Delayed development of neural language organization in very preterm born children.

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Mürner-Lavanchy, Ines; Steinlin, Maja; Kiefer, Claus; Weisstanner, Christian; Ritter, Barbara Catherine; Perrig, Walter; Everts, Regula

2014-01-01

This study investigates neural language organization in very preterm born children compared to control children and examines the relationship between language organization, age, and language performance. Fifty-six preterms and 38 controls (7-12 y) completed a functional magnetic resonance imaging language task. Lateralization and signal change were computed for language-relevant brain regions. Younger preterms showed a bilateral language network whereas older preterms revealed left-sided language organization. No age-related differences in language organization were observed in controls. Results indicate that preterms maintain atypical bilateral language organization longer than term born controls. This might reflect a delay of neural language organization due to very premature birth.

Preterm children have unfavorable motor, cognitive, and functional performance when compared to term children of preschool age.

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Maggi, Eliane F; Magalhães, Lívia C; Campos, Alexandre F; Bouzada, Maria Cândida F

2014-01-01

to compare the motor coordination, cognitive, and functional development of preterm and term children at the age of 4 years. this was a cross-sectional study of 124 four-year-old children, distributed in two different groups, according to gestational age and birth weight, paired by gender, age, and socioeconomic level. All children were evaluated by the Movement Assessment Battery for Children - second edition (MABC-2), the Pediatric Evaluation of Disability Inventory (PEDI), and the Columbia Mental Maturity Scale (CMMS). preterm children had worse performance in all tests, and 29.1% of the preterm and 6.5% of term groups had scores on the MABC-2 indicative of motor coordination disorder (p=0.002). In the CMMS (p=0.034), the median of the standardized score for the preterm group was 99.0 (± 13.75) and 103.0 (± 12.25) for the term group; on the PEDI, preterm children showed more limited skill repertoire (p=0.001) and required more assistance from the caregiver (p=0.010) than term children. this study reinforced the evidence that preterm children from different socioeconomic backgrounds are more likely to have motor, cognitive, and functional development impairment, detectable before school age, than their term peers. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Behavior Problems in Relation to Sustained Selective Attention Skills of Moderately Preterm Children.

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Bul, Kim C M; van Baar, Anneloes L

2012-04-01

Attention skills may form an important developmental mechanism. A mediation model was examined in which behavioral problems of moderately preterm and term children at school age are explained by attention performance. Parents and teachers completed behavioral assessments of 348 moderately preterm children and 182 term children at 8 years of age. Children were administered a test of sustained selective attention. Preterm birth was associated with more behavioral and attention difficulties. Gestational age, prenatal maternal smoking, and gender were associated with mothers', fathers', and teachers' reports of children's problem behavior. Sustained selective attention partially mediated the relationship between birth status and problem behavior. Development of attention skills should be an important focus for future research in moderately preterm children.

Nature and origins of mathematics difficulties in very preterm children: a different etiology than developmental dyscalculia.

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Simms, Victoria; Gilmore, Camilla; Cragg, Lucy; Clayton, Sarah; Marlow, Neil; Johnson, Samantha

2015-02-01

Children born very preterm (mathematics learning difficulties that are out of proportion to other academic and cognitive deficits. However, the etiology of mathematics difficulties in very preterm children is unknown. We sought to identify the nature and origins of preterm children's mathematics difficulties. One hundred and fifteen very preterm children aged 8-10 y were assessed in school with a control group of 77 term-born classmates. Achievement in mathematics, working memory, visuospatial processing, inhibition, and processing speed were assessed using standardized tests. Numerical representations and specific mathematics skills were assessed using experimental tests. Very preterm children had significantly poorer mathematics achievement, working memory, and visuospatial skills than term-born controls. Although preterm children had poorer performance in specific mathematics skills, there was no evidence of imprecise numerical representations. Difficulties in mathematics were associated with deficits in visuospatial processing and working memory. Mathematics difficulties in very preterm children are associated with deficits in working memory and visuospatial processing not numerical representations. Thus, very preterm children's mathematics difficulties are different in nature from those of children with developmental dyscalculia. Interventions targeting general cognitive problems, rather than numerical representations, may improve very preterm children's mathematics achievement.

Language functions in preterm-born children: a systematic review and meta-analysis.

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van Noort-van der Spek, Inge L; Franken, Marie-Christine J P; Weisglas-Kuperus, Nynke

2012-04-01

Preterm-born children (language function problems compared with term-born children. It is unknown whether these problems decrease, deteriorate, or remain stable over time. The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age. Computerized databases Embase, PubMed, Web of Knowledge, and PsycInfo were searched for studies published between January 1995 and March 2011 reporting language functions in preterm-born children. Outcome measures were simple language function assessed by using the Peabody Picture Vocabulary Test and complex language function assessed by using the Clinical Evaluation of Language Fundamentals. Pooled effect sizes (in terms of Cohen's d) and 95% confidence intervals (CI) for simple and complex language functions were calculated by using random-effects models. Meta-regression was conducted with mean difference of effect size as the outcome variable and assessment age as the explanatory variable. Preterm-born children scored significantly lower compared with term-born children on simple (d = -0.45 [95% CI: -0.59 to -0.30]; P language function tests, even in the absence of major disabilities and independent of social economic status. For complex language function (but not for simple language function), group differences between preterm- and term-born children increased significantly from 3 to 12 years of age (slope = -0.05; P = .03). While growing up, preterm-born children have increasing difficulties with complex language function.

Behavior Problems in Relation to Sustained Selective Attention Skills of Moderately Preterm Children

OpenAIRE

Bul, Kim C. M.; van Baar, Anneloes L.

2011-01-01

Attention skills may form an important developmental mechanism. A mediation model was examined in which behavioral problems of moderately preterm and term children at school age are explained by attention performance. Parents and teachers completed behavioral assessments of 348 moderately preterm children and 182 term children at 8 years of age. Children were administered a test of sustained selective attention. Preterm birth was associated with more behavioral and attention difficulties. Ges...

Preterm Versus Term Children: Analysis of Sedation/Anesthesia Adverse Events and Longitudinal Risk.

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Havidich, Jeana E; Beach, Michael; Dierdorf, Stephen F; Onega, Tracy; Suresh, Gautham; Cravero, Joseph P

2016-03-01

Preterm and former preterm children frequently require sedation/anesthesia for diagnostic and therapeutic procedures. Our objective was to determine the age at which children who are born risk for sedation/anesthesia adverse events. Our secondary objective was to describe the nature and incidence of adverse events. This is a prospective observational study of children receiving sedation/anesthesia for diagnostic and/or therapeutic procedures outside of the operating room by the Pediatric Sedation Research Consortium. A total of 57,227 patients 0 to 22 years of age were eligible for this study. All adverse events and descriptive terms were predefined. Logistic regression and locally weighted scatterplot regression were used for analysis. Preterm and former preterm children had higher adverse event rates (14.7% vs 8.5%) compared with children born at term. Our analysis revealed a biphasic pattern for the development of adverse sedation/anesthesia events. Airway and respiratory adverse events were most commonly reported. MRI scans were the most commonly performed procedures in both categories of patients. Patients born preterm are nearly twice as likely to develop sedation/anesthesia adverse events, and this risk continues up to 23 years of age. We recommend obtaining birth history during the formulation of an anesthetic/sedation plan, with heightened awareness that preterm and former preterm children may be at increased risk. Further prospective studies focusing on the etiology and prevention of adverse events in former preterm patients are warranted. Copyright © 2016 by the American Academy of Pediatrics.

Differential effects of parenting in preterm and full-term children on developmental outcomes.

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Maupin, Angela N; Fine, Jodene Goldenring

2014-12-01

To examine the relations between preterm birth, parenting behavior during early childhood, cognitive development, and social-emotional outcomes at Kindergarten entry, and to determine whether parenting behavior differentially influences this developing system in children born preterm compared to children born full-term. The nationally representative sample comprised 3600 full-term and 1300 preterm children born in the US in the year 2001. All children who entered Kindergarten and who participated in data collection at 9 months, 24 months, and Kindergarten entry were included in the study. Measures of parenting behavior were collected at 9 and 24 months and cognitive development at 24 months via home visits. Social-emotional outcomes were assessed at Kindergarten entry via parent and teacher report. Multiple-sample Structural Equation Modeling was used to analyze group differences in a model whereby early childhood parenting behavior predicted cognitive outcomes, and social-emotional outcomes at Kindergarten entry, and indirectly predicted social-emotional outcomes via early cognitive processes. The full sample developmental model indicated excellent fit to the data. Preterm birth status indirectly influenced social-emotional outcomes at Kindergarten entry via its effect on early childhood parenting behavior and cognitive development. The multi-sample model revealed significant differences in the way in which early parenting behavior exerted its influence on outcomes at Kindergarten entry in preterm children compared to full-term children. For preterm children, parenting indirectly influenced social-emotional outcomes via early cognitive functioning. Findings highlight the importance of early identification and targeted parenting programs to support early cognitive development in preterm children. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diffuse periventricular leukomalacia in preterm children: assessment of grey matter changes by MRI

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Tzarouchi, L.C.; Xydis, V.; Zikou, A.K.; Papastefanaki, M.; Argyropoulou, Maria I.; Drougia, A.; Andronikou, S.; Astrakas, L.G.

2011-01-01

Preterm children may have cognitive deficits and behavioural disorders suggestive of grey matter (GM) injury. The prevalence is higher in preterm children with diffuse periventricular leukomalacia (dPVL). Evaluate changes in the volume of 116 GM areas in preterm children with dPVL. Eleven preterm children with dPVL, gestational age 32.8 ± 2.6 weeks, examined at corrected age 22.0 ± 18.2 months and 33 matched preterm controls with normal brain MRI were studied. Volumes of 116 individual GM areas, and white matter/cerebrospinal fluid (WM/CSF) ratio were calculated on T1-weighted high-resolution images after segmentation. Relative to controls, children with dPVL had decreased GM volume of the hippocampus, amygdala, and frontal lobes and temporal middle gyrus (P < 0.05); increased GM volume of the putamen, thalamus, globus pallidum, superior temporal gyrus and of the parietal and occipital lobes (P < 0.05) and lower WM volume/higher CSF volume (P < 0.05). WM/CSF ratios also differed (P < 0.05). Preterm children with dPVL have increased regional GM volume in some areas probably related with a process of brain plasticity-regeneration and reduced GM volume in areas associated with cognition and memory. (orig.)

Diffuse periventricular leukomalacia in preterm children: assessment of grey matter changes by MRI

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Tzarouchi, L.C.; Xydis, V.; Zikou, A.K.; Papastefanaki, M.; Argyropoulou, Maria I. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Drougia, A.; Andronikou, S. [University of Ioannina, Neonatal Intensive Care Unit, Child Health Department, Medical School, Ioannina (Greece); Astrakas, L.G. [University of Ioannina, Department of Medical Physics, Medical School, Ioannina (Greece)

2011-12-15

Preterm children may have cognitive deficits and behavioural disorders suggestive of grey matter (GM) injury. The prevalence is higher in preterm children with diffuse periventricular leukomalacia (dPVL). Evaluate changes in the volume of 116 GM areas in preterm children with dPVL. Eleven preterm children with dPVL, gestational age 32.8 {+-} 2.6 weeks, examined at corrected age 22.0 {+-} 18.2 months and 33 matched preterm controls with normal brain MRI were studied. Volumes of 116 individual GM areas, and white matter/cerebrospinal fluid (WM/CSF) ratio were calculated on T1-weighted high-resolution images after segmentation. Relative to controls, children with dPVL had decreased GM volume of the hippocampus, amygdala, and frontal lobes and temporal middle gyrus (P < 0.05); increased GM volume of the putamen, thalamus, globus pallidum, superior temporal gyrus and of the parietal and occipital lobes (P < 0.05) and lower WM volume/higher CSF volume (P < 0.05). WM/CSF ratios also differed (P < 0.05). Preterm children with dPVL have increased regional GM volume in some areas probably related with a process of brain plasticity-regeneration and reduced GM volume in areas associated with cognition and memory. (orig.)

Factors associated with preterm, early preterm and late preterm birth in Malawi.

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Nynke R van den Broek

Full Text Available Assessment of risk factors for preterm birth in a population with high incidence of preterm birth and HIV infection.Secondary analysis of data for 2,149 women included in a community based randomized placebo controlled trial for the prevention of preterm birth (APPLe trial (ISRCTN84023116 with gestational age at birth determined through ultrasound measurement in early pregnancy. Multivariate Logistic Regression analyses to obtain models for three outcome variables: all preterm, early preterm, and late preterm birth.No statistical differences were noted for the prevalence of HIV infection (p = 0.30 or syphilis (p = 0.12 between women who delivered preterm versus term. BMI (Adjusted OR 0.91 (0.85-0.97; p = 0.005 and weight gain (Adjusted OR 0.89 (0.82-0.97; p = 0.006 had an independent, protective effect. Previous preterm birth doubled the odds of preterm birth (Adjusted OR 2.13 (1.198-3.80; p = 0.01. Persistent malaria (despite malaria prophylaxis increased the risk of late preterm birth (Adjusted OR 1.99 (1.05-3.79; p = 0.04. Age <20 (Adjusted OR 1.73 (1.03-2.90; p = 0.04 and anemia (Adjusted OR 1.95 (1.08-3.52; p = 0.03 were associated with early preterm birth (<34 weeks.Despite claims that HIV infection is an important cause of preterm birth in Africa, we found no evidence of an association in this population (unexposed to anti-retroviral treatment. Persistent malaria was associated with late preterm birth. Maternal undernourishment and anemia were independently associated with early preterm birth. The study did not assess whether the link was direct or whether a common precursor such as chronic infection was responsible for both maternal effects and early labour.

A Psychological Perspective on Preterm Children: The Influence of Contextual Factors on Quality of Family Interactions

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Michela Gatta

2017-01-01

Full Text Available Preterm birth has a critical influence on interactive, communicative, and expressive child behaviour, particularly during the first years of life. Few studies have stressed the assessment of mother-father-child interaction in families with preterm children, generating contradictory results. The present study wished to develop these fields: (i comparing the quality of family interactions between families with preterm children and families with children born at full term; (ii observing the development of family interactions after six months in the families with children born preterm; (iii assessing family and contextual factors, as parental stress and social support, in parents of preterm children in order to observe their influence on the quality of family interactions. 78 families are recruited: 39 families with preterm children (M = 19,8 months, SD = 11,05 and 39 families with full-term children (M = 19,66 months; SD = 13,10. Results show that families with preterm children display a low quality of mother-father-child interactions. After six months, family interactions result is generally stable, except for some LTP-scales reflecting a hard adjustment of parenting style to the evolution of the child. In families with preterm children, the parenting stress seemed to be correlated with the quality of mother-father-child interactions.

A Psychological Perspective on Preterm Children: The Influence of Contextual Factors on Quality of Family Interactions.

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Gatta, Michela; Miscioscia, Marina; Svanellini, Lorenza; Peraro, Chiara; Simonelli, Alessandra

2017-01-01

Preterm birth has a critical influence on interactive, communicative, and expressive child behaviour, particularly during the first years of life. Few studies have stressed the assessment of mother-father-child interaction in families with preterm children, generating contradictory results. The present study wished to develop these fields: (i) comparing the quality of family interactions between families with preterm children and families with children born at full term; (ii) observing the development of family interactions after six months in the families with children born preterm; (iii) assessing family and contextual factors, as parental stress and social support, in parents of preterm children in order to observe their influence on the quality of family interactions. 78 families are recruited: 39 families with preterm children ( M = 19,8 months, SD = 11,05) and 39 families with full-term children ( M = 19,66 months; SD = 13,10). Results show that families with preterm children display a low quality of mother-father-child interactions. After six months, family interactions result is generally stable, except for some LTP-scales reflecting a hard adjustment of parenting style to the evolution of the child. In families with preterm children, the parenting stress seemed to be correlated with the quality of mother-father-child interactions.

Motor learning and working memory in children born preterm: a systematic review.

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Jongbloed-Pereboom, Marjolein; Janssen, Anjo J W M; Steenbergen, Bert; Nijhuis-van der Sanden, Maria W G

2012-04-01

Children born preterm have a higher risk for developing motor, cognitive, and behavioral problems. Motor problems can occur in combination with working memory problems, and working memory is important for explicit learning of motor skills. The relation between motor learning and working memory has never been reviewed. The goal of this review was to provide an overview of motor learning, visual working memory and the role of working memory on motor learning in preterm children. A systematic review conducted in four databases identified 38 relevant articles, which were evaluated for methodological quality. Only 4 of 38 articles discussed motor learning in preterm children. Thirty-four studies reported on visual working memory; preterm birth affected performance on visual working memory tests. Information regarding motor learning and the role of working memory on the different components of motor learning was not available. Future research should address this issue. Insight in the relation between motor learning and visual working memory may contribute to the development of evidence based intervention programs for children born preterm. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of preschool and academic skills in children born very preterm

NARCIS (Netherlands)

Aarnoudse-Moens, C.S.H.; Oosterlaan, J.; Duivenvoorden, H.J.; van Goudoever, J.B.; Weisglas-Kuperus, N.

2011-01-01

Objective: To examine performance in preschool and academic skills in very preterm (gestational age ≤30 weeks) and term-born comparison children aged 4 to 12 years. Study design: Very preterm children (n = 200; mean age, 8.2 ± 2.5 years) born between 1996 and 2004 were compared with 230 term-born

The relationship between sleep problems and working memory in children born very preterm.

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McCann, Marie; Bayliss, Donna M; Anderson, Mike; Campbell, Catherine; French, Noel; McMichael, Judy; Reid, Corinne; Bucks, Romola S

2018-01-01

In two studies, the relationship between sleep and working memory performance was investigated in children born very preterm (i.e., gestation less than 32 weeks) and the possible mechanisms underlying this relationship. In Study 1, parent-reported measures of snoring, night-time sleep quality, and daytime sleepiness were collected on 89 children born very preterm aged 6 to 7 years. The children completed a verbal working memory task, as well as measures of processing speed and verbal storage capacity. Night-time sleep quality was found to be associated with verbal working memory performance over and above the variance associated with individual differences in processing speed and storage capacity, suggesting that poor sleep may have an impact on the executive component of working memory. Snoring and daytime sleepiness were not found to be associated with working memory performance. Study 2 introduced a direct measure of executive functioning and examined whether sleep problems would differentially impact the executive functioning of children born very preterm relative to children born to term. Parent-reported sleep problems were collected on 43 children born very preterm and 48 children born to term (aged 6 to 9 years). Problematic sleep was found to adversely impact executive functioning in the very preterm group, while no effect of sleep was found in the control group. These findings implicate executive dysfunction as a possible mechanism by which problematic sleep adversely impacts upon cognition in children born very preterm, and suggest that sleep problems can increase the cognitive vulnerability already experienced by many of these children.

Pathways to School Achievement in Very Preterm and Full Term Children

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Schneider, Wolfgang; Wolke, Dieter; Schlagmuller, Matthias; Meyer, Renate

2004-01-01

Individual differences in academic success were investigated in a geographically defined whole-population sample of very preterm children with a gestational age of less than 32 weeks or a birth weight of less than 1500 gm. The sample consisted of 264 very preterm children (75.6% of German-speaking survivors) and 264 controls matched for gender,…

[Neurological disorders in preterm children with neuropathy].

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Nikolaeva, G V; Sidorenko, E I; Guseva, M R; Akbasheva, N G

2017-01-01

To establish the correlation between the frequency and severity of hypoxic CNS lesions in preterm children with neuropathy and improve the early diagnosis of lesions of the brain structures based on clinical ophthalmologic results. The authors examined 712 premature infants with body mass neurological examination and neurosonography were performed. RP was found in 367 (51.5%) children. In 255 children, the disease regressed naturally. One hundred and twelve (15.7%) children, underwent laser coagulation of the avascular retina due to the severity of RP. Signs of intraventricular hemorrhages (IVH) were noted in 434 (61%) children in the neonatal period. IVH were found in 285 (77.6%) children with RP. RP with the regression after laser coagulation was combined with IVH in 98% of cases, with the higher frequency (55.3%) of IVH, 3 rd degree. Periventricular leucomalation (PVL) was found in 10% of children without RP, in 22.3% of children with RP with naturally regression and in 51,7% of children with RP with laser coagulation of the retina. In 70 children, neurosonographic signs of ischemia of the head of caudate nucleus were identified on the 14-15 th days of life. In this group, RP developed in 54 (77%) children, 27 (38.5%) children needed laser coagulation of the retina. The correlation found between the severity of RP and hypoxic CNS lesions in highly preterm infants might allow the prognosis of visual and neurosomatic disturbances in the early age and timely effective rehabilitation.

Preterm children quality of life evaluation: a qualitative study to approach physicians’ perception

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Einaudi Marie-Ange

2012-09-01

Full Text Available Abstract Background While data for preterm children health-related quality of life are available, there are little data on the perception of health-related quality of life evaluation by physicians who manage preterm children, or its use in real life and decision making. The aim of this qualitative study is to highlight among physicians, themes of reflection about health-related quality of life in extremely preterm children (less than 28 weeks’ gestation. Methods Focus groups at a French University Hospital with physicians who manage extremely preterm children: obstetricians, intensive care physicians, neonatal physicians and paediatric neurologists. The focus groups allowed the participants to discuss (drawing on their personal experience, three principal topics regarding the health-related quality of life of preterm children: representation, expectations in daily practice and evaluation method. Results We included fourteen participants in the three focus groups. Many themes emerged from the focus groups: approaches for defining health-related quality of life and difficulties of utilization, the role that health-related quality of life should have in the system of care, the problem of standards and evidence-based decision making. Physicians had difficulties with taking positions regarding this concept. There were no differences by gender, age or seniority, but points of view varied by specialty and type of practice. Physicians who had longer specialized care for extremely preterm children were more sensitive to the impact of preterm complications on health-related quality of life. Conclusions This study provides preliminary results about physicians’ perspective on the health-related quality of life of extremely preterm children. The themes emerged from the focus groups are classically described in other domains but not all in so clear a way (definition, interests and limits, ethical reflection. This approach was never developed in the field

Commentary: Supporting preterm children's parents matters - a reflection on Treyvaud et al. (2016).

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Jaekel, Julia

2016-07-01

Children born preterm or with low birth weight (LBW) grow up with an increased risk for a range of neurodevelopmental, cognitive, socioemotional, and academic problems. While long-term effects of preterm and LBW birth have traditionally been studied from a deficit perspective, Treyvaud et al. correctly state that the increased risk for impairments in this population urgently requires identification of protective factors. Their new findings add to empirical evidence from observational studies showing that sensitive parenting can protect preterm children from negative developmental outcomes. In order to identify strategies that support preterm children's life chances, well-designed longitudinal studies, such as the one by Treyvaud et al., are indispensable. Next, we will need large randomized trials to test the causality between intervention-induced parenting changes and preterm children's long-term outcomes. We need interdisciplinary and international collaboration to study preterm parent-child dyads within multimethod frameworks and uncover the highly complex mechanisms that shape individual developmental trajectories. © 2016 Association for Child and Adolescent Mental Health.

Developmental delay at 12 months in children born extremely preterm

DEFF Research Database (Denmark)

Lando, Ane; Klamer, Anja; Jonsbo, Finn

2005-01-01

AIM: To evaluate the feasibility and validity of a structured telephone interview to assess the development of children born extremely preterm. METHODS: The parents of 88 children born with a gestational age below 28 wk admitted to the neonatal intensive care unit (NICU) at Rigshospitalet......, Copenhagen, were interviewed by telephone when their child was 1 y of age, corrected for preterm birth. A fully structured questionnaire on psychomotor function was used (Revised Prescreening Developmental Questionnaire (R-PDQ)). The parents of 30 children born at term without complications were interviewed...... to use by staff and well accepted by parents. The mean score in the preterm group was 14.9+/-3.9 vs 17.7+/-2.7 in the term group (pchildren had developmental scores below-2 SD. The R-PDQ score was associated with the ASQ score 2 y later. CONCLUSION: A structured questionnaire administrated...

Attainment of gross motor milestones by preterm children with normal development upon school entry

NARCIS (Netherlands)

van Dokkum, Nienke H; de Kroon, Marlou L A; Bos, Arend F; Reijneveld, Sijmen A; Kerstjens, Jorien M

BACKGROUND: Little is known on the motor development of moderately preterm born (MPT) children, in comparison with early preterm born (EPT) children and fullterm born (FT), for children with normal motor outcomes at school entry. AIMS: To compare attainment rates of gross motor milestones reached

Increased risk of neuropsychological disorders in children born preterm without major disabilities: a neurodevelopmental model

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Dipasquale Filippo

2009-06-01

Full Text Available Over the past 30 years, preterm births have drastically increased and today represent 12.5% of total births. About 1.2% of preterm births characterize very preterm births (GA<32weeks that, with very low birth weight (BW<1500grams, are constantly found as risk factors of unfavourable neurological outcomes in longitudinal follow up studies. Actually, also “late preterm” children (preterm born from 33 to 36 weeks of gestational age, normally considered at low risk for neurodevelopmental disabilities, are supposed to represent a population of children to be monitored. Previous findings of a general cognitive impairment in children born preterm have gradually addressed the assessment of more specific neuropsychological skills and pointed out the importance to follow these children up to adolescent age. The neuroanatomical prerequisite of an abnormality in frontal lobe development and the correlation with various neuropsychological dysfunctions (fine and gross motor disabilities, executive function and working memory deficits, visual-constructional and attentional dysfunctions underline the interference of preterm birth with normal brain maturational phases. Though showing more demanding neurodevelopmental pathways than term peers, a large number of preterm children tend to functionally normalize in adolescence. The review supports the hypothesis of a neurodevelopmental model that can be at risk to influence dysfunctional neuropsychological outcome.

Hyper-responsiveness to acute stress, emotional problems and poorer memory in former preterm children.

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Quesada, Andrea A; Tristão, Rosana M; Pratesi, Riccardo; Wolf, Oliver T

2014-09-01

The prevalence of preterm birth (PTB) is high worldwide, especially in developing countries like Brazil. PTB is marked by a stressful environment in intra- as well as extrauterine life, which can affect neurodevelopment and hormonal and physiological systems and lead to long-term negative outcomes. Nevertheless, little is known about PTB and related outcomes later on in childhood. Thus, the goals of the current study were threefold: (1) comparing cortisol and alpha-amylase (sAA) profiles, including cortisol awakening response (CAR), between preterm and full-term children; (2) evaluating whether preterm children are more responsive to acute stress and (3) assessing their memory skills and emotional and behavioral profiles. Basal cortisol and sAA profiles, including CAR of 30 preterm children, aged 6 to 10 years, were evaluated. Further, we assessed memory functions using the Wide Range Assessment of Memory and Learning, and we screened behavior/emotion using the Strengths and Difficulties Questionnaire. The results of preterm children were compared to an age- and sex-matched control group. One week later, participants were exposed to a standardized laboratory stressor [Trier Social Stress Test for Children (TSST-C)], in which cortisol and sAA were measured at baseline, 1, 10 and 25 min after stressor exposure. Preterm children had higher cortisol concentrations at awakening, a flattened CAR and an exaggerated response to TSST-C compared to full-term children. These alterations were more pronounced in girls. In addition, preterm children were characterized by more emotional problems and poorer memory performance. Our findings illustrate the long-lasting and in part sex-dependent effects of PTB on the hypothalamic-pituitary-adrenal (HPA) axis, internalizing behavior and memory. The findings are in line with the idea that early adversity alters the set-point of the HPA axis, thereby creating a more vulnerable phenotype.

Neurobehavioral outcomes of school-age children born preterm: a preliminary study in the Arabic community

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Mohammed M.J. Alqahtani

2016-07-01

Full Text Available Introduction: Preterm survivors from the neonatal intensive care unit (NICU are considered as high risk group for some neurobehavioral impairments such as cognitive disabilities, developmental delays, social/emotional limitations, attention-deficit/hyperactivity disorder (ADHD, and academic difficulties. Objective: The current study aimed to investigate the neurobehavioral outcome of premature infants in Saudi Arabia at the school age.Methods: At the school age, preterm children (range 23-29 weeks or ≤ 1.52 kg born from April, 2006 through September, 2008, and who were admitted following birth to a NICU, were evaluated with several neurobehavioral tools. Results: This study includes 53 preterm children, who were followed up at the chronological age that ranged from 6.4-8.0 years. The results of the neurobehavioral assessments showed in general normal social adaptive levels and cognitive abilities, with mean total score of about 91.0 and 90.0, respectively. The prevalence of ADHD among preterm children was high, with result of 34.0% for the inattentive type and 11.3% for the hyperactive/impulsive type. None of the preterm children repeats a grade, but 22.6% utilize a form of special educational supports. Some of the preterm children showed poor school performance in reading skills, writing skills and mathematics skills, with percentages of 26.4%, 28.3% and 15.1%, respectively.Conclusions: The present results emphasize that preterm children are a group of high-risk children who need regular follow-up to track the developmental conditions and to provide the early developmental intervention for optimal outcome.

Growth and Predictors of Growth Restraint in Moderately Preterm Children Aged 0 to 4 Years

NARCIS (Netherlands)

Bocca-Tjeertes, I.F.; Kerstjens, J.M.; Reijneveld, S.A.; de Winter, A.F.; Bos, A.F.

2011-01-01

OBJECTIVE: To describe growth in moderately preterm-born children, determine the prevalence of growth restraint at the age of 4, and identify predictors of growth restraint. We hypothesized that growth in moderately preterm-born children differs from growth in term-born children and that growth

Drawings of very preterm-born children at 5 years of age: a first impression of cognitive and motor development?

Science.gov (United States)

Schepers, Sasja; Deković, Maja; Feltzer, Max; de Kleine, Martin; van Baar, Anneloes

2012-01-01

The aim of this study was to examine differences in drawing skills between very preterm and term children, and to determine whether very preterm children's cognitive and motor development is reflected in the draw-a-person test (DAP) at age 5. Seventy-two very preterm children (birth weight children at 5 years of age were compared on the DAP. Cognitive and motor skills of the very preterm children had been assessed four times, at 1/2, 1, 2, and 5 years of age. Very preterm children showed a developmental delay in drawing ability. Structural equation modeling revealed a positive relation between both cognitive as well as motor development and the DAP. The DAP could be a crude parameter for evaluating cognitive and motor deficits of very preterm children. A worrisome result should be followed by more standardized tests measuring cognitive and motor skills.

Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure study.

Science.gov (United States)

Johnson, S; Hennessy, E; Smith, R; Trikic, R; Wolke, D; Marlow, N

2009-07-01

To assess academic attainment and special educational needs (SEN) in extremely preterm children in middle childhood. Of 307 extremely preterm (special school. In mainstream schools, 105 (57%) extremely preterm children had SEN (OR 10; 6 to 18) and 103 (55%) required SEN resource provision (OR 10; 6 to 18). Teachers rated 50% of extremely preterm children as having below average attainment compared with 5% of classmates (OR 18; 8 to 41). Extremely preterm children who entered compulsory education an academic year early due to preterm birth had similar academic attainment but required more SEN support (OR 2; 1.0 to 3.6). Extremely preterm survivors remain at high risk for learning impairments and poor academic attainment in middle childhood. A significant proportion require full-time specialist education and over half of those attending mainstream schools require additional health or educational resources to access the national curriculum. The prevalence and impact of SEN are likely to increase as these children approach the transition to secondary school.

Neonatal Brain Abnormalities and Memory and Learning Outcomes at 7 Years in Children Born Very Preterm

Science.gov (United States)

Omizzolo, Cristina; Scratch, Shannon E; Stargatt, Robyn; Kidokoro, Hiroyuki; Thompson, Deanne K; Lee, Katherine J; Cheong, Jeanie; Neil, Jeffrey; Inder, Terrie E; Doyle, Lex W; Anderson, Peter J

2014-01-01

Using prospective longitudinal data from 198 very preterm and 70 full term children, this study characterised the memory and learning abilities of very preterm children at 7 years of age in both verbal and visual domains. The relationship between the extent of brain abnormalities on neonatal magnetic resonance imaging (MRI) and memory and learning outcomes at 7 years of age in very preterm children was also investigated. Neonatal MRI scans were qualitatively assessed for global, white-matter, cortical grey-matter, deep grey-matter, and cerebellar abnormalities. Very preterm children performed less well on measures of immediate memory, working memory, long-term memory, and learning compared with term born controls. Neonatal brain abnormalities, and in particular deep grey matter abnormality, were associated with poorer memory and learning performance at 7 years in very preterm children, especially global, white-matter, grey-matter and cerebellar abnormalities. Findings support the importance of cerebral neonatal pathology for predicting later memory and learning function. PMID:23805915

Factors Affecting the IQ of Preterm Born Children of 4-6 Years Old

Directory of Open Access Journals (Sweden)

Shokofeh Radfar

2014-08-01

Full Text Available Background: This research was carry out with aim of study of factors affecting the IQ of children 4-6 years old born preterm. Materials and Methods: This analytical-cross sectional study was carried out on 102 premature children with age 4-6 years old during years 2004 to 2006. The tools used in this study were Wechsler intelligence scale for children and questioner including demographical characteristic. In this study we used t-test and spearman correlation and also SPSS-18 was used to analyze data. Results: In this study there was statistical relationship between normal child development and gestational age, birth weight, maternal education, multiple pregnancies, but there were not any statistical significant relationship between the history of preterm birth and child s gender, consanguinity parents, apgar, mother job. Conclusion: IQ in preterm babies who admitted in the NICU was lower than non-admitted preterm or term babies.

Bullying of preterm children and emotional problems at school age: cross-culturally invariant effects.

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Wolke, Dieter; Baumann, Nicole; Strauss, Victoria; Johnson, Samantha; Marlow, Neil

2015-06-01

To investigate whether adolescents who were born extremely preterm (weight (bullied, and whether this contributes to higher emotional problem scores. We used 2 whole population samples: the German Bavarian Longitudinal Study (BLS) (287 very preterm/very low birth weight and 293 term comparison children) and the UK EPICure Study (183 extremely preterm and 102 term comparison children). Peer bullying was assessed by parent report in both cohorts at school years 2 and 6/7. The primary outcome was emotional problems in year 6/7. The effects of prematurity and bullying on emotional problems were investigated with regression analysis and controlled for sex, socioeconomic status, disability, and preexisting emotional problems. Preterm-born children were more often bullied in both cohorts than term comparisons (BLS: relative risk, 1.27; 95% CI, 1.07-1.50; EPICure: relative risk, 1.69; 95% CI, 1.19-2.41). Both preterm birth and being bullied predicted emotional problems, but after controlling for confounders, only being bullied at both ages remained a significant predictor of emotional problem scores in both cohorts (BLS: B, 0.78; 95% CI, 0.28-1.27; P bullied at just a single time point also predicted emotional problems. Preterm-born children are more vulnerable to being bullied by peers. Those children who experience bullying over years are more likely to develop emotional problems. Health professionals should routinely ask about peer relationships. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleep/Wake Patterns and Parental Perceptions of Sleep in Children Born Preterm

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Biggs, Sarah N.; Meltzer, Lisa J.; Tapia, Ignacio E.; Traylor, Joel; Nixon, Gillian M.; Horne, Rosemary S.C.; Doyle, Lex W.; Asztalos, Elizabeth; Mindell, Jodi A.; Marcus, Carole L.

2016-01-01

Study Objectives: To compare sleep/wake patterns in children born preterm in Australia vs Canada and determine cultural differences in the relationship between parental perception of sleep and actual sleep behaviors. Methods: Australian and Canadian children born preterm were recruited from the Caffeine for Apnea of Prematurity trial (n = 188, 5–12 y) and underwent 14 days actigraphy monitoring. Parents completed the National Sleep Foundation 2004 Sleep in America questionnaire. Cross-cultural differences in sleep characteristics assessed by actigraphy and parent-reported questionnaire were examined. Correlational analyses determined the associations between parental perceptions of child sleep need and sleep behavior. Results: Actigraphy showed preterm children obtained, on average, 8 h sleep/night, one hour less than population recommendations for their age. There was no difference in total sleep time (TST) between Australian and Canadian cohorts; however, bed and wake times were earlier in Australian children. Bedtimes and TST varied by 60 minutes from night to night in both cohorts. Parent-reported child TST on the National Sleep Foundation questionnaire was 90 minutes longer than recorded by actigraphy. Both bedtime and TST on weekdays and weekends were related to parental perception of child sleep need in the Australian cohort. Only TST on weekdays was related to parental perception of child sleep need in the Canadian cohort. Conclusions: This study suggests that short sleep duration and irregular sleep schedules are common in children born preterm. Cultural differences in the association between parental perception of child sleep need and actual sleep behaviors provide important targets for future sleep health education. Citation: Biggs SN, Meltzer LJ, Tapia IE, Traylor J, Nixon GM, Horne RS, Doyle LW, Asztalos E, Mindell JA, Marcus CL. Sleep/wake patterns and parental perceptions of sleep in children born preterm. J Clin Sleep Med 2016;12(5):711–717

Are former late-preterm children at risk for child vulnerability and overprotection?

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Samra, Haifa A; McGrath, Jacqueline M; Wey, Howard

2010-09-01

Parent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children. With recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7 weeks gestation), and PPCV, POP, and healthcare utilization (HCU). This was a cross-sectional observational design. Study participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region. Outcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD). HCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3-8 years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the child's age and gender even after controlling for age. History of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP. Published by Elsevier Ireland Ltd.

Lung function after extremely preterm birth-A population-based cohort study (EXPRESS).

Science.gov (United States)

Thunqvist, Per; Tufvesson, Ellen; Bjermer, Leif; Winberg, Anna; Fellman, Vineta; Domellöf, Magnus; Melén, Erik; Norman, Mikael; Hallberg, Jenny

2018-01-01

Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation). In a population-based cohort of children born extremely preterm and controls born at term (n = 350), follow-up at 6½-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed. Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV 1 , z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R 5-20 , 0.09, 95%CI: 0.05; 0.12 kPa · L -1  · s -1 ) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07 kPa · L -1 ) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV 1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls. Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up. © 2017 Wiley Periodicals, Inc.

Ages and Stages Questionnaire used to measure cognitive deficit in children born extremely preterm

DEFF Research Database (Denmark)

Klamer, Anja; Lando, Ane; Pinborg, Anja

2005-01-01

AIM: To validate the Ages and Stages Questionnaire (ASQ) and to measure average cognitive deficit in children born extremely preterm. METHODS: Parents of 30 term children aged 36-42 mo completed the ASQ and the children underwent the Wechsler Preschool and Primary Scales of Intelligence--Revised.......AIM: To validate the Ages and Stages Questionnaire (ASQ) and to measure average cognitive deficit in children born extremely preterm. METHODS: Parents of 30 term children aged 36-42 mo completed the ASQ and the children underwent the Wechsler Preschool and Primary Scales of Intelligence...

Information Processing in Toddlers: Continuity from Infancy and Persistence of Preterm Deficits

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Rose, Susan A.; Feldman, Judith F.; Jankowski, Jeffery J.

2009-01-01

The present report assesses information processing in the toddler years (24 and 36 months), using a cohort of preterms (less than 1750 g) and full-terms initially seen in infancy. The children received a battery of tasks tapping 11 specific abilities from four domains--memory, processing speed, attention, and representational competence. The same…

Dysphonia in preterm children: assessing incidence and response to treatment.

Science.gov (United States)

Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel P

2014-03-01

Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population. This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia; and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia. This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment. This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763). Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Drawings of very preterm-born children at 5 years of age: a first impression of cognitive and motor development?

NARCIS (Netherlands)

Schepers, Sasja; Deković, Maja; Feltzer, Max; de Kleine, Martin; van Baar, Anneloes

2012-01-01

INTRODUCTION: The aim of this study was to examine differences in drawing skills between very preterm and term children, and to determine whether very preterm children's cognitive and motor development is reflected in the draw-a-person test (DAP) at age 5. Seventy-two very preterm children (birth

Differences in attentional functioning between preterm and full-term children underline the importance of new neuropsychological detection techniques.

Science.gov (United States)

Giordano, V; Fuiko, R; Leiss, U; Brandstetter, S; Hayde, M; Bartha-Doering, E; Klebermaß-Schrehof, K; Weiler, L J

2017-04-01

The aim of this study was to investigate specific attentional components in preterm born children who had not yet started school. Between January and December 2011, we assessed 52 preterm and 52 full-term children aged between five years five months and six years two months, of comparable age and gender, at the Medical University of Vienna. Different attentional components were evaluated through selected subtests of the Test of Attentional Performance and the German version of the Wechsler Intelligence Scale for Children. Each child's behaviour was also evaluated using parental ratings and descriptive item-based evaluation during neuropsychological assessment. Children born preterm showed poor attentional performance in sustained attention, focused attention and distractibility, as well as reductions in processing speed in divided attention and flexibility tasks. Children born preterm also showed decreased volitional attention compared with automatic attention. No problems were detected in alertness or inhibition. In addition, a higher rate of aborted tests, decreased motivation and poorer parental ratings were detected among the preterm population compared with full-term born children. Our results highlighted differences in attentional functioning between preterm and full-term children, indicating the importance of new neuropsychological techniques for the detection of specific attentional disorders. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Doxapram and developmental delay at 12 months in children born extremely preterm

DEFF Research Database (Denmark)

Lando, Ane; Klamer, Anja; Jonsbo, Finn

2005-01-01

AIM: To examine the relation of doxapram to a developmental score achieved by a structured telephone interview in a group of extremely-preterm-born children. METHODS: Parents of 88 children born extremely preterm were contacted by telephone and interviewed by a structured questionnaire (R-PDQ) wh...... the corrected age of their child was 9-15 mo. RESULTS: We found that doxapram treatment was associated with a deficit in age-adjusted R-PDQ score. CONCLUSION: Doxapram may have a negative effect on neurodevelopmental outcome....

Communicative and Linguistic Development in Preterm Children: A Longitudinal Study from 12 to 24 Months

Science.gov (United States)

Cattani, Allegra; Bonifacio, Serena; Fertz, Mariacristina; Iverson, Jana M.; Zocconi, Elisabetta; Caselli, M. Cristina

2010-01-01

Background: Research conducted on preterm children's linguistic skills has provided varying pictures, and the question of whether and to what extent preterm children are delayed in early language acquisition remains largely unresolved. Aims: To examine communicative and linguistic development during the second year in a group of Italian children…

Parenting behavior is associated with the early neurobehavioral development of very preterm children.

Science.gov (United States)

Treyvaud, Karli; Anderson, Vicki A; Howard, Kelly; Bear, Merilyn; Hunt, Rod W; Doyle, Lex W; Inder, Terrie E; Woodward, Lianne; Anderson, Peter J

2009-02-01

There is an increasing focus on social and environmental factors that promote and support the early development of highly vulnerable children such as those born very preterm. The aim of this study was to assess the relationship between parenting behavior, parent-child synchrony, and neurobehavioral development in very preterm children at 24 months of age. Participants were 152 very preterm children (Cognitive and motor development was assessed by using the Bayley Scales of Infant Development II, and the Infant Toddler Social and Emotional Assessment was used to assess socioemotional development (social-emotional competence and internalizing and externalizing behavior). fter controlling for social risk, most parenting domains were associated with cognitive development, with parent-child synchrony emerging as the most predictive. Greater parent-child synchrony was also associated with greater social-emotional competence, as was parenting that was positive, warm, and sensitive. Parents who displayed higher levels of negative affect were more likely to rate their children as withdrawn, anxious, and inhibited, but, unexpectedly, higher negative affect was also associated with more optimal psychomotor development. Parenting was not associated with externalizing behaviors at this age. Specific parenting behaviors, particularly parent-child synchrony, were associated with neurobehavioral development. These findings have implications for the development of targeted parent-based interventions to promote positive outcomes across different developmental domains during the first 2 years of life for very preterm children.

Sensory processing difficulties in school-age children born very preterm : An exploratory study

NARCIS (Netherlands)

Bröring, Tinka; Königs, Marsh; Oostrom, Kim J.; Lafeber, Harrie N.; Brugman, Anniek; Oosterlaan, Jaap

Background Very preterm birth has a detrimental impact on the developing brain, including widespread white matter brain abnormalities that threaten efficient sensory processing. Yet, sensory processing difficulties in very preterm children are scarcely studied, especially at school age. Aims To

Attention problems and language development in preterm low-birth-weight children: Cross-lagged relations from 18 to 36 months

Directory of Open Access Journals (Sweden)

Rohrer-Baumgartner Nina

2011-06-01

Full Text Available Abstract Background Research has highlighted a series of persistent deficits in cognitive ability in preterm low-birth-weight children. Language and attention problems are among these deficits, although the nature of the relation between attention and language in early development is not well known. This study represents a preliminary attempt to shed light on the relations between attention problems and language development in preterm low-birth-weight children. Methods The aim of this study was to analyse reciprocal influences between language and attention problems from 18 to 36 months. We used maternal reports on attention problems and language ability referring to a sample of 1288 premature low-birth-weight infants, collected as part of the Norwegian Mother and Child Cohort Study (MoBa. A sample of children born full-term was used as the control group (N = 37010. Cross-lagged panel analyses were carried out to study reciprocal influences between attention problems and language. Results Language ability at 18 months did not significantly predict attention problems at 36 months, adjusting for attention problems at 18 months. Attention problems at 18 months significantly predicted changes in language ability from 18 to 36 months, pointing to a precursor role of attention in relation to language in children born preterm. Gender, age corrected for prematurity, and mother's education emerged as important covariates. Conclusions Preliminary evidence was found for a precursor role of early attention problems in relation to language in prematurity. This finding can contribute to a better understanding of the developmental pathways of attention and language and lead to better management of unfavourable outcomes associated with co-morbid attention and language difficulties.

Attention problems and language development in preterm low-birth-weight children: cross-lagged relations from 18 to 36 months.

Science.gov (United States)

Ribeiro, Luisa A; Zachrisson, Henrik D; Schjolberg, Synnve; Aase, Heidi; Rohrer-Baumgartner, Nina; Magnus, Per

2011-06-29

Research has highlighted a series of persistent deficits in cognitive ability in preterm low-birth-weight children. Language and attention problems are among these deficits, although the nature of the relation between attention and language in early development is not well known. This study represents a preliminary attempt to shed light on the relations between attention problems and language development in preterm low-birth-weight children. The aim of this study was to analyse reciprocal influences between language and attention problems from 18 to 36 months. We used maternal reports on attention problems and language ability referring to a sample of 1288 premature low-birth-weight infants, collected as part of the Norwegian Mother and Child Cohort Study (MoBa). A sample of children born full-term was used as the control group (N = 37010). Cross-lagged panel analyses were carried out to study reciprocal influences between attention problems and language. Language ability at 18 months did not significantly predict attention problems at 36 months, adjusting for attention problems at 18 months. Attention problems at 18 months significantly predicted changes in language ability from 18 to 36 months, pointing to a precursor role of attention in relation to language in children born preterm. Gender, age corrected for prematurity, and mother's education emerged as important covariates. Preliminary evidence was found for a precursor role of early attention problems in relation to language in prematurity. This finding can contribute to a better understanding of the developmental pathways of attention and language and lead to better management of unfavourable outcomes associated with co-morbid attention and language difficulties.

Sleep/Wake Patterns and Parental Perceptions of Sleep in Children Born Preterm.

Science.gov (United States)

Biggs, Sarah N; Meltzer, Lisa J; Tapia, Ignacio E; Traylor, Joel; Nixon, Gillian M; Horne, Rosemary S C; Doyle, Lex W; Asztalos, Elizabeth; Mindell, Jodi A; Marcus, Carole L

2016-05-15

To compare sleep/wake patterns in children born preterm in Australia vs Canada and determine cultural differences in the relationship between parental perception of sleep and actual sleep behaviors. Australian and Canadian children born preterm were recruited from the Caffeine for Apnea of Prematurity trial (n = 188, 5-12 y) and underwent 14 days actigraphy monitoring. Parents completed the National Sleep Foundation 2004 Sleep in America questionnaire. Cross-cultural differences in sleep characteristics assessed by actigraphy and parent-reported questionnaire were examined. Correlational analyses determined the associations between parental perceptions of child sleep need and sleep behavior. Actigraphy showed preterm children obtained, on average, 8 h sleep/night, one hour less than population recommendations for their age. There was no difference in total sleep time (TST) between Australian and Canadian cohorts; however, bed and wake times were earlier in Australian children. Bedtimes and TST varied by 60 minutes from night to night in both cohorts. Parent-reported child TST on the National Sleep Foundation questionnaire was 90 minutes longer than recorded by actigraphy. Both bedtime and TST on weekdays and weekends were related to parental perception of child sleep need in the Australian cohort. Only TST on weekdays was related to parental perception of child sleep need in the Canadian cohort. This study suggests that short sleep duration and irregular sleep schedules are common in children born preterm. Cultural differences in the association between parental perception of child sleep need and actual sleep behaviors provide important targets for future sleep health education. © 2016 American Academy of Sleep Medicine.

Prevalence of motor-skill impairment in preterm children who do not develop cerebral palsy: a systematic review.

Science.gov (United States)

Williams, Jacqueline; Lee, Katherine J; Anderson, Peter J

2010-03-01

Motor skill impairment is a common negative outcome in children born preterm who do not develop cerebral palsy (CP). This study aimed to conduct a systematic review of current data to provide an accurate estimate of the prevalence of non-CP motor impairment in preterm children at school age. We searched the Medline, PubMed, and PsycInfo databases and relevant journals to identify all studies published post-1990 that reported the prevalence of motor impairment in school-aged children born preterm (children was 40.5/100. and for moderate motor impairment the estimate was 19.0/100. There was also a trend for lower motor impairment levels in samples born before 1990 compared with those born after 1990. Children born preterm are at increased risk of motor impairment, with prevalence three to four times greater than in the general population. This highlights the need for improved surveillance and intervention strategies in this group of children.

Developmental Delay in Moderately Preterm-Born Children with Low Socioeconomic Status : Risks Multiply

NARCIS (Netherlands)

Potijk, Marieke R; Kerstjens, Jorien M; Bos, Arend F; Reijneveld, Sijmen A; de Winter, Andrea F

Objective To assess separate and joint effects of low socioeconomic status (SES) and moderate prematurity on preschool developmental delay. Study design Prospective cohort study with a community-based sample of preterm-and term-born children (Longitudinal Preterm Outcome Project). We assessed SES on

Parachute and lateral propping reactions in preterm children

Directory of Open Access Journals (Sweden)

Ohlweiler Lygia

2002-01-01

Full Text Available A non-controlled, prognostic cohort study was performed with the aim of establishing markers of neurological development and defining a clinical and epidemiological profile of preterm newborns at 3, 6, 9, and 12 months of gestation-corrected age in terms of parachute and lateral propping reactions. Newborns with gestational age of up to 36 weeks and 6 days, weighing 2,000 g or less at birth, were included in the study At 6 months of age, parachute and lateral propping reactions were present in 8.1% of the patients. At 9 months, the parachute reaction was present in 87.5%, and the lateral propping reaction was present in 90% of the children. It was possible to assess parachute and lateral propping reactions in preterm children in the first year of life. Alterations in trunk-limb coordination may be evidenced in the 1st year of life through postural reactions, which are maintained as prematurity markers until school age.

