Tag: neurodevelopmental disorder

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Night Shifts During Pregnancy Linked to Greater Neurodevelopmental Abnormality Risk

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But nightly prenatal sleep length may modify this association, exploratory findings suggest

Working night shifts during pregnancy is linked to a heightened risk of neurodevelopmental abnormalities detected by screening in the child by the age of 4, finds research published online in Occupational & Environmental Medicine.

But nightly prenatal sleep length during this period may modify this observed association, exploratory findings suggest.

Night shift work during pregnancy has been associated with unfavourable health outcomes for both mother and child, including neurodevelopmental issues, potentially related to body clock and sleep disturbances, note the researchers.

They therefore wanted to explore the associations between mums’ night shift work and their children’s neurodevelopment and to find out if there are potentially modifiable prenatal factors, such as changes in night shift patterns and sleep duration.

They drew on nationwide survey data for around 100 000 pregnant women from the Japan Environment and Children’s Study (JECS) who were enrolled between January 2011 and March 2014.

The women were surveyed in the first and second/third trimesters and answered questions about the number of night shifts they worked in a month.

Their responses were divided into 3 groups: no night shifts reported in either survey (27 655 women); night shifts in the first, but not second survey (‘discontinued night shifts’, 1779 women); and night shifts in both surveys (‘continued night shifts’, 2084 women).

Prenatal sleep length was calculated from self-reported bedtime and wake-up times in the second/third trimester. Sleep length was categorised as short if less than 6 hours; moderate if 6–9 hours; and long if 10 or more hours.

Child neurodevelopmental abnormalities at the age of 4 were assessed using a developmental screening tool—the Japanese version of the Ages and Stages Questionnaire, Third Edition (J-ASQ-3).

This is made up of 5 domains: communication; gross motor skills; fine motor skills (ability to make small, precise, deliberate movements); problem solving; and personal–social functioning (interpersonal skills, emotional/behavioural development, and awareness of personal boundary/space).

In all, 31,528 mothers who worked in the first trimester and completed the child development questionnaire when their children were 4 years old were included in the analysis.

Some 4189 (just over 13%) of the 4 year olds were classified as high risk of an abnormality in at least one of the five J-ASQ-3 domains: 1210 (4%) for communication; 1599 (5%) for gross motor skills; 1906 (6%) for fine motor skills; 913 (3%) for problem solving; and 1495 (5%) for personal–social functioning.

Compared with the children of mothers who didn’t work night shifts, the children of those who discontinued night shift work were more likely to have developmental screening abnormalities, but only in the fine motor skills domain (24% higher risk).

But the children of mothers who continued night shifts during their pregnancy had higher risks of developmental abnormalities in 3 domains compared with children whose mothers didn’t work night shifts.

These were in the domains of communication skills (29% higher risk); fine motor skills (34% higher risk); and personal–social functioning (31% higher risk).

Only the fine motor skills domain showed a significant association, regardless of whether night shifts were continued or discontinued.

“One possible explanation is that maternal inflammation associated with persistent night work may preferentially affect neural pathways involved in fine motor function,” suggest the researchers.

A separate exploratory analysis showed that the observed association between night shift pattern and the child’s neurodevelopmental risk differed according to how long the mothers slept.

Prenatal sleep duration of 10 or more hours was associated with an 80% heightened risk of abnormalities in any of the 5 domains compared with prenatal sleep length of 6-9 hours.

Long prenatal sleep duration may also reflect underlying fatigue, subclinical depression, inflammation, or anaemia, rather than representing a harmful exposure in itself, suggest the researchers.

This is an observational study, and as such, can’t establish cause and effect. And the researchers acknowledge that they weren’t able to account for shift rotation systems, individual chronotype, workload, exposure to light, or the timing of night shift discontinuation, all of which might have influenced the findings.

But in light of the findings, it may be worth employers considering flexible work schedules for pregnant night shift workers, they say.

Source: The BMJ Group

Categories : Obstetrics & GynaecologyTags :

Prenatal Exposure to Depression Linked to Neurodevelopmental Disorders

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Study finds higher risk cannot be attributed entirely to antidepressant exposure

Source: Pixabay CC0

Children of mothers with depression had higher rates of certain neurodevelopmental disorders regardless of whether they were exposed to antidepressants in the womb, reports a new study led by Saraid McIlvride of the University of Glasgow, UK, published September 29th in the open access journal PLOS Medicine.

Antidepressant use during pregnancy is increasing, but currently, the long-term effects of these drugs on child development are unclear. Having untreated depression during pregnancy carries its own risks, however, making it very challenging for someone with depression to make informed decisions about whether to take medication during pregnancy.

In a new study, researchers followed more than 167 000 children born in Wales between 2009 and 2016, until 2022. Using medical and school records, they looked for any links between depression diagnoses or antidepressant use in mothers, and special educational needs in their children, such as diagnoses of autism spectrum disorder or attention deficit hyperactivity disorder, or learning, behavioral, emotional or social difficulties.

