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Sample records for adolescents born preterm

  1. Advanced sleep phase in adolescents born preterm.

    PubMed

    Hibbs, Anna Maria; Storfer-Isser, Amy; Rosen, Carol; Ievers-Landis, Carolyn E; Taveras, Elsie M; Redline, Susan

    2014-09-01

    The objective of this article is to evaluate whether sleep patterns and quality differed between adolescents born preterm and term, and to further explore whether differences in sleep patterns were explained by differences in mediating factors such as mood, behavior, or socioeconomic status. Five hundred and one 16- to 19-year-old children in the longitudinal Cleveland Children's Sleep and Health Study cohort underwent overnight polysomnography (PSG), wore wrist actigraphs, and completed sleep logs for 1 week. The modified Epworth Sleepiness Scale, the Adolescent Sleep Hygiene Scale, and the Adolescent Sleep-Wake Scale were used to further assess sleep. Adolescents born preterm demonstrated significantly (p < .05) earlier bed and wake times and sleep midpoints (approximately 22 min after adjusting for demographic and psychosocial factors) by actigraphy. They also had significantly fewer arousals (by PSG), and reported being more rested and alert in the morning, as well as less sleepiness and fatigue. These findings support a growing body of evidence that perinatal factors may influence sleep phenotypes later in life. These factors may reflect developmental influences, as well as the influence of parenting styles on children's sleep. PMID:24283662

  2. Early Risk, Attention, and Brain Activation in Adolescents Born Preterm

    ERIC Educational Resources Information Center

    Carmody, Dennis P.; Bendersky, Margaret; Dunn, Stanley M.; DeMarco, J. Kevin; Hegyi, Thomas; Hiatt, Mark; Lewis, Michael

    2006-01-01

    The relations among early cumulative medical risk, cumulative environmental risk, attentional control, and brain activation were assessed in 15-16-year-old adolescents who were born preterm. Functional magnetic resonance imaging found frontal, temporal, and parietal cortex activation during an attention task with greater activation of the left…

  3. Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications

    PubMed Central

    Lundequist, Aiko; Böhm, Birgitta; Lagercrantz, Hugo; Forssberg, Hans; Smedler, Ann-Charlotte

    2015-01-01

    Aim The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5. Methods We tested 134 adolescents born preterm with a very low birthweight of <1500 g and 94 term-born controls with a comprehensive cognitive battery at 18 years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23–27, 28–31 and 32–36 weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age. Results Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks. Conclusion Adolescents born at 28 weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18 years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits. PMID:25394225

  4. Developmental Outcomes of Extremely Preterm Infants Born to Adolescent Mothers

    PubMed Central

    Bann, Carla; Higgins, Rosemary; Vohr, Betty

    2015-01-01

    BACKGROUND AND OBJECTIVES: Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adolescent mothers <20 compared with adult mothers ≥20 years and to identify socioeconomic risk factors that affect outcomes. METHODS: Retrospective cohort analysis of 211 infants >27 weeks of adolescent mothers and 1723 infants of adult mothers at Neonatal Research Network centers from 2008 to 2011. Groups were compared and regression models were run to predict 18- to 22-month adverse outcomes. Primary outcomes were Bayley-III scores, neurodevelopmental impairment, and Brief Infant Toddler Social Emotional Assessment problem scores (BITSEA/P) ≥75th percentile. RESULTS: Adolescent mothers were more often single, Hispanic, less educated, and had public insurance. By 18 to 22 months, their children had significantly increased rates of having lived ≥3 places (21% vs 9%), state supervision (7% vs 3%), rehospitalization (56% vs 46%), and BITSEA/P ≥75th percentile (50% vs 32%) and nonsignificant Bayley-III language scores <85 (56% vs 49%, P = .07). In regression analysis, children of adolescent mothers were more likely to have BITSEA/P ≥75th percentile (relative risk 1.50, 95% confidence interval 1.08–2.07). Living ≥3 places and nonwhite race were predictors of adverse behavior. State supervision was an independent predictor of each Bayley-III composite <70 and neurodevelopmental impairment. CONCLUSIONS: ELBW infants of adolescent mothers experience high social and environmental risks that are associated with adverse behavior outcomes. These findings inform the need for comprehensive follow-up, coordinated care services, and behavior interventions for ELBW infants of adolescent mothers. PMID:25963007

  5. Physiological evidence consistent with reduced neuroplasticity in human adolescents born preterm.

    PubMed

    Pitcher, Julia B; Riley, Alysha M; Doeltgen, Sebastian H; Kurylowicz, Lisa; Rothwell, John C; McAllister, Suzanne M; Smith, Ashleigh E; Clow, Angela; Kennaway, David J; Ridding, Michael C

    2012-11-14

    Preterm-born children commonly experience motor, cognitive, and learning difficulties that may be accompanied by altered brain microstructure, connectivity, and neurochemistry. However, the mechanisms linking the altered neurophysiology with the behavioral outcomes are unknown. Here we provide the first physiological evidence that human adolescents born preterm at or before 37 weeks of completed gestation have a significantly reduced capacity for cortical neuroplasticity, the key overall mechanism underlying learning and memory. We examined motor cortex neuroplasticity in three groups of adolescents who were born after gestations of ≤32 completed weeks (early preterm), 33-37 weeks (late preterm), and 38-41 weeks (term) using a noninvasive transcranial magnetic brain stimulation technique to induce long-term depression (LTD)-like neuroplasticity. Compared with term-born adolescents, both early and late preterm adolescents had reduced LTD-like neuroplasticity in response to brain stimulation that was also associated with low salivary cortisol levels. We also compared neuroplasticity in term-born adolescents with that in term-born young adults, finding that the motor cortex retains a relatively enhanced neuroplastic capacity in adolescence. These findings provide a possible mechanistic link between the altered brain physiology of preterm birth and the subsequent associated behavioral deficits, particularly in learning and memory. They also suggest that altered hypothalamic-pituitary-adrenal axis function due to preterm birth may be a significant modulator of this altered neuroplasticity. This latter finding may offer options in the development of possible therapeutic interventions. PMID:23152623

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

    PubMed

    Travis, Katherine E; Ben-Shachar, Michal; Myall, Nathaniel J; Feldman, Heidi M

    2016-01-01

    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. PMID:27158588

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

    PubMed Central

    Travis, Katherine E.; Ben-Shachar, Michal; Myall, Nathaniel J.; Feldman, Heidi M.

    2016-01-01

    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. PMID:27158588

  8. Subregional Hippocampal Morphology and Psychiatric Outcome in Adolescents Who Were Born Very Preterm and at Term

    PubMed Central

    Cole, James H.; Filippetti, Maria Laura; Allin, Matthew P. G.; Walshe, Muriel; Nam, Kie Woo; Gutman, Boris A.; Murray, Robin M.; Rifkin, Larry; Thompson, Paul M.; Nosarti, Chiara

    2015-01-01

    Background The hippocampus has been reported to be structurally and functionally altered as a sequel of very preterm birth (<33 weeks gestation), possibly due its vulnerability to hypoxic–ischemic damage in the neonatal period. We examined hippocampal volumes and subregional morphology in very preterm born individuals in mid- and late adolescence and their association with psychiatric outcome. Methods Structural brain magnetic resonance images were acquired at two time points (baseline and follow-up) from 65 ex-preterm adolescents (mean age = 15.5 and 19.6 years) and 36 term-born controls (mean age=15.0 and 19.0 years). Hippocampal volumes and subregional morphometric differences were measured from manual tracings and with three-dimensional shape analysis. Psychiatric outcome was assessed with the Rutter Parents’ Scale at baseline, the General Health Questionnaire at follow-up and the Peters Delusional Inventory at both time points. Results In contrast to previous studies we did not find significant difference in the cross-sectional or longitudinal hippocampal volumes between individuals born preterm and controls, despite preterm individual having significantly smaller whole brain volumes. Shape analysis at baseline revealed subregional deformations in 28% of total bilateral hippocampal surface, reflecting atrophy, in ex-preterm individuals compared to controls, and in 22% at follow-up. In ex-preterm individuals, longitudinal changes in hippocampal shape accounted for 11% of the total surface, while in controls they reached 20%. In the whole sample (both groups) larger right hippocampal volume and bilateral anterior surface deformations at baseline were associated with delusional ideation scores at follow-up. Conclusions This study suggests a dynamic association between cross-sectional hippocampal volumes, longitudinal changes and surface deformations and psychosis proneness. PMID:26091104

  9. Neural Correlates of Impaired Vision in Adolescents Born Extremely Preterm and/or Extremely Low Birthweight

    PubMed Central

    Kelly, Claire E.; Cheong, Jeanie L. Y.; Molloy, Carly; Anderson, Peter J.; Lee, Katherine J.; Burnett, Alice C.; Connelly, Alan; Doyle, Lex W.; Thompson, Deanne K.

    2014-01-01

    Background Adolescents born extremely preterm (EP; <28 weeks' gestation) and/or extremely low birthweight (ELBW; <1000 g) experience high rates of visual impairments, however the potential neural correlates of visual impairments in EP/ELBW adolescents require further investigation. This study aimed to: 1) compare optic radiation and primary visual cortical structure between EP/ELBW adolescents and normal birthweight controls; 2) investigate associations between perinatal factors and optic radiation and primary visual cortical structure in EP/ELBW adolescents; 3) investigate associations between optic radiation and primary visual cortical structure in EP/ELBW adolescents and the odds of impaired vision. Methods 196 EP/ELBW adolescents and 143 controls underwent magnetic resonance imaging at a mean age of 18 years. Optic radiations were delineated using constrained spherical deconvolution based probabilistic tractography. Primary visual cortices were segmented using FreeSurfer software. Diffusion tensor variables and tract volume of the optic radiations, as well as volume, surface area and thickness of the primary visual cortices, were estimated. Results Axial, radial and mean diffusivities within the optic radiations, and primary visual cortical thickness, were higher in the EP/ELBW adolescents than controls. Within EP/ELBW adolescents, postnatal corticosteroid exposure was associated with altered optic radiation diffusion values and lower tract volume, while decreasing gestational age at birth was associated with increased primary visual cortical volume, area and thickness. Furthermore, decreasing optic radiation fractional anisotropy and tract volume, and increasing optic radiation diffusivity in EP/ELBW adolescents were associated with increased odds of impaired vision, whereas primary visual cortical measures were not associated with the odds of impaired vision. Conclusions Optic radiation and primary visual cortical structure are altered in EP/ELBW adolescents

  10. Cortical trajectories during adolescence in preterm born teenagers with very low birthweight.

    PubMed

    Rimol, Lars M; Bjuland, Knut J; Løhaugen, Gro C C; Martinussen, Marit; Evensen, Kari Anne I; Indredavik, Marit S; Brubakk, Ann-Mari; Eikenes, Live; Håberg, Asta K; Skranes, Jon

    2016-02-01

    While cross-sectional neuroimaging studies on cortical development predict reductions in cortical volume (surface area and thickness) during adolescence, this is the first study to undertake a longitudinal assessment of cortical surface area changes across the continuous cortical surface during this period. We studied the developmental dynamics of cortical surface area and thickness in adolescents and young adults (aged 15-20) born with very low birth weight (VLBW; <1500 g) as well as in term-born controls. Previous studies have demonstrated brain structural abnormalities in cortical morphology, as well as long-term motor, cognitive and behavioral impairments, in adolescents and young adults with VLBW, but the developmental dynamics throughout adolescence have not been fully explored. T1-weighted MRI scans from 51 VLBW (27 scanned twice) and 79 term-born adolescents (37 scanned twice) were used to reconstruct the cortical surface and produce longitudinal estimates of cortical surface area and cortical thickness. Linear mixed model analyses were performed, and the main effects of time and group, as well as time × group interaction effects, were investigated. In both groups, cortical surface area decreased up to 5% in some regions, and cortical thickness up to 8%, over the five-year period. The most affected regions were located on the lateral aspect of the hemispheres, in posterior temporal, parietal and to some extent frontal regions. There was no significant interaction between time and group for either morphometry variable. In conclusion, cortical thickness decreases from 15 to 20 years of age, in a similar fashion in the clinical and control groups. Moreover, we show for the first time that developmental trajectories of cortical surface area in preterm and term-born adolescents do not diverge during adolescence. PMID:26773236

  11. Anxiety in Adolescents Born Preterm or with Very Low Birthweight: A Meta-Analysis of Case-Control Studies

    ERIC Educational Resources Information Center

    Somhovd, Mikael J.; Hansen, Bo M.; Brok, Jesper; Esbjorn, Barbara H.; Greisen, Gorm

    2012-01-01

    Aim: To determine if adolescents who are born very preterm (less than 32wks; of gestation) and/or with very low birthweight (VLBW; less than 1500g) have a higher risk of experiencing clinically significant anxiety problems. Method: We used a systematic review and meta-analysis. We searched the databases ISI Web of Knowledge, PubMed, PsycNET,…

  12. Case Series: Fractional Anisotropy Profiles of the Cerebellar Peduncles in Adolescents Born Preterm With Ventricular Dilation.

    PubMed

    Travis, Katherine E; Leitner, Yael; Ben-Shachar, Michal; Yeom, Kristen W; Feldman, Heidi M

    2016-03-01

    This case series assesses white matter microstructure of the cerebellar peduncles in 4 adolescents born preterm with enlarged ventricles and reduced white matter volume in the cerebrum but no apparent injury to the cerebellum. Subjects (ages 12-17 years, gestational age 26-32 weeks, birth weight 825-2211 g) were compared to a normative sample of 19 full-term controls (9-17 years, mean gestational age 39 weeks, mean birth weight 3154 g). Tract profiles for each of the cerebellar peduncles were generated by calculating fractional anisotropy at 30 points along the central portion of each tract. One or more case subjects exhibited higher fractional anisotropy beyond the 90th percentile in the inferior, middle, and superior cerebellar peduncles. Findings demonstrate that differences in cerebellar white matter microstructure can be detected in the absence of macrostructural cerebellar abnormalities. PMID:26116381

  13. Interhemispheric Temporal Lobe Connectivity Predicts Language Impairment in Adolescents Born Preterm

    ERIC Educational Resources Information Center

    Northam, Gemma B.; Liegeois, Frederique; Tournier, Jacques-Donald; Croft, Louise J.; Johns, Paul N.; Chong, Wui K.; Wyatt, John S.; Baldeweg, Torsten

    2012-01-01

    Although language difficulties are common in children born prematurely, robust neuroanatomical correlates of these impairments remain to be established. This study investigated whether the greater prevalence of language problems in preterm (versus term-born) children might reflect injury to major intra- or interhemispheric white matter pathways…

  14. Profiling the preterm or VLBW born adolescent; implications of the Dutch POPS cohort follow-up studies.

    PubMed

    van der Pal-de Bruin, K M; van der Pal, S M; Verloove-Vanhorick, S P; Walther, F J

    2015-02-01

    In 1983, data of a unique nationwide cohort of 1338 very preterm (<32 weeks of gestation) or VLBW (birth weight<1500g) infants in the Netherlands was collected and followed at several ages until they reached the age of 19 years. At 19 years of age a more extensive follow-up study was done, including questionnaires, tests on a computer and a full physical exam. These studies provide insight into how Dutch adolescents at 19 years of age, who were born very preterm or with a very low birth weight (VLBW), reach adulthood. At 19 years, 705 POPS participants participated (74% of 959 still alive). Outcome measures at 19 years included: physical outcomes (e.g. blood pressure), cognition, behavior, quality of life, and impact of handicaps. The POPS participants showed more impairments on most outcome measures at various ages, compared to norm data. Major handicaps remained stable as the children grew older, but minor handicaps and disabilities increased. At 19 years of age, only half (47.1%) of the survivors had no disabilities and no minor or major handicaps. Especially those born small for gestational age (SGA) seem most vulnerable. These long-term results help to support preterm and SGA born children and adolescents in reaching independent adulthood, and stress the need for long term follow-up studies and to promote prevention of disabilities and of preterm birth itself. PMID:25590235

  15. Association between Postnatal Dexamethasone for Treatment of Bronchopulmonary Dysplasia and Brain Volumes at Adolescence in Infants Born Very Preterm

    PubMed Central

    Cheong, Jeanie L.Y.; Burnett, Alice C.; Lee, Katherine J.; Roberts, Gehan; Thompson, Deanne K.; Wood, Stephen J.; Connelly, Alan; Anderson, Peter J.; Doyle, Lex W.

    2014-01-01

    Objectives To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose–response effect on brain volumes. Study design Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression. Results Of the 148 extremely preterm participants, 55 (37%) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference −3.6%, 95% CI [−7.0%, −0.3%], P value = .04) and smaller white matter, thalami, and basal ganglia volumes (all P < .05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient −7.7 [95% CI −16.2, 0.8] and −3.2 [−6.6, 0.2], respectively). Conclusions Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence. PMID:24332820

  16. Catch-Up Growth and Metabolic and Cognitive Outcomes in Adolescents Born Preterm.

    PubMed

    Embleton, Nicholas D; Skeath, Thomas

    2015-01-01

    The worldwide rate of premature birth is increasing. Survival has also improved, even for very preterm infants, meaning greater numbers of preterm infants surviving into later life. This has led to greater attention being focused on long-term outcomes. Recent interest in the Developmental Origins of Health and Disease has highlighted the importance of early life growth and nutritional exposures for chronic diseases such as cardiovascular disease, osteoporosis and type 2 diabetes. There is evidence linking preterm birth and poor growth in utero with worse long-term cognitive outcome, but also evidence to link more rapid growth in certain epochs of early life with adverse metabolic outcomes. The current data suggest that a diverse range of metabolic outcomes are affected by preterm birth, and that adult survivors may be more likely to develop certain chronic diseases. There are data to show that catch-up growth during the neonatal period and in infancy may affect these later outcomes, but studies are inconsistent in their findings. In addition, it is clear that lifestyle factors during childhood and adolescence have a major impact on metabolic disease that may be greater in magnitude to the effects of early growth and nutritional exposures. PMID:26111564

  17. Differences in neural activation between preterm and full term born adolescents on a sentence comprehension task: implications for educational accommodations.