Expressive language of two year-old pre-term and full-term children.

Science.gov (United States)

Isotani, Selma Mie; Azevedo, Marisa Frasson de; Chiari, Brasília Maria; Perissinoto, Jacy

2009-01-01

expressive language of pre-term children. to compare the expressive vocabulary of two year-old children born prematurely, to that of those born at term. the study sample was composed by 118 speech-language assessment protocols, divided in two groups: the pre-term group (PTG) composed by 58 underweight premature children followed by a multi-professional team at the Casa do Prematuro (House of Premature Children) at Unifesp, and the full-term group (FTG) composed by 60 full-term born children. In order to evaluate the expressive language of these children, the Lave - Lista de Avaliação do Vocabulário Expressivo (Assessment List of the Expressive Vocabulary) was used. The Lave is an adaptation of the LDS - Language Development Survey - for the Brazilian Portuguese Language. The Lave investigates the expressive language and detects delays in oral language. children born underweight and prematurely present a greater occurrence of expressive language delay, 27.6%. These pre-term children present significantly lower expressive vocabulary and phrasal extension than children of the same age born at full-term in all semantic categories. Family income proved to be positively associated to phrasal extension, as well as to gestational age and weight at birth; thus indicating the effect of these adverse conditions still during the third year of age. The audiological status was associated to word utterances in the PTG. children born prematurely and underweight are at risk in terms of vocabulary development; this determines the need for speech-therapy intervention programs.

Functional impairments at school age of preterm born children with late-onset sepsis

NARCIS (Netherlands)

van der Ree, Meike; Tanis, Jozien C.; Van Braeckel, Koenraad N. J. A.; Bos, Arend F.; Roze, Elise

2011-01-01

Background: Late-onset sepsis is a relatively common complication particularly of preterm birth that affects approximately a quarter of very low birth weight infants. Aim: We aimed to determine the motor, cognitive, and behavioural outcome at school age of preterm children with late-onset sepsis

Regional Cerebral Development at Term Relates to School-Age Social-Emotional Development in Very Preterm Children

Science.gov (United States)

Rogers, Cynthia E.; Anderson, Peter J.; Thompson, Deanne K.; Kidokoro, Hiroyuki; Wallendorf, Michael; Treyvaud, Karli; Roberts, Gehan; Doyle, Lex W.; Neil, Jeffrey J.; Inder, Terrie E.

2012-01-01

Objective: Preterm children are at risk for social-emotional difficulties, including autism and attention-deficit/hyperactivity disorder. We assessed the relationship of regional brain development in preterm children, evaluated via magnetic resonance imaging (MRI) at term-equivalent postmenstrual age (TEA), to later social-emotional difficulties.…

Altered long-range alpha-band synchronization during visual short-term memory retention in children born very preterm.

Science.gov (United States)

Doesburg, Sam M; Ribary, Urs; Herdman, Anthony T; Miller, Steven P; Poskitt, Kenneth J; Moiseev, Alexander; Whitfield, Michael F; Synnes, Anne; Grunau, Ruth E

2011-02-01

Children born very preterm, even when intelligence is broadly normal, often experience selective difficulties in executive function and visual-spatial processing. Development of structural cortical connectivity is known to be altered in this group, and functional magnetic resonance imaging (fMRI) evidence indicates that very preterm children recruit different patterns of functional connectivity between cortical regions during cognition. Synchronization of neural oscillations across brain areas has been proposed as a mechanism for dynamically assigning functional coupling to support perceptual and cognitive processing, but little is known about what role oscillatory synchronization may play in the altered neurocognitive development of very preterm children. To investigate this, we recorded magnetoencephalographic (MEG) activity while 7-8 year old children born very preterm and age-matched full-term controls performed a visual short-term memory task. Very preterm children exhibited reduced long-range synchronization in the alpha-band during visual short-term memory retention, indicating that cortical alpha rhythms may play a critical role in altered patterns functional connectivity expressed by this population during cognitive and perceptual processing. Long-range alpha-band synchronization was also correlated with task performance and visual-perceptual ability within the very preterm group, indicating that altered alpha oscillatory mechanisms mediating transient functional integration between cortical regions may be relevant to selective problems in neurocognitive development in this vulnerable population at school age. Copyright © 2010 Elsevier Inc. All rights reserved.

Symmetrical and asymmetrical growth restriction in preterm-born children

NARCIS (Netherlands)

Bocca-Tjeertes, Inger; Bos, Arend; Kerstjens, Jorien; de Winter, Andrea; Reijneveld, Sijmen

OBJECTIVE: To determine how symmetric (proportionate; SGR) and asymmetric (disproportionate; AGR) growth restriction influence growth and development in preterms from birth to 4 years. METHODS: This community-based cohort study of 810 children comprised 86 SGR, 61 AGR, and 663 non-growth restricted

Early parenting, represented family relationships, and externalizing behavior problems in children born preterm.

Science.gov (United States)

Poehlmann, Julie; Burnson, Cynthia; Weymouth, Lindsay A

2014-01-01

Through assessment of 173 preterm infants and their mothers at hospital discharge and at 9, 16, 24, 36, and 72 months, the study examined early parenting, attachment security, effortful control, and children's representations of family relationships in relation to subsequent externalizing behavior problems. Less intrusive early parenting predicted more secure attachment, better effortful control skills, and fewer early behavior problems, although it did not directly relate to the structural or content characteristics of children's represented family relationships. Children with higher effortful control scores at 24 months had more coherent family representations at 36 months. Moreover, children who exhibited less avoidance in their family representations at 36 months had fewer mother-reported externalizing behavior problems at 72 months. The study suggests that early parenting quality and avoidance in children's represented relationships are important for the development of externalizing behavior problems in children born preterm.

Maternal and pregnancy-related factors associated with developmental delay in moderately preterm-born children

NARCIS (Netherlands)

Kerstjens, Jorien M; de Winter, Andrea F; Sollie, Krystyna M; Bocca-Tjeertes, Inger F; Potijk, Marieke R; Reijneveld, Sijmen A; Bos, Arend F

OBJECTIVE: To estimate the association between preexisting maternal and pregnancy-related factors and developmental delay in early childhood in moderately preterm-born children. METHODS: We measured development with the Ages and Stages Questionnaire at age 43-49 months in 834 moderately preterm-born

Lung function in 6 years old children born very preterm and fed different diets post discharge

DEFF Research Database (Denmark)

Toftlund, Line Hedegaard; Agertoft, Lone; Halken, Susanne

Background: Research has shown that being born preterm may affect lung capacity later in childhood. It is though unknown if type of early nutrition influences lung capacity and the risk of developing asthma in childhood. Aim: The aim was to investigate if type of early nutrition has an impact...... on lung function and the possible risk of developing asthma among 6 year old children born very preterm. Method: A prospective, randomized, interventional multicentre study on nutrition of a preterm birth cohort has been established and described previously. The inclusion criteria were gestational age...... ≤ 32 weeks. From hospital discharge to 4 month corrected age, the children received three different types of nutrition: A: Human milk (HM) B: HM enriched with fortifier (HMF) C: Preterm formula (PF). At the age of 6 years, the children performed an occlusion test (Rocc) and a lung resistance test...

Executive Function Computerized Training in Very Preterm-Born Children: A Pilot Study.

Science.gov (United States)

Aarnoudse-Moens, Cornelieke S H; Twilhaar, E Sabrina; Oosterlaan, Jaap; van Veen, Heske G; Prins, Pier J M; van Kaam, Anton H L C; van Wassenaer-Leemhuis, Aleid G

2018-06-01

Attention problems are one of the most pronounced and documented consequences of very preterm birth (gestational age ≤32 weeks). However, up to now, there is no research published on suitable interventions at school age aimed to overcome these problems. Research in this population did show that executive functions (EFs) are strongly associated with inattention. BrainGame Brian is a newly developed computerized training, in which, in 25 training sessions, the core EFs, including working memory, impulse control, and cognitive flexibility, are trained. This pilot study aimed to examine the feasibility of studying BrainGame Brian in very preterm-born children with attention problems. Pilot feasibility intervention study with one baseline and one follow-up assessment. Feasibility was measured by the participation rate, dropout rate, and user experiences with regard to effort, training characteristics, and recommendation to others. From a larger cohort study, 15 very preterm-born children at age 10 years with parent-reported attention problems on the Child Behavior Checklist/6-18 years were invited to participate in this pilot study. BrainGame Brian was performed for a period of 6 weeks. Training outcome measures included visual working memory, impulse control, cognitive flexibility, speed variability, and parent-rated attention, for which pre- and post-training differences were examined at the group level by the Wilcoxon signed-rank test as well as for each individual child separately by the reliable change index. Twelve of 15 children and their parents agreed to participate and 11 children successfully completed BrainGame Brian in the 6-week period. Parents were positive about training characteristics and lack of interference with schooling, but scored the effort as high. We found clinically significant changes in visual working memory and speed variability in post-training assessments. BrainGame Brian is a feasible intervention for very preterm-born children with

Do healthy preterm children need neuropsychological follow-up? Preschool outcomes compared with term peers.

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Dall'oglio, Anna M; Rossiello, Barbara; Coletti, Maria F; Bultrini, Massimiliano; DE Marchis, Chiara; Ravà, Lucilla; Caselli, Cristina; Paris, Silvana; Cuttini, Marina

2010-10-01

the aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. a total of 35 infants who were born at less than 33 weeks' gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term-born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short-term memory, visual-motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education. the mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; psiblings or a twin (β=4.0; 95% CI 0.5-7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual-processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (pchildren to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success.

Psychiatric Outcomes at Age Seven for Very Preterm Children: Rates and Predictors

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Treyvaud, Karli; Ure, Alexandra; Doyle, Lex W.; Lee, Katherine J.; Rogers, Cynthia E.; Kidokoro, Hiroyuki; Inder, Terrie E.; Anderson, Peter J.

2013-01-01

Background: Uncertainty remains about the rate of specific psychiatric disorders and associated predictive factors for very preterm (VPT) children. The aims of this study were to document rates of psychiatric disorders in VPT children aged 7 years compared with term born children, and to examine potential predictive factors for psychiatric…

Quality of life in preschool children born preterm

NARCIS (Netherlands)

Theunissen, N.C.M.; Veen, S.; Fekkes, M.; Koopman, H.M.; Zwinderman, K.A.H.; Brugman, E.; Wit, J.M.

2001-01-01

The relationship of preterm birth to health-related quality of life (HRQoL) was examined for children aged 1 to 4 years. Three gestational age groups with a NICU history were selected, <32 weeks (n=65), 32 to 36 weeks (n=41),≥37 weeks (n=54), and a reference group from the open population (n=50).

High prevalence/low severity language delay in preschool children born very preterm.

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Foster-Cohen, Susan H; Friesen, Myron D; Champion, Patricia R; Woodward, Lianne J

2010-10-01

To examine the language development at corrected age 4 years of a regionally representative cohort of children born very preterm (VPT). Of particular interest was the identification of biological and socioenvironmental risk and protective factors that influence VPT children's early language development. Data were collected as part of a prospective longitudinal study of 110 VPT (VPT: ≤ 33 weeks gestation) and 113 full-term children (full term: 37-41 weeks gestation) born in Canterbury, New Zealand from 1998 to 2000. At corrected age 4 years, all children were assessed with the preschool version of the Clinical Evaluation of Language Fundamentals. Extensive information was also collected about children's family social background, perinatal health, childrearing environment, education/intervention exposures, and neurodevelopmental progress from birth to age 4. At the age of 4 years, VPT children were characterized by poorer receptive and expressive language development than full-term children. These differences persisted after exclusion of children with neurosensory impairment as well as statistical adjustment for the effects of social risk. Within the VPT group, the key predictors of children's overall language development were family social risk at birth (p =.05), severity of white matter abnormalities on neonatal magnetic resonance imaging (p =.49), observed parent-child synchrony (p =.001), and concurrent child cognitive ability (p =.001). Together, these factors accounted for 45% of the variance in children's total Clinical Evaluation of Language Fundamentals-Preschool scores. By preschool age, children born VPT show early emerging mild to moderate language delays that are likely to affect their school success and longer-term developmental progress. Findings highlight the importance of potentially modifiable factors such as early brain injury and parenting quality in predicting the language outcomes of children born VPT.

Sensory modulation in preterm children: Theoretical perspective and systematic review

NARCIS (Netherlands)

Bröring, Tinka; Oostrom, Kim J.; Lafeber, Harrie N.; Jansma, Elise P.; Oosterlaan, Jaap

2017-01-01

Background Neurodevelopmental sequelae in preterm born children are generally considered to result from cerebral white matter damage and noxious effects of environmental factors in the neonatal intensive care unit (NICU). Cerebral white matter damage is associated with sensory processing problems in

Effects of gestational age on brain volume and cognitive functions in generally healthy very preterm born children during school-age: A voxel-based morphometry study.

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Sakari Lemola

Full Text Available To determine whether the relationship of gestational age (GA with brain volumes and cognitive functions is linear or whether it follows a threshold model in preterm and term born children during school-age.We studied 106 children (M = 10 years 1 month, SD = 16 months; 40 females enrolled in primary school: 57 were healthy very preterm children (10 children born 24-27 completed weeks' gestation (extremely preterm, 14 children born 28-29 completed weeks' gestation, 19 children born 30-31 completed weeks' gestation (very preterm, and 14 born 32 completed weeks' gestation (moderately preterm all born appropriate for GA (AGA and 49 term-born children. Neuroimaging involved voxel-based morphometry with the statistical parametric mapping software. Cognitive functions were assessed with the WISC-IV. General Linear Models and multiple regressions were conducted controlling age, sex, and maternal education.Compared to groups of children born 30 completed weeks' gestation and later, children born <28 completed weeks' gestation had less gray matter volume (GMV and white matter volume (WMV and poorer cognitive functions including decreased full scale IQ, and processing speed. Differences in GMV partially mediated the relationship between GA and full scale IQ in preterm born children.In preterm children who are born AGA and without major complications GA is associated with brain volume and cognitive functions. In particular, decreased brain volume becomes evident in the extremely preterm group (born <28 completed weeks' gestation. In preterm children born 30 completed weeks' gestation and later the relationship of GA with brain volume and cognitive functions may be less strong as previously thought.

Persistence of ventilatory defect after resolution of pulmonary interstitial emphysema in a preterm baby.

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Filho, Luiz Vicente Ferreira da Silva; Rossi, Felipe De Souza; Deutsch, Alice d'Agostini; Yagui, Ana Cristina Zanon; Timenetsky, Karina; Rebello, Celso de Moura

2010-07-01

Pulmonary interstitial emphysema is a common complication of mechanical ventilation in preterm babies. We report a case of severe unilateral pulmonary interstitial emphysema in a premature newborn, treated with high-frequency oscillatory ventilation, lateral decubitus positioning and selective intubation. After complete radiological resolution of the pulmonary emphysema in the left lung, the patient was studied by electrical impedance tomography and a marked reduction of ventilation was identified in the left lung despite radiological resolution of the cysts. This finding indicates that functional abnormalities may persist for longer periods after radiologic resolution of such lesions.

Neonatal Morbidities and Developmental Delay in Moderately Preterm-Born Children

NARCIS (Netherlands)

Kerstjens, J.M.; Bocca-Tjeertes, I.F.; de Winter, A.F.; Reijneveld, S.A.; Bos, A.F.

BACKGROUND AND OBJECTIVE: Children born moderately preterm (32-35(6/7) weeks' gestation) are at increased risk of both neonatal morbidities and developmental delays in early childhood. It is unknown whether neonatal morbidities contribute to the increased risk of developmental delay. The objective

Memory Processes in Learning Disability Subtypes of Children Born Preterm

OpenAIRE

McCoy, Thomasin E.; Conrad, Amy L.; Richman, Lynn C.; Nopoulos, Peg C.; Bell, Edward F.

2012-01-01

The purpose of this study was to evaluate immediate auditory and visual memory processes in learning disability subtypes of 40 children born preterm. Three subgroups of children were examined: (a) primary language disability group (n = 13), (b) perceptual-motor disability group (n = 14), and (c) no learning disability diagnosis group without identified language or perceptual-motor learning disability (n = 13). Between-group comparisons indicate no significant differences in immediate auditory...

Executive Function in Very Preterm Children at Early School Age

NARCIS (Netherlands)

C.S.H. Aarnoudse-Moens (Cornelieke); D.P. Smidts (Diana); J. Oosterlaan (Jaap); H.J. Duivenvoorden (Hugo); N. Weisglas-Kuperus (Nynke)

2009-01-01

textabstractWe examined whether very preterm (≤30 weeks gestation) children at early school age have impairments in executive function (EF) independent of IQ and processing speed, and whether demographic and neonatal risk factors were associated with EF impairments. A consecutive sample of 50

Preterm children have unfavorable motor, cognitive, and functional performance when compared to term children of preschool age

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Eliane F. Maggi

2014-07-01

Full Text Available Objective: to compare the motor coordination, cognitive, and functional development of preterm and term children at the age of 4 years. Methods: this was a cross‐sectional study of 124 four‐year‐old children, distributed in two different groups, according to gestational age and birth weight, paired by gender, age, and socioeconomic level. All children were evaluated by the Movement Assessment Battery for Children – second edition (MABC‐2, the Pediatric Evaluation of Disability Inventory (PEDI, and the Columbia Mental Maturity Scale (CMMS. Results: preterm children had worse performance in all tests, and 29.1% of the preterm and 6.5% of term groups had scores on the MABC‐2 indicative of motor coordination disorder (p = 0.002. In the CMMS (p = 0.034, the median of the standardized score for the preterm group was 99.0 (± 13.75 and 103.0 (± 12.25 for the term group; on the PEDI, preterm children showed more limited skill repertoire (p = 0.001 and required more assistance from the caregiver (p = 0.010 than term children. Conclusion: this study reinforced the evidence that preterm children from different socioeconomic backgrounds are more likely to have motor, cognitive, and functional development impairment, detectable before school age, than their term peers. Resumo: Objetivo: comparar o desenvolvimento da coordenação motora, o desenvolvimento cognitivo e o desempenho funcional de crianças nascidas pré‐termo e a termo, aos quatro anos de idade. Métodos: estudo transversal com 124 crianças de quatro anos de idade, distribuídas em dois grupos distintos, de acordo com a idade gestacional e peso ao nascimento, pareadas com relação ao sexo, idade e nível socioeconômico. Todas as crianças foram avaliadas pelos testes Movement Assessment Battery for Children – Second Edition (MABC‐2, Inventário de Avaliação Pediátrica de Incapacidade (PEDI e Escala de Maturidade Mental Colúmbia (EMMC. Resultados: as crianças pr

Ages and Stages Questionnaire used to measure cognitive deficit in children born extremely preterm

DEFF Research Database (Denmark)

Klamer, Anja; Lando, Ane; Pinborg, Anja

2005-01-01

AIM: To validate the Ages and Stages Questionnaire (ASQ) and to measure average cognitive deficit in children born extremely preterm. METHODS: Parents of 30 term children aged 36-42 mo completed the ASQ and the children underwent the Wechsler Preschool and Primary Scales of Intelligence...

Pulmonary outcome in former preterm, very low birth weight children with bronchopulmonary dysplasia: a case-control follow-up at school age.

Science.gov (United States)

Vom Hove, Maike; Prenzel, Freerk; Uhlig, Holm H; Robel-Tillig, Eva

2014-01-01

To assess and compare long-term pulmonary outcomes in former preterm-born, very low birth weight (VLBW) children with and without bronchopulmonary dysplasia (BPD) born in the surfactant era. Pulmonary function tests (ie, spirometry, body plethysmography, and gas transfer testing) were performed in children with a history of VLBW and BPD (n = 28) and compared with a matched preterm-born VLBW control group (n = 28). Medical history was evaluated by questionnaire. At time of follow-up (mean age, 9.5 years), respiratory symptoms (36% vs 8%) and receipt of asthma medication (21% vs 0%) were significantly more frequent in the preterm-born children with previous BPD than in those with no history of BPD. The children with a history of BPD had significantly lower values for forced expiratory volume in 1 second (z-score -1.27 vs -0.4; P = .008), forced vital capacity (z-score -1.39 vs -0.71 z-score; P = .022), and forced expiratory flow rate at 50% of forced vital capacity (z-score -2.21 vs -1.04; P = .048) compared with the preterm control group. Preterm-born children with a history of BPD are significantly more likely to have lung function abnormalities, such as airway obstruction and respiratory symptoms, at school age compared with preterm-born children without BPD. Copyright © 2014 Mosby, Inc. All rights reserved.

Handwriting performance of preterm children at school age: a literature review

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Julie Souza de Medeiros Rocha

2015-03-01

Full Text Available Introduction: At school age, handwriting is on of the most important tasks among the fine motor activities. Good handwriting performance contributes to the child´s school performance. As prematurity impacts on motor development, it may influence handwriting. Objective: To review the specific literature and investigate whether there are differences in handwriting performance at school age between children born preterm and full term. Method: A search was performed in the Capes electronic database, in English and Portuguese, comprising the time period between January 2000 and June 2012. Articles were selected according to the inclusion criteria; the sample, objectives, instruments utilized and outcomes were analyzed. Results: Six articles were included in the study. Data analysis indicates that children born prematurely present poorer handwriting performance and a handicap in the underlying handwriting mechanisms when compared with full term infants. Conclusion: Preterm children without obvious neurological impairment are at increased risk for problems in handwriting development at school age. The small number of recent studies on this topic indicates a need for further research, as well as the development of standardized resources for the motor and handwriting assessment of Brazilian children.

Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes.

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Johnson, Samantha; Strauss, Victoria; Gilmore, Camilla; Jaekel, Julia; Marlow, Neil; Wolke, Dieter

2016-12-01

Children born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population. This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Bayley-III Cognitive and Language Scales in Preterm Children.

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Spencer-Smith, Megan M; Spittle, Alicia J; Lee, Katherine J; Doyle, Lex W; Anderson, Peter J

2015-05-01

This study aimed to assess the sensitivity and specificity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), Cognitive and Language scales at 24 months for predicting cognitive impairments in preterm children at 4 years. Children born cognitive functioning. Test norms and local term-born reference data were used to classify delay on the Bayley-III Cognitive and Language scales. Impairment on the DAS-II Global Conceptual Ability, Verbal, and Nonverbal Reasoning indices was classified relative to test norms. Scores cognitive delay on the Bayley-III for predicting impairment on DAS-II indices ranged from 29.4% to 38.5% and specificity ranged from 92.3% to 95.5%. The sensitivity of mild/moderate language delay on the Bayley-III for predicting impairment on DAS-II indices ranged from 40% to 46.7% and specificity ranged from 81.1% to 85.7%. The use of local reference data at 24 months to classify delay increased sensitivity but reduced specificity. Receiver operating curve analysis identified optimum cut-point scores for the Bayley-III that were more consistent with using local reference data than Bayley-III normative data. In our cohort of very preterm children, delay on the Bayley-III Cognitive and Language scales was not strongly predictive of future impairments. More children destined for later cognitive impairment were identified by using cut-points based on local reference data than Bayley-III norms. Copyright © 2015 by the American Academy of Pediatrics.

Preterm birth, age at school entry and educational performance.

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Odd, David; Evans, David; Emond, Alan

2013-01-01

To investigate if the lack of gestational age correction may explain some of the school failure seen in ex-preterm infants. A cohort study based on the Avon Longitudinal Study of Parents and Children (ALSPAC). The primary outcome was a low Key Stage 1 score (KS1) score at age 7 or having special educational needs (SEN). Exposure groups were defined as preterm (birth (DOB), expected date of delivery (EDD) or expected date of delivery and year of school entry. Multiple imputation was used to account for missing covariate data. When matching for DOB, infants born preterm had an increased odds of a low KS1 score (OR 1.73 (1.45-2.06)) and this association persisted after adjusting for potential confounders (OR 1.57 (1.25-1.97)). The association persisted in the analysis matching for EDD (fully adjusted OR 1.53 (1.21-1.94)) but attenuated substantially after additionally restricting to those infants who entered school at the same time as the control infants (fully adjusted OR 1.25 (0.98-1.60)). A compatible reduction in the population attributable risk fraction was seen from 4.60% to 2.12%, and year of school entry appeared to modify the association between gestational age and the risk of a poor KS1 score (p = 0.029). This study provides evidence that the school year placement and assessment of ex-preterm infants based on their actual birthday (rather than their EDD) may increase their risk of learning difficulties with corresponding school failure.

Neonatal pain-related stress predicts cortical thickness at age 7 years in children born very preterm.

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Manon Ranger

Full Text Available Altered brain development is evident in children born very preterm (24-32 weeks gestational age, including reduction in gray and white matter volumes, and thinner cortex, from infancy to adolescence compared to term-born peers. However, many questions remain regarding the etiology. Infants born very preterm are exposed to repeated procedural pain-related stress during a period of very rapid brain development. In this vulnerable population, we have previously found that neonatal pain-related stress is associated with atypical brain development from birth to term-equivalent age. Our present aim was to evaluate whether neonatal pain-related stress (adjusted for clinical confounders of prematurity is associated with altered cortical thickness in very preterm children at school age.42 right-handed children born very preterm (24-32 weeks gestational age followed longitudinally from birth underwent 3-D T1 MRI neuroimaging at mean age 7.9 yrs. Children with severe brain injury and major motor/sensory/cognitive impairment were excluded. Regional cortical thickness was calculated using custom developed software utilizing FreeSurfer segmentation data. The association between neonatal pain-related stress (defined as the number of skin-breaking procedures accounting for clinical confounders (gestational age, illness severity, infection, mechanical ventilation, surgeries, and morphine exposure, was examined in relation to cortical thickness using constrained principal component analysis followed by generalized linear modeling.After correcting for multiple comparisons and adjusting for neonatal clinical factors, greater neonatal pain-related stress was associated with significantly thinner cortex in 21/66 cerebral regions (p-values ranged from 0.00001 to 0.014, predominately in the frontal and parietal lobes.In very preterm children without major sensory, motor or cognitive impairments, neonatal pain-related stress appears to be associated with thinner cortex

Neonatal pain-related stress predicts cortical thickness at age 7 years in children born very preterm.

Science.gov (United States)

Ranger, Manon; Chau, Cecil M Y; Garg, Amanmeet; Woodward, Todd S; Beg, Mirza Faisal; Bjornson, Bruce; Poskitt, Kenneth; Fitzpatrick, Kevin; Synnes, Anne R; Miller, Steven P; Grunau, Ruth E

2013-01-01

Altered brain development is evident in children born very preterm (24-32 weeks gestational age), including reduction in gray and white matter volumes, and thinner cortex, from infancy to adolescence compared to term-born peers. However, many questions remain regarding the etiology. Infants born very preterm are exposed to repeated procedural pain-related stress during a period of very rapid brain development. In this vulnerable population, we have previously found that neonatal pain-related stress is associated with atypical brain development from birth to term-equivalent age. Our present aim was to evaluate whether neonatal pain-related stress (adjusted for clinical confounders of prematurity) is associated with altered cortical thickness in very preterm children at school age. 42 right-handed children born very preterm (24-32 weeks gestational age) followed longitudinally from birth underwent 3-D T1 MRI neuroimaging at mean age 7.9 yrs. Children with severe brain injury and major motor/sensory/cognitive impairment were excluded. Regional cortical thickness was calculated using custom developed software utilizing FreeSurfer segmentation data. The association between neonatal pain-related stress (defined as the number of skin-breaking procedures) accounting for clinical confounders (gestational age, illness severity, infection, mechanical ventilation, surgeries, and morphine exposure), was examined in relation to cortical thickness using constrained principal component analysis followed by generalized linear modeling. After correcting for multiple comparisons and adjusting for neonatal clinical factors, greater neonatal pain-related stress was associated with significantly thinner cortex in 21/66 cerebral regions (p-values ranged from 0.00001 to 0.014), predominately in the frontal and parietal lobes. In very preterm children without major sensory, motor or cognitive impairments, neonatal pain-related stress appears to be associated with thinner cortex in multiple

Preterm children have unfavorable motor, cognitive, and functional performance when compared to term children of preschool age

Directory of Open Access Journals (Sweden)

Eliane F. Maggi

2014-07-01

Conclusion: this study reinforced the evidence that preterm children from different socioeconomic backgrounds are more likely to have motor, cognitive, and functional development impairment, detectable before school age, than their term peers.

Development of fine motor skills in preterm infants.

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Bos, Arend F; Van Braeckel, Koenraad N J A; Hitzert, Marrit M; Tanis, Jozien C; Roze, Elise

2013-11-01

Fine motor skills are related to functioning in daily life and at school. We reviewed the status of knowledge, in preterm children, on the development of fine motor skills, the relation with gross motor skills, and risk factors for impaired fine motor skills. We searched the past 15 years in PubMed, using ['motor skills' or 'fine motor function' and 'preterm infant'] as the search string. Impaired gross and fine motor skills are among the most frequently occurring problems encountered by preterm children who do not develop cerebral palsy. The prevalence is around 40% for mild to moderate impairment and 20% for moderate impairment. Fine motor skill scores on the Movement Assessment Battery for Children are about 0.62 of a standard deviation lower compared with term children. Risk factors for fine motor impairments include moderately preterm birth (odds ratio [OR] 2.0) and, among very preterm children (development of and recovery from brain injury could guide future intervention attempts aimed at improving fine motor skills of preterm children. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

Variations in the neurobiology of reading in children and adolescents born full term and preterm

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Katherine E. Travis

2016-01-01

Full Text Available Diffusion properties of white matter tracts have been associated with individual differences in reading. Individuals born preterm are at risk of injury to white matter. In this study we compared the associations between diffusion properties of white matter and reading skills in children and adolescents born full term and preterm. 45 participants, aged 9–17 years, included 26 preterms (born <36 weeks' gestation and 19 full-terms. Tract fractional anisotropy (FA profiles were generated for five bilateral white matter tracts previously associated with reading: anterior superior longitudinal fasciculus (aSLF, arcuate fasciculus (Arc, corticospinal tract (CST, uncinate fasciculus (UF and inferior longitudinal fasciculus (ILF. Mean scores on reading for the two groups were in the normal range and were not statistically different. In both groups, FA was associated with measures of single word reading and comprehension in the aSLF, AF, CST, and UF. However, correlations were negative in the full term group and positive in the preterm group. These results demonstrate variations in the neurobiology of reading in children born full term and preterm despite comparable reading skills. Findings suggest that efficient information exchange required for strong reading abilities may be accomplished via a different balance of neurobiological mechanisms in different groups of readers.

Perinatal risk factors for neurocognitive impairments in preschool very preterm children

NARCIS (Netherlands)

Potharst, E.S.; van Wassenaer, A.G.; Houtzager, B.A.; Kok, J.H.; Last, P.F.; Oosterlaan, J.

2013-01-01

Aim This study aimed to compare a broad array of neurocognitive functions (processing speed, aspects of attention, executive functioning, visual-motor coordination, and both face and emotion recognition) in very preterm and term-born children and to identify perinatal risk factors for neurocognitive

Preterm birth and dyscalculia.

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Jaekel, Julia; Wolke, Dieter

2014-06-01

To evaluate whether the risk for dyscalculia in preterm children increases the lower the gestational age (GA) and whether small-for-gestational age birth is associated with dyscalculia. A total of 922 children ranging from 23 to 41 weeks' GA were studied as part of a prospective geographically defined longitudinal investigation of neonatal at-risk children in South Germany. At 8 years of age, children's cognitive and mathematic abilities were measured with the Kaufman Assessment Battery for Children and with a standardized mathematics test. Dyscalculia diagnoses were evaluated with discrepancy-based residuals of a linear regression predicting children's math scores by IQ and with fixed cut-off scores. We investigated each GA group's ORs for general cognitive impairment, general mathematic impairment, and dyscalculia by using binary logistic regressions. The risk for general cognitive and mathematic impairment increased with lower GA. In contrast, preterm children were not at increased risk of dyscalculia after statistically adjusting for child sex, family socioeconomic status, and small-for-gestational age birth. The risk of general cognitive and mathematic impairments increases with lower GA but preterm children are not at increased risk of dyscalculia. Copyright © 2014 Elsevier Inc. All rights reserved.

The Effect of Age-Correction on IQ Scores among School-Aged Children Born Preterm

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Roberts, Rachel M.; George, Wing Man; Cole, Carolyn; Marshall, Peter; Ellison, Vanessa; Fabel, Helen

2013-01-01

This study examined the effect of age-correction on IQ scores among preterm school-aged children. Data from the Flinders Medical Centre Neonatal Unit Follow-up Program for 81 children aged five years and assessed with the WPPSI-III, and 177 children aged eight years and assessed with the WISC-IV, were analysed. Corrected IQ scores were…

Social attribution skills of children born preterm at very low birth weight.

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Williamson, Kathryn E; Jakobson, Lorna S

2014-11-01

Children born prematurely at very low birth weight (social functioning, including autism spectrum disorders (e.g., Johnson et al., 2010). In the current study, we used the Happé-Frith animated triangles task (Abell, Happé, & Frith, 2000) to study social attribution skills in this population. In this task, typical viewers attribute intentionality and mental states to shapes, based on characteristics of their movements. Participants included 34 preterm children and 36 full-term controls, aged 8-11 years. Groups were comparable in terms of age at test, gender, handedness, and socioeconomic status; they also performed similarly on tests of selective attention/processing speed and verbal intelligence. Relative to full-term peers, preterm children's descriptions of the animations were less appropriate overall; they also overattributed intentionality/mental states to randomly moving shapes and underattributed intentionality/mental states to shapes that seemed to be interacting socially. Impairments in the ability to infer the putative mental states of triangles from movement cues alone were most evident in children displaying more "autistic-like" traits, and this may reflect atypical development of and/or functioning in, or atypical connections between, parts of the social brain.

Visual performance in preterm infants with brain injuries compared with low-risk preterm infants.

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Leonhardt, Merçè; Forns, Maria; Calderón, Caterina; Reinoso, Marta; Gargallo, Estrella

2012-08-01

Neonatal brain injuries are the main cause of visual deficit produced by damage to posterior visual pathways. While there are several studies of visual function in low-risk preterm infants or older children with brain injuries, research in children of early age is lacking. To assess several aspects of visual function in preterm infants with brain injuries and to compare them with another group of low-risk preterm infants of the same age. Forty-eight preterm infants with brain injuries and 56 low-risk preterm infants. The ML Leonhardt Battery of Optotypes was used to assess visual functions. This test was previously validated at a post-menstrual age of 40 weeks in newborns and at 30-plus weeks in preterm infants. The group of preterm infants with brain lesions showed a delayed pattern of visual functions in alertness, fixation, visual attention and tracking behavior compared to infants in the healthy preterm group. The differences between both groups, in the visual behaviors analyzed were around 30%. These visual functions could be identified from the first weeks of life. Our results confirm the importance of using a straightforward screening test with preterm infants in order to assess altered visual function, especially in infants with brain injuries. The findings also highlight the need to provide visual stimulation very early on in life. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Maternal and Paternal Perception of Child Vulnerability and Behaviour Problems in Very Preterm Born Children

NARCIS (Netherlands)

Potharst, E.S.; Houtzager, B.A.; van Wassenaer-Leemhuis, A.G.; Kok, J.H.; Koot, H.M.; Last, B.F.

2015-01-01

Preterm born children have more behaviour problems than term born children. Perinatal risks, current child functioning, sociodemographic characteristics, parental psychological distress and parental perceptions of child vulnerability (PCV) have been shown to be risk factors for behaviour problems.

Early language processing efficiency predicts later receptive vocabulary outcomes in children born preterm.

Science.gov (United States)

Marchman, Virginia A; Adams, Katherine A; Loi, Elizabeth C; Fernald, Anne; Feldman, Heidi M

2016-01-01

As rates of prematurity continue to rise, identifying which preterm children are at increased risk for learning disabilities is a public health imperative. Identifying continuities between early and later skills in this vulnerable population can also illuminate fundamental neuropsychological processes that support learning in all children. At 18 months adjusted age, we used socioeconomic status (SES), medical variables, parent-reported vocabulary, scores on the Bayley Scales of Infant and Toddler Development (third edition) language composite, and children's lexical processing speed in the looking-while-listening (LWL) task as predictor variables in a sample of 30 preterm children. Receptive vocabulary as measured by the Peabody Picture Vocabulary Test (fourth edition) at 36 months was the outcome. Receptive vocabulary was correlated with SES, but uncorrelated with degree of prematurity or a composite of medical risk. Importantly, lexical processing speed was the strongest predictor of receptive vocabulary (r = -.81), accounting for 30% unique variance. Individual differences in lexical processing efficiency may be able to serve as a marker for information processing skills that are critical for language learning.

Basic Information Processing Abilities at 11 years Account for Deficits in IQ Associated with Preterm Birth.

Science.gov (United States)

Rose, Susan A; Feldman, Judith F; Jankowski, Jeffery J; Van Rossem, Ronan

2011-07-01

Although it is well established that preterms as a group do poorly relative to their full-term peers on tests of global cognitive functioning, the basis for this relative deficiency is less understood. The present paper examines preterm deficits in core cognitive abilities and determines their role in mediating preterm/full-term differences in IQ. The performance of 11-year-old children born preterm (birth weight <1750g) and their full-term controls were compared on a large battery of 15 tasks, covering four basic cognitive domains -- memory, attention, speed of processing and representational competence. The validity of these four domains was established using latent variables and confirmatory factor analysis (CFA). Preterms showed pervasive deficits within and across domains. Additionally, preterm deficits in IQ were completely mediated by these four cognitive domains in a structural equation model involving a cascade from elementary abilities (attention and speed), to more complex abilities (memory and representational competence), to IQ. The similarity of findings to those obtained with this cohort in infancy and toddlerhood suggest that preterm deficits persist - across time, across task, and from the non-verbal to the verbal period.

Evaluation of early childhood social-communication difficulties in children born preterm using the Quantitative Checklist for Autism in Toddlers.

Science.gov (United States)

Wong, Hilary S; Huertas-Ceballos, Angela; Cowan, Frances M; Modi, Neena

2014-01-01

To characterize early childhood social-communication skills and autistic traits in children born very preterm using the Quantitative Checklist for Autism in Toddlers (Q-CHAT) and explore neonatal and sociodemographic factors associated with Q-CHAT scores. Parents of children born before 30 weeks gestation and enrolled in a study evaluating routinely collected neurodevelopmental data between the post-menstrual ages of 20 and 28 months were invited to complete the Q-CHAT questionnaire. Children with severe neurosensory disabilities and cerebral palsy were excluded. Participants received neurodevelopmental assessments using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Q-CHAT scores of this preterm cohort were compared with published general population scores. The association between Bayley-III cognitive and language scores and neonatal and sociodemographic factors with Q-CHAT scores were examined. Q-CHAT questionnaires were completed from 141 participants. At a mean post-menstrual age of 24 months, the Q-CHAT scores of the preterm cohort (mean 33.7, SD 8.3) were significantly higher than published general population scores (mean 26.7; SD 7.8), indicating greater social-communication difficulty and autistic behavior. Preterm children received higher scores, particularly in the categories of restricted, repetitive, stereotyped behavior, communication, and sensory abnormalities. Lower Bayley-III language scores and non-white ethnicity were associated with higher Q-CHAT scores. Preterm children display greater social-communication difficulty and autistic behavior than the general population in early childhood as assessed by the Q-CHAT. The implications for longer-term outcome will be important to assess. Copyright © 2014 Mosby, Inc. All rights reserved.

Perinatal risk factors for neurocognitive impairments in preschool children born very preterm

NARCIS (Netherlands)

Potharst, Eva S.; van Wassenaer-Leemhuis, Aleid G.; Houtzager, Bregje A.; Livesey, David; Kok, Joke H.; Last, Bob F.; Oosterlaan, Jaap

2013-01-01

This study aimed to compare a broad array of neurocognitive functions (processing speed, aspects of attention, executive functioning, visual-motor coordination, and both face and emotion recognition) in very preterm and term-born children and to identify perinatal risk factors for neurocognitive

Persistently elevated right ventricular index of myocardial performance in preterm infants with incipient bronchopulmonary dysplasia.

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Christoph Czernik

Full Text Available OBJECTIVES: Elevated pulmonary vascular resistance occurs during the first days after birth in all newborn infants and persists in infants at risk for bronchopulmonary dysplasia (BPD. It is difficult to measure in a non-invasive fashion. We assessed the usefulness of the right ventricular index of myocardial performance (RIMP to estimate pulmonary vascular resistance in very low birth weight infants. STUDY DESIGN: Prospective echocardiography on day of life (DOL 2, 7, 14, and 28 in 121 preterm infants (median [quartiles] gestational age 28 [26]-[29] weeks, birth weight 998 [743-1225] g of whom 36 developed BPD (oxygen supplementation at 36 postmenstrual weeks. RESULTS: RIMP derived by conventional pulsed Doppler technique was unrelated to heart rate or mean blood pressure. RIMP on DOL 2 was similar in infants who subsequently did (0.39 [0.33-0.55] and did not develop BPD (0.39 [0.28-0.51], p = 0.467. RIMP declined steadily in non-BPD infants but not in BPD infants (DOL 7: 0.31[0.22-0.39] vs. 0.35[0.29-0.48], p = 0.014; DOL 14: 0.23[0.17-0.30] vs. 0.35[0.25-0.43], p<0.001; DOL 28: 0.21[0.15-0.28] vs. 0.31 [0.21-0.35], p = 0.015. CONCLUSIONS: In preterm infants, a decline in RIMP after birth was not observed in those with incipient BPD. The pattern of RIMP measured in preterm infants is commensurate with that of pulmonary vascular resistance.

Language and Reading Skills in School-Aged Children and Adolescents Born Preterm Are Associated with White Matter Properties on Diffusion Tensor Imaging

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Feldman, Heidi M.; Lee, Eliana S.; Yeatman, Jason D.; Yeom, Kristen W.

2012-01-01

Children born preterm are at risk for deficits in language and reading. They are also at risk for injury to the white matter of the brain. The goal of this study was to determine whether performance in language and reading skills would be associated with white matter properties in children born preterm and full-term. Children born before 36 weeks…

Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis. A nationwide cohort study

DEFF Research Database (Denmark)

Rom, Ane L; Wu, Chunsen; Olsen, Jørn

2014-01-01

OBJECTIVE: To assess indicators of fetal growth and risk of preterm birth in children of parents with rheumatoid arthritis (RA). METHODS: Through linkage of Danish national registries, we identified all children born in Denmark between 1977 and 2008. We used general linear regression models...... to estimate mean differences in indicators of fetal growth among children with a parent with RA compared to unexposed children. Odds ratios (ORs) and 95% confidence intervals (95% CIs) of preterm birth were calculated using a logistic regression model. RESULTS: Of the 1,917,723 children included, a total...... of 13,556 children were exposed to maternal RA or maternal preclinical RA. Children exposed to maternal RA (n = 2,101) had approximately similar length, head circumference, and abdominal circumference at birth compared with children of mothers without RA. Birth weight was 87 gm lower (mean difference...

Motor learning and working memory in children born preterm: a systematic review.

NARCIS (Netherlands)

Jongbloed-Pereboom, M.; Janssen, A.J.W.M.; Steenbergen, B.; Nijhuis-Van der Sanden, M.W.G.

2012-01-01

Children born preterm have a higher risk for developing motor, cognitive, and behavioral problems. Motor problems can occur in combination with working memory problems, and working memory is important for explicit learning of motor skills. The relation between motor learning and working memory has

Motor learning and working memory in children born preterm: A systematic review

NARCIS (Netherlands)

Jongbloed-Pereboom, M.; Janssen, A.J.W.M.; Steenbergen, B.; Nijhuis-Van der Sanden, M.W.G.

2012-01-01

Children born preterm have a higher risk for developing motor, cognitive, and behavioral problems. Motor problems can occur in combination with working memory problems, and working memory is important for explicit learning of motor skills. The relation between motor learning and working memory has

Family functioning, burden and parenting stress 2 years after very preterm birth.

Science.gov (United States)

Treyvaud, Karli; Doyle, Lex W; Lee, Katherine J; Roberts, Gehan; Cheong, Jeanie L Y; Inder, Terrie E; Anderson, Peter J

2011-06-01

Examining rates of difficulties in family functioning following very preterm birth has been a relatively neglected area of research. To examine family functioning, burden and parenting stress in families with very preterm compared with term born children, and investigate influences of parental mental health problems and child neurodevelopmental disability on family outcomes in families with preterm children. Participants were 184 very preterm and 71 term children and their parents. Parents completed the Family Assessment Device, Parenting Stress Index and Impact on Family questionnaires when their children were 2 years old (corrected for prematurity). Parental mental health and social risk information were also collected. Children were assessed for neurodevelopmental disability. Families with very preterm children reported poorer family functioning (p=.03) compared with families with term born children, with less evidence for differences between families with very preterm and term born children in parenting stress and family burden. Within very preterm families, parental mental health problems were associated with higher levels of parenting stress (p=.001), and parents of children with a neurodevelopmental disability were more likely to report higher family burden (p=.04). For families with very preterm children, parental mental health symptoms and child neurodevelopmental disability may identify families at risk of greater stress and burden who may benefit from additional support. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Do Healthy Preterm Children Need Neuropsychological Follow-Up? Preschool Outcomes Compared with Term Peers

Science.gov (United States)

Dall'Oglio, Anna M.; Rossiello, Barbara; Coletti, Maria F.; Bultrini, Massimiliano; De Marchis, Chiara; Rava, Lucilla; Caselli, Cristina; Paris, Silvana; Cuttini, Marina

2010-01-01

Aim: The aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. Method : A total of 35 infants who were born at less than 33…

Hot and cool executive functions in very and extremely preterm preschool children

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Tamara Zofia Walczak

2017-12-01

Full Text Available Background In most countries, premature deliveries constitute 5% to 18% of births. Some preterm children, especially those born before 32 weeks of pregnancy, experience serious medical complications, which can affect their subsequent development and functioning. Even those who have an IQ within the normal range can be at risk of worse functioning. This study aimed to investigate the differences in development of hot and cool aspects of executive functions in children born prematurely in comparison to those born on time. It is also focused on evaluating relationships between executive functions in premature children and their socio-emotional competences. Participants and procedure All children participating in the study were preschoolers. The sample consisted of 20 children born before 32 weeks of gestation and 28 term controls (children born on time. Hot and cool aspects of executive functions were examined in both groups using tasks extracted from the Preschool Self-Regulation Assessment (PSRA. Parents of children born prematurely also completed the Strengths and Difficulties Questionnaire (SDQ, which is a brief behavioral screening questionnaire that consists of five scales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior. Results Premature children scored lower for both hot and cool executive functions in comparison to the children born at term in two of the five tasks. In addition, an association between worse executive functioning and more severe problems was found in the preterm group. This link applies to both general and specific problems, such as hyperactivity/inattention and behavioral problems. Conclusions Prematurely born children may have larger deficits both in hot and cool aspects of executive functions compared to their peers born at term. Deficits in hot aspect may be reflected in hyperactivity/inattention symptoms and conduct problems, whereas difficulties in

Attention deficit hyperactivity disorder and autism spectrum disorder symptoms in school-age children born very preterm

NARCIS (Netherlands)

Bröring, Tinka; Oostrom, Kim J.; van Dijk-Lokkart, Elisabeth M.; Lafeber, Harrie N.; Brugman, Anniek; Oosterlaan, Jaap

2018-01-01

Very preterm (VP) children face a broad range of neurodevelopmental sequelae, including behavioral problems. To investigate prevalence, pervasiveness and co-occurrence of symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in school-age children born very

Understanding mild persistent asthma in children

DEFF Research Database (Denmark)

Bisgaard, Hans; Szefler, Stanley J

2005-01-01

Limitations in asthma prevalence studies and difficulties in diagnosing pediatric asthma lead to uncertainty over the full extent of mild persistent asthma in children and adolescents. Although recent surveys have reported that the majority of pediatric patients with asthma in the United States...... and Europe have symptoms consistent with mild disease, these surveys have limitations in design. Thus, the true prevalence of mild asthma remains unknown. It is unclear whether children with mild persistent asthma progress to more severe asthma, but the risk of severe asthma exacerbations seems...... to be unrelated to the symptom severity. Clinical studies restricted to pediatric patients with mild asthma are limited, but available data do suggest substantial morbidity of mild persistent asthma in this population and support inhaled corticosteroid intervention. There is a need for further investigation...

Stress in parents of children born very preterm is predicted by child externalising behaviour and parent coping at age 7 years.

Science.gov (United States)

Linden, Mark A; Cepeda, Ivan L; Synnes, Anne; Grunau, Ruth E

2015-06-01

To examine factors which predict parenting stress in a longitudinal cohort of children born very preterm, and seen at age 7 years. We recruited 100 very preterm (≤32 weeks gestational age) child-parent dyads and a control group of 50 term-born dyads born between 2001 and 2004 with follow-up at 7 years. Parents completed the Parenting Stress Index, Ways of Coping Questionnaire, Child Behavior Check List, Beck Depression Inventory and the State Trait Anxiety Inventory questionnaires. Child IQ was assessed using the Wechsler Intelligence Scale-IV. After controlling for maternal education, parents of preterm children (95% CI 111.1 to 121.4) scored higher (p=0.027) on the Parenting Stress Index than term-born controls (95% CI 97.8 to 113.2). Regression analyses showed that child externalising behaviour, sex and parent escape/avoidance coping style, predicted higher parenting stress in the preterm group. Parents of preterm girls expressed higher levels of stress than those of boys. Maladaptive coping strategies contribute to greater stress in parents of very preterm children. Our findings suggest that these parents need support for many years after birth of a very preterm infant. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children

NARCIS (Netherlands)

Kerstjens, Jorien M.; Nijhuis, Ard; Hulzebos, Christian V.; van Imhoff, Deirdre E.; van Wassenaer-Leemhuis, Aleid G.; van Haastert, Ingrid C.; Lopriore, Enrico; Katgert, Titia; Swarte, Renate M.; van Lingen, Richard A.; Mulder, Twan L.; Laarman, Celeste R.; Steiner, Katerina; Dijk, Peter H.

