risk factors that contribute significantly to autism spectrum disorder (ASD). A total of 400 online questionnaires were sent to the mothers who had children not older than 12 years of age. Only 76.25% of the questionnaires were fully complete, with 160 of the 305 mothers had a child with ASD while 145 had a neurotypical child. The risk factors were analyzed using binary logistic regression. The results showed four factors that contributed significantly (p

The purpose of this study was to examine the moderating role of maternal sensitivity on the association between prenatal adversity and externalizing behaviors at 24 months of age in a diverse, high-risk sample. We hypothesized that among children with higher prenatal adversity, high maternal sensitivity would serve as a protective factor. Participants were 247 primarily low-income, diverse dyads. Results indicated a significant interaction effect of maternal sensitivity and prenatal adversity on externalizing problems. The association between prenatal adversity and externalizing behaviors was significant only among children who experienced low prenatal adversity, with higher maternal sensitivity associated with lower externalizing behaviors. These findings indicate that, in the absence of high prenatal risk, responsive and sensitive parenting can buffer children in an otherwise high-risk sample from the development of externalizing behaviors.El propósito de este estudio fue examinar el papel moderador que la sensibilidad materna tiene sobre la asociación entre adversidad prenatal y las conductas de externalización a los 24 meses de edad en un grupo muestra diverso y de alto riesgo. Nuestra hipótesis es que entre los niños con más alta adversidad prenatal (PA), una alta sensibilidad materna serviría como un factor de protección. Participaron 247 díadas diversas, primariamente de bajos recursos económicos (173 infantes expuestos a sustancias). Los resultados indicaron un significativo efecto de interacción de la sensibilidad materna y la adversidad prenatal sobre los problemas de externalización. La asociación entre la adversidad prenatal y las conductas de externalización fue significativa sólo entre niños que habían experimentado una adversidad prenatal baja, mientras que una más alta sensibilidad materna se asoció con más bajas conductas de externalización. Estos resultados indican que, en ausencia de un riesgo prenatal alto, una crianza receptiva y sensible puede amortiguar el desarrollo de conductas de externalización en niños que, de lo contrario, están dentro de un grupo muestra de alto riesgo.Le but de cette étude était d'examiner le rôle modérateur de la sensibilité maternelle sur l'association entre l'adversité prénatale et les comportements d'externalisation à l’âge de 24 mois chez un échantillon varié, et à haut risque. Nous avons pris comme hypothèse que chez les enfants avec une adversité prénatale élevée (PA), une sensibilité maternelle élevée servirait de facteur de protection. Les participants ont consisté en 247 dyades diverse et principalement issues de milieux défavorisés (173 bébés exposés à la toxicomanie). Les résultats indiquent un effet d'interaction important de la sensibilité maternelle et de l'adversité prénatale sur les problèmes d'externalisation. Le lien entre l'adversité prénatale et les comportements d'externalisation n’était important que chez les enfants ayant fait l'expérience d'une adversité prénatale peu élevée, avec une sensibilité maternelle plus élevée liée à des comportements d'externalisation moins élevés. Ces résultats indiquent que, en l'absence d'une risque prénatal élevé, le parentage réactif et sensible peut servir de tampon aux enfants contre le développement de comportements d'externalisation dans un échantillon qui est par ailleurs à haut risque.Die Auswirkung pränataler Belastung auf externalisierendes Verhalten im Alter von 24 Monaten in einer Stichprobe mit hohem Risiko: Mütterliche Sensibilität als Moderator Ziel dieser Studie war es, die moderierende Rolle mütterlicher Sensibilität im Zusammenhang zwischen pränataler Belastung und Externalisierungsverhalten im Alter von 24 Monaten in einer diversen Stichprobe mit hohem Risiko zu untersuchen. Die Hypothese bestand darin, dass bei Kindern mit höherer pränataler Belastung (prenatal adversity; PA) eine hohe Sensibilität der Mutter als Schutzfaktor dient. 247 hauptsächlich einkommensschwache, diverse Mutter-Kind Dyaden (173 davon substanzexponierte Säuglinge) nahmen an der Studie teil. Die Ergebnisse zeigten einen signifikanten Interaktionseffekt von mütterlicher Sensibilität und pränataler Belastung auf Externalisierungsprobleme. Der Zusammenhang zwischen pränataler Belastung und Externalisierungsverhalten war nur bei Kindern signifikant, bei denen eine geringe pränatale Belastung vorhanden war, wobei eine höhere Sensibilität der Mutter mit einem geringeren Externalisierungsverhalten assoziiert war. Diese Ergebnisse deuten darauf hin, dass, wenn kein hohes pränatales Risiko vorhanden ist, ein responsives und sensibles elterliches Verhalten Kinder in einer ansonsten risikoreichen Stichprobe vor der Entwicklung von Externalisierungsverhalten schützen kann.ハイリスク群の生後24ヶ月における外在化型の問題行動に対する出生前の困難な 課題の影響:緩和する役としての母親の感受性 本論文の目的は、多様でハイリスク群の出生前の困難な課題と生後24ヶ月における外在化型の問題行動の関連に対する母親の感受性の緩和する役割について調査することであった。我々は、より高い出生前の困難な課題(PA)のある子どもの中で、母親の高い感受性が予防要素として役立つのではないだろうかと仮定した。対象者は主に低収入で 多様な背景をもつ母子親子247組(173人の薬物曝露の新生児)である。結果は、外在化型の問題行動に対して母親の感受性と出生前の困難な課題との有意な相互作用の影響が示唆された。出生前の困難な課題と外在化型の問題行動の間の関連は、出生前の困難な課題を少なく体験した子どもの中で、外在化型の問題行動が低いことに関連した母親の感受性がより高いことのみ有意であった。これらの結果は、出生前の高いリスクがない場合において、応答的で感受性豊かな子育てが、それでもハイリスク群には入る子どもを外在化型の問題行動の発達から子どもを守ることができることを示唆している。.本研究的目的是在一个多样化的高风险样本中, 检验母亲敏感性在产前逆境与儿童24月龄时的外化行为之间的调节作用。我们假设处于更恶劣的产前逆境 (PA)中的儿童, 较高的母亲敏感性可以作为一个保护因素。研究参与者主要是247名低收入、多样化的母婴 (包含173名药物暴露的婴儿) 。结果表明, 母亲敏感性与产前逆境对儿童的外化问题有显著的相互作用。产前逆境与儿童外化行为之间的关联仅在经历过低程度的产前逆境的儿童中才有意义, 较高的母亲敏感性会导致较低的儿童外化行为。这些发现表明, 在没有经历高产前风险的情况下, 反应敏感的育儿可以缓冲儿童外化行为的发展, 否则他们会发展为高风险的样本。.تأثير الشدائد السابقة للولادة على السلوكيات السلبية في عمر 24 شهرًا في عينة عالية المخاطرة: حساسية الأمهات كعامل وسيط ملخص كان الغرض من هذه الدراسة هو دراسة الدور الوسيط للحساسية الأمومية في الارتباط بين الشدائد السابقة للولادة والسلوكيات السلبية في عمر 24 شهرًا في عينة متنوعة وعالية المخاطرة. افترضنا أنه بين الأطفال الذين يعانون من الشدائد ما قبل الولادة (PA) ، فإن الحساسية العالية للأمهات ستكون بمثابة عامل وقائي. وكان المشاركون 247 من الثنائيات المتنوعة ذات الدخل المنخفض (173 رضيع من المعرضين للمواد المخدرة). وأشارت النتائج إلى تأثير تفاعلي كبير لحساسية الأمهات والشدائد السابقة للولادة على مشاكل السلوكيات السلبية. كان الارتباط بين الشدائد السابقة للولادة والسلوكيات السلبية مهمًا فقط بين الأطفال الذين عانوا من الشدائد المنخفضة قبل الولادة ، بينما كان ارتفاع حساسية الأم مرتبطاَ بسلوكيات سلبية أقل. وتشير هذه النتائج إلى أنه في غياب مخاطر عالية قبل الولادة، يمكن الرعاية الوالدية المستجيبة والحساسة أن تشكل عامل وقائي للأطفال في عينة عالية الخطورة من تطور سلوكيات سلبية.