    PubMed

    Barde, Laura H F; Yeatman, Jason D; Lee, Eliana S; Glover, Gary; Feldman, Heidi M

    2012-02-15

    Adolescent survivors of preterm birth experience persistent functional problems that negatively impact academic outcomes, even when standardized measures of cognition and language suggest normal ability. In this fMRI study, we compared the neural activation supporting auditory sentence comprehension in two groups of adolescents (ages 9-16 years); sentences varied in length and syntactic difficulty. Preterms (n=18, mean gestational age 28.8 weeks) and full terms (n=14) had scores on verbal IQ, receptive vocabulary, and receptive language tests that were within or above normal limits and similar between groups. In early and late phases of the trial, we found interactions by group and length; in the late phase, we also found a group by syntactic difficulty interaction. Post hoc tests revealed that preterms demonstrated significant activation in the left and right middle frontal gyri as syntactic difficulty increased. ANCOVA showed that the interactions could not be attributed to differences in age, receptive language skill, or reaction time. Results are consistent with the hypothesis that preterm birth modulates brain-behavior relations in sentence comprehension as task demands increase. We suggest preterms' differences in neural processing may indicate a need for educational accommodations, even when formal test scores indicate normal academic achievement. PMID:22682901

  18. Literacy Skills of Children Born Preterm

    ERIC Educational Resources Information Center

    Holm, Alison; Crosbie, Sharon

    2010-01-01

    Most children born preterm are considered neurologically normal and free of disability. However in follow-up studies at school age, preterm children, born without major impairment, have been shown to have lower cognitive abilities and associated academic, social and behavioural difficulties. This study investigated the literacy, phonological…

  19. Differences in neural activation between preterm and full term born adolescents on a sentence comprehension task: Implications for educational accommodations

    PubMed Central

    Barde, Laura H.F.; Yeatman, Jason D.; Lee, Eliana S.; Glover, Gary; Feldman, Heidi M.

    2012-01-01

    Adolescent survivors of preterm birth experience persistent functional problems that negatively impact academic outcomes, even when standardized measures of cognition and language suggest normal ability. In this fMRI study, we compared the neural activation supporting auditory sentence comprehension in two groups of adolescents (ages 9–16 years); sentences varied in length and syntactic difficulty. Preterms (n = 18, mean gestational age 28.8 weeks) and full terms (n = 14) had scores on verbal IQ, receptive vocabulary, and receptive language tests that were within or above normal limits and similar between groups. In early and late phases of the trial, we found interactions by group and length; in the late phase, we also found a group by syntactic difficulty interaction. Post hoc tests revealed that preterms demonstrated significant activation in the left and right middle frontal gyri as syntactic difficulty increased. ANCOVA showed that the interactions could not be attributed to differences in age, receptive language skill, or reaction time. Results are consistent with the hypothesis that preterm birth modulates brain-behavior relations in sentence comprehension as task demands increase. We suggest preterms’ differences in neural processing may indicate a need for educational accommodations, even when formal test scores indicate normal academic achievement. PMID:22682901

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

    ERIC Educational Resources Information Center

    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…

  1. Cerebellar Growth and Behavioural & Neuropsychological Outcome in Preterm Adolescents

    ERIC Educational Resources Information Center

    Parker, Jennifer; Mitchell, Ann; Kalpakidou, Anastasia; Walshe, Muriel; Jung, Hee-Yeon; Nosarti, Chiara; Santosh, Paramala; Rifkin, Larry; Wyatt, John; Murray, Robin M.; Allin, Matthew

    2008-01-01

    Adolescence is a time of social and cognitive development associated with changes in brain structure and function. These developmental changes may show an altered path in individuals born before 33 weeks' gestation (very preterm; VPT). The cerebellum is affected by VPT birth, but no studies have yet assessed the adolescent development of this…

  2. Cardiometabolic Risk Factors in Young Adults Who Were Born Preterm

    PubMed Central

    Sipola-Leppänen, Marika; Vääräsmäki, Marja; Tikanmäki, Marjaana; Matinolli, Hanna-Maria; Miettola, Satu; Hovi, Petteri; Wehkalampi, Karoliina; Ruokonen, Aimo; Sundvall, Jouko; Pouta, Anneli; Eriksson, Johan G.; Järvelin, Marjo-Riitta; Kajantie, Eero

    2015-01-01

    Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985–1989 in Northern Finland. In 2009–2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34–36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985–1986 or 1987–1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: −0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm. PMID:25947956

  3. Neuropsychological outcomes of children born very preterm.

    PubMed

    Anderson, Peter J

    2014-04-01

    Considerable research has investigated the consequences of being born very preterm (VP; <32 weeks of gestation), especially in relation to cognitive functioning. While numerous cognitive and neuropsychological outcome studies have been published, it is important to consider methodological issues when reviewing this research, as the generalizability of the studies varies greatly. This article describes the nature of cognitive difficulties confronting VP children, both in terms of the frequency and severity of deficits. The breadth of cognitive difficulties reported in this population implies a generalized cognitive impairment; however, the presence of selective or primary cognitive deficits is discussed. It is concluded that whereas mortality and neonatal morbidity rates have decreased significantly in VP infants in recent decades, these children continue to be at significant risk for cognitive impairments and need to be closely monitored throughout childhood. PMID:24361279

  4. Extremely Preterm Born Children at Very High Risk for Developing Autism Spectrum Disorder.

    PubMed

    Verhaeghe, Liedewij; Dereu, Mieke; Warreyn, Petra; De Groote, Isabel; Vanhaesebrouck, Piet; Roeyers, Herbert

    2016-10-01

    This study aimed to provide a more comprehensive picture of the prevalence of autism spectrum disorder (ASD) in a geographic cohort of extremely preterm born adolescents by using established diagnostic instruments in addition to screening instruments. 53 participants passed a screening procedure with two screening instruments and a diagnostic evaluation with a semi-structured assessment and a parent interview. 28 % of the adolescents had a community based clinical diagnosis of ASD. When research diagnoses were also taken into account, this rate increased to 40 %. Intellectual disability, language impairment and behavioural difficulties are characteristic for these children with ASD. This study is to our knowledge the first to use ASD-specific diagnostic instruments to confirm ASD diagnoses in extremely preterm born children in early adolescence. The study expands findings of previous research and raises the need for follow-up into late childhood and early adolescence. PMID:26546379

  5. Very Preterm Adolescents Show Gender-Dependent Alteration of the Structural Brain Correlates of Spelling Abilities

    ERIC Educational Resources Information Center

    Scott, Fiona E.; Mechelli, Andrea; Allin, Matthew P.; Walshe, Muriel; Rifkin, Larry; Murray, Robin M.; Nosarti, Chiara

    2011-01-01

    Individuals born very preterm (VPT) are at risk of neurodevelopmental damage and of adverse educational outcomes in childhood and adolescence. The present study used voxel-based morphometry to investigate the association between grey matter and white matter volume and measures of language and executive functioning in VPT born adolescents and…

  6. Functional magnetic resonance connectivity studies in infants born preterm: suggestions of proximate and long-lasting changes in language organization.

    PubMed

    Kwon, Soo Hyun; Scheinost, Dustin; Vohr, Betty; Lacadie, Cheryl; Schneider, Karen; Dai, Feng; Sze, Gordon; Constable, R Todd; Ment, Laura R

    2016-03-01

    Sophisticated neuroimaging strategies demonstrate alterations in functional connectivity at school age, adolescence, and young adulthood in individuals born preterm. Recent data suggest these alterations are present in the postnatal period prior to term-equivalent age in neonates born preterm. Likewise, functional organization increases across development, but the influence of preterm birth on this fundamental infrastructure is immediate and unchanging. This article briefly reviews the current methods of measuring functional connectivity throughout development in those born preterm, and the association of functional connectivity with language disorders. Taken together, these data suggest that the effects of preterm birth on the functional organization of language in the developing brain are both proximate and long-lasting. PMID:27027605

  7. Alterations in cortical thickness development in preterm-born individuals: Implications for high-order cognitive functions.

    PubMed

    Nam, Kie Woo; Castellanos, Nazareth; Simmons, Andrew; Froudist-Walsh, Seán; Allin, Matthew P; Walshe, Muriel; Murray, Robin M; Evans, Alan; Muehlboeck, J-Sebastian; Nosarti, Chiara

    2015-07-15

    Very preterm birth (gestational age <33 weeks) is associated with alterations in cortical thickness and with neuropsychological/behavioural impairments. Here we studied cortical thickness in very preterm born individuals and controls in mid-adolescence (mean age 15 years) and beginning of adulthood (mean age 20 years), as well as longitudinal changes between the two time points. Using univariate approaches, we showed both increases and decreases in cortical thickness in very preterm born individuals compared to controls. Specifically (1) very preterm born adolescents displayed extensive areas of greater cortical thickness, especially in occipitotemporal and prefrontal cortices, differences which decreased substantially by early adulthood; (2) at both time points, very preterm-born participants showed smaller cortical thickness, especially in parahippocampal and insular regions. We then employed a multivariate approach (support vector machine) to study spatially discriminating features between the two groups, which achieved a mean accuracy of 86.5%. The spatially distributed regions in which cortical thickness best discriminated between the groups (top 5%) included temporal, occipitotemporal, parietal and prefrontal cortices. Within these spatially distributed regions (top 1%), longitudinal changes in cortical thickness in left temporal pole, right occipitotemporal gyrus and left superior parietal lobe were significantly associated with scores on language-based tests of executive function. These results describe alterations in cortical thickness development in preterm-born individuals in their second decade of life, with implications for high-order cognitive processing. PMID:25871628

  8. Alterations in cortical thickness development in preterm-born individuals: Implications for high-order cognitive functions

    PubMed Central

    Nam, Kie Woo; Castellanos, Nazareth; Simmons, Andrew; Froudist-Walsh, Seán; Allin, Matthew P.; Walshe, Muriel; Murray, Robin M.; Evans, Alan; Muehlboeck, J-Sebastian; Nosarti, Chiara

    2015-01-01

    Very preterm birth (gestational age < 33 weeks) is associated with alterations in cortical thickness and with neuropsychological/behavioural impairments. Here we studied cortical thickness in very preterm born individuals and controls in mid-adolescence (mean age 15 years) and beginning of adulthood (mean age 20 years), as well as longitudinal changes between the two time points. Using univariate approaches, we showed both increases and decreases in cortical thickness in very preterm born individuals compared to controls. Specifically (1) very preterm born adolescents displayed extensive areas of greater cortical thickness, especially in occipitotemporal and prefrontal cortices, differences which decreased substantially by early adulthood; (2) at both time points, very preterm-born participants showed smaller cortical thickness, especially in parahippocampal and insular regions. We then employed a multivariate approach (support vector machine) to study spatially discriminating features between the two groups, which achieved a mean accuracy of 86.5%. The spatially distributed regions in which cortical thickness best discriminated between the groups (top 5%) included temporal, occipitotemporal, parietal and prefrontal cortices. Within these spatially distributed regions (top 1%), longitudinal changes in cortical thickness in left temporal pole, right occipitotemporal gyrus and left superior parietal lobe were significantly associated with scores on language-based tests of executive function. These results describe alterations in cortical thickness development in preterm-born individuals in their second decade of life, with implications for high-order cognitive processing. PMID:25871628

  9. The Development of Effortful Control in Children Born Preterm

    ERIC Educational Resources Information Center

    Poehlmann, Julie; Schwichtenberg, A. J. Miller; Shah, Prachi E.; Shlafer, Rebecca J.; Hahn, Emily; Maleck, Sarah

    2010-01-01

    This prospective longitudinal study examined emerging effortful control skills at 24- and 36-months postterm in 172 children born preterm (less than 36 weeks gestation). Infant (neonatal health risks), family (sociodemographic risks), and maternal risk factors (depressive symptoms, anger expressions during play interactions) were assessed at six…

  10. Responses to a Modified Visual Cliff by Pre-Walking Infants Born Preterm and at Term

    ERIC Educational Resources Information Center

    Lin, Yuan-Shan; Reilly, Marie; Mercer, Vicki S.

    2010-01-01

    The purpose of this study was to examine, using a modified visual cliff apparatus, possible perceptual differences at crawling age between infants born preterm and infants born at term without documented visual or motor impairments. Sixteen infants born at term and 16 born preterm were encouraged to crawl to their caregivers on a modified visual…

  11. Development of Emotional and Behavioral Regulation in Children Born Extremely Preterm and Very Preterm: Biological and Social Influences

    ERIC Educational Resources Information Center

    Clark, Caron A. C.; Woodward, Lianne J.; Horwood, L. John; Moor, Stephanie

    2008-01-01

    This study describes the development of emotional and behavioral regulation in a regional cohort of children born extremely preterm (less than 28 weeks gestational age, n = 39), very preterm (less than 34 weeks gestational age, n = 56), and full term (n = 103). At 2 and 4 years, children born at younger gestational ages demonstrated poorer…

  12. School-Aged Children Born Preterm: Review of Functioning across Multiple Domains and Guidelines for Assessment

    ERIC Educational Resources Information Center

    Dempsey, Allison G.; Keller-Margulis, Milena; Mire, Sarah; Abrahamson, Catherine; Dutt, Sonia; Llorens, Ashlie; Payan, Anita

    2015-01-01

    Children born preterm are at risk for developmental deficits across multiple functional domains. As the rate of survival for preterm infants increases due to medical advancements, a greater understanding is needed for how to meet the needs of this growing population in schools. Because approximately 50-70% of children born preterm require…

  13. Preterm birth and unintentional injuries: risks to children, adolescents and young adults show no consistent pattern

    PubMed Central

    Calling, Susanna; Palmér, Karolina; Jönsson, Lena; Sundquist, Jan; Winkleby, Marilyn; Sundquist, Kristina

    2012-01-01

    Aim Preterm birth is associated with a number of physical and mental health issues. The aim of this study was to find out if there was also any association between individuals born preterm in Sweden between 1984 and 2006 and the risk of unintentional injuries during childhood, adolescence and young adulthood. Methods The study followed 2,297,134 individuals, including 5.9% born preterm, from 1985 to 2007 for unintentional injuries leading to hospitalisation or death (n=244,021). The males and females were divided into four age groups: 1–5 years, 6–12 years, 13–18 years and 19–23 years. Hazard ratios were calculated for falls, transport injuries and other injuries. Results After adjusting for a comprehensive set of covariates, some of the preterm subgroups demonstrated slightly increased risks of unintentional injuries, while others showed slightly decreased risks. However, most of the estimates were borderline or non-significant in both males and females. In addition, the absolute risk differences between individuals born preterm and full term were small. Conclusion Despite the association between preterm birth and a variety of physical and mental health consequences, this study shows that there is no consistent risk pattern between preterm birth and unintentional injuries in childhood, adolescence and young adulthood. PMID:23181809

  14. Neural correlates of executive attention in adults born very preterm

    PubMed Central

    Daamen, Marcel; Bäuml, Josef G.; Scheef, Lukas; Meng, Chun; Jurcoane, Alina; Jaekel, Julia; Sorg, Christian; Busch, Barbara; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter; Wohlschläger, Afra; Boecker, Henning

    2015-01-01

    Very preterm birth is associated with an increased prevalence of attention problems and may especially impair executive attention, i.e., top-down control of attentional selection in situations where distracting information interferes with the processing of task-relevant stimuli. While there are initial findings linking structural brain alterations in preterm-born individuals with attention problems, the functional basis of these problems are not well understood. The present study used an fMRI adaptation of the Attentional Network Test to examine the neural correlates of executive attention in a large sample of N = 86 adults born very preterm and/or with very low birth weight (VP/VLBW), and N = 100 term-born controls. Executive attention was measured by comparing task behavior and brain activations associated with the processing of incongruent vs. congruent arrow flanker stimuli. Consistent with subtle impairments of executive attention, the VP/VLBW group showed lower accuracy and a tendency for increased response times during the processing of incongruent stimuli. Both groups showed similar activation patters, especially within expected fronto-cingulo-parietal areas, but no significant between-group differences. Our results argue for a maintained attention-relevant network organization in high-functioning preterm born adults in spite of subtle deficits in executive attention. Gestational age and neonatal treatment variables showed associations with task behavior, and brain activation in the dorsal ACC and lateral occipital areas, suggesting that the degree of prematurity (and related neonatal complications) has subtle modulatory influences on executive attention processing. PMID:26640769

  15. Neural correlates of executive attention in adults born very preterm.

    PubMed

    Daamen, Marcel; Bäuml, Josef G; Scheef, Lukas; Meng, Chun; Jurcoane, Alina; Jaekel, Julia; Sorg, Christian; Busch, Barbara; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter; Wohlschläger, Afra; Boecker, Henning

    2015-01-01

    Very preterm birth is associated with an increased prevalence of attention problems and may especially impair executive attention, i.e., top-down control of attentional selection in situations where distracting information interferes with the processing of task-relevant stimuli. While there are initial findings linking structural brain alterations in preterm-born individuals with attention problems, the functional basis of these problems are not well understood. The present study used an fMRI adaptation of the Attentional Network Test to examine the neural correlates of executive attention in a large sample of N = 86 adults born very preterm and/or with very low birth weight (VP/VLBW), and N = 100 term-born controls. Executive attention was measured by comparing task behavior and brain activations associated with the processing of incongruent vs. congruent arrow flanker stimuli. Consistent with subtle impairments of executive attention, the VP/VLBW group showed lower accuracy and a tendency for increased response times during the processing of incongruent stimuli. Both groups showed similar activation patters, especially within expected fronto-cingulo-parietal areas, but no significant between-group differences. Our results argue for a maintained attention-relevant network organization in high-functioning preterm born adults in spite of subtle deficits in executive attention. Gestational age and neonatal treatment variables showed associations with task behavior, and brain activation in the dorsal ACC and lateral occipital areas, suggesting that the degree of prematurity (and related neonatal complications) has subtle modulatory influences on executive attention processing. PMID:26640769

  16. Educational Needs of School-Aged Children Born Very and Extremely Preterm: A Review

    ERIC Educational Resources Information Center

    Hornby, Garry; Woodward, Lianne J.

