Mijna Hadders-Algra - Academia.edu (original) (raw)
Papers by Mijna Hadders-Algra
Pediatric Research, Dec 1, 2003
Gradually it is getting clear that motor development-in particular balance control-in so-called "... more Gradually it is getting clear that motor development-in particular balance control-in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural behavior during reaching by means of kinetic and kinematic measurements. Preterm infants (n ϭ 32) without cerebral palsy were investigated longitudinally at the corrected ages of 4 and 6 mo. Thirteen age-matched full-term infants served as controls. Cognitive and motor development were assessed by means of the quality of General Movements (GMs) at 4 mo and Bayley scales at 6 and 12 mo. The infants were lying supine on a forceplate reaching for a toy and the kinetics of the total body's Center of Pressure (COP) was measured in cranial-caudal and medial-lateral direction. The analysis focused on COP displacement, V max and oscillatory changes of the COP displacement during reaching. The kinematic analysis of reaching focused on movement units, V max and a compound kinematic variable reflecting the quality of reaching. The results showed that preterm infants showed a remarkable "still" postural behavior, which differed significantly from the mobile COP behavior of the full-term infants. More "still" postural behavior at 6 mo was associated with a better quality of reaching movements and with normal GMs at 4 mo. We concluded that "still" postural behavior is an adequate postural strategy of preterm infants. But it might be that this postural behavior is an indicator of later dysfunction. (Pediatr Res 54: 826-833, 2003) Abbreviations COP, center of pressure cc , cranial-caudal direction HR, high-risk LR, low-risk MDI, Mental Developmental Index (of Bayley test) m-l, medial-lateral direction MU, movement units PDI, Psychomotor Developmental Index (of Bayley test) PT, preterm GMs, general movements
Pediatric Research, 2005
A substantial proportion of the "apparently normal" preterm infants exhibit minor and moderate dy... more A substantial proportion of the "apparently normal" preterm infants exhibit minor and moderate dysfunctions in neuromotor outcome as they grow older. Birth characteristics, minor abnormalities on the neonatal ultrasound scan of the brain, and motor milestones have only limited value in the early detection of these children. The aim of the present study was to investigate whether nonoptimal reaching and relatively immobile postural behavior at an early age are associated with dysfunctional neuromotor and behavioural development at school age. The preterm children and full-term children of the present follow-up study participated in a previous study on the characteristics of reaching kinematics and the kinetics of posture at 4 and 6 mo corrected age. At the age of 6 y, the children were reassessed by means of the Touwen neurologic assessment, the Movement ABC, and the Child Behavior Check List. The results demonstrated that in preterm children without cerebral palsy, a lack of successful reaching at 4 mo and a nonoptimal quality of reaching at 6 mo are related to the development of a complex form of minor neurologic dysfunction (MND) and fine manipulative disability at 6 y. Thus, these early signs indicate the presence of clinically significant brain dysfunction. A relatively immobile postural behavior at 4 mo was associated with simple MND, coordination problems, and at 6 mo with a worse score on the Movement ABC and internalizing behavior. This suggests that a relatively immobile postural behavior points to a mild form of brain dysfunction.
Neuroscience & Biobehavioral Reviews, 2018
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Current Nutrition & Food Science, 2005
The present review evaluates the effect of pre-and postnatal supplementation of nutrition with lo... more The present review evaluates the effect of pre-and postnatal supplementation of nutrition with long-chain polyunsaturated fatty acids (LCPUFA) on neurodevelopmental outcome of term infants. The few studies which have been performed on the role of prenatal LCPUFA status or prenatal LCPUFA supplementation in neurodevelopmental outcome suggest that a better prenatal arachidonic acid (AA) and doxosahexaenoic acid (DHA) status might be related to a better neurodevelopmental outcome in early infancy. A review of the randomised controlled trials on postnatal formula supplementation with LCPUFA in term infants revealed that supplementation with LCPUFA, in particularly supplementation with ≥ 0.30% DHA, has a beneficial effect on neurodevelopmental outcome till 4 months of age. The studies could not demonstrate a consistent positive effect beyond that age. However, in the majority of studies neurodevelopmental outcome was assessed at 6 to 24 months, i.e. at an age where there is a 'latency' in the expression of minor neurological dysfunction. This may mean that it is possible that LCPUFA may have a long lasting beneficial effect on neurodevelopmental outcome at school-age and beyond. This hypothesis urgently needs testing in nutritional intervention studies in which children are followed till at least school-age.
Prostaglandins, leukotrienes, and essential fatty acids, 2009
Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for neurodevelopment. Maternal... more Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for neurodevelopment. Maternal diet influences milk DHA, whereas milk AA seems rather constant. We investigated milk AA, DHA and DHA/AA after supplementation of AA plus DHA, or DHA alone during pregnancy and lactation. Women were supplemented with AA+DHA (220mg each/day), DHA (220mg/day) or placebo during pregnancy and lactation. Milk samples were collected at 2 (n=86) and 12 weeks (n=69) postpartum. Supplementation of AA+DHA elevated milk AA (week 2, 14%; week 12, 23%) and DHA (43% and 52%) as compared to placebo. DHA tended to decrease milk AA and vice versa. Milk AA, DHA and DHA/AA decreased from 2 to 12 weeks postpartum. Milk AA and in particular DHA are sensitive to maternal supplementation. It seems that maternal AA and notably DHA status decline with advancing lactation.