2015-01-01

Objective To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two. Methods We studied the test results of 224 children, born at <32 postmenstrual weeks,

Feasibility of a Preventive Parenting Intervention for Very Preterm Children at 18 Months Corrected Age: A Randomized Pilot Trial

NARCIS (Netherlands)

Flierman, Monique; Koldewijn, Karen; Meijssen, Dominique; van Wassenaer-Leemhuis, Aleid; Aarnoudse-Moens, Cornelieke; van Schie, Petra; Jeukens-Visser, Martine

2016-01-01

To evaluate the feasibility and potential efficacy of an age-appropriate additional parenting intervention for very preterm born toddlers. In a randomized controlled pilot study, 60 of 94 eligible very preterm born children who had received a responsive parenting intervention in their first year

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children

NARCIS (Netherlands)

Kerstjens, Jorien M.; Nijhuis, Ard; Hulzebos, Christian V.; van Imhoff, Deirdre E.; van Wassenaer-Leemhuis, Aleid G.; van Haastert, Ingrid C.; Lopriore, Enrico; Katgert, Titia; Swarte, Renate M.; van Lingen, Richard A.; Mulder, Twan L.; Laarman, Céleste R.; Steiner, Katerina; Dijk, Peter H.

2015-01-01

To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two. We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on

Successful pleurodesis with OK-432 (picibanil in preterm infants with persistent pleural effusion

Directory of Open Access Journals (Sweden)

Jeong Eun Kim

2012-05-01

Full Text Available OK-432 (picibanil is an inactivated preparation of &lt;em&gt;Streptococcus pyogenes&lt;/em&gt; that causes pleurodesis by inducing a strong inflammatory response. Intrapleural instillation of OK-432 has recently been used to successfully treat neonatal and fetal chylothorax. Here we report a trial of intrapleural instillation of OK-432 in two preterm infants who were born with hydrops fetalis and massive bilateral pleural effusion. Both cases showed persistent pleural effusion, refractory to conservative treatment, up to postnatal days 26 and 46, respectively. An average of 80 to 140 mL of pleural fluid was drained daily. In case 1, the infant was treated with OK-432 during the fetal period at gestation 28 weeks and 4 days of gestation, but showed recurrence of pleural effusion and progressed into hydrops. Within two to three days after OK-432 injection, the amount of pleural fluid drainage was dramatically decreased and there was no reaccumulation. We did not observe any side effects related to OK-432 injection. We suggest that OK-432 should be considered as a therapeutic option in infants who have persistent pleural effusion for more than four weeks, with the expectation of the early removal of the chest tube and a good outcome.

Very preterm born children at early school age: Healthcare therapies and educational provisions

NARCIS (Netherlands)

van Veen, S.; Aarnoudse-Moens, C. S. H.; Oosterlaan, J.; Van Sonderen, L.; de Haan, T. R.; van Kaam, A. H.; van Wassenaer-Leemhuis, A. G.

2017-01-01

To explore changes in motor and cognitive outcomes in very preterm (VP; gestational age <30weeks) born children between ages five and six years, and to determine whether changes in these outcomes were associated with the use of healthcare therapies and educational provisions. Single-center

Bilingualism as a potential strategy to improve executive function in preterm infants: a review.

Science.gov (United States)

Head, Lauren M; Baralt, Melissa; Darcy Mahoney, Ashley E

2015-01-01

Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. Using the model of brain plasticity as a theoretical framework, it is possible that preterm infants' neurodevelopmental sequelae can be altered. Evidence suggests that bilingualism confers cognitive advantages on executive functioning, so it is possible that bilingualism may improve preterm infants' neurodevelopment. However, bilingualism has only been studied in term children. This review examined literature that compared the performance of preterm-born children to term children and bilingual children to monolingual children on executive function tasks. To address cognitive disparities in preterm-born children, studies investigating the effect of bilingualism on preterm infants' executive functioning is warranted. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Multiple courses of antenatal corticosteroids for preterm birth study: outcomes in children at 5 years of age (MACS-5).

Science.gov (United States)

Asztalos, Elizabeth V; Murphy, Kellie E; Willan, Andrew R; Matthews, Stephen G; Ohlsson, Arne; Saigal, Saroj; Armson, B Anthony; Kelly, Edmond N; Delisle, Marie-France; Gafni, Amiram; Lee, Shoo K; Sananes, Renee; Rovet, Joanne; Guselle, Patricia; Amankwah, Kofi; Saleem, Mariam; Sanchez, Johanna

2013-12-01

A single course of antenatal corticosteroid therapy is recommended for pregnant women at risk of preterm birth between 24 and 33 weeks' gestational age. However, 50% of women remain pregnant 7 to 14 days later, leading to the question of whether additional courses should be given to women remaining at risk for preterm birth. The Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS) was an international randomized clinical trial that compared multiple courses of antenatal corticosteroids with a single course in women at risk of preterm birth. To determine the effects of single vs multiple courses of antenatal corticosteroid therapy on death or neurodevelopmental disability (neuromotor, neurosensory, or neurocognitive/neurobehavioral function) at 5 years of age in children whose mothers participated in MACS. Our secondary aims were to determine the effect on height, weight, head circumference, blood pressure, intelligence, and specific cognitive (visual, spatial, and language) skills. Cohort follow-up study of children seen between June 2006 and May 2012 at 55 centers. In total, 1724 women (2141 children) were eligible for the study, of whom 1728 children (80.7% of the 2141 eligible children) participated and 1719 children contributed to the primary outcome. Single and multiple courses of antenatal corticosteroid therapy. The primary outcome was death or survival with a neurodevelopmental disability in 1 of the following domains: neuromotor (nonambulatory cerebral palsy), neurosensory (blindness, deafness, or need for visual/hearing aids), or neurocognitive/neurobehavioral function (abnormal attention, memory, or behavior). There was no significant difference between the groups in the risk of death or neurodevelopmental disability: 217 of 871 children (24.9%) in the multiple-courses group vs 210 of 848 children (24.8%) in the single-course group (odds ratio, 1.02 [95% CI, 0.81 to 1.29]; P = .84). Multiple courses, compared with a single

Periventricular leukomalacia in preterm children: assessment of grey and white matter and cerebrospinal fluid changes by MRI

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Tzarouchi, Loukia C.; Zikou, Anastasia; Xydis, Vassilios; Kosta, Paraskevi; Argyropoulou, Maria I. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Astrakas, Loukas G. [University of Ioannina, Department of Medical Physics, Medical School, Ioannina (Greece); Andronikou, Styliani [University of Ioannina, Intensive Care Unit, Child Health Department, Medical School, Ioannina (Greece)

2009-12-15

Brain plasticity in patients with periventricular leukomalacia (PVL) may suggest grey matter (GM) changes. To assess the volume of 116 GM areas and total volume of GM, white matter (WM) and cerebrospinal fluid (CSF) in preterm children with PVL, using the Statistical Parametric Mapping (SPM5) and the Individual Brain Atlases Statistical Parametric Mapping (IBASPM) toolboxes. Ten preterm children (gestational age 31.7{+-}4.2 weeks, corrected age 27.8{+-}21.7 months) with PVL and 46 matched, preterm control subjects were studied using a three-dimensional T1-weighted sequence. Volumes were calculated using SPM5 and IBASPM. GM volume in frontal superior orbital, posterior cingulum and lingual gyrus, the putamen and thalamus was significantly higher in children with PVL (3.6{+-}0.6 cm{sup 3}, 2.0{+-}0.5 cm{sup 3}, 9.7{+-}1.7 cm{sup 3}, 2.5{+-}0.6 cm{sup 3}, 2.6{+-}0.9 cm{sup 3}, respectively) than in controls (3.1{+-}0.7 cm{sup 3}, 1.5{+-}0.2 cm{sup 3}, 8.2{+-}1.3 cm{sup 3}, 1.7{+-}1.4 cm{sup 3}, 1.8{+-}0.4 cm{sup 3}, respectively). White matter volume was lower (182.1{+-}40.5 cm{sup 3}) and CSF volume was higher (300.8{+-}56.2 cm{sup 3}) in children with PVL than in controls (222.9{+-}67.2 cm{sup 3}, 219.0{+-}61.8 cm{sup 3}, respectively), P<0.05. No significant difference was found in the total GM volume and the volume of neocortex. Preterm children with PVL show regional GM volume increase, possibly explained by axonal sprouting, neuronal hypertrophy and neurogenesis, which in turn may reflect brain plasticity. (orig.)

Tolerance to early human milk feeding is not compromised by indomethacin in preterm infants with persistent ductus arteriosus.

Science.gov (United States)

Bellander, M; Ley, D; Polberger, S; Hellström-Westas, L

2003-09-01

Early human milk feeding is beneficial for gut and brain development. Persistent ductus arteriosus (PDA) and indomethacin may compromise enteral function in preterm infants. For many years enteral milk feedings have continued in preterm infants receiving indomethacin for PDA. The aim of this study was to investigate whether this strategy is efficient in terms of risks and tolerance to early enteral feeding. This retrospective study included 64 inborn infants of respiratory morbidity; 90.6% versus 50% of controls needed mechanical ventilation (p = 0.000). Case infants received human milk from a median (range) age of 4.0 h (1.5-27.5), and controls from 5.3 h (2.0-38.0) (p = 0.092). The first dose of indomethacin was given at a mean age of 1.7 d (1.0). There were no differences between the two groups in feeding volumes or gastric residuals on days 1 to 7. Mean (SD) feeding volume on day 7 was 64 ml/kg (31) in case infants and 76 ml/kg (30) in controls (p = 0.23). Four infants developed necrotizing enterocolitis: two case infants and two controls (p = 1.00). Early enteral feeding with human milk, starting within the first hours of life, seems to be as well tolerated in preterm infants treated with indomethacin for PDA as in their matched controls.

Preventing academic difficulties in preterm children: a randomised controlled trial of an adaptive working memory training intervention - IMPRINT study.

Science.gov (United States)

Pascoe, Leona; Roberts, Gehan; Doyle, Lex W; Lee, Katherine J; Thompson, Deanne K; Seal, Marc L; Josev, Elisha K; Nosarti, Chiara; Gathercole, Susan; Anderson, Peter J

2013-09-16

Very preterm children exhibit difficulties in working memory, a key cognitive ability vital to learning information and the development of academic skills. Previous research suggests that an adaptive working memory training intervention (Cogmed) may improve working memory and other cognitive and behavioural domains, although further randomised controlled trials employing long-term outcomes are needed, and with populations at risk for working memory deficits, such as children born preterm.In a cohort of extremely preterm (memory and attention 2 weeks', 12 months' and 24 months' post-intervention, and to investigate training related neuroplasticity in working memory neural networks 2 weeks' post-intervention. This double-blind, placebo-controlled, randomised controlled trial aims to recruit 126 extremely preterm/extremely low birthweight 7-year-old children. Children attending mainstream school without major intellectual, sensory or physical impairments will be eligible. Participating children will undergo an extensive baseline cognitive assessment before being randomised to either an adaptive or placebo (non-adaptive) version of Cogmed. Cogmed is a computerised working memory training program consisting of 25 sessions completed over a 5 to 7 week period. Each training session takes approximately 35 minutes and will be completed in the child's home. Structural, diffusion and functional Magnetic Resonance Imaging, which is optional for participants, will be completed prior to and 2 weeks following the training period. Follow-up assessments focusing on academic skills (primary outcome), working memory and attention (secondary outcomes) will be conducted at 2 weeks', 12 months' and 24 months' post-intervention. To our knowledge, this study will be the first randomised controlled trial to (a) assess the effectiveness of Cogmed in school-aged extremely preterm/extremely low birthweight children, while incorporating advanced imaging techniques to investigate neural changes

Parents' Perceptions of Primary Health Care Physiotherapy With Preterm Infants: Normalization, Clarity, and Trust.

Science.gov (United States)

Håkstad, Ragnhild B; Obstfelder, Aud; Øberg, Gunn Kristin

2016-08-01

Having a preterm infant is a life-altering event for parents. The use of interventions intended to support the parents is recommended. In this study, we investigated how parents' perceptions of physiotherapy in primary health care influenced their adaptation to caring for a preterm child. We conducted 17 interviews involving parents of seven infants, at infants' corrected age (CA) 3, 6, and 12 months. The analysis was a systematic text condensation, connecting to theory of participatory sense-making. The parents described a progression toward a new normalcy in the setting of persistent uncertainty. Physiotherapists can ameliorate this uncertainty and support the parents' progression toward normalization, by providing knowledge and acknowledging both the child as subject and the parent-child relationship. Via embodied interaction and the exploration of their child's capacity, the parents learn about their children's individuality and gain the confidence necessary to support and care for their children in everyday life. © The Author(s) 2015.

[Examination of psychomotor development in relation to social-environmental factors in preterm children at 2 years old].

Science.gov (United States)

Kenyhercz, Flóra; Nagy, Beáta

2017-01-01

The development of children born prematurely is an important aspect in public health, because preterm birth rates are not decreasing with the development of medical sciences. Description of psychomotor development of preterm children related to potentially influencing environmental factors. Children born below 2.500 grams at the age of two (n = 75). Psychomotor development, quality of home environment, socio-demographic background were measured. Lower birth weight was associated with lower development quotients. Psychomotor development was also negatively affected by child deprivation, low levels of cognitive stimulation and maternal empathy, regardless of birth weight. Increased performance loss was found related to lower sociodemographic variables, such as low maternal education or ethnicity. Psychomotor development of 2-year-old premature children is affected by the examined social-environmental factors. We recommend the screening and developmental interventions for premature children as early as possible, thus preventing difficulties in mental and motor development in the future. Orv. Hetil., 2017, 158(1), 31-38.

Visuospatial working memory in very preterm and term born children—Impact of age and performance

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I. Mürner-Lavanchy

2014-07-01

Full Text Available Working memory is crucial for meeting the challenges of daily life and performing academic tasks, such as reading or arithmetic. Very preterm born children are at risk of low working memory capacity. The aim of this study was to examine the visuospatial working memory network of school-aged preterm children and to determine the effect of age and performance on the neural working memory network. Working memory was assessed in 41 very preterm born children and 36 term born controls (aged 7–12 years using functional magnetic resonance imaging (fMRI and neuropsychological assessment. While preterm children and controls showed equal working memory performance, preterm children showed less involvement of the right middle frontal gyrus, but higher fMRI activation in superior frontal regions than controls. The younger and low-performing preterm children presented an atypical working memory network whereas the older high-performing preterm children recruited a working memory network similar to the controls. Results suggest that younger and low-performing preterm children show signs of less neural efficiency in frontal brain areas. With increasing age and performance, compensational mechanisms seem to occur, so that in preterm children, the typical visuospatial working memory network is established by the age of 12 years.

Socioeconomic inequalities in very preterm birth rates.

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Smith, L K; Draper, E S; Manktelow, B N; Dorling, J S; Field, D J

2007-01-01

To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the past decade. Ecological study of all 549 618 births in the former Trent health region, UK, from 1 January 1994 to 31 December 2003. All singleton births of 22(+0) to 32(+6) weeks gestation (7 185 births) were identified from population surveys of neonatal services and stillbirths. Poisson regression was used to calculate incidence of very preterm birth (22-32 weeks) and extremely preterm birth (22-28 weeks) by year of birth and decile of deprivation (child poverty section of the Index of Multiple Deprivation). Incidence of very preterm singleton birth rose from 11.9 per 1000 births in 1994 to 13.7 per 1000 births in 2003. Those from the most deprived decile were at nearly twice the risk of very preterm birth compared with those from the least deprived decile, with 16.4 per 1000 births in the most deprived decile compared with 8.5 per 1000 births in the least deprived decile (incidence rate ratio 1.94; 95% CI (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socio-economic inequalities was the same for extremely preterm births (22-28 weeks incidence rate ratio 1.94; 95% CI (1.62 to 2.32)). This large, unique dataset of very preterm births shows wide socio-economic inequalities that persist over time. These findings are likely to have consequences on the burden of long-term morbidity. Our research can assist future healthcare planning, the monitoring of socio-economic inequalities and the targeting of interventions in order to reduce this persistent deprivation gap.

Screening for autism in preterm children with extremely low and very low birth weight

Czech Academy of Sciences Publication Activity Database

Dudová, I.; Kašparová, M.; Marková, D.; Zemánková, J.; Beranová, Š.; Urbánek, Tomáš; Hrdlička, M.

2014-01-01

Roč. 10, Feb (2014), s. 277-282 ISSN 1176-6328 Institutional support: RVO:68081740 Keywords : autism spectrum disorder * preterm children * screening Subject RIV: AN - Psychology Impact factor: 2.154, year: 2013 http://dx.doi.org/10.2147/NDT.S57057

Clinical Implications of Diffuse Excessive High Signal Intensity (DEHSI on Neonatal MRI in School Age Children Born Extremely Preterm.

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Lina Broström

Full Text Available Magnetic resonance imaging (MRI of the brain carried out during the neonatal period shows that 55-80% of extremely preterm infants display white matter diffuse excessive high signal intensity (DEHSI. Our aim was to study differences in developmental outcome at the age of 6.5 years in children born extremely preterm with and without DEHSI.This was a prospective cohort study of 83 children who were born in Stockholm, Sweden, between 2004 and 2007, born at gestational age of < 27 weeks + 0 days and who underwent an MRI scan of their brain at term equivalent age. The outcome measures at 6.5 years included testing 66 children with the modified Touwen neurology examination, the Movement Assessment Battery for Children 2, the Wechsler Intelligence Scale for Children-Fourth Edition, Beery Visual-motor Integration test-Sixth Edition, and the Strengths and Difficulties Questionnaire. Group-wise comparisons were done between children with and without DEHSI using Student t-test, Mann Whitney U test, Chi square test and regression analysis.DEHSI was detected in 39 (59% of the 66 children who were assessed at 6.5 years. The presence of DEHSI was not associated with mild neurological dysfunction, scores on M-ABC assessment, cognition, visual-motor integration, or behavior at 6.5 years.The presence of qualitatively defined DEHSI on neonatal MRI did not prove to be a useful predictor of long-term impairment in children born extremely preterm.

Maternal support for autonomy: relationships with persistence for children with Down syndrome and typically developing children.

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Gilmore, Linda; Cuskelly, Monica; Jobling, Anne; Hayes, Alan

2009-01-01

Maternal behaviors and child mastery behaviors were examined in 25 children with Down syndrome and 43 typically developing children matched for mental age (24-36 months). During a shared problem-solving task, there were no group differences in maternal directiveness or support for autonomy, and mothers in the two groups used similar verbal strategies when helping their child. There were also no group differences in child mastery behaviors, measured as persistence with two optimally challenging tasks. However, the two groups differed in the relationships of maternal style with child persistence. Children with Down syndrome whose mothers were more supportive of their autonomy in the shared task displayed greater persistence when working independently on a challenging puzzle, while children of highly directive mothers displayed lower levels of persistence. For typically developing children, persistence was unrelated to maternal style, suggesting that mother behaviors may have different causes or consequences in the two groups.

Neonatal Morphine Exposure in Very Preterm Infants – Cerebral Development and Outcomes

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Steinhorn, Rachel; McPherson, Chris; Anderson, Peter J; Neil, Jeffrey; Doyle, Lex W; Inder, Terrie

2015-01-01

Objective To investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood. Study design Observational study of very preterm infants in the Victorian Infant Brain Study cohort. 230 infants born neonatal intensive care unit (NICU) of the Royal Women’s Hospital. 57 (25%) infants received morphine analgesia during their NICU stay at the attending physician’s discretion. Primary outcomes were regional brain volumes at term and 7 years; neurobehavioral performance at term; and cognitive, motor, emotional, behavioral, communication, and executive function scores at age 2 and 7 years. Linear regressions were used to compare outcomes between participants who did and did not receive morphine. Results At term, preterm infants who received morphine had similar rates of grey matter injury to no-morphine infants, but a trend towards smaller cortical volumes in the orbitofrontal (pleft=0.002, pright=0.01) and subgenual (pleft=0.01) regions. At seven years, cortical volumes did not differ between groups. At 2 years, morphine-exposed children were more likely to show behavioral dysregulation (p=0.007) than no-morphine children, but at seven years no detrimental impacts of morphine on neurobehavioral outcome were observed. Conclusions Low-dose morphine analgesia received during neonatal intensive care was associated with early alterations in cerebral structure and short-term neurobehavioral problems that did not persist into childhood. PMID:25919729

Cerebral palsy in preterm infants

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Demeši-Drljan Čila

2016-01-01

Full Text Available Background/Aim. Cerebral palsy (CP is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS. Results. More than half of the children with CP were born prematurely (54.4%. Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001. In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049, children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0% affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032. Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike

Delayed growth, motor function and learning in preterm pigs during early postnatal life

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Andersen, Anders D.; Sangild, Per T.; Munch, Sara L.

2016-01-01

Preterm birth interrupts normal fetal growth with consequences for postnatal growth and organ development. In preterm infants, many physiological deficits adapt and disappear with advancing postnatal age, but some may persist into childhood. We hypothesized that preterm birth would induce impaired......, and learning, relative to term pigs (all P

Influence of post discharge nutrition on body composition at 6 years of age among children born very preterm

DEFF Research Database (Denmark)

Toftlund, Line Hedegaard; Zachariassen, Gitte; Agertoft, Lone

Background Very preterm born infants receive nutrition that ensures optimal growth during the neonatal period. New research has shown that the type of nutrition in early life may affect not only growth but also later body composition and risk of developing metabolic syndrome. Aim • To evaluate...... if type of nutrition in early life effects the body composition in later life among very preterm born children Method In 2004-08 a birth cohort of very preterm born infants with a gestational age ≤32+0 weeks. At time of hospital discharge, the infants were randomised into 3 different feeding groups...

Cognitive, motor, behavioural and academic performances of children born preterm: a meta-analysis and systematic review involving 64 061 children

NARCIS (Netherlands)

Allotey, J.; Zamora, J.; Cheong-See, F.; Kalidindi, M.; Arroyo-Manzano, D.; Asztalos, E.; van der Post, J. A. M.; Mol, B. W.; Moore, D.; Birtles, D.; Khan, K. S.; Thangaratinam, S.

2018-01-01

BackgroundPreterm birth may leave the brain vulnerable to dysfunction. Knowledge of future neurodevelopmental delay in children born with various degrees of prematurity is needed to inform practice and policy. ObjectiveTo quantify the long-term cognitive, motor, behavioural and academic performance

Immunizations for Preterm Babies

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... Issues Health Issues Health Issues Conditions Injuries & Emergencies Vaccine Preventable Diseases ... Children > Safety & Prevention > Immunizations > Immunizations For Preterm Babies Safety & ...

Parenting Behavior at 2 Years Predicts School-age Performance at 7 Years in Very Preterm Children

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Treyvaud, Karli; Doyle, Lex W.; Lee, Katherine J.; Ure, Alexandra; Inder, Terrie E.; Hunt, Rod W.; Anderson, Peter J.

2016-01-01

Parenting influences child development, but it is unclear whether early parenting behavior can influence school-age outcomes in very preterm (VPT) children, and/or if certain groups of VPT children may be more affected by early parenting behavior. These research questions were examined. Participants were 147 children born <30 weeks' gestation…

Radiologic differences in white matter maturation between preterm and full-term infants: TBSS study

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Lee, Ah Young; Jang, Sung Ho; Ahn, Sang Ho; Cho, Hee Kyung; Jo, Hae Min; Son, Su Min [Yeungnam University, Department of Physical Medicine and Rehabilitation, College of Medicine, Taegu (Korea, Republic of); Lee, Eunsil [Yeungnam University, Department of Pediatrics, College of Medicine, Taegu (Korea, Republic of)

2013-03-15

Widespread white matter (WM) pathology in preterm children has been proposed. The purpose of this study was to investigate maturational differences of WM between preterm infants with thinning of the corpus callosum and full-term infants. A total of 18 preterm children and 18 full-term children were divided into three subgroups according to the corrected age at the time of diffusion tensor imaging scanning. Tract-based spatial statistics was used for assessing differences in fractional anisotropy (FA) between preterm and full-term children, and between each age-related subgroup in preterm and in full-term children. In the preterm group, FA values of overall WM showed an increase with age. This trend indicates that WM maturation is a gradual occurrence during a child's first 2 years. In the full-term group, most WM structures had reached maturation at around 1 year of age; however, centrum semiovale level showed sustained maturation during the first 2 years. Results of our study demonstrate radiologic maturational differences of WM and provide evidence of the need for therapeutic intervention within 2 years of birth to prevent specific functional impairment and to improve clinical outcome in preterm children. (orig.)

Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children

NARCIS (Netherlands)

C.S.H. Aarnoudse-Moens (Cornelieke); N. Weisglas-Kuperus (Nynke); J.B. van Goudoever (Hans); J. Oosterlaan (Jaap)

2009-01-01

textabstractOBJECTIVE: Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (≤33 weeks' gestation) and/or very low birth weight (VLBW) (≤1500 g) children. Great variability in the published results, however,

Prediction of cognitive abilities at the age of 5 years using developmental follow-up assessments at the age of 2 and 3 years in very preterm children

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Potharst, Eva S.; Houtzager, Bregje A.; van Sonderen, Loekie; Tamminga, Pieter; Kok, Joke H.; Last, Bob F.; van Wassenaer, Aleid G.

2012-01-01

Aim This study investigated prediction of separate cognitive abilities at the age of 5 years by cognitive development at the ages of both 2 and 3 years, and the agreement between these measurements, in very preterm children. METHODS Preterm children (n=102; 44males; 58 females) with a gestational

Rethinking Stress in Parents of Preterm Infants: A Meta-Analysis

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Schappin, Renske; Wijnroks, Lex; Uniken Venema, Monica M. A. T.; Jongmans, Marian J.

2013-01-01

Background With improved medical outcome in preterm infants, the psychosocial situation of their families is receiving increasing attention. For parents, the birth of a preterm infant is generally regarded as a stressful experience, and therefore many interventions are based on reducing parental stress. Nevertheless, it remains unclear whether parents of children born preterm experience more stress than parents of term-born children, which would justify these interventions. This meta-analysis provides a comprehensive account of parental stress in parents of preterm infants, from birth of the infant through to their adolescence. Mean levels of stress in specific domains of family functioning were investigated, and stress levels in parents of preterm and term infants, and fathers and mothers of preterm infants, were compared. Furthermore, we investigated moderators of parental stress. Methods and Findings A random-effects meta-analysis was conducted including 38 studies describing 3025 parents of preterm (stress was measured with two parent-reported questionnaires, the Parenting Stress Index and the Parental Stressor Scale: Neonatal Intensive Care Unit. The results indicate that parents of preterm-born children experience only slightly more stress than parents of term-born children, with small effect sizes. Furthermore, mothers have slightly more stress than fathers, but these effect sizes are also small. Parents report more stress for infants with lower gestational ages and lower birth weights. There is a strong effect for infant birth year, with decreasing parental stress from the 1980s onward, probably due to increased quality of care for preterm infants. Conclusions Based on our findings we argue that prematurity can best be regarded as one of the possible complications of birth, and not as a source of stress in itself. PMID:23405105

Attention deficit hyperactivity disorder and autism spectrum disorder symptoms in school-age children born very preterm

NARCIS (Netherlands)

Bröring, Tinka; Oostrom, Kim J.; van Dijk-Lokkart, Elisabeth M.; Lafeber, Harrie N.; Brugman, Anniek; Oosterlaan, Jaap

Background: Very preterm (VP) children face a broad range of neurodevelopmental sequelae, including behavioral problems. Aim: To investigate prevalence, pervasiveness and co-occurrence of symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in school-age

Prediction of cognitive abilities at the age of 5 years using developmental follow-up assessments at the age of 2 and 3 years in very preterm children

NARCIS (Netherlands)

Potharst, E.S.; Houtzager, B.A.; van Sonderen, L.; Tamminga, P.; Kok, J.H.; Last, B.F.; van Wassenaer, A.G.

2012-01-01

Aim This study investigated prediction of separate cognitive abilities at the age of 5years by cognitive development at the ages of both 2 and 3years, and the agreement between these measurements, in very preterm children. Methods Preterm children (n=102; 44 males; 58 females) with a gestational age

Cognition, behavior and social competence of preterm low birth weight children at school age

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Rachel Gick Fan

2013-07-01

Full Text Available OBJECTIVE: The aim of this study was to assess the cognitive and behavioral development of preterm and low birth weight newborns living in a disadvantageous socioeconomic environment at school age. METHODS: This cross-sectional study included children aged 6-7 from a historical birth cohort of preterm (gestational age <37 weeks and low birth weight (<2,500 g infants. The Wechsler Intelligence Scale for Children III (WISC-III was administered by a psychologist while the parents completed the Child Behavior Checklist. The results were compared to the test's reference. The perinatal information and follow-up data were collected from the hospital files. The demographic data were collected from the parents. The current performance was compared with the results from the Denver II and Bayley II tests, which were administered during the first years of life. RESULTS: The total intelligence quotient varied from 70 to 140 (mean 98.7±15.8. The borderline intelligence quotient was observed in 9.3% of the children. The Child Behavior Checklist indicated a predominance of social competence problems (27.8%, CI 19.2 to 37.9 compared with behavioral problems (15.5%, CI 8.9 to 24.2. Both the Child Behavior Checklist domains, such as schooling, social and attention problems, and the cognitive scores were significantly associated with maternal education and family income. The results of the Denver and Bayley tests were associated with the cognitive performance (p<0.001 and the Child Behavior Checklist social profile, including aggressive and externalizing behavior (p<0.001. CONCLUSIONS: Our data suggest that even low-risk preterm newborns are at risk for developing disturbances in early school age, such as mild cognitive deficits and behavioral disorders. This risk might increase under unfavorable socioeconomic conditions.

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children.

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Jorien M Kerstjens

Full Text Available To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3 to help identify or exclude neurodevelopmental impairment (NDI in very preterm-born children at the corrected age of two.We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on ASQ3 and Bayley Scales of Infant and Toddler Development, Third Edition (BSIDIII and neurological examination at 22-26 months' corrected age. We defined NDI as a score of <70 on the cognitive--or motor composite scale of BSIDIII, or impairment on neurological examination or audiovisual screening. We compared NDI with abnormal ASQ3 scores, i.e., < -2SDs on any domain, and with ASQ3 total scores. To correct for possible overestimation of BSIDIII, we also analyzed the adjusted BSIDIII thresholds for NDI, i.e., scores <80 and <85.We found 61 (27% children with abnormal ASQ3 scores, and 10 (4.5% children who had NDI with original BSIDIII thresholds (<70. Twelve children had NDI at BSIDIII thresholds at <80, and 15 had <85. None of the 163 (73% children who passed ASQ3 had NDI. The sensitivity of ASQ3 to detect NDI was excellent (100%, its specificity was acceptable (76%, and its negative predictive value (NPV was 100%. Sensitivity and NPV remained high with the adjusted BSIDIII thresholds.The Ages and Stages Questionnaire is a simple, valid and cost-effective screening tool to help identify and exclude NDI in very preterm-born children at the corrected age of two years.

Regional vulnerability of longitudinal cortical association connectivity: Associated with structural network topology alterations in preterm children with cerebral palsy.

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Ceschin, Rafael; Lee, Vince K; Schmithorst, Vince; Panigrahy, Ashok

2015-01-01

Preterm born children with spastic diplegia type of cerebral palsy and white matter injury or periventricular leukomalacia (PVL), are known to have motor, visual and cognitive impairments. Most diffusion tensor imaging (DTI) studies performed in this group have demonstrated widespread abnormalities using averaged deterministic tractography and voxel-based DTI measurements. Little is known about structural network correlates of white matter topography and reorganization in preterm cerebral palsy, despite the availability of new therapies and the need for brain imaging biomarkers. Here, we combined novel post-processing methodology of probabilistic tractography data in this preterm cohort to improve spatial and regional delineation of longitudinal cortical association tract abnormalities using an along-tract approach, and compared these data to structural DTI cortical network topology analysis. DTI images were acquired on 16 preterm children with cerebral palsy (mean age 5.6 ± 4) and 75 healthy controls (mean age 5.7 ± 3.4). Despite mean tract analysis, Tract-Based Spatial Statistics (TBSS) and voxel-based morphometry (VBM) demonstrating diffusely reduced fractional anisotropy (FA) reduction in all white matter tracts, the along-tract analysis improved the detection of regional tract vulnerability. The along-tract map-structural network topology correlates revealed two associations: (1) reduced regional posterior-anterior gradient in FA of the longitudinal visual cortical association tracts (inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, optic radiation, posterior thalamic radiation) correlated with reduced posterior-anterior gradient of intra-regional (nodal efficiency) metrics with relative sparing of frontal and temporal regions; and (2) reduced regional FA within frontal-thalamic-striatal white matter pathways (anterior limb/anterior thalamic radiation, superior longitudinal fasciculus and cortical spinal tract) correlated with

Maternal rigidity in infancy and level of intelligence at school age in children born preterm

NARCIS (Netherlands)

Butcher, P.R.; Wijnberg-Williams, B.J; Hegemann, N; Stremmelaar, E.F; Schoemaker, M.M.; Van der Meere, J.J.; Bambang Oetomo, S

2004-01-01

Forty-four children who had been born preterm and their mothers participated in the follow-up study. At 3 and 14 months (corrected age) cognitive development was assessed using the BOS 2-30, the Dutch version of the Bayley Scales of Infant Development. The BOS yields measures of mental and motor

Attention problems in very preterm children from childhood to adulthood: the Bavarian Longitudinal Study.

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Breeman, Linda D; Jaekel, Julia; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter

2016-02-01

Very preterm (VP; gestational age attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses. At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced. Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children. © 2015 Association for Child and Adolescent Mental Health.

Comparison of three screening tests for autism in preterm children with birth weights less than 1,500 grams

Czech Academy of Sciences Publication Activity Database

Dudová, I.; Marková, D.; Kašparová, M.; Zemánková, J.; Beranová, Š.; Urbánek, Tomáš; Hrdlička, M.

2014-01-01

Roč. 10, č. 11 (2014), s. 2201-2208 ISSN 1176-6328 Institutional support: RVO:68081740 Keywords : autism spectrum disorders * preterm children * screening Subject RIV: AN - Psychology Impact factor: 2.154, year: 2013

Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.

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Stéphane Marret

Full Text Available OBJECTIVE: To investigate the association of motor and cognitive/learning deficiencies and overall disabilities in very preterm (VPT children and their relations to gestational age (GA and brain lesions. DESIGN SETTING AND PARTICIPANTS: EPIPAGE is a longitudinal population-based cohort study of children born before 33 weeks' gestation (WG in 9 French regions in 1997-1998. Cumulating data from all follow up stages, neurodevelopmental outcomes were available for 90% of the 2480 VPT survivors at 8 years. Main outcomes were association of motor and cognitive deficiencies and existence of at least one deficiency (motor, cognitive, behavioral/psychiatric, epileptic, visual, and/or hearing deficiencies in three GA groups (24-26, 27-28, and 29-32WG and four groups of brain lesions (none, minor, moderate, or severe. RESULTS: VPT had high rates of motor (14% and cognitive (31% deficiencies. Only 6% had an isolated motor deficiency, 23% an isolated cognitive one and 8% both types. This rate reached 20% among extremely preterm. Psychiatric disorders and epilepsy were observed in 6% and 2% of children, respectively. The risks of at least one severe or moderate deficiency were 11 and 29%. These risks increased as GA decreased; only 36% of children born extremely preterm had no reported deficiency. Among children with major white matter injury (WMI, deficiency rates reached 71% at 24-26WG, 88% at 27-28WG, and 80% at 29-32WG; more than 40% had associated motor and cognitive deficiencies. By contrast, isolated cognitive deficiency was the most frequent problem among children without major lesions. CONCLUSIONS: In VPT, the lower the GA, the higher the neurodisability rate. Cerebral palsy is common. Impaired cognitive development is more frequent. Its occurrence in case without WMI or early motor disorders makes long-term follow up necessary. The strong association between motor impairments, when they exist, and later cognitive dysfunction supports the hypothesis

Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

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Rogers, Cynthia E.; Lenze, Shannon N.; Luby, Joan L.

2013-01-01

Objective: Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early…

Associations of motor co-ordination and attention with motor-perceptual development in 3-year-old preterm and full-term children who needed neonatal intensive care.

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Hemgren, E; Persson, K

2007-01-01

Children who have needed neonatal intensive care (NIC) are considered to be at risk for deficits such as developmental co-ordination disorder and attention-deficit/hyperactivity disorder. By assessing motor-perceptual development, motor co-ordination and attention already at 3 years of age, it might be possible to identify such deficits earlier than they are today. To investigate the motor-perceptual development in a group of 202 NIC children but had no major impairments, to describe associations of deficits in co-ordination and attention with motor-perceptual delays, and to estimate the prevalence of NIC children with combined deficits together with a motor-perceptual delay. Co-ordination and attention in children born very preterm (n = 57), moderately preterm (n = 75) and full-term (n = 70) were observed according to a model for Combined Assessment of Motor Performance and Behaviour while they were assessed using a developmental scale, Motor-Perceptual Development, 0-7 years, MPU. In two out of 14 MPU areas, a larger proportion of very preterm than of moderately preterm and full-term children had marked developmental delay. Overall, the proportion of NIC children having a motor-perceptual delay increased with increasing incoordination and especially increasing lack of attention. Twenty-one (11%) of the NIC children had different motor-perceptual delays combined with pronounced incoordination and pronounced lack of attention. Deficits in co-ordination and attention were associated with motor-perceptual delays in areas important for daily living and development of academic skills. Therefore, to find children at risk for developmental co-ordination disorder and attention-deficit/hyperactivity disorder, assessments of co-ordination and attention should be added to assessments of motor-perceptual development in 3-year-old NIC children.

The persistent stereotype: children's images of scientists

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Emens McAdam, Janice

1990-03-01

Through their reading children learn to regard scientists as eccentrics. It is shown that this stereotype has persisted for over thirty years and affects many adult attitudes. Some methods of breaking the author-reader cycle are suggested.

The link between motor and cognitive development in children born preterm and/or with low birth weight : A review of current evidence

NARCIS (Netherlands)

Oudgenoeg-Paz, Ora; Mulder, Hanna; Jongmans, Marian J.; van der Ham, Ineke J.M.; Van der Stigchel, Stefan

2017-01-01

The current review focuses on evidence for a link between early motor development and later cognitive skills in children born preterm or with Low Birth Weight (LBW). Studies with term born children consistently show such a link. Motor and cognitive impairments or delays are often seen in children

Improved Cognitive Development in Preterm Infants with Shared Book Reading.

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Braid, Susan; Bernstein, Jenny

2015-01-01

To examine the effect of shared book reading on the cognitive development of children born preterm and to determine what factors influence shared book reading in this population. Secondary analysis using the Early Childhood Longitudinal Study-Birth Cohort, a large, nationally representative survey of children born in the United States in 2001. One thousand four hundred singleton preterm infants (22-36 weeks gestation). Cognitive development measured using the Bayley Mental Scale score from the Bayley Scales of Infant Development Research Edition. Adjusting for neonatal, maternal, and socioeconomic characteristics, reading aloud more than two times a week is associated with higher cognitive development scores in two-year-old children born preterm (p book reading holds potential as an early developmental intervention for this population.

CMV infection associated with severe lung involvement and persistent pulmonary hypertension of the newborn (PPHN) in two preterm twin neonates.

Science.gov (United States)

Manzoni, Paolo; Vivalda, Mauro; Mostert, Michael; Priolo, Claudio; Galletto, Paolo; Gallo, Elena; Stronati, Mauro; Gili, Renata; Opramolla, Anna; Calabrese, Sara; Tavella, Elena; Luparia, Martina; Farina, Daniele

2014-09-01

The diagnosis of congenital CMV is usually guided by a number of specific symptoms and findings. Unusual presentations may occur and diagnosis is challenging due to uncommon or rare features. Here we report the case of two preterm, extremely low birthweight, 28-week gestational age old twin neonates with CMV infection associated with severe lung involvement and persistent pulmonary hypertension of the newborn (PPHN). They were born to a HIV-positive mother, hence they underwent treatment with zidovudine since birth. Both infants featured severe refractory hypoxemia, requiring high-frequency ventilation, inhaled nitric oxide and inotropic support, with full recovery after 2 months. Treatment with ganciclovir was not feasible due the concomitant treatment with zidovudine and the risk of severe, fatal toxicity. Therefore administration of intravenous hyperimmune anti-CMV immunoglobulin therapy was initiated. Severe lung involvement at birth and subsequent pulmonary hypertension are rarely described in preterm infants as early manifestations of CMV congenital disease. In the two twin siblings here described, the extreme prematurity and the treatment with zidovudine likely worsened immunosuppression and ultimately required a complex management of the CMV-associated lung involvement. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months.

Science.gov (United States)

Lowe, Jean R; Duncan, Andrea Freeman; Bann, Carla M; Fuller, Janell; Hintz, Susan R; Das, Abhik; Higgins, Rosemary D; Watterberg, Kristi L

2013-12-01

Difficulties with executive function have been found in preterm children, resulting in difficulties with learning and school performance. This study evaluated the relationship of early working memory as measured by object permanence items to the cognitive and language scores on the Bayley Scales-III in a cohort of children born extremely preterm. Logistic regression models were conducted to compare object permanence scores derived from the Bayley Scales-III by race/ethnicity and maternal education, controlling for medical covariates. Extremely preterm toddlers (526), who were part of a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's multi-center study, were evaluated at 18-22 months corrected age. Object permanence scores derived from the Bayley Developmental Scales were compared by race/ethnicity and maternal education, controlling for medical covariates. There were no significant differences in object permanence mastery and scores among the treatment groups after controlling for medical and social variables, including maternal education and race/ethnicity. Males and children with intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia were less likely to demonstrate object permanence mastery and had lower object permanence scores. Children who attained object permanence mastery had significantly higher Bayley Scales-III cognitive and language scores after controlling for medical and socio-economic factors. Our measure of object permanence is free of influence from race, ethnic and socio-economic factors. Adding this simple task to current clinical practice could help detect early executive function difficulties in young children. Published by Elsevier Ireland Ltd.

Preterm birth, infant weight gain, and childhood asthma risk: a meta-analysis of 147,000 European children.

Science.gov (United States)

Sonnenschein-van der Voort, Agnes M M; Arends, Lidia R; de Jongste, Johan C; Annesi-Maesano, Isabella; Arshad, S Hasan; Barros, Henrique; Basterrechea, Mikel; Bisgaard, Hans; Chatzi, Leda; Corpeleijn, Eva; Correia, Sofia; Craig, Leone C; Devereux, Graham; Dogaru, Cristian; Dostal, Miroslav; Duchen, Karel; Eggesbø, Merete; van der Ent, C Kors; Fantini, Maria P; Forastiere, Francesco; Frey, Urs; Gehring, Ulrike; Gori, Davide; van der Gugten, Anne C; Hanke, Wojciech; Henderson, A John; Heude, Barbara; Iñiguez, Carmen; Inskip, Hazel M; Keil, Thomas; Kelleher, Cecily C; Kogevinas, Manolis; Kreiner-Møller, Eskil; Kuehni, Claudia E; Küpers, Leanne K; Lancz, Kinga; Larsen, Pernille S; Lau, Susanne; Ludvigsson, Johnny; Mommers, Monique; Nybo Andersen, Anne-Marie; Palkovicova, Lubica; Pike, Katharine C; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Roberts, Graham; Schmidt, Anne; Sram, Radim J; Sunyer, Jordi; Thijs, Carel; Torrent, Maties; Viljoen, Karien; Wijga, Alet H; Vrijheid, Martine; Jaddoe, Vincent W V; Duijts, Liesbeth

2014-05-01

Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age childhood asthma outcomes. Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights

Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

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Sonnenschein-van der Voort, Agnes M.M.; Arends, Lidia R.; de Jongste, Johan C.; Annesi-Maesano, Isabella; Arshad, S. Hasan; Barros, Henrique; Basterrechea, Mikel; Bisgaard, Hans; Chatzi, Leda; Corpeleijn, Eva; Correia, Sofia; Craig, Leone C.; Devereux, Graham; Dogaru, Cristian; Dostal, Miroslav; Duchen, Karel; Eggesbø, Merete; van der Ent, C. Kors; Fantini, Maria P.; Forastiere, Francesco; Frey, Urs; Gehring, Ulrike; Gori, Davide; van der Gugten, Anne C.; Hanke, Wojciech; Henderson, A. John; Heude, Barbara; Iñiguez, Carmen; Inskip, Hazel M.; Keil, Thomas; Kelleher, Cecily C.; Kogevinas, Manolis; Kreiner-Møller, Eskil; Kuehni, Claudia E.; Küpers, Leanne K.; Lancz, Kinga; Larsen, Pernille S.; Lau, Susanne; Ludvigsson, Johnny; Mommers, Monique; Nybo Andersen, Anne-Marie; Palkovicova, Lubica; Pike, Katharine C.; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Roberts, Graham; Schmidt, Anne; Sram, Radim J.; Sunyer, Jordi; Thijs, Carel; Torrent, Maties; Viljoen, Karien; Wijga, Alet H.; Vrijheid, Martine; Jaddoe, Vincent W.V.; Duijts, Liesbeth

2014-01-01

Background Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. Objectives We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). Methods First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age childhood asthma outcomes. Results Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). Conclusion Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth. PMID:24529685

Functioning of very preterm born children at preschool age: Follow-up of an early intervention programme

NARCIS (Netherlands)

Verkerk, G.J.Q.

2014-01-01

The thesis presents the effects of the multicentre RCT on the Infant Behavioral Assessment and Intervention Program (IBAIP) in children born preterm, with a gestation of less than 32 weeks and/or a birth weight below 1500 grams (VLBW), at the age of school entry. Eighty-six infants were enrolled in

Preterm Birth, Age at School Entry and Long Term Educational Achievement.

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Odd, David; Evans, David; Emond, Alan

2016-01-01

To investigate if the detrimental impact of year of entering education in preterm infants persists into adolescence. Preterm infants are often enrolled in school a year earlier than would be expected if this decision is based on their actual date of birth rather than their due date. Initially these infants appear to do disproportionately worse than those who do not 'skip' a year. However, it is unclear if this effect remains as the infants grow, to have an important effect on long term achievements in education. A cohort study, drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC). The exposure measurement was gestational age (defined as preterm (birth (DOB), their expected date of delivery (EDD), or their expected date of delivery and year of school entry. After matching for DOB, preterm infants had an increased odds of SEN (OR 1.57 (1.33-1.86)) and the association remained after adjusting for potential confounders (OR 1.39 (1.14-1.68)). The association remained in the analysis matching for EDD (fully adjusted OR 1.43 (1.17-1.74)) but attenuated after restricting to those infants who were enrolled in school in the same year as the control infants (fully adjusted OR 1.21 (0.97-1.52)). There was less evidence for an impact of prematurity on the KS4 score (Matched for DOB; OR 1.10 (0.91 to 1.34), matched for EDD OR 1.17 (0.96 to 1.42) and EDD and same year of schooling, OR 1.00 (0.80 to 1.26)). This modifiable effect of going to school a year earlier than predicted by their due date appears to have measurable consequences for ex-preterm infants in adolescence and is likely to limit adulthood opportunities.

Associations between parental psychological well-being and socio-emotional development in 5-year-old preterm children.

Science.gov (United States)

Huhtala, Mira; Korja, Riikka; Lehtonen, Liisa; Haataja, Leena; Lapinleimu, Helena; Rautava, Päivi

2014-03-01

Preterm children are at risk for developing behavioral and emotional problems, as well as being less socially competent. Premature birth causes chronic distress in the parents. The aim of the paper is to discover whether parental psychological well-being is associated with the social, behavioral, and functional development of very low birth weight (VLBW, ≤1500g) children at 5years of age. A longitudinal prospective cohort study. A cohort of 201 VLBW infants (≤1500g, parents independently completed validated questionnaires (Beck Depression Inventory, Parenting Stress Index and Sense of Coherence Scale). At 5years, parents and day-care providers evaluated the development of the child by completing the Five to Fifteen questionnaire. The parents of VLBW children reported significantly more problems in child development compared to the Finnish normative data. Depressive symptoms and weaker sense of coherence in mothers, but not in fathers, were associated with more problems in child development. Parenting stress, for both mothers and fathers, was associated with developmental problems in their child at 5years of age. Maternal depressive symptoms and parenting stress of both parents may be risk factors for the social, behavioral, and functional development of 5-year-old preterm children. On the other hand, stronger maternal sense of coherence may be a protective factor. Copyright © 2013 Elsevier Ltd. All rights reserved.

Body fat and dairy product intake in lactase persistent and non-persistent children and adolescents.

Science.gov (United States)

Almon, Ricardo; Patterson, Emma; Nilsson, Torbjörn K; Engfeldt, Peter; Sjöström, Michael

2010-06-16

Lactase non-persistent (LNP) individuals may be lactose intolerant and therefore on a more restricted diet concerning milk and milk products compared to lactase persistent (LP) individuals. This may have an impact on body fat mass. This study examines if LP and LNP children and adolescents, defined by genotyping for the LCT-13910 C > T polymorphism, differ from each other with regard to milk and milk product intake, and measures of body fat mass. Children (n=298, mean age 9.6 years) and adolescents (n=386, mean age 15.6 years), belonging to the Swedish part of the European Youth Heart Study, were genotyped for the LCT-13910 C > T polymorphism. Dietary intakes of reduced and full-fat dairy varieties were determined. LNP (CC genotype) subjects consumed less milk, soured milk and yoghurt compared to LP (CT/TT genotype) subjects (pproducts than LP children and adolescents (p=0.009 for children and p=0.001 for adolescents). We conclude that LP is linked to an overall higher milk and dairy intake, but is not linked to higher body fat mass in children and adolescents.

Time from cervical conization to pregnancy and preterm birth.

Science.gov (United States)

Himes, Katherine P; Simhan, Hyagriv N

2007-02-01

To estimate whether the time interval between cervical conization and subsequent pregnancy is associated with risk of preterm birth. Our study is a case control study nested in a retrospective cohort. Women who underwent colposcopic biopsy or conization with loop electrosurgical excision procedure, large loop excision of the transformation zone, or cold knife cone and subsequently delivered at our hospital were identified with electronic databases. Variables considered as possible confounders included maternal race, age, marital status, payor status, years of education, self-reported tobacco use, history of preterm delivery, and dimensions of cone specimen. Conization was not associated with preterm birth or any subtypes of preterm birth. Among women who underwent conization, those with a subsequent preterm birth had a shorter conization-to-pregnancy interval (337 days) than women with a subsequent term birth (581 days) (P=.004). The association between short conization-to-pregnancy interval and preterm birth remained significant when controlling for confounders including race and cone dimensions. The effect of short conization-to-pregnancy interval on subsequent preterm birth was more persistent among African Americans when compared with white women. Women with a short conization-to-pregnancy interval are at increased risk for preterm birth. Women of reproductive age who must have a conization procedure can be counseled that conceiving within 2 to 3 months of the procedure may be associated with an increased risk of preterm birth. II.