    2009-01-01

    Recent decades have witnessed dramatically improved survival rates for infants born prematurely, especially those born very and extremely preterm. Follow-up studies concerned with long-term neurodevelopmental outcomes for children born preterm indicate that these children are at high risk for a range of cognitive, learning, neuromotor, and…

  17. Phenotypic Differences in Individuals with Autism Spectrum Disorder Born Preterm and at Term Gestation

    ERIC Educational Resources Information Center

    Bowers, Katherine; Wink, Logan K.; Pottenger, Amy; McDougle, Christopher J.; Erickson, Craig

    2015-01-01

    The objective of the study was to characterize the phenotype of males and females with autism spectrum disorder born preterm versus those born at term. Descriptive statistical analyses identified differences between male and female autism spectrum disorder subjects born preterm compared to term for several phenotypic characteristics and…

  18. Physical Activity and Sedentary Behavior in Preterm-Born 7-Year Old Children

    PubMed Central

    Lowe, John; Watkins, W. John; Kotecha, Sarah J.; Kotecha, Sailesh

    2016-01-01

    Background Previous studies of preterm-born children (<37 weeks’ gestation) have demonstrated decrements in lung function, exercise capacity, and increased respiratory symptoms compared to their term-born peers. However, it is unclear if these children have decreased levels of physical activity (PA) and increased sedentary behavior as a consequence of this increased respiratory morbidity. We therefore compared objectively measured PA in 7-year old preterm-born children with those born at term. Methods Children in the Millennium Cohort Study underwent assessment of PA at 7 years of age using accelerometry. 6422/12781 (50%) provided valid accelerometry and had gestational age data. A series of general linear models adjusted for confounders investigated the association between gestational age and levels of Total PA (average accelerometer counts per minute over the period of the recording), Moderate-to-Vigorous PA (MVPA) and sedentary behavior. Mediation analysis was performed to specifically investigate whether the observed association of gestational age on PA was mediated by respiratory symptoms. Results PA data were available for 79, 119, 275 and 5949 children born at 25–32, 33–34, 35–36 and 37–43 weeks’ gestation respectively. Boys born at ≤32 weeks’ gestation had modest but statistically significant reductions in MVPA when compared to term controls. This equated to a reduction of 9 minutes per day. No differences were found for Total PA or sedentary behavior. The association between gestational age and MVPA was not mediated by respiratory symptoms. In females, there was no association between gestational age and any measure of PA or sedentary behavior. Conclusions Boys born at ≤32 weeks’ gestation took part in less MVPA than their term-born peers at 7 years of age. The differences were modest, but equated to a reduction of over 1 hour per week. Since PA levels have been shown to decline during childhood and adolescence, this vulnerable group

  19. Quality of Life of Adolescents and Young Adults Born at High Risk

    ERIC Educational Resources Information Center

    Dahan-Oliel, Noemi; Majnemer, Annette; Mazer, Barbara

    2011-01-01

    Research on quality of life (QoL) of adolescents and young adults born preterm and those with congenital heart disease (CHD) was systematically reviewed, and factors associated with QoL were identified. Forty-five studies met the inclusion criteria for review. Although the majority of studies found that self-reported QoL of adolescents and young…

  20. Personality in Adults Who Were Born Very Preterm

    PubMed Central

    Hertz, Christin L.; Mathiasen, René; Hansen, Bo M.; Mortensen, Erik L.; Greisen, Gorm

    2013-01-01

    Aim To investigate the personality in very preterm individuals (VPT; gestational age, GA, <32 weeks) at adult age in two cohorts born in 1974–76 and 1980–82, respectively, and to illuminate the effect of increased survival rates and the clinical implications of deviations in personality. Method Demographic data were extracted for all individuals born in Denmark in 1974–76 and 1980–82. From each period one index-group each comprising 150 individuals with the lowest gestational age was selected. Thereafter two control groups born at term were matched by gender, age and residential area. Personality was assessed with the short version of NEO PI-R, and psychiatric diagnoses were obtained from the Danish Psychiatric Central Research Register. Results Of all the individuals born <32 weeks of gestation in 1980–82 67% were alive in 2006 vs. 43% of those born in 1974–76 (p<0.0001). A total of 433 individuals participated in the study, 76% of the VPT groups (n = 227, mean GA = 27.9) and 69% of the control groups (n = 206). There were no significant differences on personality scores between the two VPT groups. Compared to the control groups, the combined VPT groups scored higher on neuroticism (p = 0.005) and agreeableness (p = 0.012), but lower on extraversion (p = 0.002). Psychiatric disorder was strongly associated with higher scores on neuroticism and lower scores on extraversion. Interpretation Improved survival of VPT infants was not associated with increased deviances in the personality as adults. The personality traits in VPT individuals differ moderately from those of term born controls. High scores in neuroticism and low scores in extraversion were associated with increased risk psychiatric disorders. VPT adults also showed signs of positive adaptation in the form of an agreeable and confident attitude towards others. What this paper adds The much improved survival rate in very preterm infants during the early years of active

  1. Born Too Soon: Care for the preterm baby

    PubMed Central

    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 <2000 g. Case management of newborns with signs of infection, safe oxygen management and supportive care for those with respiratory complications, and care for those with significant jaundice are all critical, and are especially dependent on competent nursing care. 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

  2. Development of emotional and behavioral regulation in children born extremely preterm and very preterm: biological and social influences.

    PubMed

    Clark, Caron A C; Woodward, Lianne J; Horwood, L John; Moor, Stephanie

    2008-01-01

    This study describes the development of emotional and behavioral regulation in a regional cohort of children born extremely preterm (<28 weeks gestational age, n = 39), very preterm (<34 weeks gestational age, n = 56), and full term (n = 103). At 2 and 4 years, children born at younger gestational ages demonstrated poorer self-regulation across multiple contexts spanning observed interactions, formal cognitive testing, and parental report of child behavior at home. Among children born preterm, the 2 strongest predictors of impairments in self-regulation were the presence of moderate-to-severe cerebral white matter abnormalities on neonatal magnetic resonance and a less sensitive parenting style when children were aged 2 years. Findings support the importance of early neurological development and parenting for developing regulation in children born very preterm. PMID:18826535

  3. Thalamocortical Connectivity Predicts Cognition in Children Born Preterm

    PubMed Central

    Ball, Gareth; Pazderova, Libuse; Chew, Andrew; Tusor, Nora; Merchant, Nazakat; Arichi, Tomoki; Allsop, Joanna M.; Cowan, Frances M.; Edwards, A. David; Counsell, Serena J.

    2015-01-01

    Thalamocortical connections are: essential for brain function, established early in development, and significantly impaired following preterm birth. Impaired cognitive abilities in preterm infants may be related to disruptions in thalamocortical connectivity. The aim of this study was to test the hypothesis: thalamocortical connectivity in the preterm brain at term-equivalent is correlated with cognitive performance in early childhood. We examined 57 infants who were born <35 weeks gestational age (GA) and had no evidence of focal abnormality on magnetic resonance imaging (MRI). Infants underwent diffusion MRI at term and cognitive performance at 2 years was assessed using the Bayley III scales of Infant and Toddler development. Cognitive scores at 2 years were correlated with structural connectivity between the thalamus and extensive cortical regions at term. Mean thalamocortical connectivity across the whole cortex explained 11% of the variance in cognitive scores at 2 years. The inclusion of GA at birth and parental socioeconomic group in the model explained 30% of the variance in subsequent cognitive performance. Identifying impairments in thalamocortical connectivity as early as term equivalent can help identify those infants at risk of subsequent cognitive delay and may be useful to assess efficacy of potential treatments at an early age. PMID:25596587

  4. Academic Outcomes for Children Born Preterm: A Summary and Call for Research

    ERIC Educational Resources Information Center

    Keller-Margulis, Milena; Dempsey, Allison; Llorens, Ashlie

    2011-01-01

    The developmental outcomes for children born preterm have been examined by many, with results unequivocally indicating that children born preterm tend to have poorer cognitive outcomes and more developmental difficulties. Less attention has been paid to academic outcomes. The purpose of this paper is to review the academic skills assessment of…

  5. Long-Term Cognitive Outcomes of Infants Born Moderately and Late Preterm

    ERIC Educational Resources Information Center

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

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: 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…

  6. Born too soon: the global epidemiology of 15 million preterm births.

    PubMed

    Blencowe, Hannah; Cousens, Simon; Chou, Doris; Oestergaard, Mikkel; Say, Lale; Moller, Ann-Beth; Kinney, Mary; Lawn, Joy

    2013-01-01

    This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. Direct complications of preterm birth account for one million deaths each year, and preterm birth is a risk factor in over 50% of all neonatal deaths. In addition, preterm birth can result in a range of long-term complications in survivors, with the frequency and severity of adverse outcomes rising with decreasing gestational age and decreasing quality of care. The economic costs of preterm birth are large in terms of immediate neonatal intensive care, ongoing long-term complex health needs, as well as lost economic productivity. Preterm birth is a syndrome with a variety of causes and underlying factors usually divided into spontaneous and provider-initiated preterm births. Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. Context specific innovative solutions to prevent preterm birth and hence reduce preterm birth rates all around the world are urgently needed. Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness. These efforts must be coupled with action now to implement improved antenatal, obstetric and newborn care to increase survival and reduce disability amongst those born too soon. PMID:24625129

  7. Responses to a modified visual cliff by pre-walking infants born preterm and at term.

    PubMed

    Lin, Yuan-Shan; Reilly, Marie; Mercer, Vicki S

    2010-02-01

    The purpose of this study was to examine, using a modified visual cliff apparatus, possible perceptual differences at crawling age between infants born preterm and infants born at term without documented visual or motor impairments. Sixteen infants born at term and 16 born preterm were encouraged to crawl to their caregivers on a modified visual cliff. Successful trials, crossing time, duration of visual attention, duration of tactile exploration, motor strategies, and avoidance behaviors were analyzed. A significant surface effect was found, with longer crossing times and longer durations of visual attention and tactile exploration in the condition with the visual appearance of a deep cliff. Although the two groups of infants did not differ on any of the timed measures, infants born at term demonstrated a larger number of motor strategies and avoidance behaviors by simple tally. This study indicates that infants born at term and those born preterm can perceive a visual cliff and adapt their responses accordingly. PMID:20170433

  8. Visuospatial working memory in very preterm and term born children--impact of age and performance.

    PubMed

    Mürner-Lavanchy, I; Ritter, B C; Spencer-Smith, M M; Perrig, W J; Schroth, G; Steinlin, M; Everts, R

    2014-07-01

    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. PMID:24631800

  9. Specific Relations between Neurodevelopmental Abilities and White Matter Microstructure in Children Born Preterm

    ERIC Educational Resources Information Center

    Counsell, Serena J.; Edwards, A. David; Chew, Andrew T. M.; Anjari, Mustafa; Dyet, Leigh E.; Srinivasan, Latha; Boardman, James P.; Allsop, Joanna M.; Hajnal, Joseph V.; Rutherford, Mary A.; Cowan, Frances M.

    2008-01-01

    Survivors of preterm birth have a high incidence of neurodevelopmental impairment which is not explained by currently understood brain abnormalities. The aim of this study was to test the hypothesis that the neurodevelopmental abilities of 2-year-old children who were born preterm and who had no evidence of focal abnormality on conventional MR…

  10. Decreased and Increased Anisotropy along Major Cerebral White Matter Tracts in Preterm Children and Adolescents

    PubMed Central

    Ben-Shachar, Michal; Feldman, Heidi M.

    2015-01-01

    Premature birth is highly prevalent and associated with neurodevelopmental delays and disorders. Adverse outcomes, particularly in children born before 32 weeks of gestation, have been attributed in large part to white matter injuries, often found in periventricular regions using conventional imaging. To date, tractography studies of white matter pathways in children and adolescents born preterm have evaluated only a limited number of tracts simultaneously. The current study compares diffusion properties along 18 major cerebral white matter pathways in children and adolescents born preterm (n = 27) and full term (n = 19), using diffusion magnetic resonance imaging and tractography. We found that compared to the full term group, the preterm group had significantly decreased FA in segments of the bilateral uncinate fasciculus and anterior segments of the right inferior fronto-occipital fasciculus. Additionally, the preterm group had significantly increased FA in segments of the right and left anterior thalamic radiations, posterior segments of the right inferior fronto-occipital fasciculus, and the right and left inferior longitudinal fasciculus. Increased FA in the preterm group was generally associated with decreased radial diffusivity. These findings indicate that prematurity-related white matter differences in later childhood and adolescence do not affect all tracts in the periventricular zone and can involve both decreased and increased FA. Differences in the patterns of radial diffusivity and axial diffusivity suggest that the tissue properties underlying group FA differences may vary within and across white matter tracts. Distinctive diffusion properties may relate to variations in the timing of injury in the neonatal period, extent of white matter dysmaturity and/or compensatory processes in childhood. PMID:26560745

  11. Association between preterm birth and thoracic musculoskeletal static alterations in adolescents

    PubMed Central

    Garcia, Kessey M. B.; Davidson, Josy; Goulart, Ana L.; dos Santos, Amelia M. N.

    2015-01-01

    OBJECTIVE: To compare thoracic musculoskeletal static alterations in adolescents born prematurely with those born at term and investigate neonatal and post-neonatal variables associated with thoracic alterations. METHOD: This is a cross-sectional study with 57 adolescents aged 10-15 years born prematurely and 57 adolescents born at term paired by gender and age. Photographs of the head and thorax in the front, back, and right side views were studied using a computer program. The two groups were compared in regards to: elevation of clavicles, elevation of shoulders, protrusion of the head, and anteroposterior and mediolateral thoracic length. Factor associated with thoracic disorders were evaluated by linear regression analysis. RESULTS: The Preterm group had mean gestational age of 32.0±2.8 weeks and the birth weight was 1462±338 and 3342±430 g for the Preterm and Term adolescents, respectively. Preterm adolescents had higher elevation of the left shoulder (22.7±5.4o vs. 20.6±5.3o;sim, p=0.038) and the right shoulder (22.2±4.4o vs. 18.5±5.7o; p<0.001). Smaller protrusion of the head (27.8±6.1o vs. 32.4±7.9o; p=0.008), mediolateral thoracic length (22.9±2.3 cm vs. 25.1±3.1 cm; p<0.001) and anteroposterior thoracic length (19.7±2.2 cm vs. 21.1±3.4 cm; p<0.001) were found in preterm adolescents. By multiple regression analysis, factors associated with higher shoulder elevation were birth weight <1500 g (p<0.001) and mechanical ventilation during neonatal period >5 days (p=0.009). CONCLUSION: Adolescents born prematurely presented greater thoracic musculoskeletal static alterations compared to those born at term. Factors associated with these alterations were: very low birth weight and longer duration of mechanical ventilation in the neonatal unit. PMID:25651130

  12. Brain Development of Very Preterm and Very Low-Birthweight Children in Childhood and Adolescence: A Meta-Analysis

    ERIC Educational Resources Information Center

    de Kieviet, Jorrit F.; Zoetebier, Lydia; van Elburg, Ruurd M.; Vermeulen, R. Jeroen; Oosterlaan, Jaap

    2012-01-01

    Aim: The aim of this article was to clarify the impact and consequences of very preterm birth (born less than 32wks of gestation) and/or very low birthweight ([VLBW], weighing less than 1500g) on brain volume development throughout childhood and adolescence. Method: The computerized databases PubMed, Web of Knowledge, and EMBASE were searched for…

  13. Infants Born Preterm Demonstrate Impaired Object Exploration Behaviors Throughout Infancy and Toddlerhood

    PubMed Central

    Kokkoni, Elena; Cunha, Andrea Baraldi; Galloway, James Cole

    2015-01-01

    Background Object exploration behaviors form the foundation for future global development, but little is known about how these behaviors are exhibited by infants born preterm. Objective The study objective was to longitudinally compare a comprehensive set of object exploration behaviors in infants born preterm and infants born full-term from infancy into toddlerhood. Design Twenty-two infants born full-term and 28 infants born preterm were monitored as they interacted with objects throughout their first 2 years. Methods Infants were provided up to 30 seconds to interact with each of 7 objects across 9 visits. Experimenters coded videos of infants' behaviors. Growth modeling and t tests were used to compare how much infants exhibited behaviors and how well they matched their behaviors to the properties of objects. Results Infants born preterm explored objects less in the first 6 months, exhibited less visual-haptic multimodal exploration, displayed reduced variability of exploratory behavior in a manner that reflected severity of risk, and were less able to match their behaviors to the properties of objects in a manner that reflected severity of risk. Infants born preterm with significant brain injury also had impaired bimanual abilities. Limitations There was a limited sample of infants born preterm with significant brain injury. Conclusions Infants born preterm have impaired abilities to interact with objects even in the first months of life. This impairment likely limits the knowledge they acquire about objects and about how they can act on them; this limited knowledge may, in turn, impair their early learning abilities. These results highlight the need for assessment and intervention tools specific for object exploration in young infants. PMID:25169919

  14. Comparison of Cerebral Volume in Toddlers 18 and 36 months Born Preterm and Term

    PubMed Central

    Lowe, Jean R.; MacLean, Peggy C.; Caprihan, Arvind; Ohls, Robin K; Qualls, Clifford; VanMeter, Joy; Phillips, John

    2013-01-01

    Studies investigating differences in regional brain volumes in children born preterm and term during early childhood are limited. Neuroimaging could help understand patterns of deficit in children born preterm and target areas of development associated with these regions. The goal of this study was to identify differences in regional brain volume at two different ages using magnetic resonance imaging in preterm and term children. Magnetic resonance imaging and developmental testing occurred in children 18-22 month olds (16 preterm and 10 term children) and 36-47 month olds (12 preterm and 10 term children). There were significant differences between the four groups in the parietal region, cerebral white matter, third ventricle and lateral ventricle. Correlations between regional cerebral volume and developmental testing were explored for the third and lateral ventricles. Our findings indicate that in young toddlers differences in regional cerebral volume are due to both maturation and prematurity. PMID:21917544

  15. Daytime Sleep and Parenting Interactions in Infants Born Preterm

    PubMed Central

    Schwichtenberg, A. J.; Anders, Thomas F.; Vollbrecht, Melissa; Poehlmann, Julie

    2010-01-01

    Objective Following a transactional perspective, this longitudinal study assessed concurrent and time-lagged associations between infant daytime sleep behaviors and maternal play interactions within a sample of infants born preterm. Method Data were collected from 134 families recruited from 3 Wisconsin NICUs. Multiple methods were used to collect data at infant NICU discharge and when infants were 4, 9, and 24 months postterm, including parent-report infant sleep logs, family sociodemographic assets and a 15 minute video-taped play session. Results Within time points, infants who napped more had mothers who were rated as more positive and communicative or less negative during play interactions at 4, 9 and 24 months compared to infants who napped less. Time-lagged findings indicated that infants who took more naps experienced more optimal maternal interactive behaviors later in development than infants who took fewer naps. Additionally, mothers who expressed more negative affect at 4 months or 9 months predicted more infant daytime sleep later in development. Conclusion Previous studies document that nighttime parent-child interactions influence nighttime sleep. This study presents the natural extension that daytime sleep influences daytime interactions. The present study draws attention to the understudied area of daytime naps in young children and provides support for the longitudinal bi-directional processes between sleep and parenting interactions. PMID:20978444