Neuropraxis, 1997
Het centrale zenuwstelsel (CZS) is een bijzonder ingewikkeld systeem. Het bestaat uit beiljoenen ... more Het centrale zenuwstelsel (CZS) is een bijzonder ingewikkeld systeem. Het bestaat uit beiljoenen cellen, en elke cel maakt tientallen tot duizenden contacten met andere cellen. Contacten met cellen in de buurt of contacten met cellen op een meter afstand. Hoe meer je je de complexiteit van het systeem realiseert, des te meer raak je verwonderd over het feit dat het zenuwstelsel meestal adequaat functioneert.
Pediatric Research, 2005
Kinematic characteristics of reaching movements of the dominant arm were assessed in 51 sitting p... more Kinematic characteristics of reaching movements of the dominant arm were assessed in 51 sitting preterm children who were aged 2-11 y and had cerebral palsy (CP), including 33 with spastic hemiplegia and 18 with bilateral CP (Bi-CP). Reference data of 29 typically developing children were present. The results indicated that the quality of reaching movements from the dominant arm of children with CP was significantly worse than that of typically developing children. This held true in particular for the children with Bi-CP. For example, reaching movements of children with CP took more time and consisted less often of one movement unit. The quality of reaching was related to the severity of lesion present on the neonatal ultrasound scan of the brain, the severity of motor disorder, the degree of spasticity, and the ability to perform activities of daily life. The last indicates that movements of the dominant arm in children with spastic hemiplegia and Bi-CP deserve clinical attention.
Pediatric Research, 2013
Clinical Investigation nature publishing group Background: Recent studies suggest that in vitro f... more Clinical Investigation nature publishing group Background: Recent studies suggest that in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are associated with suboptimal cardiometabolic outcome in offspring. It is unknown whether preimplantation genetic screening (PGS), which involves embryo biopsy, affects blood pressure (BP), anthropometrics, and the frequency of received medical care. Methods: In this prospective multicenter follow-up study, we assessed BP, anthropometrics, and received medical care of 4-y-old children born to women who were randomly assigned to IVF/ICSI with PGS (n = 49) or without PGS (controls; n = 64). We applied linear and generalized linear mixed-effects models to investigate possible effects of PGS. results: BP in the PGS and control groups was similar: 102/64 and 100/64 mm Hg, respectively. Main anthropometric outcomes in the PGS vs. control group were: BMI: 16.1 vs. 15.8; triceps skinfold: 108 vs. 98 mm; and subscapular skinfold: 54 vs. 53 mm (all P values > 0.05). More PGS children than controls had received paramedical care (speech, physical, or occupational therapy: 14 (29%) vs. 9 (14%); P = 0.03 in multivariable analysis). The frequency of medicial treatment was comparable. conclusion: PGS does not seem to affect BP or anthropometrics in 4-y-old children. The higher frequency of received paramedical care after PGS may suggest an effect of PGS on subtle developmental parameters.
Pediatric Physical Therapy, 2010
The study aim was to describe and quantify physical therapy interventions for infants at high ris... more The study aim was to describe and quantify physical therapy interventions for infants at high risk for developmental disorders. Methods: An observation protocol was developed based on knowledge about infant physical therapy and analysis of directly observable physiotherapeutic (PT) actions. The protocol's psychometric quality was assessed. Videos of 42 infant physical therapy sessions at 4 or 6 months of corrected age were analyzed. Results: The observation protocol classified PT actions into 8 mutually exclusive categories. Virtually all PT actions during treatment could be classified. Inter-and intrarater agreements were satisfactory (intraclass correlations, 0.68-1.00). Approximately 40% of treatment time was spent challenging the infant to produce motor behavior by themselves, whereas approximately 30% of time facilitation techniques were applied. Tradition-based sessions could be differentiated from function-oriented ones. Conclusions: It is possible to document PT actions during physical therapy treatment of infants at high risk for cerebral palsy in a systematic, standardized, and reliable way.
Neuroscience & Biobehavioral Reviews, 1998
Postural control is organized in basic, direction specific synergies which can be adapted to task... more Postural control is organized in basic, direction specific synergies which can be adapted to task-related conditions. Studies on the development of postural adjustments in young sitting children revealed that largely variable, direction specific muscle activation patterns are already present in 5-6 month old children not able to sit without support. With increasing age, the variation in muscle activation patterns decreases, resulting in a selection of the most complete patterns of synergist activation at 9-10 months of age. The synergy of the dorsal extensor muscles (during a forward sway of the body) develops faster than the synergy of the ventral flexors (during backward body-sway). A 'fixed' extensor synergy is prominently present between 9 months and 3 years, i.e. during the period when standing and walking abilities develop. With increasing age the 'fixed' extensor synergy gradually dissolves. The flexor synergy shows a larger flexibility than the extensor synergy, a difference which can be attributed to differences in stability limits and differences in the degree of supraspinal modulation.
