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Biomedical subjects

J Dittrichová

Publications and source records attributed to J Dittrichová.

At least 19 recordsLinked to original sources

[Psychological condition of children from pregnancies after assisted reproduction in the third year of life].

OBJECTIVE: To analyse psychological development of children born after assisted reproductive technology. DESIGN: Psychological analysis of the child's development related to the technology of assisted reproduction, length of pregnancy and multiple birth was performed and compared with the control group. SETTING: Institute for the Care of Mother and Child, Prague. METHODS: Out of the total number of 123 children born after assisted reproductive technology during the 1st half of the year 1998 in the Center ISCARE IVF, psychological development was evaluated in 109 children (88.6%). Ninety four children from this sample were assessed using mental, motor and behavior scales of the Bayley Scales of Infant Development II. RESULTS: Mental and motor development of infants born after intracytoplasmatic injection (ICSI) and after in-vitro-fertilisation (IVF) was not significantly different. Fullterm singletons born after assisted reproductive technology did not differ from control fullterm children. There was a developmental delay in both fullterm and preterm children from multiple pregnancies in comparison to control children. No child had serious impairment of psychic functions (developmental index <50). There were no significant differences in behavior records between children born after assisted reproductive technology and control children, but some parents had problems in educational care of their children born after assisted reproductive technology. CONCLUSION: From children born after assisted reproductive technology, those from multiple pregnancies may be at risk for later psychological development. The occurrence of educational problems in assisted reproductive families indicates a need of accessible professional care in this field.

Adult↗

[Further development of neonates with severe pneumopathy].

OBJECTIVE: To assess the risk and the degree of possible unfavourable development in neonates with bronchopulmonal dysplasia and with congenital diaphragmatic hernia. DESIGN: Longitudinal monitoring of the mental, motoric and neurological development until the age of 2 years. Comparison of the findings with the result of polygraphic examination carried out at the expected time of birth. METHODS: The following children were monitored: a) 38 children with bronchopulmonal dysplasia born between the 24th and 33rd post-conception weeks; b) 18 children with congenital diaphragmatic hernia, of whom 3 children were born between the 34th and 36th post-conception weeks, while the remaining 15 children were born on the expected date. All children underwent polygraphic examinations (EEG - 8 channels, respiration, EKG, EOG and EMG) between the 38th and 42nd post-conception weeks. During the 1st and the 2nd years, their psychomotoric development and neurological status were repeatedly evaluated according to Bayley and Vlach, respectively. RESULTS: Up until the 2nd year of life, approximately 2/3 of the children in both monitored groups were developing favourably or satisfactorily. However, the development of the remaining 1/3 was not favourable: The children were mentally or motorically retarded and/or cerebral palsy developed in them. The polygraphic examination in the neonatal period predicted the favourable or unfavourable development of the monitored children with high probability. CONCLUSION: The study showed that in accordance with the data stated in the literature, the development of neural functions is seriously affected in a relatively high percentage of neonates with severe pneumopathy. Neonatal polygraphy can contribute to timely determination of the prognosis for these children. Children with serious neonatal pneumopathies need to be provided with dispensary care on a long-term basis, and professional consultancy and intervention programmes need to be ensured for them.

Bronchopulmonary Dysplasia↗

[Effect of early nutrition on growth parameters and psychomotor development of children of very low birth weight].

OBJECTIVE: The aim of the study was to evaluate influence of early nutrition on growth parameters and psychomotor development of children with very low birth weight (VLBW). DESIGN: A prospective clinical study. SETTING: Institute for Care of Mother and Child, Prague. METHODS: Thirty nine children of birth weight 1,000-1,499 were followed up to one year of their corrected age in a prospective study. The group was divided in two groups according to type of nutrition: 17 children (group A) were fed with milk of own mother - "preterm milk", 22 children (group B) were orally fed with mature milk from the Bank of mother milk - "term milk", which was fortified with BMF preparation (Nutricia, Netherlands). Both groups were comparable in basic anthropometric parameters (weight, lenght, circumference of head and thotax) and in psychosocial characteristics of their mothers. Growths parameters were monitored in weekly intervals for approximatelly eight weeks. In the period between 11th and 15th month of corrected age, the children were evaluated by a clinical psychologist on a blind basis in mental a motor development by using Bayley Scales of Infant Development (BSID-II). Statistical analysis was performed by chi-square test and t-test. RESULTS: No statistically significant differences between the two groups in evaluating the growth parameters were observed. The psychological examination demonstrated statistically significant differences in the motor development. The psychomotor developmental index (PVI) proved to be 84.4 +/- 14.6 in the group A and 94.3 +/- 12.5 in the group B (t-test = 2.28, p<0.05). There was not any statistically significent difference in metal development between the two groups. The mean mentel developmental index (MVI) was 98.2 +/- 10.2 in the A group and 101.0 +/- 13.3 in the group B. CONCLUSION: Result of the study indicate favorable effect of fortification of breast milk in VLBW newborns, especially in view of the observed favorable influence of fortfication on motor development of the children.

