Early human development最新文献

{"title":"Optimizing antenatal corticosteroid therapy: Balancing benefit and risk in the era of precision medicine","authors":"Hannah R.S. Watson ,&nbsp;Matthew W. Kemp ,&nbsp;Erin L. Johnson","doi":"10.1016/j.earlhumdev.2025.106389","DOIUrl":"10.1016/j.earlhumdev.2025.106389","url":null,"abstract":"<div><div>Antenatal corticosteroid (ACS) therapy is a cornerstone of modern perinatal care and remains an effective intervention for reducing neonatal morbidity and mortality associated with preterm birth. However, emerging evidence highlights the need for a more refined approach to ACS use, especially with contemporary expansion of the ACS therapy eligible population. A relatively small pool of evidence exists for several sub-populations exposed to ACS therapy, including multiple pregnancies, intrauterine growth restriction and in the setting of chorioamnionitis. This review synthesized current evidence on the pharmacokinetics, efficacy, and safety of ACS, with particular focus on dose optimization, long-term outcomes, and variability in fetal treatment response. We examined the potential of developing tools to assess fetal lung maturation and thus pregnancies that would most benefit from ACS therapy. Additionally, we sought to address emerging concerns regarding ACS overexposure and unintended effects on non-pulmonary fetal systems. The review highlights key knowledge gaps, particularly in relation to long-term neurodevelopmental outcomes, optimal dosing strategies, and tools for individualized risk prediction. Development of precision-based approaches to ACS therapy is essential to ensure maximal benefit and minimal harm across varied clinical contexts in which this intervention is used.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106389"},"PeriodicalIF":2.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Effectiveness of an oral-motor intervention for premature infants: Feeding and maternal self-efficacy\" [Early Human Development 210 (2025) 106382].","authors":"Zohar Meroz, Jennifer R Budman, Aviva Yochman, Alona Bin-Nun, Anat Golos","doi":"10.1016/j.earlhumdev.2025.106390","DOIUrl":"https://doi.org/10.1016/j.earlhumdev.2025.106390","url":null,"abstract":"","PeriodicalId":11435,"journal":{"name":"Early human development","volume":" ","pages":"106390"},"PeriodicalIF":2.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between 2D:4D digit ratios and metabolic markers and hormonal parameters in children with premature adrenarche: A cross-sectional study from Türkiye","authors":"Pınar Koç ,&nbsp;Ayça Kömürlüoğlu ,&nbsp;Nurullah Çelik","doi":"10.1016/j.earlhumdev.2025.106391","DOIUrl":"10.1016/j.earlhumdev.2025.106391","url":null,"abstract":"<div><h3>Background</h3><div>The appearance of pubic or axillary hair before the age of eight in girls or nine in boys, without other signs of puberty, is defined as premature adrenarche (PA) and may be an early sign of the metabolic syndrome. The second to fourth digit ratio (2D:4D), thought to reflect prenatal androgen exposure, has been associated with a variety of behavioral, metabolic, and hormonal conditions.</div></div><div><h3>Objective</h3><div>To evaluate the relationship between 2D:4D digit ratios and anthropometric, metabolic, and hormonal parameters in children with PA.</div></div><div><h3>Methods</h3><div>This cross-sectional study evaluated a Turkish sample of 49 children diagnosed with PA and 41 healthy controls, who were matched for age and gender. Anthropometric measurements, pubertal staging, biochemical and hormonal profiles, and bilateral 2D:4D ratios were recorded. Insulin resistance was assessed using the HOMA-IR, FGIR and QUICKI indices. Correlations between digit ratios and metabolic/hormonal markers were analyzed.</div></div><div><h3>Results</h3><div>Children with PA had significantly higher Body Mass Index (BMI), waist circumference, fasting glucose, insulin, HOMA-IR and DHEA-S levels, and lower QUICKI and FGIR values compared to controls (<em>p</em> &lt; 0.05). No significant differences were found in 2D:4D ratios between groups. However, in the PA group, the left-hand 2D:4D ratio showed a negative correlation with DHEA-S and systolic blood pressure standard deviation scores (SDS) and a positive correlation with the waist-to-hip ratio (WHR), suggesting early hormonal and cardiovascular alterations in PA. In multivariable regression analysis, only DHEA-S found as an independent negative predictor of the left-hand 2D:4D ratio.