Background: Florida's Healthy Start Program is a statewide prenatal screening program that aims to identify pregnant women at risk of adverse birth outcomes. However, the effectiveness of this legislatively mandated prenatal risk screening tool in predicting poor birth outcomes is unknown. This study aimed to evaluate associations between risk factors self-reported on this screening tool and adverse birth outcomes. Materials and Methods: A 1-year retrospective birth cohort at a large academic referral center was created. Risk factors reported on the tool by mothers who had a preterm or low-birthweight (LBW) infant were compared with those reported by mothers who delivered full-term non-LBW infants in bivariate and multivariate analyses. All data were extracted from maternal or infant electronic health records. Results: The Mother/Infant Dyad Screening cohort consisted of 528 dyads. We identified two items on the screening tool that significantly associated with adverse birth outcomes, but which do not currently contribute to the total risk score used to identify women for referral to preventive social services. These items were feeling alone and thinking it was not a good time to be pregnant. Conclusions: Comprehensive prenatal risk screening is an underutilized strategy in medicine. Florida's mandatory self-reported, prenatal survey can identify women at risk for poor neonatal outcomes. A more nuanced understanding how women are interpreting survey items and a re-evaluation of scoring practices may allow the tool to better serve as a model for other programs seeking to identify pregnant women at risk of poor birth outcomes.

Because aggressive behavior during early childhood has been related to negative developmental outcomes, a further understanding of the underlying mechanisms of aggression during the first years of life is essential. Although the factors prenatal risk, parenting behavior, temperament and cognitive functions have consistently been related to externalizing behavior during preschool and school age, research focusing on their interplay in relation to aggressive behavior earlier in life is scarce. The aim of the current dissertation was to gain more insight into these associations during infancy and toddlerhood. Our studies indicated that impairments in children’s early cognitive regulation abilities play a role in the development of aggressive behavior. It can also be concluded that both adverse pre- and postnatal environmental influences have an impact on child aggression: higher prenatal risk and adverse parenting behavior were directly or indirectly (via poor cognitive functioning) related to higher levels of aggression. In addition, it was found that poor cognitive skills increased the risk of aggression in case of high prenatal risk or a highly reactive temperament during early development. These results suggest that early intervention programs to prevent aggression should focus on prenatal risk, parenting behavior and cognitive development during the first years of life.

Background: Preterm birth is one of the world’s critical health problems, with an incidence of 5% to 18% of living newborns according to various countries. White matter injuries due to preoligodendrocytes deficits cause hypomyelination in children born preterm. Preterm infants also have multiple neurodevelopmental sequelae due to prenatal and perinatal risk factors for brain damage. The purpose of this work was to explore the effects of the brain risk factors and MRI volumes and abnormalities on the posterior motor and cognitive development at 3 years of age. Methods: A total of 166 preterm infants were examined before 4 months and clinical and MRI evaluations were performed. MRI showed abnormal findings in 89% of the infants. Parents of all infants were invited to receive the Katona neurohabilitation treatment. The parents of 128 infants accepted and received Katona’s neurohabilitation treatment. The remaining 38 infants did not receive treatment for a variety of reasons. At the three-year follow-up, Bayley’s II Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) were compared between treated and untreated subjects. Results: The treated children had higher values of both indices than the untreated. Linear regression showed that the antecedents of placenta disorders and sepsis as well as volumes of the corpus callosum and of the left lateral ventricle significantly predicted both MDI and PDI, while Apgar < 7 and volume of the right lateral ventricle predicted the PDI. Conclusions: (1) The results indicate that preterm infants who received Katona’s neurohabilitation procedure exhibited significantly better outcomes at 3 years of age compared to those who did not receive the treatment. (2) The presence of sepsis and the volumes of the corpus callosum and lateral ventricles at 3–4 months were significant predictors of the outcome at 3 years of age.

Advanced maternal age was the be all and end all of prenatal risk assessment for aneuploidy for nearly half a century. In virtually all countries, women a given age cutoff were regarded as being at high enough risk of aneuploidy to warrant the costs, hazards of performing an invasive, diagnostic procedure. Since alpha-fetoprotein (AFP) was already widely being used to screen for neural tube defects, at 16 to 18 weeks of gestation, it was relatively simple to include aneuploidy. Maternal serum AFP screening for aneuploidy was widely adopted, had the potential to increase the detection rate, but it was inefficient. While the diagnosis of Mendelian disorders may be possible by fetal cells or cell-free DNA, it is very likely that aneuploidy detection will be seen as a screening test to modify risk as a predicate for invasive diagnostic procedures. Considerable work in the mid-1990s focused on the development of ultrasound markers to be used to modify the risk of aneuploidy.

\n Otizm spektrum bozuklugu, sosyal etkilesim ve iletisim bozuklugu ile kisitli ve tekrarlayici davranislarla karakterize norogelisimsel bozukluklardan biridir. Otizm yaklasik 68 cocukta 1 gorulmektedir. Son yillarda yapilan calismalarda gorulme sikliginin arttigi bildirilmekte olup bu artisin bilgi ve farkindaligin artmasi ve tani olcutlerinin degismesinden kaynaklandigi iddia edilmekle birlikte yapilan calismalarda cevresel faktorler ve bunlarin henuz bilinmeyen genetik bir takim etkenlerle iliskisinin de bu artisa katki sagladigi dusunulmektedir. Norogelisimsel olarak onemli ve kirilgan bir donem olan prenatal donemde cocugun maruz kaldigi cevresel faktorlerin otizm spektrum bozuklugu gelismesi acisindan risk etkeni olup olmadiginin degerlendirilmesi onemlidir. Gebelik doneminde ozellikle valproik asit, terbutalin, selektif serotonin geri alim inhibitorleri gibi ilaclarla otizm spektrum bozuklugu arasinda bir iliski oldugu, bu donemde agir metal ve pestisite maruz kalmanin otizm spektrum bozuklugu riskini arttirdigi, yogun sigara, alkol ve madde kullaniminin norogelisimsel sureci sekteye ugrattigi, gebelik doneminde gecirilen gestasyonel diyabet, otoimmun hastaliklar, enfeksiyonlar ve uzamis atesin inflamatuar surecler araciligiyla otizm spektrum bozuklugu riskini artirabilecegi bildirilmektedir. Goc, mevsimler ve gebelik doneminde maruz kalinan hava kirliligininde risk artisina etkisi oldugu bildirilmis ve daha fazla epidemiyolojik calismaya ihtiyac oldugu vurgulanmistir. otizm spektrum bozuklugu ile iliskili cevresel etkenlerin taninmasi, anne adaylarinin bu risk etkenleri ile ilgili bilgilendirilmesinin saglanarak bu etkenlerden uzak durmalari veya bu etkenlerin elimine edilmesi ile otizm spektrum bozuklugu riskinin azaltilmasina yardimci olabileceginden bu alanda yapilan calismalarin derlenmesi ve risklerin ortaya konulmasi ozellikle onemlidir. Bu gozden gecirmede son donemde sayisi artan prenatal etkenler ile ilgili yapilan calismalarin derlenerek butuncul olarak ele almasinin kolaylastirilmasi hedeflemektedir. \n

Though the etiology of autism spectrum disorder (ASD) remains largely unknown, recent findings suggest that hormone dysregulation within the prenatal environment, in conjunction with genetic factors, may alter fetal neurodevelopment. Early emphasis has been placed on the potential role of in utero exposure to androgens, particularly testosterone, to theorize ASD as the manifestation of an “extreme male brain.” The relationship between autism risk and obstetric conditions associated with inflammation and steroid dysregulation merits a much broader understanding of the in utero steroid environment and its potential influence on fetal neuroendocrine development. The exploration of hormone dysregulation in the prenatal environment and ASD development builds upon prior research publishing associations with obstetric conditions and ASD risk. The insight gained may be applied to the development of chronic adult metabolic diseases that share prenatal risk factors with ASD. Future research directions will also be discussed.