  16. Born Too Soon: The global epidemiology of 15 million preterm births

    PubMed Central

    2013-01-01

    This second paper in the Born Too Soon supplement presents a review of the epidemiology of preterm birth, and its burden globally, including priorities for action to improve the data. Worldwide an estimated 11.1% of all livebirths in 2010 were born preterm (14.9 million babies born before 37 weeks of gestation), with preterm birth rates increasing in most countries with reliable trend data. Direct complications of preterm birth account for one million deaths each year, and preterm birth is a risk factor in over 50% of all neonatal deaths. In addition, preterm birth can result in a range of long-term complications in survivors, with the frequency and severity of adverse outcomes rising with decreasing gestational age and decreasing quality of care. The economic costs of preterm birth are large in terms of immediate neonatal intensive care, ongoing long-term complex health needs, as well as lost economic productivity. Preterm birth is a syndrome with a variety of causes and underlying factors usually divided into spontaneous and provider-initiated preterm births. Consistent recording of all pregnancy outcomes, including stillbirths, and standard application of preterm definitions is important in all settings to advance both the understanding and the monitoring of trends. Context specific innovative solutions to prevent preterm birth and hence reduce preterm birth rates all around the world are urgently needed. Strengthened data systems are required to adequately track trends in preterm birth rates and program effectiveness. These efforts must be coupled with action now to implement improved antenatal, obstetric and newborn care to increase survival and reduce disability amongst those born too soon. Declaration This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal

  17. Preterm birth: Transition to adulthood.

    PubMed

    Allen, Marilee C; Cristofalo, Elizabeth; Kim, Christina

    2010-01-01

    Preterm birth is associated with greater difficulty with transitions from childhood to adolescence to adulthood. Adolescents and young adults born preterm have higher rates of cerebral palsy, intellectual disability, cognitive impairment, learning disability, executive dysfunction, attention deficit disorder, and social-emotional difficulties than their peers born fullterm. Compared to individuals born fullterm, more preterm survivors have major neurodevelopmental or psychiatric disability and need financial supports and societal resources. Neuroimaging studies of adolescents and adults born preterm report higher rates of brain injury, differences in regional brain structure, and different brain circuits than in those born fullterm. Making the transition to adulthood is more difficult for young adults who were born preterm than their peers born fullterm, in that fewer complete high school and higher education, find and keep meaningful employment, and live independently from their parents. As a group, they do not tend to be risk-takers, and they have lower rates of alcohol abuse, use of illicit drugs, and criminal offenses than do their peers. Despite their many challenges, the majority of adults born preterm function well, form personal relationships, integrate well into their community, and are as satisfied with their quality of life as are their peers. Concerns regarding current preterm infants, with more extremely preterm survivors, overwhelming our medical, educational, and societal resources should serve as an impetus for research on prevention of preterm births and brain injury, as well as how to support and promote their ongoing neuromaturation and recovery from injury. PMID:25708075

  18. Phenotypic differences in individuals with autism spectrum disorder born preterm and at term gestation.

    PubMed

    Bowers, Katherine; Wink, Logan K; Pottenger, Amy; McDougle, Christopher J; Erickson, Craig

    2015-08-01

    The objective of the study was to characterize the phenotype of males and females with autism spectrum disorder born preterm versus those born at term. Descriptive statistical analyses identified differences between male and female autism spectrum disorder subjects born preterm compared to term for several phenotypic characteristics and comorbidities. Of the 115 (13.0% of 883) born preterm, a greater percentage of males had sleep apnea (13.8% vs. 2.5%, p < 0.0001), seizure disorders (17.0% vs. 8.5%, p = 0.01), and attention-deficit/hyperactivity disorder (14.9% vs. 6.6%, p = 0.005). Females born preterm were more likely to be nonverbal (22.2% vs. 4.6%, p = 0.001). In summary, phenotypic differences were observed, especially among males. The results may have implications for understanding the underpinnings of a subset of individuals with autism spectrum disorder and contribute to the development of focused treatments for autism spectrum disorder among children born preterm. PMID:25192860

  19. Neonatal Cerebral Morphometry and Later Risk of Persistent Inattention/Hyperactivity in Children Born Very Preterm

    ERIC Educational Resources Information Center

    Bora, Samudragupta; Pritchard, Verena E.; Chen, Zhe; Inder, Terrie E.; Woodward, Lianne J.

    2014-01-01

    Background: Attention problems are among the most prevalent neurobehavioral morbidities affecting very preterm (VPT) born children. The first study aim was to document rates of persistent attention/hyperactivity problems from ages 4 to 9 years in a regional cohort of VPT born children. The second aim was to examine the extent to which persistent…

  20. T2 relaxometry in the extremely-preterm brain at adolescence.

    PubMed

    Dingwall, Nicholas; Chalk, Alan; Martin, Teresa I; Scott, Catherine J; Semedo, Carla; Le, Quan; Orasanu, Eliza; Cardoso, Jorge M; Melbourne, Andrew; Marlow, Neil; Ourselin, Sebastien

    2016-05-01

    Survival following very preterm birth is associated with cognitive and behavioral sequelae, which may have identifiable neural correlates. Many survivors of modern neonatal care in the 1990s are now young adults and the evolution of MRI findings into adult life has rarely been evaluated. We have investigated a cohort of 19-year-old adolescents without severe impairments born between 22 and 26weeks of gestation in 1995 (extremely preterm: EP). Using T2 data derived from magnetic resonance imaging we investigate differences between the brains of 46 EP participants (n=46) and the brains of a group of term-born controls (n=20). Despite EP adolescents having significantly reduced gray and white matter volumes, the composition of these tissues, assessed by both single and multi-component relaxometry, appears to be unrelated to either preterm status or gender. This may represent either insensitivity of the imaging technique or reflect that there are only subtle differences between EP subjects and their term-born peers. PMID:26723846

  1. T2 relaxometry in the extremely-preterm brain at adolescence

    PubMed Central

    Dingwall, Nicholas; Chalk, Alan; Martin, Teresa I.; Scott, Catherine J.; Semedo, Carla; Le, Quan; Orasanu, Eliza; Cardoso, Jorge M.; Melbourne, Andrew; Marlow, Neil; Ourselin, Sebastien

    2016-01-01

    Survival following very preterm birth is associated with cognitive and behavioral sequelae, which may have identifiable neural correlates. Many survivors of modern neonatal care in the 1990s are now young adults and the evolution of MRI findings into adult life has rarely been evaluated. We have investigated a cohort of 19-year-old adolescents without severe impairments born between 22 and 26 weeks of gestation in 1995 (extremely preterm: EP). Using T2 data derived from magnetic resonance imaging we investigate differences between the brains of 46 EP participants (n = 46) and the brains of a group of term-born controls (n = 20). Despite EP adolescents having significantly reduced gray and white matter volumes, the composition of these tissues, assessed by both single and multi-component relaxometry, appears to be unrelated to either preterm status or gender. This may represent either insensitivity of the imaging technique or reflect that there are only subtle differences between EP subjects and their term-born peers. PMID:26723846

  2. Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age.

    PubMed

    Hunt, Carl E

    2006-04-01

    Late preterm infants (34-37 weeks postmenstrual age at birth) are intermediate between less mature preterm infants and infants born at 38 weeks or more in regard to autonomic brain stem maturation. Ventilatory responses to CO(2) in preterm infants born at 33 to 36 week are significantly higher than in infants born at 29 to 32 weeks both at 3 to 4 and 10 to 14 days postnatal age, but do not differ from full-term reference levels. The ventilatory response to hypoxia in preterm infants is biphasic; initial transient hyperventilation is followed by a return to baseline and then a decrease below baseline. In infants born at 32 to 37 weeks, parasympathetic maturation appears significantly less than in full-term infants based on diminished increases in high frequency heart rate variability in quiet sleep, suggesting that late preterm infants are still more susceptible to bradycardia than full-term infants. Both the presence and severity of apnea of prematurity progressively decrease the higher the postmenstrual age. Late preterm infants, however, are still at risk, with prevalence rates as high as 10% compared with about 60% in infants born at <1500 g. The incidence of apparent life-threatening events is more common in preterm infants (8-10%) than full-term infants (1% or less). In the Collaborative Home Infant Monitoring Evaluation studies, the frequency of conventional and extreme events in near term infants is intermediate between preterm infants <34 weeks at birth and full-term infants. The relative risk for at least one extreme event in late preterm infants is increased (5.6 and 7.6, respectively, P < 0.008) compared with full-term infants and remains higher until 43 weeks postmenstrual age. The rate for Sudden Infant Death Syndrome in preterm infants born at 33 to 36 weeks is 1.37/1000 live births compared with 0.69 in infants born full term. Affected late preterm infants die at a older mean postmenstrual age compared with less mature infants (48 and 46 weeks

  3. Leukocyte Telomere Length in Young Adults Born Preterm: Support for Accelerated Biological Ageing

    PubMed Central

    Smeets, Carolina C. J.; Codd, Veryan; Samani, Nilesh J.; Hokken-Koelega, Anita C. S.

    2015-01-01

    Background Subjects born preterm have an increased risk for age-associated diseases, such as cardiovascular disease in later life, but the underlying causes are largely unknown. Shorter leukocyte telomere length (LTL), a marker of biological age, is associated with increased risk of cardiovascular disease. Objectives To compare LTL between subjects born preterm and at term and to assess if LTL is associated with other putative cardiovascular risk factors at young adult age. Methods We measured mean LTL in 470 young adults. LTL was measured using a quantitative PCR assay and expressed as T/S ratio. We analyzed the influence of gestational age on LTL and compared LTL between subjects born preterm (n = 186) and at term (n = 284). Additionally, we analyzed the correlation between LTL and potential risk factors of cardiovascular disease. Results Gestational age was positively associated with LTL (r = 0.11, p = 0.02). Subjects born preterm had shorter LTL (mean (SD) T/S ratio = 3.12 (0.44)) than subjects born at term (mean (SD) T/S ratio = 3.25 (0.46)), p = 0.003). The difference remained significant after adjustment for gender and size at birth (p = 0.001). There was no association of LTL with any one of the putative risk factors analyzed. Conclusions Young adults born preterm have shorter LTL than young adults born at term. Although we found no correlation between LTL and risk for CVD at this young adult age, this biological ageing indicator may contribute to CVD and other adult onset diseases at a later age in those born preterm. PMID:26619005

  4. Preterm Birth: Transition to Adulthood

    ERIC Educational Resources Information Center

    Allen, Marilee C.; Cristofalo, Elizabeth; Kim, Christina

    2010-01-01

    Preterm birth is associated with greater difficulty with transitions from childhood to adolescence to adulthood. Adolescents and young adults born preterm have higher rates of cerebral palsy, intellectual disability, cognitive impairment, learning disability, executive dysfunction, attention deficit disorder, and social-emotional difficulties than…

  5. Reduced corticomotor excitability and motor skills development in children born preterm.

    PubMed

    Pitcher, Julia B; Schneider, Luke A; Burns, Nicholas R; Drysdale, John L; Higgins, Ryan D; Ridding, Michael C; Nettelbeck, Theodore J; Haslam, Ross R; Robinson, Jeffrey S

    2012-11-15

    The mechanisms underlying the altered neurodevelopment commonly experienced by children born preterm, but without brain lesions, remain unknown. While individuals born the earliest are at most risk, late preterm children also experience significant motor, cognitive and behavioural dysfunction from school age, and reduced income and educational attainment in adulthood. We used transcranial magnetic stimulation and functional assessments to examine corticomotor development in 151 children without cerebral palsy, aged 10-13 years and born after gestations of 25-41 completed weeks. We hypothesized that motor cortex and corticospinal development are altered in preterm children, which underpins at least some of their motor dysfunction. We report for the first time that every week of reduced gestation is associated with a reduction in corticomotor excitability that remains evident in late childhood. This reduced excitability was associated with poorer motor skill development, particularly manual dexterity. However, child adiposity, sex and socio-economic factors regarding the child's home environment soon after birth were also powerful influences on development of motor skills. Preterm birth was also associated with reduced left hemisphere lateralization, but without increasing the likelihood of being left handed per se. These corticomotor findings have implications for normal motor development, but also raise questions regarding possible longer term consequences of preterm birth on motor function. PMID:22966161

  6. Self-Regulation: A New Perspective on Learning Problems Experienced by Children Born Extremely Preterm

    ERIC Educational Resources Information Center

    Lynn, Lisa N.; Cuskelly, Monica; O'Callaghan, Michael J.; Gray, Peter H.

    2011-01-01

    Survival rates are increasing for children born extremely preterm, yet despite the majority of these children having IQ scores within the average range, 50-70% of these children have later school difficulties. This paper reviews factors associated with academic difficulties in these children, emphasizing the contributions of executive functions…

  7. Patterns of Functioning and Predictive Factors in Children Born Moderately Preterm or at Term

    ERIC Educational Resources Information Center

    Cserjesi, Renata; van Braeckel, Koenraad N. J. A.; Timmerman, Marieke; Butcher, Phillipa R.; Kerstjens, Jorien M.; Reijneveld, Sijmen A.; Bouma, Anke; Bos, Arend F.; Geuze, Reint H.

    2012-01-01

    Aim: The aim of this study was to identify subgroups of children born moderately preterm (MPT) and term with distinctive levels and patterns of functioning, and the perinatal and demographic factors that predict subgroup membership. Method: A total of 378 children aged 7 years, 248 MPT (138 males, 110 females; gestational age 32-36 wks) and a…

  8. Pathogenesis, Neuroimaging and Management in Children with Cerebral Palsy Born Preterm

    ERIC Educational Resources Information Center

    Hoon, Alexander H., Jr.; Faria, Andreia Vasconcellos

    2010-01-01

    With advances in obstetric and perinatal management, the incidence of intraventricular hemorrhage in premature infants has declined, while periventricular leukomalacia remains a significant concern. It is now known that brain injury in children born preterm also involves neuronal-axonal disease in supratentorial and infratentorial structures. The…

  9. Maternal Rigidity in Infancy and Level of Intelligence at School Age in Children Born Preterm

    ERIC Educational Resources Information Center

    Butcher, Phillipa R.; Wijnberg-Williams, Barbara J.; Hegemann, Nicole; Stremmelaar, Elisabeth F.; Schoemaker, Marina M.; van der Meere, Jaap J.; Oetomo, Siddartho Bambang

    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 development. At 7.5 years, intelligence was measured…

  10. Neonatal pain in relation to postnatal growth in infants born very preterm.

    PubMed

    Vinall, Jillian; Miller, Steven P; Chau, Vann; Brummelte, Susanne; Synnes, Anne R; Grunau, Ruth E

    2012-07-01

    Procedural pain is associated with poorer neurodevelopment in infants born very preterm (≤ 32 weeks gestational age), however, the etiology is unclear. Animal studies have demonstrated that early environmental stress leads to slower postnatal growth; however, it is unknown whether neonatal pain-related stress affects postnatal growth in infants born very preterm. The aim of this study was to examine whether greater neonatal pain (number of skin-breaking procedures adjusted for medical confounders) is related to decreased postnatal growth (weight and head circumference [HC] percentiles) early in life and at term-equivalent age in infants born very preterm. Participants were n=78 preterm infants born ≤ 32 weeks gestational age, followed prospectively since birth. Infants were weighed and HC measured at birth, early in life (median: 32 weeks [interquartile range 30.7-33.6]) and at term-equivalent age (40 weeks [interquartile range 38.6-42.6]). Weight and HC percentiles were computed from sex-specific British Columbia population-based data. Greater neonatal pain predicted lower body weight (Wald χ(2)=7.36, P=0.01) and HC (Wald χ(2)=4.36, P=0.04) percentiles at 32 weeks postconceptional age, after adjusting for birth weight percentile and postnatal risk factors of illness severity, duration of mechanical ventilation, infection, and morphine and corticosteroid exposure. However, later neonatal infection predicted lower weight percentile at term (Wald χ(2)=5.09, P=0.02). Infants born very preterm undergo repetitive procedural pain during a period of physiological immaturity that appears to impact postnatal growth, and may activate a downstream cascade of stress signaling that affects later growth in the neonatal intensive care unit. PMID:22704600

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

    PubMed

    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. PMID:22353425

  12. Born Too Soon: Care during pregnancy and childbirth to reduce preterm deliveries and improve health outcomes of the preterm baby

    PubMed Central

    2013-01-01

    implemented in conjunction with antenatal care models that promote women's empowerment as a strategy for reducing preterm delivery. The global community needs to support more discovery research on normal and abnormal pregnancies to facilitate the development of preventive interventions for universal application. As new evidence is generated, resources need to be allocated to its translation into new and better screening and diagnostic tools, and other interventions aimed at saving maternal and newborn lives that can be brought to scale in all countries. Declaration This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was published in PDF format in the WHO Report "Born Too Soon: the global action report on preterm birth" (ISBN 978 92 4 150343 30), which involved collaboration from more than 50 organizations. The article has been reformatted for journal publication and has undergone peer review according to Reproductive Health's standard process for supplements and may feature some variations in content when compared to the original report. This co-publication makes the article available to the community in a full-text format. PMID:24625215

  13. Growth changes in infants born of adolescent mothers: Results of a national cohort study in Taiwan

    PubMed Central

    Chen, Yu-Ju; Li, Chi-Rong; Lee, Shu-Hsin; Hsu, Bu-Qing; Wu, Wei-Ya; Kuo, Ching-Pyng; Hwang, Shiow-Li; Lee, Ming-Chih

    2014-01-01

    Background: Adolescent pregnancy and childbirth are associated with increased risk and challenges for both mothers and birth outcomes. Objective: To investigate the associations of growth change over time with parenting factors and to compare the differences between children born to adolescent and adult mothers in Taiwan. Materials and Methods: The dataset retrieved from Taiwan birth cohort study (TBCS) was collected by interviews using structured questionnaires, birth certificate and Passport of Well-baby Care of each child. Changes in body weight, body height and head circumference from birth to 18 months, as well as other variables were assessed by statistical analysis. Results: There were 4.13% births born to adolescent mothers in 2005. Higher ratios of breastfeeding and working were found among adult mothers (p<0.001). Significantly higher percentage of adolescent mothers caregave their infants up to 18 months (p<0.001). Children born to adolescent mothers were associated with statistically significant lower body weight (p<0.001), body height (p<0.001) and head circumference (p<0.001) in spite of velocity and slop of growth patterns were similar over time. Breastfeeding did not significantly affected growth rate during the first 6 months. Generalized estimated equation models showed that gender and preterm birth were predictive factors for birth outcomes (both p<0.001) and correlated to changes over time. Conclusion: Adolescent childbearing was associated with preterm birth and lower body weight, body height and head circumference from birth to 18 months. The changes in growth and development among children born to adolescent mothers remain to be followed and evaluated with the TBCS. PMID:25709629

  14. Born early and born poor: An eco-bio-developmental model for poverty and preterm birth.

    PubMed

    Brumberg, H L; Shah, S I

    2015-01-01

    Poverty is associated with adverse long-term cognitive outcomes in children. Poverty is also linked with preterm delivery which, in turn, is associated with adverse cognitive outcomes. However, the extent of the effect of poverty on preterm delivery, as well as proposed mechanisms by which they occur, have not been well described. Further, the impact of poverty on preterm school readiness has not been reviewed. As the childhood poverty level continues to increase in the U.S., we examine the evidence around physiological, neurological, cognitive and learning outcomes associated with prematurity in the context of poverty. We use the evidence gathered to suggest an Eco-Bio-Developmental model, emphasizing poverty as a toxic stress which predisposes preterm birth and which, via epigenetic forces, can continue into the next generation. Continued postnatal social disadvantage for these developmentally high-risk preterm infants is strongly linked with poor neurodevelopmental outcomes, decreased school readiness, and decreased educational attainment which can perpetuate the poverty cycle. We suggest social remedies aimed at decreasing the impact of poverty on mothers, fathers, and children which may be effective in reducing the burden of preterm birth. PMID:26485551

  15. Surface displacement based shape analysis of central brain structures in preterm-born children

    NASA Astrophysics Data System (ADS)

    Garg, Amanmeet; Grunau, Ruth E.; Popuri, Karteek; Miller, Steven; Bjornson, Bruce; Poskitt, Kenneth J.; Beg, Mirza Faisal

    2016-03-01

    Many studies using T1 magnetic resonance imaging (MRI) data have found associations between changes in global metrics (e.g. volume) of brain structures and preterm birth. In this work, we use the surface displacement feature extracted from the deformations of the surface models of the third ventricle, fourth ventricle and brainstem to capture the variation in shape in these structures at 8 years of age that may be due to differences in the trajectory of brain development as a result of very preterm birth (24-32 weeks gestation). Understanding the spatial patterns of shape alterations in these structures in children who were born very preterm as compared to those who were born at full term may lead to better insights into mechanisms of differing brain development between these two groups. The T1 MRI data for the brain was acquired from children born full term (FT, n=14, 8 males) and preterm (PT, n=51, 22 males) at age 8-years. Accurate segmentation labels for these structures were obtained via a multi-template fusion based segmentation method. A high dimensional non-rigid registration algorithm was utilized to register the target segmentation labels to a set of segmentation labels defined on an average-template. The surface displacement data for the brainstem and the third ventricle were found to be significantly different (p < 0.05) between the PT and FT groups. Further, spatially localized clusters with inward and outward deformation were found to be associated with lower gestational age. The results from this study present a shape analysis method for pediatric MRI data and reveal shape changes that may be due to preterm birth.