</div></div><div><h3>Conclusion</h3><div>Although 2D:4D ratios may not distinguish between PA and controls, the left-hand 2D:4D ratio may serve as a subtle anthropometric marker reflecting hormonal and metabolic variations in children with PA. In multivariable regression, only DHEA-S remained an independent negative predictor of the left-hand 2D:4D ratio, highlighting the role of adrenal androgens in shaping digit ratio patterns in PA. Given the well-established link between PA and an increased risk of developing metabolic syndrome during adolescence, analysing digit ratios may provide additional value in the early assessment of metabolic risk.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106391"},"PeriodicalIF":2.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth deficits and craniofacial dynamics in preschool children with microcephaly: A comprehensive study","authors":"Anusha Doraiswamy ,&nbsp;Neha Sudhera ,&nbsp;Arushi Gahlot Saini ,&nbsp;A.K. Bhalla ,&nbsp;Pratibha Singhi ,&nbsp;Harvinder Kaur","doi":"10.1016/j.earlhumdev.2025.106392","DOIUrl":"10.1016/j.earlhumdev.2025.106392","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to examine physical and craniofacial growth patterns in preschool-aged children with microcephaly and evaluate their potential clinical significance.</div></div><div><h3>Methods</h3><div>A total of 130 children (76 boys, 54 girls) aged 1–5 years with microcephaly (head circumference &lt;−3 standard deviations) were enrolled in this prospective study at a tertiary care hospital, with 130 age- and sex-matched healthy controls. Nine craniofacial dimensions (head circumference, head length, head width, physiognomic facial length, morphological facial length, minimum frontal diameter, bizygomatic diameter, bigonial diameter, and total jaw height) were measured every six months using standardized techniques and instruments. Body weight and height were also recorded. Data analysis involved comparison of growth parameters using Mann-Whitney tests and correlation analysis to explore relationships between head circumference and other physical measurements.</div></div><div><h3>Results</h3><div>Children with microcephaly exhibited significantly reduced body weight, height, and cranial dimensions compared to controls (<em>p</em> &lt; 0.001). There was a higher incidence of underweight (36.69 %), stunted (40.89 %), and wasted (34.45 %) children within this group. The majority of microcephalic children had a brachycephalic head shape, with broad faces and wide foreheads. Facial measurements differed by sex: boys showed shorter physiognomic facial lengths, while girls had longer faces, suggesting sex-specific craniofacial trends in microcephaly. A significant correlation was found between head circumference and body dimensions, though jaw-related measurements were independent.</div></div><div><h3>Conclusions</h3><div>Children with microcephaly demonstrated considerable growth deficits and altered craniofacial development emphasizing the need for comprehensive assessments. The findings highlight the importance of early, targeted interventions to address the complex growth and developmental challenges in these children.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106392"},"PeriodicalIF":2.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of multisensory stimulation and priming (MuSSAP) upper limb training in 3–8 months old infants with unilateral brain lesion – a retrospective clinical cohort study","authors":"Anke Verhaegh ,&nbsp;Lisa Mailleux ,&nbsp;Maria Nijhuis-van der Sanden ,&nbsp;Pauline Aarts ,&nbsp;Michèl Willemsen ,&nbsp;Brenda Groen","doi":"10.1016/j.earlhumdev.2025.106388","DOIUrl":"10.1016/j.earlhumdev.2025.106388","url":null,"abstract":"<div><h3>Introduction</h3><div>Multi Sensory Stimulation And Priming (MuSSAP) is an early upper limb training for infants at high risk of unilateral cerebral palsy (CP). MuSSAP is designed to enhance awareness of the affected upper limb facilitating initiation of goal-directed movements. This study assesses the effectiveness of an 8-week MuSSAP training on manual ability in a clinical setting.