MRC ORACLE Children Study. Long term outcomes following prescription of antibiotics to pregnant women with either spontaneous preterm labour or preterm rupture of the membranes

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Salt Alison

2008-04-01

Full Text Available Abstract Background The Medical Research Council (MRC ORACLE trial evaluated the use of co-amoxiclav 375 mg and/or erythromycin 250 mg in women presenting with preterm rupture of membranes (PROM ORACLE I or in spontaneous preterm labour (SPL ORACLE II using a factorial design. The results showed that for women with a singleton baby with PROM the prescription of erythromycin is associated with improvements in short term neonatal outcomes, although co-amoxiclav is associated with prolongation of pregnancy, a significantly higher rate of neonatal necrotising enterocolitis was found in these babies. Prescription of erythromycin is now established practice for women with PROM. For women with SPL antibiotics demonstrated no improvements in short term neonatal outcomes and are not recommended treatment. There is evidence that both these conditions are associated with subclinical infection so perinatal antibiotic administration may reduce the risk of later disabilities, including cerebral palsy, although the risk may be increased through exposure to inflammatory cytokines, so assessment of longer term functional and educational outcomes is appropriate. Methods The MRC ORACLE Children's Study will follow up UK children at age 7 years born to 4809 women with PROM and the 4266 women with SPL enrolled in the earlier ORACLE trials. We will use a parental questionnaire including validated tools to assess disability and behaviour. We will collect the frequency of specific medical conditions: cerebral palsy, epilepsy, respiratory illness including asthma, diabetes, admission to hospital in last year and other diseases, as reported by parents. National standard test results will be collected to assess educational attainment at Key Stage 1 for children in England. Discussion This study is designed to investigate whether or not peripartum antibiotics improve health and disability for children at 7 years of age. Trial registration The ORACLE Trial and Children

MRC ORACLE Children Study. Long term outcomes following prescription of antibiotics to pregnant women with either spontaneous preterm labour or preterm rupture of the membranes.

Science.gov (United States)

Kenyon, Sara; Brocklehurst, Peter; Jones, David; Marlow, Neil; Salt, Alison; Taylor, David

2008-04-24

The Medical Research Council (MRC) ORACLE trial evaluated the use of co-amoxiclav 375 mg and/or erythromycin 250 mg in women presenting with preterm rupture of membranes (PROM) ORACLE I or in spontaneous preterm labour (SPL) ORACLE II using a factorial design. The results showed that for women with a singleton baby with PROM the prescription of erythromycin is associated with improvements in short term neonatal outcomes, although co-amoxiclav is associated with prolongation of pregnancy, a significantly higher rate of neonatal necrotising enterocolitis was found in these babies. Prescription of erythromycin is now established practice for women with PROM. For women with SPL antibiotics demonstrated no improvements in short term neonatal outcomes and are not recommended treatment. There is evidence that both these conditions are associated with subclinical infection so perinatal antibiotic administration may reduce the risk of later disabilities, including cerebral palsy, although the risk may be increased through exposure to inflammatory cytokines, so assessment of longer term functional and educational outcomes is appropriate. The MRC ORACLE Children's Study will follow up UK children at age 7 years born to 4809 women with PROM and the 4266 women with SPL enrolled in the earlier ORACLE trials. We will use a parental questionnaire including validated tools to assess disability and behaviour. We will collect the frequency of specific medical conditions: cerebral palsy, epilepsy, respiratory illness including asthma, diabetes, admission to hospital in last year and other diseases, as reported by parents. National standard test results will be collected to assess educational attainment at Key Stage 1 for children in England. This study is designed to investigate whether or not peripartum antibiotics improve health and disability for children at 7 years of age. The ORACLE Trial and Children Study is registered in the Current Controlled Trials registry. ISCRTN 52995660.

Successful Treatment of Candida parapsilosis Fungemia in Two Preterms with Voriconazole

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Emel Altuncu

2015-01-01

Full Text Available Herein, we report two preterms with invasive candidiasis refractory to liposomal amphotericin B (AMB treatment in spite of low MIC levels (MIC: 0.5 mcg/mL. Both of the patients’ blood cultures were persistently positive for C. parapsilosis despite high therapeutic doses (AMB: 7 mg/kg per day. After starting voriconazole blood cultures became negative and both of the patients were treated successfully without any side effects. In conclusion, although it is not a standard treatment in neonatal patients, our limited experience with these patients suggests that voriconazole appears to be a safe antifungal agent to be used in critically ill preterm infants with persistent fungemia despite AMB treatment.

Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence

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Farin Soleimani

2013-12-01

Full Text Available Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory, contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and

Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study.

Science.gov (United States)

Quigley, Maria A; Poulsen, Gry; Boyle, Elaine; Wolke, Dieter; Field, David; Alfirevic, Zarko; Kurinczuk, Jennifer J

2012-05-01

To compare school performance at age 5 years in children born at full term (39-41 weeks gestation) with those born at early term (37-38 weeks gestation), late preterm (34-36 weeks gestation), moderately preterm (32-33 weeks gestation) and very preterm (2000-2001 and attending school in England in 2006. School performance was measured using the foundation stage profile (FSP), a statutory assessment by teachers at the end of the child's first school year. The FSP comprises 13 assessment scales (scored from 1 to 9). Children who achieve an average of 6 points per scale and at least 6 in certain scales are classified as 'reaching a good level of overall achievement'. Fifty-one per cent of full term children had not reached a good level of overall achievement; this proportion increased with prematurity (55% in early term, 59% in late preterm, 63% in moderately preterm and 66% in very preterm children). Compared with full term children, an elevated risk remained after adjustment, even in early term (adjusted RR 1.05, 95% 1.00 to 1.11) and late preterm children (adjusted RR 1.12, 95% CI 1.04 to 1.22). Similar effects were noted for 'not working securely' in mathematical development, physical development and creative development. The effects of late preterm and early term birth were small in comparison with other risk factors. Late preterm and early term birth are associated with an increased risk of poorer educational achievement at age 5 years.

Body fat and dairy product intake in lactase persistent and non-persistent children and adolescents

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Ricardo Almon

2010-06-01

Full Text Available Background : Lactase non-persistent (LNP individuals may be lactose intolerant and therefore on a more restricted diet concerning milk and milk products compared to lactase persistent (LP individuals. This may have an impact on body fat mass. Objective : This study examines if LP and LNP children and adolescents, defined by genotyping for the LCT-13910 C > T polymorphism, differ from each other with regard to milk and milk product intake, and measures of body fat mass. Design : Children (n=298, mean age 9.6 years and adolescents (n=386, mean age 15.6 years, belonging to the Swedish part of the European Youth Heart Study, were genotyped for the LCT-13910 C > T polymorphism. Dietary intakes of reduced and full-fat dairy varieties were determined. Results : LNP (CC genotype subjects consumed less milk, soured milk and yoghurt compared to LP (CT/TT genotype subjects (p<0.001. Subsequent partitioning for age group attenuated this observation (p=0.002 for children and p=0.023 in adolescents. Six subjects were reported by parents to be ‘lactose intolerant’, none of whom were LNP. LNP children and adolescents consumed significantly less reduced fat milk and milk products than LP children and adolescents (p=0.009 for children and p = 0.001 for adolescents. Conclusions : We conclude that LP is linked to an overall higher milk and dairy intake, but is not linked to higher body fat mass in children and adolescents.

Persistent proteinuria as an indicator of renal disease in HIV-infected children

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Yuni Hisbiiyah

2017-01-01

Full Text Available Background Persistent proteinuria (microalbuminuria has been reported to be a precursor of HIV-related renal disease. Screening allows for early management in order to prevent the progression of renal disease and decrease morbidity and mortality associated with chronic kidney disease in HIV. Several studies have been done on renal manifestation in HIV-infected children from American and African regions, but similar studies from Asia are lacking. Objective To determine the prevalence of persistent proteinuria in HIV-positive children on antiretroviral therapy (ARV in Dr. Soetomo Hospital, Surabaya. Methods A cross-sectional study on children with HIV and treated with  highly active antiretroviral therapy (HARRT was done from August 2014 to February 2015. Microalbuminuria was measured by the ratio of urine albumin to creatinine (ACR, while proteinuria was measured by dipstick. Measurements were performed 3 times in 4-8 weeks. All subjects underwent complete evaluation of blood tests, serum creatinine, blood urea nitrogen (BUN, CD4 counts, and urinalysis. Data were analyzed using Chi-square and logistic regression tests. Results Of 38 children on HARRT enrolled in this study, 2 subjects developed acute kidney injury (AKI, 4 subjects were suspected to have urinary tract infection (UTI, and 1 subject was suspected to have urinary tract stones. The prevalence of persistent microalbuminuria was 2.6%. There was no correlation between immunological status, WHO clinical stage, or duration of ARV and the incidence of persistent proteinuria (P>0.05. Conclusion The prevalence of persistent proteinuria is  lower in younger HIV-infected children at a non-advanced stage and HIV-infected children with normal immunological status who are on HAART. We provide baseline data on the renal conditions of HIV-infected children in the era of HAART, before tenovofir is  increasingly used as an antiretroviral therapy regimen in Indonesia.

Preterm Birth and Adult Wealth: Mathematics Skills Count.

Science.gov (United States)

Basten, Maartje; Jaekel, Julia; Johnson, Samantha; Gilmore, Camilla; Wolke, Dieter

2015-10-01

Each year, 15 million babies worldwide are born preterm. Preterm birth is associated with adverse neurodevelopmental outcomes across the life span. Recent registry-based studies suggest that preterm birth is associated with decreased wealth in adulthood, but the mediating mechanisms are unknown. This study investigated whether the relationship between preterm birth and low adult wealth is mediated by poor academic abilities and educational qualifications. Participants were members of two British population-based birth cohorts born in 1958 and 1970, respectively. Results showed that preterm birth was associated with decreased wealth at 42 years of age. This association was mediated by decreased intelligence, reading, and, in particular, mathematics attainment in middle childhood, as well as decreased educational qualifications in young adulthood. Findings were similar in both cohorts, which suggests that these mechanisms may be time invariant. Special educational support in childhood may prevent preterm children from becoming less wealthy as adults. © The Author(s) 2015.

VISUAL OUTCOME IN PRETERM INFANTS ANALYSIS OF PRETERM INFANTS BORN IN LJUBLJANA 1990–1999

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Branka Stirn-Kranjc

2002-12-01

Full Text Available Background. Improved perinatal care has increased the survival rate of prematurely born infants. An epidemiological fact that 6–18% and more visually impaired children were prematurely born, emphasises the effect of premature birth on both visual function and development. Despite better knowledge on retinopathy of prematurity (ROP it is stressed not to underestimate refractive errors, strabismus and visual impairment after brain lesions, being more common in preterm babies.Methods. Over 1300 preterm infants with a birth weight of 1500 g or less and gestational age of 30 weeks or less, born in Maternity Hospital of Ljubljana, Slovenia in the period 1990– 1999 were examined according to contemporary paediatricophthalmologic recommendations. At least one year ophthalmologic follow-up (average 3.5 years of 594 prematurely born infants with high neonatal risk factors for ROP and with general health problems, was performed. Sex, gestational age, birth weight, artificial ventilation, exchange blood transfusion, bronchopulmonary dysplasia, respiratory distress syndrome, apnoea, septicaemia, intraventricular haemorrhage, hyperbilirubinemia were analysed for correlation with ROP and visual impairment.Results. The survival rate of the studied preterm infants was 65–87% (mean 77.3%. ROP stage 1, 2 has developed in 33 children with a birth weight under 900 g and in 10 with a birth weight 900–1200 g (altogether in 8%. ROP stage 3–5 has been registered (with or without plus disease in 7 children (below 6%. In 6 children cryo or argon laser photocoagulation has been performed and vitreoretinal surgery in 1 child (without functional results. In the studied group altogether 4 children (below 1% became blind (visual acuity < 0.05, all of them have had septicaemia. Squint has been registered in 6.9% of children, and has correlated with higher refractive error, mostly myopia. Severe optic nerve atrophy has been noticed already in the first year of follow

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

DEFF Research Database (Denmark)

Hansen, Carl Frederik; Thymann, Thomas; Andersen, Anders Daniel

2016-01-01

BACKGROUND: Preterm infants often tolerate full enteral nutrition few weeks after birth but it is not known how this is related to gut maturation. Using pigs as models, we hypothesized that intestinal structure and digestive function are similar in preterm and term individuals at 3-4 weeks after...... to term pigs. CONCLUSION: Intestinal structure shows a remarkable growth adaptation in the first week after preterm birth, especially with enteral nutrition, while some digestive functions remain immature until at least 3-4 weeks. It is important to identify feeding regimens that stimulate intestinal...

Long-term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labour

NARCIS (Netherlands)

Houtzager, B. A.; Hogendoorn, S. M.; Papatsonis, D. N. M.; Samsom, J. F.; van Geijn, H. P.; Bleker, O. P.; van Wassenaer, A. G.

2006-01-01

OBJECTIVE: To compare the long-term psychosocial and motor effects on children exposed in utero to nifedipine or ritodrine for the management of preterm labour. DESIGN: Randomised controlled trial. SETTING: Multicentre study in two university and one primary hospital in the Netherlands. POPULATION:

[Language acquisition in preterm infants during the first year of life].

Science.gov (United States)

Nazzi, T; Nishibayashi, L L; Berdasco-Muñoz, E; Baud, O; Biran, V; Gonzalez-Gomez, N

2015-10-01

Previous studies have shown that preterm children are at a higher risk for cognitive and language delays than full-term children. Most of these studies have concentrated on the effects of prematurity during the preschool or school years, while the effect of preterm birth on the early development of language, much of which occurs during the first year of life, remains very little explored. This article focuses on this crucial period and reviews the studies that have explored early phonological and lexical development in preterm infants. The results of these studies show uneven proficiency in different language subdomains in preterm infants. This raises the possibility that different constraints apply to the acquisition of different linguistic subcomponents in this population, in part as a result of a complex interaction between maturation, experience, and language subdomains. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Does perinatal asphyxia contribute to neurological dysfunction in preterm infants?

NARCIS (Netherlands)

van Iersel, Patricia A. M.; Bakker, Saskia C. M.; Jonker, Arnold J. H.; Hadders-Algra, Mijna

Background: Children born preterm are known to be at risk for neurodevelopmental disorders. The role of perinatal asphyxia in this increased risk is still a matter of debate. Aim: To analyze the contribution of perinatal asphyxia in a population of preterm infants admitted to a secondary paediatric

Difference in mother-child interaction between preterm- and term-born preschoolers with and without disabilities

NARCIS (Netherlands)

Potharst, Eva S.; Schuengel, Carlo; Last, Bob F.; van Wassenaer, Aleid G.; Kok, Joke H.; Houtzager, Bregje A.

2012-01-01

Aim: To investigate differences in the quality of motherchild interaction between preterm- and term-born children at age 5, and to study the association of motherchild interaction with sociodemographic characteristics and child disability. Methods: Preterm children (n = 94), born at <30 weeks

Transactional processes in children born preterm: Influences of mother-child interactions and parenting stress.

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Gerstein, Emily D; Poehlmann-Tynan, Julie

2015-10-01

This prospective, longitudinal study examined the transactional relations among perceived maternal parenting stress, maternal insensitivity, and child behavior across toddlerhood through age 6 within families of a child born preterm. A sample of 173 mother-child dyads were followed from just before the infant was discharged from the neonatal intensive care unit to 6 years of age, with observational measurements of maternal insensitivity and child noncompliance (24 and 36 months), maternal self-reports of perceived parenting stress (24 months, 36 months, 6 years), and maternal reports of child externalizing behavior at 6 years. Results indicated that maternal insensitivity at 36 months significantly mediated the relation between parenting stress at 24 months and externalizing behaviors at 6 years. Parenting stress was also directly associated with child noncompliance at 36 months and with child externalizing behavior at 6 years. Neonatal risk was associated with increased maternal insensitivity at 24 months, but also decreased parenting stress at 24 months. No significant "child effects" from child behavior to either maternal insensitivity or parenting stress were found. Parenting stress appears to play a critical role for children born preterm, and it is associated with children's behavior both directly and through its influence on parenting. The role of neonatal risk needs continued investigation, as families traditionally considered to be at lower risk may still face significant challenges. (c) 2015 APA, all rights reserved).

Relation between sleep status of preterm infants aged 1-2 years and mothers' parenting stress.

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Asaka, Yoko; Takada, Satoshi

2013-08-01

The aim of this study was to compare infants' sleep measures through an actigraph and maternal parenting stress among preterm and full-term mothers, and to explore the factors affecting maternal parenting stress in relation to infants' sleep. The subjects were 44 pairs of mothers and children. Twenty-one were in the preterm group, and 23 were in the full-term group. Inclusion criteria for preterm infants were born at less than 36 weeks and birthweight of less than 2500 g. The Parenting Stress Index (PSI) Short Form assesses maternal perception of the degree of parenting stress: the children's domain, and the parent's domain. An actigraph was applied to assess the infants' sleep measures. The PSI showed significant differences, with high scores in parenting stress in the preterm group. Also, the number of mothers who complained about their infant's sleep issues was significantly higher in the preterm group. Most of the sleep measures showed improvement by their age in both preterm and full-term infants. Multiple linear regression analysis showed that sleep efficiency, longest sleep duration at nighttime accounted for 71% of stress in the children's domain of the PSI of the preterm group. The parenting stress among mothers of preterm infants was significantly higher than that of mothers of full-term infants. The mothers of preterm infants were concerned about their infant's nocturnal sleep quality. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Military duty: risk factor for preterm labor? A review.

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McNeary, A M; Lomenick, T S

2000-08-01

The female military population represents a high-risk group for preterm labor and other adverse pregnancy outcomes. As the number of women entering the armed forces continues to increase, concerns regarding the effects of military service on pregnancy must persist. Although active duty females have access to prenatal care and maintain consistent follow-up, previous research has noted a 5-fold increase in preterm labor compared with civilian working women. Hospitalization and loss of work attributable to pregnancy complications directly affect productivity and mission accomplishment; therefore, it is crucial to identify those at risk to institute measures that will prevent such occurrences and decrease time away from work. This article provides a review of the existing literature concerning preterm labor in military women, comparisons with the civilian population, and recommendations for future research.

The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm

NARCIS (Netherlands)

Jensen, Elizabeth T; van der Burg, Jelske W; O'Shea, Thomas M; Joseph, Robert M; Allred, Elizabeth N; Heeren, Tim; Leviton, Alan; Kuban, Karl C K

OBJECTIVE: To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm. STUDY DESIGN: Study participants were 535 ten-year-old children enrolled previously in the

Difference in mother–child interaction between preterm- and term-born preschoolers with and without disabilities

NARCIS (Netherlands)

Potharst, E.S.; Schuengel, C.; Last, B.F.; van Wassenaer, A.G.; Kok, J.H.; Houtzager, B.A.

2012-01-01

Aim: To investigate differences in the quality of mother-child interaction between preterm- and term-born children at age 5, and to study the association of mother-child interaction with sociodemographic characteristics and child disability. Methods: Preterm children (n = 94), born at <30 weeks'

Attention and Regional Gray Matter Development in Very Preterm Children at Age 12 Years.

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Lean, Rachel E; Melzer, Tracy R; Bora, Samudragupta; Watts, Richard; Woodward, Lianne J

2017-08-01

This study examines the selective, sustained, and executive attention abilities of very preterm (VPT) born children in relation to concurrent structural magnetic resonance imaging (MRI) measures of regional gray matter development at age 12 years. A regional cohort of 110 VPT (≤32 weeks gestation) and 113 full term (FT) born children were assessed at corrected age 12 years on the Test of Everyday Attention-Children. They also had a structural MRI scan that was subsequently analyzed using voxel-based morphometry to quantify regional between-group differences in cerebral gray matter development, which were then related to attention measures using multivariate methods. VPT children obtained similar selective (p=.85), but poorer sustained (p=.02) and executive attention (p=.01) scores than FT children. VPT children were also characterized by reduced gray matter in the bilateral parietal, temporal, prefrontal and posterior cingulate cortices, bilateral thalami, and left hippocampus; and increased gray matter in the occipital and anterior cingulate cortices (family-wise error-corrected pregional gray matter development appear to contribute, at least in part, to the poorer attentional performance of VPT children at school age. (JINS, 2017, 23, 539-550).

Atopy, but not obesity is associated with asthma severity among children with persistent asthma.

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Lu, Kim D; Phipatanakul, Wanda; Perzanowski, Matthew S; Balcer-Whaley, Susan; Matsui, Elizabeth C

2016-12-01

Obesity is associated with an increased risk of asthma in children. Atopic sensitization is a major risk factor for asthma including severe asthma in children. It is unclear if obesity is associated with worse asthma control or severity in children and how its effects compare to atopy. We sought to examine relationships of weight status and atopy to asthma control and severity among a population of predominantly low income, minority children and adolescents with persistent asthma. A cross-sectional analysis of 832 children and adolescents, age range 5-17 years, with persistent asthma was performed. Clinical assessments included asthma questionnaires of symptoms, asthma severity score, health care utilization and medication treatment step, lung function testing, and skin prick testing as well as measures of adiposity. Data were collected between December 2010 and August 2014 from Johns Hopkins Hospital in Baltimore, MD and Children's Hospital of Boston, MA. Obesity was not associated with worse asthma control or severity in this group of predominantly low income, minority children and adolescents with persistent asthma. However, a greater degree of atopy was associated with lower lung function, higher asthma severity score, and higher medication treatment step. Atopy may be a more important risk factor for asthma severity than obesity among low-income minority children and adolescents with persistent asthma living in Northeastern cities in the United States.

Potential of diffusion tensor MR imaging in the assessment of cognitive impairments in children with periventricular leukomalacia born preterm

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Wang, Shanshan; Fan, Guoguang; Xu, Ke; Wang, Ci

2013-01-01

Purpose: To investigate MR diffusion tensor imaging (DTI) and fiber tractography (FT) in the assessment of altered major white matter fibers correlated with cognitive functions in preterm infants with periventricular leukomalacia (PVL), to explore the neural foundation for PVL children's cognitive impairments. Materials and methods: Forty six preterm infants (16 ± 4.7 months) suffered from PVL and 16 age-matched normal controls were recruited. Developmental quotient (DQ) was recorded to evaluate PVL children's cognitive functions. According to the DQ scores, patients were divided into three groups: mild, moderate and severe cognitive impairment groups. DTI scan was performed. Fractional anisotropy (FA) values of major white matter fibers were measured and their correlation with cognitive levels was evaluated. Results: Compared with the control group, the PVL group showed a significant mean FA reduction in bilateral corticospinal tract (CST), anterior/posterior limb of internal capsule (ICAL/ICPL), arcuate fasciculus (AF), corona radiate (CR), superior longitudinal fasciculus (SLF), splenium of corpus callosum (SCC) (p < 0.05) and bilateral posterior thalamic radiation (PTR) (p < 0.01). The FA values of left CST, bilateral AF, anterior cingulum (ACG), SLF, ICAL, ICPL, PTR, CR, genu of corpus callosum (GCC), SCC and middle cerebellar peduncle showed significant negative correlations with the cognitive levels. Conclusions: DTI can provide more information for understanding the pathophysiology of cognitive impairment in preterm infants with PVL

Potential of diffusion tensor MR imaging in the assessment of cognitive impairments in children with periventricular leukomalacia born preterm

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Wang, Shanshan, E-mail: jelly_66@126.com [Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001 (China); Fan, Guoguang, E-mail: cjr.fanguoguang@vip.163.com [Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001 (China); Xu, Ke, E-mail: cjr.xuke@vip.163.com [Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001 (China); Wang, Ci, E-mail: xiangxuehai19850224@yahoo.cn [Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001 (China)

2013-01-15

Purpose: To investigate MR diffusion tensor imaging (DTI) and fiber tractography (FT) in the assessment of altered major white matter fibers correlated with cognitive functions in preterm infants with periventricular leukomalacia (PVL), to explore the neural foundation for PVL children's cognitive impairments. Materials and methods: Forty six preterm infants (16 ± 4.7 months) suffered from PVL and 16 age-matched normal controls were recruited. Developmental quotient (DQ) was recorded to evaluate PVL children's cognitive functions. According to the DQ scores, patients were divided into three groups: mild, moderate and severe cognitive impairment groups. DTI scan was performed. Fractional anisotropy (FA) values of major white matter fibers were measured and their correlation with cognitive levels was evaluated. Results: Compared with the control group, the PVL group showed a significant mean FA reduction in bilateral corticospinal tract (CST), anterior/posterior limb of internal capsule (ICAL/ICPL), arcuate fasciculus (AF), corona radiate (CR), superior longitudinal fasciculus (SLF), splenium of corpus callosum (SCC) (p < 0.05) and bilateral posterior thalamic radiation (PTR) (p < 0.01). The FA values of left CST, bilateral AF, anterior cingulum (ACG), SLF, ICAL, ICPL, PTR, CR, genu of corpus callosum (GCC), SCC and middle cerebellar peduncle showed significant negative correlations with the cognitive levels. Conclusions: DTI can provide more information for understanding the pathophysiology of cognitive impairment in preterm infants with PVL.

Original article The effects of kangaroo mother care in a sample of preterm, preschool aged children

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Magdalena Chrzan-Dętkoś

2014-08-01

Full Text Available Background The research has shown that kangaroo mother care has a protective impact both on health and future cognitive skills of prematurely born babies. The aim of this study was to investigate the relation between the early skin-to-skin contact and the cognitive and emotional-social functioning of preschool aged preterm babies. Participants and procedure The study group included 99 preterm babies. The children participated in a psychological examination conducted using the Columbia Mental Maturity Scale and the Terman-Merrill Test. The data concerning the skin-to-skin contact during the child’s hospitalisation were acquired during interviews with mothers. The emotional development was assessed on the basis of interviews with mothers, conducted using the Rescorla DSM-IV Orientation Scale (2005. Results The study showed no relation between kangaroo mother care and cognitive development. Nevertheless the early skin-to-skin contact turned out to be connected with the emotional functioning of the subjects. Preterm babies who used to experience kangaroo mother care experienced fewer anxiety and depressive disorders than those who did not. In addition it was revealed that the children who suffered from early damage to the brain in the forms of intraventricular and periventricular haemorrhages and experienced kangaroo mother care demonstrated less intense depressive symptoms than those who did not. Conclusions The obtained results, combined with the review of the foreign literature of the subject, indicate the usefulness of introducing kangaroo mother care to neonatal wards and encouraging parents to care about their prematurely born babies in such a way.

Medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder.

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Ayaz, Muhammed; Ayaz, Ayşe Burcu; Soylu, Nusret; Yüksel, Serhat

2014-10-01

The aim of this study was to investigate medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The effects of sociodemographic characteristics, symptom severity of ADHD, comorbidity, and treatment-related factors influencing medication persistence in children diagnosed with ADHD were studied. Medication persistence over a continuous 12 month period was evaluated for 877 children and adolescents between 6 and 18 years of age, who were diagnosed with ADHD for the first time and started to receive medication. Medication persistence was determined according to whether or not taking the prescribed medication continued for 12 months after the initiation of treatment. Whereas the symptom severity of ADHD was assessed by using the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)-based Child and Adolescent Behaviour Disorders Screening and Rating Scale-Parents Form (T-DSM-IV-S), perceived medication efficacy after the first treatment was evaluated by the Clinical Global Impressions-Improvement Scale (CGI-I). In this study, medication persistence over a continuous 12 month period occurred at a rate of 30.2% (n=265) in the subjects studied. The hierarchical regression analysis conducted in this research revealed that younger age, higher hyperactivity/impulsivity symptom severity, use of long-acting methylphenidate, addition of another ADHD medication, addition of other psychotropic medications, absence of side effects, and perceived medication efficacy were associated with successful medication persistence over a continuous 12 month period. Understanding the factors that affect medication persistence in ADHD may improve treatment efficacy and symptom control, while minimizing future risks.

Exploring predictors of change in behavioral problems over a 1-year period in preterm born preschoolers

NARCIS (Netherlands)

Schappin, Renske; Wijnroks, Lex; Uniken Venema, Monica; Jongmans, Marian

OBJECTIVE: Although predictors of the prevalence of behavioral problems in preterm-born children have been frequently studied, predictors of behavioral change in these children remain unknown. Therefore, in this study we explore predictors of short-term changes in problem behavior in preterm-born

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

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Nicholas, Johanna; Tobey, Emily; Davidson, Lisa

2016-01-01

Purpose The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation. Materials and Method Children receiving unilateral CIs at young ages (12–38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined. Results Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy. Conclusion CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes. PMID:26501740

Functional Outcomes at Age 7 Years of Moderate Preterm and Full Term Children Born Small for Gestational Age

NARCIS (Netherlands)

Tanis, Jozien C; van Braeckel, Koenraad N J A; Kerstjens, Jorien M; Bocca-Tjeertes, Inger F A; Reijneveld, Sijmen A; Bos, Arend F

OBJECTIVE: To compare functional outcomes of 7-year-old (school-age) children born small for gestational age (SGA; ie, a birth weight z score ≤ -1 SD), with appropriate for gestational age (AGA) peers, born moderately preterm or full term. STUDY DESIGN: Data were collected as part of the

Tracking Change in Children with Severe and Persisting Speech Difficulties

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Newbold, Elisabeth Joy; Stackhouse, Joy; Wells, Bill

2013-01-01

Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this,…

Long-Term Neuropsychological Outcome in Preterm Twins

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Giovanni Iannone

2006-01-01

Full Text Available Few long-term studies have yet described neuropsychological outcome in preterm twins. Our aim was to assess, by long-term evaluation, neuropsychological outcome in preterm twins in order to define a correct follow-up program. Our study was a cohort one, with an index and a comparison group. Neonatal medical records of all preterm newborns admitted to our centre between 1991 and 1997 were reviewed and selected patients were recalled. The sample population included two matched groups of children aged 6—12 years, 86 twins and 86 singletons, submitted to paediatric, neurological, psychological, and ophthalmological examinations. Inclusion criteria were twin pregnancy and gestational age 27—36 weeks for index group; same gestational age, but single pregnancy, for the comparison group. All children underwent paediatric and neuropsychiatric examinations, cognitive assessment, and psychological evaluation by standardized tests for screening of learning specific disorders and language difficulties, and finally, ophthalmological examination. In order to study their role in predicting neuropsychological outcome, we examined some perinatal prognostic factors by statistical analysis. Unfavourable neuropsychological outcome was observed in 55/172 (32% children, with different prevalence in the two groups, 42/172 (24% in twins and 13/172 (8% in singletons. Statistical analysis performed for examined prognostic factors showed significant differences in neuropsychological outcome with regard only to gestational age < 32 weeks, low birth weight, intraventricular haemorrhage, and periventricular leukomalacia. The incidence of neuropsychological diseases in the two groups showed significant difference about language and learning difficulties. Our data suggest that preterm twins represent a particular high-risk category of premature babies, mostly regarding the risk of so-called “minimal brain dysfunction”, so a careful follow-up is recommended.

Neural correlates of "Theory of Mind" in very preterm born children.

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Mossad, Sarah I; Smith, Mary Lou; Pang, Elizabeth W; Taylor, Margot J

2017-11-01

Very preterm (VPT) birth (Theory of Mind (ToM); the ability to attribute mental states to others and understand that those beliefs can differ from one's own or reality. The neural bases for ToM deficits in VPT born children have not been examined. We used magnetoencephalography (MEG) for its excellent spatial and temporal resolution to determine the neural underpinnings of ToM in 24 VPT and 24 full-term born (FT) children (7-13 years). VPT children performed more poorly on neuropsychological measures of ToM but not inhibition. In the MEG task, both FT children and VPT children recruited regions involved in false belief processing such as the rIFG (VPT: 275-350 ms, FT: 250-375 ms) and left inferior temporal gyrus (VPT: 375-450 ms, FT: 325-375 ms) and right fusiform gyrus (VPT: 150-200 ms, FT: 175-250 ms). The rIPL (included in the temporal-parietal junction) was recruited in FT children (475-575 ms) and the lTPJ in VPT children (500-575 ms). However, activations in all regions were reduced in the VPT compared to the FT group. We suggest that with increasing social-cognitive demands such as varying the type of scenarios in the standardized measure of ToM, reduced activations in the rIFG and TPJ in the VPT group may reflect the decreased performance. With access to both spatial and temporal information, we discuss the role of domain general and specific regions of the ToM network in both groups. Hum Brain Mapp 38:5577-5589, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

[The connection between maltreatment and preterm birth - in the light of psychomotor development at 2 years old].

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Szele, Anna Szabina; Nagy, Beáta Erika

2017-06-01

Preterm children' development and harmful affecting factors to development are important aspects of public health, because in our country the number of preterm birth is very high. Description of psychomotor development of preterm children (Brunet-Lézine; Bayley-III) and connection between psychomotor development and maternal abuse history (own questionnaire). Extremely (psychomotor development quotients and higher development risk. Strong associations were found between maternal history of childhood abuse and the development quotients. We would like to draw attention to the importance of assessing preterm children, as well as to the importance of maltreatment and the severity of its consequences. With the early recognition of necessity for developmental interventions we can prevent problems in the future. Orv Hetil. 2017; 158(25): 976-983.

Association between neurological assessment and developmental outcome in preterm toddlers

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Jana Kodrič

2011-01-01

Full Text Available There has been an increase in prevalence of low severity dysfunctions such as minor neurological dysfunction and cognitive deficits which consequently lead to school and behavior problems. The study presents the outcomes of a small group of preterm children with different medical complications at birth on follow-up at toddler age. In the neonatal period and at three months corrected age the neurological examination by the Amiel-Tison neurological assessment and the assessment of general movements was done. Both measures were compared with the criterion measure Bayley Scales of Infant Development - II. Results of the preterm group were compared with results of the normative group. According to results for both methods of neurological examination, children were classified into different categories meaning optimal or different degrees of non-optimal neurological results. The results of the children from different categories of neurological functioning were compared with the criterion measure. Children from the preterm group attained lower results on the developmental test compared to normative data. Children from groups with the lowest birth weight and gestational age attained the lowest results. These findings suggest that children from less optimal or non-optimal categories according to both methods of neurological examination attained lower developmental scores. The difference between groups was higher on the mental scale than on the motor scale of the developmental test.

A randomised trial of enteral glutamine supplementation for very preterm children showed no beneficial or adverse long-term neurodevelopmental outcomes

NARCIS (Netherlands)

Twilhaar, E.S.; de Kieviet, J.F.; Oosterlaan, J.; van Elburg, R.M.

2017-01-01

Aim This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. Methods The cohort was enrolled in a randomised placebo-controlled trial between 2001 and 2003 in which infants received

A randomised trial of enteral glutamine supplementation for very preterm children showed no beneficial or adverse long-term neurodevelopmental outcomes

NARCIS (Netherlands)

Twilhaar, E. Sabrina; de Kieviet, Jorrit F.; Oosterlaan, Jaap; van Elburg, Ruurd M.

2017-01-01

This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. The cohort was enrolled in a randomised placebo-controlled trial between 2001-2003 in which infants received glutamine- or

Immunological aspects of persistent hepatitis B in children

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Harsoyo Notoatmojo

2006-08-01

Full Text Available We studied the immunological status of 203 children having persistence Hepatitis B (positive HBsAg ranging in age from 6 to 14 years in Semarang Municipality. The results of humoral immunity examination (IgM Anti-HBc showed that all were negative, indicating that they are not in acute phase of hepatitis B infection. Cellular immunity examination, i.e., CMI skin test has shown positive result in 64.9% on persistent and 65.2% in non persistent hepatitis B (p>0.05. T cell examination showed statistically significant difference (p<0.01 between persistenct and non persistent hepatitis B patients, there was is also significant difference (p<0.01 on CD4 cell examination. These findings indicated that there was difference in immunoregulation function and response repression of antivirus between both groups of patients. On the other hand CD4/ CD8 ratio and T cell function showed no significant difference between the two gorups of patients; similarly the specific function of cytotoxic T cell was not significantly difference.

Catch-up growth up to ten years of age in children born very preterm or with very low birth weight

NARCIS (Netherlands)

Knops, N.B.B.; Sneeuw, K.C.A.; Brand, R.; Hille, E.T.M.; Ouden, A.L. den; Wit, J.M.; Verloove-Vanhorick, S.P.

2005-01-01

Background: Improved survival due to advances in neonatal care has brought issues such as postnatal growth and development more to the focus of our attention. Most studies report stunting in children born very preterm and/or small for gestational age. In this article we study the growth pattern of

Post-term growth and cognitive development at 5 years of age in preterm children: Evidence from a prospective population-based cohort.

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Simon, Laure; Nusinovici, Simon; Flamant, Cyril; Cariou, Bertrand; Rouger, Valérie; Gascoin, Géraldine; Darmaun, Dominique; Rozé, Jean-Christophe; Hanf, Matthieu

2017-01-01

While the effects of growth from birth to expected term on the subsequent development of preterm children has attracted plentiful attention, less is known about the effects of post-term growth. We aimed to delineate distinct patterns of post-term growth and to determine their association with the cognitive development of preterm children. Data from a prospective population-based cohort of 3,850 surviving infants born at less than 35 weeks of gestational age were used. Growth was assessed as the Body Mass Index (BMI) Z-scores at 3, 9, 18, 24, 36, 48, and 60 months. Cognitive development at five years of age was evaluated by the Global School Adaptation score (GSA). Latent class analysis was implemented to identify distinct growth patterns and logistic regressions based on propensity matching were used to evaluate the relationship between identified growth trajectories and cognitive development. Four patterns of post-term growth were identified: a normal group with a Z-score consistently around zero during childhood (n = 2,469; 64%); a group with an early rapid rise in the BMI Z-score, but only up to 2 years of age (n = 195; 5%); a group with a slow yet steady rise in the BMI Z-score during childhood (n = 510; 13%); and a group with a negative Z-score growth until 3 years of age (n = 676; 18%). The group with a slow yet steady rise in the BMI Z-score was significantly associated with low GSA scores. Our findings indicate heterogeneous post-term growth of preterm children, with potential for association with their cognitive development.

Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders.

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Emerson, Eric; Blacher, Jan; Einfeld, Stewart; Hatton, Chris; Robertson, Janet; Stancliffe, Roger J

2014-12-01

We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

Teachers' Ability and Help Attributions and Children's Math Performance and Task Persistence

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Tõeväli, Paula-Karoliina; Kikas, Eve

2016-01-01

The present longitudinal study examined the reciprocal relationships between teachers' causal attributions and children's math performance and task persistence. In total, 760 elementary school children and their teachers participated in this study. The children were tested in math twice, at the end of the second and third grades. At both time…

Deficits in vision and visual attention associated with motor performance of very preterm/very low birth weight children.

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Geldof, Christiaan J A; van Hus, Janeline W P; Jeukens-Visser, Martine; Nollet, Frans; Kok, Joke H; Oosterlaan, Jaap; van Wassenaer-Leemhuis, Aleid G

2016-01-01

To extend understanding of impaired motor functioning of very preterm (VP)/very low birth weight (VLBW) children by investigating its relationship with visual attention, visual and visual-motor functioning. Motor functioning (Movement Assessment Battery for Children, MABC-2; Manual Dexterity, Aiming & Catching, and Balance component), as well as visual attention (attention network and visual search tests), vision (oculomotor, visual sensory and perceptive functioning), visual-motor integration (Beery Visual Motor Integration), and neurological status (Touwen examination) were comprehensively assessed in a sample of 106 5.5-year-old VP/VLBW children. Stepwise linear regression analyses were conducted to investigate multivariate associations between deficits in visual attention, oculomotor, visual sensory, perceptive and visual-motor integration functioning, abnormal neurological status, neonatal risk factors, and MABC-2 scores. Abnormal MABC-2 Total or component scores occurred in 23-36% of VP/VLBW children. Visual and visual-motor functioning accounted for 9-11% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Visual perceptive deficits only were associated with Aiming & Catching. Abnormal neurological status accounted for an additional 19-30% of variance in MABC-2 Total, Manual Dexterity and Balance scores, and 5% of variance in Aiming & Catching, and neonatal risk factors for 3-6% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Motor functioning is weakly associated with visual and visual-motor integration deficits and moderately associated with abnormal neurological status, indicating that motor performance reflects long term vulnerability following very preterm birth, and that visual deficits are of minor importance in understanding motor functioning of VP/VLBW children. Copyright © 2016 Elsevier Ltd. All rights reserved.

IQ Score of Children with Persistent or Perennial Allergic Rhinitis: A Comparison with Healthy Children.

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Ghaffari, Javad; Abbaskhanian, Ali; Jalili, Masumeh; Yazdani Charati, Jamshid

2014-01-01

Prevalence of allergies is different around the world. Allergic rhinitis is a common chronic disease in children. Intelligence quotient (IQ) is an indicator of efficacy and many factors including chronic diseases may affect it. This study compares the IQs of children diagnosed with persistent or perennial allergic rhinitis with healthy children. This was a comparative study that was conducted from June 2011-May 2013 in an academic referral clinic. In this study, 90 patients aged 6- to 14-yearsold who were diagnosed with persistent or perennial allergic rhinitis and were compared to 90 age and gender match healthy patients from their respective families. The Wechsler Intelligence Scale for Children was used to divide and calculate overall IQ, verbal IQ, and practical IQ. The t-test and chi square were used to analyze quantitative variables and qualitative variables, respectively. In this study, out of total 180 children, 90 (50%) in the case group and 90 children (50%), the control group participated for IQ comparison. One hundred (57%) were male and 80 (43%) were female. The overall IQ for allergic rhinitis patients and healthy patients was 109.2 and 107.5, respectively. This difference was not considered significant. Furthermore, there was no significant difference between the IQ scores of males and females. Although allergic rhinitis is a chronic disease and effects quality of life, there were no identifiable negative effects on IQ.

Neonatal brain structure on MRI and diffusion tensor imaging, sex, and neurodevelopment in very-low-birthweight preterm children.

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Rose, Jessica; Butler, Erin E; Lamont, Lauren E; Barnes, Patrick D; Atlas, Scott W; Stevenson, David K

2009-07-01

The neurological basis of an increased incidence of cerebral palsy (CP) in preterm males is unknown. This study examined neonatal brain structure on magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) at term-equivalent age, sex, and neurodevelopment at 1 year 6 months on the basis of the Amiel-Tison neurological examination, Gross Motor Function Classification System, and Bayley Scales of Infant Development in 78 very-low-birthweight preterm children (41 males, 37 females; mean gestational age 27.6 wks, SD 2.5; mean birthweight 1021 g, SD 339). Brain abnormalities on MRI and DTI were not different between males and females except in the splenium of the corpus callosum, where males had lower DTI fractional anisotropy (p=0.025) and a higher apparent diffusion coefficient (p=0.013), indicating delayed splenium development. In the 26 infants who were at higher risk on the basis of DTI, males had more abnormalities on MRI (p=0.034) and had lower fractional anisotropy and a higher apparent diffusion coefficient in the splenium (p=0.049; p=0.025) and right posterior limb of the internal capsule (PLIC; p=0.003; p=0.033). Abnormal neurodevelopment was more common in males (n=9) than in females (n=2; p=0.036). Children with abnormal neurodevelopment had more abnormalities on MRI (p=0.014) and reduced splenium and right PLIC fractional anisotropy (p=0.001; p=0.035). In children with abnormal neurodevelopment, right PLIC fractional anisotropy was lower than left (p=0.035), whereas in those with normal neurodevelopment right PLIC fractional anisotropy was higher than left (p=0.001). Right PLIC fractional anisotropy correlated to neurodevelopment (rho=0.371, p=0.002). Logistic regression predicted neurodevelopment with 94% accuracy; only right PLIC fractional anisotropy was a significant logistic coefficient. Results indicate that the higher incidence of abnormal neurodevelopment in preterm males relates to greater incidence and severity of brain abnormalities

Spontaneous preterm birth and single nucleotide gene polymorphisms: a recent update

Directory of Open Access Journals (Sweden)

Ishfaq A. Sheikh

2016-10-01

Full Text Available Abstract Background Preterm birth (PTB, birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 % of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors. Genetic factors are one of the significant risks for PTB. The focus of this review is on single nucleotide gene polymorphisms (SNPs that are reported to be associated with PTB. Results A comprehensive evaluation of studies on SNPs known to confer potential risk of PTB was done by performing a targeted PubMed search for the years 2007–2015 and systematically reviewing all relevant studies. Evaluation of 92 studies identified 119 candidate genes with SNPs that had potential association with PTB. The genes were associated with functions of a wide spectrum of tissue and cell types such as endocrine, tissue remodeling, vascular, metabolic, and immune and inflammatory systems. Conclusions A number of potential functional candidate gene variants have been reported that predispose women for PTB. Understanding the complex genomic landscape of PTB needs high-throughput genome sequencing methods such as whole-exome sequencing and whole-genome sequencing approaches that will significantly enhance the understanding of PTB. Identification of high risk women, avoidance of possible risk factors, and provision of personalized health care are important to manage PTB.

A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children.

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Geldof, Christiaan J A; van Wassenaer-Leemhuis, Aleid G; Dik, Marjolein; Kok, Joke H; Oosterlaan, Jaap

2015-08-01

Cerebral visual impairment (CVI) is a major cause of visual impairment, with very preterm birth/very low birth weight (VP/VLBW) being a major risk factor. There is no generally accepted definition of CVI. This study aims to investigate the usefulness of an empirically-based functional definition of CVI. One-hundred-five VP/VLBW children and 67 controls participated. CVI was defined after comprehensive oculomotor, visual sensory and perceptive assessment, and validated against vision problems in daily life and in terms of intellectual, behavioral, emotional and social functioning, as well as use of therapeutic services. Twenty-four per cent of the VP/VLBW children met criteria for CVI, compared to 7% of controls (P = 0.006, OR: 3.86, 95% CI: 1.40-10.70). VP/VLBW children with CVI had lower performance IQ, but not verbal IQ, than those without CVI. Visual problems in daily life were confirmed in VP/VLBW children classified with CVI. Additionally, difficulties in behavioral and social functioning were most prominent among VP/VLBW children with CVI. In VP/VLBW children, CVI defined in terms of visual function deficits is accompanied by intellectual, behavioral, and social impairments, validating our operational definition of CVI. CVI might act as a marker for developmental problems in VP/VLBW children.

Preterm newborns show slower repair of oxidative damage and paternal smoking associated DNA damage.

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Vande Loock, Kim; Ciardelli, Roberta; Decordier, Ilse; Plas, Gina; Haumont, Dominique; Kirsch-Volders, Micheline

2012-09-01

Newborns have to cope with hypoxia during delivery and a sudden increase in oxygen at birth. Oxygen will partly be released as reactive oxygen species having the potential to cause damage to DNA and proteins. In utero, increase of most (non)-enzymatic antioxidants occurs during last weeks of gestation, making preterm neonates probably more sensitive to oxidative stress. Moreover, it has been hypothesized that oxidative stress might be the common etiological factor for certain neonatal diseases in preterm infants. The aim of this study was to assess background DNA damage; in vitro H(2)O(2) induced oxidative DNA damage and repair capacity (residual DNA damage) in peripheral blood mononucleated cells from 25 preterm newborns and their mothers. In addition, demographic data were taken into account and repair capacity of preterm was compared with full-term newborns. Multivariate linear regression analysis revealed that preterm infants from smoking fathers have higher background DNA damage levels than those from non-smoking fathers, emphasizing the risk of paternal smoking behaviour for the progeny. Significantly higher residual DNA damage found after 15-min repair in preterm children compared to their mothers and higher residual DNA damage after 2 h compared to full-term newborns suggest a slower DNA repair capacity in preterm children. In comparison with preterm infants born by caesarean delivery, preterm infants born by vaginal delivery do repair more slowly the in vitro induced oxidative DNA damage. Final impact of passive smoking and of the slower DNA repair activity of preterm infants need to be confirmed in a larger study population combining transgenerational genetic and/or epigenetic effects, antioxidant levels, genotypes, repair enzyme efficiency/levels and infant morbidity.

Reducing tobacco smoking and smoke exposure to prevent preterm birth and its complications.

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Wagijo, Mary-Ann; Sheikh, Aziz; Duijts, Liesbeth; Been, Jasper V

2017-03-01

Tobacco smoking and smoke exposure during pregnancy are associated with a range of adverse health outcomes, including preterm birth. Also, children born preterm have a higher risk of complications including bronchopulmonary dysplasia and asthma when their mothers smoked during pregnancy. Smoking cessation in early pregnancy can help reduce the adverse impact on offspring health. Counselling interventions are effective in promoting smoking cessation and reducing the incidence of preterm birth. Peer support and incentive-based approaches are likely to be of additional benefit, whereas the effectiveness of pharmacological interventions, including nicotine replacement therapy, has not definitely been established. Smoke-free legislation can help reduce smoke exposure as well as maternal smoking rates at a population level, and is associated with a reduction in preterm birth. Helping future mothers to stop smoking and protect their children from second hand smoke exposure must be a key priority for health care workers and policy makers alike. Copyright © 2015 Elsevier Ltd. All rights reserved.

Task Persistence Mediates the Effect of Children's Literacy Skills on Mothers' Academic Help

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Kikas, Eve; Silinskas, Gintautas

2016-01-01

This longitudinal study aimed at examining the relationship between children's task persistence, mothers' academic help, and the development of children's literacy skills (reading and spelling) at the beginning of primary school. The participants were 870 children, 682 mothers, and 53 class teachers. Data were collected three times--at the…

Focused attention, heart rate deceleration, and cognitive development in preterm and full-term infants.