  16. Memory function and hippocampal volumes in preterm born very-low-birth-weight (VLBW) young adults.

    PubMed

    Aanes, Synne; Bjuland, Knut Jørgen; Skranes, Jon; Løhaugen, Gro C C

    2015-01-15

    The hippocampi are regarded as core structures for learning and memory functions, which is important for daily functioning and educational achievements. Previous studies have linked reduction in hippocampal volume to working memory problems in very low birth weight (VLBW; ≤ 1500 g) children and reduced general cognitive ability in VLBW adolescents. However, the relationship between memory function and hippocampal volume has not been described in VLBW subjects reaching adulthood. The aim of the study was to investigate memory function and hippocampal volume in VLBW young adults, both in relation to perinatal risk factors and compared to term born controls, and to look for structure-function relationships. Using Wechsler Memory Scale-III and MRI, we included 42 non-disabled VLBW and 61 control individuals at age 19-20 years, and related our findings to perinatal risk factors in the VLBW-group. The VLBW young adults achieved lower scores on several subtests of the Wechsler Memory Scale-III, resulting in lower results in the immediate memory indices (visual and auditory), the working memory index, and in the visual delayed and general memory delayed indices, but not in the auditory delayed and auditory recognition delayed indices. The VLBW group had smaller absolute and relative hippocampal volumes than the controls. In the VLBW group inferior memory function, especially for the working memory index, was related to smaller hippocampal volume, and both correlated with lower birth weight and more days in the neonatal intensive care unit (NICU). Our results may indicate a structural-functional relationship in the VLBW group due to aberrant hippocampal development and functioning after preterm birth. PMID:25451477

  17. Effect of primary language on developmental testing in children born extremely preterm

    PubMed Central

    Lowe, Jean R.; Nolen, Tracy L.; Vohr, Betty; Adams-Chapman, Ira; Duncan, Andrea F.; Watterberg, Kristi

    2014-01-01

    Aim To better understand the impact of non-English language spoken in the home on measures of cognition, language, and behavior in toddlers born extremely preterm. Methods Eight hundred and fifty children born at <28 weeks gestational ages were studied. 427 male and 423 female participants from three racial/ethnic groups (White, Black, and Hispanic) were evaluated at 18-22 months adjusted age using the Bayley Scales of Infant Development 3rd edition and the Brief Infant Toddler Social Emotional Assessment (BITSEA). Children whose primary language was Spanish (n=98) were compared with children whose primary language was English (n=752), using multivariable regression adjusted for medical and psychosocial factors. Results Cognitive scores were similar between groups; however, receptive, expressive and composite language scores were lower for children whose primary language was Spanish. These differences remained significant after adjustment for medical and socio-economic factors. Spanish speaking children scored worse on the BITSEA competence and problem scores using univariate analysis, but not after adjustment for medical and socio-economic factors. Conclusions Our finding that preterm children whose primary language was Spanish had similar cognitive but lower language scores than those whose primary language was English suggests that using English language-based testing tools may introduce bias against non-English speaking children born preterm. PMID:23735043

  18. Effortful Control, Positive Emotional Expression, and Behavior Problems in Children Born Preterm

    PubMed Central

    Burnson, Cynthia; Poehlmann, Julie; Schwichtenberg, A. J.

    2013-01-01

    The present study focused on the role of high effortful control in the expression of positive emotion and development of behavior problems in children born preterm (mean gestational age = 31.4 weeks). Using data from a prospective longitudinal study, the present study assessed effortful control and behavior problems at 24 and 36 months and positive emotional expression at 24 months in a sample of 173 children born preterm. Less positive emotional expression was associated with higher effortful control for boys but not girls. Higher effortful control was associated with fewer total behavior problems, but this relation was attenuated when socioeconomic assets were included in the model. More socioeconomic assets were associated with fewer behavior problems for both boys and girls and higher effortful control for girls. Socioeconomic assets appear to be an important factor in the development of effortful control and behavior problems in children born preterm regardless of gender, whereas positive emotional expression was important for boys. Future intervention research should examine fostering adaptive levels of effortful control in high-risk populations as a means to facilitate resilience processes. PMID:23810984

  19. Effortful control, positive emotional expression, and behavior problems in children born preterm.

    PubMed

    Burnson, Cynthia; Poehlmann, Julie; Schwichtenberg, A J

    2013-12-01

    The present study focused on the role of high effortful control in the expression of positive emotion and development of behavior problems in children born preterm (mean gestational age = 31.4 weeks). Using data from a prospective longitudinal study, the present study assessed effortful control and behavior problems at 24 and 36 months and positive emotional expression at 24 months in a sample of 173 children born preterm. Less positive emotional expression was associated with higher effortful control for boys but not girls. Higher effortful control was associated with fewer total behavior problems, but this relation was attenuated when socioeconomic assets were included in the model. More socioeconomic assets were associated with fewer behavior problems for both boys and girls and higher effortful control for girls. Socioeconomic assets appear to be an important factor in the development of effortful control and behavior problems in children born preterm regardless of gender, whereas positive emotional expression was important for boys. Future intervention research should examine fostering adaptive levels of effortful control in high-risk populations as a means to facilitate resilience processes. PMID:23810984

  20. Early Parenting, Represented Family Relationships, and Externalizing Behavior Problems in Children Born Preterm

    PubMed Central

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

    2015-01-01

    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. PMID:24580068

  1. Value Socialization in Families of Israeli-Born and Soviet-Born Adolescents in Israel.

    ERIC Educational Resources Information Center

    Knafo, Ariel; Schwartz, Shalom H.

    2001-01-01

    Examined the impact of immigration on parent-adolescent value similarity, consistency of parents' value messages, and value transmission processes. Data from Soviet immigrant families in Israel and matched Israeli families indicated that immigrant adolescents resembled native-born adolescents more that they resembled their parents in value…

  2. Contribution of Brain Size to IQ and Educational Underperformance in Extremely Preterm Adolescents

    PubMed Central

    Cheong, Jeanie L. Y.; Anderson, Peter J.; Roberts, Gehan; Burnett, Alice C.; Lee, Katherine J.; Thompson, Deanne K.; Molloy, Carly; Wilson-Ching, Michelle; Connelly, Alan; Seal, Marc L.; Wood, Stephen J.; Doyle, Lex W.

    2013-01-01

    Objectives Extremely preterm (EP) survivors have smaller brains, lower IQ, and worse educational achievement than their term-born peers. The contribution of smaller brain size to the IQ and educational disadvantages of EP is unknown. This study aimed (i) to compare brain volumes from multiple brain tissues and structures between EP-born (<28weeks) and term-born (≥37weeks) control adolescents, (ii) to explore the relationships of brain tissue volumes with IQ and basic educational skills and whether this differed by group, and (iii) to explore how much total brain tissue volume explains the underperformance of EP adolescents compared with controls. Methods Longitudinal cohort study of 148 EP and 132 term controls born in Victoria, Australia in 1991-92. At age 18, magnetic resonance imaging-determined brain volumes of multiple tissues and structures were calculated. IQ and educational skills were measured using the Wechsler Abbreviated Scale of Intelligence (WASI) and the Wide Range Achievement Test(WRAT-4), respectively. Results Brain volumes were smaller in EP adolescents compared with controls (mean difference [95% confidence interval] of -5.9% [-8.0, -3.7%] for total brain tissue volume). The largest relative differences were noted in the thalamus and hippocampus. The EP group had lower IQs(-11.9 [-15.4, -8.5]), spelling(-8.0 [-11.5, -4.6]), math computation(-10.3 [-13.7, -6.9]) and word reading(-5.6 [-8.8, -2.4]) scores than controls; all p-values<0.001. Volumes of total brain tissue and other brain tissues and structures correlated positively with IQ and educational skills, a relationship that was similar for both the EP and controls. Total brain tissue volume explained between 20-40% of the IQ and educational outcome differences between EP and controls. Conclusions EP adolescents had smaller brain volumes, lower IQs and poorer educational performance than controls. Brain volumes of multiple tissues and structures are related to IQ and educational outcomes

  3. Association between brain activation (fMRI), cognition and school performance in extremely preterm and term born children.

    PubMed

    Griffiths, Silja Torvik; Aukland, Stein Magnus; Markestad, Trond; Eide, Geir Egil; Elgen, Irene; Craven, Alexander R; Hugdahl, Kenneth

    2014-10-01

    The purpose of the study was to investigate a possible association between brain activation in functional magnetic resonance imaging scans, cognition and school performance in extremely preterm children and term born controls. Twenty eight preterm and 28 term born children were scanned while performing a working memory/selective attention task, and school results from national standardized tests were collected. Brain activation maps reflected difference in cognitive skills but not in school performance. Differences in brain activation were found between children born preterm and at term, and between high and low performers in cognitive tests. However, the differences were located in different brain areas. The implication may be that lack of cognitive skills does not alone explain low performance due to prematurity. PMID:25040580

  4. Corpus Callosum and Prefrontal Functions in Adolescents with History of Very Preterm Birth

    ERIC Educational Resources Information Center

    Narberhaus, Ana; Segarra, Dolors; Caldu, Xavier; Gimenez, Monica; Pueyo, Roser; Botet, Francesc; Junque, Carme

    2008-01-01

    Very preterm (VPT) birth can account for thinning of the corpus callosum and poorer cognitive performance. Research findings about preterm and VPT adolescents usually describe a small posterior corpus callosum, although our research group has also found reductions of the anterior part, specifically the genu. The aim of the present study was to…

  5. Early Indications of Delayed Cognitive Development in Preschool Children Born Very Preterm: Evidence from Domain-General and Domain-Specific Tasks

    ERIC Educational Resources Information Center

    Pitchford, Nicola; Johnson, Samantha; Scerif, Gaia; Marlow, Neil

    2011-01-01

    Cognitive impairment often follows preterm birth but its early underlying nature is not well understood. We used a novel approach by investigating the development of colour cognition in 54 very preterm children born less than or equal to 30 weeks gestational age without severe neurosensory impairment and 37 age-matched term-born controls, aged 2-5…

  6. First- and second-born adolescents' decision-making autonomy throughout adolescence.

    PubMed

    Campione-Barr, Nicole; Lindell, Anna K; Short, Stephen D; Greer, Kelly Bassett; Drotar, Scott D

    2015-12-01

    First- and second-born adolescents' and their parents' perceptions of adolescents' decision-making autonomy were compared from ages 12 to 19 in a longitudinal sample of 145 predominantly White, middle class families. Utilizing a multivariate, multilevel modeling approach, differences in perceptions of adolescents' autonomy between parents and each adolescent, as well as by social-cognitive domain were examined. The present study found that when comparing parents' perceptions of their children at the same age, second-borns were granted more autonomy regarding conventional issues than first-borns during early adolescence, but by later adolescence first-borns were granted more autonomy regarding prudential issues than second-borns. However, comparisons between adolescents' and siblings' perceptions showed no differences. Potential reasons for, and implications of, differences in perceptions of adolescent autonomy are discussed. PMID:26519875

  7. Cognitive development in 7- to 24-month-old extremely/very-to-moderately/late preterm and full-term born infants: The mediating role of focused attention.

    PubMed

    Reuner, Gitta; Weinschenk, Andrea; Pauen, Sabina; Pietz, Joachim

    2015-01-01

    The present study analyzed the links between prematurity, attention, and global cognitive performance in infancy and early childhood. At 7 months, focused attention (FA) was examined with an object examination task in 93 preterm infants (39 of them born extremely/very preterm, 54 born moderately/late preterm, and 38 infants born full-term). Global cognition was assessed at 7 and 24 months with the Bayley-II cognitive scale. Groups did not differ with respect to global cognitive performance but FA of infants born extremely/very preterm was significantly lower than in infants born moderately/late preterm. FA correlated significantly with both prematurity and cognitive performance at 7 months of age but not with global cognition in childhood. Findings point to a subtle adverse effect of prematurity on early attention and reveal evidence for the mediating role of FA on the effect of prematurity on cognition. PMID:24697340

  8. Relation Between Birth Weight and Weight and Height at Age Two in Children Born Preterm

    PubMed Central

    Olson, Gayle; Weiner, Steven J.; Rouse, Dwight J.; Reddy, Uma M.; Mercer, Brian M.; Varner, Michael W.; Leveno, Kenneth J.; Iams, Jay D.; Wapner, Ronald J.; Ramin, Susan M.; Malone, Fergal D.; Carpenter, Marshall W.; O’Sullivan, Mary J.; Dinsmoor, Mara J.; Hankins, Gary D. V.; Caritis, Steve N.

    2015-01-01

    Objective To evaluate associations between fetal growth and weight at two years in infants born preterm using a customized approach for birth weight. Study Design This is a secondary analysis of a multicenter trial that included a two year follow up of children born prematurely. Customized birth weight percentiles were calculated using the Gardosi model for a US population, and the relation between customized percentile and weight and height at two years (adjusted for gender using z score) was determined using regression analysis and by comparing z scores for children with birth weight <10th versus ≥10th percentile. Results Weight z score at two years was significantly lower in the <10th versus ≥10th percentile group (median [IQR]: −0.66 [−1.58, −0.01] vs −0.23 [−1.05, 0.55]; p<0.001), and remained after adjusting for maternal education (p<0.001). A similar relationship was noted for height z score between groups. (median [IQR]: −0.56 [−1.29, 0.19] vs −0.24 [−0.99, 0.37]; p<0.001). Positive relationships between customized birth weight percentile and weight and height at two years were noted (p<0.001 for both), but were not strong (R2= 0.04 and 0.02, respectively). Conclusions Customized birth weight percentile is a minor determinant of weight at two years among children born preterm. PMID:25730133

  9. Can the Home Environment Promote Resilience for Children Born Very Preterm in the Context of Social and Medical Risk?

    ERIC Educational Resources Information Center

    Treyvaud, Karli; Inder, Terrie E.; Lee, Katherine J.; Northam, Elisabeth A.; Doyle, Lex W.; Anderson, Peter J.

    2012-01-01

    Relationships between the home environment and early developmental outcomes were examined in 166 children born very preterm in one tertiary maternity hospital to explore whether a more optimal home environment could promote resilience. In particular, we explored whether this effect was apparent over and above social risk and children's biological…

  10. Motor fMRI and cortical grey matter volume in adults born very preterm

    PubMed Central

    Lawrence, E.J.; Froudist-Walsh, S.; Neilan, R.; Nam, K.W.; Giampietro, V.; McGuire, P.; Murray, R.M.; Nosarti, C.