</div></div><div><h3>Participants and methods</h3><div>Twenty-eight infants (mean corrected age at T0: 5.0 months) were included in a retrospective clinical cohort study with assessments pre- (T0), post- (T1) and at 8-week follow-up (T2) using the Hand Assessment for Infants (HAI). The primary outcome was the HAI ‘affected hand score’, secondary outcomes included the ‘unit score’ and item 1 (‘initiates to side’). Data were analysed using linear mixed models.</div></div><div><h3>Results</h3><div>HAI scores improved between T0-T1 (<em>n</em> = 25) for both affected hand score (estimate: 3.2, <em>p</em> &lt; 0.001), and unit score (estimate: 9.7, p &lt; 0.001). Scores remained stable between T1-T2. The number of infants who never initiated or only when restrained/sometimes initiated or only when prompted/almost always spontaneously initiated goal-directed movements changed from 8/13/7 at T0 to 5/5/15 at T1 (three missing). Of the five infants who did not initiate goal-directed movements after training, three had drug-resistant epilepsy.</div></div><div><h3>Conclusion</h3><div>MuSSAP appears to improve manual ability in infants at high risk of unilateral CP in a clinical setting. A larger randomized controlled trial incorporating brain-based measures is needed to further investigate its effectiveness and working mechanism, especially for infants who do not initiate goal-directed movements with the affected upper limb.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106388"},"PeriodicalIF":2.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in EEG functional connectivity in preterm infants: A systematic review","authors":"Jiaqi Li ,&nbsp;Chunjie Jiang ,&nbsp;Xin Xu ,&nbsp;Guoqiang Cheng","doi":"10.1016/j.earlhumdev.2025.106387","DOIUrl":"10.1016/j.earlhumdev.2025.106387","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesise current evidence on electroencephalography-based functional connectivity in preterm infants and clarify how prematurity alters early brain-network maturation.</div></div><div><h3>Methods</h3><div>A PRISMA-guided search (PubMed and Web of Science, inception–Mar 2025) identified 24 studies that quantified resting-state functional connectivity or graph-theory metrics in infants born &lt;37 weeks' gestation. Study quality was rated with a six-item electroencephalography-functional connectivity checklist (reference montage, epoch length/number, artefact rejection, volume-conduction control, multiple-comparison correction).</div></div><div><h3>Results</h3><div>Across studies, neonatal functional connectivity development showed patterns that varied by frequency band, postmenstrual age, and behavioural state. Reported trends included decreasing delta-band coherence with advancing postmenstrual age, increasing frontal theta synchrony, and sleep-state differences in which active sleep more often featured focal high-frequency coupling, whereas quiet sleep involved broader low-frequency integration. Some longitudinal and follow-up studies suggested beta-band connectivity alterations and changes in network topology that may persist into adolescence or adulthood. Graph-theoretical analyses generally described a shift from neonatal small-world organization toward greater segregation, although preterm groups in several studies showed higher clustering and lower efficiency than controls. Methodological heterogeneity was notable, with only one study fulfilling all quality criteria; common limitations included low-density montages (≤ 32 channels) and lack of multiple-comparison control.</div></div><div><h3>Conclusions</h3><div>Prematurity induces lasting alterations in segregation–integration balance and frequency-specific coupling that relate to later cognitive and motor outcomes. Methodological heterogeneity and small samples, however, limit cross-study comparability.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106387"},"PeriodicalIF":2.