Necrotizing enterocolitis is a serious and yet incompletely understood gastrointestinal disease of infancy that predominately impacts premature neonates. Prevention is a key strategy for the management of necrotizing enterocolitis. Although postnatal risk factors have been the focus of prevention efforts, obstetric complications, including intrauterine inflammation and infection, growth restriction, preeclampsia, and prenatal medications, have been associated with an increased risk of necrotizing enterocolitis. This article reviews the evidence behind the prenatal risk factors for necrotizing enterocolitis, and discusses how these risk factors may elucidate the pathogenesis of necrotizing enterocolitis and provide insight into prevention and treatment.

Background Children adopted from foster care are at heightened risk for emotional and behavioral challenges, potentially due to early trauma exposure and related risk factors. Research has demonstrated that adoptees with greater pre-adoptive risk exhibit higher rates of internalizing and externalizing problems across childhood and into adulthood. However, these studies have been limited by their use of individual risk factors or sum scores of cumulative risk and their measurement of internalizing and externalizing behaviors separately. Objective The current study aimed to examine effects of pre-adoptive risk on long-term functioning in children adopted from foster care. Method In a longitudinally-followed sample of 82 adoptees, we utilized latent growth curve modeling to examine effects of two latent indices of pre-adoptive risk, postnatal (i.e., trauma-related) risk and prenatal risk (not including prenatal substance exposure, since it was nearly ubiquitous in this sample), on adoptee internalizing, externalizing, and latent scores of dysregulation across childhood. Additionally, in three separate models, we tested whether baseline levels and change across childhood in internalizing, externalizing, and dysregulation mediated effects of prenatal and postnatal risk on adolescent/young-adult functioning. Results Greater postnatal risk, but not prenatal risk, predicted higher levels of internalizing and dysregulation across childhood. However, only dysregulation mediated the effect of postnatal risk on adolescent/young-adult functioning. Conclusions These results are consistent with prior research evidencing long-term effects of postnatal pre-adoptive risk, but not prenatal risk, in adoptees. Furthermore, they suggest that trauma exposure in this population may result in a profile of broad dysregulation that increases risk for maladjustment into adulthood.

The survey given by the World Health Organization (WHO), says that most of the women who are pregnant die every day related to issues during pregnancy and childbirth such as still birth/pre-term/miscarriage etc., which are preventable at an earlier stage. The women need support and access to care by the skilled nurse at the appropriate time during the period of pregnancy. But due to the factors such as lack of awareness, delays, lack of information, poverty, few skilled health professionals, and less adequate health care services, pregnant women do not receive proper care during pregnancy. In poor and rural areas, the ratio of maternal mortality is high, as these areas are too remote to have an access to immediate medical attention. Timely monitoring of vital parameters during pregnancy can help in identification and diagnosis of such pregnancy related risks. The proposed remote pregnancy risk monitoring (RPRM) system is a non-invasive and real-time system which uses a combination of wireless sensors and the internet to measure the risk status of such pregnant women. The proposed remote pregnancy risk monitoring (RPRM) system provides healthcare services, which can be used by pregnant women in the comfort of the home,. It allows connecting these pregnant women to their healthcare providers thus allowing remote supervision and consultation in time of need. In addition, the proposed system also provides an effective data visualization mechanism for the health care provider to view and monitor the status of their patients remotely overcoming the barriers of distance.

This study aims to discuss diagnostic criteria and severity assessment for craniofacial microsomia (CFM). A series of 61 patients with diverse CFM phenotypes had their clinical data collected by experienced dysmorphologists using a single protocol. Genetic abnormalities were searched through karyotype and chromosomal microarray analysis. Sex ratio, prenatal risk factors, and recurrence rate corroborated the literature. Despite the wide variability of clinical findings, ear disruption was universal. Eight patients were assigned as syndromic, four of whom had demonstrable genetic alterations. The majority of patients (67.2%) fulfilled four known diagnostic criteria, while 9.8% fulfilled one of them. Data strengthened disruptions of the ear and deafness as a semiotically valuable sign in CFM. Facial impairment should consider asymmetry as a mild expression of microsomia. Spinal and cardiac anomalies, microcephaly, and developmental delay were prevalent among extra craniofacial features and should be screened before planning treatment and follow up. The severity index was able to recognize the less and the most affected patients. However, it was not useful to support therapeutic decisions and prognosis in the clinical scenario due to syndromic and non-syndromic phenotypes overlapping. These issues make contemporary the debate on diagnostic methods and disease severity assessment for CFM. They also impact care and etiopathogenetic studies.

INTRODUCCION: La tetralogia de Fallot representa la cardiopatia congenita cianogena mas frecuente despues del primer ano de vida, ocurre aproximadamente en 1 de cada 3 500 nacimientos y representa el 7 al 10% de todas las Enfermedades Cardiacas Congenitas. Su variante extrema que se acompana de atresia pulmonar representa el 1 a 2% de las cardiopatias congenitas. Presentamos una Tetralogia de Fallot Extrema Ductus Dependiente de manejo complejo.CASO CLINICO: Se trata de un neonato a termino de 12 dias de vida, adecuado para la edad gestacional, sin factores de riesgo prenatales, ni antecedentes patologicos familiares, el cual es diagnosticado de Tetralogia de Fallot Extrema por ecocardiograma.EVOLUCION: Paciente inicialmente tratado con infusion de prostaglandina E1. Posteriormente mediante fistula Blalock-Taussig izquierda.CONCLUSIONES: Para mejorar el pronostico y sobrevida de un paciente con Tetralogia de Fallot Extrema el diagnostico prenatal oportuno y el tratamiento apropiado es de vital importancia, sin embargo el tratamiento definitivo con derivaciones pulmonares sistemicas representan complicaciones con riesgo de mortalidad. El presente caso tuvo un desenlace desfavorable.ABSTRACT BACKGROUND: The Tetralogy of Fallot represents the most common cyanogenic heart disease after the first year of life. It occurs in 1 of 3 500 live births and accounts as 7 to 10% of all Congenital Heart Diseases. Its extreme variant is accompanied by pulmonary atresia and accounts 1 to 2% of the Congenital Heart Diseases. We present an Extreme Tetralogy of Fallot– Ductus Dependent of complex management.CLINICAL CASE: A full term 12 day neonate, adequate for gestational age, without prenatal risk factors or pathologic family antecedents, is diagnosed with Extreme Tetralogy of Fallot by echocardiogram.EVOLUTION: The patient was treated initially with an infusion of prostaglandin E1. Then, a left Blalock-Taussig shunt was performed.CONCLUSIONS: To improve the prognosis and survival rates of patients with Extreme Tetralogy of Fallot , a timely diagnosis and treatment are of vital importance. Definitive treatment with systemic pulmonary shunts carries high risk complications. The present case had an unfavorable evolution.

BACKGROUND/OBJECTIVES: Specific maternal risk factors have recently been identified in the development of infantile hemangiomas (IH), including gestational diabetes (GDM), maternal anti-hypertensive medication use and/or gestational hypertension (GHTN), maternal progesterone use, and artificial reproductive technologies (ART). We sought to explore the change in incidence of these risk factors over time, and determine their association with the increased incidence of hemangiomas over 35 years, as previously reported. METHODS: The charts of 869 mother and infant pairs (infants previously diagnosed with IH between January 1, 1976 and December 31, 2010) were reviewed for prenatal complications. Rates of the prenatal complications over the 35-year period in birth mothers of infants diagnosed with IH were determined, and evaluated by year of diagnosis (1976–1990, 1991–2000 and 2001–2010). RESULTS: Over the 35-year period in which the incidence of IH was previously examined, maternal age at delivery, pre-pregnancy body mass index (BMI), use of ART, maternal progesterone use, placental abnormalities, and GDM also increased. CONCLUSIONS: GDM, ART, and maternal progesterone use increased over the past 35 years, mirroring the previously reported trend of increasing incidence of IH. Maternal age and BMI also increased in mothers of infants with IH. Further exploration of this association may direct future research in the pathogenesis of infantile hemangiomas.

