Abstract
Objective
Children born <30 weeks of gestation have more motor impairment than do children born at term (37–42 weeks gestation), but reported outcomes have largely focused on cerebral palsy ...and developmental coordination disorder. The aim of this study was to compare muscle strength, motor skills, and physical activity (PA) of preschool-aged children born <30 weeks with those born at term.
Methods
In this cohort study, 123 children born <30 weeks and 128 born at term were assessed. Children were aged ≥4 years, 0 months and <6 years, 0 months’ corrected age at the time of the assessment. Outcomes included grip strength (kg), Movement Assessment Battery for Children 2nd edition (MABC-2), Little Developmental Coordination Disorder Questionnaire, accelerometer-measured PA, and a parent-completed PA diary. Linear regression and mixed effects models were used to examine differences between children born <30 weeks and those born at term.
Results
Children born <30 weeks had poorer grip strength (preferred hand; mean difference 95% CI −0.60 kg −1.04 to −0.15) and poorer motor competence (Movement Assessment Battery for Children 2nd edition standard score mean difference −2.17 −3.07 to −1.27; Little Developmental Coordination Disorder Questionnaire total score mean difference −5.5 −9.2 to −2.8) than term-born children. Children born <30 weeks also completed fewer minutes of accelerometer-measured PA (mean difference −41 minutes −62 to −20), more minutes of accelerometer-measured stationary behavior (mean difference 33 minutes 12 to 54), and more minutes of parent-reported screen time (mean difference 21 minutes 10 to 32) per day.
Conclusion
Preschool-aged children born <30 weeks had poorer muscle strength, motor skills, and PA levels than term-born children. These findings suggest that preschool-aged children born <30 weeks may benefit from enhanced surveillance and PA promotion to improve life-long health outcomes.
Impact
In our study, children born <30 weeks had reduced muscle strength and poorer motor skills, participated in less PA, and had more stationary and screen behavior than term-born children. These findings emphasize that awareness of multidomain motor deficits in children born <30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits and the recognition that PA levels can track from early childhood into adulthood, our study highlights the need for assessment and promotion of PA in preschool-aged children born <30 weeks’ gestation.
Lay Summary. Preschool-aged children born <30 weeks’ gestation have poorer strength, motor skills, and physical activity behaviors than their term-born peers. Clinicians and early childhood educators should recognize that the preschool period is a critical time for the assessment and promotion of PA in children born <30 weeks.
Day surgery allows families to return home quickly. Only a few approaches to preparing for day surgery have demonstrated how digital solutions can support families and children. This study aims to ...evaluate the effectiveness of a mobile app intervention on preschool children’s fear and pain and parents’ anxiety and stress in preparing children for day surgery. This study was conducted at the Pediatric Day Surgical Department of a university hospital in Finland between 2018 and 2020. Parents of children (aged 2-6 y) who were in a queue for elective day surgery were randomized into the intervention group (IG; n=36) and control group (CG; n=34). The CG received routine preparations, whereas the IG was prepared using a mobile app. Parents’ and children’s outcomes were measured using validated scales at 4 different points: at home (T1 and T4) and at the hospital (T2 and T3) before and after surgery. Group differences were analyzed using statistical methods suitable for the material. Before surgery, parents in both groups experienced mild anxiety, which decreased after surgery. Parental anxiety did not differ between groups preoperatively (P=.78) or postoperatively (P=.63). Both groups had less anxiety at home after surgery compared with before. The IG showed a significant decrease (P=.003); the CG also improved (P=.002). Preoperatively at home, most parents in both groups experienced no stress or mild stress (P=.61). Preoperatively at the hospital, parents in both groups experienced mild stress; however, parents in the IG experienced more stress during this phase (P=.02). Parents in the IG experienced significantly less stress postoperatively than those in the CG (P=.05). Both groups showed decreased stress levels from before to after surgery (IG: P=.003; CG: P=.004) within each group. There were no significant differences in children’s pain levels between the groups and measurement points. This was observed before surgery at home (P=.25), before surgery at the hospital (P=.98), and after surgery at the hospital (P=.72). Children’s fear decreased more in the IG (P=.006) than in the CG (P=.44) comparing the phases before and after surgery at home. Fear did not differ between the IG and CG preoperatively at home (P=.20) or at the hospital (P=.59) or postoperatively at the hospital (P=.62) or at home (P=.81). The mobile app intervention did not reduce anxiety or pain. However, it was observed that parents in the IG experienced substantially heightened stress levels before surgery at the hospital, which decreased significantly after surgery at home. In addition, fear levels in children in the IG decreased over time, whereas no significant change was observed in the CG. These results are important for developing health care service chains and providing families with innovative and customer-oriented preparation methods.
Background
Prediction of asthma in young children with respiratory symptoms is hampered by the lack of objective measures applicable in clinical routine. In this prospective study in a preschool ...children cohort, we assessed whether the fraction of exhaled nitric oxide (FeNO), a biomarker of airway inflammation, is associated with asthma at school age.
Methods
At baseline, IgE and eosinophils were measured in the blood, and FeNO was measured offline in 391 children aged 3–47 months with lower airway symptoms. We developed an asthma predictive index (API) including high FeNO as major criterion. At follow‐up, primary outcome was physician‐diagnosed asthma based on standardized interviews in those children reaching school age (n = 166).
