Publications by authors named "Julie Hofheimer"

Article Synopsis
  • - The study investigates attention problems in children born preterm (<30 weeks gestation) from ages 2 to 5, analyzing factors that influence these attention trajectories and their relationship to ADHD diagnoses.
  • - Using data from 608 infants in a large prospective study, researchers found that while most children displayed low initial attention problems, there were notable individual differences in symptom progression over time.
  • - The findings indicate that children with higher initial attention issues and faster increases in symptoms are at a greater risk for an ADHD diagnosis, highlighting the need for tailored interventions based on individual characteristics.
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Article Synopsis
  • * A study analyzed DNA methylation patterns in buccal cells from VPT infants to see how their gestational age (GA) and age since conception (post-menstrual age, PMA) affect their development.
  • * Researchers found thousands of DNA sites linked to GA and PMA, with pathways related to brain development and growth significantly affected, indicating that early life epigenetic changes are vital for neurodevelopment in preterm infants.
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Importance: Preeclampsia has direct influences on a developing fetus and may impact postnatal health, and fetal growth restriction (FGR) is often seen co-occurring with preeclampsia. The development of children born very preterm after preeclampsia diagnosis with and without FGR is not well characterized.

Objective: To examine the associations of preeclampsia and FGR with developmental and/or behavioral outcomes in a cohort of very preterm infants.

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Objective: Understand how high-risk infants' development changes over time. Examine whether NICU Network Neurobehavioral Scale (NNNS) profiles are associated with decrements in developmental outcomes between ages 2 and 3 years in infants born very preterm.

Study Design: The Neonatal Outcomes for Very preterm Infants (NOVI) cohort is a multisite prospective study of 704 preterm infants born <30 weeks' gestation across nine university and VON affiliated NICUs.

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Objective: To evaluate associations between change in weight z score after neonatal intensive care unit (NICU) discharge and neurodevelopmental outcomes and obesity at 12-48 months of age among individuals born very preterm.

Study Design: This secondary analysis used data from infants born very preterm participating in the Environmental influences on Child Health Outcomes cohort (n = 1400). Growth during infancy was calculated as change in weight z score between NICU discharge and follow-up at a mean of 27 months of age.

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Article Synopsis
  • The study evaluated the Modified Checklist for Autism in Toddlers (M-CHAT) to determine its accuracy as a screening tool for autism in a large sample of nearly 3,400 children from the ECHO program, particularly focusing on both term and preterm children.
  • Results indicated that while the M-CHAT showed high specificity (88-99%), its sensitivity was relatively low (36-60%), suggesting it is better at identifying low-risk children rather than accurately diagnosing those at higher risk for autism.
  • Overall, the findings support the use of M-CHAT as a valuable tool for identifying developmental delays and behavioral concerns in children, even though it has limitations in detecting all cases of autism risk effectively.
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Background: Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology.

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Article Synopsis
  • Bronchopulmonary dysplasia (BPD) in very preterm infants is linked to long-term health issues and might be influenced by changes in glucocorticoid (GC) activity, affecting the hypothalamic-pituitary-adrenal (HPA) axis and its genetics.
  • * DNA methylation (DNAm) of HPA genes was studied using samples from infant tissues, revealing that antenatal steroid exposure correlated with changes in sex-specific methylation, particularly within genes like FKBP5 and POMC related to stress response.
  • * The results indicate that while BPD severity doesn't directly relate to these epigenetic changes, antenatal steroids do, suggesting potential pathways for understanding how preterm birth impacts infant development
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Prior research has identified epigenetic predictors of attention problems in school-aged children but has not yet investigated these in young children, or children at elevated risk of attention problems due to preterm birth. The current study evaluated epigenome-wide associations between neonatal DNA methylation and attention problems at age 2 years in children born very preterm. Participants included 441 children from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a multi-site study of infants born < 30 weeks gestational age.

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Children born less than 30 weeks gestational age (GA) are at high risk for neurodevelopmental delay compared to term peers. Prenatal risk factors and neonatal epigenetics could help identify preterm children at highest risk for poor cognitive outcomes. We aimed to understand the associations among cumulative prenatal risk, neonatal DNA methylation, and child cognitive ability at age 3 years, including whether DNA methylation mediates the association between prenatal risk and cognitive ability.

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Importance: Use of the Modified Checklist for Autism in Toddlers, Revised With Follow-Up, a 2-stage parent-report autism risk screening tool, has been questioned due to reports of poor sensitivity and specificity. How this measure captures developmental delays for very preterm infants may provide support for continued use in pediatric care settings.

Objective: To determine whether autism risk screening with the 2-stage parent-report autism risk screening tool at age 2 years is associated with behavioral and developmental outcomes at age 3 in very preterm infants.

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Objective: Broadband parent rating scales are commonly used to assess behavioral problems in children. Multiple rating scales are available, yet agreement between them is not well-understood. The objective of this study was to evaluate agreement between the Behavior Assessment System for Children, Third Edition (BASC-3), and Child Behavior Checklist 1.