Lipids, 2002
Long-chain PUFA play an important role in early human neurodevelopment. Significant inverse corre... more Long-chain PUFA play an important role in early human neurodevelopment. Significant inverse correlations were reported between values of trans isomeric and long-chain PUFA in plasma lipids of preterm infants and children aged 1-15 yr as well as in venous cord blood lipids of full-term infants. Here we report FA compositional data of cord blood vessel wall lipids in 308 healthy, full-term infants (gestational age: 39.7 ± 1.2 wk, birth weight: 3528 ± 429 g, mean ± SD). The median (interquartile range) of the sum of 18-carbon trans FA was 0.22 (0.13) % w/w in umbilical artery and 0.16 (0.10) % w/w in umbilical vein lipids. Nonparametric correlation analysis showed significant inverse correlations between the sum of 18-carbon trans FA and both arachidonic acid and DHA in artery (r = −0.38, P < 0.01, and r = −0.20, P < 0.01) and vein (r = −0.36, P < 0.01, and −0.17, P < 0.01) wall lipids. In addition, the sum of 18-carbon trans FA was significantly positively correlated to Mead acid, a general indicator of EFA deficiency, in both artery (r = +0.35, P < 0.01) and vein (r = +0.31, P < 0.01) wall lipids. The present results obtained in a large group of full-term infants suggest that maternal trans FA intake is inversely associated with long-chain PUFA status of the infant at birth.
Journal of Pediatric Gastroenterology & Nutrition, 2010
Objectives: To find out whether supplementation of formula milk by long-chain polyunsaturated fat... more Objectives: To find out whether supplementation of formula milk by long-chain polyunsaturated fatty acids (LCPUFA) affects neurodevelopment at 18 months of age in term or preterm infants by an individual patient data (IPD) meta-analysis. Materials and Methods: Data of 870 children from 4 large randomised clinical trials for formula milk with and without LCPUFAs allowed for assessing the effect of LCPUFA with adjustment for potential confounders and extensive subgroup analysis on prematurity, LCPUFA source, and dosage. Any additional clinical trials examining the effect of LCPUFA supplementation on Bayley Scales of Infant Development at 18 months were regarded as relevant. Two relevant studies were identified by MEDLINE, but were not available to us. An IPD meta-analysis was performed with subgroup analyses by preterm delivery, very low birth weight (<1500 g), trials with higher amounts of docosahexaenoic acid (DHA) and arachidonic acid (AA), and specific sources of LCPUFA. The sample size of 870 children was sufficient to detect clinically relevant differences in Bayley Scales even in subgroups. Results: There were no significant differences in mental or psychomotor developmental indexes between LCPUFAsupplemented and control groups for all children or in subgroups. This was confirmed with adjustment for the possible confounders: sex, gestational age, birth weight, maternal age, and maternal smoking. The adjusted mean differences in mental developmental index and psychomotor developmental index for all of the children were À0.8 (95% confidence interval À2.8 to 1.2) and À1.0 (À2.7 to 0.7), respectively. Conclusions: These data based on considerable sample size provide substantial evidence that LCPUFA supplementation of infant formula does not have a clinically meaningful effect on the neurodevelopment as assessed by Bayley scores at 18 months. Inclusion of all relevant data should not have led to differing conclusions except, possibly, for very-low-birthweight infants. JPGN 50:000-000, 2010.
Journal of Developmental & Behavioral Pediatrics, 2008
Background: Neuromotor function in infancy can be evaluated in various ways. Assessment instrumen... more Background: Neuromotor function in infancy can be evaluated in various ways. Assessment instruments are used for early detection of children with a high risk for developmental disorders. Early detection enables clinicians to provide intervention at a young age when plasticity of the nervous system is high. The assessments may also be used to monitor intervention. The present paper will review the psychometric properties of methods to assess neuromotora function in infancy. Methods: A literature search was performed in PubMed, Medline and PsycINFO (1966 to March 2007) on instruments to assess neuromotor functioning of infants. Results: Fifteen instruments were included and classi ed into four groups: 1) Comprehensive neurological examinations (n=4). These techniques are widely used, though little is known about their reliability. Their validity in predicting major developmental disorders such as cerebral palsy is good; their predictive validity for minor motor disorders is moderate at best. 2) Procedures with standardized scoring (n=7). These have good reliability, but only moderate predictive validity for major developmental disorders. No data available for prediction of minor developmental disorders. 3) Observation of milestones (n=2). Its predictive validity for major developmental disorders is only moderate, while reliability is good. 4) Assessment of quality of motor behavior or motor patterns (n=2). These instruments have the best predictive validity for major and minor developmental motor disorders, but current methods are only useful under the age of four months. Conclusion: Prediction of developmental outcome at an early age is di cult. In medical evaluations of high-risk infants the best predictions are achieved through a combination of multiple, complementary tools, that is, achieved milestones, neurological examination and assessment of the quality of motor behavior.