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Petrie Thomas, Julianne H; Whitfield, Michael F; Oberlander, Tim F; Synnes, Anne R; Grunau, Ruth E

2012-05-01

The majority of children who are born very preterm escape major impairment, yet more subtle cognitive and attention problems are very common in this population. Previous research has linked infant focused attention during exploratory play to later cognition in children born full-term and preterm. Infant focused attention can be indexed by sustained decreases in heart rate (HR). However there are no preterm studies that have jointly examined infant behavioral attention and concurrent HR response during exploratory play in relation to developing cognition. We recruited preterm infants free from neonatal conditions associated with major adverse outcomes, and further excluded infants with developmental delay (Bayley Mental Development Index [MDI attention and concurrent HR response were compared in 83 preterm infants (born 23-32 weeks gestational age [GA]) who escaped major impairment to 46 full-term infants. Focused attention and HR response were then examined in relation to Bayley MDI, after adjusting for neonatal risk. MDI did not differ by group, yet full-term infants displayed higher global focused attention ratings. Among the extremely preterm infants born attention episodes, accounted for 49% of adjusted variance in predicting concurrent MDI. There were no significant associations for later-born gestational age (29-32 weeks) or full-term infants. Among extremely preterm infants who escape major impairment, our findings suggest unique relationships between focused attention, HR deceleration, and developing cognition. Copyright © 2011 Wiley Periodicals, Inc.

Working memory in school-age children with and without a persistent speech sound disorder.

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Farquharson, Kelly; Hogan, Tiffany P; Bernthal, John E

2017-03-17

The aim of this study was to explore the role of working memory processes as a possible cognitive underpinning of persistent speech sound disorders (SSD). Forty school-aged children were enrolled; 20 children with persistent SSD (P-SSD) and 20 typically developing children. Children participated in three working memory tasks - one to target each of the components in Baddeley's working memory model: phonological loop, visual spatial sketchpad and central executive. Children with P-SSD performed poorly only on the phonological loop tasks compared to their typically developing age-matched peers. However, mediation analyses revealed that the relation between working memory and a P-SSD was reliant upon nonverbal intelligence. These results suggest that co-morbid low-average nonverbal intelligence are linked to poor working memory in children with P-SSD. Theoretical and clinical implications are discussed.

Preterm birth rates in Japan from 1979 to 2014: Analysis of national vital statistics.

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Sakata, Soyoko; Konishi, Shoko; Ng, Chris Fook Sheng; Watanabe, Chiho

2018-03-01

Secular trends of preterm birth in Japan between 1979 and 2014 were examined to determine whether changes could be explained by a shift in the distribution of maternal age at delivery and parity and/or by changes in age-specific preterm birth rates. Live birth data for 1979 to 2014 were obtained from the Japanese Ministry of Health, Labour and Welfare. Analyses were limited to singleton children born in Japan (n = 43 632 786). Preterm birth was defined using two cut-offs at rates of preterm birth were calculated for firstborn and later-born singletons by maternal age at delivery for specific time periods. Throughout the study period, the rates of preterm birth (both at rates of preterm birth at rates of preterm birth showed a secular increase for preterm births at rates of preterm birth among mothers aged in their 20s and early 30s increased between 1979 and 2014, which contributed to the secular increase in rates of preterm birth at < 37 weeks. © 2017 Japan Society of Obstetrics and Gynecology.

Early pregnancy vaginal microbiome trends and preterm birth.

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Stout, Molly J; Zhou, Yanjiao; Wylie, Kristine M; Tarr, Phillip I; Macones, George A; Tuuli, Methodius G

2017-09-01

Despite decades of attempts to link infectious agents to preterm birth, an exact causative microbe or community of microbes remains elusive. Nonculture 16S ribosomal RNA gene sequencing suggests important racial differences and pregnancy specific changes in the vaginal microbial communities. A recent study examining the association of the vaginal microbiome and preterm birth documented important findings but was performed in a predominantly white cohort. Given the important racial differences in bacterial communities within the vagina as well as persistent racial disparities in preterm birth, it is important to examine cohorts with varied demographic compositions. To characterize vaginal microbial community characteristics in a large, predominantly African-American, longitudinal cohort of pregnant women and test whether particular vaginal microbial community characteristics are associated with the risk for subsequent preterm birth. This is a nested case-control study within a prospective cohort study of women with singleton pregnancies, not on supplemental progesterone, and without cervical cerclage in situ. Serial mid-vaginal swabs were obtained by speculum exam at their routine prenatal visits. Sequencing of the V1V3 region of the 16S rRNA gene was performed on the Roche 454 platform. Alpha diversity community characteristics including richness, Shannon diversity, and evenness as well as beta diversity metrics including Bray Curtis Dissimilarity and specific taxon abundance were compared longitudinally in women who delivered preterm to those who delivered at term. A total of 77 subjects contributed 149 vaginal swabs longitudinally across pregnancy. Participants were predominantly African-American (69%) and had a preterm birth rate of 31%. In subjects with subsequent term delivery, the vaginal microbiome demonstrated stable community richness and Shannon diversity, whereas subjects with subsequent preterm delivery had significantly decreased vaginal richness

Persistent maternal depressive symptoms trajectories influence children's IQ: The EDEN mother-child cohort.

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van der Waerden, Judith; Bernard, Jonathan Y; De Agostini, Maria; Saurel-Cubizolles, Marie-Josèphe; Peyre, Hugo; Heude, Barbara; Melchior, Maria

2017-02-01

This study assessed the association between timing and course of maternal depression from pregnancy onwards and children's cognitive development at ages 5 to 6. Potential interaction effects with child sex and family socioeconomic status were explored. One thousand thirty-nine mother-child pairs from the French EDEN mother-child birth cohort were followed from 24 to 28 weeks of pregnancy onwards. Based on Center for Epidemiological Studies Depression (CES-D) and Edinburgh Postnatal Depression Scale (EPDS) scores assessed at six timepoints, longitudinal maternal depressive symptom trajectories were calculated with a group-based semiparametric method. Children's cognitive function was assessed at ages 5 to 6 by trained interviewers with the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III), resulting in three composite scores: Verbal IQ (VIQ), Performance IQ (PIQ), and Full-Scale IQ (FSIQ). Five trajectories of maternal symptoms of depression could be distinguished: no symptoms, persistent intermediate-level depressive symptoms, persistent high depressive symptoms, high symptoms in pregnancy only, and high symptoms in the child's preschool period only. Multiple linear regression analyses showed that, compared to children of mothers who were never depressed, children of mothers with persistent high levels of depressive symptoms had reduced VIQ, PIQ, and FSIQ scores. This association was moderated by the child's sex, boys appearing especially vulnerable in case of persistent maternal depression. Chronicity of maternal depression predicts children's cognitive development at school entry age, particularly in boys. As maternal mental health is an early modifiable influence on child development, addressing the treatment needs of depressed mothers may help reduce the associated burden on the next generation. © 2016 Wiley Periodicals, Inc.

Rates of preterm birth following antenatal exposure to severe life events: A population-based cohort study

DEFF Research Database (Denmark)

Khashan, Ali; McNamee, R.; Abel, Kathryn

2009-01-01

BACKGROUND: Preterm birth and other pregnancy complications have been linked to maternal stress during pregnancy. We investigated the association between maternal exposure to severe life events and risk of preterm birth. METHODS: Mothers of all singleton live births (n = 1.35 million births...... to estimate the effect of exposure on preterm birth, very preterm birth and extremely preterm birth. RESULTS: There were 58 626 (4.34%) preterm births (births and 3288 (0.24%) extremely preterm births in the study cohort. Severe life events in close relatives in the 6...... months before conception increased the risk of preterm birth by 16% (relative risk, RR = 1.16, [95% CI: 1.08-1.23]). Severe life events in older children in the 6 months before conception increased the risk of preterm birth by 23% (RR = 1.23, [95% CI: 1.02-1.49]) and the risk of very preterm birth by 59...

A randomised trial of enteral glutamine supplementation for very preterm children showed no beneficial or adverse long-term neurodevelopmental outcomes.

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Twilhaar, E Sabrina; de Kieviet, Jorrit F; Oosterlaan, Jaap; van Elburg, Ruurd M

2018-04-01

This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. The cohort was enrolled in a randomised placebo-controlled trial between 2001 and 2003 in which infants received glutamine- or alanine-supplemented enteral nutrition during the first month of life. Participants were invited for follow-up at a mean age of 13.30 years. Motor, neurocognitive, academic and behavioural outcomes were assessed in 61 children. No differences were found between the groups regarding motor, intellectual, academic and behavioural functioning. Forward span visuospatial working memory performance was better in the controls (crude/adjusted model: d = 0.67/0.64, p = 0.02/0.02), but no difference was found for backward span. After the data were adjusted for confounders, the groups differed regarding parent-rated attention (crude/adjusted model: d = 0.47/0.73, p = 0.07/0.003), but both groups scored within the normal range. This was the first study on the long-term effects of enteral glutamine supplementation on the neurodevelopmental outcomes of very preterm children. Our study provided no evidence that enteral glutamine supplementation had any beneficial or adverse effects on the children's motor, neurocognitive, academic and behavioural outcomes at 13 years of age. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Preterm birth and oxidative stress: Effects of acute physical exercise and hypoxia physiological responses

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Agnès Martin

2018-07-01

Full Text Available Preterm birth is a global health issue that can induce lifelong medical sequela. Presently, at least one in ten newborns are born prematurely. At birth, preterm newborns exhibit higher levels of oxidative stress (OS due to the inability to face the oxygen rich environment in which they are born into. Moreover, their immature respiratory, digestive, immune and antioxidant defense systems, as well as the potential numerous medical interventions following a preterm birth, such as oxygen resuscitation, nutrition, phototherapy and blood transfusion further contribute to high levels of OS. Although the acute effects seem well established, little is known regarding the long-term effects of preterm birth on OS. This matter is especially important given that chronically elevated OS levels may persist into adulthood and consequently contribute to the development of numerous non-communicable diseases observed in people born preterm such as diabetes, hypertension or lung disorders. The purpose of this review is to summarize the current knowledge regarding the consequences of preterm birth on OS levels from newborn to adulthood. In addition, the effects of physical activity and hypoxia, both known to disrupt redox balance, on OS modulation in preterm individuals are also explored. Keywords: Reactive oxygen species, Antioxidants, Prematurity, Physical exercise, Hypoxia

Mothers singing and speaking to preterm infants in NICU

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Manuela Filippa

2015-10-01

Full Text Available Preterm infants are at greater risk for long-term morbidities, a problem representing also a growing public health concern. Early experiences can affect infants’ brain development, especially if conducted during critical periods of important growth. Early interventions involving parents in preterm infants care improve developmental outcomes for preterm infants, minimizing also the stress of the Neonatal Intensive Care Unit (NICU environment. Mother-infant separation and alteration of maternal care soon after birth can lead to a wide array of adverse physiological, emotional and behavioural consequences that can persist throughout life. It’s suggested that Maternal Vocal Intervention (MVI in NICU, as a specific form of environmental and interactional enrichment, as part of an individualized care and as a tool to involve families in early care of preterm infants, may be adopted by the health community as a standard of care. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

Melatonin prevents experimental preterm labor and increases offspring survival.

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Domínguez Rubio, Ana P; Sordelli, Micaela S; Salazar, Ana I; Aisemberg, Julieta; Bariani, María V; Cella, Maximiliano; Rosenstein, Ruth E; Franchi, Ana M

2014-03-01

Preterm delivery is the leading cause of neonatal mortality and contributes to delayed physical and cognitive development in children. At present, there is no efficient therapy to prevent preterm labor. A large body of evidence suggests that intra-amniotic infections may be a significant and potentially preventable cause of preterm birth. This work assessed the effect of melatonin in a murine model of inflammation-associated preterm delivery which mimics central features of preterm infection in humans. For this purpose, preterm labor was induced in BALB/c mice by intraperitoneal injections of bacterial lipopolysaccharide (LPS) at 10.00 hr (10 μg LPS) and 13.00 hr (20 μg LPS) on day 15 of pregnancy. On day 14 of pregnancy, a pellet of melatonin (25 mg) had been subcutaneously implanted into a group of animals. In the absence of melatonin, a 100% incidence of preterm birth was observed in LPS-treated animals, and the fetuses showed widespread damage. By comparison, treatment with melatonin prevented preterm birth in 50% of the cases, and all pups from melatonin-treated females were born alive and their body weight did not differ from control animals. Melatonin significantly prevented the LPS-induced rises in uterine prostaglandin (PG) E2 , PGF2α, and cyclooxygenase-2 protein levels. In addition, melatonin prevented the LPS-induced increase in uterine nitric oxide (NO) production, inducible NO synthase protein, and tumor necrosis factor-alpha (TNFα) levels. Collectively, our results suggest that melatonin could be a new therapeutic tool to prevent preterm labor and to increase offspring survival. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cognitive Outcomes of Children Born Extremely or Very Preterm Since the 1990s and Associated Risk Factors : A Meta-analysis and Meta-regression

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Twilhaar, E Sabrina; Wade, Rebecca M; de Kieviet, Jorrit F; van Goudoever, Johannes B; van Elburg, Ruurd M; Oosterlaan, Jaap

2018-01-01

Importance: Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective: To examine the cognitive abilities of

Long-term cognitive outcomes of infants born moderately and late preterm.

Science.gov (United States)

Odd, David Edward; Emond, Alan; Whitelaw, Andrew

2012-08-01

To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. A cohort study based on the Avon Longitudinal Study of Parents and Children. Cognitive measures were assessed between the ages of 8 and 11 years. Exposure groups were defined as moderate/late preterm (32-36 weeks' gestation) or term (37-42 wk). Regression models were used to investigate the association between gestational age and IQ. Seven hundred and forty-one infants (5.4% of total eligible population; 422 males, 319 females; mean (SD) birthweight 2495 g [489]) were born between 32 and 36 weeks' gestation. The analysis was based on 6957 infants with IQ data at age 11 (50% of eligible infants). In the adjusted model, children born moderately and late preterm had similar IQ scores to peers born at term (mean difference [95% confidence interval] -0.18 [-1.88 to 1.52]). However, the preterm infants had a higher risk of having special educational needs at school (odds ratio 1.56 [1.18-2.07]). Despite an increased risk of special educational needs, there is little evidence of a reduction in IQ, memory, or attention measures at school age in children born between 32 and 36 weeks' gestation. Although interpretation is limited by the amount of missing data, further work is needed to identify why these infants have increased educational needs. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

Rehabilitative training of preterm children’s attention: a study on sustainability

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Giovanna Perricone

2012-10-01

Full Text Available This article is concerned with the description of rehabilitative training aimed at severely and moderately preterm children at preschool age who display impairments of processes of selective attention, self-control and problem solving and who are at risk of Attention Deficit Hyperactivity Disorders. In line with a perspective of field study suggested by pediatric psychology, the treatment calls for the involvement of parents, teachers, neonatologists and children’s reference pediatricians. To be more precise, it is a study aimed at investigating the sustainability of the training path in terms of impact and transformative valence of the focalised processes. Involved in the study was a group of 55 healthy preterm children (35 moderately preterm children and 20 severely preterm children at mean age of 5.2 years attending the third year of infancy school; a group of 55 mothers; a group of 15 pediatricians; a group of 5 neonatologists and one of 10 teachers. Specific questionnaires (the IPDAG and IPDDAI were administered to parents and teachers before and after the training sessions to detect the transformation of the focalised processes. According to a modality of continuous observation during the activities, the trainer used techniques of narrative (the critical incident technique and descriptive (encoding scheme observation. A checklist to detect the participation of adults was used. It was structured as follows: presence, production and aftermath of the effects of the personal intervention with child. A telephone follow-up was performed three months after the end of training to detect the involved adults’ considerations about the stability of promoted changes. Data show good levels of sustainability of the proposed training.

Prenatal and neonatal variables associated with enamel hypoplasia in deciduous teeth in low birth weight preterm infants

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Kátia Maria Dmytraczenko Franco

2007-12-01

Full Text Available This study investigated possible prenatal and neonatal variables that may influence the prevalence of tooth enamel hypoplasia in preterm and low birth weight children (LBW and a matched control group of term children with normal birth weight (NBW. The study sample consisted of 61 children born preterm and with LBW examined at 18-34 months of age. The control group was formed by 61 infants born full term and with NBW examined at 31-35 months of age. All children were born at the Center of Integrated Attention of Women's Health (CAISM-UNICAMP. FDI criteria were followed for dental examination. Medical data was collected retrospectively from hospital records. Among preterms, 57.4% had some type of developmental defects of enamel (DDE, 52.5 % had opacities and 21.3 % presented hypoplasia. Among full-term children, 24.6% presented DDE, 24.6% had opacities and 3.3% had hypoplasia. LBW preterm infants presented a higher prevalence of hypoplasia than NBW controls. The deciduous teeth most affected by hypoplasia were maxillary incisors. There was no significant association with prenatal variables; among neonatal variables there was a significant association with respiratory distress syndrome and neurological examination at discharge with an altered result.

Preterm birth-associated cost of early intervention services: an analysis by gestational age.

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Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

2007-04-01

Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

Prevalence of Persistent Primary Reflexes and Motor Problems in Children with Reading Difficulties

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McPhillips, M.; Sheehy, N.

2004-01-01

It has been shown that some children with reading difficulties have underlying developmental delay and that this may be related to the persistence of primary reflexes. This study investigated the prevalence of persistent primary reflexes in the ordinary primary school population and how this related to other cognitive and social factors. Three…

Emotional and behavioral problems in late preterm and early term births: outcomes at child age 36 months.

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Stene-Larsen, Kim; Lang, Astri M; Landolt, Markus A; Latal, Beatrice; Vollrath, Margarete E

2016-12-01

Recent findings has shown that late preterm births (gestational weeks 34-36) and early term births (gestational weeks 37-38) is associated with an increased risk of several psychological and developmental morbidities. In this article we investigate whether late preterm and early term births is associated with an increased risk of emotional and behavioral problems at 36 months of age and whether there are gender differences in risk of these outcomes. Forty-three thousand, two hundred ninety-seven children and their mothers participating in the Norwegian Mother and Child Cohort Study (MoBa). One thousand, eight hundred fifty-three (4.3%) of the children in the sample were born late preterm and 7,835 (18.1%) were born early term. Information on gestational age and on prenatal and postnatal risk factors was retrieved from the Medical Birth Registry of Norway. Information on emotional and behavioral problems was assessed by standardized questionnaires (CBCL/ITSEA) filled out by the mothers. Gender-stratified logistic regression analyses were used to explore the association between late preterm / early term and emotional and behavioral problems at 36 months of age. We found a gender-specific increased risk of emotional problems in girls born late preterm (OR 1.47 95%CI 1.11-1.95) and in girls born early term (OR 1.21 95%CI 1.04-1.42). We did not find an increased risk of emotional problems in boys born late preterm (OR 1.09 95%CI 0.82-1.45) or early term (OR 0.93 95%CI 0.79-1.10). Behavioral problems were not increased in children born late preterm or early term. Girls born late preterm and early term show an increased risk of emotional problems at 36 months of age. This finding suggests that gender should be taken into account when evaluating children born at these gestational ages.

The Val66Met brain-derived neurotrophic factor gene variant interacts with early pain exposure to predict cortisol dysregulation in 7-year-old children born very preterm: Implications for cognition.

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Chau, C M Y; Cepeda, I L; Devlin, A M; Weinberg, J; Grunau, R E

2017-02-07

Early stress in the form of repetitive neonatal pain, in infants born very preterm, is associated with long-term dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and with poorer cognitive performance. Brain-derived neurotrophic factor (BDNF) which is important in synaptic plasticity and cognitive functions is reduced by stress. Therefore the BDNF Val66Met variant, which affects secretion of BDNF, may interact with early exposure to pain-related stress in children born very preterm, to differentially affect HPA regulation that in turn may be associated with altered cognitive performance. The aims of this study were to investigate whether in children born very preterm, the BDNF Val66Met variant modulates the association between neonatal pain-related stress and cortisol levels at age 7years, and if cortisol levels were related to cognitive function. Furthermore, we examined whether these relationships were sex-specific. Using a longitudinal cohort design, N=90 children born very preterm (24-32weeks gestation) were followed from birth to age 7years. Cortisol was assayed from hair as an index of cumulative stress and from saliva to measure reactivity to a cognitive challenge. BDNF Val66Met variant was genotyped at 7years using real-time polymerase chain reaction (PCR). Using generalized linear modeling, in boys with the Met allele, greater neonatal pain-related stress (adjusted for clinical risk factors) predicted lower hair cortisol (p=0.006) and higher reactivity salivary cortisol (p=0.002). In both boys and girls with the Met allele, higher salivary cortisol reactivity was correlated with lower IQ (r=-0.60; p=0.001) and poorer visual-motor integration (r=-0.48; p=0.008). Our findings show associations between lower BDNF availability (presence of the Met allele) and vulnerability to neonatal pain/stress in boys, but not girls. This exploratory study suggests new directions for research into possible mechanisms underlying how neonatal pain/stress is

Surfactant therapy in late preterm infants

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Murat Yurdakök

2013-06-01

Full Text Available Late preterm (LPT neonates are at a high risk for respiratory distress soon after birth due to respiratory distress syndrome (RDS, transient tachypnea of the newborn, persistent pulmonary hypertension, and pneumonia along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support when compared with the term neonates. In the past, studies on outcomes of infants with respiratory distress have primarily focused on extremely premature infants, leading to a gap in knowledge and understanding of the developmental biology and mechanism of pulmonary diseases in LPT neonates. Surfactant deficiency is the most frequent etiology of RDS in very preterm and moderately preterm infants, while cesarean section and lung infection play major roles in RDS development in LPT infants. The clinical presentation and the response to surfactant therapy in LPT infants may be different than that seen in very preterm infants. Incidence of pneumonia and occurrence of pneumothorax are significantly higher in LPT and term infants. High rates of pneumonia in these infants may result in direct injury to the type II alveolar cells of the lung with decreasing synthesis, release, and processing of surfactant. Increased permeability of the alveolar capillary membrane to both fluid and solutes is known to result in entry of plasma proteins into the alveolar hypophase, further inhibiting the surface properties of surfactant. However, the oxygenation index value do not change dramatically after ventilation or surfactant administration in LPT infants with RDS compared to very preterm infants. These finding may indicate a different pathogenesis of RDS in late preterm and term infants. In conclusion, surfactant therapy may be of significant benefit in LPT infants with serious respiratory failure secondary to a number of insults. However, optimal timing and dose of administration are not so clear in this group. Additional

Pathogens associated with persistent diarrhoea in children in low and middle income countries: systematic review

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Hart C Anthony

2009-06-01

Full Text Available Abstract Background Persistent diarrhoea in children is a common problem in low and middle income countries. To help target appropriate treatment for specific pathogens in the absence of diagnostic tests, we systematically reviewed pathogens most commonly associated with persistent diarrhoea in children. Methods We sought all descriptive studies of pathogens in the stool of children with diarrhoea of over 14 days duration in low and middle income countries with a comprehensive search of the MEDLINE, EMBASE, LILACS and WEB OF SCIENCE databases. We described the study designs and populations, assessed the quality of the laboratory tests, and extracted and summarised data on pathogens. For Escherichia coli, we calculated high and low prevalence estimates of all enteropathic types combined. Results across studies were compared for geographical patterns. Results Nineteen studies were included. Some used episodes of diarrhoea as the unit of analysis, others used children. The quality of reporting of laboratory procedures varied, and pathogens (particularly E. coli types were classified in different ways. As there were no apparent regional differences in pathogen prevalence, we aggregated data between studies to give a guide to overall prevalence. Enteropathic E. coli types were commonly found in children with persistent diarrhoea (up to 63%. Various other organisms, including viruses, bacteria and parasites, were detected but across all studies their prevalence was under 10%. However, these pathogens were also found in similar frequencies in children without diarrhoea. Conclusion A number of pathogens are commonly associated with persistent diarrhoea in children, but in children without diarrhoea the pathogens are found with similar frequencies. New research with carefully selected controls and standardised laboratory investigations across countries will help map causes and help explore effective options for presumptive treatment.

Language Profiles and Literacy Outcomes of Children with Resolving, Emerging, or Persisting Language Impairments

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Snowling, Margaret J.; Duff, Fiona J.; Nash, Hannah M.; Hulme, Charles

2016-01-01

Background: Children with language impairment (LI) show heterogeneity in development. We tracked children from pre-school to middle childhood to characterize three developmental trajectories: resolving, persisting and emerging LI. Methods: We analyzed data from children identified as having preschool LI, or being at family risk of dyslexia,…

Primary reflex persistence in children with reading difficulties (dyslexia): a cross-sectional study.

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McPhillips, Martin; Jordan-Black, Julie-Anne

2007-03-02

The primary reflex system emerges during fetal life and is inhibited during the first year after birth. Our aim was to examine the effects of persistence of this early neurological system on the attainment of core literacy skills in dyslexic and non-dyslexic poor readers. We assessed the prevalence of a persistent primary reflex in a cross-sectional, representative sample of children (n=739) aged 7-9 years old attending mainstream primary school in Northern Ireland using standardised educational tests, and a clinical diagnostic test for a primary reflex (the asymmetrical tonic neck reflex (ATNR)). Multiple regression analyses, involving all of the sample children, revealed that persistence of the ATNR was significantly predictive of attainments in reading (t=-8.34, pschooling, the attainment of core educational skills may be affected by the persistence of a brainstem mediated reflex system that should have been inhibited in the first year after birth. Furthermore, these findings suggest that dyslexia is not a distinct category of poor reading, and that it may be more valid to term all poor readers as dyslexic irrespective of IQ.

Individualized Approaches Have Profitable Clinical Value for Strengthening Fathers' Confidence in the Care of Preterm Infants. Commentary on: "Variations in Early Attachment Mechanisms Contribute to Attachment Quality: Case Studies Including Babies Born Preterm"

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Buchheim, Anna

2016-01-01

In this commentary, Buchheim states that she recognizes that infant-parent relationship has been shown to be of particular significance to preterm infants' socioemotional development, and that preterm children have been reported to be at higher risk of developing attachment insecurity and disorganized attachment. In the feature paper on attachment…

A Lag in Speech Motor Coordination during Sentence Production Is Associated with Stuttering Persistence in Young Children

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Usler, Evan; Smith, Anne; Weber, Christine

2017-01-01

Purpose: The purpose of this study was to determine if indices of speech motor coordination during the production of sentences varying in sentence length and syntactic complexity were associated with stuttering persistence versus recovery in 5- to 7-year-old children. Methods: We compared children with persistent stuttering (CWS-Per) with children…

Executive and Memory Function in Adolescents Born Very Preterm

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Ment, Laura; Allan, Walter; Schneider, Karen; Vohr, Betty R.

2011-01-01

BACKGROUND: Many preterm children display school difficulties, which may be mediated by impairment in executive function and memory. OBJECTIVE: To evaluate executive and memory function among adolescents born preterm compared with term controls at 16 years. METHODS: A total of 337 of 437 (77%) adolescents born in 1989 to 1992 with a birth weight executive function and memory tasks. Multiple regression analyses were used to compare groups and to identify associations between selected factors and outcomes among preterm subjects. RESULTS: Adolescents born preterm, compared with term controls, showed deficits in executive function in the order of 0.4 to 0.6 SD on tasks of verbal fluency, inhibition, cognitive flexibility, planning/organization, and working memory as well as verbal and visuospatial memory. After exclusion of adolescents with neurosensory disabilities and full-scale IQ executive dysfunction, as measured with the Behavior Rating Inventory of Executive Function, on the Metacognition Index (odds ratio [OR]: 2.5 [95% confidence interval (CI): 1.2–5.1]) and the Global Executive Composite (OR: 4.2 [95% CI: 1.6–10.9]), but not on the Behavioral Regulation index (OR: 1.5 [95% CI: 0.7–3.5]). Among adolescents born preterm, severe brain injury on neonatal ultrasound and lower maternal education were the most consistent factors associated with poor outcomes. CONCLUSIONS: Even after exclusion of preterm subjects with significant disabilities, adolescents born preterm in the early 1990s were at increased risk of deficits in executive function and memory. PMID:21300680

Readmission of Preterm Infants Less Than 32 Weeks Gestation Into Early Childhood

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Ralser Elisabeth MD

2014-09-01

Full Text Available The aim of the study was to investigate the frequency of and the predictors for rehospitalization in preterm infants into early childhood, focusing on gender differences. All preterm infants born at <32 weeks of gestation in North Tyrol between January 2003 and December 2005 were enrolled in this survey. About one fifth of all children were readmitted, showing an inverse downward trend with increasing age. The most common reason for readmission in the third (36.5% and fourth (42.9% years of life was respiratory infection, but changed to miscellaneous surgeries in the fifth (52.1%. Male sex showed significantly higher readmission rates and more miscellaneous surgeries. Additionally, male sex and chronic lung disease were risk conditions for rehospitalization in the multivariate analysis. Readmission rates and respiratory infections in preterm-born children showed an inverse downward trend with increasing age. In early childhood, gender difference still plays a role with regard to rehospitalization.

Validity of the language development survey in infants born preterm.

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Beaulieu-Poulin, Camille; Simard, Marie-Noëlle; Babakissa, Hélène; Lefebvre, Francine; Luu, Thuy Mai

2016-07-01

Preterm infants are at greater risk of language delay. Early identification of language delay is essential to improve functional outcome in these children. To examine the concurrent validity of Rescorla's Language Development Survey and the Bayley Scales of Infant and Toddler Development (Bayley-III) at 18months corrected age in preterm infants. Test accuracy study. 189 preterm infants born Language Development Survey, a parent-reported screening instrument, was administered in French concurrently with the Language Scales of the Bayley-III. Receiver-Operating-Characteristics curves were used to determine optimal cut-off score on the Language Development Survey to identify Bayley-III score language delay as per the Bayley-III. The optimal threshold was ≤10 words for both boys and girls. In girls, lowering the cut-off score decreased sensitivity (79%), but improved specificity (82%), thus lowering the number of false-positives. Our findings support using the Language Development Survey as an expressive language screener in preterm infants. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Developmental trajectories of attention and executive functioning in infants born preterm: The influence of perinatal risk factors and maternal interactive styles

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van de Weijer-Bergsma, E.

2009-01-01

Infants born preterm (born before 37 weeks of gestation) are at a heightened risk for developmental delay and learning disabilities. Even children born preterm who have intellectual abilities within the normal range at school age often require special educational services. The preterm population is

Chest radiography in supporting the diagnosis of asthma in children with persistent cough.

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Halaby, Claudia; Feuerman, Martin; Barlev, Dan; Pirzada, Melodi

2014-03-01

To establish whether chest radiographic findings suggestive of lower airway obstruction (LAO) disease support the diagnosis of asthma in pediatric patients with persistent cough in an outpatient setting. 180 patient charts were reviewed. The patients were children aged 1 to 18 years referred over a 3-year period to a pediatric pulmonary subspecialty clinic for evaluation of cough lasting ≥ 4 weeks. Chest radiographic images obtained after the initial evaluation of 90 patients diagnosed with cough-variant asthma and 90 patients diagnosed with persistent cough from nonasthma origins were compared with radiologic findings of a control group consisting of patients with a positive tuberculin skin test and no respiratory symptoms. Increased peribronchial markings/peribronchial cuffing and hyperinflation were considered radiographically suggestive findings of LAO disease. Children diagnosed with cough-variant asthma at the initial evaluation had higher rates of chest radiographic findings suggestive of LAO disease (30.00%) than children with persistent cough from other causes (17.80%) or those with a positive tuberculin skin test and no respiratory symptoms (8.16%) (overall P value = 0.0063). They also had higher rates of spirometry abnormalities suggestive of an LAO defect. Children with chest radiographic findings suggestive of LAO disease were found to be younger than those with normal chest radiographic findings (5.0 ± 2.7 years vs 8.6 ± 4.7 years; P < 0.0001). This study suggests that chest radiographic findings indicative of an LAO in correlation with the clinical presentation can support the diagnostic suspicion of asthma, especially in younger children unable to perform spirometry.

Very Preterm Birth and Parents' Quality of Life 27 Years Later.

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Wolke, Dieter; Baumann, Nicole; Busch, Barbara; Bartmann, Peter

2017-09-01

Parents of preterm children experience increased distress early in their children's lives. Whether the quality of life of parents of preterm children is comparable to that of parents of term children by the time their offspring reach adulthood is unknown. What precursors in their offspring's childhood predict parental quality of life? A prospective whole-population study in Germany followed very preterm (VP) (parents (VP or VLBW: N = 219; term: N = 227) from birth to adulthood. Parental quality of life was evaluated with the World Health Organization Quality of Life assessment and the Satisfaction with Life questionnaire when their offspring were adults (mean age 27.3 years, 95% confidence interval [CI]: 27.2 to 27.3). Childhood standard assessments of VP or VLBW and term offspring included neurosensory disability, academic achievement, mental health, and parent-child and peer relationships. Overall quality of life of parents of VP or VLBW adults was found to be comparable to parents of term individuals ( P > .05). Parental quality of life was not predicted by their children being born VP or VLBW, experiencing disability, academic achievement, or the parent-child relationship in childhood but by their offspring's mental health (B = 0.15, 95% CI: 0.08 to 0.22) and peer relationships (B = 0.09, 95% CI: 0.02 to 0.16) in childhood. As a testament to resilience, parents of VP or VLBW adults had quality of life comparable to parents of term adults. Support and interventions to improve mental health and peer relationships in all children are likely to improve parents' quality of life. Copyright © 2017 by the American Academy of Pediatrics.

Persistent optimizing: how mothers make food choices for their preschool children.

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Walsh, Audrey; Meagher-Stewart, Donna; Macdonald, Marilyn

2015-04-01

Mothers' ability to provide healthy food choices for their children has become more complex in our current obesogenic environment. We conducted a total of 35 interviews with 18 mothers of preschool children. Using constructivist grounded theory methods, we developed a substantive theory of how mothers make food choices for their preschoolers. Our substantive theory, persistent optimizing, consists of three main integrated conceptual categories: (a) acknowledging contextual constraints, (b) stretching boundaries, and (c) strategic positioning. Implications to improve mothers' ability to make healthy food choices that reduce their children's risk of becoming overweight or obese are discussed. © The Author(s) 2014.

Cognitive impairment at age 5 years in very preterm infants born following premature rupture of membranes.

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Mura, Thibault; Picaud, Jean-Charles; Larroque, Béatrice; Galtier, Florence; Marret, Stephane; Roze, Jean-Christophe; Truffert, Patrick; Kuhn, Pierre; Fresson, Jeanne; Thiriez, Gérard; Arnaud, Catherine; Mercier, Gregoire; Picot, Marie-Christine; Ancel, Pierre-Yves; Ledesert, Bernard

2013-08-01

To evaluate the relationship between preterm premature rupture of membranes (PPROM) and cognitive impairment in 5-year-old children born very preterm. The Etude Epidémiologique sur les Petits Ages Gestationnels Study is a population-based cohort of children followed up from birth to age 5 years recruited in 9 French regions in 1997. We analyzed data from singletons born between 24 and 32 weeks gestation categorized into 4 groups according to etiology of prematurity: infants born after PPROM, after idiopathic preterm labor, in a vascular context (Vasc), and to women with other complications (Other). Cognitive development at age 5 years was assessed using the Mental Processing Composite score of the Kaufman-Assessment Battery for Children. Among the 1051 children followed up to age 5 years, the mean Mental Processing Composite score was 93.6 ± 19.7, and 13.3% of the children (140 of 1051) had cognitive impairment. After adjustment for potential confounders, the risk of cognitive impairment among infants in the PPROM group was not significantly different than that in the idiopathic preterm labor group (OR, 1.09; 95% CI, 0.62-1.92) and the Other group (OR, 1.36; 95% CI, 0.75-2.47), but was lower than that in the Vasc group (OR, 1.86; 95% CI, 1.16-2.97). In the PPROM group, the risk of cognitive impairment was greater when the latency period (ie, time from rupture to delivery) was <3 days (OR, 2.32; 95% CI, 1.07-5.02). Preterm infants born after PPROM are not at increased risk for cognitive impairment in childhood, but the time between PPROM and birth may influence that risk. Copyright © 2013 Mosby, Inc. All rights reserved.

Extremely Preterm Birth

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... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

Mental Health in Low-to-Moderate Risk Preterm, Low Birth Weight, and Small for Gestational Age Children at 4 to 5 Years: The Role of Early Maternal Parenting

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Westrupp, Elizabeth M.; Mensah, Fiona K.; Giallo, Rebecca; Cooklin, Amanda; Nicholson, Jan M.

2012-01-01

Objectives: The majority of children born preterm, with low birth weight, or small for gestational age are born with low-to-moderate risk (LTM), yet most research focuses on the high-risk group. Little is known about whether children with LTM perinatal risk are at greater risk for mental health problems, or what the role of early maternal…

Prediction of preterm deliveries from EHG signals using machine learning.

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Paul Fergus

Full Text Available There has been some improvement in the treatment of preterm infants, which has helped to increase their chance of survival. However, the rate of premature births is still globally increasing. As a result, this group of infants are most at risk of developing severe medical conditions that can affect the respiratory, gastrointestinal, immune, central nervous, auditory and visual systems. In extreme cases, this can also lead to long-term conditions, such as cerebral palsy, mental retardation, learning difficulties, including poor health and growth. In the US alone, the societal and economic cost of preterm births, in 2005, was estimated to be $26.2 billion, per annum. In the UK, this value was close to £2.95 billion, in 2009. Many believe that a better understanding of why preterm births occur, and a strategic focus on prevention, will help to improve the health of children and reduce healthcare costs. At present, most methods of preterm birth prediction are subjective. However, a strong body of evidence suggests the analysis of uterine electrical signals (Electrohysterography, could provide a viable way of diagnosing true labour and predict preterm deliveries. Most Electrohysterography studies focus on true labour detection during the final seven days, before labour. The challenge is to utilise Electrohysterography techniques to predict preterm delivery earlier in the pregnancy. This paper explores this idea further and presents a supervised machine learning approach that classifies term and preterm records, using an open source dataset containing 300 records (38 preterm and 262 term. The synthetic minority oversampling technique is used to oversample the minority preterm class, and cross validation techniques, are used to evaluate the dataset against other similar studies. Our approach shows an improvement on existing studies with 96% sensitivity, 90% specificity, and a 95% area under the curve value with 8% global error using the polynomial

Persistence of Sleep Problems in Children with Anxiety and Attention Deficit Hyperactivity Disorders

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Hansen, Berit Hjelde; Skirbekk, Benedicte; Oerbeck, Beate; Wentzel-Larsen, Tore; Kristensen, Hanne

2013-01-01

This study examines the persistence of sleep problems over 18 months in 76 referred children with anxiety disorders and/or attention deficit hyperactivity disorders (ADHD) and 31 nonreferred controls, and explores predictors of sleep problems at follow-up (T2) in the referred children. Diagnoses were assessed at initial assessment (T1) using the…

Desenvolvimento motor de crianças pré-termo moderadas aos sete e oito anos de idade Motor development of moderate preterm children at seven and eight years of age

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Ana Cristina Resende Camargos

2011-06-01

Full Text Available Crianças pré-termo podem apresentar distúrbios leves do desenvolvimento motor, que podem ser imperceptíveis até a idade pré-escolar ou escolar. O objetivo desse estudo foi comparar o desenvolvimento motor de crianças pré-termo moderadas com crianças a termo aos sete e oito anos de idade. Foram coletados dados de 13 crianças pré-termo e 13 crianças a termo de uma escola da rede municipal de Betim. Foi utilizada a Escala de Desenvolvimento Motor para avaliar motricidade fina, motricidade global, equilíbrio, esquema corporal, organização espacial e organização temporal, bem como a idade motora geral e o quociente motor geral. O teste Mann-Whitney foi utilizado para comparar as idades motoras e os quocientes motores entre os grupos. Foi encontrada diferença significativa somente nos valores da motricidade fina entre os grupos (p=0,01, sendo que o grupo pré-termo apresentou desempenho inferior. Dessa forma, crianças pré-termo moderadas que não apresentam características de alto risco biológico ao nascimento também podem necessitar de acompanhamento ambulatorial até a idade escolar.Preterm children may have light motor developmental impairments, which may be imperceptible until pre-school age or even school age. The aim of this study was to compare the motor development of moderate preterm children with full-term ones at seven and eight years of age. Data from 13 preterm and 13 full-term children were collected from a public school in Betim-MG. The Motor Development Scale was used to access fine and global motricity, balance, body scheme, spatial organization, time organization, as well as general motor age and general motor quotient. The Mann-Whitney's Test was used to compare the motor ages and motor quotients between the groups. A significant difference was only found in the fine motricity values between the groups (p=0.01, the preterm group having shown a poorer performance. Therefore, moderate preterm children who do not

Cranial ultrasound findings in preterm infants predict the development of cerebral palsy

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Skovgaard, Ann Lawaetz; Zachariassen, Gitte

2017-01-01

record review. The cohort consisted of very preterm born children (gestational age ≤ 32 + 0) born from 2004 to 2008. For each infant, we obtained results from all cranial ultrasounds performed during hospitalisation. In 2014, patient records were evaluated for cerebral palsy, Gross Motor Function...... haemorrhagic infarction (PVHI), of whom two developed cerebral palsy. Nine children were diagnosed with periventricular leukomalacia (PVL), of whom six developed cerebral palsy. Cerebral palsy was detected in 14 children (6.4%), and one (0.5%) child was in need of a hearing assistive device. Severe brain...... injury (GMH-IVH3, PVHI or PVL) (p = 0.000) and being of male gender (p = 0.03) were associated with cerebral palsy in childhood. Conclusion: Severe brain injuries detected by neonatal cranial ultrasound in very preterm infants is associated with development of cerebral palsy in childhood....

Effect of preterm birth on motor development, behavior, and school performance of school-age children: a systematic review

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Rafaela S. Moreira

2014-04-01

Full Text Available OBJECTIVES: to examine and synthesize the available knowledge in the literature about the effects of preterm birth on the development of school-age children. SOURCES: This was a systematic review of studies published in the past ten years indexed in MEDLINE/Pubmed, MEDLINE/BVS; LILACS/BVS; IBECS/BVS; Cochrane/BVS, CINAHL, Web of Science, Scopus, and PsycNET in three languages (Portuguese, Spanish, and English. Observational and experimental studies that assessed motor development and/or behavior and/or academic performance and whose target-population consisted of preterm children aged 8 to 10 years were included. Article quality was assessed by the Strengthening the reporting of observational studies in epidemiology (STROBE and Physiotherapy Evidence Database (PEDro scales; articles that did not achieve a score of 80% or more were excluded. SUMMARY OF FINDINGS: the electronic search identified 3,153 articles, of which 33 were included based on the eligibility criteria. Only four studies found no effect of prematurity on the outcomes (two articles on behavior, one on motor performance and one on academic performance. Among the outcomes of interest, behavior was the most searched (20 articles, 61%, followed by academic performance (16 articles, 48% and motor impairment (11 articles, 33%. CONCLUSION: premature infants are more susceptible to motor development, behavior and academic performance impairment when compared to term infants. These types of impairments, whose effects are manifested in the long term, can be prevented through early parental guidance, monitoring by specialized professionals, and interventions.

[Quality analyses of the development of preterm infants: results of the Lower-Saxonian preterm infant follow-up project and a comparison group of term infants].

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Damm, Gabriele; Macha, Thorsten; Petermann, Franz; Voss, Wolfgang; Sens, Brigitte

2015-01-01

Based on perinatal and neonatal quality assurance programmes, a follow-up project for the high-risk group of extremely preterm infants, unparalleled in Germany, was initiated in the federal state of Lower Saxony in 2004. Here we describe the new approach of examining a comparison group of term infants, which, for the first time, allows a valid interpretation of the collection of area-wide long-term outcome data on preterm children. The prospective long-term outcome project investigates the medical care situation for children born at less than 28 weeks of gestation up to school age. Based on the information obtained about the children's development the quality of health care will be optimised. A standardised examining concept with established development tests at defined follow-up intervals (at the age of 6 months, 2, 5 and 10 years) is used. At the age of five years 75 % of the examined premature children exhibited impairments. In order to better assess remarkable results, a comparison group of term infants (n=305) selected by a matched-pairs method was examined at the age of five using an analogous concept in kindergartens in Lower Saxony. The results were compared with the first two age cohorts of the follow-up-project (n=226) and quality analyses performed. As expected, significant differences have been found in the children's motor, cognitive and linguistic development between the preterm and term infants examined. This fact draws attention to the importance of early support for the majority of extremely premature infants. Feedback on the results given to the medical staff involved allows for the implementation of best practices and quality improvements. Identifying potential for improvement in everyday health care will help to develop specific optimisation measures. Copyright © 2015. Published by Elsevier GmbH.

Hydronephrosis in Infants and Children: Natural History and Risk Factors for Persistence in Children Followed by a Medical Service

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Kristy Van Dervoort

2009-01-01

Full Text Available Background Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG are presumed to have ureteropelvic junction obstruction (UPJO. There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality. Objective To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality. Methods This retrospective single center review examined infants and children <5 years of age with hydronephrosis who were followed for at least 12 months. Results 136 children were identified (96 male:40 female. The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72% of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67% available patients, 30 (26% had been referred to urology, and 12 (10% had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001. There was an association between detection at birth and lack of resolution of hydronephrosis. Conclusions Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.

Preterm birth, infant weight gain, and childhood asthma risk

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Sonnenschein-van der Voort, Agnes M M; Arends, Lidia R; de Jongste, Johan C

2014-01-01

BACKGROUND: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. OBJECTIVES: We performed an individual participant data meta-analysis for 147,252 children of 31...

Persistent renal cortical scintigram defects in children 2 years after urinary tract infection

International Nuclear Information System (INIS)

Ditchfield, Michael R.; Cook, David J.; Campo, John F. de; Grimwood, Keith; Powell, Harley R.; Gulati, Sanjeev; Sloane, Robert

2004-01-01

Background: Renal cortical scintigraphic studies challenge the role of vesicoureteric reflux in renal scar development, emphasizing instead the part played by acute pyelonephritis. Objective: To determine the prevalence of renal cortical defects in a child cohort 2 years after the child's first diagnosed urinary tract infection and to analyze the relationship of these defects with acute illness variables, primary vesicoureteric reflux and recurrent infections. Materials and methods: In a prospective cohort study, 193 children younger than 5 years with their first proven urinary tract infection underwent renal sonography, voiding cystourethrogram, and renal cortical scintigraphy within 15 days of diagnosis. Two years later, 150 of the 193 children, or 77.7%, had a further renal cortical scintigram, including 75, or 86.2%, of the 87 children who had acute scintigraphic defects. The relationship of cortical defects to age, gender, pre-treatment symptom duration, hospitalization, presence and grade of vesicoureteric reflux, and recurrent urinary tract infections was evaluated. Results: Overall, 20 of the 150 (13.3%; 95% confidence interval (CI) 8.3, 19.8) children had persistent defects 2 years after infection. This included 20 of 75 (26.7%; 95% CI 17.1, 38.1) with initially abnormal scintigrams. No new defects were detected. Although acute defects were more common in the young, those with persistent defects were older (median ages 16.4 vs. 6.8 months, P=0.004) than those with transient abnormalities. After adjustment for age, persistent defects were no longer associated with gender and were not predicted by acute illness variables, primary vesicoureteric reflux or recurrent infections. (orig.)

Neonatal hydrocortisone treatment related to 1H-MRS of the hippocampus and short-term memory at school age in preterm born children.

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Rademaker, Karin J; Rijpert, Maarten; Uiterwaal, Cuno S P M; Lieftink, Arno F; van Bel, Frank; Grobbee, Diederick E; de Vries, Linda S; Groenendaal, Floris

2006-02-01

Animal studies have shown that corticosteroids (dexamethasone) cause neuronal loss in the hippocampus and deficits in short term memory. Proton magnetic resonance spectroscopy can measure brain metabolites in vivo and give an indication of neuronal integrity. We investigated whether prolonged administration of hydrocortisone during the neonatal period for bronchopulmonary dysplasia (BPD) in preterm born children changes the metabolism in the hippocampus, measured at school age. Secondly, we investigated whether hippocampal metabolism and short-term memory and neurodevelopmental outcome are related. In this observational study 37 preterm born children (children were treated with hydrocortisone for BPD (starting dose 5 mg/kg/d tapered over a minimum period of 22 d, median duration 28 d) and 19 never received corticosteroids during the perinatal period. N-acetyl aspartate/ Choline + Creatine/phosphocreatine (NAA/(Cho + Cr)) ratios were determined. A 15-word recall memory test and an IQ measurement were obtained on the same day. Hydrocortisone treated children were younger, lighter and sicker than their nonsteroid treated counterparts. Mean NAA/(Cho + Cr) ratios in the hippocampus were not significantly different in the hydrocortisone group compared with the non-steroid group. Performance on the 15-word memory test and IQ were similar in the two groups. There was no relation between NAA/(Cho + Cr) ratios and memory nor between NAA/(Cho + Cr) ratios and IQ. We conclude that hydrocortisone in the mentioned dose, administered in the neonatal period for BPD, does not appear to have any long-term effects on memory and/or hippocampal metabolism.

Economic costs associated with moderate and late preterm birth: a prospective population-based study.

Science.gov (United States)

Khan, K A; Petrou, S; Dritsaki, M; Johnson, S J; Manktelow, B; Draper, E S; Smith, L K; Seaton, S E; Marlow, N; Dorling, J; Field, D J; Boyle, E M

2015-10-01

We sought to determine the economic costs associated with moderate and late preterm birth. An economic study was nested within a prospective cohort study. Infants born between 32(+0) and 36(+6)  weeks of gestation in the East Midlands of England. A sample of infants born at ≥37 weeks of gestation acted as controls. Data on resource use, estimated from a National Health Service (NHS) and personal social services perspective, and separately from a societal perspective, were collected between birth and 24 months corrected age (or death), and valued in pounds sterling, at 2010-11 prices. Descriptive statistics and multivariable analyses were used to estimate the relationship between gestational age at birth and economic costs. Cumulative resource use and economic costs over the first two years of life. Of all eligible births, 1146 (83%) preterm and 1258 (79%) term infants were recruited. Mean (standard error) total societal costs from birth to 24 months were £12 037 (£1114) and £5823 (£1232) for children born moderately preterm (32(+0) -33(+6)  weeks of gestation) and late preterm (34(+0) -36(+6)  weeks of gestation), respectively, compared with £2056 (£132) for children born at term. The mean societal cost difference between moderate and late preterm and term infants was £4657 (bootstrap 95% confidence interval, 95% CI £2513-6803; P economic costs over the first 2 years of life. Our economic estimates can be used to inform budgetary and service planning by clinical decision-makers, and economic evaluations of interventions aimed at preventing moderate and late preterm birth or alleviating its adverse consequences. Moderate and late preterm birth is associated with increased economic costs over the first 2 years of life. © 2015 Royal College of Obstetricians and Gynaecologists.

The Burden of Provider-Initiated Preterm Birth and Associated Factors: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP.