Breast Feeding↗

[Psychomotor development of children with signs of intrapartum hypoxia and monitored by intrapartum fetal pulse oxymetry].

OBJECTIVE: The following questions were investigated: 1) the psychomotor development in newborns with pathological cardiotocographic recording (CTG), having been born spontaneously due to a normal oxygen saturation monitored by intrapartum pulse oxymetry (IFPO)(group I), 2) possible difference in development of children in group I in comparison with those with pathological CTG without IFPO monitoring delivered by cesarean section (group II), 3) possible differences in children in these two groups with signs of intrapartum hypoxia (groups I and II, respectively) from children delivered spontaneously during physiological delivery without signs of hypoxia (group III). DESIGN: A prospective clinical study SETTING: Institute for the Care of Mother and Child METHODS: There have been 88 children born in the years 2000-2001 from singleton pregnancies in gestational ages > 36 weeks. Three groups of children were established: 1) in the group I (IFPO, n=32) there were children born spontaneously having pathological CTG detected by cardiotocograph HP50A and simultaneously monitored by intrapartum fetal pulse oxymeter NELLCOR Puritan Benett A400 with the NELLCOR FE 14 sensor with normal values of oxygen saturation. The children of group II (CTG-SC, n=25) were born by cesarean section due to acute intrapartum fetal hypoxia (IH) indicated by CTG recording without IFPO. The group III (physiological, n=31) was formed by children from physiological deliveries without signs of IH. All children underwent psychological examination at the average age of 21.8 months by the Bayley Scales of Infant Development (BSID-II). The statistical analysis of data was performed according to the variables using t-test or chi-square test, respectively. RESULTS: Group I (IFPO) did not differ significantly from group II (CTG-SC) in any area of psychological evaluation. The prevention of cesarean section due to IFPO method in the group I therefore prevented a significant increase of psychological morbidity in children of this early age. In spite of that the children of the group I (IFPO) reached the lowest evaluation and differed significantly from the most favorably evaluated group III (physiological) in motor development, behavior, and in a total number of deviations. Group II (CTG-SC) was evaluated significantly worse in comparison with group III (physiological) only in behavior items. On the other hand the occurrence of children of above-average mental development in the groups I and II were the same as in group III. The results indicate complex character of the problem. CONCLUSION: The prevention of CS due to IFPO prevented a development of psychological morbidity in children. The increased occurrence of deviations in psychomotor development of children with signs of acute IH (groups I and II) in comparison with children of group III (physiological) will be analyzed in detail in relation to further data.

Cardiotocography↗

[Regular respiration during sleep in children in the first months of life].

Regular respiration is an important parameter of quiet sleep in infants. At the earliest age, the periods of regular respiration are shorter as compared with the periods of EEG, EMG and EOG patterns of quiet sleep. The duration of periods with regular respiration significantly increases with age, and their coincidence with other parameters of quiet sleep becomes higher. The frequency of regular respiration significantly decreases with age. Very short periods of regular respiration, low coincidence with other parameters of quiet sleep, and very high frequency of regular respiration after the 12th week of life may indicate a delay in the central nervous system development.

Aging↗

Infant feeding behavior: development in patterns and motivation.