Infant Behavior and Development, 2010
Reaching movements are initiated by activity of the prime mover, i.e. the first activated arm mus... more Reaching movements are initiated by activity of the prime mover, i.e. the first activated arm muscle. We aimed to investigate the relationship between prime mover activity and kinematics of reaching in typically developing (TD) infants in supine and sitting position. Fourteen infants were assessed at 4 and 6 months during reaching in supine and supported sitting. Kinematics and EMG-activity of deltoid, pectoralis major, biceps (BB) and triceps brachii were recorded. Kinematic analysis focused on number of movement units (MUs) and transport MU (MU with longest duration). Prime mover use was variable, but at 6 months a dominance of BB emerged in both testing conditions. Kinematics were also variable, but with increasing age the number of MU decreased and the relative proportion of the transport MU increased. BB as prime mover at 6 months was related to a larger transport MU. Conclusion: Between 4 and 6 months BB prime mover dominance emerges which is related to relatively efficient reaching characteristics.
Fertility and Sterility, 2011
Objective: To evaluate the effect of preimplantation genetic screening (PGS) on neurodevelopmenta... more Objective: To evaluate the effect of preimplantation genetic screening (PGS) on neurodevelopmental outcomes in children. Design: Prospective, assessor-blinded, follow-up study of children born to women randomly assigned to in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) with or without PGS.
Fertility and Sterility, 2010
Objective: To evaluate specific effects of ovarian hyperstimulation, the in vitro procedure, and ... more Objective: To evaluate specific effects of ovarian hyperstimulation, the in vitro procedure, and a history of subfertility on neuromotor development at 3 months of age. Design: Prospective, cohort study. Setting: University Medical Center Groningen, The Netherlands. Patient(s): Singletons conceived after controlled ovarian hyperstimulation-IVF/intracytoplasmic sperm injection (COH-IVF; n ¼ 68) or modified natural cycle-IVF/intracytoplasmic sperm injection (MNC-IVF; n ¼ 57), and naturally conceived singletons of subfertile couples (NC; n ¼ 90). Data from a reference population were available (n ¼ 450). Intervention(s): None. Main Outcome Measure(s): Quality of general movements (GMs), classified as normal-optimal, normal-suboptimal, mildly abnormal, or definitely abnormal. Definitely abnormal GMs indicate brain dysfunction, mildly abnormal GMs normal but non-optimal brain function. Result(s): Mildly abnormal and definitely abnormal GMs were observed equally frequently in COH-IVF, MNC-IVF, and NC singletons. The three subfertile groups showed a reduction in GM quality, in particular more mildly abnormal GMs, in comparison with the reference population. Conclusion(s): Singletons born after IVF (with or without ovarian hyperstimulation) are not at increased risk for abnormal GMs compared with naturally conceived peers of subfertile parents. Mildly abnormal GMs occur more often in infants of subfertile parents than in the general population, suggesting that factors associated with subfertility rather than those related to IVF procedures may be associated with less-optimal early neurodevelopmental outcome. These results need confirmation through replication and follow-up at older ages. (Fertil Steril Ò 2010;93:544-53. Ó2010 by American Society for Reproductive Medicine.
Early Human Development, 2013
Background: In children with developmental disorders, motor problems often co-occur with cognitiv... more Background: In children with developmental disorders, motor problems often co-occur with cognitive difficulties. Associations between specific cognitive deficits underlying learning problems and minor neurological dysfunction (MND) are still unknown. Aims: To assess associations between specific types of MND as clinical markers of non-optimal brain function and performance in specific cognitive domains. Study design: Part of a randomized controlled trial. Subjects: Three hundred and forty one 9-year-old children born at term (177 boys, 164 girls). Outcome measures: Children were neurologically assessed to detect eight types of MND: mild dysfunction in posture and muscle tone, reflexes, coordination, fine manipulative ability, sensory function, cranial nerve function, choreiform dyskinesia and excessive associated movements. Cognitive function in the domains of attention, memory and language was evaluated using the Test of Everyday Attention for Children (TEA-Ch), a developmental neuropsychological assessment (NEPSY) and the Children's Memory Scale. Results: Fine manipulative disability and coordination problems were associated with lower scores on attention, memory and learning and language, other types of MND were not. Girls with coordination problems performed significantly worse on attention/executive function than those without this dysfunction; however, in boys, such association was absent. Conclusion: Particularly, fine manipulative disability and coordination problems were associated with worse cognitive function in the domains of attention, learning and memory and language. Previous and present data suggest a minor sex difference in neurocognitive associations: in girls dysfunction of the cerebello-thalamo-cortical pathways may be associated with cognitive deficits, while in boys cognitive impairment may be associated with dysfunction of cortico-striato-thalamo-cortical pathways.