    2014-01-01

    The primary aim of this study was to investigate the functional neuroanatomy of motor planning, initiation and execution in a cohort of young adults (mean age 20 years) who were born very preterm (VPT; <33 weeks of gestation), as these individuals are at increased risk of experiencing neuromotor difficulties compared to controls. A cued motor task was presented to 20 right-handed VPT individuals and 20 controls within a functional magnetic resonance imaging (fMRI) paradigm. Whole-brain grey matter volume was also quantified and associations with functional data were examined. Despite comparable task performance, fMRI results showed that the VPT group displayed greater brain activation compared to controls in a region comprising the right cerebellum and the lingual, parahippocampal and middle temporal gyri. The VPT group also displayed decreased grey matter volume in the right superior frontal/premotor cortex and left middle temporal gyri. Grey matter volume in the premotor and middle temporal clusters was significantly negatively correlated with BOLD activation in the cerebellum. Overall, these data suggest that preterm birth is associated with functional neuronal differences that persist into adulthood, which are likely to reflect neural reorganisation following early brain injury. PMID:25016248

  11. Motor fMRI and cortical grey matter volume in adults born very preterm.

    PubMed

    Lawrence, E J; Froudist-Walsh, S; Neilan, R; Nam, K W; Giampietro, V; McGuire, P; Murray, R M; Nosarti, C

    2014-10-01

    The primary aim of this study was to investigate the functional neuroanatomy of motor planning, initiation and execution in a cohort of young adults (mean age 20 years) who were born very preterm (VPT; <33 weeks of gestation), as these individuals are at increased risk of experiencing neuromotor difficulties compared to controls. A cued motor task was presented to 20 right-handed VPT individuals and 20 controls within a functional magnetic resonance imaging (fMRI) paradigm. Whole-brain grey matter volume was also quantified and associations with functional data were examined. Despite comparable task performance, fMRI results showed that the VPT group displayed greater brain activation compared to controls in a region comprising the right cerebellum and the lingual, parahippocampal and middle temporal gyri. The VPT group also displayed decreased grey matter volume in the right superior frontal/premotor cortex and left middle temporal gyri. Grey matter volume in the premotor and middle temporal clusters was significantly negatively correlated with BOLD activation in the cerebellum. Overall, these data suggest that preterm birth is associated with functional neuronal differences that persist into adulthood, which are likely to reflect neural reorganisation following early brain injury. PMID:25016248

  12. Functional Neuroanatomy of Executive Function after Neonatal Brain Injury in Adults Who Were Born Very Preterm

    PubMed Central

    Kalpakidou, Anastasia K.; Allin, Matthew P. G.; Walshe, Muriel; Giampietro, Vincent; McGuire, Philip K.; Rifkin, Larry; Murray, Robin M.; Nosarti, Chiara

    2014-01-01

    Individuals who were born very preterm (VPT; <33 gestational weeks) are at risk of experiencing deficits in tasks involving executive function in childhood and beyond. In addition, the type and severity of neonatal brain injury associated with very preterm birth may exert differential effects on executive functioning by altering its neuroanatomical substrates. Here we addressed this question by investigating with functional magnetic resonance imaging (fMRI) the haemodynamic response during executive-type processing using a phonological verbal fluency and a working memory task in VPT-born young adults who had experienced differing degrees of neonatal brain injury. 12 VPT individuals with a history of periventricular haemorrhage and ventricular dilatation (PVH+VD), 17 VPT individuals with a history of uncomplicated periventricular haemorrhage (UPVH), 13 VPT individuals with no history of neonatal brain injury and 17 controls received an MRI scan whilst completing a verbal fluency task with two cognitive loads (‘easy’ and ‘hard’ letters). Two groups of VPT individuals (PVH+VD; n = 10, UPVH; n = 8) performed an n-back task with three cognitive loads (1-, 2-, 3-back). Results demonstrated that VPT individuals displayed hyperactivation in frontal, temporal, and parietal cortices and in caudate nucleus, insula and thalamus compared to controls, as demands of the verbal fluency task increased, regardless of type of neonatal brain injury. On the other hand, during the n-back task and as working memory load increased, the PVH+VD group showed less engagement of the frontal cortex than the UPVH group. In conclusion, this study suggests that the functional neuroanatomy of different executive-type processes is altered following VPT birth and that neural activation associated with specific aspects of executive function (i.e., working memory) may be particularly sensitive to the extent of neonatal brain injury. PMID:25438043

  13. Altered Gray Matter Volume and School Age Anxiety in Children Born Late Preterm

    PubMed Central

    Rogers, Cynthia E; Barch, Deanna M; Sylvester, Chad M; Pagliaccio, David; Harms, Michael P; Botteron, Kelly N; Luby, Joan L

    2014-01-01

    Objectives To determine if late preterm (LP) children differ from full term (FT) children in volumes of the cortex, hippocampus, corpus callosum, or amygdala and whether these differences are associated with anxiety symptoms at school-age. Study design LP children born between 34 and 36 weeks gestation and FT children born between 39 and 41 weeks gestation from a larger longitudinal cohort had MRI scans at school-age. Brain volumes, cortical surface area and thickness measures were obtained. Anxiety symptoms were assessed using a structured diagnostic interview annually beginning at preschool-age and following the MRI. Results LP children (n=21) had a smaller percentage of total, right parietal, and right temporal lobe gray matter volume than FT children (n=87). There were no differences in hippocampal, callosal, or amygdala volumes or cortical thickness. LP children also had a relative decrease in right parietal lobe cortical surface area. LP children had greater anxiety symptoms over all assessments. The relationship between late prematurity and school-age anxiety symptoms was mediated by the relative decrease in right temporal lobe volume. Conclusion LP children, comprising 70% of preterm children, are also at increased risk for altered brain development particularly in the right temporal and parietal cortices. Alterations in the right temporal lobe cortical volume may underlie the increased rate of anxiety symptoms among these LP children. These findings suggest that LP delivery may disrupt temporal and parietal cortical development that persists until school-age with the right temporal lobe conferring risk for elevated anxiety symptoms. PMID:25108541

  14. Moderate and late preterm infants exhibit widespread brain white matter microstructure alterations at term-equivalent age relative to term-born controls.

    PubMed

    Kelly, Claire E; Cheong, Jeanie L Y; Gabra Fam, Lillian; Leemans, Alexander; Seal, Marc L; Doyle, Lex W; Anderson, Peter J; Spittle, Alicia J; Thompson, Deanne K

    2016-03-01

    Despite the many studies documenting cerebral white matter microstructural alterations associated with very preterm birth (<32 weeks' gestation), there is a dearth of similar research in moderate and late preterm infants (born 32-36 weeks' gestation), who experience higher rates of neurodevelopmental delays than infants born at term (≥37 weeks' gestation). We therefore aimed to determine whether whole brain white matter microstructure differs between moderate and late preterm infants and term-born controls at term-equivalent age, as well as to identify potential perinatal risk factors for white matter microstructural alterations in moderate and late preterm infants. Whole brain white matter microstructure was studied in 193 moderate and late preterm infants and 83 controls at term-equivalent age by performing Tract-Based Spatial Statistics analysis of diffusion tensor imaging data. Moderate and late preterm infants had lower fractional anisotropy and higher mean, axial and radial diffusivities compared with controls in nearly 70 % of the brain's major white matter fiber tracts. In the moderate and late preterm group, being born small for gestational age and male sex were associated with lower fractional anisotropy, largely within the optic radiation, corpus callosum and corona radiata. In conclusion, moderate and late preterm infants exhibit widespread brain white matter microstructural alterations compared with controls at term-equivalent age, in patterns consistent with delayed or disrupted white matter microstructural development. These findings may underpin some of the neurodevelopmental delays observed in moderate and late preterm children. PMID:25739350

  15. Cognitive and behavioral aspects of executive functions in children born very preterm.

    PubMed

    Ritter, Barbara Catherine; Perrig, Walter; Steinlin, Maja; Everts, Regula

    2014-03-01

    This study investigated whether children aged between 8 and 12 years born very preterm (VPT) and/or at very low birth weight (VLBW) performed lower than same-aged term-born controls in cognitive and behavioral aspects of three executive functions: inhibition, working memory, and shifting. Special attention was given to sex differences. Fifty-two VPT/VLBW children (26 girls, 50%) born in the cohort of 1998-2003 and 36 same-aged term-born children (18 girls, 50%) were recruited. As cognitive measures, children completed tasks of inhibition (Color-Word Interference Test, D-KEFS; Delis, Kaplan, & Kramer, 2001), working memory (digit span backwards, HAWIK-IV; Petermann & Petermann, 2008), and shifting (Trail Making Test, number-letter-switching, D-KEFS; Delis et al., 2001). As behavioral measures, mothers completed the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000). Scales of interest were inhibit, working memory, and shift. Analyses of the cognitive aspects of executive functions revealed that VPT/VLBW children performed significantly lower than controls in the shifting task but not in the working memory and inhibition tasks. Analyses of behavioral aspects of executive functions revealed that VPT/VLBW children displayed more problems than the controls in working memory in everyday life but not in inhibition and shifting. No sex differences could be detected either in cognitive or behavioral aspects of executive functions. To conclude, cognitive and behavioral measures of executive functions were not congruent in VPT/VLBW children. In clinical practice, the combination of cognitive and behavioral instruments is required to disclose children's executive difficulties. PMID:23458400

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

    PubMed Central

    Padilla, Nelly; Skiöld, Béatrice; Eklöf, Eva; Mårtensson, Gustaf; Vollmer, Brigitte; Ådén, Ulrika

    2016-01-01

    Objective 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. Study Design 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. Results 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. Conclusion 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. PMID:26886451

  17. Preterm and postterm birth in immigrant- and Swedish-born parents: a population register-based study.

    PubMed

    Khanolkar, Amal R; Wedrén, Sara; Essén, Birgitta; Sparén, Pär; Koupil, Ilona

    2015-05-01

    Ethnic minorities/immigrant groups tend to have increased risk for preterm birth. Less is known about this risk in diverse immigrant groups, couples of mixed ethnic-origin and in relation to duration of residence. Data from the Swedish Medical Birth Register on 1,028,303 mothers who gave birth to 1,766,026 singleton live born infants (1982-2002), was linked to the Education and Total Population Registers. Immigrant parents were identified by country of birth. Risk of early preterm, late preterm and postterm birth was analyzed using multinomial logistic regression. Polish, Yugoslavian, Iranian, South Asian, East Asian and Sub-Saharan African parents, Swedish mothers who had children with non-Swedish fathers, and parents from two different immigrant groups had higher risk of early preterm birth [adjusted relative risk (RR) (95% CI) 1.76 (1.24-2.50), 1.57 (1.31-1.87), 1.67 (1.30-2.14), 1.52 (1.07-2.16), 1.51 (1.08-2.10), 2.03 (1.32-3.12), 1.56 (1.45-1.67), and 1.55 (1.35-1.77) respectively] compared to Swedish-born parents. South Asian, Sub-Saharan African, and East Asian immigrants had a higher risk of late preterm birth compared to Swedish-born parents. North African and Middle Eastern, Somali, and Ethiopian/Eritrean groups had increased risk of postterm birth [adjusted RR 1.31 (1.16-1.47), 2.57 (2.31-2.86), 1.85 (1.67-2.04) respectively]. Adjustment for covariates did not substantially change associations. Immigrant mothers resident <3 years had higher risk for early preterm and postterm birth compared to residents >10 years [adjusted RR 1.46 (1.24-1.71) and 1.16 (1.11-1.23) respectively]. In addition to higher risk of preterm birth in select immigrant groups, some immigrant groups are also at higher risk of postterm birth. Shorter duration of residence is associated with higher risk of non-term deliveries. PMID:25687167

  18. WHO Child Growth Standards Are Often Incorrectly Applied to Children Born Preterm in Epidemiologic Research.

    PubMed

    Perumal, Nandita; Gaffey, Michelle F; Bassani, Diego G; Roth, Daniel E

    2015-11-01

    In epidemiologic research, there is no standard approach for accounting for gestational age (GA) at birth when interpreting postnatal anthropometric data in analyses of cohorts that include children born preterm (CBP). A scoping review was conducted to describe analytical approaches to account for GA at birth when applying the WHO Growth Standards (WHO-GS) to anthropometric data in epidemiologic studies. We searched PubMed, Scopus, MEDLINE, Embase, and Web of Science for studies that applied WHO-GS, included CBP in the study population, had access to data within 1 mo of age, and were published between 2006 and 2015 in English. Of the 80 included studies that used the WHO-GS, 80% (64 of 80) included all children regardless of GA, whereas 20% (16 of 80) restricted analyses that used WHO-GS to term-born children. Among the 64 studies that included all children, 53 (83%) used chronological age and 11 (17%) used corrected age for CBP. Of the 53 studies that used chronological age, 12 (23%) excluded data that were likely contributed by CBP (e.g., very low birth weight or extremely low outlying z scores) and 19 (36%) adjusted for or stratified by GA at birth in regression analyses. In summary, researchers commonly apply WHO-GS to CBP, usually based on chronological age. Methodologic challenges of analyzing data from CBP in the application of WHO-GS were rarely explicitly addressed. Further efforts are required to establish acceptable approaches to account for heterogeneity in GA at birth in the analysis of post-term anthropometric data in epidemiologic research. PMID:26377758

  19. Using Geographical Information Systems to Explore Disparities in Preterm Birth Rates Among Foreign-born and U.S.-born Black Mothers

    PubMed Central

    Bloch, Joan Rosen

    2012-01-01

    Objective To examine spatial patterns of neighborhood contextual factors of stress with preterm birth (PTB) and nativity (foreign-born and U.S.-born) among Black mothers. Design Descriptive geographic-spatial research. Setting & Participants Births to Philadelphia residents during 2003–2005 in the context of Philadelphia residential neighborhoods (N = 350) were studied. Methods All data were aggregated to neighborhood levels (census tracts). Maps were created to assess geographic-spatial patterns. A geographic information system (GIS) database was created that imported geo-coded data on births, crime (assaults with guns and domestic abuse), poverty, race, and nativity (foreign-born vs. U.S.-born). Results Clear visual patterns of “bad” neighborhoods emerged and were significantly associated with higher prevalence of PTB for foreign-born Black and U.S.-born Black mothers (p < .0001). Conclusions This study demonstrated how GIS visually clarified important spatial patterns of adverse living conditions and PTB prevalence. Nurses can use GIS to better understand living environments of mothers and their families and to target interventions in geographical areas with the greatest service needs. Further research on individual and contextual factors is warranted to address the observed health disparities among the heterogeneous groups of foreign-born Black mothers. Despite limitations of aggregate data, it is clear that where mothers live matters. This has important implications for nursing practice and policy. PMID:22273411

  20. The renin–angiotensin–aldosterone system in adolescent offspring born prematurely to mothers with preeclampsia

    PubMed Central

    Washburn, Lisa K; Brosnihan, K Bridget; Chappell, Mark C; Diz, Debra I; Gwathmey, TanYa M; Nixon, Patricia A; Russell, Gregory B; Snively, Beverly M; O’Shea, T Michael

    2014-01-01

    Hypothesis/introduction Preeclampsia is associated with alterations in the maternal renin–angiotensin–aldosterone system (RAAS), increased blood pressure (BP), and cardiovascular risk in the offspring. We hypothesized that preeclampsia is associated with alterations in the RAAS in the offspring that persist into adolescence. Materials and methods We compared components of the circulating (n = 111) and renal (n = 160) RAAS in adolescents born prematurely with very low birth weight (VLBW) of preeclamptic (PreE) and normotensive (NoHTN) pregnancies. Multivariable linear regression was used to evaluate potential confounding and intermediate variables. Analyses were stratified by sex. Results Adjusting for race and antenatal steroid exposure, male offspring of PreE mothers had higher circulating aldosterone than those of NoHTN mothers (adjusted mean difference = 109; 95% confidence limits: −9, 227 pmol/L). Further adjustment for current BMI attenuated this difference (adjusted mean difference: 93; 95% confidence limits: −30, 215 pmol/L). Conclusion Among male preterm VLBW infants, maternal preeclampsia is associated with increased circulating aldosterone level in adolescence, which appears to be mediated in part by higher BMI. PMID:24737639

  1. Socio-Economic Achievements of Individuals Born Very Preterm at the Age of 27 to 29 Years: A Nationwide Cohort Study

    ERIC Educational Resources Information Center

    Mathiasen, Rene; Hansen, Bo M.; Anderson, Anne-Marie Nybo; Greisen, Gorm

    2009-01-01

    Aim: To describe the socio economic achievement of individuals born very preterm (VPT) at the age of 27 to 29 years. Method: Demographic and social data were extracted from national registers for all individuals born between 1974 and 1976 in Denmark (n = 208 656). Of these, 203 283 individuals were alive in 2006. We compared VPT individuals…

  2. Neonatal brain abnormalities associated with autism spectrum disorder in children born very preterm.

    PubMed

    Ure, Alexandra M; Treyvaud, Karli; Thompson, Deanne K; Pascoe, Leona; Roberts, Gehan; Lee, Katherine J; Seal, Marc L; Northam, Elisabeth; Cheong, Jeanie L; Hunt, Rod W; Inder, Terrie; Doyle, Lex W; Anderson, Peter J

    2016-05-01

    Very preterm (VP) survivors are at increased risk of autism spectrum disorder (ASD) compared with term-born children. This study explored whether neonatal magnetic resonance (MR) brain features differed in VP children with and without ASD at 7 years. One hundred and seventy-two VP children (<30 weeks' gestation or <1250 g birth weight) underwent structural brain MR scans at term equivalent age (TEA; 40 weeks' gestation ±2 weeks) and were assessed for ASD at 7 years of age. The presence and severity of white matter, cortical gray matter, deep nuclear gray matter, and cerebellar abnormalities were assessed, and total and regional brain volumes were measured. ASD was diagnosed using a standardized parent report diagnostic interview and confirmed via an independent assessment. Eight VP children (4.7%) were diagnosed with ASD. Children with ASD had more cystic lesions in the cortical white matter at TEA compared with those without ASD (odds ratio [OR] 8.7, 95% confidence interval [CI] 1.5, 51.3, P = 0.02). There was also some evidence for smaller cerebellar volumes in children with ASD compared with those without ASD (OR = 0.82, CI = 0.66, 1.00, P = 0.06). Overall, the results suggest that VP children with ASD have different brain structure in the neonatal period compared with those who do not have ASD. Autism Res 2016, 9: 543-552. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. PMID:26442616

  3. Comparison in Outcomes at Two-Years of Age of Very Preterm Infants Born in 2000, 2005 and 2010

    PubMed Central

    Abily-Donval, Lénaïg; Pinto-Cardoso, Gaëlle; Chadie, Alexandra; Guerrot, Anne-Marie; Torre, Stéphanie; Rondeau, Stéphane; Marret, Stéphane

    2015-01-01

    Objective To investigate alteration in 2-year neurological/behavioral outcomes of very preterm infants born in a French level three neonatal intensive care unit. Methods We conducted a prospective, comparative study of very preterm infants born before 33 weeks’ gestation at 5-year intervals in 2000, 2005 and 2010 at Rouen University Hospital. Neonatal mortality/morbidities, ante- and neonatal treatments, and at age 2 years motor, cognitive and behavioral data were collected by standardized questionnaires. Results We included 536 very preterm infants. Follow-up rates at two years old were 78% in 2000, 93% in 2005 and 92% in 2010 respectively. No difference in gestational age, birthweight, neonatal mortality/morbidities was observed except a decrease in low grade subependymal/intraventricular hemorrhages. Care modifications concerned use of antenatal magnesium sulfate, breast-feeding and post-natal corticosteroid therapy. Significant improvement in motor outcome and dramatic decrease in cerebral palsy rates (12% in 2000, 6% in 2005, 1% in 2010, p<0.001) were observed, as were improvements in feeding behavior. Although a non significant difference to better psychosocial behavior was reported, there was no difference in cognitive outcome. Conclusions Improvement in neuromotor outcome and behavior was reported. This could be due to multiple modifications in care: including administration of magnesium sulfate to women at risk of preterm birth, increase in breast-feeding, decrease in low grade subependymal/intraventricular hemorrhages, and decrease in post-natal corticosteroid therapy, all of which require further investigation in other studies. Extended follow-up until school age is mandatory for better detection of cognitive, learning and behavioral disorders. PMID:25658321

  4. Downward economic mobility and preterm birth: an exploratory study of Chicago-born upper class White mothers.

    PubMed

    Collins, James W; Rankin, Kristin M; David, Richard J

    2015-07-01

    A paucity of published data exists on the factors underlying the relatively poor birth outcome of non-Hispanic White women in the United States. To determine whether downward economic mobility is a risk factor for preterm birth (<37 weeks, PTB) among upper class-born White women. Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational dataset of non-Hispanic White infants (1989-1991) and their women (1956-1976) with appended US census income information. The study sample was restricted to singleton births of Chicago-born upper-class (defined by early-life residence in affluent neighborhoods) non-Hispanic White women. Upper class-born White women (n = 4,891) who did not experience downward economic mobility by the time of delivery had a PTB rate of 5.4 %. Those women who experienced slight (n = 5,112), moderate (n = 2,158), or extreme (n = 339) downward economic mobility had PTB rates of 6.5, 8.5, and 10.1 %, respectively; RR (95 % CI) = 1.2 (1.0-4.0), 1.6 (1.3-1.9), and 1.9 (1.3-2.6), respectively. Maternal downward economic mobility was also associated with an increased prevalence of biologic, medical, and behavioral risk factors. Interestingly, the relationship between moderate to extreme downward mobility and preterm birth was stronger among former low birth weight (<2500 g, LBW) than non-LBW women: 2.8 (1.4-5.8) versus 1.6 (1.3-1.9), respectively. In multilevel logistic regression models, the adjusted odds ratio of preterm birth for former LBW and non-LBW women who experienced any downward mobility (compared to those women with lifelong upper class status) equaled 2.4 (1.1-5.3) and 1.1 (1.0-1.1), respectively. Downward economic mobility is associated with an increased risk of preterm birth among upper class-born White urban women; this phenomenon is strongest among former low birth weight women. PMID:25656715

  5. Behaviour Difficulties and Cognitive Function in Children Born Very Prematurely

    ERIC Educational Resources Information Center

    Bayless, Sarah; Pit-ten Cate, Ineke M.; Stevenson, Jim

    2008-01-01

    Children born very prematurely are at risk of low average IQ and behaviour difficulties throughout childhood and adolescence. Associations among preterm birth, IQ and behaviour have been reported; however, the nature of the relationship among these outcomes is not fully understood. Some studies have proposed that the consequences of preterm birth,…

  6. Low Exercise Capacity Increases the Risk of Low Cognitive Function in Healthy Young Men Born Preterm: A Population-Based Cohort Study

    PubMed Central

    Svedenkrans, Jenny; Kowalski, Jan; Norman, Mikael; Bohlin, Kajsa

    2016-01-01

    Background Preterm birth is a risk factor for decreased exercise capacity and impaired cognitive functions in later life. The objective of this study was to disentangle the associations between preterm birth, physical fitness and cognitive performance in young adulthood. Methods This population-based cohort study included 218,802 young men born in Sweden 1973–1983. Data on birth characteristics was obtained from the Medical Birth Register and linked to exercise capacity assessed by ergometer cycling and cognitive tests performed at conscription for military service in 1993–2001. Cognitive performance was assessed using stanine (STAndard NINE) scores. The results were adjusted for socioeconomic factors. Results Exercise capacity was positively associated with cognitive performance across all gestational ages. The sub-group of men who were born extremely preterm (gestational age <28 weeks) and had low exercise capacity exhibited the lowest odds ratio (OR = 0.26, 95%CI:0.09–0.82) of having a cognitive function above the mean stanine score (2.9) for men born at term with normal birth weight. Men born extremely preterm with a high exercise capacity had similar or even higher ORs for cognitive function (OR = 0.59; 95% CI:0.35–0.99) than men born at term with low Wmax (OR = 0.57; 95% CI:0.55–0.59). Conclusions Physical fitness is associated with higher cognitive function at all gestational ages, also in young men born extremely preterm. Targeting early physical exercise may be a possible intervention to enhance cognitive performance and educational achievements in populations at risk, such as childhood and adult survivors of preterm birth. PMID:27548612

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

    PubMed Central

    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

    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, 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. Results 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. Conclusion 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. PMID:26193474

  8. Working memory in preterm-born adults: load-dependent compensatory activity of the posterior default mode network.

    PubMed

    Daamen, Marcel; Bäuml, Josef G; Scheef, Lukas; Sorg, Christian; Busch, Barbara; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter; Wohlschläger, Afra; Boecker, Henning

    2015-03-01

    Premature birth is associated with an increased risk of cognitive performance deficits that are dependent on working memory (WM) load in childhood. Less clear is whether preterm-born adults show similar WM impairments, or develop compensatory brain mechanisms that help to overcome prematurity-related functional deficits, for example, by a workload-dependent over-recruitment of WM-typical areas, and/or engagement of alternative brain networks. In this functional magnetic resonance imaging study, 73 adults born very preterm and/or with very low birth weight (VP/VLBW) and 73 term-born controls (CON, mean age: 26.5 years) performed a verbal N-Back paradigm with varying workload (0-back, 1-back, 2-back). Generally, both groups showed similar performance accuracy and task-typical patterns of brain activations (especially in fronto-cingulo-parietal, thalamic, and cerebellar areas) and deactivations (especially in mesial frontal and parietal aspects of the default mode network [DMN]). However, VP/VLBW adults showed significantly stronger deactivations (P < 0.05, cluster-level corrected) than CON in posterior DMN regions, including right ventral precuneus, and right parahippocampal areas (with adjacent cerebellar areas), which were specific for the most demanding 2-back condition. Consistent with a workload-dependent effect, VP/VLBW adults with stronger deactivations (1-back > 2-back) in the parahippocampal/cerebellar cluster also presented a greater slowing of response latencies with increasing WM load (2-back > 1-back), indicative of higher effort. In conclusion, VP/VLBW adults recruited similar anatomical networks as controls during N-back performance, but showed an enhanced suppression of posterior DMN regions during higher workload, which may reflect a temporary suppression of stimulus-independent thoughts that helps to maintain adequate task performance with increasing attentional demands. PMID:25413496

  9. Delayed early developmental trajectories of white matter tracts of functional pathways in preterm-born infants: Longitudinal diffusion tensor imaging data

    PubMed Central

    Chang, Linda; Akazawa, Kentaro; Yamakawa, Robyn; Hayama, Sara; Buchthal, Steven; Alicata, Daniel; Andres, Tamara; Castillo, Deborrah; Oishi, Kumiko; Skranes, Jon; Ernst, Thomas; Oishi, Kenichi

    2016-01-01

    Probabilistic maps of white matter pathways related to motor, somatosensory, auditory, visual, and limbic functions, and major white matter tracts (the corpus callosum, the inferior fronto-occipital fasciculus, and the middle cerebellar peduncle) were applied to evaluate the developmental trajectories of these tracts, using longitudinal diffusion tensor imaging (DTI) obtained in term-born and preterm-born healthy infants. Nineteen term-born and 30 preterm-born infants completed MR scans at three time points: Time-point 1, 41.6±2.7 postmenstrual weeks; Time-point 2, 46.0±2.9 postmenstrual weeks; and Time-point 3, 50.8±3.7 postmenstrual weeks. The DTI-derived scalar values (fractional anisotropy, eigenvalues, and radial diffusivity) of the three time points are available in this Data article. PMID:26958632

  10. The power of early interventions in families with preterm born children.

    PubMed

    Landsem, Inger Pauline

    2016-05-01

    The Tromsø Intervention Study on Preterms (TISP) started in 1999 and we may now present results on children's socio-emotional and behavioural development, parental wellbeing and perceptions of the children's quality of life until children's age of nine. PMID:27214412

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

    ERIC Educational Resources Information Center

    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…

  12. Probabilistic maps of the white matter tracts with known associated functions on the neonatal brain atlas: Application to evaluate longitudinal developmental trajectories in term-born and preterm-born infants.

    PubMed

    Akazawa, Kentaro; Chang, Linda; Yamakawa, Robyn; Hayama, Sara; Buchthal, Steven; Alicata, Daniel; Andres, Tamara; Castillo, Deborrah; Oishi, Kumiko; Skranes, Jon; Ernst, Thomas; Oishi, Kenichi

    2016-03-01

    Diffusion tensor imaging (DTI) has been widely used to investigate the development of the neonatal and infant brain, and deviations related to various diseases or medical conditions like preterm birth. In this study, we created a probabilistic map of fiber pathways with known associated functions, on a published neonatal multimodal atlas. The pathways-of-interest include the superficial white matter (SWM) fibers just beneath the specific cytoarchitectonically defined cortical areas, which were difficult to evaluate with existing DTI analysis methods. The Jülich cytoarchitectonic atlas was applied to define cortical areas related to specific brain functions, and the Dynamic Programming (DP) method was applied to delineate the white matter pathways traversing through the SWM. Probabilistic maps were created for pathways related to motor, somatosensory, auditory, visual, and limbic functions, as well as major white matter tracts, such as the corpus callosum, the inferior fronto-occipital fasciculus, and the middle cerebellar peduncle, by delineating these structures in eleven healthy term-born neonates. In order to characterize maturation-related changes in diffusivity measures of these pathways, the probabilistic maps were then applied to DTIs of 49 healthy infants who were longitudinally scanned at three time-points, approximately five weeks apart. First, we investigated the normal developmental pattern based on 19 term-born infants. Next, we analyzed 30 preterm-born infants to identify developmental patterns related to preterm birth. Last, we investigated the difference in diffusion measures between these groups to evaluate the effects of preterm birth on the development of these functional pathways. Term-born and preterm-born infants both demonstrated a time-dependent decrease in diffusivity, indicating postnatal maturation in these pathways, with laterality seen in the corticospinal tract and the optic radiation. The comparison between term- and preterm-born

  13. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010

    PubMed Central

    Lee, Anne CC; Katz, Joanne; Blencowe, Hannah; Cousens, Simon; Kozuki, Naoko; Vogel, Joshua P; Adair, Linda; Baqui, Abdullah H; Bhutta, Zulfiqar A; Caulfield, Laura E; Christian, Parul; Clarke, Siân E; Ezzati, Majid; Fawzi, Wafaie; Gonzalez, Rogelio; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Marchant, Tanya; Merialdi, Mario; Mongkolchati, Aroonsri; Mullany, Luke C; Ndirangu, James; Newell, Marie-Louise; Nien, Jyh Kae; Osrin, David; Roberfroid, Dominique; Rosen, Heather E; Sania, Ayesha; Silveira, Mariangela F; Tielsch, James; Vaidya, Anjana; Willey, Barbara A; Lawn, Joy E; Black, Robert E

    2013-01-01

    Summary Background National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 g), in 138 countries of low and middle income in 2010. Methods Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal and Perinatal Health (23 countries) were used to model the prevalence of term-SGA births. Prevalence of preterm-SGA infants was calculated from meta-analyses. Findings In 2010, an estimated 32·4 million infants were born small for gestational age in low-income and middle-income countries (27% of livebirths), of whom 10·6 million infants were born at term and low birthweight. The prevalence of term-SGA babies ranged from 5·3% of livebirths in east Asia to 41·5% in south Asia, and the prevalence of preterm-SGA infants ranged from 1·2% in north Africa to 3·0% in southeast Asia. Of 18 million low-birthweight babies, 59% were term-SGA and 41% were preterm. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were born in India, Pakistan, Nigeria, and Bangladesh. Interpretation The burden of small-for-gestational-age births is very high in countries of low and middle income and is concentrated in south Asia. Implementation of effective interventions for babies born too small or too soon is an urgent priority to increase survival and reduce disability, stunting, and non-communicable diseases. Funding Bill & Melinda Gates Foundation by a grant to the US Fund for UNICEF to

  14. Ethnic Identity and Its Relation to Personal Self-Esteem: A Comparison of Canadian-Born and Foreign-Born Chinese Adolescents.

    ERIC Educational Resources Information Center

    Lay, Clarry; Verkuyten, Maykel

    1999-01-01

    Examines ethnic identity and its relation to personal self-esteem by comparing Chinese adolescents who immigrated to Canada and Canadian-born Chinese adolescents. Finds that aspects of collective self-esteem were positively related to personal self-esteem for the foreign-born group, not the Canadian-born group. (CMK)

  15. Postural Complexity Influences Development in Infants Born Preterm With Brain Injury: Relating Perception-Action Theory to 3 Cases

    PubMed Central

    Izzo, Theresa; Thacker, Leroy R.; Galloway, James Cole

    2014-01-01

    Background and Purpose Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. Case Description Three infants born preterm with periventricular white matter injury were included. Outcomes Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. Discussion Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury. PMID:24903116

  16. Risk and Resilience in Preterm Children at Age 6

    PubMed Central

    Poehlmann, Julie; Gerstein, Emily D.; Burnson, Cynthia; Weymouth, Lindsay; Bolt, Daniel M.; Maleck, Sarah; Schwichtenberg, A.J.

    2016-01-01

    Children born preterm are at risk for experiencing significant deleterious developmental outcomes throughout their childhood and adolescence. However, individual variation and resilience are hallmarks of the preterm population. The present study examined pathways to resilience across multiple domains (e.g. social activities, peer relations, ADHD symptomology, externalizing and internalizing behavior, sleep quality) as children born preterm reached school age. The study also examined early child and family predictors of resilience. Using a prospective longitudinal design, 173 infants born preterm and without significant neurological complications were assessed at 5 timepoints: NICU discharge, 9 months, 16 months, 24 months, and 6 years. Three pathways of adaptation emerged at 6 years: children who were resilient, those who remained at-risk, and children who exhibited significant difficulties. Resilient children were less likely to have experienced negative parenting at 9 and 16 months, more likely to delay gratification at 24 months, and more likely to experience neonatal health complications than non-resilient children. PMID:25196017

  17. Should we definitively abandon prophylaxis for patent ductus arteriosus in preterm new-borns?

    PubMed Central

    Fanos, Vassilios; Pusceddu, Michele; Dessì, Angelica; Marcialis, Maria Antonietta

    2011-01-01

    Although the prophylactic administration of indomethacin in extremely low-birth weight infants reduces the frequency of patent ductus arteriosus and severe intraventricular hemorrhage, it does not appear to provide any long-term benefit in terms of survival without neurosensory and cognitive outcomes. Considering the increased drug-induced reduction in renal, intestinal, and cerebral blood flow, the use of prophylaxis cannot be routinely recommended in preterm neonates. However, a better understanding of the genetic background of each infant may allow for individualized prophylaxis using NSAIDs and metabolomics. PMID:22189742

  18. What about the Dads: A Case Study of Young Fathers of Babies Born to Adolescent Mothers

    ERIC Educational Resources Information Center

    Scholl, Marilyn Faris

    2012-01-01

    Adolescent pregnancy remains a persistent societal problem. Both teenage mothers and the fathers of their babies are unprepared for parenthood and often drop out of school, take low-paying jobs, and never complete their education. Fathers of babies born to adolescent mothers are a critical but often forgotten component of the adolescent pregnancy…

  19. Epicardial fat thickness, an emerging cardiometabolic risk factor, is increased in young adults born preterm.

    PubMed

    Bassareo, P P; Fanos, V; Puddu, M; Marras, S; Mercuro, G

    2016-08-01

    Preterm birth and epicardial fat thickness (EFT) constitute novel risk factors for the onset of future adverse cardiovascular events. In total, 30 ex-extremely low birth weight (ex-ELBW) subjects (10 males, 20 females, aged 17-28) were enrolled and compared with 30 healthy peers. EFT was significantly higher (8.7±0.7 mm v. 5.6±0.9 mm; P<0.001) in ex-ELBW than in controls and was correlated with birth weight (r=-0.47, P=0.0009), gestational age (r=-0.39, P=0.03) and cardiac left ventricular mass (r=0.51, P=0.004). When excluding the influence of body mass index, birth weight was the sole remaining determinant of EFT, irrespective of gestational age (r=-0.37, P=0.04). The same findings when excluding the possible influence of blood pressure values on the cardiac structures (r=-0.40, P=0.028). In conclusion, EFT is significantly higher in former preterm subjects and is likewise associated with an increase in left ventricular mass. In view of the acknowledged correlation between the latter and an increased incidence of cardiovascular diseases, EFT appears to be an easy-to-measure tool capable of predicting the likely development of future adverse cardiovascular events in these subjects. PMID:27256709

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

    PubMed

    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. PMID:26031342

  1. Preterm infants--odontological aspects.

    PubMed

    Rythén, Marianne

    2012-01-01

    Preterm birth is associated with medical complications and treatments postnatally and disturbances in growth and development. Primary and permanent teeth develop during this postnatal period. The overall aim of the present thesis was to elucidate the effects of preterm birth and postnatal complications on oral health and the dentoalveolar development during adolescence, and to study the effects of preterm birth on caries during childhood, in a well-defined group of preterm infants. In the same group, explore the development of the primary and permanent teeth and compare the results with a matched control group and control teeth. The subjects consisted of 40 (45) of 56 surviving infants, born < 29 weeks of gestational age (GA), and matched healthy children born at term. The material consisted of 44 teeth from 14 of the preterm adolescents and 36 control teeth from healthy children. Clinical examinations and dental cast analysis were performed during adolescence and morbidity was noted. Retrospective information from medical and dental records was obtained. Dental enamel was analyzed in a polarized light microscopy, and scanning electron microscopy. Further, chemical analyses of enamel and dentin were performed with X-ray microanalysis. The results showed that during adolescence, more preterms had plaque and gingival inflammation, lower salivary secretion, more S. mutans and severe hypomineralization. Retrospectively, less caries was noted at six years of age, but more children had hypomineralization in the primary dentition. Angle Class II malocclusion, large over-bite and deep bite associated with medical diagnoses were frequent. Furthermore, smaller dental arch perimeters in girls, at 16 years of age, and smaller tooth size in the incisors, canines and first molars were found. The morphological findings were confirmed in the XRMA analyses. In postnatal enamel, varying degrees of porosities > 5% and incremental lines were seen. Lower values of Ca and Ca/C ratio and

  2. Neuropsychological analysis of the visuomotor problems in children born preterm at < or = 32 weeks of gestation: a 5-year prospective follow-up.