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Epigenetic age acceleration is a risk factor for chronic diseases of ageing and may reflect aspects of biological ageing. However, few studies have examined epigenetic ageing during the early neonatal period in preterm infants, who are at heightened risk of developmental problems. We examined relationships between neonatal age acceleration, neonatal morbidities, and neurobehavioral domains among very preterm (<30 weeks gestation) infants to characterize whether infants with early morbidities or different neurobehavioral characteristics had accelerated or decelerated epigenetic ageing.

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Article Synopsis
  • Researchers developed the Pandemic-Related Traumatic Stress Scale (PTSS) to measure the mental health effects of the COVID-19 pandemic on adolescents and adults, along with caregiver reports for younger children.
  • The study analyzed data from over 18,000 participants, assessing the PTSS's reliability and its relationships with factors like depression and anxiety.
  • Results showed that adult caregivers reported the highest stress levels, with variations based on age, gender, and the age of children being cared for.
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Background: Very preterm infants are at high risk for neurodevelopmental impairments. We used a child-centered approach (latent profile analysis [LPA]) to describe 2-year neurobehavioral profiles for very preterm infants based on cognitive, motor, and behavioral outcomes. We hypothesized that distinct outcome profiles would differ in the severity and co-occurrence of neurodevelopmental and behavioral impairment.

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Objective: To identify neonatal characteristics and 2-year neurodevelopmental outcomes associated with positive screening for risk of autism.

Study Design: Nine university-affiliated neonatal intensive care units (NICUs) enrolled infants born at <30 weeks of gestation. Infants underwent the NICU Network Neurobehavioral Scale examination before discharge and the Bayley Scales of Infant and Toddler Development, Third Edition, the Child Behavior Checklist, and the Modified Checklist for Autism in Toddlers, revised with follow-up (M-CHAT-R/F) at 2 years of corrected age.

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Article Synopsis
  • This study aimed to investigate the link between prenatal risk factors and neurobehavioral impairments in children born before 30 weeks of gestation, both at NICU discharge and at a 24-month follow-up.
  • The research involved 704 newborns from the NOVI study, focusing on maternal health risks categorized as physical and psychological, and assessed neurobehavioral outcomes using established scales.
  • Results showed that children of mothers in high-risk groups faced increased risks for neurobehavioral issues, including severe motor delays and externalizing problems, highlighting the need for identifying at-risk newborns for better support and interventions.
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Objectives: To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use.

Study Design: As part of the Environmental influences on Child Health Outcomes Program, we harmonized prenatal substance use data and child behavior outcomes from 2195 women and their 6- to 11-year-old children across 10 cohorts in the US and used latent class-adjusted regression models to predict parent-rated child behavior.

Results: Three latent classes fit the data: low use (90.

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Importance: Emotional and behavioral dysregulation during early childhood are associated with severe psychiatric, behavioral, and cognitive disorders through adulthood. Identifying the earliest antecedents of persisting emotional and behavioral dysregulation can inform risk detection practices and targeted interventions to promote adaptive developmental trajectories among at-risk children.

Objective: To characterize children's emotional and behavioral regulation trajectories and examine risk factors associated with persisting dysregulation across early childhood.

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Objective: To identify psychological, medical, and socioenvironmental risk factors for maternal postpartum depression (PPD) and severe psychological distress (SPD) at intensive care nursery discharge among mothers of very preterm infants.

Study Design: We studied 562 self-identified mothers of 641 infants born <30 weeks who were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study (NOVI) conducted in nine university-affiliated intensive care nurseries. Enrollment interviews collected socioenvironmental data, depression, and anxiety diagnoses prior to and during the study pregnancy.

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Background: Single-cohort studies have identified distinct neurobehavioral profiles that are associated with prenatal and neonatal factors based on the NICU Network Neurobehavioral Scale (NNNS). We examined socioeconomic, medical, and substance use variables as predictors of NNNS profiles in a multi-cohort study of preterm and term-born infants with different perinatal exposures.

Methods: We studied 1112 infants with a neonatal NNNS exam from the Environmental influences on Child Health Outcomes (ECHO) consortium.

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Importance: Acoustic cry characteristics have been associated with severe medical problems in newborns. However, little is known about the utility of neonatal acoustic cry characteristics in the prediction of long-term outcomes of very preterm infants.

Objectives: To evaluate whether acoustic characteristics of infant cry at neonatal intensive care unit (NICU) discharge are associated with behavioral and developmental outcomes at age 2 years in infants born very preterm.

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Importance: The primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown.

Objectives: To identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms.

Design, Setting, And Participants: This multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program.

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Opioid use has disproportionally impacted pregnant people and their fetuses. Previous studies describing opioid use among pregnant people are limited by geographic location, type of medical coverage, and small sample size. We described characteristics of a large, diverse group of pregnant people who were enrolled in the Environmental Influences on Child Health Outcomes (ECHO) Program, and determined which characteristics were associated with opioid use during pregnancy.

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Objective: To identify neurobehavioural risks in preterm infants with bronchopulmonary dysplasia (BPD) prior to hospital discharge.

Design And Patients: Longitudinal study of 676 newborns born before 30 weeks of gestation.

Setting: Nine university NICUs affiliated with six universities.

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