Growth of children whose mothers have depressive symptoms

Birth weight and CNS tumors —Robert W. Wilmott, MD

Growth of children whose mothers have depressive symptoms —Sarah S. Long, MD

Neurodevelopment in children with hypoplastic left heart syndrome —Stephen R. Daniels, MD, PhD

How important is a bicuspid aortic valve? —Stephen R. Daniels, MD, PhD

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he relationship between birth weight, birth order, and the risk of central nervous system tumors in childhood was evaluated by MacLean et al from Stanford University. The results of this study show that the risk of high-grade gliomas increases with birth order and birth weight. The authors speculate that factors that drive growth in utero may alter the risk of gliomas. Article page 450 <

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nvestigators in Pelotas in southern Brazil entered an entire 2004 birth cohort of infants and mothers into a 4-year study to assess the effect of sustained maternal depression on children’s growth. A remarkably high rate of depression (17.9%) and persistent depression (4.7%) was observed in mothers. In crude analysis, maternal depression was associated with underweight and stunting. After adjusted analyses for confounding variables, however, maternal depression was not associated with anthropometric abnormalities, suggesting that both are the consequences of multiple adversities. In the accompanying editorial, Grupp-Phelan both praises many aspects of the study and cautions interpretation of this and many studies that attempt to bring into black-and-white relief a highly complex, intertwined set of risk factors for maternal and child morbidities, as well as data for analysis. Article page 401 < Editorial page 359 <

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here are concerns about neurodevelopment in patients with hypoplastic left heart syndrome as successful surgical treatment becomes more common. In this issue of The Journal, Sarajuuri et al compared neurodevelopment at a median age of 30 months in patients with hypoplastic left heart syndrome, univentricular heart, and healthy controls. The mean developmental index was lower in patients with hypoplastic left heart syndrome compared with patients with other forms of single ventricle and controls. The mean psychomotor developmental index was lower for both groups with congenital heart disease compared with controls. It is clear that ongoing neurodevelopmental assessment is needed for patients with hypoplastic left heart syndrome, but psychomotor assessment may be needed more broadly for patients with complex congenital heart disease. Article page 414 <

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icuspid aortic valve is the most common congenital anomaly in children, with a prevalence of 1% or more in the general population. It usually has been considered to be a relatively unimportant defect, but good epidemiologic data have been lacking. In this issue of the Journal, Mahle et al review information from a large single institutional cohort with isolated bicuspid aortic valve. They found a low incidence of adverse cardiac events. Patients with bicuspid aortic valve may develop mild ascending aortic dilation, but this was not clinically important, and aortic dissection did not occur. However, it is not known if aortic dilation could be progressive with aging in some patients. Longer term follow up is required. Article page 445 <

Vol. 157, No. 3