Background: Various neuro-developmental impairment (NDI) among very low birth weight babies (VLBW) and extremely low birth weight (ELBW) babies are common in Indian scenario. This study was designed to assess the impact between prenatal risk factors and neuro-developmental outcomes of premature infants.Methods: This descriptive study was conducted on 143 VLBW and ELBW babies admitted in SNCU of North Bengal Medical College, Darjeeling, West Bengal and discharged babies were followed up.Results: Total 143 neonates were studied among male 82 (57.3%) and female 61 (42.7%) and AGA: SGA ratio was 1.97. Birth weight ranged from 500 to 1500grams with mean was 1199.6±244.14 and the median was 1240 gm. The mean gestational age (Mean± SD) was 29.65±2.032 weeks with range 24-32 weeks and the median was 30 weeks. 28 (19.6%) had PIH, 39 (27.3%) had multiple gestation, 18 (12.6%) had perinatal infection and 25 (17.5%) had birth asphyxia. CRIB II score ranged from 3-18 with mean was 8.021±3.883 and median was 7. 73.4% (105/143) were discharged alive. Significant positive correlations were found among birth weight, gestational age, perinatal infection (p

Introduction: Cerebral Palsy is a disease that is less recognized by the public due to the lack of information related to CP in Indonesia. Aims to analyze prenatal risk factors that influence the evidence of CP RSIA Bunda Jakarta.Methods: This study was conducted in April 2021 at RSIA Bunda Jakarta, an analytical study with a case control design. The sample in this study were 124 respondents from mothers of children who underwent outpatient treatment at the RSIA Bunda Jakartaas cases and controls. each taken by simple random sampling technique. Data were analyzed using the test chi-square to analyze the relationship between variables.Results: The results of statistical analysis showed that the risk factors associated with the incidence of CP were maternal age (p= 0.00; OR= 13.25; 95% CI= 2.93-59.93), preeclampsia (p= 0.00; OR= 2,06; 95% CI= 1,71-2,48), TORCH (p= 0.00; OR= 2.40; 95% CI= 1.92-3.01), and antenatal care (p= 0.00; OR= 41.2; 95% CI= 5.45-317.0). Conclusion: Risk factors affecting the occurrence of CP in children include age

Background: The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed mental health of pregnant women with threatened preterm labour (TPL). In the present study, we investigated self-perceived burden (SPB) and postpartum depression (PPD) among hospitalized pregnant women with TPL, exploring the association of SPB with PPD, and identifying other potential risk factors of early PPD. Methods: A self- reported survey conducted in the Obstetrics Department of Anhui Provincial Hospital, People’s Republic of China. Women hospitalized with TPL were approached one week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. Self-Perceived Burden Scale (SPBS), Edinburgh Postnatal Depression Scale (EPDS), and Multidimensional Scale of Perceived Social Support (MSPSS) were the main measures. Descriptive statistics, Spearman's correlation, and multiple logistic regression were employed for data analysis.Results: SPB and PPD were commonly experienced by women hospitalized with TPL, and SPB was positively and significantly correlated with PPD. A multiple logistic regression analysis revealed that, for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.473, 95% CI = 1.141–1.903, p = 0.003), age (OR = 1.178, 95%CI = 1.056–1.314, p = 0.003), occupation (OR = 0.282, 95%CI = 0.095–0.023, p = 0.023), history of scarred uterus (OR = 0.163, 95%CI = 0.034–0.769, p = 0.022), delivery mode (OR = 5.974, 95%CI = 1.750–20.396, p = 0.004), and family support to women hospitalized with TPL during pregnancy (OR = 0.665, 95% CI = 0.498–0.887, p = 0.006) were the significant factors predicting early signs of PPD. Conclusion: This study indicated that SPB and PPD were prevalent mental issues among hospitalized women with TPL, and SPB, especially perceived emotional burden, is a strong predictor of PPD. Our study suggests the necessity of paying attention to mental health issues—especially SPB and PPD—among hospitalized women with TPL, as well as providing appropriate interventions at the prenatal stage to prevent adverse consequences. Perceiving support from family during pregnancy with high risk can help women in reducing the risk of PPD.

Prenatal risk, temperamental negative affect, and specific cognitive abilities have all individually been identified as predictors of behavior problems during early childhood, but less is known about their interplay in relation to aggression during toddlerhood. This study examined the main and interaction effects of prenatal risk, negative affect, inhibitory control, attention, and vocabulary in the prediction of aggression in 150 children (75 boys). During pregnancy, a cumulative risk index was calculated based on the presence of 10 well-established maternal risk factors, such as prenatal substance use, maternal psychiatric disorder, and financial problems. Negative affect was measured at 6 and 20 months using maternal report. Child cognition was examined at 30 months using laboratory tasks for inhibitory control and attention, and a questionnaire was administered to assess vocabulary. In addition, mothers reported on their children's aggressive behavior at 30 months. Higher prenatal risk and negative affect at 20 months and, to a lesser extent, at 6 months were related to more aggression at 30 months. Poorer inhibitory control and, to a lesser extent, vocabulary at 30 months also predicted higher levels of aggressive behavior. Two-way interaction effects were found for cumulative risk and inhibitory control, negative affect (at 20 months) and inhibitory control, and negative affect (at 6 months) and vocabulary: aggressive behavior was most pronounced when combinations of high prenatal risk, high negative affect, and poor cognition were present. These results suggest that the impact of prenatal risk and child temperament depends in part on child's cognitive development during toddlerhood.