Results
FeNO was significantly elevated in those children with later asthma (68/166) as compared to children not developing asthma. Median (IQR) FeNO was 10.5 (6.6–17.2) vs 7.4 (5.3–10.3) ppb. Per 5 ppb FeNO increase, the odds ratio (95% CI) for asthma increased by 2.44 (1.61–3.70) without changing when adjusting for confounders. Using the new API, children scored at risk had 58.0% probability for later asthma, whereas the negative predictive value was 78.2%, which was comparable to the classical API.
Conclusions
In this cohort of high‐risk preschool children, elevated FeNO is associated with increased risk for school‐age asthma. The new API including FeNO identifies children at risk of later asthma comparably to the classical API, but does not require blood sampling.
Indoor air pollution is a recognized risk factor for a range of negative health outcomes. This study aimed to investigate the association between maternal prenatal exposure to indoor air pollution ...and the presence of autistic‐like behaviors among preschool children. Data were obtained from the Longhua Child Cohort Study in 2017, in which we enrolled a total of 65 317 preschool children. Associations between maternal exposure to four sources of indoor air pollution (e.g., cooking, environmental tobacco smoke (ETS), mosquito coils, and home decoration) during pregnancy and preschool children's autistic traits were analyzed using multivariate logistic regression. Our results showed that maternal exposure to indoor air pollution from four different sources during pregnancy was associated with the presence of children's autistic‐like behaviors. There was dose‐response relationship between the accumulative exposure to the four different indoor air pollution sources and the risk of autistic‐like behaviors. Furthermore, we found a significant additive interaction between prenatal exposure to both cooking and mosquito coil incense on the risk of autistic‐like behaviors. Maternal prenatal exposure to the indoor air pollution from four sources might increase with the risk of autistic‐like behaviors being present among preschool children, with an additive interaction effect between some pollution sources.
Introduction: Previous studies have demonstrated the long-term effectiveness of behavioral interventions for attention-deficit hyperactivity disorder (ADHD) in preschool children. We continue to ...design a case-control study to further investigate the factors influencing the long-term effect of behavioral intervention. Methods: From May 2020 to August 2021, children who were newly diagnosed with ADHD and not receiving any treatment received a one-year behavioral intervention. A total of 86 children completed the behavioral intervention and assessment. Results: 50 children (58.140%) were in the effective group, and 36 children (41.860%) were in the ineffective group. Attention retention time (OR=0.559, 0.322-0.969), Swanson, Nolan, and Pelham total score (OR=1.186, 1.024-1.374) at baseline, performance score for parents (OR=0.631, 0.463-0.859), and teacher coordination (OR=0.032, 0.002-0.413) were the influencing factors of behavioral intervention effects. The area under the receiver operating curve was 0.979 (p<0.001). The comprehensive nomogram model showed that the discrimination and mean absolute error were 0.979 and 0.023, respectively. Discussion: During behavioral intervention, the implementation skills of parents should be evaluated in a timely manner. The behavioral intervention effect can be predicted based on a child's attention retention time at baseline, teacher involvement, behavioral scale score, and performance score for parents, which can guide clinicians in adjusting personalized treatment plans and provide a basis for clinical decision-making. The treatment of ADHD in preschool children requires a systematic framework that integrates family, school, and society. Keywords: attention-deficit hyperactivity disorder, behavioral intervention, influencing factors, preschool child
Background:
GNAO1
is an emerging disorder characterized with hypotonia, developmental delay, epilepsy, and movement disorder, which can be potentially life threatening during acute exacerbation. In ...the USA, deep brain stimulation (DBS) has been licensed for treating children with chronic, treatment-resistant primary dystonia, who are 7 years old or older.
Case Description:
A 4-year-old girl diagnosed to have
GNAO1-
related dyskinesia and severe global developmental delay. She had severe dyskinesia precipitated by intercurrent infection, requiring prolonged intensive care for heavy sedation and related complications. Her dyskinesia improved dramatically after DBS implantation. Technical difficulties and precautions of DBS in preschool children were discussed.
Conclusion:
DBS should be considered early in the treatment of drug-resistant movement disorders in young children with
GNAO1
, especially after dyskinetic crisis, as they tend to recur. Presurgical counseling to parents and close monitoring of complications is also important in the process.
This study aimed to examine the associations between parental mindfulness and preschool child behavior problems and to investigate the mediating role of marital satisfaction and coparenting in the ...relationship between mindfulness and preschool child behavior problems. This was a cross-sectional study in which general sociodemographic data were obtained from 3448 parents of children in grades junior to senior of kindergarten who were assessed using instruments such as the Mindful Attention Awareness Scale (MAAS), the Strengths and Difficulties Questionnaire (SDQ), the ENRICH Marital Satisfaction Scale (TEMSS), and the Parents' Perceptions of the Coparenting Relationship Questionnaire (PPCR). (1) Mindfulness, preschool child behavior problems, marital satisfaction, and coparenting were significantly correlated with each other, where mindfulness was positively correlated with marital satisfaction and coparenting and significantly negatively correlated with preschool child behavior problems. (2) Mindfulness negatively predicted preschool children's problem behaviors. (3) Marital satisfaction independently mediated the relationship between mindfulness and preschool child behavior problems. (4) Coparenting also independently mediated the relationship between mindfulness and preschool child behavior problems. (5) Marital satisfaction and coparenting play a chain-mediating role between mindfulness and preschool children's problem behaviors. Mindfulness predicted preschool child behavior problems, with marital satisfaction and coparenting as mediators.
