Article

The aim of this study was to assess the associations between dysmorphic
features and neurological, mental, psychomotor, and behavioural development in
order to improve our understanding of aetiological pathways leading to minor
developmental problems. METHOD: In our cross-sectional study, 272 generally
healthy 2-year-olds (143 males, 129 females; median gestational age 39 weeks,
[range 30-43wks]), born after a parental history of subfertility either with or
without fertility treatment, were examined. Dysmorphic features were classified
as abnormalities (clinically relevant or not), minor anomalies, or common
variants according to Merks' classification system. Hempel's neurological
assessment resulted in a neurological optimality score (NOS) and fluency score.
Mental and psychomotor development were assessed with the Dutch version of the
Bayley Scales of Infant Development and behavioural development with the
Achenbach Child Behaviour Checklist. RESULTS: Of the different types of
dysmorphic feature, clinically relevant abnormalities were most strongly
associated with a lower NOS (difference -2.53, 95% confidence interval [CI] -4.23
to -0.83) and fluency score (difference -0.62, 95% CI -1.1 to -0.15). The
presence of one or more abnormalities (clinically relevant or not) or one or more
common variants was significantly associated with a lower NOS, and the presence
of three or more minor anomalies was associated with lower fluency scores.
Dysmorphic features were not associated with mental, psychomotor, or behavioural
development. INTERPRETATION: As dysmorphic features originate during the first
trimester of pregnancy, the association between dysmorphic features and minor
alterations in neurodevelopment may suggest an early ontogenetic origin of subtle
neurological deviations.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS