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Objectives This study evaluated the question whether length of in utero exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants might affect neonatal outcome and psychomotor development in infancy. Methods Birth outcome was determined in the offspring of 55 women with major depressive disorder who used SSRI medication for different durations during their pregnancies. At an average age of 14 months, children underwent a pediatric examination and an evaluation with the Bayley Scales of Infant Development (BSID-II). Results Duration of in utero exposure to SSRIs was negatively associated with total Apgar scores, specifically the activity subscale. Odds ratios for a low score (

The current meta-analysis reviews research on the treatment of pediatric obesity focusing on studies that have been published since 1994. Eleven studies (22 comparisons, 115 effect sizes, N = 447) were included in the present meta-analysis. Results indicated that comprehensive behavioral interventions may be improved in at least two ways: increasing the "dose" of behavioral components and increasing parental involvement. Although limited to just one investigation, support for the use of medication was also found. The addition of cognitive therapy techniques did not appear to increase, and possibly detracted from, the efficacy of established treatments.

Background: Infants exposed prenatally to alcohol are at increased risk for poor neurodevelopmental outcome including Sudden Infant Death Syndrome. Aim: To examine the relationship between prenatal alcohol exposure, sleep, arousal and sleep-related spontaneous motor movements in early infancy. Study design: Low-income women ( N =13) were interviewed regarding pre- and pregnancy rates of alcohol, cigarette smoking and other substance use in the perinatal period. Infants were examined in a laboratory nap study using EEG, videography and actigraphy at 6–8 weeks of age. Estimates of maternal pre- and pregnancy alcohol use were used to divide infants into high vs. low maternal alcohol use groups. Subjects: Mother–infant dyads recruited from a family practice clinic. Outcome measures: Sleep-related spontaneous movements, behavioral state, and maternal assessments of infant alertness and irritability. Results: Pre-pregnancy rates of alcohol consumption including binge drinking correlated with maternal report of poor infant alertness, and increased irritability. High maternal exposure groups showed increased sleep fragmentation, e.g. frequency and duration of wakefulness following sleep onset and decreased active sleep. Bout analysis of the temporal structure of sleep-related spontaneous movements showed significantly reduced bout duration associated with high maternal alcohol use. Conclusion: These results present evidence that prenatal alcohol exposure disrupts postnatal sleep organization and suppresses spontaneous movements during sleep, and increased sleep fragmentation promotes sleep deprivation. Results are consistent with the SIDS model of chronic sleep debt and suggest that attenuated sleep-related movements should be examined as an important modulator of cardiorespiratory functions during sleep in high-risk groups.

Infancy and early childhood sleep–wake behaviours from current and retrospective parental reports were used to explore the relationship between sleeping arrangements and parent–child nighttime interactions at both time points. Children (N=45) from educated, middle-class families, mostly breastfed in infancy, composed a convenience sample that was recruited from a university preschool in the Northeast US. Parents responded to the Sleep Habits Inventory, a 19-item Likert-style inventory measuring sleep-related behaviours during the last week, and the Sleeping Arrangements Questionnaire, a 30-question, open-ended, short-answer-style instrument which queries both retrospective infancy and current sleep location, bedtime routine, night waking and parent–child interactions during the sleep period. Co-sleeping in early childhood was associated with sleep location in infancy (i.e. proximity to the mother's bed) during wake–sleep transitions and night feedings. Security object use during infancy was inversely related to early childhood co-sleeping (calling for the parents, night waking, poor bedtime routine and fear of the dark). Results showed that early childhood co-sleeping in this sample was reactive, i.e. associated with current parent-seeking, night waking and social contact during wake–sleep transitions. These findings suggest that co-sleeping in early childhood is related to social experiences during infancy, particularly the amount of parent social contact and security object use. Copyright © 2007 John Wiley & Sons, Ltd.

Objective To compare the structural growth and developmental outcome of children born to mothers diagnosed with major depressive disorder during pregnancy who were exposed or not exposed to selective serotonin reuptake inhibitors (SSRIs) in utero. Study design Children whose mothers were diagnosed with major depressive disorder in pregnancy and elected not to take medication (n = 13) were compared with children of depressed mothers treated with SSRIs (n = 31) on birth outcomes and postnatal neurodevelopmental functioning between ages 6 and 40 months. Children underwent blinded standardized pediatric and dysmorphology examinations and evaluations of their mental and psychomotor development with the use of the Bayley Scales of Infant Development (BSID II). Results The Bayley mental developmental indexes were similar in both groups. Children exposed to SSRIs during pregnancy had lower APGAR scores and scored lower on the Bayley psychomotor development indexes and the motor quality factor of the Bayley Behavioral Rating Scale than unexposed children. Conclusions The findings that SSRIs during fetal development might have subtle effects on motor development and motor control are consistent with the pharmacologic properties of the drugs. (J Pediatr 2003;142:402-8) .

To determine if apneic preterm infants currently treated with methylxanthines develop evidence of sleep deprivation from cumulative arousal and motor activational effects. Sleep, wake, arousal and actigraphic movements were monitored in extubated clinically stable premature infants (N=37). Neonates were free of other medications for >72 h and were grouped based on methylxanthine exposure: >5 days with caffeine (n=14), >5 days theophylline (n=13) or no prior exposure (n=10). Duration of methylxanthine treatment predicted increased arousals, wakefulness and actigraphic movements, and decreased active sleep. Recording from 1200 to 0500 hours, methylxanthine-treated groups showed reductions in all arousal parameters: waking state, number of wake epochs, brief arousals and composite arousal index, and shorter fast-burst, sleep-related motility than untreated controls. In apneic preterms, chronic methylxanthine treatment appears to produce sleep deprivation secondary to the stimulatory action of methylxanthines on arousal and motor systems.