Given the importance of early prevention and intervention strategies for children exposed to trauma, detection of early risk factors for exposure to traumatic events in childhood is critical. The present study examined associations between three known prenatal risk factors that characterize environmental instability in utero-prenatal substance exposure, prenatal violence victimization, and unintended pregnancy-and child exposure to interparental violence and other adverse experiences in a sample of 198 mother-child dyads (M child age = 44.48 months) referred to a hospital clinic for treatment following exposure to trauma. Prenatal substance and violence exposure were associated with child trauma exposure, and prenatal violence victimization was also associated with maternal severity ratings of traumatic exposures. Unintended pregnancy was not associated with child trauma exposure or severity. These findings expand our understanding of prenatal risk factors for trauma exposure in childhood and, specifically, highlight prenatal substance exposure and violence victimization as risk factors for subsequent exposure to trauma in early childhood. Results suggest that prenatal prevention and intervention programs should target reducing maternal substance use and in-utero exposure to violence.Dada la importancia de las estrategias de prevención e intervención tempranas para niños expuestos al trauma, el detectar los tempranos factores de riesgo en el caso de estar expuesto a eventos traumáticos en la niñez es crítico. El presente estudio examinó las asociaciones entre tres conocidos factores de riesgo prenatales que caracterizan la inestabilidad ambiental en el útero -el haber estado expuesto a sustancias prenatalmente, la victimización de la violencia prenatal, y el embarazo no intencional -y el que el niño esté expuesto a la violencia entre progenitores (IPV) y otras experiencias adversas en un grupo muestra de 198 díadas madre-niño (edad promedio del niño = 44.48 meses) que habían sido referidas a una clínica hospital para el tratamiento que seguía al haber estado expuestos al trauma. El haber estado expuesto a sustancia y violencia prenatal se asoció con el hecho de que el niño había estado expuesto a trauma, y la victimización de la violencia prenatal también se asoció con la severidad maternal de clasificación de la exposición traumática. El embarazo no intencional no se asoció con la exposición del niño al trauma o la severidad. Estos resultados amplían nuestra comprensión de los factores de riesgo prenatales en cuanto al haber estado expuesto al trauma en la niñez y, específicamente, subrayan el haber estado expuesto a sustancias prenatalmente y la victimización de la violencia como subsecuentes factores de riesgo para estar expuesto al trauma en la temprana niñez. Los resultados sugieren que los programas de prevención e intervención prenatales deber enfocarse en reducir el uso de sustancias por parte de la madre y el estar expuesto dentro del útero a la violencia.Vu l'importance des stratégies de prévention précoce et d'intervention pour les enfants exposés au trauma, la détection de facteurs de risque précoce pour l'exposition à des événements traumatiques s'avère critique. Cette étude a examiné les liens entre trois facteurs de risque prénatals connus qui caractérisent l'instabilité environnementale in utero - l'exposition prénatale à des substances toxiques, la victimisation liée à la violence prénatale, et la grossesse involontaire - ainsi que l'exposition à la violence conjugale et d'autres expériences adverses chez un échantillon de 198 dyades mère-enfant (moyenne d’âge de l'enfant = 44,48 mois) envoyées consulter en clinique hospitalière pour un traitement suivant une exposition à un trauma. L'exposition à la toxicomanie et l'exposition à la violence étaient liées à l'exposition de l'enfant au trauma et la victimisation liée à la violence prénatale était également liée à la sévérité des scores maternels d'expositions traumatiques. La grossesse involontaire n’était pas liée à l'exposition au trauma de l'enfant ou à la sévérité. Ces résultats élargissent notre compréhension des facteurs prénatals d'exposition au trauma dans l'enfance et mettent en lumière plus spécifiquement l'exposition à la toxicomanie prénatale et la victimisation liée à la violence en tant que facteurs de risque d'exposition ultérieure au trauma durant la petite enfance. Les résultats suggèrent que la prévention prénatale et les programmes d'intervention devraient cibler la réduction d'utilisation toxicomane maternelle et l'exposition à la violence in-utero.Zusammenhänge zwischen pränataler Drogen- bzw. Gewaltexposition, ungewollter Schwangerschaft und Traumatisierung in der Kindheit in einem klinischen Setting Angesichts der Bedeutung früher Präventions- und Interventionsstrategien bei traumatisierten Kindern, ist die Aufdeckung potenzieller Risikofaktoren für Traumatisierung entscheidend. Die vorliegende Studie überprüft Zusammenhänge zwischen drei bekannten, eine Umgebungsinstabilität in utero charakterisierenden, pränatalen Risikofaktoren (pränatale Drogen- bzw. Gewaltexposition und ungewollte Schwangerschaft) und kindlicher Belastung durch zwischenelterliche Gewalt (interparental violence; IPV) sowie anderen widrigen Erfahrungen. Die Stichprobe bestand aus 198 Mutter-Kind Dyaden (mittleres Alter der Kinder = 44.48 Monate), die sich aufgrund traumatischer Erfahrungen in Behandlung begeben haben. Pränatale Drogen- bzw. Gewaltexposition wiesen Zusammenhänge zu kindlicher Traumatisierung auf. Des Weiteren wies pränatale Gewaltexposition auch einen Zusammenhang zu den mütterlichen Ratings der Traumaschwere auf. Ungewollte Schwangerschaft war nicht mit kindlicher Traumatisierung oder Traumaschwere assoziiert. Diese Ergebnisse ermöglichen es uns, pränatale Risikofaktoren für kindliche Traumatisierung besser zu verstehen. Insbesondere werden pränatale Drogen- und Gewaltexposition als Risikofaktoren für eine darauffolgende Traumatisierung in der frühen Kindheit hervorgehoben. Die Ergebnisse legen nahe, dass pränatale Präventions- und Interventionsprogramme darauf abzielen sollten, mütterlichen Drogenkonsum und Gewalterfahrungen in utero zu minimieren.胎児期の薬物暴露・胎児期の暴力虐待・予期せぬ妊娠と、臨床現場における小児期のトラウマ暴露の関連 トラウマに曝された子どもへの早期予防と介入の方法の重要性を考えると、小児期にトラウマとなる出来事に暴露される初期の危険因子を検出することは必須である。本研究は、トラウマに曝され治療のために病院の外来に紹介された198 組の母子 (子どもの平均年齢 44.48 ヶ月) において、胎内の環境不安定性を特徴づける３つの既知の出生前リスク因子−胎児期の薬物暴露、胎児期の暴力虐待、予期せぬ妊娠―と、パートナー間の暴力 (IPV) やその他の逆境体験に子どもが曝されること、との関連性を検討した。胎児期の薬物と暴力への暴露は、子どものトラウマ暴露と関連し、胎児期の暴力虐待は母親のトラウマ暴露の深刻さの評価とも関連した。予期せぬ妊娠は子どものトラウマ暴露や深刻さに関連していなかった。これらの結果から小児期のトラウマ暴露に関連する胎児期のリスク因子への我々の理解が広まり、特に胎児期の薬物暴露と暴力虐待は早期小児期のトラウマ暴露に引き続くリスク因子であると強調する。出生前の予防と介入プログラムは、母親の薬物使用と胎児期に暴力に晒されることを減らすことをターゲットにすべきであると、この結果から提案する。.產前物質使用丶產前暴力受害丶意外懷孕和兒童創傷在臨床環境中的關係 鑑於經歷過創傷的兒童早期預防和干預策略的重要性, 檢測兒童受創事件的早期風險因素至關重要。本研究在受創傷後轉診到醫院診所接受治療的 198 個母親-兒童二元組樣本中 (平均兒童年齡 = 44.48 個月), 探討三種已知的產前風險因素 - 產前使用物質丶產前暴力受害丶及意外懷孕 - 做成的不穩定環境與兒童經歷過父母間暴力 (IPV) 和其他不良經歷的關聯。母親產前物質使用和暴力經歷與兒童創傷有關, 產前暴力受害也與母親創傷的評分相關。意外懷孕與兒童創傷或嚴重程度無關。這些研究結果擴展了我們對兒童創傷的產前風險因素的理解, 特別強調產前物質使用和暴力受害, 是隨後兒童早期創傷的風險因素。結果表明, 產前預防和干預計劃的目標, 應該是減少母體物質使用和產前暴力經歷。.العلاقة بين التعرض للمواد المخدرة قبل الولادة، وإيذاء العنف قبل الولادة، والحمل غير المقصود، والتعرض للصدمات النفسية في مرحلة الطفولة في سياق إكلينيكي بالنظر إلى أهمية استراتيجيات الوقاية والتدخل المبكرة للأطفال المعرضين للصدمات النفسية، فإن الكشف عن عوامل الخطر المبكرة للتعرض للأحداث الصادمة في مرحلة الطفولة أمر بالغ الأهمية. تناولت هذه الدراسة الارتباطات بين ثلاثة عوامل خطر معروفة قبل الولادة تميز عدم الاستقرار البيئي في التعرض للمواد داخل الرحم قبل الولادة، والإيذاء أثناء الولادة، والحمل غير المقصود - وتعرض الأطفال للعنف بين الوالدين وغيره من التجارب السلبية في عينة من 198 من ثنائيات الأم والطفل (متوسط عمر الطفل = 44.48 شهراً) الذين تم إحالتهم إلى عيادة لتلقي العلاج بعد التعرض للصدمات. وترتبط المواد السابقة للولادة والتعرض للعنف بالتعرض لصدمات الأطفال، كما يرتبط الإيذاء الناجم عن العنف قبل الولادة بتقديرات الأم بشدة الصدمات. ولا يرتبط الحمل غير المقصود بالتعرض لصدمات الأطفال أو شدتها. وتوسع هذه النتائج فهمنا لعوامل الخطر قبل الولادة للتعرض للصدمات في مرحلة الطفولة، وعلى وجه التحديد، تسليط الضوء على التعرض لمواد ما قبل الولادة والإيذاء الناجم عن العنف كعوامل خطر للتعرض اللاحق للصدمات في مرحلة الطفولة المبكرة. وتشير النتائج إلى أن برامج الوقاية والتدخل قبل الولادة ينبغي أن تستهدف الحد من تعاطي المواد أثناء الحمل والتعرض للعنف داخل الرحم.