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of father-infant attachment security in a Portuguese sample","authors":"Rita Almeida ,&nbsp;Luísa Barros ,&nbsp;Margarida Santos ,&nbsp;Marjorie Beeghly ,&nbsp;Marina Fuertes","doi":"10.1016/j.earlhumdev.2025.106374","DOIUrl":"10.1016/j.earlhumdev.2025.106374","url":null,"abstract":"<div><div>A growing literature shows that fathers play a critical role in their children's development and mental health. However, few studies have evaluated fathers as caregivers and attachment figures, particularly across cultures. We address this gap by investigating specific predictors of infant-father attachment patterns during the first year postpartum and their links to infant-father attachment at 12 months. The sample included Portuguese father-infant dyads who were recruited at the infant's birth and followed longitudinally to 12 months. At 3 and 9 months, dyads were observed during free play and the Face-to-Face Still-Face paradigm (FFSF). Fathers also reported on their involvement in daily caregiving activities. At 12 months, father-infant dyads were observed in Ainsworth's Strange Situation paradigm (SSP), and fathers reported on their parenting stress. Results showed that multiple infant and paternal variables were associated with secure attachment at 12 months, including a social-positive regulatory pattern exhibited in the FFSF at 9 months, greater paternal sensitivity and less control, and more infant cooperation, during free play at 3 and 9 months, and greater paternal involvement in specific caregiving activities at 9 months. Fathers of infants with a disorganized attachment were less involved in play interactions at 3 and 9 months, and their infants exhibited less cooperative behavior and were more likely to display an inconsolable regulatory pattern during the FFSF. Results of binary logistic regression indicate that 9-month paternal sensitivity and control predicted secure attachment. This study confirms the uniqueness of father-infant relationships.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106374"},"PeriodicalIF":2.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation of automated oxygen control in preterm infants in the NICU: A 5-year single centre real-world experience","authors":"Fleur Brouwer ,&nbsp;Sophie J.E. Cramer ,&nbsp;Ratna N.G.B. Tan ,&nbsp;Arjan B. te Pas ,&nbsp;Janneke Dekker","doi":"10.1016/j.earlhumdev.2025.106386","DOIUrl":"10.1016/j.earlhumdev.2025.106386","url":null,"abstract":"<div><h3>Objective</h3><div>With AOC integrated as standard care, this study aimed to evaluate the experience of discontinuation in a real-world single centre setting.</div></div><div><h3>Methods</h3><div>This observational study at Leiden University Medical Centre combined focus groups, which explored caregivers' criteria for AOC discontinuation and restart, with a retrospective analysis of preterm infants (24–37 weeks gestation) who received AOC for ≥24 h. This analysis assessed caregivers' decision-making regarding AOC discontinuation, success rate and clinical parameters within 48 hour post-discontinuation.</div></div><div><h3>Results</h3><div>Discontinuation decisions were based on FiO₂ levels and variability over the preceding 24 h. Among 172 infants, the success rate was 78.5 %, varying by gestational age (GA): 50 % for extremely preterm (&lt;28 weeks), 84.8 % for very preterm (28–32 weeks), and 84.0 % for preterm infants (&gt;32 weeks) (<em>p</em> &lt; 0.001).</div><div>Clinical parameters over the 48 hour post-discontinuation differed between infants who successfully discontinued and those requiring a restart. Extremely preterm infants showed lower SpO₂ levels, reflecting a leftward shift in SpO₂ distribution post-discontinuation and prolonged instability during the restart phase. Very preterm infants showed a similar shift, though less pronounced, while preterm infants maintained SpO₂ levels above 90 %. Further analysis revealed extremely preterm infants exhibited greater SpO₂ fluctuations, which further increases after AOC restart. Variability in FiO₂ increased across all GA subgroups after AOC restart, with the most significant increase in extremely preterm infants.</div></div><div><h3>Conclusion</h3><div>AOC discontinuation success rates vary by GA, with extremely preterm infants facing the most difficulty maintaining stable oxygenation, even after AOC restart.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106386"},"PeriodicalIF":2.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an oral-motor intervention for premature infants: Feeding and maternal self-efficacy","authors":"Zohar Meroz ,&nbsp;Jennifer R. Budman ,&nbsp;Aviva Yochman ,&nbsp;Alona Bin-Nun ,&nbsp;Anat Golos","doi":"10.1016/j.earlhumdev.2025.106382","DOIUrl":"10.1016/j.earlhumdev.2025.106382","url":null,"abstract":"<div><h3>Objective</h3><div>This pilot study examines the effects of a non-invasive mother-administered oral motor stimulation intervention incorporating maternal breast milk, on feeding quality, and maternal self-efficacy, which has not previously been examined.