Pediatric development generally refers to two types: physical development – growth in height, weight, etc.; and organ and system development. Neurodevelopment, especially brain development, is very important in pediatric development. Developmental delay or psychomotor retardation in general refers to neurodevelopment, i.e., brain development. Delayed brain development is not an uncommon abnormality in the pediatric population. When a child is diagnosed with a developmental delay or psychomotor retardation, one of the main concerns of parents is: why did the brain delay occur? The causes are varied, complex, and sometimes may not be found.
I. Adverse factors in the fetal period that affect brain development.
1. Maternal factors.
High-risk factors at the time of pregnancy
(1) age: under 18 years old and over 40 years old for delivery, over 35 years old for first-time mothers
(2) Past history of pregnancy and delivery: history of habitual abortion, multiple births, immature babies, malformed babies and huge babies
(3) bleeding from sexual organs in early pregnancy (pre-eclampsia, etc.)
(4) Teratogenic viral infections during the third trimester of pregnancy: rubella, cytomegalovirus infection
(5) radiation exposure
(6) Smoking and drinking habits, excessive coffee consumption
(7) diabetes mellitus, hypertension and other endocrine diseases
(8) Obesity
(9) Elevated antibodies in Rh-negative individuals
(10) Pregnancy toxicity, especially severe
(11) Infections in pregnancy: giant cell, toxoplasmosis, syphilis, tuberculosis, chronic urinary tract infections and herpes simplex, etc.
(12) serious illnesses in pregnancy: heart disease, kidney disease, liver disease, nutritional disorders and psychiatric disorders, etc.
(13) Long-term use of therapeutic drugs: anti-cancer agents, steroid therapy, anti-epileptic agents
(14) Severe anemia
2.High risk factors during delivery
(1) Delayed delivery time: 24 hours for the first delivery, 12 hours for the second delivery, and more than 4 hours for the second delivery
(2) Early (early) water breakage: more than 24 hours before delivery
(3) Multiple births
(4) Early placental abruption
(5) Placenta praevia
(6) Amniotic fluid abnormalities: muddy and cloudy, excessive amniotic fluid
(7) Abnormal umbilical cord: prolapse, prolapse, thin
(8) Umbilical cord wrapping around the neck
(9) Fetal distress
(10) High or intermediate forceps
(11) Emergency cesarean delivery
(12) Breech position and transverse position
(13) Placental insufficiency
B. High risk factors for newborns after birth
(1) Birth weight: less than 2.5 kg and more than 4.1 kg, especially less than 2.0 kg
(2) Birth weeks less than 34 weeks or more than 43 weeks
(3) Less than gestational age
(4) Asphyxia: Apgar score below 3 at 1 minute and below 5 at 5 minutes
(5) Multiple malformations and degenerative diseases
(6) Birth injury
(7) Respiratory disorders
(8) Cerebrospinal meningitis, herpetic hepatitis
(9) Abnormal symptoms of the central nervous system: convulsions, breastfeeding disorders
(10) Cerebral hemorrhage: brain parenchyma, intraventricular hemorrhage and subarachnoid hemorrhage
(11) Neonatal hypoglycemia
(12) Pathological jaundice
(3) Genetic diseases, metabolic diseases
(4) Socio-cultural causes, etc.
Generally, medical diseases caused by the environment account for 50%, genetic factors account for 20%, socio-cultural causes account for 10%, and unknown causes account for about 20%.