Pediatric Research, Dec 1, 2003
Gradually it is getting clear that motor development-in particular balance control-in so-called "... more Gradually it is getting clear that motor development-in particular balance control-in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural behavior during reaching by means of kinetic and kinematic measurements. Preterm infants (n ϭ 32) without cerebral palsy were investigated longitudinally at the corrected ages of 4 and 6 mo. Thirteen age-matched full-term infants served as controls. Cognitive and motor development were assessed by means of the quality of General Movements (GMs) at 4 mo and Bayley scales at 6 and 12 mo. The infants were lying supine on a forceplate reaching for a toy and the kinetics of the total body's Center of Pressure (COP) was measured in cranial-caudal and medial-lateral direction. The analysis focused on COP displacement, V max and oscillatory changes of the COP displacement during reaching. The kinematic analysis of reaching focused on movement units, V max and a compound kinematic variable reflecting the quality of reaching. The results showed that preterm infants showed a remarkable "still" postural behavior, which differed significantly from the mobile COP behavior of the full-term infants. More "still" postural behavior at 6 mo was associated with a better quality of reaching movements and with normal GMs at 4 mo. We concluded that "still" postural behavior is an adequate postural strategy of preterm infants. But it might be that this postural behavior is an indicator of later dysfunction. (Pediatr Res 54: 826-833, 2003) Abbreviations COP, center of pressure cc , cranial-caudal direction HR, high-risk LR, low-risk MDI, Mental Developmental Index (of Bayley test) m-l, medial-lateral direction MU, movement units PDI, Psychomotor Developmental Index (of Bayley test) PT, preterm GMs, general movements
Pediatric Research, 2005
A substantial proportion of the "apparently normal" preterm infants exhibit minor and moderate dy... more A substantial proportion of the "apparently normal" preterm infants exhibit minor and moderate dysfunctions in neuromotor outcome as they grow older. Birth characteristics, minor abnormalities on the neonatal ultrasound scan of the brain, and motor milestones have only limited value in the early detection of these children. The aim of the present study was to investigate whether nonoptimal reaching and relatively immobile postural behavior at an early age are associated with dysfunctional neuromotor and behavioural development at school age. The preterm children and full-term children of the present follow-up study participated in a previous study on the characteristics of reaching kinematics and the kinetics of posture at 4 and 6 mo corrected age. At the age of 6 y, the children were reassessed by means of the Touwen neurologic assessment, the Movement ABC, and the Child Behavior Check List. The results demonstrated that in preterm children without cerebral palsy, a lack of successful reaching at 4 mo and a nonoptimal quality of reaching at 6 mo are related to the development of a complex form of minor neurologic dysfunction (MND) and fine manipulative disability at 6 y. Thus, these early signs indicate the presence of clinically significant brain dysfunction. A relatively immobile postural behavior at 4 mo was associated with simple MND, coordination problems, and at 6 mo with a worse score on the Movement ABC and internalizing behavior. This suggests that a relatively immobile postural behavior points to a mild form of brain dysfunction.
Neuroscience & Biobehavioral Reviews, 2018
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Current Nutrition & Food Science, 2005
The present review evaluates the effect of pre-and postnatal supplementation of nutrition with lo... more The present review evaluates the effect of pre-and postnatal supplementation of nutrition with long-chain polyunsaturated fatty acids (LCPUFA) on neurodevelopmental outcome of term infants. The few studies which have been performed on the role of prenatal LCPUFA status or prenatal LCPUFA supplementation in neurodevelopmental outcome suggest that a better prenatal arachidonic acid (AA) and doxosahexaenoic acid (DHA) status might be related to a better neurodevelopmental outcome in early infancy. A review of the randomised controlled trials on postnatal formula supplementation with LCPUFA in term infants revealed that supplementation with LCPUFA, in particularly supplementation with ≥ 0.30% DHA, has a beneficial effect on neurodevelopmental outcome till 4 months of age. The studies could not demonstrate a consistent positive effect beyond that age. However, in the majority of studies neurodevelopmental outcome was assessed at 6 to 24 months, i.e. at an age where there is a 'latency' in the expression of minor neurological dysfunction. This may mean that it is possible that LCPUFA may have a long lasting beneficial effect on neurodevelopmental outcome at school-age and beyond. This hypothesis urgently needs testing in nutritional intervention studies in which children are followed till at least school-age.
Prostaglandins, leukotrienes, and essential fatty acids, 2009
Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for neurodevelopment. Maternal... more Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for neurodevelopment. Maternal diet influences milk DHA, whereas milk AA seems rather constant. We investigated milk AA, DHA and DHA/AA after supplementation of AA plus DHA, or DHA alone during pregnancy and lactation. Women were supplemented with AA+DHA (220mg each/day), DHA (220mg/day) or placebo during pregnancy and lactation. Milk samples were collected at 2 (n=86) and 12 weeks (n=69) postpartum. Supplementation of AA+DHA elevated milk AA (week 2, 14%; week 12, 23%) and DHA (43% and 52%) as compared to placebo. DHA tended to decrease milk AA and vice versa. Milk AA, DHA and DHA/AA decreased from 2 to 12 weeks postpartum. Milk AA and in particular DHA are sensitive to maternal supplementation. It seems that maternal AA and notably DHA status decline with advancing lactation.