</div></div><div><h3>Background</h3><div>Preterm infants are at risk of feeding difficulties, and while oral motor interventions have demonstrated efficacy, few have examined outcomes related to parental self-efficacy.</div></div><div><h3>Methods</h3><div>In a controlled prospective pilot study, 46 preterm infants were randomly assigned to intervention (<em>n</em> = 26) or control (<em>n</em> = 20) groups. The intervention group received an oral-motor stimulation program using breast milk, which involved mothers performing external oral stimulation followed by non-nutritive sucking with breast milk for 10 min, twice a day, over a 10-day period. The control group received routine care.</div></div><div><h3>Results</h3><div>Intervention group showed significantly improved oral feeding quality as measured by the Infant-Driven Feeding Scales (IDFS). No significant group differences were observed in days to full oral feeding or hospital stay length. Maternal parenting self-efficacy increased significantly over time for both groups, with no significant group differences. Intervention's feasibility showed through intervention group mothers' reports that it is an applicable treatment, contributes to strengthening mother-infant bond, maternal sense of self-efficacy in the general care of their preterm infants, particularly in feeding them</div></div><div><h3>Conclusions</h3><div>Non-invasive oral motor stimulation using breast milk promotes oral feeding quality in preterm infants.</div></div><div><h3>Implications</h3><div>Implementation of this intervention by mothers, at early hospitalization stages, may strengthen maternal self-efficacy, especially in acquiring feeding skills.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106382"},"PeriodicalIF":2.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of chorionicity and histological chorioamnionitis on neurodevelopment and mortality in extremely preterm twins","authors":"Shuji Ishida ,&nbsp;Hidehiko Nakanishi ,&nbsp;Rika Sekiya ,&nbsp;Kohei Kawada ,&nbsp;Yukako Kosaka ,&nbsp;Ayano Yamaguchi ,&nbsp;Mari Ooka ,&nbsp;Neonatal Research Network, Japan","doi":"10.1016/j.earlhumdev.2025.106370","DOIUrl":"10.1016/j.earlhumdev.2025.106370","url":null,"abstract":"<div><h3>Background</h3><div>Histological chorioamnionitis (HCAM) is associated with adverse neurodevelopmental outcomes; however, its role in extremely preterm twin pregnancies (&lt;28 weeks of gestation), particularly in relation to chorionicity, is unclear.</div></div><div><h3>Objective</h3><div>To evaluate the association between HCAM severity and neurodevelopmental outcomes at 3 years old in extremely preterm twins, focusing on the modifying effect of chorionicity.</div></div><div><h3>Methods</h3><div>Utilizing data from the Neonatal Research Network of Japan (2004–2020), this retrospective cohort study included twins born at &lt;28 weeks' gestation and birth weight &lt; 1500 g. HCAM severity was classified based on Blanc's criteria. Primary outcomes were cerebral palsy (CP) and developmental quotient (DQ) &lt; 70 at 3 years old, assessed using the Kyoto Scale of Psychological Development. Secondary outcomes included death before neonatal intensive care unit (NICU) discharge and a composite outcome of death, including CP or DQ &lt; 70. Multivariate logistic regression was performed adjusting for confounders and including interaction terms.</div></div><div><h3>Results</h3><div>Among 1249 infants, HCAM severity was not significantly associated with CP or DQ &lt; 70 in monochorionic diamniotic (MD) or dichorionic diamniotic (DD) twins. MD twins exhibited a significantly higher mortality risk than DD twins (adjusted odds ratio: 1.73; 95 % confidence intervals: 1.22–2.46). Moreover, significant interaction between HCAM and chorionicity was not observed for mortality.</div></div><div><h3>Conclusion</h3><div>In this large, multicenter cohort of extremely preterm twins, HCAM was not associated with adverse neurodevelopmental outcomes or early mortality. However, monochorionic status was independently associated with increased NICU mortality, highlighting the predominant role of chorionicity in twin pregnancy–related outcomes.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"210 ","pages":"Article 106370"},"PeriodicalIF":2.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}