Studies of feeding behaviors in human infants not only provide normative data but also allow analyses of the behavioral regulation. Twenty healthy full-term infants were observed by two examiners and were audiovisually and polygraphically recorded under standard conditions at 2, 10, 18, and 26 weeks of age prior to, during, and after breast- or bottle-feeding. The parameters of sucking, breathing and swallowing significantly changed during the first 6 months of age. At 2 weeks, infants were alert and visually attentive during sucking. Breast-fed infants had more opportunities for intimate social contacts than bottle-fed infants because breast feeding took significantly longer time than bottle feeding. Alert motor activities significantly shifted from the prefeeding to the postfeeding time during the first 6 months of age. Together with an increase in visual exploration and theta index in EEG, this shift seems to relate to developmental changes and interindividual differences in the intrinsic motivation.

Brain↗

[Behavior of neonates with hyperbilirubinemia treated with blue light].

Two groups of fullterm newborns were polygraphically examined. The first group consisted of 10 newborns with hyperbilirubinemia treated by phototherapy, the second group was a control one and consisted also of 10 newborns. The polygrams were made at the age of four days. The length of the sleep cycle, the length of quiet and paradoxical sleep, respiratory rate during both sleep states, the frequency of rapid eye movements during paradoxical sleep, the frequency of EMG discharges during paradoxical sleep, the number of sleep apneas during paradoxical sleep and the incidence of body movements during the whole recording time (100 minutes) were assessed. There were no significant differences in majority of parameters, only the length of paradoxical sleep and the number of sleep apneas were significantly higher in infants with hyperbilirubinemia. Infants with higher levels of bilirubin had longer sleep cycle, longer paradoxical sleep and lower incidence of body movements. Large individual differences in all parameters studied were observed, especially in infants with hyperbilirubinemia. This indicates that special observational care should be given to these infants.

Humans↗

Feeding behaviour in infants.

20 healthy full-term infants have been studied in their 2nd, 10th, 18th and 26th weeks of life in three standard situations: before feeding, in the course of milk drinking and after feeding. A polygraphic record of sucking, breathing, swallowing, the oculomotor activity, the EEG and vocalization has been taken simultaneously with a video-recording of the infant's behaviour. Physiological patterns and developmental changes of sucking, breathing and swallowing are described. These activities are considered as fine motor activity of the earliest age. The possibility of using polygraphic recordings of these variables for the diagnosis of the neurological syndrome called feeding problems is discussed. Further, behavioural activities in above mentioned three situations and their developmental changes, are described. None of the infants, not even the smallest ones, were asleep in the beginning of feeding. On the contrary, their eyes were open and there were more eye movements during feeding than in other situations. In the authors' opinions, the situation of feeding has, especially in the first days and weeks of life, a special significance for the development of social interactions between the infant and the person taking care of him. The behaviour of a regularly fed infant in the second quarter of his first year seems to be no longer influenced in the periods proceeding and following the feeding act by the prandial cycle but rather by cognitive needs. The influences involved in the regulation of the behaviour of the youngest infants are discussed.

Aging↗

[The effect of blue light on the behavior of neonates].

In ten healthy neonates the influence of blue light was analyzed, using polygraphy. In each child the polygrams were assessed under two conditions--without irradiation and without irradiation. The length of the sleep, cycle, the length of quit and paradoxical sleep, the respiration rate during both behavioural states, the frequency of rapid eye movements during paradoxical sleep, the incidence of EEG activity corresponding to age and the EMG activity during both behavioural states did not change significantly under the influence of light. Only the number of apnoeic intervals during paradoxical sleep under blue light increased significantly. The authors assessed, using polygraphy, also a control group of ten healthy mature neonates. The two groups of children did not differ significantly in the investigated parameters. The results revealed a great inter- and intraindividual variability which suggests the low stability of the child's behaviour during the first days of life. Among the numerous stimuli of the external and internal environment which modify the behaviour during the period of postpartum adaptation, the influence of blue light did not play a significant role under the above conditions.

Child Behavior↗

Screening of perinatal risk factors leading to deviations of physical development and/or mental retardation of the child and their prevention.

We tried to demonstrate some results obtained from the analysis of one selective and one countrywide follow-up study the mode of detection of risk pregnancies and of risk factors that could be the cause of physical and mental congenital defects; the search for optimal form of screening and prevention in these cases; and verification of the effectivity of these measures.

Congenital Abnormalities↗