Neuropraxis, 1997
Het centrale zenuwstelsel (CZS) is een bijzonder ingewikkeld systeem. Het bestaat uit beiljoenen ... more Het centrale zenuwstelsel (CZS) is een bijzonder ingewikkeld systeem. Het bestaat uit beiljoenen cellen, en elke cel maakt tientallen tot duizenden contacten met andere cellen. Contacten met cellen in de buurt of contacten met cellen op een meter afstand. Hoe meer je je de complexiteit van het systeem realiseert, des te meer raak je verwonderd over het feit dat het zenuwstelsel meestal adequaat functioneert.
Pediatric Research, 2005
Kinematic characteristics of reaching movements of the dominant arm were assessed in 51 sitting p... more Kinematic characteristics of reaching movements of the dominant arm were assessed in 51 sitting preterm children who were aged 2-11 y and had cerebral palsy (CP), including 33 with spastic hemiplegia and 18 with bilateral CP (Bi-CP). Reference data of 29 typically developing children were present. The results indicated that the quality of reaching movements from the dominant arm of children with CP was significantly worse than that of typically developing children. This held true in particular for the children with Bi-CP. For example, reaching movements of children with CP took more time and consisted less often of one movement unit. The quality of reaching was related to the severity of lesion present on the neonatal ultrasound scan of the brain, the severity of motor disorder, the degree of spasticity, and the ability to perform activities of daily life. The last indicates that movements of the dominant arm in children with spastic hemiplegia and Bi-CP deserve clinical attention.
Pediatric Research, 2013
Clinical Investigation nature publishing group Background: Recent studies suggest that in vitro f... more Clinical Investigation nature publishing group Background: Recent studies suggest that in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are associated with suboptimal cardiometabolic outcome in offspring. It is unknown whether preimplantation genetic screening (PGS), which involves embryo biopsy, affects blood pressure (BP), anthropometrics, and the frequency of received medical care. Methods: In this prospective multicenter follow-up study, we assessed BP, anthropometrics, and received medical care of 4-y-old children born to women who were randomly assigned to IVF/ICSI with PGS (n = 49) or without PGS (controls; n = 64). We applied linear and generalized linear mixed-effects models to investigate possible effects of PGS. results: BP in the PGS and control groups was similar: 102/64 and 100/64 mm Hg, respectively. Main anthropometric outcomes in the PGS vs. control group were: BMI: 16.1 vs. 15.8; triceps skinfold: 108 vs. 98 mm; and subscapular skinfold: 54 vs. 53 mm (all P values > 0.05). More PGS children than controls had received paramedical care (speech, physical, or occupational therapy: 14 (29%) vs. 9 (14%); P = 0.03 in multivariable analysis). The frequency of medicial treatment was comparable. conclusion: PGS does not seem to affect BP or anthropometrics in 4-y-old children. The higher frequency of received paramedical care after PGS may suggest an effect of PGS on subtle developmental parameters.
Pediatric Physical Therapy, 2010
The study aim was to describe and quantify physical therapy interventions for infants at high ris... more The study aim was to describe and quantify physical therapy interventions for infants at high risk for developmental disorders. Methods: An observation protocol was developed based on knowledge about infant physical therapy and analysis of directly observable physiotherapeutic (PT) actions. The protocol's psychometric quality was assessed. Videos of 42 infant physical therapy sessions at 4 or 6 months of corrected age were analyzed. Results: The observation protocol classified PT actions into 8 mutually exclusive categories. Virtually all PT actions during treatment could be classified. Inter-and intrarater agreements were satisfactory (intraclass correlations, 0.68-1.00). Approximately 40% of treatment time was spent challenging the infant to produce motor behavior by themselves, whereas approximately 30% of time facilitation techniques were applied. Tradition-based sessions could be differentiated from function-oriented ones. Conclusions: It is possible to document PT actions during physical therapy treatment of infants at high risk for cerebral palsy in a systematic, standardized, and reliable way.
Neuroscience & Biobehavioral Reviews, 1998
Postural control is organized in basic, direction specific synergies which can be adapted to task... more Postural control is organized in basic, direction specific synergies which can be adapted to task-related conditions. Studies on the development of postural adjustments in young sitting children revealed that largely variable, direction specific muscle activation patterns are already present in 5-6 month old children not able to sit without support. With increasing age, the variation in muscle activation patterns decreases, resulting in a selection of the most complete patterns of synergist activation at 9-10 months of age. The synergy of the dorsal extensor muscles (during a forward sway of the body) develops faster than the synergy of the ventral flexors (during backward body-sway). A 'fixed' extensor synergy is prominently present between 9 months and 3 years, i.e. during the period when standing and walking abilities develop. With increasing age the 'fixed' extensor synergy gradually dissolves. The flexor synergy shows a larger flexibility than the extensor synergy, a difference which can be attributed to differences in stability limits and differences in the degree of supraspinal modulation.