Directory of Open Access Journals (Sweden)

Renato T Souza

Full Text Available About 15 million children are born under 37 weeks of gestation worldwide. Prematurity is the leading cause of neonatal deaths and short/long term morbidities, entailing consequences not only for the individual, but also their family, health agencies, facilities and all community. The provider-initiated preterm birth is currently one of the most important obstetric conditions related to preterm births, particularly in middle and high income countries, thus decreasing the need for therapeutic preterm birth is essential to reduce global prematurity. Therefore detailed knowledge on the factors associated with provider-initiated preterm birth is essential for the efforts to reduce preterm birth rates and its consequences. In this current analysis we aimed to assess the proportion of provider-initiated (pi-PTB among preterm births in Brazil and identify associated factors.This is an analysis of a multicenter cross-sectional study with a nested case-control component called Brazilian Multicenter Study on Preterm Birth (EMIP. EMIP was conducted in 20 referral obstetric hospitals located in the three most populated of the five Brazilian regions. We analysed data of women with pi-PTB, defined as childbirth occurring at less than 37 weeks, medically indicated for maternal/fetal compromise or both; and women with term birth, childbirth at or after 37 weeks. Maternal, sociodemographic, obstetric, prenatal care, delivery, and postnatal characteristics were assessed as possible factors associated with pi-PTB, compared to term births. The overall prevalence of preterm births was 12.3%. Of these, approximately one-third of cases were initiated by the provider. Hypertensive disorders, placental abruption, and diabetes were the main maternal conditions leading to pi-PTB. Caesarean section was the most common mode of delivery. Chronic hypertension (OR 7.47; 95%CI 4.02-13.88, preeclampsia/eclampsia/HELLP syndrome (OR 15.35; 6.57-35.88, multiple pregnancy (OR 12

Development of fine motor skills in preterm infants

NARCIS (Netherlands)

Bos, Arend F.; Van Braeckel, Koenraad N. J. A.; Hitzert, Marrit M.; Tanis, Jozien C.; Roze, Elise

2013-01-01

Fine motor skills are related to functioning in daily life and at school. We reviewed the status of knowledge, in preterm children, on the development of fine motor skills, the relation with gross motor skills, and risk factors for impaired fine motor skills. We searched the past 15 years in PubMed,

SENSORY PROCESSING DURING CHILDHOOD IN PRETERM INFANTS: A SYSTEMATIC REVIEW.

Science.gov (United States)

Machado, Ana Carolina Cabral de Paula; Oliveira, Suelen Rosa de; Magalhães, Lívia de Castro; Miranda, Débora Marques de; Bouzada, Maria Cândida Ferrarez

2017-01-01

To conduct a systematic search for grounded and quality evidence of sensory processing in preterm infants during childhood. The search of the available literature on the theme was held in the following electronic databases: Medical Literature Analysis and Retrieval System Online (Medline)/PubMed, Latin American and Caribbean Literature in Health Sciences (Lilacs)/Virtual Library in Health (BVS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS)/BVS, Scopus, and Web of Science. We included only original indexed studies with a quantitative approach, which were available in full text on digital media, published in Portuguese, English, or Spanish between 2005 and 2015, involving children aged 0-9years. 581 articles were identified and eight were included. Six studies (75%) found high frequency of dysfunction in sensory processing in preterm infants. The association of sensory processing with developmental outcomes was observed in three studies (37.5%). The association of sensory processing with neonatal characteristics was observed in five studies (62.5%), and the sensory processing results are often associated with gestational age, male gender, and white matter lesions. The current literature suggests that preterm birth affects the sensory processing, negatively. Gestational age, male gender, and white matter lesions appear as risk factors for sensoryprocessing disorders in preterm infants. The impairment in the ability to receivesensory inputs, to integrateand to adapt to them seems to have a negative effect on motor, cognitive, and language development of these children. We highlight the feasibility of identifying sensory processing disorders early in life, favoring early clinical interventions.

Visual search and attention in five-year-old very preterm/very low birth weight children.

Science.gov (United States)

Geldof, Christiaan J A; de Kieviet, Jorrit F; Dik, Marjolein; Kok, Joke H; van Wassenaer-Leemhuis, Aleid G; Oosterlaan, Jaap

2013-12-01

This study aimed to establish visual search performance and attention functioning in very preterm/very low birth weight (VP/VLBW) children using novel and well established measures, and to study their contribution to intellectual functioning. Visual search and attention network efficiency were assessed in 108 VP/VLBW children and 72 age matched term controls at 5.5 years corrected age. Visual search performance was investigated with a newly developed paradigm manipulating stimulus density and stimulus organization. Attention functioning was studied using the Attention Network Test (ANT). Intellectual functioning was measured by a short form of the Wechsler Preschool and Primary Scale of Intelligence. Data were analyzed using ANOVAs and multiple regression analyses. Visual search was less efficient in VP/VLBW children as compared to term controls, as indicated by increased search time (0.31 SD, p = .04) and increased error rate (0.36 SD, p = .02). In addition, VP/VLBW children demonstrated poorer executive attention as indicated by lower accuracy for the executive attention measure of the ANT (0.61 SD, p attention measures (0.13 SD, p = .42). Visual search time and error rate, and executive attention, collectively, accounted for 14% explained variance in full scale IQ (R(2) = .14, p attention. Visual attention dysfunctions contributed to intelligence, suggesting the opportunity to improve intellectual functioning by using interventions programs that may enhance attention capacities. © 2013.

Lower mortality but higher neonatal morbidity over a decade in very preterm infants

NARCIS (Netherlands)

Kleine, M.J.K. de; Ouden, A.L. den; Kollée, L.A.A.; Ilsen, A.; Wassenaer, A.G. van; Brand, R.; Verloove-Vanhorick, S.P.

2007-01-01

Better perinatal care has led to better survival of very preterm children, but may or may not have increased the number of children with cerebral and pulmonary morbidity. We therefore investigated the relationship between changes in perinatal care during one decade, and short-term outcome in very

Preterm Labor

Science.gov (United States)

Preterm labor is labor that starts before 37 completed weeks of pregnancy. It can lead to premature birth. Premature babies may face serious health risks. Symptoms of preterm labor include Contractions every 10 minutes or more often ...

The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm.

Science.gov (United States)

Jensen, Elizabeth T; van der Burg, Jelske W; O'Shea, Thomas M; Joseph, Robert M; Allred, Elizabeth N; Heeren, Tim; Leviton, Alan; Kuban, Karl C K

2017-08-01

To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm. Study participants were 535 ten-year-old children enrolled previously in the prospective multicenter Extremely Low Gestational Age Newborns cohort study who were products of singleton pregnancies. Soon after delivery, mothers provided information about prepregnancy weight. Prepregnancy body mass index and adequacy of weight gain were characterized based on this information. Children underwent a neurocognitive evaluation at 10 years of age. Maternal prepregnancy obesity was associated with increased odds of a lower score for Differential Ability Scales-II Verbal IQ, for Developmental Neuropsychological Assessment-II measures of processing speed and visual fine motor control, and for Wechsler Individual Achievement Test-III Spelling. Children born to mothers who gained an excessive amount of weight were at increased odds of a low score on the Oral and Written Language Scales Oral Expression assessment. Conversely, children whose mother did not gain an adequate amount of weight were at increased odds of a lower score on the Oral and Written Language Scales Oral Expression and Wechsler Individual Achievement Test-III Word Reading assessments. In this cohort of infants born extremely preterm, maternal obesity was associated with poorer performance on some assessments of neurocognitive function. Our findings are consistent with the observational and experimental literature and suggest that opportunities may exist to mitigate risk through education and behavioral intervention before pregnancy. Copyright © 2017 Elsevier Inc. All rights reserved.

Parenting behavior at 2 years predicts school-age performance at 7 years in very preterm children.

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Treyvaud, Karli; Doyle, Lex W; Lee, Katherine J; Ure, Alexandra; Inder, Terrie E; Hunt, Rod W; Anderson, Peter J

2016-07-01

Parenting influences child development, but it is unclear whether early parenting behavior can influence school-age outcomes in very preterm (VPT) children, and/or if certain groups of VPT children may be more affected by early parenting behavior. These research questions were examined. Participants were 147 children born parent-child interaction was assessed, and at 7 years CA, general intelligence (IQ), language, executive function, academic skills, and social-emotional functioning were assessed. Higher levels of parent-child synchrony, and parent facilitation, sensitivity and positive affect at 2 years were associated with better child outcomes at 7 years, while higher levels of intrusiveness and negative affect were associated with poorer outcomes. Many of these relationships remained after controlling for early child cognitive development. Interactions between child medical risk (higher/lower) and parenting were limited to child reading, math, and executive functioning outcomes, with stronger relationships for lower medical risk children. The contribution of early parenting to VPT children's school-age performance is significant, with stronger effects for lower medical risk children in some outcomes. These findings support the premise that parenting strategies should be included in the NICU and early interventions programs for VPT infants. © 2015 Association for Child and Adolescent Mental Health.

Mandibular function, temporomandibular disorders, and headache in prematurely born children.

Science.gov (United States)

Paulsson, Liselotte; Ekberg, Ewacarin; Nilner, Maria; Bondemark, Lars

2009-01-01

To evaluate mandibular function, signs, and symptoms of temporomandibular disorders (TMDs) and headache in prematurely born 8- to 10-year-old children, and to compare the findings with matched full-term born controls. Seventy-three preterm children were selected from the Medical Birth Register--one group comprising 36 extremely preterm children born before the 29th gestational week, the other group 37 very preterm children born during gestational weeks 29 to 32. The preterm children were compared with a control group of 41 full-term children matched for gender, age, nationality, and living area. The subjective symptoms of TMD and headache were registered using a questionnaire. Mandibular function, signs, and symptoms of TMD and headache were registered. TMD diagnoses were set per Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). No significant differences between groups or gender were found for TMD diagnoses according to RDC/TMD or for headache. The preterm children had smaller mandibular movement capacity than the full-term control group, but when adjusting for weight, height, and head circumference mostly all group differences disappeared. Prematurely born children of 8 to 10 years of age did not differ from full-term born children when considering diagnoses according to RDC/TMD, signs, and symptoms of TMD or headache.

Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after threatened preterm labour.

Science.gov (United States)

Papatsonis, Dimitri N M; Flenady, Vicki; Liley, Helen G

2013-10-13

In some women, an episode of preterm labour settles and does not result in immediate preterm birth. Subsequent treatment with tocolytic agents such as oxytocin receptor antagonists may then have the potential to prevent the recurrence of preterm labour, prolonging gestation, and preventing the adverse consequences of prematurity for the infant. To assess the effects of maintenance therapy with oxytocin antagonists administered by any route after an episode of preterm labour in order to delay or prevent preterm birth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2013), sought ongoing and unpublished trials by contacting experts in the field and searched the reference lists of relevant articles. Randomised controlled trials comparing oxytocin antagonists with any alternative tocolytic agent, placebo or no treatment, used for maintenance therapy after an episode of preterm labour. We used the standard methods of The Cochrane Collaboration and the Cochrane Pregnancy and Childbirth Group. Two review authors independently undertook evaluation of methodological quality and extracted trial data. This review includes one trial of 513 women. When compared with placebo, atosiban did not reduce preterm birth before 37 weeks (risk ratio (RR) 0.89; 95% confidence intervals (CI) 0.71 to 1.12), 32 weeks (RR 0.85; 95% CI 0.47 to 1.55), or 28 weeks (RR 0.75; 95% CI 0.28 to 2.01). No difference was shown in neonatal morbidity, or perinatal mortality. There is insufficient evidence to support the use of oxytocin receptor antagonists to inhibit preterm birth after a period of threatened or actual preterm labour. Any future trials using oxytocin antagonists or other drugs as maintenance therapy for preventing preterm birth should examine a variety of important infant outcome measures, including reduction of neonatal morbidity and mortality, and long-term infant follow-up. Future research should also focus on the pathophysiological pathways that

Delayed development of systemic immunity in preterm pigs as a model for preterm infants

DEFF Research Database (Denmark)

Nguyen, Duc Ninh; Jiang, Pingping; Frøkiær, Hanne

2016-01-01

-mediated IL-6 and TNF-α production. These immune parameters remained different between preterm and near-term pigs at 2-3 weeks, even when adjusted for post-conceptional age. Our data suggest that systemic immunity follows a distinct developmental trajectory following preterm birth that may be influenced......Preterm neonates are highly sensitive to systemic infections in early life but little is known about systemic immune development following preterm birth. We hypothesized that preterm neonates have immature systemic immunity with distinct developmental trajectory for the first several weeks of life......, relative to those born at near-term or term. Using pigs as a model, we characterized blood leukocyte subsets, antimicrobial activities and TLR-mediated cytokine production during the first weeks after preterm birth. Relative to near-term and term pigs, newborn preterm pigs had low blood leukocyte counts...

Should preterm labour and preterm premature rupture of ...

African Journals Online (AJOL)

Should preterm labour and preterm premature rupture of membranes be treated with antibiotics? AP Macdonald. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/ogf.v19i2.43719 · AJOL African Journals Online. HOW TO ...

Growth restriction and gender influence cerebral oxygenation in preterm neonates

NARCIS (Netherlands)

Cohen, Emily; Baerts, Willem; Alderliesten, Thomas; Derks, Jan; Lemmers, Petra; van Bel, Frank

2016-01-01

OBJECTIVE: To investigate the effect of fetal growth restriction and gender on cerebral oxygenation in preterm neonates during the first 3 days of life. DESIGN: Case-control study. SETTING: Neonatal Intensive Care Unit of the Wilhelmina Children's Hospital, The Netherlands. PATIENTS: 68 (41 males)

Hot Executive Function Following Moderate-to-Late Preterm Birth: Altered Delay Discounting at 4 Years of Age

Science.gov (United States)

Hodel, Amanda S.; Brumbaugh, Jane E.; Morris, Alyssa R.; Thomas, Kathleen M.

2016-01-01

Interest in monitoring long-term neurodevelopmental outcomes of children born moderate-to-late preterm (32-36 weeks gestation) is increasing. Moderate-to-late preterm birth has a negative impact on academic achievement, which may relate to differential development of executive function (EF). Prior studies reporting deficits in EF in preterm…

Refraction and visual acuity in a national Danish cohort of 4-year-old children of extremely preterm delivery

DEFF Research Database (Denmark)

Fledelius, Hans C; Bangsgaard, Regitze; Slidsborg, Carina

2015-01-01

PURPOSE: A recent threefold increase in laser treatment for advanced retinopathy of prematurity (ROP) triggered a nationwide preschool ophthalmic and developmental status among extremely preterm survivors. Here, we discuss refraction and visual acuity. METHODS: Survivors (n = 178) from a national...... was 0.1 in FT and 0.2 in PT, in Snellen equivalents 0.8 and 0.63. Snellen acuity ≤0.5 occurred across the ROP subgroups, but mainly in those with at least ROP stage 3. Two children had low vision. CONCLUSIONS: The overall fair outcome for refraction and function is in accordance with other recent...

Acetaminophen versus Ibuprofen in Young Children with Mild Persistent Asthma.

Science.gov (United States)

Sheehan, William J; Mauger, David T; Paul, Ian M; Moy, James N; Boehmer, Susan J; Szefler, Stanley J; Fitzpatrick, Anne M; Jackson, Daniel J; Bacharier, Leonard B; Cabana, Michael D; Covar, Ronina; Holguin, Fernando; Lemanske, Robert F; Martinez, Fernando D; Pongracic, Jacqueline A; Beigelman, Avraham; Baxi, Sachin N; Benson, Mindy; Blake, Kathryn; Chmiel, James F; Daines, Cori L; Daines, Michael O; Gaffin, Jonathan M; Gentile, Deborah A; Gower, W Adam; Israel, Elliot; Kumar, Harsha V; Lang, Jason E; Lazarus, Stephen C; Lima, John J; Ly, Ngoc; Marbin, Jyothi; Morgan, Wayne J; Myers, Ross E; Olin, J Tod; Peters, Stephen P; Raissy, Hengameh H; Robison, Rachel G; Ross, Kristie; Sorkness, Christine A; Thyne, Shannon M; Wechsler, Michael E; Phipatanakul, Wanda

2016-08-18

Studies have suggested an association between frequent acetaminophen use and asthma-related complications among children, leading some physicians to recommend that acetaminophen be avoided in children with asthma; however, appropriately designed trials evaluating this association in children are lacking. In a multicenter, prospective, randomized, double-blind, parallel-group trial, we enrolled 300 children (age range, 12 to 59 months) with mild persistent asthma and assigned them to receive either acetaminophen or ibuprofen when needed for the alleviation of fever or pain over the course of 48 weeks. The primary outcome was the number of asthma exacerbations that led to treatment with systemic glucocorticoids. Children in both groups received standardized asthma-controller therapies that were used in a simultaneous, factorially linked trial. Participants received a median of 5.5 doses (interquartile range, 1.0 to 15.0) of trial medication; there was no significant between-group difference in the median number of doses received (P=0.47). The number of asthma exacerbations did not differ significantly between the two groups, with a mean of 0.81 per participant with acetaminophen and 0.87 per participant with ibuprofen over 46 weeks of follow-up (relative rate of asthma exacerbations in the acetaminophen group vs. the ibuprofen group, 0.94; 95% confidence interval, 0.69 to 1.28; P=0.67). In the acetaminophen group, 49% of participants had at least one asthma exacerbation and 21% had at least two, as compared with 47% and 24%, respectively, in the ibuprofen group. Similarly, no significant differences were detected between acetaminophen and ibuprofen with respect to the percentage of asthma-control days (85.8% and 86.8%, respectively; P=0.50), use of an albuterol rescue inhaler (2.8 and 3.0 inhalations per week, respectively; P=0.69), unscheduled health care utilization for asthma (0.75 and 0.76 episodes per participant, respectively; P=0.94), or adverse events. Among

Absence of Circadian Rhythms of Preterm Premature Rupture of Membranes and Preterm Placental Abruption

Science.gov (United States)

Luque-Fernandez, Miguel Angel; Ananth, Cande V.; Sanchez, Sixto E.; Qiu, Chun-fang; Hernandez-Diaz, Sonia; Valdimarsdottir, Unnur; Gelaye, Bizu; Williams, Michelle A.

2014-01-01

Purpose Data regarding circadian rhythm in the onset of spontaneous preterm premature rupture of membranes (PROM) and placental abruption (PA) cases are conflicting. We modeled the time of onset of preterm PROM and PA cases and examined if the circadian profiles varied based on the gestational age at delivery. Methods We used parametric and nonparametric methods, including trigonometric regression in the framework of generalized linear models, to test the presence of circadian rhythms in the time of onset of preterm PROM and PA cases, among 395 women who delivered a singleton between 2009 and 2010 in Lima, Peru. Results We found a diurnal circadian pattern, with a morning peak at 07h:32’ (95%CI:05h:46’ – 09h:18’) among moderate preterm PROM cases (P-value<0.001), and some evidence of a diurnal circadian periodicity among PA cases in term infants (P-value=0.067). However, we did not find evidence of circadian rhythms in the time of onset of extremely or very preterm PROM (P-value=0.259) and preterm PA (P-value=0.224). Conclusions The circadian rhythms of the time of onset of preterm PROM and PA cases varied based on gestational weeks at delivery. While circadian rhythms were presented among moderate preterm PROM and term PA cases, there was no evidence of circadian rhythms among preterm PA and very or extremely preterm PROM cases, underlying other mechanisms associated with the time of onset. PMID:25453346

Respiratory management of the preterm newborn in the delivery room

Directory of Open Access Journals (Sweden)

Abdel-Hady H

2012-05-01

Full Text Available Hesham Abdel-Hady, Nehad NasefNeonatal Intensive Care Unit, Mansoura University Children's Hospital, Mansoura, EgyptAbstract: The survival of preterm infants has improved significantly during the past several decades. However, bronchopulmonary dysplasia remains a major morbidity. Preterm infants have both structural and functional lung immaturity compared with term infants, making them more likely to require resuscitation and more vulnerable to developing bronchopulmonary dysplasia. Interventions in the delivery room may affect short-term and long-term outcomes for preterm infants. The paradigm of resuscitation of preterm infants has been changing over the past decade from being interventional and invasive to be observational and gentle. Recent developments in respiratory management of preterm infants in the delivery room include oxygen supplementation and monitoring, alveolar recruitment techniques, noninvasive ventilation, new surfactant preparations, and new techniques for administration of surfactant. Providing nasal continuous positive airway pressure (CPAP rather than intubating has been identified as a potentially better practice. Experimental studies have demonstrated that early application of nasal CPAP is protective for the preterm lung and brain compared with mechanical ventilation. Several observational studies have suggested that early nasal CPAP and avoiding intubation leads to reduced oxygen requirements, intubation rates, duration of mechanical ventilation, and may decrease rates of bronchopulmonary dysplasia. Multicenter, randomized controlled trials support the use of nasal CPAP as a primary strategy in preterm babies with respiratory distress syndrome. This approach leads to a reduction in the number of infants who are intubated and given surfactant without an impact on bronchopulmonary dysplasia rates. On the other hand, half of the infants enrolled in these studies failed nasal CPAP treatment. New techniques for surfactant

Preterm birth

Science.gov (United States)

2010-01-01

Introduction Preterm birth occurs in about 5% to 10% of all births in resource-rich countries, but in recent years the incidence seems to have increased in some countries, particularly in the USA. We found little reliable evidence for incidence in resource-poor countries. The rate in northwestern Ethiopia has been reported to vary from 11% to 22%, depending on the age group of mothers studied, and is highest in teenage mothers. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in women at high risk of preterm delivery? What are the effects of interventions to improve neonatal outcome after preterm rupture of membranes? What are the effects of treatments to stop contractions in preterm labour? What are the effects of elective compared with selective caesarean delivery for women in preterm labour? What are the effects of interventions to improve neonatal outcome in preterm delivery? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 58 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: amnioinfusion for preterm rupture of membranes; antenatal corticosteroids; antibiotic treatment; bed rest; beta mimetics; calcium-channel blockers; elective caesarean; enhanced antenatal care programmes; magnesium sulphate; oxytocin receptor antagonists (atosiban); progesterone

Axon density and axon orientation dispersion in children born preterm

NARCIS (Netherlands)

Kelly, Claire E.; Thompson, Deanne K.; Chen, Jian; Leemans, Alexander; Adamson, Christopher L.; Inder, Terrie E.; Cheong, Jeanie L Y; Doyle, Lex W.; Anderson, Peter J.

2016-01-01

Background Very preterm birth (VPT, <32 weeks' gestation) is associated with altered white matter fractional anisotropy (FA), the biological basis of which is uncertain but may relate to changes in axon density and/or dispersion, which can be measured using Neurite Orientation Dispersion and Density

Mathematics ability and related skills in preschoolers born very preterm.

Science.gov (United States)

Hasler, Holly M; Akshoomoff, Natacha

2017-12-12

Children born very preterm (VPT) are at risk for academic, behavioral, and/or emotional problems. Mathematics is a particular weakness and better understanding of the relationship between preterm birth and early mathematics ability is needed, particularly as early as possible to aid in early intervention. Preschoolers born VPT (n = 58) and those born full term (FT; n = 29) were administered a large battery of measures within 6 months of beginning kindergarten. A multiple-mediation model was utilized to characterize the difference in skills underlying mathematics ability between groups. Children born VPT performed significantly worse than FT-born children on a measure of mathematics ability as well as full-scale IQ, verbal skills, visual-motor integration, phonological awareness, phonological working memory, motor skills, and executive functioning. Mathematics was significantly correlated with verbal skills, visual-motor integration, phonological processing, and motor skills across both groups. When entered into the mediation model, verbal skills, visual-motor integration, and phonological awareness were significant mediators of the group differences. This analysis provides insights into the pre-academic skills that are weak in preschoolers born VPT and their relationship to mathematics. It is important to identify children who will have difficulties as early as possible, particularly for VPT children who are at higher risk for academic difficulties. Therefore, this model may be used in evaluating VPT children for emerging difficulties as well as an indicator that if other weaknesses are found, an assessment of mathematics should be conducted.

Total matrix metalloproteinase-8 serum levels in patients labouring preterm and patients with threatened preterm delivery.

Directory of Open Access Journals (Sweden)

Piotr Laudański

2010-11-01

Full Text Available Preterm labour and prematurity are still a main cause of perinatal morbidity nowadays. The aim of our study was to assess the role of MMP-8 as a predictive marker of preterm delivery. Four groups of patients were involved to the study: I - pregnant women at 24-34 weeks of gestation with any symptoms of threatened preterm labour; II - threatened preterm labour patients between 24-34 weeks of gestation; III - preterm vaginal delivery patients; IV - healthy term vaginal delivery patients. Serum concentration of total MMP-8 was measured using two enzyme-linked immunosorbent assays. There were no significant differences in the median concentrations of total MMP-8 between physiological pregnancy and threatened preterm labour patients with existing uterine contractility. No significant differences of total MMP-8 were either found between healthy term and preterm labouring patients. The studies on a larger population are needed to reject the hypothesis that preterm labour is connected with increased MMP-8 plasma concentrations of women in preterm labour and threatened preterm delivery.

Can Parents Influence Children's Mathematics Achievement and Persistence in STEM Careers?

Science.gov (United States)

Ing, Marsha

2014-01-01

This study explores the relationship between parental motivational practices, Children's mathematics achievement trajectories, and persistence in science, technology, engineering, and mathematics (STEM) careers. Nationally representative longitudinal survey data were analyzed using latent growth curve analysis. Findings indicate that…

Vitamin D Levels and myocardial function in preterm infants

LENUS (Irish Health Repository)

Armstrong, K

2013-08-20

Bakground Low Vitamin D levels have been linked to cardiac failure in the adults and children. Tissue Doppler Imaging (TDI) is evolving as a superior measure of subtle changes in myocardial contractility in preterm infants. We aimed to correlate Vitamin D levels at birth with TDI measures of systolic and diastolic function. \\r\

Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome

Energy Technology Data Exchange (ETDEWEB)

Panigrahy, Ashok [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States); Wisnowski, Jessica L. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Southern California, Brain and Creativity Institute, Los Angeles, CA (United States); Furtado, Andre [Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States); Lepore, Natasha [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Paquette, Lisa [Children' s Hospital Los Angeles, Center for Fetal and Neonatal Medicine, Los Angeles, CA (United States); Bluml, Stefan [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Southern California, Department of Biomedical Engineering, Los Angeles, CA (United States)

2012-01-15

For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage (IVH) and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the ''connectome'' is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long

Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome

International Nuclear Information System (INIS)

Panigrahy, Ashok; Wisnowski, Jessica L.; Furtado, Andre; Lepore, Natasha; Paquette, Lisa; Bluml, Stefan

2012-01-01

For typically developing infants, the last trimester of fetal development extending into the first post-natal months is a period of rapid brain development. Infants who are born premature face significant risk of brain injury (e.g., intraventricular or germinal matrix hemorrhage and periventricular leukomalacia) from complications in the perinatal period and also potential long-term neurodevelopmental disabilities because these early injuries can interrupt normal brain maturation. Neuroimaging has played an important role in the diagnosis and management of the preterm infant. Both cranial US and conventional MRI techniques are useful in diagnostic and prognostic evaluation of preterm brain development and injury. Cranial US is highly sensitive for intraventricular hemorrhage (IVH) and provides prognostic information regarding cerebral palsy. Data are limited regarding the utility of MRI as a routine screening instrument for brain injury for all preterm infants. However, MRI might provide diagnostic or prognostic information regarding PVL and other types of preterm brain injury in the setting of specific clinical indications and risk factors. Further development of advanced MR techniques like volumetric MR imaging, diffusion tensor imaging, metabolic imaging (MR spectroscopy) and functional connectivity are necessary to provide additional insight into the molecular, cellular and systems processes that underlie brain development and outcome in the preterm infant. The adult concept of the ''connectome'' is also relevant in understanding brain networks that underlie the preterm brain. Knowledge of the preterm connectome will provide a framework for understanding preterm brain function and dysfunction, and potentially even a roadmap for brain plasticity. By combining conventional imaging techniques with more advanced techniques, neuroimaging findings will likely be used not only as diagnostic and prognostic tools, but also as biomarkers for long-term neurodevelopmental

Progesterone for preterm birth prevention

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Miha Lucovnik

2015-10-01

Full Text Available Background: Progesterone is important in maintaining pregnancy. Progesterone supplementation may reduce risk of preterm birth in certain populations of pregnant women. The objective of this review was to develop evidence-based clinical recommendation for progesterone treatment in the prevention of preterm birth.Methods: A search in the Medline database was performed using keywords: progesterone, pregnancy, preterm birth, preterm labour, preterm delivery, randomized trial, and randomized controlled trial. We only included studies of vaginal progesterone treatments for the prevention of preterm birth and excluded studies on 17-α-hydroksiprogesterone caproate.Results: We report findings from twelve randomized trials conducted since 2003. These trials differ regarding inclusion criteria, progesterone dose, vehicle used, and duration of treatment. Inclusion criteria were: short uterine cervix (two trials, history of previous preterm birth (two trials, signs and symptoms of preterm labour (three trials, twin pregnancies (three trials, and multiple risk factors (among these history of previous preterm birth was the most common (two trials. Six of these twelve trials showed a significant reduction in preterm birth in the progesterone groups.Conclusions: Based on current evidence we recommend treatment with 200 mg of micronized progesterone daily, administered vaginally, in pregnant women found to have a short cervix (≤ 25 mm at 19-24 weeks. The treatment should be continued until 37 weeks.

The general movement assessment helps us to identify preterm infants at risk for cognitive dysfunction

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Christa eEinspieler

2016-03-01

Full Text Available Apart from motor and behavioral dysfunctions, deficits in cognitive skills are among the well-documented sequelae of preterm birth. However, early identification of infants at risk for poor cognition is still a challenge, as no clear association between pathological findings based on neuroimaging scans and cognitive functions have been detected as yet. The Prechtl General Movement Assessment (GMA has shown its merits for the evaluation of the integrity of the young nervous system. It is a reliable tool for identifying infants at risk for neuromotor deficits. Recent studies on preterm infants demonstrate that abnormal general movements also reflect impairments of brain areas involved in cognitive development. The aim of this systematic review was to discuss studies that included (i the Prechtl GMA applied in preterm infants, and (ii cognitive outcome measures in six data bases. Seven studies met the inclusion criteria and yielded the following results: (a children born preterm with consistently abnormal general movements up to 8 weeks after term had lower intelligence quotients at school age than children with an early normalization of general movements; (b from 3 to 5 months after term, several qualitative and quantitative aspects of the concurrent motor repertoire, including postural patterns, were predictive of intelligence at 7 to 10 years of age. These findings in 428 individuals born preterm suggest that normal general movements along with a normal motor repertoire during the first months after term are markers for normal cognitive development until at least age 10.

Maternal bereavement and the risk of preterm delivery: the importance of gestational age and of the precursor of preterm birth.

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László, K D; Li, J; Olsen, J; Vestergaard, M; Obel, C; Cnattingius, S

2016-04-01

Maternal stress during pregnancy may increase the risk of preterm delivery (PD), but the associations between stress and subtypes of PD are not clear. We investigated maternal loss of a close relative and risks of very and moderately PD (information on death of women's family members (children, partner, siblings, parents), birth outcomes and maternal characteristics from nationwide registries. Overall, the death of a close family member the year before pregnancy or in the first 36 weeks of pregnancy was associated with a 7% increased risk of PD [95% confidence interval (CI) 1.04-1.10]. The highest hazard ratios (HR) for PD were found for death of an older child [HR (95% CI) 1.20 (1.10-1.31)] and for death of a partner [HR (95% CI) 1.31 (1.03-1.66)]. These losses were associated with higher risks of very preterm [HR (95% CI) 1.61 (1.29-2.01) and 2.07 (1.15-3.74), respectively] than of moderately preterm [HR (95% CI) 1.14 (1.03-1.26) and 1.22 (0.94-1.58), respectively] delivery. There were no substantial differences in the association between death of a child or partner and the risk of spontaneous v. medically indicated PD. Death of a close family member the year before or during pregnancy was associated with an increased risk of PD, especially very PD. Possible mechanisms include both spontaneous and medically indicated preterm birth.

Preschool outcome of less than 801-gram preterm infants compared with full-term siblings.

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Kilbride, Howard W; Thorstad, Karla; Daily, Donna K

2004-04-01

Extremely low birth weight (ELBW) infants are at greater risk for neurodevelopmental delay than full-term infants. Outcomes may be compromised secondary to abnormal brain development associated with complications of prematurity. Long-term cognitive outcome has also been reported to be significantly influenced by postnatal factors. The objective of this study was to clarify the effects of prematurity separate from environmental factors on growth and neurodevelopmental outcomes by comparing ELBW children with their full-term siblings. The study consisted of 25 ELBW children, a subset selected from a larger population of infants who were siblings. Twenty-three sets of siblings were evaluated at 5 years of age and 2 sets at 3 years of age with standardized medical, social, cognitive, motor, and language testing. Physical and neurodevelopmental outcomes were compared between groups, controlling for gender and socioeconomic status (SES). At follow-up, ELBW children were lighter, were shorter, and had smaller head circumference. The ELBW children had lower Stanford-Binet IQs (85 +/- 12 [mean +/- SD] and 95 +/- 11), with lower Stanford-Binet subtests except short-term memory and quantitative reasoning, lower spelling scores on the Wide Range Achievement Test, and lower Peabody motor quotients (79 +/- 11 and 92 +/- 17). Preschool Language Scale quotients were not different, but other receptive language measures were lower for ELBW children. High SES seemed to modify the impact of preterm status on cognitive and language but not motor scores. The mean IQ for high-SES ELBW children was equivalent to that of the low-SES term siblings. Preschool-age cognitive and language functioning in ELBW children seemed to be affected by both prenatal and birth influences (preterm status) and postnatal influences (SES variables). Motor scores were significantly related to preterm status but not to SES.

Mothers of Pre-Term Infants in Neonate Intensive Care

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MacDonald, Margaret

2007-01-01

In this study, eight mothers of pre-term infants under the care of nursing staff and neonatologists in the Neonatal Intensive Care Unit (NICU) of Children's Hospital in Vancouver, British Columbia, were observed and interviewed about their birth experience and their images of themselves as mothers during their stay. Patterns and themes in the…

Comparison of three screening tests for autism in preterm children with birth weights less than 1,500 grams

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Dudova I

2014-11-01

Full Text Available Iva Dudova,1 Daniela Markova,2 Martina Kasparova,3 Jana Zemankova,4 Stepanka Beranova,1 Tomas Urbanek,5 Michal Hrdlicka1 1Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic; 2Department of Pediatrics and Adolescent Medicine, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic; 3Department of Pediatrics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic; 4Department of Pediatrics, Charles University Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic; 5Institute of Psychology, Academy of Sciences, Brno, Czech Republic Background: Preterm children seem to be at increased risk for autism spectrum disorders (ASD. Methods: Parents of 157 children with birth weights less than 1,500 g (age 2 years, corrected for prematurity; 88 boys, 69 girls completed screening questionnaires. The screening battery included the Modified Checklist for Autism in Toddlers (M-CHAT, Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC, and the Infant/Toddler Sensory Profile (ITSP. Children with disabilities were excluded. All children who screened positive on any of the screening tools were subsequently assessed by clinical examination including the Autism Diagnostic Observation Schedule. Results: Fifty-six children (35.7% screened positive on at least one of the parental screening questionnaires. Of the 56 children who tested positive, 33 participated in the detailed clinical follow-up assessment. A diagnosis of ASD was confirmed in 13 of the 33 children. The ASD prevalence was 9.7% of the sample. Analysis of children with and without an ASD diagnosis found significant differences relative to gestational age (26.9 weeks vs 28.3 weeks, P=0.033 and length of the stay in hospital (89.5 days vs 75.4 days, P=0.042. The

Preterm dietary study

DEFF Research Database (Denmark)

Zachariassen, G; Fenger-Gron, J

2014-01-01

To describe eating habits and possible feeding intolerance among preterm infants based on type of nutrition.......To describe eating habits and possible feeding intolerance among preterm infants based on type of nutrition....

Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery

NARCIS (Netherlands)

Schaaf, J. M.; Hof, M. H. P.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.

2012-01-01

Please cite this paper as: Schaaf J, Hof M, Mol B, Abu-Hanna A, Ravelli A. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery.BJOG 2012;119:16241629. Objective To determine the risk of preterm birth in a subsequent twin pregnancy after previous singleton

Maintaining persistence and adherence with subcutaneous growth-hormone therapy in children: comparing jet-delivery and needle-based devices

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Spoudeas HA

2014-09-01

Full Text Available Helen A Spoudeas,1 Priti Bajaj,2 Nathan Sommerford3 1London Centre for Paediatric Endocrinology, University College London, London, 2Ferring Pharmaceuticals, London, 3Health Informatics Research, Sciensus Ltd, Brighton, UK Purpose: Persistence and adherence with subcutaneous growth hormone (GH; somatropin therapy in children is widely acknowledged to be suboptimal. This study aimed to investigate how the use of a jet-delivery device, ZomaJet®, impacts on medication-taking behaviors compared to needle-based devices.Materials and methods: A retrospective cohort study of children aged ≤18 years was conducted using a UK-based, nationwide database of GH home-delivery schedules. Data were evaluated for the period between January 2010 and December 2012 for 6,061 children receiving either Zomacton® (somatropin via the ZomaJet jet-delivery device or one of six brands of GH all administered via needle-based devices. Persistence was analyzed for patients with appropriate data, measured as the time interval between first and last home deliveries. An analysis of adherence was conducted only for patients using ZomaJet who had appropriate data, measured by proportion of days covered. Brand switches were identified for all patients.Results: Persistence with GH therapy was significantly longer in patients using ZomaJet compared to needle-based devices (599 days versus 535 days, respectively, n=4,093; P<0.001; this association was observed in both sexes and across age subgroups (≤10 and 11–16 years. The majority (58% of patients using ZomaJet were classed as adherent (n=728. Only 297 patients (5% switched GH brand (n=6,061, and patients tended to use ZomaJet for longer than other devices before switching.Conclusion: It appears important that the choice of a jet-delivery device is offered to children prescribed daily GH therapy. These devices may represent a much-needed effective strategy for maintaining persistence with subcutaneous GH administration in

Nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge.

Science.gov (United States)

Lapillonne, Alexandre; O'Connor, Deborah L; Wang, Danhua; Rigo, Jacques

2013-03-01

Early nutritional support of preterm infants is critical to life-long health and well being. Numerous studies have demonstrated that preterm infants are at increased risk of mortality and morbidity, including disturbances in brain development. To date, much attention has focused on enhancing the nutritional support of very low and extremely low birth weight infants to improve survival and quality of life. In most countries, preterm infants are sent home before their expected date of term birth for economic or other reasons. It is debatable whether these newborns require special nutritional regimens or discharge formulas. Furthermore, guidelines that specify how to feed very preterm infants after hospital discharge are scarce and conflicting. On the other hand, the late-preterm infant presents a challenge to health care providers immediately after birth when decisions must be made about how and where to care for these newborns. Considering these infants as well babies may place them at a disadvantage. Late-preterm infants have unique and often-unrecognized medical vulnerabilities and nutritional needs that predispose them to greater rates of morbidity and hospital readmissions. Poor or inadequate feeding during hospitalization may be one of the main reasons why late-preterm infants have difficulty gaining weight right after birth. Providing optimal nutritional support to late premature infants may improve survival and quality of life as it does for very preterm infants. In this work, we present a review of the literature and provide separate recommendations for the care and feeding of late-preterm infants and very preterm infants after discharge. We identify gaps in current knowledge as well as priorities for future research. Copyright © 2013 Mosby, Inc. All rights reserved.

Preterm birth, an unresolved issue.

Science.gov (United States)

Belizán, Jose M; Hofmeyr, Justus; Buekens, Pierre; Salaria, Natasha

2013-11-15

Premature birth is the world's leading cause of neonatal mortality with worldwide estimates indicating 11.1% of all live births were preterm in 2010. Preterm birth rates are increasing in most countries with continual differences in survival rates amongst rich and poor countries. Preterm birth is currently an important unresolved global issue with research efforts focusing on uterine quiescence and activation, the 'omics' approaches and implementation science in order to reduce the incidence and increase survival rates of preterm babies. The journal Reproductive Health has published a supplement entitled Born Too Soon which addresses factors in the preconception and pregnancy period which may increase the risk of preterm birth and also outlines potential interventions which may reduce preterm birth rates and improve survival of preterm babies by as much as 84% annually. This is critical in order to achieve the Millennium Development Goal (MDG 4) for child survival by 2015 and beyond.

Early identification of cerebral visual impairments in infants born extremely preterm

NARCIS (Netherlands)

Pel, Johan J M; Dudink, Jeroen; Vonk, Mark; Plaisier, Annemarie; Reiss, Irwin K M; van der Steen, Johannes

2016-01-01

AIM: Children born extremely preterm are at risk of visual processing problems related to brain damage. Damage in visual pathways can remain undetected by conventional magnetic resonance imaging (MRI) and functional consequences cannot always be predicted. The aim of this study was to assess the

Behaviour and development in 24-month-old moderately preterm toddlers

NARCIS (Netherlands)

de Jong, Marjanneke; Verhoeven, Marjolein; Lasham, Carole A.; Meijssen, Clemens B.; van Baar, Anneloes L.

2015-01-01

OBJECTIVE: Moderately preterm children (gestational age 32-36+6 weeks) are at risk of cognitive and behaviour problems at school age. The aim of this study was to investigate if these problems are already present at the age of 2 years. STUDY DESIGN: Developmental outcome was assessed at 24-months

Persistent hyperinsulinemic hypoglycemia of infancy in 38 children

International Nuclear Information System (INIS)

Bin-Abbas, Bassam S.; Al-Mulhim, Abdulmohsin N.; Sakati, Nadia A.; Al-Ashwal, Abdullah A.

2003-01-01

To describe the clinical, biochemical,radiological and electrophysiological features of 38 Saudi children with persistent hyperinsulinemic hypoglycemia(PHH) that have been followed sine 1983. Data from 38 patients followed at King Faisal Specialist Hospital,Riyadh, Kingdom of Saudi Arabia 1983-2002 were analyzed. PHH of infancy was diagnosed on the basis of high intravenous glucose requirement,high insulin to glucose ratio, negative urinary ketones and normal tandem mass spectrometry. Patients were assessed radiologically by brain magnetic resonance imaging and computerized tomography. Patients were severely hypoglycaemic and intolerance to fast hypoglycaemic convulsion was the most commonly presenting complaint. 18 patients were developmentally delayed and 14 of them had brain atrophy.All patients except 9 did not respond to medical treatment and had surgery. Four of the pancreatectomized patients developed diabetes and 2 had malabsorption. PHH of infancy is relatively common and serious disease in Saudi children. Early medical intervention is necessary to avoid neurological damage. Surgically and probably medically treated patients are at a high risk of developing diabetes that could be the natural outcome of this disease. (author)

Parenting stress trajectories in mothers of very preterm infants to 2 years.

Science.gov (United States)

Gray, Peter H; Edwards, Dawn M; Gibbons, Kristen

2018-01-01

To examine levels of parenting stress in mothers of preterm and term infants when the children were 2 years old; to determine the trajectory of stress over three time periods and to examine the association of maternal and neonatal factors and developmental outcomes with parenting stress. It is a prospective longitudinal study to determine parenting stress in mothers of preterm and term infants with outcomes having been previously obtained at 4 and 12 months. At 2 years, 79 preterm mothers (96 babies) and 64 term mothers (77 babies) participated. The mothers completed the Parenting Stress Index-Short Form (PSI-SF), the Depression, Anxiety, Stress Scale (DASS) and the Child Behaviour Checklist (CBCL). The infants had a neurological examination and the Bayley-III scales were administered. The mean total PSI-SF at 2 years was significantly higher for the preterm group compared with the term group of mothers (p=0.007). There was a significant increase in the mean total PSI over time for the preterm mothers (pparenting stress and abnormal scores on the DASS (pparenting stress and maternal demographics, neonatal factors or Bayley-III results. Parenting stress in mothers of preterm infants continues to be high at 2 years having increased over time. Maternal mental health problems and infant behavioural issues contribute to the stress. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Corticosteroids for treating hypotension in preterm infants.

Science.gov (United States)

Ibrahim, Hafis; Sinha, Ian P; Subhedar, Nimish V

2011-12-07

weighted mean difference for outcomes measured on a continuous scale, with 95% confidence intervals. Four studies were included in this review enrolling a total of 123 babies. In one study, persistent hypotension was more common in hydrocortisone treated infants as compared to those who received dopamine as primary treatment for hypotension (RR 8.2, 95% CI 0.47 to 142.6; RD 0.19, 95% CI 0.01 to 0.37). In two studies comparing steroid versus placebo, persistent hypotension (defined as a continuing need for inotrope infusion) was less common in steroid treated infants as compared to controls who received placebo for refractory hypotension (RR 0.35, 95% CI 0.19 to 0.65; RD -0.47, 95% CI - 0.68 to - 0.26; NNT = 2.1, 95% CI 1.47, 3.8). There were no statistically significant effects on any other short or long-term outcome. A further two studies that have only been published in abstract form to date, may be eligible for inclusion in a future update of this review. Hydrocortisone may be as effective as dopamine when used as a primary treatment for hypotension. But the long term safety data on the use of hydrocortisone in this manner is unknown.Steroids are effective in treatment of refractory hypotension in preterm infants without an increase in short term adverse consequences. However, long term safety or benefit data is lacking. With long term benefit or safety data lacking steroids cannot be recommended routinely for the treatment of hypotension in preterm infants.

Greater brain response to emotional expressions of their own children in mothers of preterm infants: an fMRI study.

Science.gov (United States)

Montirosso, R; Arrigoni, F; Casini, E; Nordio, A; De Carli, P; Di Salle, F; Moriconi, S; Re, M; Reni, G; Borgatti, R

2017-06-01

The birth of a preterm infant and Neonatal Intensive Care Unit hospitalization constitute a potentially traumatic experience for mothers. Although behavioral studies investigated the parenting stress in preterm mothers, no study focused on the underlying neural mechanisms. We examined the effect of preterm births in mothers, by comparing brain activation in mothers of preterm and full-term infants. We used functional magnetic resonance imaging to measure the cerebral response of 10 first-time mothers of preterm infants (gestational age mothers of full-term infants, viewing happy-, neutral- and distress-face images of their own infant, along with a matched unknown infant. While viewing own infant's face preterm mothers showed increased activation in emotional processing area (i.e., inferior frontal gyrus) and social cognition (i.e., supramarginal gyrus) and affiliative behavior (i.e., insula). Differential brain activation patterns in mothers appears to be a function of the atypical parenthood transition related to prematurity.

Progesterone to prevent spontaneous preterm birth

Science.gov (United States)

Romero, Roberto; Yeo, Lami; Chaemsaithong, Piya; Chaiworapongsa, Tinnakorn; Hassan, Sonia

2014-01-01

Summary Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important healthcare priority. Preterm parturition is one of the ‘great obstetrical syndromes’ and is caused by multiple etiologies. One of the mechanisms of disease is the untimely decline in progesterone action, which can be manifested by a sonographic short cervix in the midtrimester. The detection of a short cervix in the midtrimester is a powerful risk factor for preterm delivery. Vaginal progesterone can reduce the rate of preterm delivery by 45%, and the rate of neonatal morbidity (admission to neonatal intensive care unit, respiratory distress syndrome, need for mechanical ventilation, etc.). To prevent one case of spontaneous preterm birth birth in women with a short cervix both with and without a prior history of preterm birth. In patients with a prior history of preterm birth, vaginal progesterone is as effective as cervical cerclage to prevent preterm delivery. 17α-Hydroxyprogesterone caproate has not been shown to be effective in reducing the rate of spontaneous preterm birth in women with a short cervix. PMID:24315687

Probing the Nature of Deficits in the "Approximate Number System" in Children with Persistent Developmental Dyscalculia

Science.gov (United States)

Bugden, Stephanie; Ansari, Daniel

2016-01-01

In the present study we examined whether children with Developmental Dyscalculia (DD) exhibit a deficit in the so-called "Approximate Number System" (ANS). To do so, we examined a group of elementary school children who demonstrated persistent low math achievement over 4 years and compared them to typically developing (TD), aged-matched…

Mesenchymal stem cells induce T-cell tolerance and protect the preterm brain after global hypoxia-ischemia.

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Reint K Jellema

Full Text Available Hypoxic-ischemic encephalopathy (HIE in preterm infants is a severe disease for which no curative treatment is available. Cerebral inflammation and invasion of activated peripheral immune cells have been shown to play a pivotal role in the etiology of white matter injury, which is the clinical hallmark of HIE in preterm infants. The objective of this study was to assess the neuroprotective and anti-inflammatory effects of intravenously delivered mesenchymal stem cells (MSC in an ovine model of HIE. In this translational animal model, global hypoxia-ischemia (HI was induced in instrumented preterm sheep by transient umbilical cord occlusion, which closely mimics the clinical insult. Intravenous administration of 2 x 10(6 MSC/kg reduced microglial proliferation, diminished loss of oligodendrocytes and reduced demyelination, as determined by histology and Diffusion Tensor Imaging (DTI, in the preterm brain after global HI. These anti-inflammatory and neuroprotective effects of MSC were paralleled by reduced electrographic seizure activity in the ischemic preterm brain. Furthermore, we showed that MSC induced persistent peripheral T-cell tolerance in vivo and reduced invasion of T-cells into the preterm brain following global HI. These findings show in a preclinical animal model that intravenously administered MSC reduced cerebral inflammation, protected against white matter injury and established functional improvement in the preterm brain following global HI. Moreover, we provide evidence that induction of T-cell tolerance by MSC might play an important role in the neuroprotective effects of MSC in HIE. This is the first study to describe a marked neuroprotective effect of MSC in a translational animal model of HIE.

Maternal obesity and development of the preterm newborn at 2 year

NARCIS (Netherlands)

van der Burg, J.W.; Allred, E.N.; Kuban, K.; O'Shea, T.M.; Dammann, O.; Leviton, A.

2015-01-01

Aim To evaluate to what extent extremely preterm children (<28 weeks' gestational age) of overweight (BMI 25-29) or obese (BMI ≥30) women are at increased risk of adverse development at 2 years measured with the Bayley Scales of Infant Development II in a multicenter prospective cohort study.

Screening for spontaneous preterm birth

NARCIS (Netherlands)

van Os, M.A.; van Dam, A.J.E.M.