They found that children of women who received antidepressant treatment had higher rates of certain neurodevelopmental disorders than women with depression who were untreated. However, these results could be affected by the fact that women with more severe depression are more likely to be prescribed antidepressants. When comparing between treated depression, untreated depression and antidepressant exposure without depression, the analyses showed that antidepressant exposure was associated with an additional 6.3 cases per 100 children in those not exposed to depression, and an additional 2.9 cases per 100 children in those exposed to depression.

The researchers conclude that children of mothers with depression have a higher risk of neurodevelopmental disorders regardless of whether they were exposed to antidepressants, but medication may carry an additional risk. They caution that any potential risk of treatment should be balanced against the risks of untreated depression in mothers, which is associated with a higher risk of postnatal depression.

The authors add, “We showed that if women with depression took antidepressants while pregnant their children were more likely to have special educational needs, but it was only a very slight increase and may have been due to them having more severe depression, rather than an effect of the medicine. 

“Among children of mothers with depression, 24 in every 100 children had special educational needs if she was not on treatment, and this increased by just 3 in every 100 children if she was taking antidepressants. This is compared to 20 in every 100 children for those not exposed to depression or antidepressants in the womb.

“Our results don’t suggest that women should automatically stop taking their antidepressants because depression can harm both mother and baby if not treated. Women should always speak to their doctor about what is best in their situation.

“Our study indicates that exposure to antidepressants during pregnancy could serve as a marker for additional support being needed at school.

“Linking mothers’ and babies’ routinely collected data and being able to follow their health and development over time is an amazing resource which can support research into maternal mental health, an area which urgently needs more attention.

“Further studies are needed to empower women with the knowledge they need to make informed decisions, together with their doctor or midwife, about their own health as well as their baby’s.”

Provided by PLOS

Categories : PaediatricsTags :

Neurodevelopmental Disorders Widespread in Extremely Preterm Babies

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Preterm baby
Photo by Hush Naidoo on Unsplash

An Acta Paediatrica analysis of data for extremely preterm babies (born before 24 weeks) found that most had neurodevelopmental disorders and/or other diagnoses during childhood and were referred for habilitational care.

In the Swedish study of 383 children from 2007 to 2018, 75% had neurodevelopmental disorders (including speech disorders, intellectual disabilities, attention deficit hyperactivity disorder, autism spectrum disorders, visual impairment, cerebral palsy, epilepsy, and hearing impairment).

More boys than girls had intellectual disabilities (45% versus 27%) and visual impairment (25% versus 14%). Fifty-five percent of children were referred for habilitation services, and 88% had additional diagnoses such as asthma and short stature.

“Due to improved medical care, an increasing number of extremely preterm infants survive. Our study shows that a large proportion of the most immature new survivors suffer from persisting somatic and neurodevelopmental disorders,” said senior author Ann Hellström, MD, PhD, of Gothenburg University.

A better understanding of the long-term consequences of preterm birth will assist clinicians and healthcare systems in optimising care. “Awareness of the lifelong needs of these children is also necessary for society at large to provide adequate resources and support for the tiniest of our children and their families,” said lead author Eva Morsing, MD, PhD of Lund University.

Source: Wiley

Categories : Genetics NeurologyTags :

Scientists Identify A New Recessive Neurodevelopmental Disorder

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Image source: Pixabay

In the Journal of Clinical Investigation, researchers have reported a rare neurodevelopmental condition characterised by intellectual disability, ataxia with cerebellar hypoplasia and delayed puberty with hypogonadotropic hypogonadism (HH).

Patients with this unusual combination of conditions were referred to Mehul Dattani (UCL), and affected individuals were found to carry the same homozygous mutation in the PRDM13 gene, which encodes a chromatin modifying factor that contributes to regulating cell fate. Intriguingly, an unaffected heterozygous carrier of this mutation was identified by screening 42 unaffected individuals in the Maltese population, suggesting that this mutation is present at low levels in the population.

The researchers set out to model this condition and identify the underlying causes using a PRDM13-deficient mouse model. The researchers found evidence that both the cerebellar hypoplasia and reproductive phenotypes resulted from defects in the specification of specific populations of GABAergic neuronal progenitors in the developing cerebellum and hypothalamus, respectively.

The results indicate that this condition results from abnormal cell fate specification during development. Consequently, the hypoplastic cerebellum is deficient in molecular layer interneurons, which play critical roles in regulating cerebellar circuits. In the hypothalamus, fewer Kisspeptin neurons, which are important regulators of gonadotropin releasing hormone and puberty, were present in PRDM13 mutant mice.

Together, these findings identify PRDM13 as a critical regulator of neuronal cell fate in the cerebellum and hypothalamus, providing a mechanistic explanation for the co-occurrence of hypogonadism and cerebellar hypoplasia in this syndrome.

Source: King’s College London