Prenatal risk and a lack of inhibitory control have consistently been related to the development of physical aggression in older children. This study examined whether inhibitory control mediated the relation between prenatal risk and aggression in infants and toddlers. The role of gender in this mediation model was also examined. The sample consisted of 161 mother-child dyads (83 boys). A prenatal cumulative risk score was created from a number of well-established risk factors including maternal psychopathology, substance use, and social and socioeconomic disadvantages. At 12 months, children performed an inhibitory control task. Physical aggression was assessed through maternal reports at 12 and 20 months of age. Results showed that higher prenatal risk was associated with more physical aggression. Inhibitory control mediated this association at both 12 and 20 months: higher prenatal risk was related to lower inhibitory control, which in turn led to higher aggression. At 20 months, gender moderated the mediation effect: the mediating role of inhibitory control was only found for girls. These results suggest that even before 2 years of age, inhibitory control is an important construct involved in the relation between prenatal risk and physical aggression.

Little research has considered whether prenatal experience contributes to executive function (EF) development above and beyond postnatal experience. This study tests direct, mediated, and moderated associations between prenatal risk factors and preschool EF and IQ in a longitudinal sample of 1,292 children from the Family Life Project. A composite of prenatal risk factors (i.e., low birth weight, prematurity, maternal emotional problems, maternal prepregnancy obesity, and obstetric complications) significantly predicted EF and IQ at age 3, above quality of the postnatal environment. This relationship was indirect, mediated through infant general cognitive abilities. Quality of the postnatal home and child-care environments did not moderate the cascade model. These findings highlight the role of prenatal experience as a contributor to individual differences in cognitive development.

Background: Preterm infants are still at an increased risk for suboptimal neurodevelopmental outcomes when compared with term born infants. The development of a child born preterm can be jeopardized by suboptimal conditions during pregnancy, in addition to the suboptimal growth environment postnatally compared to the normal in utero environment. This review summarizes the literature on the role of chorioamnionitis, placental insufficiency, and maternal smoking on the developmental outcomes of preterm infants. Methods: A systematic database search was performed to identify all original articles published on or before September 12, 2018 that evaluated the impact of clinical or histological chorioamnionitis, abnormal prenatal fetal and placental blood flow, and prenatal smoking exposure on the neuropsychological and cognitive outcomes of preterm infants. We identified a total of 54 studies. Thirty five original articles evaluated the effects of clinical or histological chorioamnionitis; 15 studies evaluated the effects of abnormal blood flow patterns; and four studies evaluated the effects of maternal smoking during pregnancy. Results: The studies on prenatal risk factors showed conflicting results about the impact on the neurodevelopment of preterm infants. The majority of the studies did not show that chorioamnionitis poses a direct risk to the development of preterm infants. The role of abnormal prenatal placental and fetal blood flow on the development of preterm infants remained inconclusive because the sample sizes were often small and methodological problems complicated the interpretation of the data. Maternal smoking during pregnancy was assessed only in one cohort which showed that maternal smoking is a risk for suboptimal cognitive and neuropsychological development in preterm infants. Conclusions: This review summarizes the data on several prenatal risk factors which play a role in the developmental outcomes of preterm infants. To optimize the developmental outcomes, we need to first optimize the fetal wellbeing before birth. More research that extends from the fetal life to long-term developmental outcomes is needed.

Purpose. Assessment of the scope and coverage of the surveys of patients with recurrent pregnancy losses in primary care of Zelenograd administrative district of Moscow. Materials and methods. Comparison of the frequency of occurrence of miscarriage in Europe, USA, Russia and in Moscow has been held. They performed a retrospective analysis of 221 history for the period 2013–2015 in patients with a history of 2 or more cases of miscarriage. The selection criteria for the study were: completion of pregnancy at term of gestation from 22 to 37 weeks, presence of a diagnosis of “habitual miscarriage” at statement on the account of pregnancy. Results. The factors predisposing to miscarriage are described, the coverage of the primary care of these patients, timeliness of registration of pregnancy, the completeness of the survey related professionals if patients ‘ comorbidity are estimated. The estimation of the frequency of occurrence of extragenital somatic pathology in patients with HM and the impact of this disease on pregnancy is held. The influence of previously deferred inflammatory diseases of the pelvic organs on a probable miscarriage is estimated, the evaluation of the quality of diagnosis of such diseases at an early stage of monitoring in primary care is held. It is established that pregravid preparation of patients with HM in 80% can be made in surveys provided by the territorial program of medical service. They evaluated the role of costly research conducted in the framework of pregravid training in patients with HM and the feasibility of conducting of these studies. Conclusion. The recommendations for the prevention of a probable miscarriage and the principles of monitoring of these patients in primary care on the example of Zelenograd administrative district basis are developed, the proposal for the introduction of these techniques in primary health care is formulated.

Objective To determine whether prenatal risk factors (RFs) that predict cord blood iron status in term newborns also predict iron status of premature newborns. Study design Cord blood iron indices from 80 preterm newborns were compared with historical and demographic RFs for developing iron deficiency if born at term. Result The presence of multiple RFs did not incrementally interfere with cord iron status in preterm newborns. Poorer iron status accompanied being small for gestational age in prematurity, but other RFs, including diabetes, had relatively little impact. Conclusion Growth-restricted preterm newborns are at risk for poor iron endowment, likely due to uteroplacental insufficiency. Other RFs were less impactful on iron status of premature newborns than in term newborns, likely reflecting that disruptive effects of RFs are more impactful in the third trimester. Understanding RFs for poor iron endowment is important for clinical recognition and treatment of premature babies.

Parents' representations of their infants consist of parents' subjective experiences of how they perceive their infants. They provide important information about the quality of the parent-infant relationship and are closely related to parenting behavior and infant attachment. Previous studies have shown that parents' representations emerge during pregnancy. However, little is known about prenatal (risk) factors that are related to parents' representations. In a prospective study, 308 mothers and 243 fathers were followed during pregnancy and postpartum. Prenatal risk factors were assessed with an adapted version of the Dunedin Family Services Indicator (T.G. Egan et al., ; R.C. Muir et al., ). At 26 weeks' gestation and 6 months' postpartum, parents' representations of their children were assessed with the Working Model of the Child Interview (C.H. Zeanah, D. Benoit, L. Hirshberg, M.L. Barton, & C. Regan). Results showed stability between pre- and postnatal representations, with fathers having more disengaged representations than did mothers. In addition, prenatal risk factors of parenting problems were associated with the quality of parents' prenatal (only in mothers) and postnatal representations. This study provides valuable information concerning parents at risk of developing nonbalanced representations of their children. In clinical practice, these families could be monitored more intensively and may be supported in developing a more optimal parent-infant relationship.

Early maternal resolution with preterm birth was assessed at one month corrected age (CA), and potential maternal and infant characteristics that may be associated with early resolution were examined. Fifty-five mothers of preterm infants (≤34 weeks) participated. Data regarding pregnancy, prenatal risk, delivery, infant's medical risk, maternal well-being status, and infant's early developmental status were collected. Resolution was examined using the Reaction to Diagnosis Interview (RDI). A total of 38.2% of the mothers were classified as resolved. Only completion of antenatal corticosteroids (ACS) treatment and high prenatal risk significantly predicted maternal resolution. Early maternal resolution of preterm birth is associated with early knowledge regarding the preterm birth.