2015-01-01

Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

Mother and Child Behaviour in Very Preterm and Term Dyads at 6 and 8 Years

Science.gov (United States)

Jaekel, Julia; Wolke, Dieter; Chernova, Julia

2012-01-01

Aim: Mothers of very preterm children have been reported to behave less sensitively and to be more controlling. It is unknown whether this is the result of maternal factors or due to maternal adaptation to children's cognitive problems. Method: We investigated a geographically defined prospective whole-population sample of very low birthweight (…

Screening for autism in preterm children with extremely low and very low birth weight

Directory of Open Access Journals (Sweden)

Dudova I

2014-02-01

diagnosis of ASD was confirmed in eight of the 19 children. ASD prevalence, calculated from those 19 children and those with negative screening results (43 children, yielded a prevalence of 12.9% in the sample. The difference in frequency of positive screens between the tests was significant (P=0.011. In pair comparisons, ITSP was found to be significantly less positive than CSBS-DP-ITC (P=0.032. No significant differences were found between the M-CHAT and CSBS-DP-ITC or between the M-CHAT and ITSP. Conclusion: The results strongly support the hypothesis of an increased prevalence of autism in children with a birth weight less than 1,500 g. Keywords: autism spectrum disorder, preterm children, screening, Autism Diagnostic Observation Schedule, prevalence

Preschool self regulation predicts later mental health and educational achievement in very preterm and typically developing children.

Science.gov (United States)

Woodward, Lianne J; Lu, Zhigang; Morris, Alyssa R; Healey, Dione M

2017-02-01

To examine the extent to which preschool emotional and behavioral regulatory difficulties were associated with an increased risk of later mental health and educational problems. Of particular interest was whether early regulatory abilities contributed to later risk once baseline child behavioral adjustment and cognitive function were taken into account. Data were drawn from a prospective longitudinal study of 223 children born very preterm (VPT; Regulation Checklist, and (3) tester ratings of child behavior during neuropsychological testing. At age 9 years, mental health and educational achievement were assessed using the Development and Well-being Assessment interview and the Woodcock Johnson-III Tests of Achievement. VPT-born children had poorer emotional and behavioral regulation across all measures and time points. They also had higher rates of DSM-IV mental health disorder and educational delay at age 9. Across both study groups, poorer self regulation was associated with an increased risk of ADHD, conduct disorder, anxiety disorders and any disorder net of preschool child behavior problems and social risk. In contrast, only associations between early regulation and later language and any educational delay remained significant after adjustment for preschool cognitive functioning and family social risk. Early assessment of regulation in addition to behavioral screening may improve the early identification of preschool children at mental health risk.

Exploring predictors of change in behavioral problems over a 1-year period in preterm born preschoolers.

Science.gov (United States)

Schappin, Renske; Wijnroks, Lex; Uniken Venema, Monica; Jongmans, Marian

2018-02-01

Although predictors of the prevalence of behavioral problems in preterm-born children have been frequently studied, predictors of behavioral change in these children remain unknown. Therefore, in this study we explore predictors of short-term changes in problem behavior in preterm-born preschoolers, an age period characterized by rapid behavioral change. Two- to 5-year-old children born with a gestational age behavioral problems. Following screening, 59 children with a t-score ≥60 on either the internal, external or total problem scale of the Child Behavior Checklist were included in the study. Linear mixed modeling was used to investigate predictors of change in behavior over a 1-year period. Higher levels of parenting stress, parent perceived child vulnerability, and parental hostility towards the child and lower educational levels of the mother significantly predicted increases in externalizing behavior. The higher the age of the child, the more internalizing problems decreased. Parenting stress, parent perceived child vulnerability and parental hostility towards the child were the only modifiable predictors of increases in externalizing behavior, whilst no modifiable predictors of internalizing behavior were found. There may be a reciprocal interaction between stress in parents and child externalizing problems. Furthermore, stress and worries may directly influence parents' reports on behavioral measures, because it could cause them to be concerned by behavior otherwise perceived as normal. Therefore, future interventions for parents of preterm-born children should primarily address parental stress and concerns regarding their child. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Effect of intervention on development of hip posture in very preterm babies.

OpenAIRE

Downs, J A; Edwards, A D; McCormick, D C; Roth, S C; Stewart, A L

1991-01-01

Preterm babies are physiologically hypotonic, which causes their posture to be flattened when lying in the prone position. This flattened posture may persist beyond term. In a prospective, randomised, controlled, double blind trial of postural support carried out on 45 babies born at less than 33 weeks of gestation, we showed that infants positioned with specific hip support during the period of intensive care had significantly fewer features of flattened posture at the age equivalent to term.

Intermittent versus Persistent Wolff-Parkinson-White Syndrome in Children: Electrophysiologic Properties and Clinical Outcomes.

Science.gov (United States)

Kiger, Michelle E; McCanta, Anthony C; Tong, Suhong; Schaffer, Michael; Runciman, Martin; Collins, Kathryn K

2016-01-01

Intermittent Wolff-Parkinson-White (WPW) syndrome is considered to have a lower risk of sudden death. Fewer data exist regarding electrophysiologic (EP) characteristics and the natural history of intermittent WPW in children. All patients with WPW age 1-18 years at a single institution (1996-2013) were reviewed. Patients with intermittent preexcitation were compared to those with loss of preexcitation on Holter/exercise testing and those with persistent preexcitation. High-risk accessory pathway (AP) was defined as AP effective refractory period (APERP), block cycle length, or shortest preexcited RR interval during atrial fibrillation ≤250 ms. A total of 295 patients were included: 226 (76.6%) persistent, 39 (13.2%) intermittent, and 30 (10.2%) loss of preexcitation Holter/exercise. There were no differences in symptoms between groups. Median interquartile range APERP was significantly longer in intermittent WPW (380 [320, 488] ms vs 320 [300, 350] ms persistent, 310 [290, 330] ms loss of preexcitation Holter/exercise; P = 0.0008). At baseline, there was no difference between groups in frequency of high-risk pathways. However, when isoproterenol values were included, high-risk pathways were more frequent among patients with loss of preexcitation on Holter/exercise (54% vs 16% persistent, 11% intermittent; P = 0.005). There was one death in a patient with loss of preexcitation on exercise testing, no EP study, and prior drug use. A second patient with persistent WPW and APERP 270 ms required resuscitation following a methadone overdose. Intermittent preexcitation in children does not connote a lower risk AP by EP criteria or reduced symptoms. The low number of pediatric WPW patients who develop preexcited atrial fibrillation or sudden death warrants larger studies to investigate these outcomes. ©2015 Wiley Periodicals, Inc.

The present challenges of parenteral nutrition in preterm infants and children

NARCIS (Netherlands)

van Goudoever, Johannes B.; Vlaardingerbroek, Hester

2013-01-01

The goal of pediatricians involved in the nutritional management of preterm infants is to mimic intrauterine growth and to obtain a functional outcome comparable to that for infants born at term. Appropriate administration of nutrients in the first few days to weeks of life will reduce the growth

Birth weight and postnatal growth in preterm born children are associated with cortisol in early infancy, but not at age 8 years.

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Ruys, Charlotte A; van der Voorn, Bibian; Lafeber, Harrie N; van de Lagemaat, Monique; Rotteveel, Joost; Finken, Martijn J J

2017-08-01

Preterm birth has been associated with altered hypothalamic-pituitary-adrenal (HPA-) axis activity as well as cardiometabolic diseases and neurodevelopmental impairments later in life. We assessed cortisol from term age to age 8 y in children born preterm, to explore the development of HPA-axis activity in association with intrauterine and early-postnatal growth until 6 mo. corrected age. In 152 children born at a gestational age ≤32 wks. and/or with a birth weight ≤1,500g, random serum cortisol was assessed at term age (n=150), 3 mo. (n=145) and 6 mo. corrected age (n=144), and age 8 y (n=59). Salivary cortisol was assessed at age 8 y (n=75): prior to bedtime, at awakening, 15min after awakening, and before lunch. Cortisol was analyzed in association with birth weight-standard deviation score (SDS), being born small for gestational age (SGA), and combinations of intrauterine and postnatal growth: appropriate for gestational age (AGA) with or without growth restriction (AGA GR+ or AGA GR-) at 6 mo. corrected age, and SGA with or without catch-up growth (SGA CUG+ or SGA CUG-) at 6 mo. corrected age. Cross-sectional associations at all time points were analyzed using linear regression, and longitudinal associations were analyzed using generalized estimating equations. Longitudinally, birth weight-SDS was associated with cortisol (β [95%CI]): lower cortisol over time was seen in infants with a birth weight ≤-2 SDS (-50.69 [-94.27; -7.11], p=0.02), infants born SGA (-29.70 [-60.58; 1.19], p=0.06), AGA GR+ infants (-55.10 [-106.02; -4.17], p=0.03) and SGA CUG- infants (-61.91 [-104.73; -19.10], p=0.01). In cross-sectional analyses at age 8 y, no associations were found between either serum or salivary cortisol and birth weight-SDS, SGA-status, or growth from birth to 6 mo. corrected age. In children born preterm, poor intrauterine and postnatal growth were associated with lower cortisol in early infancy, but not at age 8 y. Even though HPA-axis activity no longer

Challenges and Consequences of Preterm Birth

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Sribas Goswami

2014-11-01

Full Text Available Preterm births have been a challenge to obstetricians and paediatricians. Preterm births affect all population irrespective of age, race and economic status due to lack of seriousness and awareness among the pregnant women. Preterm birth is one of the leading causes of infant morbidity and mortality, amounting to billions of dollars each year, thus increasing the cost for health care. Proper awareness programs about preterm birth may help the women population to know and understand better the signs and symptoms of preterm labour. Preterm birth is a complex cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, neighborhood characteristics, environmental exposures, medical conditions, infertility treatments, biological factors and genetics. Many of these factors occur in combination, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. The empirical investigation was carried out to draw correlation between preterm birth and eventuality through this study.

Evolução ecocardiográfica de recém-nascidos com persistência do canal arterial Echocardiographic post-neonatal progress of preterm neonates with patent ductus arteriosus

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Jorge Yussef Afiune

2005-12-01

Full Text Available OBJETIVO: Analisar características ecocardiográficas e manifestações clínicas na evolução de recém-nascidos pré-termo com persistência do canal arterial e identificar indicadores mais confiáveis do fechamento espontâneo deste. MÉTODOS: Sessenta e um recém-nascidos pré-termo com idade gestacional de 30±2 semanas (26-34 semanas peso de 1,2±0,2 kg (0,7-1,7 kg foram avaliados semanalmente desde o terceiro dia de vida até o termo através de ecocardiograma. O diâmetro do canal arterial e medidas das cavidades cardíacas foram determinados. Avaliação clínica procurou detectar sinais clínicos de persistência do canal arterial. Recém-nascidos pré-termo com persistência do canal arterial foram divididos em dois grupos: Grupo A, onde houve fechamento espontâneo do canal arterial, e Grupo B, onde não houve. Análise estatística foi realizada através do teste t e curva ROC. RESULTADOS: Vinte e um (34,4% recém-nascidos pré-termo apresentaram persistência do canal arterial no terceiro dia de vida, sendo sete do grupo A e 14 do grupo B. Sinais clínicos de persistência do canal arterial ocorreram em 14,3% do grupo A e 71,4% do grupo B (p = 0,013. Persistência do canal arterial aumentou significativamente os diâmetros do átrio e ventrículo esquerdo e débito cardíaco aórtico. Diâmetro médio do canal arterial foi maior no grupo B (2,6±0,6 mm versus 1,4±0,6 mm; p = 0,003. Área abaixo da curva ROC em relação ao diâmetro do canal foi de 0,93 (p = 0,003, sendo 1,7 mm o ponto de corte de maior sensibilidade (100% para identificar os recém-nascidos onde o canal arterial não apresentará fechamento espontâneo e 2,2 mm o ponto de maior especificidade (100%. CONCLUSÕES: Em recém-nascidos pré-termo, uma persistência do canal arterial maior que 2,2 mm de diâmetro no terceiro dia de vida prediz ausência de fechamento espontâneo e sugere necessidade de tratamento, especialmente quando da presença de algum sinal cl

Establishing a reference range for triiodothyronine levels in preterm infants.

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Oh, Ki Won; Koo, Mi Sung; Park, Hye Won; Chung, Mi Lim; Kim, Min-ho; Lim, Gina

2014-10-01

Thyroid dysfunction affects clinical complications in preterm infants and older children. However, thyroid hormone replacement in preterm infants has no proven benefits, possibly owing to the lack of an appropriate reference range for thyroid hormone levels. We aimed to establish a reference range for triiodothyronine (T3) levels at 1-month postnatal age (PNA) in preterm infants. This retrospective study included preterm infants born at a tertiary referral neonatal center at gestational age (GA)<35 weeks with no apparent thyroid dysfunction, for 6 consecutive years, with follow-up from PNA 2 weeks to 16 weeks. Using thyroid function tests (TFT), the relationships between T3 levels and thyrotropin (TSH) and free thyroxine (fT4) levels, birth weight, GA, postmenstrual age (PMA), and PNA were examined. The conversion trend for fT4 to T3 was analyzed using the T3/fT4 ratio. Overall, 464 TFTs from 266 infants were analyzed, after excluding 65 infants with thyroid dysfunction. T3 levels increased with fT4 levels, birth weight, GA, PMA, and PNA but not with TSH levels. The T3/fT4 ratio also increased with GA, PNA, and PMA. The average T3 level at 1 month PNA was 72.56 ± 27.83 ng/dL, with significant stratifications by GA. Relatively low T3 and fT4 levels in preterm infants were considered normal, with T3 levels and conversion trends increasing with GA, PMA, and PNA. Further studies are required to confirm the role of the present reference range in thyroid hormone replacement therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maternal serum C-reactive protein in early pregnancy and occurrence of preterm premature rupture of membranes and preterm birth.

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Moghaddam Banaem, Lida; Mohamadi, Bita; Asghari Jaafarabadi, Mohamad; Aliyan Moghadam, Narges

2012-05-01

The aim of this study was to determine the relationship between maternal serum C-reactive protein (CRP) levels in the first 20 weeks of pregnancy and later occurrence of preterm premature rupture of membranes and preterm birth. A prospective cohort study that measured maternal serum CRP levels in 778 pregnant women in the first half of pregnancy was performed in the city of Noor (north Iran), and included follow-up of patients up to time of delivery. Preterm premature rupture of membranes and preterm birth were defined as the occurrence of membranes rupture and birth, respectively before 37 weeks of gestation. Of the 778 pregnancies studied, 19 (2.41%) preterm premature rupture of membranes and 58 (7.3%) preterm births were seen. Median CRP levels in preterm premature rupture of membranes and preterm birth cases were much higher than in term deliveries (7 and 6.8 respectively vs 2.4 mg/L; 66.67 and 64.76, respectively vs 24.38 nmol/L). CRP levels >4 mg/L had statistically significant relationships with preterm premature rupture of membranes (OR 5.91, 95% CI 2.07-16.89) and preterm birth (OR 8.95, 95% CI 4.60-17.43). With a cut-off level of 4 mg/L of CRP, sensitivity, specificity, and likelihood ratios (LR(+) and LR(-) ) for preterm birth were 81, 70, 2.70, 0.28%, respectively, and for preterm premature rupture of membranes they were 79, 67, 2.41 and 0.31%, respectively. It seems that the inflammatory marker, CRP, can be used in the early stages of pregnancy to identify women at risk of experiencing preterm premature rupture of membranes and preterm birth. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Preterm Labor and Birth

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... Facebook Twitter Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about ... is called preterm labor (or premature labor). A birth that occurs before 37 weeks is considered a ...

Acute relief of exercise-induced bronchoconstriction by inhaled formoterol in children with persistent asthma

DEFF Research Database (Denmark)

Hermansen, Mette Northman; Nielsen, Kim Gjerum; Buchvald, Frederik

2006-01-01

-controlled, crossover study of the immediate effect of formoterol, 9 microg, vs terbutaline, 0.5 mg, and placebo administered as dry powder at different study days. Exercise challenge test was used as a model of acute bronchoconstriction. PATIENTS: Twenty-four 7- to 15-year-old children with persistent asthma...

Association of maternal depression with dietary intake, growth, and development of preterm infants: a cohort study in Beijing, China.

Science.gov (United States)

Wang, Han; Zhou, Hong; Zhang, Yan; Wang, Yan; Sun, Jing

2017-11-27

This study aimed to explore the association of maternal depression with nutrient intake, growth, and development of preterm infants. A cohort study of 201 infants was conducted in Beijing. Based on the gestational age of an infant and status of the mother, the infants were divided into four groups: non-depression-fullterm (64), non-depression-preterm (70), depression-fullterm (36), and depression-preterm (31). Data on sociodemographic characteristics, nutritional intake, growth, and developmental status of children at 8 months (corrected ages) were collected using a quantitative questionnaire, a 24-Hour Dietary Recall, anthropometric measurements, and the Bayley-III scale. A multivariate analysis was used to evaluate the effects of maternal depression and preterm birth on infant growth and development. The energy, protein, and carbohydrate intake in the depression group was lower than the recommended amounts. The depression preterm groups indicated the lowest Z-scores for length and weight and the lowest Bayley-III scores. Preterm infants of depressed mothers are at high risks of poor growth and development delay.

Does microtia predict severity of temporal bone CT abnormalities in children with persistent conductive hearing loss?

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Tekes, Aylin; Ishman, Stacey L; Baugher, Katherine M; Brown, David J; Lin, Sandra Y; Tunkel, David E; Unalp-Arida, Aynur; Huisman, Thierry A G M

2013-07-01

This study aimed to determine the spectrum of temporal bone computed tomography (CT) abnormalities in children with conductive hearing loss (CHL) with and without microtia. From 1993 to 2008, a total of 3396 pediatric records including CHL were reviewed at our institution and revealed 180 cases of persistent CHL, 46 of whom had diagnostic temporal bone CT examinations. All of these examinations were systematically reviewed by two pediatric neuroradiologists, working in consensus, who had 5 and 18 years, respectively, of dedicated pediatric neuroradiology experience. Of the 46 children, 16 were boys and 30 were girls (age: 0.2-16 years; mean: 5 years). Also, 21 (46%) children had microtia and 25 (54%) children did not, as determined by clinical evaluation. External auditory canal atresia/stenosis (EAC-A/S) was the most common anomaly in both microtia and non-microtia groups. Two or more anomalies were observed in 18/21 children with microtia. The frequency of EAC-A/S was greater in children with microtia versus those without it (86% versus 32%, respectively; P = 0.0003). Syndromic diagnoses were also significantly more frequently made in children with microtia versus those without microtia (76% versus 20%, respectively; P = 0.0001). Temporal bone CT scans were normal in 10 children (22%) with persistent CHL. Microtia is an important finding in children with CHL. EAC and middle ear/ossicle anomalies were significantly more frequently seen in children with microtia, and multiple anomalies and bilateral microtia were more common in children with syndromic associations. These findings highlight the importance of understanding the embryological development of the temporal bone. The presence of one anomaly should raise suspicion of the possibility of other anomalies, especially in the setting of microtia. Bilateral microtia and multiple anomalies should also raise suspicion of genetic syndromes. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Effect of antenatal corticosteroids on postmortem brain weight of preterm babies.

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Murphy, D J

2001-07-01

To investigate the effects of single and repeated courses of antenatal corticosteroids on brain growth in very preterm babies. Retrospective study of 110 very preterm babies delivered at a single University Teaching Hospital between 1992 and 1999 who had a full necropsy including detailed examination of the brain. Mean brain weight did not differ significantly between babies who received corticosteroids and those who did not 160 vs. 157 g, (p=0.82), nor was there a difference between mean brain weight of stillborn or liveborn babies in relation to steroid use 164 vs. 159 g, (p=0.84) and 156 vs. 152g (p=0.81). There was no apparent dose-response relationship between the total number of doses of corticosteroids or timing since the first dose of corticosteroids and brain weight, p=0.95 and p=0.87. Single and multiple courses of antenatal corticosteroids had no significant effect on brain growth in babies delivered preterm who died but long-term follow-up studies are required to evaluate the functional neurological outcome of surviving children.

Visual orienting and attention deficits in 5- and 10-month-old preterm infants.

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Ross-Sheehy, Shannon; Perone, Sammy; Macek, Kelsi L; Eschman, Bret

2017-02-01

Cognitive outcomes for children born prematurely are well characterized, including increased risk for deficits in memory, attention, processing speed, and executive function. However, little is known about deficits that appear within the first 12 months, and how these early deficits contribute to later outcomes. To probe for functional deficits in visual attention, preterm and full-term infants were tested at 5 and 10 months with the Infant Orienting With Attention task (IOWA; Ross-Sheehy, Schneegans and Spencer, 2015). 5-month-old preterm infants showed significant deficits in orienting speed and task related error. However, 10-month-old preterm infants showed only selective deficits in spatial attention, particularly reflexive orienting responses, and responses that required some inhibition. These emergent deficits in spatial attention suggest preterm differences may be related to altered postnatal developmental trajectories. Moreover, we found no evidence of a dose-response relation between increased gestational risk and spatial attention. These results highlight the critical role of postnatal visual experience, and suggest that visual orienting may be a sensitive measure of attentional delay. Results reported here both inform current theoretical models of early perceptual/cognitive development, and future intervention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Undiagnosed coeliac disease in a father does not influence birthweight and preterm birth.

LENUS (Irish Health Repository)

Khashan, Ali S

2012-01-31

There is conflicting evidence regarding the effect of coeliac disease (CD) in the father on birthweight and preterm birth. We investigated the association between paternal CD and birthweight and preterm birth. Medical records of all singleton live-born children in Denmark between 1 January 1979 and 31 December 2004 were linked to information about parents\\' diseases. Fathers who were diagnosed with CD were then identified. Fathers with CD were considered treated if they were diagnosed before pregnancy and untreated if they were diagnosed after the date of conception. The outcome measures were: birthweight, small-for-gestational age (birthweight<10th centile for gestational age) and preterm birth (<37 weeks). We compared the offspring of men without CD (n = 1 472 352) and offspring of those with CD [untreated (n = 138) and treated (n = 473)]. There was no significant association between untreated CD in the father and birthweight (adjusted mean difference = -3 g; [95% CI -46, 40]) or preterm birth (adjusted odds ratio (OR) = 0.86, [95% CI 0.53, 1.37]) (compared with no CD). There was some evidence for an association between treated paternal CD and birthweight (adjusted mean difference = -81 g; [95% CI -161, -3]), but not preterm birth (adjusted OR = 1.76, [95% CI 0.95, 3.26]). Untreated paternal CD was not associated with an increased risk of reduced birthweight, or of preterm birth. There was some evidence that diagnosis and presumed treatment of paternal CD with a gluten-free diet is associated with reduced birthweight.

Behavioural symptoms of attention deficit/hyperactivity disorder in preterm and term children born small and appropriate for gestational age: A longitudinal study

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Kajantie Eero

2010-12-01

Full Text Available Abstract Background It remains unclear whether it is more detrimental to be born too early or too small in relation to symptoms of attention deficit/hyperactivity disorder (ADHD. Thus, we tested whether preterm birth and small body size at birth adjusted for gestational age are independently associated with symptoms of ADHD in children. Methods A longitudinal regional birth cohort study comprising 1535 live-born infants between 03/15/1985 and 03/14/1986 admitted to the neonatal wards and 658 randomly recruited non-admitted infants, in Finland. The present study sample comprised 828 children followed up to 56 months. The association between birth status and parent-rated ADHD symptoms of the child was analysed with multiple linear and logistic regression analyses. Results Neither prematurity (birth Conclusions Intrauterine growth restriction, reflected in SGA status and lower birth weight, rather than prematurity or lower gestational age per se, may increase risk for symptoms of ADHD in young children.

Ventilatory Efficiency in Children and Adolescents Born Extremely Preterm

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Julie Hestnes

2017-07-01

Full Text Available Purpose: Children and adolescents born extremely preterm (EP have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP−born compared to term−born individuals.Methods: Two area−based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982−85 (n = 46 and 1991–92 (n = 35 were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation (V˙E and carbon dioxide output (V˙CO2 was described by a linear model, and the relationship between tidal volume (VT and V˙E by a quadratic model. Multivariate regression analyses were done with curve parameters as dependent variables, and the categories EP vs. term−born, sex, age, height, weight and forced expiratory volume in 1 s (FEV1 as independent variables.Results: In adjusted analyses, the slope of the V˙E−V˙CO2 relationship was significantly steeper in the EP than the term-born group, whereas no group difference was observed for the breathing pattern, which was related to FEV1 only.Conclusion: EP-born participants breathed with higher V˙E for any given CO2 output, indicating lower ventilatory efficiency, possibly contributing to lower aerobic capacity. The breathing patterns did not differ between the EP and term−born groups when adjusted for FEV1.

Brain lesions in preterms: origin, consequences and compensation

DEFF Research Database (Denmark)

Krageloh-Mann, I; Toft, P; Lunding, J

1999-01-01

of motor tracts), mental retardation (bilateral extensive white matter reduction or cerebellar atrophy) and severe visual impairment (severe optic radiation involvement). A morphological correlate for minor disabilities, i.e. functional variations in motor performance or intelligence, was not found...... (n = 19), especially periventricular leucomalacia (PVL, n = 17). Three of the very preterm children had severe cerebellar atrophy in addition to relatively mild periventricular abnormalities. MRI showed specific morphological correlates for the major disabilities, e.g. spastic CP (involvement...

Do very preterm twins and singletons differ in their neurodevelopment at 5 years of age?

Science.gov (United States)

Bodeau-Livinec, Florence; Zeitlin, Jennifer; Blondel, Béatrice; Arnaud, Catherine; Fresson, Jeanne; Burguet, Antoine; Subtil, Damien; Marret, Stéphane; Rozé, Jean-Christophe; Marchand-Martin, Laetitia; Ancel, Pierre-Yves; Kaminski, Monique

2013-11-01

Twins have inconsistently shown poorer outcomes than singletons. Although a high proportion of twins are born very preterm, data are sparse on the long-term outcomes in very preterm twins. The objective of this study was to compare mortality and neurodevelopmental outcomes of very preterm singletons and twins and to study outcomes in relation to factors specific to twins. Birth cohort study Etude Epidemiologique sur les Petits Ages Gestationnels (EPIPAGE). Nine regions in France. All very preterm live births occurring from 22 to 32 weeks of gestation in all maternity wards of nine French regions in 1997 (n=2773). Neurodevelopmental status, including cerebral palsy, and a cognitive assessment with the Kaufman Assessment Battery for Children, with scores on the Mental Processing Composite (MPC) scale, was available for 1732 and 1473 children at 5 years of age, respectively. Among live births, twins had higher hospital mortality than singletons (adjusted (a)OR: 1.4 (95% CI 1.1 to 1.9)). Among survivors, there was no crude difference at 5 years between twins and singletons in the prevalence of cerebral palsy (8.0% vs 9.1%, respectively), MPC <70 (9.5% vs 11.1%) and mean MPC (94.6 vs 94.4). However, after adjustment for sex, gestational age, intrauterine growth restriction and social factors, twins were more likely to have lower MPC scores (mean difference: -2.4 (95% CI-4.8 to 0.01)). Live born twins had a higher risk of mortality when birth weight discordance was present (aOR:2.9 (95% CI 1.7 to 4.8)), but there were no differences in long-term outcomes. Compared with very preterm singletons, twins had higher mortality, no difference with respect to severe deficiencies, but slightly lower MPC scores at 5 years.

Born Too Soon: Care for the preterm baby

Science.gov (United States)

2013-01-01

As part of a supplement entitled "Born Too Soon", this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care. We outline a series of packages of care that build on essential care for every newborn comprising support for immediate and exclusive breastfeeding, thermal care, and hygienic cord and skin care. For babies who do not breathe at birth, rapid neonatal resuscitation is crucial. Extra care for small babies, including Kangaroo Mother Care, and feeding support, can halve mortality in babies weighing Neonatal intensive care units in high income settings are de-intensifying care, for example increasing use of continuous positive airway pressure (CPAP) and this makes comprehensive preterm care more transferable. For health systems in low and middle income settings with increasing facility births, district hospitals are the key frontier for improving obstetric and neonatal care, and some large scale programmes now include specific newborn care strategies. However there are still around 50 million births outside facilities, hence home visits for mothers and newborns, as well as women's groups are crucial for reaching these families, often the poorest. A fundamental challenge is improving programmatic tracking data for coverage and quality, and measuring disability-free survival. The power of parent's voices has been important in high-income countries in bringing attention to preterm newborns, but is still missing from the most affected countries. Declaration This article is part of a supplement jointly funded by Save the Children

[Description and evaluation of creative thinking in preterm low birth weight infants].

Science.gov (United States)

Parisi, L; Di Filippo, T; Firrigno, L; La Grutta, S; Testa, D; Roccella, M

2007-04-01

Since the 1950s, the problem of how to evaluate creativity has been addressed in studies on the definition of measurement criteria and on the relationship between intelligence and creative thinking. Many revealed cognitive and relational disorders in preterm infants, particularly in preterm very low birth weight infants (birth weight 2500 g. The test battery included: Torrance Test of Creative Thinking (TCTT); WISC-R intelligence test; Goodenough Human Figure Drawing Test. Statistical analysis (Mann-Whitney U test) showed a statistically significant difference (P>0.05) between the 2 groups; scores for figure originality, figure fluidity and figure elaboration were consistently higher in the control group. Within the low birth weight group, there was a significant correlation (Spearman r) between verbal IQ and verbal fluidity and verbal flexibility subscale scores and between IQ performance and figure elaboration. Scores on the figure drawing tests showed higher creative ability in the control group. In children born preterm with low birth weight, emotive dynamics and flow of affection may influence the channels of communication between child and family. The low figure originality subscale scores support the hypothesis that psychodynamic and relational factors (worry about the preterm condition, overprotective behaviour by parents and others) could lead to diminished autonomy, flexibility and manipulatory interest in the child.

Effects of Maternal Age and Age-Specific Preterm Birth Rates on Overall Preterm Birth Rates - United States, 2007 and 2014.

Science.gov (United States)

Ferré, Cynthia; Callaghan, William; Olson, Christine; Sharma, Andrea; Barfield, Wanda

2016-11-04

Reductions in births to teens and preterm birth rates are two recent public health successes in the United States (1,2). From 2007 to 2014, the birth rate for females aged 15-19 years declined 42%, from 41.5 to 24.2 per 1,000 females. The preterm birth rate decreased 8.4%, from 10.41% to 9.54% of live births (1). Rates of preterm births vary by maternal age, being higher among the youngest and oldest mothers. It is unknown how changes in the maternal age distribution in the United States have affected preterm birth rates. CDC used birth data to assess the relative contributions of changes in the maternal age distribution and in age-specific preterm birth rates to the overall decrease in preterm birth rates. The preterm birth rate declined in all age groups. The effects of age distribution changes on the preterm birth rate decrease were different in younger and older mothers. The decrease in the proportion of births to mothers aged ≤19 and 20-24 years and reductions in age-specific preterm rates in all age groups contributed to the overall decline in the preterm birth rate. The increase in births to mothers aged ≥30 years had no effect on the overall preterm birth rate decrease. The decline in preterm births from 2007 to 2014 is related, in part, to teen pregnancy prevention and the changing maternal age distribution. Effective public health strategies for further reducing preterm birth rates need to be tailored to different age groups.

Macrophage phenotype is associated with disease severity in preterm infants with chronic lung disease.

Directory of Open Access Journals (Sweden)

Lynne R Prince

Full Text Available The etiology of persistent lung inflammation in preterm infants with chronic lung disease of prematurity (CLD is poorly characterized, hampering efforts to stratify prognosis and treatment. Airway macrophages are important innate immune cells with roles in both the induction and resolution of tissue inflammation.To investigate airway innate immune cellular phenotypes in preterm infants with respiratory distress syndrome (RDS or CLD.Bronchoalveolar lavage (BAL fluid was obtained from term and preterm infants requiring mechanical ventilation. BAL cells were phenotyped by flow cytometry.Preterm birth was associated with an increase in the proportion of non-classical CD14(+/CD16(+ monocytes on the day of delivery (58.9 ± 5.8% of total mononuclear cells in preterm vs 33.0 ± 6.1% in term infants, p = 0.02. Infants with RDS were born with significantly more CD36(+ macrophages compared with the CLD group (70.3 ± 5.3% in RDS vs 37.6 ± 8.9% in control, p = 0.02. At day 3, infants born at a low gestational age are more likely to have greater numbers of CD14(+ mononuclear phagocytes in the airway (p = 0.03, but fewer of these cells are functionally polarized as assessed by HLA-DR (p = 0.05 or CD36 (p = 0.05 positivity, suggesting increased recruitment of monocytes or a failure to mature these cells in the lung.These findings suggest that macrophage polarization may be affected by gestational maturity, that more immature macrophage phenotypes may be associated with the progression of RDS to CLD and that phenotyping mononuclear cells in BAL could predict disease outcome.

Macrophage phenotype is associated with disease severity in preterm infants with chronic lung disease.

Science.gov (United States)

Prince, Lynne R; Maxwell, Nicola C; Gill, Sharonjit K; Dockrell, David H; Sabroe, Ian; McGreal, Eamon P; Kotecha, Sailesh; Whyte, Moira K

2014-01-01

The etiology of persistent lung inflammation in preterm infants with chronic lung disease of prematurity (CLD) is poorly characterized, hampering efforts to stratify prognosis and treatment. Airway macrophages are important innate immune cells with roles in both the induction and resolution of tissue inflammation. To investigate airway innate immune cellular phenotypes in preterm infants with respiratory distress syndrome (RDS) or CLD. Bronchoalveolar lavage (BAL) fluid was obtained from term and preterm infants requiring mechanical ventilation. BAL cells were phenotyped by flow cytometry. Preterm birth was associated with an increase in the proportion of non-classical CD14(+)/CD16(+) monocytes on the day of delivery (58.9 ± 5.8% of total mononuclear cells in preterm vs 33.0 ± 6.1% in term infants, p = 0.02). Infants with RDS were born with significantly more CD36(+) macrophages compared with the CLD group (70.3 ± 5.3% in RDS vs 37.6 ± 8.9% in control, p = 0.02). At day 3, infants born at a low gestational age are more likely to have greater numbers of CD14(+) mononuclear phagocytes in the airway (p = 0.03), but fewer of these cells are functionally polarized as assessed by HLA-DR (p = 0.05) or CD36 (p = 0.05) positivity, suggesting increased recruitment of monocytes or a failure to mature these cells in the lung. These findings suggest that macrophage polarization may be affected by gestational maturity, that more immature macrophage phenotypes may be associated with the progression of RDS to CLD and that phenotyping mononuclear cells in BAL could predict disease outcome.

Socio-economic inequality in preterm birth

DEFF Research Database (Denmark)

Petersen, Christina Bjørk; Mortensen, Laust Hvas; Morgen, Camilla Schmidt

2009-01-01

increased slightly over time in very preterm births in Denmark, while there was a slight narrowing of the gap in Sweden. In moderately preterm births, the educational inequality gap was constant over the study period in Denmark, Norway and Sweden, but narrowed in Finland. The educational gradient in preterm...... birth remained broadly stable from 1981 to 2000 in all four countries. Consequently, the socio-economic inequalities in preterm birth were not strongly influenced by structural changes during the period....

Preterm delivery predicted by soluble CD163 and CRP in women with symptoms of preterm delivery

DEFF Research Database (Denmark)

Vogel, Ida; Grove, Jakob; Thorsen, Poul

2005-01-01

: High levels of sCD163 or CRP are associated with an increased risk of preterm delivery in women with symptoms of delivery. Good prediction of preterm delivery before 34 weeks of gestation was obtained by a combination of preterm prelabour rupture of membranes (PPROM), overweight, relaxin, CRP and s...

Born too soon: preterm birth matters.

Science.gov (United States)

Howson, Christopher P; Kinney, Mary V; McDougall, Lori; Lawn, Joy E

2013-01-01

Urgent action is needed to address preterm birth given that the fi rst country-level estimates show that globally 15 million babies are born too soon and rates are increasing in most countries with reliable time trend data. As the fi rst in a supplement entitled “Born Too Soon”, this paper focuses on the global policy context. Preterm birth is critical for progress on Millennium Development Goal 4 (MDG) for child survival by 2015 and beyond, and gives added value to maternal health (MDG 5) investments also linking to non-communicable diseases. For preterm babies who survive, the additional burden of prematurity-related disability may aff ect families and health systems. Prematurity is an explicit priority in many high-income settings; however, more attention is needed especially in low- and middle-income countries where the invisibility of preterm birth as well as its myths and misconceptions have slowed action on prevention and care. Recent global attention to preterm birth hit a tipping point in 2012, with the May 2 publication of Born Too Soon: The Global Action Report on Preterm Birth and with the 2nd annual World Prematurity Day on November 17 which mobilised the actions of partners in many countries to address preterm birth and newborn health. Interventions to strengthen preterm birth prevention and care span the continuum of care for reproductive, maternal, newborn and child health. Both prevention of preterm birth and implementation of care of premature babies require more research, as well as more policy attention and programmatic investment.

Changes in the Pattern of Stuttering over Development for Children Who Recover or Persist

Science.gov (United States)

Howell, Peter; Bailey, Eleanor; Kothari, Nayomi

2010-01-01

Three schemes for assessing stuttering were compared. They differed with respect to whether they included whole-word repetitions as characteristics more typical of stuttering. Persistent and recovered groups of children were examined to see whether: (1) one of the schemes differentiated the groups better than others; (2) more and less typical of…

Prevention of preterm birth.

LENUS (Irish Health Repository)

Flood, Karen

2012-02-01

Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

Cerebral oxygenation in the preterm neonate

NARCIS (Netherlands)

Dix, L.M.L.

2017-01-01

Although survival rates of preterm infants are improving, preterm birth is still associated with significant morbidity.The brain is one of the most vulnerable organs in preterm infants. Neonatal brain injury can have a large impact on the quality of life. Monitoring the immature brain is therefore

Brain lesions in preterms: origin, consequences and compensation

DEFF Research Database (Denmark)

Krageloh-Mann, I; Toft, P; Lunding, J

1999-01-01

of motor tracts), mental retardation (bilateral extensive white matter reduction or cerebellar atrophy) and severe visual impairment (severe optic radiation involvement). A morphological correlate for minor disabilities, i.e. functional variations in motor performance or intelligence, was not found......Twenty-nine high-risk preterm born children, from a cohort with cerebral blood flow (CBF) measurements in the first 2 d of life, were examined prospectively at the age of 5.5-7 y neurologically, neuropsychologically and by magnetic resonance imaging (MRI). They were compared to 57 control children...... in terms of neurology and neuropsychology. Abnormal MRI was found in 19 children. Low oxygen delivery to the brain was found in 63% of them, in contrast to 12.5% in those with normal MRI, indicating neonatal hypoxia-ischemia as an important factor. The MRI abnormalities were mainly periventricular lesions...

Evolution of care indicators after an early discharge intervention in preterm infants.

Science.gov (United States)

Toral-López, Isabel; González-Carrión, María Pilar; Rivas-Campos, Antonio; Lafuente-Lorca, Justa; Castillo-Vera, Josefa; de Casas, Carmen; Peña-Caballero, Manuela

To evaluate the evolution of health outcomes in preterm infants included in an early discharge programme. Controlled, non-randomised trial with an intervention group and a control group children admitted to the Neonatal Intensive Care Unit of the University Hospital Virgen de las Nieves of Granada were included in the study. The intervention group comprised preterm infants admitted to the neonatal unit clinically stable, whose family home was located within 20km. from the hospital. They were discharged two weeks before the established time and a skilled nurse in neonatal care monitored them at home. The control group comprised infants who could not be included in home monitoring due to the distance to the hospital criterion or because their families did not give their consent and who received the usual care until their discharge. The study variables were the outcome indicators of the Nursing Outcomes Classification. Differences were found in the Nursing Outcomes Classification scores in the intervention group compared to the control group. The early discharge of preterm infants followed up at home by an expert nurse in neonatal care is a health service that achieves results in preparating parents for the care of their child, enabling them to learn about the health services, adapt to their new life, and establishbreastfeeding times. It constitutes safe intervention for children and is beneficial to parents. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Motor development in very preterm and very low-birth-weight children from birth to adolescence: A meta-analysis

NARCIS (Netherlands)

de Kieviet, J.F.; Piek, J.P.; Aarnoudse-Moens, C.S.H.; Oosterlaan, J.

2009-01-01

Context: Infants who are very preterm (born ≤32 weeks of gestation) and very low birth weight (VLBW) (weighing ≤1500 g) are at risk for poor developmental outcomes. There is increasing evidence that very preterm birth and VLBW have a considerable effect on motor development, although findings are

Executive Function Computerized Training in Very Preterm-Born Children: A Pilot Study

NARCIS (Netherlands)

Aarnoudse-Moens, C.S.H.; Twilhaar, E.S.; Oosterlaan, J.; van Veen, H.G.; Prins, P.J.M.; van Kaam, A.H.; van Wassenaer-Leemhuis, A.G.

2018-01-01

Objective: Attention problems are one of the most pronounced and documented consequences of very preterm birth (gestational age ≤32 weeks). However, up to now, there is no research published on suitable interventions at school age aimed to overcome these problems. Research in this population did

Preterm birth, an unresolved issue

OpenAIRE

Beliz?n, Jose M; Hofmeyr, Justus; Buekens, Pierre; Salaria, Natasha

2013-01-01

Premature birth is the world?s leading cause of neonatal mortality with worldwide estimates indicating 11.1% of all live births were preterm in 2010. Preterm birth rates are increasing in most countries with continual differences in survival rates amongst rich and poor countries. Preterm birth is currently an important unresolved global issue with research efforts focusing on uterine quiescence and activation, the ?omics? approaches and implementation science in order to reduce the incidence ...

Persistent ovarian masses and pregnancy outcomes.

Science.gov (United States)

Goh, William A; Rincon, Monica; Bohrer, Justin; Tolosa, Jorge E; Sohaey, Roya; Riaño, Rene; Davis, James; Zalud, Ivica

2013-07-01

To determine if persistent ovarian masses in pregnancy are associated with increased adverse outcomes. This is a retrospective cohort of 126 pregnant women with a persistent ovarian mass measuring 5 cm or greater who delivered at two university hospitals between 2001 and 2009. Maternal outcomes included gestational age (GA) at diagnosis, delivery and surgery as well as miscarriage, preterm birth (PTB), ovarian torsion and hospital admission for pain. Neonatal outcomes included birth weight, respiratory distress syndrome (RDS), intra-ventricular hemorrhage (IVH), death and sepsis. A total of 1225 ovarian masses were identified (4.9%) in 24,868 patients. A persistent ovarian mass was found in 0.7%. Average GA at diagnosis was 17.8 weeks. Miscarriage rate was 3.3%. Average GA at delivery was 37.9 weeks. Of the patients, 8.5% had ovarian torsion, 10.3% had admission for pain and 9.3% had PTBs. The mean cesarean delivery rate was 46.3%. The average neonatal weight was 3273 g. There was one neonatal death in this cohort. The rate of RDS was 2.8%, IVH 0.9% and neonatal sepsis 1.9%. The most common surgical pathologic diagnosis was dermoids (37.6%). No overt malignancies were seen. A persistent ovarian mass in pregnancy does not confer an increased risk of adverse pregnancy outcomes.

Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes.

Science.gov (United States)

Lee, Seung Mi; Park, Jeong Woo; Kim, Byoung Jae; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun

2013-01-01

The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005) than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.

Risk assessment and management to prevent preterm birth.

Science.gov (United States)

Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

2016-04-01

Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influences of Teachers' Attitudes and Oral Guidance on the Persistence of Young Children Aged 3-6 Years Old

Science.gov (United States)

Dan, Fei; Feng, Lu; Wang, Qiong

2009-01-01

Persistence is important in developing pre-school children's ego control. Based on the fact that during the teaching process a teacher's communication and actions will have a significant influence on young children, which is due to the teachers' high degree of control over them, four experiments were designed to probe the influences of teachers'…

Prophylactic Probiotics for Preterm Infants

DEFF Research Database (Denmark)

Olsen, Rie; Greisen, Gorm; Schrøder, Morten

2016-01-01

BACKGROUND: Necrotizing enterocolitis (NEC) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the efficacy...... of probiotics in preterm neonates obtained in observational studies. OBJECTIVE: To assess the effects of prophylactic probiotics in preterm infants. METHODS: A meta-analysis was performed searching PubMed, EMBASE, CENTRAL (the Cochrane Library) and www.clinicaltrials.gov. Reference lists of reviews of RCTs were...... also searched. Included studies were observational studies that enrolled preterm infants probiotics and measured at least one clinical outcome (e.g. NEC, all-cause mortality, sepsis or long-term development scores). Two authors...

Ethanol for preventing preterm birth in threatened preterm labor.

Science.gov (United States)

Haas, David M; Morgan, Amanda M; Deans, Samantha J; Schubert, Frank P

2015-11-05

Preterm birth is the leading cause of death and disability in newborns worldwide. A wide variety of tocolytic agents have been utilized to delay birth for women in preterm labor. One of the earliest tocolytics utilized for this purpose was ethanol infusion, although this is not generally used in current practice due to safety concerns for both the mother and her baby. To determine the efficacy of ethanol in stopping preterm labor, preventing preterm birth, and the impact of ethanol on neonatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. We included randomized and quasi-randomized studies. Cluster-randomized trials and cross-over design trials were not eligible for inclusion. We only included studies published in abstract form if there was enough information on methods and relevant outcomes. Trials were included if they compared ethanol infusion to stop preterm labor versus placebo/control or versus other tocolytic drugs. At least two review authors independently assessed studies for inclusion and risk of bias. At least two review authors independently extracted data. Data were checked for accuracy. Twelve trials involving 1586 women met inclusion criteria for this review. One trial did not report on the outcomes of interest in this review.Risk of bias of included studies: The included studies generally were of low quality based on inadequate reporting of methodology. Only three trials had low risk of bias for random sequence generation and one had low risk of bias for allocation concealment and participant blinding. Most studies were either high risk of bias or uncertain in these key areas. Comparison 1: Ethanol versus placebo/control (two trials, 77 women) Compared to controls receiving pain medications and dextrose solution, ethanol did not improve any of the primary outcomes: birth labour. However, it would be useful for long-term follow-up studies on the babies born

Antenatal steroid exposure in the late preterm period is associated with reduced cord blood neurotrophin-3.

Science.gov (United States)

Hodyl, Nicolette A; Crawford, Tara M; McKerracher, Lorna; Lawrence, Andrew; Pitcher, Julia B; Stark, Michael J

2016-10-01

Neurotrophins are proteins critically involved in neural growth, survival and differentiation, and therefore important for fetal brain development. Reduced cord blood neurotrophins have been observed in very preterm infants (neurotrophin concentrations, yet studies to date have not examined whether this occurs in the late preterm infant (33-36weeks gestation), despite increasing recognition of subtle neurodevelopmental deficits in this population. To assess the impact of antenatal steroids on cord blood neurotrophins in late preterm infants following antenatal steroid exposure. Retrospective analysis. Late preterm infants (33-36weeks; n=119) and term infants (37-41weeks; n=129) born at the Women's and Children's Hospital, Adelaide. Cord blood neurotrophin-3 (NT-3), NT-4, nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) concentrations measured by ELISA. Cord blood NT-4 and NGF were increased at term compared to the late preterm period (p24h prior to delivery (p<0.01). This study identified an association between reduced cord blood NT-3 and antenatal steroid exposure in the late preterm period. The reduced NT-3 may be a consequence of steroids inducing neuronal apoptosis, thereby reducing endogenous neuronal NT3 production, or be an action of steroids on other maternal or fetal NT-3 producing cells, which may then affect neuronal growth, differentiation and survival. Regardless of the specific mechanism, a reduction in NT-3 may have long term implications for child neurodevelopment, and emphasizes the ongoing vulnerability of the fetal brain across the full preterm period. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Variable Methylation Potential in Preterm Placenta: Implication for Epigenetic Programming of the Offspring.

Science.gov (United States)

Khot, Vinita V; Chavan-Gautam, Preeti; Mehendale, Savita; Joshi, Sadhana R

2017-06-01

Children born preterm are reported to be at increased risk of developing noncommunicable diseases in later life. Altered placental DNA methylation patterns are implicated in fetal programming of adult diseases. Our earlier animal studies focus on micronutrients (folic acid, vitamin B 12 ) and long-chain polyunsaturated fatty acids (LCPUFAs) that interact in the 1 carbon cycle, thereby influencing methylation reactions. Our previous studies in women delivering preterm show altered plasma levels of micronutrients and lower plasma LCPUFA levels. We postulate that alterations in the micronutrient metabolism may affect the regulation of enzymes, methionine adenosyltransferase ( MAT2A), and SAH-hydrolase ( AHCY), involved in the production of methyl donor S-adenosylmethionine (SAM), thereby influencing the methylation potential (MP) in the placenta of women delivering preterm. The present study, therefore, examines the mRNA, protein levels of enzymes ( MAT2A and AHCY), SAM, S-adenosylhomocysteine (SAH) levels, and global DNA methylation levels from preterm (n = 73) and term (n = 73) placentae. The enzyme messenger RNA (mRNA) levels were analyzed by real-time quantitative polymerase chain reaction, protein levels by enzyme-linked immunosorbent assay, and SAM-SAH levels by high-performance liquid chromatography. The mRNA levels for MAT2A and AHCY are higher ( P programming of the developing fetus.

Neonatology oxidative status in preterm infants with premature preterm rupture of membranes and fetal inflammatuar response syndrome.

Science.gov (United States)

Özalkaya, Elif; Karatekin, Güner; Topçuoğlu, Sevilay; Karatepe, Hande Özgün; Hafızoğlu, Taner; Baran, Pervin; Ovalı, Fahri

2017-10-01

The aim of this study, to determine an index of oxidative stress index in preterm infants less than 34 weeks gestational age with premature preterm rupture of membrane (PPROM) and fetal inflammatory response syndrome (FIRS). This study was designed as a prospective study. Fifty-one premature infants less than 35 weeks of gestational age were included in the study. The umbilical cord blood concentrations of IL-6, TAC (total antioxidant capacity) and PON-1 (paraoxonase-1) levels and TOS (total oxidative stress) were studied. The oxidative stress index (OSI = TAC/TOS) was calculated in all of prematüre infants. PPROM was defined as rupture of membranes at least 24 hours before the onset of labor. FIRS was defined by an umbilical cord IL-6 level greater than 11 pg/mL. Premature infants included in the study were divided into 4 groups. Group 1 included preterm infants without FIRS and with PPROM (n = 16), while Group 2 included preterm infants without PPROM and with FIRS (n = 9), Group 3 consisted of premature infants with PPROM and FIRS (n = 21) and Group 4 included premature infants without PPROM or FIRS (n = 5). Umbilical cord TOS level was found to be higher in the preterm infants without FIRS and with PPROM (36.1 μmol H 2 O 2 Equiv./L) compared to the preterm infants without PPROM or FIRS (11.9 μmol H 2 O 2 Equiv./L) (p = 0.03). Umbilical cord PON-1 level was found to be lower in the preterms without FIRS and with PPROM (32 U/L), preterms without PPROM and with FIRS (30. 3 U/L) and the preterm infants with both PPROM and FIRS (48.6 U/L) compared to the preterm infants having no PPROM or FIRS (85.6 U/L) (p = 0.001). High pro-oxidant capacity was found in PPROM and low antioxidant capacity in PPROM and FIRS. Copyright © 2017. Published by Elsevier B.V.