Lipids, 2002
Long-chain PUFA play an important role in early human neurodevelopment. Significant inverse corre... more Long-chain PUFA play an important role in early human neurodevelopment. Significant inverse correlations were reported between values of trans isomeric and long-chain PUFA in plasma lipids of preterm infants and children aged 1-15 yr as well as in venous cord blood lipids of full-term infants. Here we report FA compositional data of cord blood vessel wall lipids in 308 healthy, full-term infants (gestational age: 39.7 ± 1.2 wk, birth weight: 3528 ± 429 g, mean ± SD). The median (interquartile range) of the sum of 18-carbon trans FA was 0.22 (0.13) % w/w in umbilical artery and 0.16 (0.10) % w/w in umbilical vein lipids. Nonparametric correlation analysis showed significant inverse correlations between the sum of 18-carbon trans FA and both arachidonic acid and DHA in artery (r = −0.38, P < 0.01, and r = −0.20, P < 0.01) and vein (r = −0.36, P < 0.01, and −0.17, P < 0.01) wall lipids. In addition, the sum of 18-carbon trans FA was significantly positively correlated to Mead acid, a general indicator of EFA deficiency, in both artery (r = +0.35, P < 0.01) and vein (r = +0.31, P < 0.01) wall lipids. The present results obtained in a large group of full-term infants suggest that maternal trans FA intake is inversely associated with long-chain PUFA status of the infant at birth.
Journal of Pediatric Gastroenterology & Nutrition, 2010
Objectives: To find out whether supplementation of formula milk by long-chain polyunsaturated fat... more Objectives: To find out whether supplementation of formula milk by long-chain polyunsaturated fatty acids (LCPUFA) affects neurodevelopment at 18 months of age in term or preterm infants by an individual patient data (IPD) meta-analysis. Materials and Methods: Data of 870 children from 4 large randomised clinical trials for formula milk with and without LCPUFAs allowed for assessing the effect of LCPUFA with adjustment for potential confounders and extensive subgroup analysis on prematurity, LCPUFA source, and dosage. Any additional clinical trials examining the effect of LCPUFA supplementation on Bayley Scales of Infant Development at 18 months were regarded as relevant. Two relevant studies were identified by MEDLINE, but were not available to us. An IPD meta-analysis was performed with subgroup analyses by preterm delivery, very low birth weight (<1500 g), trials with higher amounts of docosahexaenoic acid (DHA) and arachidonic acid (AA), and specific sources of LCPUFA. The sample size of 870 children was sufficient to detect clinically relevant differences in Bayley Scales even in subgroups. Results: There were no significant differences in mental or psychomotor developmental indexes between LCPUFAsupplemented and control groups for all children or in subgroups. This was confirmed with adjustment for the possible confounders: sex, gestational age, birth weight, maternal age, and maternal smoking. The adjusted mean differences in mental developmental index and psychomotor developmental index for all of the children were À0.8 (95% confidence interval À2.8 to 1.2) and À1.0 (À2.7 to 0.7), respectively. Conclusions: These data based on considerable sample size provide substantial evidence that LCPUFA supplementation of infant formula does not have a clinically meaningful effect on the neurodevelopment as assessed by Bayley scores at 18 months. Inclusion of all relevant data should not have led to differing conclusions except, possibly, for very-low-birthweight infants. JPGN 50:000-000, 2010.
Journal of Developmental & Behavioral Pediatrics, 2008
Background: Neuromotor function in infancy can be evaluated in various ways. Assessment instrumen... more Background: Neuromotor function in infancy can be evaluated in various ways. Assessment instruments are used for early detection of children with a high risk for developmental disorders. Early detection enables clinicians to provide intervention at a young age when plasticity of the nervous system is high. The assessments may also be used to monitor intervention. The present paper will review the psychometric properties of methods to assess neuromotora function in infancy. Methods: A literature search was performed in PubMed, Medline and PsycINFO (1966 to March 2007) on instruments to assess neuromotor functioning of infants. Results: Fifteen instruments were included and classi ed into four groups: 1) Comprehensive neurological examinations (n=4). These techniques are widely used, though little is known about their reliability. Their validity in predicting major developmental disorders such as cerebral palsy is good; their predictive validity for minor motor disorders is moderate at best. 2) Procedures with standardized scoring (n=7). These have good reliability, but only moderate predictive validity for major developmental disorders. No data available for prediction of minor developmental disorders. 3) Observation of milestones (n=2). Its predictive validity for major developmental disorders is only moderate, while reliability is good. 4) Assessment of quality of motor behavior or motor patterns (n=2). These instruments have the best predictive validity for major and minor developmental motor disorders, but current methods are only useful under the age of four months. Conclusion: Prediction of developmental outcome at an early age is di cult. In medical evaluations of high-risk infants the best predictions are achieved through a combination of multiple, complementary tools, that is, achieved milestones, neurological examination and assessment of the quality of motor behavior.