Dynamic systems methods offer invaluable insight into the nuances of the early parent–child relationship. This prospective study aimed to highlight the characteristics of mother–infant dyadic behavior at 12 weeks post-partum using state space grid analysis (total n = 322). We also examined whether maternal prenatal depressive symptoms and perceived stress were associated with reduced non-negative engagement in exchange for more negativity and unengagement, and contrasted them with global observational methods. Non-negative engagement (NNE) was an attractor for dyads during a teaching task, with a range of flexibility and entropy across dyads. Further, dyads with mothers reporting higher prenatal depressive symptoms demonstrated less 12-week NNE dyadic behavior and more dyadic negativity. Prenatal maternal perceived stress was associated with reduced negativity and reduced flexibility in NNE states. However, maternal distress of any kind was not associated with entropy of behavior. Finally, direct comparisons with global perspectives of dyadic behavior indicated strong external validity relating to concepts of dyadic affect and engagement, and dynamic approaches remained uniquely related to prenatal distress above and beyond global observations of behavior. Findings lend support to the utility and necessity of dynamic systems approaches for identifying mechanisms of prenatal risk and emerging parent–child social–emotional functioning. Copyright © 2015 John Wiley & Sons, Ltd.

Objetive: To describe the clinical and electroencephalographic features in a sample of patients diagnosed with Lennox-Gastaut syndrome. The patients were part of the epilepsy program at the University of Antioquia in Medellin between 2007 and 2012. Materials and methods: This was completed with an observational, descriptive and retrospective method. The data used was taken from the records of all patients diagnosed with Lennox-Gastaut syndrome included in the epilepsy program at the University of Antioquia and who were evaluated by EEG video monitoring. Clinical and electroencephalographic variables were analyzed. For the analysis we used SPSS. Resualts: We reviewed 18 video EEG. The average age of the patients was 19,89 years, with the gender being equally being balanced. Half of the patients had a prenatal risk. The average age of the first seizure was at 4,67 years and the average number of attacks per week was 31,17. The most frequent were atypical absence seizures in 17 patients (94,4%). The most commonly used drug was valproic acid. All patients experienced mental retardation and characteristic electroencephalographic findings of the syndrome, during both times of wakefulness and sleep. Most abnormalities were observed during superficial sleep. Conclusions: The Lennox-Gastaut syndrome is one of the most severe epileptic encephalopathies with onset during childhood and with large social and economic costs and poor prognosis due to its associated morbid conditions.

Objective The Changing Childbirth in British Columbia study explored women’s preferences and experiences of maternity care, including women’s role in decision-making. Methods Following content validation by community members, we administered a cross-sectional online survey exploring novel topics, including drivers for interventions, and experiences of autonomy, respect, or mistreatment during maternity care. Using the Mothers Autonomy in Decision-Making (MADM) scale as an outcome measure in a mixed-effects analysis, we examined differential experiences by socio-demographic and prenatal risk profile, type of care provider, interventions received, and nature of communication with care providers. Results A geographically representative sample of Canadian women (n = 2051) reported on 3400 pregnancies. Most women (95.2%) preferred to be the lead decision-maker during care. Patients of physicians had significantly lower autonomy (MADM) scores than midwifery clients as did women who felt pressured to accept interventions. Women who had a difference in opinion with their provider, and those who felt their provider seemed rushed reported the lowest MADM scores. Conclusion Women’s autonomy is significantly altered by model of maternity care, the nature of interactions with care providers, and women’s ability for self-determination. Practice Implications If health professionals acquire skills in person-centred decision-making experience of autonomy among pregnant women may improve.

To evaluate the status of congenital diaphragmatic hernia (CDH) management in France and to assess predictors of adverse outcomes.We reviewed the first-year outcome of all cases of CDH reported to the French National Register in 2011.A total of 158 cases were included. Of these, 83% (131) were prenatally diagnosed, with a mortality rate of 39% (44 of 112) for live born infants with a known outcome at hospital discharge. Mortality increased to 47% (60 of 128) including those with termination of pregnancy and fetal loss. This contrasts with the 7% (2 of 27) mortality rate of the patients diagnosed postnatally (P = .002). Mortality worsened with 1 prenatal marker of CDH severity (OR 3.38 [1.30-8.83] P = .013) and worsened further with 2 markers (OR 20.64 [5.29-80.62] P .001). Classic postnatal risk factors of mortality such as side of hernia (nonleft P = .001), prematurity (P .001), low birth weight (P = .002), and size of the defect (P .001) were confirmed. Of the 141 live births (114 prenatal and 27 postnatal diagnosis) with known outcomes, 93 (67%) survived to hospital discharge, 68 (60%) with a prenatal diagnosis and 25 (93%) with a postnatal diagnosis. The median time to hospital discharge was 34 days (IQR, 19.25-62). Of these survivors, 71 (76%) were followed up for 1 year.Despite advances in management of CDH, mortality was high and associated with prenatal risk factors. Postnatally, severe persistent pulmonary hypertension was difficult to predict and presented persistent challenges in management.

Current professional and policy debate over the use of prenatal testing emphasizes the need for informed choice making and for services that provide prospective parents with what is referred to as ‘non-directive counseling’. On the basis of an ethnography of prenatal decision making in the context of first trimester prenatal risk assessment (FTPRA) in Denmark, the chapter challenges the representational view of knowledge production and the liberal notion of human action underlying these ideals. The paper develops an account of prenatal decision making as a process of knowledge production and illustrates how this approach allows us to study processes of decision making as an effect of an assemblage of multiple forms of actors involved in the process of prenatal decision making (such as human actors, technologies, standards, policies and non-verbal aspects of knowledge production). I argue that framing the problems and solutions about prenatal testing only through the lens of choice tends to collapse ethical questions on prenatal testing into questions about the possibility of autonomous decision making. Ethical consideration express an ethics of being locally accountable for the ways in which programs of prenatal testing intervene in pregnant women’s lives and of taking responsibility for the entities and phenomena that emerge through such knowledge production.

espanolIntroduccion: las alteraciones auditivas en el recien nacido prematuro impactan en su desarrollo y lenguaje y por ende a la calidad de vida. Se conocen varios factores de riesgo asociados a estas alteraciones, pero poco sobre los aspectos socioeconomicos, nutricionales y de inseguridad alimentaria. Objetivo: analizar la asociacion con la inseguridad alimentaria y los factores de riesgo prenatales en prematuros con problemas de audicion. Material y metodos: estudio de 35 casos y 105 controles, en prematuros de 30 a 37 SDG de un hospital publico, realizado a traves de una encuesta donde se recopilaron datos del expediente materno y del recien nacido (antropometria), asi como factores de riesgo para alteracion auditiva, aspectos sociodemograficos, seguridad alimentaria con sus respectivas clasificaciones y tipo de alimentacion. Resultados: el principal factor de riego perinatal asociado a las alteraciones auditivas fue la administracion de gentamicina (antibiotico ototoxico) en 18,1% de los casos (OR: 5,61 [IC = 1,29-24,50]). La inseguridad alimentaria severa se asocio con las alteraciones auditivas, en 27,2% de casos y en 2,8% de controles (OR: 12,75 [IC = 2,89-56,16]). Ademas, se encontraron diferencias entre los grupos para el nivel de escolaridad (casos: 50% de las madres tuvieron primaria terminada o incompleta vs. controles con 19%; Ji2 = 0,008) y Las variables antropometricas presentaron diferencias en peso, longitud y perimetro cefalico (p Conclusion: la inseguridad alimentaria severa, exposicion a gentamicina, el nivel de escolaridad de la madre, tuvieron una asociacion significativa con las alteraciones auditivas en el prematuro. Variables como el peso, longitud y perimetro cefalico al nacimiento presentaron valores inferiores en el grupo casos. Estos primeros hallazgos, reflejan riesgos ambientales como la inseguridad alimentaria en las alteraciones auditivas ademas de las ya conocidas. EnglishBackground: hearing disorders in the premature newborns impact on their development and language and therefore, on their quality of life. Several risk factors have been associated to these conditions, but little is known about socioeconomic, nutrition factors and food security. Objective: to analyze the association between food security and prenatal risk factors in newborns with hearing disorders. Material and methods: study of 35 cases and 105 controls in premature newborns from 30 to 37 weeks of gestation (WG) in a public hospital. The working tool was a questionnaire to collect data about the maternal medical record and the anthropometry of the newborn, as well as the risk factors for the auditory function, sociodemographic aspects, and food security with its respective classification and food habits. Results: the principal perinatal risk factor associated to hearing impairment was the use of gentamycin (ototoxic drug) in 18.1% of the total (OR: 5.61 [1.29-24.50]). Severe food insecurity was associated with auditory disfunctions in 27.2% of cases and in 2.8% of controls (OR: 12.75 [2.89-56.16]). There were differences between the groups regarding the education level (cases: 50% of the mothers finished or interrupted primary education level vs controls with 19%; Ji2 = 0.008). The anthropomorphic variables showed differences in weight, length and cephalic perimeter for the newborns (p Conclusion: severe food insecurity, exposure to gentamycin and low education level of the mother had a significant association with auditory impairments in preterm children. For these newborns, variables like weight, length and cephalic perimeter at the moment of birth were lower than in controls. These initial findings point to the important role that environmental risks, like food insecurity, have in auditory impairments in addition to those previously described.