Differential effects of intrauterine growth restriction on brain structure and development in preterm infants: a magnetic resonance imaging study.

Science.gov (United States)

Padilla, Nelly; Falcón, Carles; Sanz-Cortés, Magdalena; Figueras, Francesc; Bargallo, Núria; Crispi, Fátima; Eixarch, Elisenda; Arranz, Angela; Botet, Francesc; Gratacós, Eduard

2011-03-25

Previous evidence suggests that preterm newborns with intrauterine growth restriction (IUGR) have specific neurostructural and neurodevelopmental anomalies, but it is unknown whether these effects persist in early childhood. We studied a sample of 18 preterm IUGR, 15 preterm AGA - born between 26 and 34 weeks of gestational age (GA) - and 15 healthy born-term infants. Infants were scanned at 12 months corrected age (CA), in a 3T scanner, without sedation. Analyses were made by automated lobar volumetry and voxel-based morphometry (VBM). The neurodevelopmental outcome was assessed in all subjects at 18 months CA with the Bayley Scale for Infant and Toddler Development, third edition. IUGR infants had reduced relative volumes for the insular and temporal lobes. According to VBM, IUGR infants had bilateral reduced gray matter (GM) in the temporal, parietal, frontal, and insular regions compared with the other groups. IUGR infants had increased white matter (WM) in temporal regions compared to the AGA group and in frontal, parietal, occipital, and insular regions compared to the term group. They also showed decreased WM in the cerebellum and a non-significant trend in the hippocampus compared to term infants. IUGR infants had reduced neurodevelopmental scores, which were positively correlated with GM in various regions. These data suggest that the IUGR induces a distinct brain pattern of structural changes that persist at 1 year of life and are associated with specific developmental difficulties. Copyright © 2011 Elsevier B.V. All rights reserved.

Comparison of three screening tests for autism in preterm children with birth weights less than 1,500 grams

Science.gov (United States)

Dudova, Iva; Markova, Daniela; Kasparova, Martina; Zemankova, Jana; Beranova, Stepanka; Urbanek, Tomas; Hrdlicka, Michal

2014-01-01

Background Preterm children seem to be at increased risk for autism spectrum disorders (ASD). Methods Parents of 157 children with birth weights less than 1,500 g (age 2 years, corrected for prematurity; 88 boys, 69 girls) completed screening questionnaires. The screening battery included the Modified Checklist for Autism in Toddlers (M-CHAT), Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC), and the Infant/Toddler Sensory Profile (ITSP). Children with disabilities were excluded. All children who screened positive on any of the screening tools were subsequently assessed by clinical examination including the Autism Diagnostic Observation Schedule. Results Fifty-six children (35.7%) screened positive on at least one of the parental screening questionnaires. Of the 56 children who tested positive, 33 participated in the detailed clinical follow-up assessment. A diagnosis of ASD was confirmed in 13 of the 33 children. The ASD prevalence was 9.7% of the sample. Analysis of children with and without an ASD diagnosis found significant differences relative to gestational age (26.9 weeks vs 28.3 weeks, P=0.033) and length of the stay in hospital (89.5 days vs 75.4 days, P=0.042). The screening tool with the most positive results was CSBS-DP-ITC (42 positive screens [PS]), followed by M-CHAT (28 PS), and ITSP (22 PS). Differences in the frequency of PS among the tests were significant (P=0.008). CSBS-DP-ITC had the highest sensitivity (0.846), followed by M-CHAT (0.692) and ITSP (0.462). Conclusion Our results indicate a higher prevalence of autism in children with birth weights <1,500 g at 2 years of age compared to the general population prevalence. The ASD diagnosis was associated with shorter gestation times and longer hospital stays. Our findings support the simultaneous use of more than one screening tests in order to increase screening sensitivity. PMID:25484588

Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes.

Directory of Open Access Journals (Sweden)

Seung Mi Lee

Full Text Available BACKGROUND: The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. METHODOLOGY/PRINCIPAL FINDINGS: The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005 than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. CONCLUSIONS/SIGNIFICANCE: The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.

Neuroprotection in Preterm Infants

Directory of Open Access Journals (Sweden)

R. Berger

2015-01-01

Full Text Available Preterm infants born before the 30th week of pregnancy are especially at risk of perinatal brain damage which is usually a result of cerebral ischemia or an ascending intrauterine infection. Prevention of preterm birth and early intervention given signs of imminent intrauterine infection can reduce the incidence of perinatal cerebral injury. It has been shown that administering magnesium intravenously to women at imminent risk of a preterm birth leads to a significant reduction in the likelihood of the infant developing cerebral palsy and motor skill dysfunction. It has also been demonstrated that delayed clamping of the umbilical cord after birth reduces the rate of brain hemorrhage among preterm infants by up to 50%. In addition, mesenchymal stem cells seem to have significant neuroprotective potential in animal experiments, as they increase the rate of regeneration of the damaged cerebral area. Clinical tests of these types of therapeutic intervention measures appear to be imminent. In the last trimester of pregnancy, the serum concentrations of estradiol and progesterone increase significantly. Preterm infants are removed abruptly from this estradiol and progesterone rich environment. It has been demonstrated in animal experiments that estradiol and progesterone protect the immature brain from hypoxic-ischemic lesions. However, this neuroprotective strategy has unfortunately not yet been subject to sufficient clinical investigation.

Preterm labor

DEFF Research Database (Denmark)

Jørgensen, Jan Stener; Weile, Louise Katrine Kjær; Lamont, Ronald Francis

2014-01-01

While tocolytic therapy may not be indicated in all cases of spontaneous preterm labor (SPTL), the evidence that they are superior to placebo is robust. The perfect tocolytic that is 100% efficacious and 100% safe does not exist and efforts should continue to develop and introduce safer and more...... and arrange in utero transfer to a center with neonatal intensive care facilities, both of which reduce neonatal mortality and morbidity. Few tocolytics (β₂-agonists and atosiban) are licensed for use as tocolytics and only one was developed specifically to treat preterm labor (atosiban). Accordingly, most...

Speed of Language Comprehension at 18 Months Old Predicts School-Relevant Outcomes at 54 Months Old in Children Born Preterm.

Science.gov (United States)

Marchman, Virginia A; Loi, Elizabeth C; Adams, Katherine A; Ashland, Melanie; Fernald, Anne; Feldman, Heidi M

2018-04-01

Identifying which preterm (PT) children are at increased risk of language and learning differences increases opportunities for participation in interventions that improve outcomes. Speed in spoken language comprehension at early stages of language development requires information processing skills that may form the foundation for later language and school-relevant skills. In children born full-term, speed of comprehending words in an eye-tracking task at 2 years old predicted language and nonverbal cognition at 8 years old. Here, we explore the extent to which speed of language comprehension at 1.5 years old predicts both verbal and nonverbal outcomes at 4.5 years old in children born PT. Participants were children born PT (n = 47; ≤32 weeks gestation). Children were tested in the "looking-while-listening" task at 18 months old, adjusted for prematurity, to generate a measure of speed of language comprehension. Parent report and direct assessments of language were also administered. Children were later retested on a test battery of school-relevant skills at 4.5 years old. Speed of language comprehension at 18 months old predicted significant unique variance (12%-31%) in receptive vocabulary, global language abilities, and nonverbal intelligence quotient (IQ) at 4.5 years, controlling for socioeconomic status, gestational age, and medical complications of PT birth. Speed of language comprehension remained uniquely predictive (5%-12%) when also controlling for children's language skills at 18 months old. Individual differences in speed of spoken language comprehension may serve as a marker for neuropsychological processes that are critical for the development of school-relevant linguistic skills and nonverbal IQ in children born PT.

Preterm Infants and Parents’ self-esteem

DEFF Research Database (Denmark)

Aagaard, Hanne; Madsen, Mette Kold

Background: Little is known about parents to preterm infants and their self-esteem. The care of preterm infants in the neonatal intensive care unit (NICU) is in accordance with the principles of Family Centered Care. Previously, focus has mainly been on the mother-infant-dyad. Current research has...... shown that involving the father at an early stage improves the psychological dynamic of fatherhood and encourages bonding with the infant. The self-esteem of parents appears to be negatively affected after preterm birth. Objective: To get more knowledge and a deeper understanding of the preterm parents......’ experiences of their self-esteem during admission to the NICU and later eight months after discharge. Method and data collection: A qualitative semi-structured interview was conducted in two phases: 1) Three weeks after giving birth to a preterm infant and eight months after discharge. Parents were...

Antecedents of Screening Positive for Attention Deficit Hyperactivity Disorder in Ten-Year-Old Children Born Extremely Preterm.

Science.gov (United States)

Leviton, Alan; Hooper, Stephen R; Hunter, Scott J; Scott, Megan N; Allred, Elizabeth N; Joseph, Robert M; O'Shea, T Michael; Kuban, Karl

2018-04-01

The incidence of attention deficit hyperactivity disorder is higher among children born very preterm than among children who are mature at birth. We studied 583 ten-year-old children who were born before 28 weeks of gestation whose IQ was above 84 and had a parent-completed Child Symptom Inventory-4, which allowed classification of the child as having or not having symptoms of attention deficit hyperactivity disorder. For 422 children, we also had a teacher report, and for 583 children, we also had a parent report of whether or not a physician made an attention deficit hyperactivity disorder diagnosis. The risk profile of screening positive for attention deficit hyperactivity disorder based on a parent's report differed from the risk profile based on the teacher's report, whereas the risk profile according to a physician and according to any two observers closely resembled the parent-reported profile. Among the statistically significant risk factors were young maternal age (parent, physician, and two observers), maternal obesity (parent, physician, and two observers), maternal smoking (parent, physician, and two observers), magnesium given at delivery for seizure prophylaxis (parent and two observers), recovery of Mycoplasma sp. from the placenta (teacher and two observers), low gestational age (parent and two observers), low birth weight (teacher and physician), singleton (parent, physician, and two observers), male (parent, teacher, physician, and two observers), mechanical ventilation on postnatal day seven (physician), receipt of a sedative (parent and two observers), retinopathy of prematurity (parent), necrotizing enterocolitis (physician), antibiotic receipt (physician and two observers), and ventriculomegaly on brain scan (parent and two observers). The multiplicity of risk factors identified can be subsumed as components of four broad themes: low socioeconomic state, immaturity or vulnerability, inflammation, and epigenetic phenomena. Copyright © 2017

Sex of the first-born and risk of preterm birth in the subsequent pregnancy

DEFF Research Database (Denmark)

Mortensen, Laust H; Nielsen, Henriette Svarre; Cnattingius, Sven

2011-01-01

BACKGROUND: Recent data suggest that the chance of successfully maintaining a pregnancy may be influenced by the sex of previously born children. We explored a possible relation between sex of the first-born infant and the risk of preterm birth in the second pregnancy. METHODS: Using data from...... the National Medical Birth Registries in Denmark 1980-2004 and Sweden 1980-2001, we selected all women whose first and second births were singleton and who had information on sex of first-born infant and gestational age for the second (Denmark, n = 393,686; Sweden, n = 603,282). Cox proportional hazards...... regression analysis was used to estimate the hazard ratio of preterm birth in the second pregnancy according to the sex of the first-born infant. RESULTS: Compared with women whose first baby was a girl, women with boys had an increased risk of preterm birth in a second pregnancy (hazard ratio = 1.10 [95...

Selenium deficiency and the effects of supplementation on preterm infants

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Renata Germano B. O. N. Freitas

2014-03-01

Full Text Available Objective: This study aimed to review the literature about blood concentrations of selenium associated with gestational age, feeding, supplementation and related clinical features in preterm infants. Data sources: Systematic review in the following databases: MEDLINE, PubMed, Google academics, SciELO. org, ScienceDirect (Elsevier and CINAHL-Plus with Full Text (EBSCO. Articles published up to January 2013 with the keywords "selenium deficiency", "selenium supplementation", "neonates", "infants", "newborn" and "preterm infants" were selected. Data synthesis: The studies reported that low blood selenium levels are associated with increased risk of respiratory diseases. Preterm infants, especially with low birth weight, presented lower selenium levels. Selenium deficiency has also been associated with the use of oral infant formula, enteral and parenteral nutrition (with or without selenium addition. The optimal dose and length of selenium supplementation is not well-established, since they are based only on age group and selenium ingestion by breastfed children. Furthermore, the clinical status of the infant affected by conditions that may increase oxidative stress, and consequently, selenium requirements is not taken into account. Conclusions: Prematurity and low birth weight can contribute to low blood selenium in premature infants. Selenium supplementation seems to minimize or prevent clinical complications caused by prematurity.

Preeclampsia and retinopathy of prematurity in preterm births.

Science.gov (United States)

Yu, Xiao Dan; Branch, D Ware; Karumanchi, S Ananth; Zhang, Jun

2012-07-01

The relationship between gestational hypertension, preeclampsia, and the risk of retinopathy of prematurity (ROP) remains unclear. Thus, we used a large cohort database to study the influence of maternal gestational hypertension and preeclampsia on the occurrence of ROP in preterm infants. We used data from a previous retrospective cohort study that includes 25,473 eligible preterm neonates. We examined the association between gestational hypertension, preeclampsia, and ROP while controlling for potential confounders by multiple logistic regression analysis. Of the 8758 early preterm infants (gestational age <34 weeks), 1024 (11.69%) had ROP, while of the 16,715 late preterm infants, only 29 (0.17%) had ROP. After adjusting for confounders, preeclampsia was associated with a significantly reduced risk of ROP (adjusted odds ratio [aOR], 0.65; 95% confidence interval [CI], 0.49-0.86 for early preterm birth; aOR, 0.10; 95% CI, 0.01-0.93 for late preterm birth; aOR, 0.66; 95% CI, 0.50-0.87 for all preterm births). Gestational hypertension was not significantly associated with ROP at early or late preterm births. Preeclampsia, but not gestational hypertension, was associated with a reduced risk of ROP in preterm births.

A Randomized Case-Controlled Study of Recombinant Human Granulocyte Colony Stimulating Factor for the Treatment of Sepsis in Preterm Neutropenic Infants

OpenAIRE

Aktaş, Doğukan; Demirel, Bilge; Gürsoy, Tuğba; Ovalı, Fahri

2015-01-01

To investigate the efficacy and safety of recombinant human granulocyte colony-stimulating factor, recombinant human granulocyte-macrophage colony-stimulating factor (rhG-CSF) to treat sepsis in neutropenic preterm infants. Methods: Fifty-six neutropenic preterm infants with suspected or culture-proven sepsis hospitalized in Zeynep Kamil Maternity and Children's Educational and Training Hospital, Kozyatağı/Istanbul, Turkey between January 2008 and January 2010 were enrolled. Patients were ...

Survival, morbidity, growth and developmental delay for babies born preterm in low and middle income countries - a systematic review of outcomes measured.

Directory of Open Access Journals (Sweden)

Melissa Gladstone

Full Text Available Premature birth is the leading cause of neonatal death and second leading in children under 5. Information on outcomes of preterm babies surviving the early neonatal period is sparse although it is considered a major determinant of immediate and long-term morbidity.Systematic review of studies reporting outcomes for preterm babies in low and middle income settings was conducted using electronic databases, citation tracking, expert recommendations and "grey literature". Reviewers screened titles, abstracts and articles. Data was extracted using inclusion and exclusion criteria, study site and facilities, assessment methods and outcomes of mortality, morbidity, growth and development. The Child Health Epidemiology Reference Group criteria (CHERG were used to assess quality.Of 197 eligible publications, few (10.7% were high quality (CHERG. The majority (83.3% report on the outcome of a sample of preterm babies at time of birth or admission. Only 16.0% studies report population-based data using standardised mortality definitions. In 50.5% of studies, gestational age assessment method was unclear. Only 15.8% followed-up infants for 2 years or more. Growth was reported using standardised definitions but recommended morbidity definitions were rarely used. The criteria for assessment of neurodevelopmental outcomes was variable with few standardised tools - Bayley II was used in approximately 33% of studies, few studies undertook sensory assessments.To determine the relative contribution of preterm birth to the burden of disease in children and to inform the planning of healthcare interventions to address this burden, a renewed understanding of the assessment and documentation of outcomes for babies born preterm is needed. More studies assessing outcomes for preterm babies who survive the immediate newborn period are needed. More consistent use of data is vital with clear and aligned definitions of health outcomes in newborn (preterm or term and

Survival, morbidity, growth and developmental delay for babies born preterm in low and middle income countries - a systematic review of outcomes measured.

Science.gov (United States)

Gladstone, Melissa; Oliver, Clare; Van den Broek, Nynke

2015-01-01

Premature birth is the leading cause of neonatal death and second leading in children under 5. Information on outcomes of preterm babies surviving the early neonatal period is sparse although it is considered a major determinant of immediate and long-term morbidity. Systematic review of studies reporting outcomes for preterm babies in low and middle income settings was conducted using electronic databases, citation tracking, expert recommendations and "grey literature". Reviewers screened titles, abstracts and articles. Data was extracted using inclusion and exclusion criteria, study site and facilities, assessment methods and outcomes of mortality, morbidity, growth and development. The Child Health Epidemiology Reference Group criteria (CHERG) were used to assess quality. Of 197 eligible publications, few (10.7%) were high quality (CHERG). The majority (83.3%) report on the outcome of a sample of preterm babies at time of birth or admission. Only 16.0% studies report population-based data using standardised mortality definitions. In 50.5% of studies, gestational age assessment method was unclear. Only 15.8% followed-up infants for 2 years or more. Growth was reported using standardised definitions but recommended morbidity definitions were rarely used. The criteria for assessment of neurodevelopmental outcomes was variable with few standardised tools - Bayley II was used in approximately 33% of studies, few studies undertook sensory assessments. To determine the relative contribution of preterm birth to the burden of disease in children and to inform the planning of healthcare interventions to address this burden, a renewed understanding of the assessment and documentation of outcomes for babies born preterm is needed. More studies assessing outcomes for preterm babies who survive the immediate newborn period are needed. More consistent use of data is vital with clear and aligned definitions of health outcomes in newborn (preterm or term) and intervention

preterm births in a resource constrained setting: soci

African Journals Online (AJOL)

2015-12-01

Dec 1, 2015 ... cerebral palsy, visual and hearing impairment are also more common in preterm infants. Preterm birth in it- ... vious history of induced abortion, previous history of pre-term delivery, history of antenatal ..... cioeconomic status with stress which has been found to be a trigger for preterm labour and delivery.6 ...

Does fish oil prevent preterm birth?

DEFF Research Database (Denmark)

Secher, Niels Jørgen

2007-01-01

A literature review was performed on the effect of fish oil on preterm birth in observational and randomized studies. The only weak effect on preterm birth found in meta-analyses could be caused by the low compliance, and the fact that many women stop supplementation before term together with a f......A literature review was performed on the effect of fish oil on preterm birth in observational and randomized studies. The only weak effect on preterm birth found in meta-analyses could be caused by the low compliance, and the fact that many women stop supplementation before term together...... with a fast acting effect on fish oil....

Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea

OpenAIRE

Betina Hebbelstrup Jensen; Anja Poulsen; Stig Hebbelstrup Rye Rasmussen; Carsten Struve; Jørgen H. Engberg; Alice Friis-Møller; Nadia Boisen; Rie Jønsson; Randi F. Petersen; Andreas M. Petersen; Andreas M. Petersen; Andreas M. Petersen; Karen A. Krogfelt

2017-01-01

Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish ...

Impact of Persistent Intracellular Infections on the Processes of Airway Remodeling in Children with Bronchial Asthma

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O.Ye. Chernyshova

2015-03-01

Full Text Available The article presents information about the impact of persistent intracellular infections on the processes of airway remodeling in bronchial asthma in children. The influence of matrix metalloproteinases, tissue inhibitor of matrix metalloproteinase, transforming growth factor, antibodies to type III collagen, endothelin-1 on the processes of morphological reconstruction of the airway by way of smooth muscle hypertrophy, enhanced neovascularization, epithelial cell hyperplasia, collagen deposition, thickening of the basal membrane, observed in bronchial asthma in children, were described.

Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

Science.gov (United States)

Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

2016-10-01

-income health insurance who had at least 1 mental illness diagnostic code were 1.2-3.3-times more likely to have a preterm birth than women without a mental illness, and these risks persisted across most illness classifications. Although it cannot be determined from these data whether specific treatments for mental illness contribute to the observed associations, elevated risk across different diagnoses suggests that some aspects of mental illness itself may confer risk. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of status of preterm infants with bronchopulmonary dysplasia

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Chernenkov Yu.V.

2017-06-01

Full Text Available Objective: the combination frequency of BPD in premature infants, assessment of the degree of functional lesion of the respiratory tract and the efficiency of respiratory support. Material and Methods. The survey included 36 women and 38 preterm infants (two twins. Results. In 99% of the surveyed women pregnancy was complicated by chronic intrauterine fetal hypoxia, 2.1% — RH-conflict. At 43.2% of cases acute respiratory viral infection during pregnancy was revealed, 15.3% of bad obstetric history, 5% of women who had bad habits (smoking, alcohol intake. In 2015 there were 5 deaths (13.2%. 14 children (36.8% were transferred to other hospitals for further treatment, the remaining 19 (50% were discharged from the hospital. One child — full-term, the other— premature. At 87.7% of children with BPD, the diagnosis was RDS, in 4.2% — aspiration of meconium, 8.1% — congenital pneumonia. 15 children (30.5% received therapy with surfactant once, including 9 newborns (23.7% received medication twice. All newborns were carried out intensive care, including respiratory support. Mechanical ventilation in 14 children had been conducting for 8.4±2.3 day, in 13 cases for 17.3±3.8 day, in 11 cases for 23.4±4.1 day. Nasal CPAP was conducted in 23 newborns: from 4 to 6.8±1.9 day, 13 — less of 16.8±2.9 per day, 6 children have had more than 23.2±3.8 day. Conclusion. There is necessity for prevention during pregnancy with glucocorticoids, the prolongation of pregnancy; preterm neonates — surfactant therapy; adequate provision of resuscitation care in the delivery room and respiratory support. The reduction of time of mechanical ventilation and the expansion of the indications for non-invasive methods of respiratory therapy reduced the incidence of BPD, the severity of the disease and improve the prognosis.

[2,3 diphosphoglycerate in preterm newborns].

Science.gov (United States)

Scopesi, F; Canini, S; Mazzella, M; Arioni, C; Lantieri, P; Serra, G

2000-01-01

It has been largely shown that during the first month of life, in the preterm neonate Hb levels and Hct percentages rapidly decrease, high HbF concentration persists and a high oxygen affinity occurs. Data are needed to establish the level at which 2,3 dyphosphoglycerate (2,3 DPG) interacts with the regulation of oxygen affinity. 24 samples, from eight uncomplicated preterm newborns (34.1 +/- 1.83 GW, 1869 +/- +/- 291 BW) obtained at the same time as those required for the clinical management of the infants, were collected on the 2nd, 7th and 14th day of life. Blood gases, total hemoglobin and hematocrit were obtained from 0.3 ml arterialised capillary blood. Assays of 2,3 DPG were made separately on 0.4 ml venous blood. As expected tHb concentration and Hct percentages significantly decreased from day 2 to day 14 in all eight cases. On the contrary 2,3 DPG and p50 values remained stable. Subsequently throughout the study period all neonates had an increased 2,3 DPG/Hb ratio that was significantly related with p50 at standard conditions (p < 0.05). Stable 2,3 DPG concentrations during all study period have been detected. The subsequent significant increased 2.3 DPG/Hb, ratio related to increased p50 values, could have a key role in a physiological mechanism aimed to ensure adequate oxygen delivery to the tissues and to counteract the higher oxygen affinity of fetal hemoglobin. A wider sample is needed to validate this hypothesis.

The effect of emotion on articulation rate in persistence and recovery of childhood stuttering.

Science.gov (United States)

Erdemir, Aysu; Walden, Tedra A; Jefferson, Caswell M; Choi, Dahye; Jones, Robin M

2018-06-01

This study investigated the possible association of emotional processes and articulation rate in pre-school age children who stutter and persist (persisting), children who stutter and recover (recovered) and children who do not stutter (nonstuttering). The participants were ten persisting, ten recovered, and ten nonstuttering children between the ages of 3-5 years; who were classified as persisting, recovered, or nonstuttering approximately 2-2.5 years after the experimental testing took place. The children were exposed to three emotionally-arousing video clips (baseline, positive and negative) and produced a narrative based on a text-free storybook following each video clip. From the audio-recordings of these narratives, individual utterances were transcribed and articulation rates were calculated. Results indicated that persisting children exhibited significantly slower articulation rates following the negative emotion condition, unlike recovered and nonstuttering children whose articulation rates were not affected by either of the two emotion-inducing conditions. Moreover, all stuttering children displayed faster rates during fluent compared to stuttered speech; however, the recovered children were significantly faster than the persisting children during fluent speech. Negative emotion plays a detrimental role on the speech-motor control processes of children who persist, whereas children who eventually recover seem to exhibit a relatively more stable and mature speech-motor system. This suggests that complex interactions between speech-motor and emotional processes are at play in stuttering recovery and persistency; and articulation rates following negative emotion or during stuttered versus fluent speech might be considered as potential factors to prospectively predict persistence and recovery from stuttering. Copyright © 2017 Elsevier Inc. All rights reserved.

The Peculiarities of Observation of Preterm Babies with Very Low Birth Weight

Directory of Open Access Journals (Sweden)

S.V. Alifanova

2015-10-01

Full Text Available The article presents the results of follow-up of 59 preterm babies with very low birth weight during the first year of life. It was found that the most frequent causes of disability are cerebral palsy, retinopathy of prematurity, sensorineural deafness, congenital malformations. The main tasks and the algorithm of observation of these children in policlinic are described.

Developmental dynamics of radial vulnerability in the cerebral compartments in preterm infants and neonates

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Ivica eKostović

2014-07-01

Full Text Available The developmental vulnerability of different classes of axonal pathways in preterm white matter is not known. We propose that laminar compartments of the developing cerebral wall serve as spatial framework for axonal growth and evaluate potential of anatomical landmarks for understanding reorganization of the cerebral wall after perinatal lesions. The 3T MRI (in vivo and histological analysis were performed in a series of cases ranging from 22 PCW to 3 years. For the follow-up scans, three groups of children (control, normotypic and preterms with lesions were examined at the term equivalent age and after the first year of life. MRI and histological abnormalities were analyzed in the following compartments: (a periventricular, with periventricular fibre system; (b intermediate, with periventricular crossroads, sagittal strata and centrum semiovale; (c superficial, composed of gyral white matter, subplate and cortical plate. Vulnerability of thalamo-cortical pathways within the crossroads and sagittal strata seems to be characteristic for early preterms, while vulnerability of long association pathways in the centrum semiovale seems to be predominant feature of late preterms. The structural indicator of the lesion of the long association pathways is the loss of delineation between centrum semiovale and subplate remnant, which is possible substrate of the diffuse periventricular leukomalacia. The enhanced difference in MR signal intensity of centrum semiovale and subplate remnant, observed in damaged children after first year, we interpret as structural plasticity of intact short cortico-cortical fibres, which grow postnatally through U-zones and enter the cortex through the subplate remnant. Our findings indicate that radial distribution of MRI signal abnormalities in the cerebral compartments may be related to lesion of different classes of axonal pathways and have prognostic value for predicting the likely outcome of prenatal and perinatal

Cervical mucus properties stratify risk for preterm birth.

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Agatha S Critchfield

Full Text Available Ascending infection from the colonized vagina to the normally sterile intrauterine cavity is a well-documented cause of preterm birth. The primary physical barrier to microbial ascension is the cervical canal, which is filled with a dense and protective mucus plug. Despite its central role in separating the vaginal from the intrauterine tract, the barrier properties of cervical mucus have not been studied in preterm birth.To study the protective function of the cervical mucus in preterm birth we performed a pilot case-control study to measure the viscoelasticity and permeability properties of mucus obtained from pregnant women at high-risk and low-risk for preterm birth. Using extensional and shear rheology we found that cervical mucus from women at high-risk for preterm birth was more extensible and forms significantly weaker gels compared to cervical mucus from women at low-risk of preterm birth. Moreover, permeability measurements using fluorescent microbeads show that high-risk mucus was more permeable compared with low-risk mucus.Our findings suggest that critical biophysical barrier properties of cervical mucus in women at high-risk for preterm birth are compromised compared to women with healthy pregnancy. We hypothesize that impaired barrier properties of cervical mucus could contribute to increased rates of intrauterine infection seen in women with preterm birth. We furthermore suggest that a robust association of spinnbarkeit and preterm birth could be an effectively exploited biomarker for preterm birth prediction.

Spontaneous preterm birth : prevention, management and outcome

NARCIS (Netherlands)

Vermeulen, Gustaaf Michiel

1999-01-01

Preterm birth (birth before 37 completed weeks of pregnancy) is a major cause of perinatal morbidity and mortality. Strategies to prevent and adequately treat preterm labour, in order to postpone birth and to identify risk factors for neonatal damage due to preterm birth, have to be developed by

Current Approaches to the Choice of Basic Therapy for Mild Persistent Bronchial Asthma in Children

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S.M. Nedelska

2015-03-01

Conclusions. Leukotrien modifier as monotherapy is indicated to 6–7-year-old children with mild persistent bronchial asthma and serum levels of leukotrienes from 500 to 1000 pg/ml. At the level of leukotrienes below 500 pg/ml it is advisable to administer fluticasone propionate, above 1000 pg/ml — combination of leukotrien modifier and inhaled corticosteroid.

Prevalence and determinants of pre-term deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria

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O. A. Mokuolu

2010-03-01

Full Text Available In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60-70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71-7.30, antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06-19.78, premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33-9.67, maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16-27.57, pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09-4.99, type of labor (P=0.000; OR=6.44; 95%CI=4.42-9.38 and booking status (P=0.000; OR=4.67; 95%CI=3.33-6.56. The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital.

Soluble tumor necrosis factor receptor-I in preterm infants with chorioamnionitis.

Science.gov (United States)

Sato, Miho; Nishimaki, Shigeru; An, Hiromi; Shima, Yoshio; Naruto, Takuya; Sugai, Toshiyuki; Iwasaki, Shiho; Seki, Kazuo; Imagawa, Tomoyuki; Mori, Masaaki; Yokota, Shumpei

2009-04-01

The aim of our study was (i) to determine whether chorioamnionitis (CAM) is associated with an elevated soluble tumor necrosis factor receptor I (sTNFR-I) level and (ii) to examine the time course of the concentration of sTNFR-I in preterm infants after birth. We measured sTNFR-I levels in the cord blood of 112 preterm infants (gestational age < or =34 weeks), and those in peripheral blood of 30 preterm infants on days 7, 14, 21 and 28. The median value for the sTNFR-I was significantly elevated in 33 infants with CAM at stage 3 (4618 pg/mL) compared with the 52 infants without CAM (2866 pg/mL), or the 13 infants with CAM at stage 1 (3638 pg/mL) and the 14 infants at stage 2 (3242 pg/mL). The severity of CAM is an independent factor for the elevation of cord blood sTNFR-I. The sTNFR-I level on day 0 was significantly higher in eight infants with CAM at stage 3 than in the 22 infants without CAM or with CAM at stage 1 and 2; however there were no significant differences on days 7, 14, 21 and 28. The serum level of sTNFR-I showed a significant gradual decline with time. We suggest that there is an association between elevated sTNFR-I levels in cord blood and maternal CAM, and this elevation may reflect the fetal inflammation. However the elevation of sTNFR-I could not persist postnatally for a long time.

Asthma in children in relation to pre-term birth and fetal growth restriction

NARCIS (Netherlands)

Koshy, Gibby; Akrouf, Kafya A. S.; Kelly, Yvonne; Delpisheh, Ali; Brabin, Bernard J.

2013-01-01

To assess the impact of parental asthma on risk of pre-term birth (PTB) and intrauterine growth restriction, and their subsequent association with childhood asthma. Three sequential cross-sectional surveys were conducted in 1993 (3,746), 1998 (1,964) and 2006 (1,074) in the same 15 schools among

Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21(st) Project.

Science.gov (United States)

Villar, José; Giuliani, Francesca; Bhutta, Zulfiqar A; Bertino, Enrico; Ohuma, Eric O; Ismail, Leila Cheikh; Barros, Fernando C; Altman, Douglas G; Victora, Cesar; Noble, Julia A; Gravett, Michael G; Purwar, Manorama; Pang, Ruyan; Lambert, Ann; Papageorghiou, Aris T; Ochieng, Roseline; Jaffer, Yasmin A; Kennedy, Stephen H

2015-11-01

Charts of size at birth are used to assess the postnatal growth of preterm babies on the assumption that extrauterine growth should mimic that in the uterus. The INTERGROWTH-21(st) Project assessed fetal, newborn, and postnatal growth in eight geographically defined populations, in which maternal health care and nutritional needs were met. From these populations, the Fetal Growth Longitudinal Study selected low-risk women starting antenatal care before 14 weeks' gestation and monitored fetal growth by ultrasonography. All preterm births from this cohort were eligible for the Preterm Postnatal Follow-up Study, which included standardised anthropometric measurements, feeding practices based on breastfeeding, and data on morbidity, treatments, and development. To construct the preterm postnatal growth standards, we selected all live singletons born between 26 and before 37 weeks' gestation without congenital malformations, fetal growth restriction, or severe postnatal morbidity. We did analyses with second-degree fractional polynomial regression models in a multilevel framework accounting for repeated measures. Fetal and neonatal data were pooled from study sites and stratified by postmenstrual age. For neonates, boys and girls were assessed separately. From 4607 women enrolled in the study, there were 224 preterm singleton births, of which 201 (90%) were enrolled in the Preterm Postnatal Follow-up Study. Variance component analysis showed that only 0·2% and 4·0% of the total variability in postnatal length and head circumference, respectively, could be attributed to between-site differences, justifying pooling the data from all study sites. Preterm growth patterns differed from those for babies in the INTERGROWTH-21(st) Newborn Size Standards. They overlapped with the WHO Child Growth Standards for term babies by 64 weeks' postmenstrual age. Our data have yielded standards for postnatal growth in preterm infants. These standards should be used for the assessment of

Occupational lifting of heavy loads and preterm birth:

DEFF Research Database (Denmark)

Runge, Stine Bjerrum; Pedersen, Jacob Krabbe; Svendsen, Susanne Wulff

2013-01-01

To examine the association between occupational lifting during pregnancy and preterm birth. The risk of preterm birth was estimated for total burden lifted per day and number of medium and heavy loads lifted per day.......To examine the association between occupational lifting during pregnancy and preterm birth. The risk of preterm birth was estimated for total burden lifted per day and number of medium and heavy loads lifted per day....

Immune cells in term and preterm labor

Science.gov (United States)

Gomez-Lopez, Nardhy; StLouis, Derek; Lehr, Marcus A; Sanchez-Rodriguez, Elly N; Arenas-Hernandez, Marcia

2014-01-01

Labor resembles an inflammatory response that includes secretion of cytokines/chemokines by resident and infiltrating immune cells into reproductive tissues and the maternal/fetal interface. Untimely activation of these inflammatory pathways leads to preterm labor, which can result in preterm birth. Preterm birth is a major determinant of neonatal mortality and morbidity; therefore, the elucidation of the process of labor at a cellular and molecular level is essential for understanding the pathophysiology of preterm labor. Here, we summarize the role of innate and adaptive immune cells in the physiological or pathological activation of labor. We review published literature regarding the role of innate and adaptive immune cells in the cervix, myometrium, fetal membranes, decidua and the fetus in late pregnancy and labor at term and preterm. Accumulating evidence suggests that innate immune cells (neutrophils, macrophages and mast cells) mediate the process of labor by releasing pro-inflammatory factors such as cytokines, chemokines and matrix metalloproteinases. Adaptive immune cells (T-cell subsets and B cells) participate in the maintenance of fetomaternal tolerance during pregnancy, and an alteration in their function or abundance may lead to labor at term or preterm. Also, immune cells that bridge the innate and adaptive immune systems (natural killer T (NKT) cells and dendritic cells (DCs)) seem to participate in the pathophysiology of preterm labor. In conclusion, a balance between innate and adaptive immune cells is required in order to sustain pregnancy; an alteration of this balance will lead to labor at term or preterm. PMID:24954221

Prediction of Spontaneous Preterm Birth

NARCIS (Netherlands)

Dijkstra, Karolien

2002-01-01

Preterm birth is a leading cause of neonatal morbidity and mortality. It is a major goal in obstetrics to lower the incidence of spontaneous preterm birth (SPB) and related neonatal morbidity and mortality. One of the principal objectives is to discover early markers that would allow us to identify

Bacterial Hyaluronidase Promotes Ascending GBS Infection and Preterm Birth

Science.gov (United States)

Vornhagen, Jay; Quach, Phoenicia; Boldenow, Erica; Merillat, Sean; Whidbey, Christopher; Ngo, Lisa Y.; Adams Waldorf, K. M.

2016-01-01

ABSTRACT Preterm birth increases the risk of adverse birth outcomes and is the leading cause of neonatal mortality. A significant cause of preterm birth is in utero infection with vaginal microorganisms. These vaginal microorganisms are often recovered from the amniotic fluid of preterm birth cases. A vaginal microorganism frequently associated with preterm birth is group B streptococcus (GBS), or Streptococcus agalactiae. However, the molecular mechanisms underlying GBS ascension are poorly understood. Here, we describe the role of the GBS hyaluronidase in ascending infection and preterm birth. We show that clinical GBS strains associated with preterm labor or neonatal infections have increased hyaluronidase activity compared to commensal strains obtained from rectovaginal swabs of healthy women. Using a murine model of ascending infection, we show that hyaluronidase activity was associated with increased ascending GBS infection, preterm birth, and fetal demise. Interestingly, hyaluronidase activity reduced uterine inflammation but did not impact placental or fetal inflammation. Our study shows that hyaluronidase activity enables GBS to subvert uterine immune responses, leading to increased rates of ascending infection and preterm birth. These findings have important implications for the development of therapies to prevent in utero infection and preterm birth. PMID:27353757

Bacterial Hyaluronidase Promotes Ascending GBS Infection and Preterm Birth

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Jay Vornhagen

2016-06-01

Full Text Available Preterm birth increases the risk of adverse birth outcomes and is the leading cause of neonatal mortality. A significant cause of preterm birth is in utero infection with vaginal microorganisms. These vaginal microorganisms are often recovered from the amniotic fluid of preterm birth cases. A vaginal microorganism frequently associated with preterm birth is group B streptococcus (GBS, or Streptococcus agalactiae. However, the molecular mechanisms underlying GBS ascension are poorly understood. Here, we describe the role of the GBS hyaluronidase in ascending infection and preterm birth. We show that clinical GBS strains associated with preterm labor or neonatal infections have increased hyaluronidase activity compared to commensal strains obtained from rectovaginal swabs of healthy women. Using a murine model of ascending infection, we show that hyaluronidase activity was associated with increased ascending GBS infection, preterm birth, and fetal demise. Interestingly, hyaluronidase activity reduced uterine inflammation but did not impact placental or fetal inflammation. Our study shows that hyaluronidase activity enables GBS to subvert uterine immune responses, leading to increased rates of ascending infection and preterm birth. These findings have important implications for the development of therapies to prevent in utero infection and preterm birth.

Bilirubin-Induced Neurotoxicity in the Preterm Neonate.

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Watchko, Jon F

2016-06-01

Bilirubin-induced neurotoxicity in preterm neonates remains a clinical concern. Multiple cellular and molecular cascades likely underlie bilirubin-induced neuronal injury, including plasma membrane perturbations, excitotoxicity, neuroinflammation, oxidative stress, and cell cycle arrest. Preterm newborns are particularly vulnerable secondary to central nervous system immaturity and concurrent adverse clinical conditions that may potentiate bilirubin toxicity. Acute bilirubin encephalopathy in preterm neonates may be subtle and manifest primarily as recurrent symptomatic apneic events. Low-bilirubin kernicterus continues to be reported in preterm neonates, and although multifactorial in nature, is often associated with marked hypoalbuminemia. Copyright © 2016 Elsevier Inc. All rights reserved.

[Persistent diarrhea

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Andrade, J A; Moreira, C; Fagundes Neto, U

2000-07-01

INTRODUCTION: Persistent diarrhea has high impact on infantile morbidity and mortality rates in developing countries. Several studies have shown that 3 to 20% of acute diarrheal episodes in children under 5 years of age become persistent. DEFINITION: Persistent diarrhea is defined as an episode that lasts more than 14 days. ETIOLOGY: The most important agents isolated in persistent diarrhea are: Enteropathogenic E. coli (EPEC), Salmonella, Enteroaggregative E. coli (EAEC), Klebisiella and Cryptosporidium. CLINICAL ASPECTS: In general, the clinical characteristics of patients with persistent diarrhea do not change with the pathogenic agent. Persistent diarrhea seems to represent the final result of a several insults a infant suffers that predisposes to a more severe episode of diarrhea due to a combination of host factors and high rates of enviromental contamination. Therefore, efforts should be made to promptly treat all episodes of diarrhea with apropriate follow-up. THERAPY: The aim of the treatment is to restore hydroelectrolytic deficits and to replace losses until the diarrheal ceases. It is possible in the majority of the cases, using oral rehydration therapy and erly an appropriate type of diet. PREVENTION: It is imperative that management strategies also focus on preventive aspects. The most effective diarrheal prevention strategy in young infants worldwide is promotion of exclusive breast feeding.

Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double-blind placebo-controlled trial

NARCIS (Netherlands)

Martinez de Tejada, B.; Karolinski, A.; Ocampo, M. C.; Laterra, C.; Hösli, I.; Fernández, D.; Surbek, D.; Huespe, M.; Drack, G.; Bunader, A.; Rouillier, S.; López de Degani, G.; Seidenstein, E.; Prentl, E.; Antón, J.; Krähenmann, F.; Nowacki, D.; Poncelas, M.; Nassif, J. C.; Papera, R.; Tuma, C.; Espoile, R.; Tiberio, O.; Breccia, G.; Messina, A.; Peker, B.; Schinner, E.; Mol, B. W.; Kanterewicz, L.; Wainer, V.; Boulvain, M.; Othenin-Girard, V.; Bertolino, M. V.; Irion, O.; Tellenbach, M.; Vögele, E.; Azbar, R.; Raggi, A.; Birkenmaier, A.; Kann, S.; Scheibner, K.; Huguelet, M.; Amann, E.; Baumann, M.; Jakob, E.; Biedermann, K.; Hodel, M.; Fischer, T.; Pfau, K.; Estermann, K.

2015-01-01

To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. Multicentre, randomised, double-blind, placebo-controlled trial. Twenty-nine centres in Switzerland and Argentina. A total of 385 women with preterm labour (24(0/7) to

Changes in perinatal care and survival in very preterm and extremely preterm infants in the Netherlands between 1983 and 1995

NARCIS (Netherlands)

Anthony, S.; Ouden, L.D.; Brand, R.; Verloove-Vanhorick, P.; Gravenhorst, J.B.

2004-01-01

Objective: To evaluate changes in obstetrical and neonatal care for very preterm and extremely preterm infants between 1983 and 1995 in The Netherlands and to evaluate the effect of those changes. Study design: Data on all very preterm or VLBW infants from the linked national obstetrical and

Regional white matter development in very preterm infants: perinatal predictors and early developmental outcomes.

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Rogers, Cynthia E; Smyser, Tara; Smyser, Christopher D; Shimony, Joshua; Inder, Terrie E; Neil, Jeffrey J

2016-01-01

Preterm infants are at risk for white matter (WM) injury and adverse neurodevelopmental outcomes. Serial diffusion tensor magnetic resonance imaging data were obtained from very preterm infants (N = 78) born regions of interest for infants with ≥2 scans (N = 50). Sixty-five children underwent neurodevelopmental testing at 2 y of age. FA slope for the posterior limb of the internal capsule was greater than other regions. The anterior limb of the internal capsule (ALIC), corpus callosum, and optic radiations demonstrated greater FA slope with increasing gestational age. Infants with patent ductus arteriosus had lower FA slope in the ALIC. MD slope was lower with prolonged ventilation or lack of antenatal steroids. At 2 y of age, lower motor scores were associated with lower FA in the left but higher FA in the right inferior temporal lobe at term-equivalent age. Better social-emotional competence was related to lower FA in the left cingulum bundle. This study demonstrates regional variability in the susceptibility/sensitivity of WM maturation to perinatal factors and relationships between altered diffusion measures and developmental outcomes in preterm neonates.

Persistent Skin Reactions and Aluminium Hypersensitivity Induced by Childhood Vaccines.

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Salik, Elaha; Løvik, Ida; Andersen, Klaus E; Bygum, Anette

2016-11-02

There is increasing awareness of reactions to vaccination that include persistent skin reactions. We present here a retrospective investigation of long-lasting skin reactions and aluminium hypersensitivity in children, based on medical records and questionnaires sent to the parents. In the 10-year period 2003 to 2013 we identified 47 children with persistent skin reactions caused by childhood vaccinations. Most patients had a typical presentation of persisting pruritic subcutaneous nodules. Five children had a complex diagnostic process involving paediatricians, orthopaedics and plastic surgeons. Two patients had skin biopsies performed from their skin lesions, and 2 patients had the nodules surgically removed. Forty-two children had a patch-test performed with 2% aluminium chloride hexahydrate in petrolatum and 39 of them (92%) had a positive reaction. The persistent skin reactions were treated with potent topical corticosteroids and disappeared slowly. Although we advised families to continue vaccination of their children, one-third of parents omitted or postponed further vaccinations.

Pertussis prevalence and its determinants among children with persistent cough in urban Uganda.

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Vincent Kayina

Full Text Available We determined prevalence of pertussis infection and its associated host and environmental factors to generate information that would guide strategies for disease control.In a cross-sectional study, 449 children aged 3 months to 12 years with persistent cough lasting ≥14 days were enrolled and evaluated for pertussis using DNA polymerase chain reaction (PCR and ELISA serology tests.Pertussis prevalence was 67 (15% (95% Confidence Interval (CI: 12-18 and 81 (20% (95% CI: 16-24 by PCR and ELISA, respectively among 449 participating children. The prevalence was highest in children with >59 months of age despite high vaccination coverage of 94% in this age group. Study demographic and clinical characteristics were similar between pertussis and non-pertussis cases. Of the 449 children, 133 (30% had a coughing household member and 316 (70% did not. Among 133 children that had a coughing household member, sex of child, sharing bed with a coughing household member and having a coughing individual in the neighborhood were factors associated with pertussis. Children that had shared a bed with a coughing household individual had seven-fold likelihood of having pertussis compared to children that did not (odds ratio (OR 7.16 (95% CI: 1.24-41.44. Among the 316 children that did not have a coughing household member, age 40 years of age were the factors associated with pertussis. Age 59 months of age, suggesting the possibility of waning immunity. The factors associated with pertussis varied by presence or absence of a coughing household member.

The Effect of a Social-Emotional Intervention on the Development of Preterm Infants in Institutions

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Chernego, Daria I.; McCall, Robert B.; Wanless, Shannon B.; Groark, Christina J.; Vasilyeva, Marina J.; Palmov, Oleg I.; Nikiforova, Natalia V.; Muhamedrahimov, Rifkat J.

2018-01-01

This study examined the effect of a social-emotional intervention implemented in one St. Petersburg (Russian Federation) institution (called a Baby Home, BH) on the general behavioral development of preterm children (gestational ages of 30-36 weeks) during their first 2 years of life. The intervention consisted of training caregivers and…

Persistent Skin Reactions and Aluminium Hypersensitivity Induced by Childhood Vaccines

DEFF Research Database (Denmark)

Salik, Elaha; Løvik, Ida; Andersen, Klaus E

2016-01-01

There is increasing awareness of reactions to vaccination that include persistent skin reactions. We present here a retrospective investigation of long-lasting skin reactions and aluminium hypersensitivity in children, based on medical records and questionnaires sent to the parents. In the 10-year...... period 2003 to 2013 we identified 47 children with persistent skin reactions caused by childhood vaccinations. Most patients had a typical presentation of persisting pruritic subcutaneous nodules. Five children had a complex diagnostic process involving paediatricians, orthopaedics and plastic surgeons...... treated with potent topical corticosteroids and disappeared slowly. Although we advised families to continue vaccination of their children, one-third of parents omitted or postponed further vaccinations....

Attention Problems in Very Preterm Children from Childhood to Adulthood: The Bavarian Longitudinal Study

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Breeman, Linda D.; Jaekel, Julia; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter

2016-01-01

Background: Very preterm (VP; gestational age attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. Methods: The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born…

Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses.

Science.gov (United States)

Bianchi-Jassir, Fiorella; Seale, Anna C; Kohli-Lynch, Maya; Lawn, Joy E; Baker, Carol J; Bartlett, Linda; Cutland, Clare; Gravett, Michael G; Heath, Paul T; Ip, Margaret; Le Doare, Kirsty; Madhi, Shabir A; Saha, Samir K; Schrag, Stephanie; Sobanjo-Ter Meulen, Ajoke; Vekemans, Johan; Rubens, Craig E

2017-11-06

Preterm birth complications are the leading cause of deaths among children birth in order to inform estimates of the burden of GBS. We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data from investigator groups on the association of preterm birth (birth with maternal GBS colonization to be 1.21 (95% confidence interval [CI], .99-1.48; P = .061) in cohort and cross-sectional studies, and the odds ratio to be 1.85 (95% CI, 1.24-2.77; P = .003) in case-control studies. Preterm birth was associated with GBS bacteriuria in cohort studies (RR, 1.98 [95% CI, 1.45-2.69]; P birth is associated with maternal GBS colonization, especially where there is evidence of ascending infection (bacteriuria). Several biases reduce the chance of detecting an effect. Equally, however, results, including evidence for the association, may be due to confounding, which is rarely addressed in studies. Assessment of any effect on preterm delivery should be included in future maternal GBS vaccine trials. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Prenatal Opioid Exposure and Intermittent Hypoxemia in Preterm Infants: A Retrospective Assessment

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Elie G. Abu Jawdeh

2017-12-01