Infant Behavior and Development, 2010
Reaching movements are initiated by activity of the prime mover, i.e. the first activated arm mus... more Reaching movements are initiated by activity of the prime mover, i.e. the first activated arm muscle. We aimed to investigate the relationship between prime mover activity and kinematics of reaching in typically developing (TD) infants in supine and sitting position. Fourteen infants were assessed at 4 and 6 months during reaching in supine and supported sitting. Kinematics and EMG-activity of deltoid, pectoralis major, biceps (BB) and triceps brachii were recorded. Kinematic analysis focused on number of movement units (MUs) and transport MU (MU with longest duration). Prime mover use was variable, but at 6 months a dominance of BB emerged in both testing conditions. Kinematics were also variable, but with increasing age the number of MU decreased and the relative proportion of the transport MU increased. BB as prime mover at 6 months was related to a larger transport MU. Conclusion: Between 4 and 6 months BB prime mover dominance emerges which is related to relatively efficient reaching characteristics.
Fertility and Sterility, 2011
Objective: To evaluate the effect of preimplantation genetic screening (PGS) on neurodevelopmenta... more Objective: To evaluate the effect of preimplantation genetic screening (PGS) on neurodevelopmental outcomes in children. Design: Prospective, assessor-blinded, follow-up study of children born to women randomly assigned to in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) with or without PGS.
Fertility and Sterility, 2010
Objective: To evaluate specific effects of ovarian hyperstimulation, the in vitro procedure, and ... more Objective: To evaluate specific effects of ovarian hyperstimulation, the in vitro procedure, and a history of subfertility on neuromotor development at 3 months of age. Design: Prospective, cohort study. Setting: University Medical Center Groningen, The Netherlands. Patient(s): Singletons conceived after controlled ovarian hyperstimulation-IVF/intracytoplasmic sperm injection (COH-IVF; n ¼ 68) or modified natural cycle-IVF/intracytoplasmic sperm injection (MNC-IVF; n ¼ 57), and naturally conceived singletons of subfertile couples (NC; n ¼ 90). Data from a reference population were available (n ¼ 450). Intervention(s): None. Main Outcome Measure(s): Quality of general movements (GMs), classified as normal-optimal, normal-suboptimal, mildly abnormal, or definitely abnormal. Definitely abnormal GMs indicate brain dysfunction, mildly abnormal GMs normal but non-optimal brain function. Result(s): Mildly abnormal and definitely abnormal GMs were observed equally frequently in COH-IVF, MNC-IVF, and NC singletons. The three subfertile groups showed a reduction in GM quality, in particular more mildly abnormal GMs, in comparison with the reference population. Conclusion(s): Singletons born after IVF (with or without ovarian hyperstimulation) are not at increased risk for abnormal GMs compared with naturally conceived peers of subfertile parents. Mildly abnormal GMs occur more often in infants of subfertile parents than in the general population, suggesting that factors associated with subfertility rather than those related to IVF procedures may be associated with less-optimal early neurodevelopmental outcome. These results need confirmation through replication and follow-up at older ages. (Fertil Steril Ò 2010;93:544-53. Ó2010 by American Society for Reproductive Medicine.
Early Human Development, 2013
Background: In children with developmental disorders, motor problems often co-occur with cognitiv... more Background: In children with developmental disorders, motor problems often co-occur with cognitive difficulties. Associations between specific cognitive deficits underlying learning problems and minor neurological dysfunction (MND) are still unknown. Aims: To assess associations between specific types of MND as clinical markers of non-optimal brain function and performance in specific cognitive domains. Study design: Part of a randomized controlled trial. Subjects: Three hundred and forty one 9-year-old children born at term (177 boys, 164 girls). Outcome measures: Children were neurologically assessed to detect eight types of MND: mild dysfunction in posture and muscle tone, reflexes, coordination, fine manipulative ability, sensory function, cranial nerve function, choreiform dyskinesia and excessive associated movements. Cognitive function in the domains of attention, memory and language was evaluated using the Test of Everyday Attention for Children (TEA-Ch), a developmental neuropsychological assessment (NEPSY) and the Children's Memory Scale. Results: Fine manipulative disability and coordination problems were associated with lower scores on attention, memory and learning and language, other types of MND were not. Girls with coordination problems performed significantly worse on attention/executive function than those without this dysfunction; however, in boys, such association was absent. Conclusion: Particularly, fine manipulative disability and coordination problems were associated with worse cognitive function in the domains of attention, learning and memory and language. Previous and present data suggest a minor sex difference in neurocognitive associations: in girls dysfunction of the cerebello-thalamo-cortical pathways may be associated with cognitive deficits, while in boys cognitive impairment may be associated with dysfunction of cortico-striato-thalamo-cortical pathways.