Psychological aggression has been shown to have harmful effects on both partners, sometimes above and beyond the effects of physical aggression. However, very little is known about psychological aggression during the transition to parenthood. The transition to parenthood is a time where relationship satisfaction often declines and stress increases, which may put the couples at higher risk for psychological aggression. The purpose of this study was to examine if prenatal risk factors related to interpersonal style (specifically, emotional flooding and hostility) predict changes in psychological aggression from pregnancy to 2 years postpartum. Ninety eight couples took part in this study. The couples completed self-report questionnaires during pregnancy, 1 year postpartum, and 2 years postpartum. Both partners were asked about perpetrating and experiencing psychological aggression in their current relationship. Two level Hierarchical Linear Models (HLMs) were used to examine longitudinal associations between hostility, flooding, and psychological aggression. For women, hostility during pregnancy was a significant longitudinal predictor of psychological aggression. For men, flooding was a significant longitudinal predictor of psychological aggression. For both men and women, relationship satisfaction partially mediated the relationship between flooding/hostility and psychological aggression, indicating that women's hostile attitudes and men's tendency to be flooded tend to erode relationship quality, leading to increases in psychological aggression. This may represent a classic demand-withdraw dynamic in couples. The results indicate hostility for women and flooding for men are potential prenatal risk factors for future psychological aggression. Implications and future research directions are discussed. Aggr. Behav. 42:134-148, 2015. © 2014 Wiley Periodicals, Inc.

Physeal injuries occurring secondary to neonatal birth-related trauma are rare entities. Most reported cases of physeal injury involve the distal humerus with only a few published case reports of proximal femoral involvement. So far, we have found only one reported case of neonatal distal femoral epiphysiolysis following Caesarean section. We hereby report a unique case of distal femoral physeal injury with at least partial epiphyseal separation following an uneventful, spontaneous vaginal delivery. Given the uneventful delivery and no known prenatal risk factors, the imaging findings were initially not recognized as being secondary to birth-related injury. Nonaccidental trauma and infection were considered among the possible etiologies for the clinical and imaging findings and a detailed workup for both these entities was performed. Distal femoral physeal injury was considered as a diagnosis of exclusion only after both initial differential considerations were excluded. The authors hope that a knowledge of this entity will facilitate a more accurate differential in cases of thigh swelling and hypomobility in the newborn.

Exposure to prenatal adversity is associated with aggression later in life. Individual differences in autonomic nervous system (ANS) functioning, specifically nonreciprocal activation of the parasympathetic (PNS) and sympathetic (SNS) nervous systems, increase susceptibility to aggression, especially in the context of adversity. Previous work examining interactions between early adversity and ANS functioning in infancy is scarce and has not examined interaction between PNS and SNS. This study examined whether the PNS and SNS moderate the relation between cumulative prenatal risk and early physical aggression in 124 children (57% male). Cumulative risk (e.g., maternal psychiatric disorder, substance (ab)use, and social adversity) was assessed during pregnancy. Parasympathetic respiratory sinus arrhythmia (RSA) and sympathetic pre-ejection period (PEP) at baseline, in response to and during recovery from emotional challenge were measured at 6 months. Physical aggression and non-physical aggression/oppositional behavior were measured at 30 months. The results showed that cumulative prenatal risk predicted elevated physical aggression and non-physical aggression/oppositional behavior in toddlerhood; however, the effects on physical aggression were moderated by PNS and SNS functioning. Specifically, the effects of cumulative risk on physical aggression were particularly evident in children characterized by low baseline PNS activity and/or by nonreciprocal activity of the PNS and SNS, characterized by decreased activity (i.e., coinhibition) or increased activity (i.e., coactivation) of both systems at baseline and/or in response to emotional challenge. These findings extend our understanding of the interaction between perinatal risk and infant ANS functioning on developmental outcome. Electronic supplementary material The online version of this article (doi:10.1007/s10802-017-0337-y) contains supplementary material, which is available to authorized users.

Pathways from maternal tobacco, marijuana, stress, and anger in pregnancy to infant reactivity and regulation (RR) at 9 months of infant age were examined in a low-income, diverse sample beginning in the first trimester of pregnancy, with fetal growth and postnatal stress/anger as potential mediators, and infant sex as a moderator. Participants were 247 dyads (173 substance-exposed infants). There were no direct effects of prenatal risk on RR and no moderation by sex. However, there were significant indirect effects on RR via poor fetal growth and higher postnatal anger. The study adds to the sparse literature on joint effects of tobacco and marijuana, and highlights the role of fetal growth and maternal anger as important pathways from prenatal risk to infant RR.

Background: Advancement of skill, technology and perinatal medicine has led to improve survival of low birth weight babies during the last few decades but they have reported high incidence of growth failure during infancy and early childhood. The objective of the study was to find out the influence of perinatal risk factors on anthropometric outcome.Methods: A prospective cohort study conducted on 143 ELBW and VLBW babies admitted in Sick Newborn Care Unit (SNCU and PICU) of North Bengal Medical College and Hospital (NBMC), Darjeeling, West Bengal from 2016 to 2017 and discharged babies were followed up.Results: Total 143 neonates were studied at NBMC among male 82(57.3%) and female 61(42.7%), 95 were AGA and 48 were SGA babies. Significant positive correlations were found among birth weight, gestational age, perinatal infection (p

Objective The objective of this study was to use two-dimensional (2D) ultrasound (US) during routine prenatal surveillance to develop normative estimated placental volume (EPV) growth curves. Study Design Patients ≥ 18 years old with singleton pregnancies were prospectively followed from 11 weeks gestational age (GA) until delivery. At routine US visits, placental width, height, and thickness were measured and EPV calculated using a validated mathematical model. Results In this study, 423 patients were scanned between 9.7 and 39.3 weeks GA to generate a total of 627 EPV calculations. Readings were clustered at 12 and 20 weeks, times of routine scanning. The mean EPV was 73 ± 47 cc at 12.5 ± 1.5 weeks (n = 444) and 276 ± 106 cc at 20 ± 2 weeks (n = 151). The data best fit a parabolic function as follows: EPV = (0.384GA – 0.00366GA2)3. Tenth and 90th percentile lines were generated with ± 1.28 SE offset. EPV readings below the 10th or above the 90th percentiles tended to be associated with either small or large newborns, respectively. Conclusion Routine 2D US created EPV growth curves, which may be useful for stratifying patients into prenatal risk groups.

The cause of PHACE syndrome is unknown. In a study of 218 patients, we examined potential prenatal risk factors for PHACE syndrome. Rates of pre-eclampsia and placenta previa in affected individuals were significantly greater than in the general population. No significant risk factor differences were detected between male and female subjects.