    PubMed

    Luoma, L; Herrgård, E; Martikainen, A

    1998-01-01

    Forty-six intellectually normal children born preterm (< or =32 weeks of gestation) without major neurological disabilities and a control group of term children matched for age, sex, and parental educational and occupational status were assessed at the age of 5 years using neuropsychological tests emphasizing perceptual and visuomotor functions. The results show that in terms of cognitive functions these preterm children are a very heterogenous group, but many of them still have problems in visuospatial and sensorimotor functions. The preterm children achieved lower mean scores in tests where coordination and voluntary control of hands in combination with tactile, kinaesthetic, and visuospatial perception were needed. They had most difficulty with drawing directions of lines and in integrating two or more forms. They also had problems with 3-dimensional constructions as well as visual perception of rotated shapes or slopes of lines. PMID:9459213

  3. How do you think she feels? Vulnerability in empathy and the role of attention in school-aged children born extremely preterm.

    PubMed

    Campbell, Catherine; Horlin, Chiara; Reid, Corinne; McMichael, Judy; Forrest, Laura; Brydges, Chris; French, Noel; Anderson, Mike

    2015-09-01

    The aim of this study was to examine empathic competence in children born extremely preterm (EP, <28 weeks) given vulnerabilities in social relationships. Empathy in typically developing children is mediated by executive functions. Executive functioning is also impaired in preterm children. Of particular interest in this study are the attentional components of executive functioning as mediators of empathic development. Thirty-two 7-year-old EP children and 40 age-matched term children participated in the Project K.I.D.S program and completed the Kids Empathy Development Scale (KEDS), Wechsler Intelligence Scale for Children (WISC-IV), and Test of Everyday Attention for Children (TEA-Ch). Children born extremely preterm exhibited poorer performance on all measures. The mediating role of attention in empathy competence was not supported by mediation modelling when FSIQ was controlled. As predicted, the EP group showed weaker empathic development relative to typically developing children. They also showed poorer attentional abilities. However, the effect of preterm birth on empathy was not mediated by executive-level attention. The cognitive mechanisms underpinning poor empathy competence in EP children remain unclear. Future research needs to examine the role of inhibition, social-emotional recognition, and regulation. PMID:26061791

  4. Survival, Morbidity, Growth and Developmental Delay for Babies Born Preterm in Low and Middle Income Countries – A Systematic Review of Outcomes Measured

    PubMed Central

    Gladstone, Melissa; Oliver, Clare; Van den Broek, Nynke

    2015-01-01

    Background 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. Methods 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. Findings 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. Conclusions 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

  5. fMRI Evidence for Dorsal Stream Processing Abnormality in Adults Born Preterm

    ERIC Educational Resources Information Center

    Chaminade, Thierry; Leutcher, Russia Ha-Vinh; Millet, Veronique; Deruelle, Christine

    2013-01-01

    We investigated the consequences of premature birth on the functional neuroanatomy of the dorsal stream of visual processing. fMRI was recorded while sixteen healthy participants, 8 (two men) adults (19 years 6 months old, SD 10 months) born premature (mean gestational age 30 weeks), referred to as Premas, and 8 (two men) matched controls (20…

  6. Comparison at 32-37 Weeks Postconception of Infants Born 1983-1989 and 1995-2004 on the Neurobehavioral Assessment of the Preterm Infant

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger; Sampers, Jackie S.; Korner, Anneliese F.; Constantinou, Janet C.; Anand, K. J. S.

    2008-01-01

    In spite of numerous recent outcome studies of extremely low birth weight (ELBW) infants, no data exist on their development prior to term. In this study we traced and compared the neurobehavioral development of 251 ELBW (less than 1,000 g) and 240 low birth weight (LBW; 1,000 g-2,500 g) preterms born between 1995 and 2004 from 32 to 37 weeks…

  7. Cognitive Profile in Young Adults Born Preterm at Very Low Birthweight

    ERIC Educational Resources Information Center

    Lohaugen, Gro C. C.; Gramstad, Arne; Evensen, Kari Anne I.; Martinussen, Marit; Lindqvist, Susanne; Indredavik, Marit; Vik, Torstein; Brubakk, Ann-Mari; Skranes, Jon

    2010-01-01

    Aim: The aim of this study was to assess cognitive function at the age of 19 years in individuals of very low birthweight (VLBW; less than or equal to 1500g) and in term-born comparison individuals. Method: In this hospital-based follow-up study, 55 VLBW participants (30 males, 25 females; mean birthweight 1217g, SD 233g; mean gestational age…

  8. Stress and Coping among Migrant and Local-Born Adolescents in Hong Kong

    ERIC Educational Resources Information Center

    Tam, Vicky Chiu-Wan; Lam, Rebecca Siu-Yuk

    2005-01-01

    This study compared stress and coping among 243 migrant and 750 local-born Chinese adolescents in Hong Kong. Findings showed that compared to their local-born counterparts, migrants showed no difference in perceived stress, whereas they were less likely to use withdrawal coping and showed higher self-esteem and less delinquent behavior. Adjustment…

  9. Individual Differences In The School Performance of 2nd-Grade Children Born to Low-Income Adolescent Mothers

    ERIC Educational Resources Information Center

    Apiwattanalunggarn, Kunlakarn Lekskul; Luster, Tom

    2005-01-01

    The purpose of this study was to investigate factors that contribute to individual differences in the school performance of 2nd-grade children born to adolescent mothers. The sample of this study was 90 low-income adolescent mothers and their children. Data were collected from the adolescent mothers and their first-born children, now in 2nd grade,…

  10. Alterations in Functional Connectivity for Language in Prematurely Born Adolescents

    ERIC Educational Resources Information Center

    Schafer, Robin J.; Lacadie, Cheryl; Vohr, Betty; Kesler, Shelli R.; Katz, Karol H.; Schneider, Karen C.; Pugh, Kenneth R.; Makuch, Robert W.; Reiss, Allan L.; Constable, R. Todd; Ment, Laura R.

    2009-01-01

    Recent data suggest recovery of language systems but persistent structural abnormalities in the prematurely born. We tested the hypothesis that subjects who were born prematurely develop alternative networks for processing language. Subjects who were born prematurely (n = 22; 600-1250 g birth weight), without neonatal brain injury on neonatal…

  11. Neighborhood Disadvantage, Racial Concentration and the Birthweight of Infants born to Adolescent Mothers

    PubMed Central

    Madkour, Aubrey Spriggs; Harville, Emily Wheeler; Xie, Yiqiong

    2013-01-01

    Objective To study the relationship between neighborhood demographic characteristics (disadvantage, racial concentration) and the birthweight of infants born to adolescent mothers, potentially as mediated by smoking, prenatal care use, or perceptions of neighborhood safety. Methods Data from Waves I and IV of the National Longitudinal Survey of Adolescent Health were analyzed. Birthweight (continuous) and low birthweight (<2.5 kg) of singleton infants born to non-Hispanic Black and non-Hispanic White adolescent mothers (<20 years) after Wave I were examined as outcomes. Neighborhood demographic characteristics included Census Block Group socioeconomic disadvantage and Black racial concentration. Possible mediators (smoking during pregnancy, early initiation of prenatal care, and perceptions of safety) were also examined. Controls for adolescent baseline age, age at pregnancy, body mass index (BMI) and parental education were included. Analyses were run stratified on race. Results Baseline continuous birthweight, BMI and neighborhood demographics varied significantly between non-Hispanic Black and White adolescent mothers, with Black adolescent mothers evidencing lower birthweight and higher BMI, neighborhood disadvantage and Black racial concentration. In multivariable analyses among Black adolescent mothers, Black racial concentration was positively associated with birthweight, and negatively associated with low birthweight; no mediators were supported. Neighborhood disadvantage and Black racial concentration were unassociated with birthweight outcomes among White adolescent mothers. Conclusions Infants born to Black adolescent mothers evidenced higher birthweight with increasing Black neighborhood concentration. Further exploration of mechanisms by which Black racial concentration may positively impact birthweight is warranted. PMID:23771237

  12. Predicting School Readiness from Neurodevelopmental Assessments at Age 2 Years after Respiratory Distress Syndrome in Infants Born Preterm

    ERIC Educational Resources Information Center

    Patrianakos-Hoobler, Athena I.; Msall, Michael E.; Huo, Dezheng; Marks, Jeremy D.; Plesha-Troyke, Susan; Schreiber, Michael D.

    2010-01-01

    Aim: To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth. Method: Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric…

  13. fMRI evidence for dorsal stream processing abnormality in adults born preterm.

    PubMed

    Chaminade, Thierry; Leutcher, Russia Ha-Vinh; Millet, Véronique; Deruelle, Christine

    2013-02-01

    We investigated the consequences of premature birth on the functional neuroanatomy of the dorsal stream of visual processing. fMRI was recorded while sixteen healthy participants, 8 (two men) adults (19 years 6 months old, SD 10 months) born premature (mean gestational age 30 weeks), referred to as Premas, and 8 (two men) matched controls (20 years 1 month old, SD 13 months), performed a 1-back memory task of Object or Grip information using a hand grasping a drinking vessel as stimulus. While history of prematurity did not significantly affect task performance, Group by Task analysis of variance in regions of interest spanning the occipital, temporal and parietal lobes revealed main effects of Task and interactions between the two factors. Object processing activated the left inferior occipital cortex and bilateral ventral temporal regions, belonging to the ventral stream, with no effect of Group. Grip processing across groups activated the early visual cortex and the left supramarginal gyrus belonging to the dorsal stream. Group effect on the brain activity during Grip suggested that Controls represented the actions' goal while Premas relied more on low-level visual information. This shift from higher- to lower-order visual processing between Controls and Premas may reflect a more general trend, in which Premas inadequately recruit higher-order visual functions for dorsal stream task performance, and rely more on lower-level functions. PMID:23174430

  14. Outcomes of intraventricular hemorrhage and posthemorrhagic hydrocephalus in a population-based cohort of very preterm infants born to residents of Nova Scotia from 1993 to 2010.

    PubMed

    Radic, Julia A E; Vincer, Michael; McNeely, P Daniel

    2015-06-01

    OBJECT Intraventicular hemorrhage (IVH) is a common complication of preterm birth, and the prognosis of IVH is incompletely characterized. The objective of this study was to describe the outcomes of IVH in a population-based cohort with minimal selection bias. METHODS All very preterm (≥ 30 completed weeks) patients born in the province of Nova Scotia were included in a comprehensive database. This database was screened for infants born to residents of Nova Scotia from January 1, 1993, to December 31, 2010. Among very preterm infants successfully resuscitated at birth, the numbers of infants who died, were disabled, developed cerebral palsy, developed hydrocephalus, were blind, were deaf, or had cognitive/language scores assessed were analyzed by IVH grade. The relative risk of each outcome was calculated (relative to the risk for infants without IVH). RESULTS Grades 2, 3, and 4 IVH were significantly associated with an increased overall mortality, primarily in the neonatal period, and the risk increased with increasing grade of IVH. Grade 4 IVH was significantly associated with an increased risk of disability (RR 2.00, p < 0.001), and the disability appeared to be primarily due to cerebral palsy (RR 6.07, p < 0.001) and cognitive impairment (difference in mean MDI scores between Grade 4 IVH and no IVH: -19.7, p < 0.001). No infants with Grade 1 or 2 IVH developed hydrocephalus, and hydrocephalus and CSF shunting were not associated with poorer outcomes when controlling for IVH grade. CONCLUSIONS Grades 1 and 2 IVH have much better outcomes than Grades 3 or 4, including a 0% risk of hydrocephalus in the Grade 1 and 2 IVH cohort. Given the low risk of selection bias, the results of this study may be helpful in discussing prognosis with families of very preterm infants diagnosed with IVH. PMID:26030329

  15. Road work on memory lane--functional and structural alterations to the learning and memory circuit in adults born very preterm.

    PubMed

    Salvan, Piergiorgio; Froudist Walsh, Seán; Allin, Matthew P G; Walshe, Muriel; Murray, Robin M; Bhattacharyya, Sagnik; McGuire, Philip K; Williams, Steven C R; Nosarti, Chiara

    2014-11-15

    Very preterm (VPT) birth is considered a risk factor not only for neurological impairment, but also for reduced function in several cognitive domains in childhood and later in life. Individuals who were born VPT are more likely to demonstrate learning and memory difficulties compared to term-born controls. These problems contribute to more VPT-born children repeating grades and underachieving in school. This, in turn, affects their prospects in adult life. Here we aimed to 1) study how the VPT-born adult brain functionally recruited specific areas during learning, i.e. encoding and recall across four repeated blocks of verbal stimuli, and to investigate how these patterns of activation differed from term-born subjects; and 2) probe the microstructural differences of white-matter tracts connecting these areas to other parts of the learning and memory network. To investigate these functional-structural relationships we analyzed functional and diffusion-weighted MRI. Functional-MRI and a verbal paired associate learning (VPAL) task were used to extract Blood Oxygenation Level Dependent (BOLD) activity in 21 VPT-born adults (<33 weeks of gestation) (mean age: 19.68 years ± 0.85; IQ: 99.86 ± 11.20) and 10 term-born controls (mean age: 19.87 years ± 2.04; IQ: 108.9 ± 13.18). Areas in which differences in functional activation were observed between groups were used as seed regions for tractography. Fractional anisotropy (FA) of the tract-skeleton was then compared between groups on a voxel-wise basis. Results of functional MRI analysis showed a significantly different pattern of activation between groups during encoding in right anterior cingulate-caudate body, and during retrieval in left thalamus, hippocampus and parts of left posterior parahippocampal gyrus. The number of correctly recalled word pairs did not statistically differ between individuals who were born VPT and controls. The VPT-born group was found to have reduced FA in tracts passing through the

  16. Limited microstructural and connectivity deficits despite subcortical volume reductions in school-aged children born preterm with very low birth weight.

    PubMed

    Sølsnes, Anne Elisabeth; Sripada, Kam; Yendiki, Anastasia; Bjuland, Knut Jørgen; Østgård, Heidi Furre; Aanes, Synne; Grunewaldt, Kristine Hermansen; Løhaugen, Gro C; Eikenes, Live; Håberg, Asta K; Rimol, Lars M; Skranes, Jon

    2016-04-15

    Preterm birth and very low birth weight (VLBW, ≤1500 g) are worldwide problems that burden survivors with lifelong cognitive, psychological, and physical challenges. In this multimodal structural magnetic resonance imaging (MRI) and diffusion MRI (dMRI) study, we investigated differences in subcortical brain volumes and white matter tract properties in children born preterm with VLBW compared to term-born controls (mean age=8 years). Subcortical brain structure volumes and cortical thickness estimates were obtained, and fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were generated for 18 white matter tracts. We also assessed structural relationships between white matter tracts and cortical thickness of the tract endpoints. Compared to controls, the VLBW group had reduced volumes of thalamus, globus pallidus, corpus callosum, cerebral white matter, ventral diencephalon, and brain stem, while the ventricular system was larger in VLBW subjects, after controlling for age, sex, IQ, and estimated total intracranial volume. For the dMRI parameters, group differences were not significant at the whole-tract level, though pointwise analysis found shorter segments affected in forceps minor and left superior longitudinal fasciculus - temporal bundle. IQ did not correlate with subcortical volumes or dMRI measures in the VLBW group. While the deviations in subcortical volumes were substantial, there were few differences in dMRI measures between the two groups, which may reflect the influence of advances in perinatal care on white matter development. PMID:26712340

  17. Preterm children at early adolescence and continuity and discontinuity in maternal responsiveness from infancy.

    PubMed

    Beckwith, L; Rodning, C; Cohen, S

    1992-10-01

    Patterns in mother-child interaction from infancy to age 12 were investigated in a prospective, longitudinal study of 44 English-speaking mothers and their preterm children. Maternal responsiveness was assessed by home observations during infancy and the Family Interaction Q-Sort at age 12, derived from 2 structured laboratory situations requiring cooperation of mother and child. A cluster of maternal behaviors of critical control toward the toddler was assessed at age 2 years. Children of mothers who were consistently more responsive during both infancy and early adolescence, as well as children whose mothers became more responsive by age 12, achieved higher IQ and arithmetic scores, had more positive self-esteem, and their teachers reported fewer behavioral and emotional problems than children of mothers who were consistently less responsive both during infancy and at age 12. Continuity in parenting behaviors was related to control and criticism beginning in the toddler period and not to degree of responsiveness to the infant. PMID:1446549

  18. An Analysis of Self-Concept among Ethiopian Immigrant and Israeli-Born Children and Adolescents

    ERIC Educational Resources Information Center

    Tannenbaum, Michal

    2008-01-01

    This article reports a study comparing self-concept among 114 immigrant children and adolescents of Ethiopian origin in Israel and among 164 native-born Israelis, including an exploration of how age, gender, and first-language proficiency affect various dimensions of this construct. For the younger children (aged 8-9 years), self-concept was found…

  19. Predictors of Academic Motivation in First Grade among Children Born to Low-Income Adolescent Mothers

    ERIC Educational Resources Information Center

    Luster, Tom; Lekskul, Kunlakarn; Oh, Su Min

    2004-01-01

    The central question addressed in this study was: What factors are associated with individual differences in academic motivation among first-grade students who were born to low-income adolescent mothers? Data from a 7-year longitudinal study were used to address the question. First-grade teachers assessed academic motivation for 89 children at the…

  20. Factors Related to Successful Outcomes among Preschool Children Born to Low-Income Adolescent Mothers.

    ERIC Educational Resources Information Center

    Luster, Tom; Bates, Laura; Fitzgerald, Hiram; Vandenbelt, Marcia; Key, Judith Peck

    2000-01-01

    This study describes how the experiences and circumstances of most successful children born to low-income adolescent mothers differ from less successful children over the first 54 months of their lives, as defined by scores on the Peabody Picture Vocabulary Test-Revised. The two groups differed markedly on measures of caregiving, home environment,…

  1. Applying Dutch and US Versions of the BSID-II in Dutch Children Born Preterm Leads to Different Outcomes

    ERIC Educational Resources Information Center

    Westera, J. J.; Houtzager, B. A.; Overdiek, B.; van Wassenaer, A. G.

    2008-01-01

    The aim of the present study was to evaluate whether the application of Dutch versus US test procedures and norms of the Bayley Scales of Infant Development-2nd edition (BSID-II) leads to different developmental outcomes. The BSID-II was administered to 376 preterm infants (191 males, 185 females; mean gestational age 30wks [SD 2.7], mean…

  2. Maturation of Corpus Callosum Anterior Midbody Is Associated with Neonatal Motor Function in Eight Preterm-Born Infants

    PubMed Central

    Mathew, Preethi; Pannek, Kerstin; D'Acunto, M. Giulia; Guzzetta, Andrea; Rose, Stephen E.; Colditz, Paul B.; Finnigan, Simon

    2013-01-01

    Background. The etiology of motor impairments in preterm infants is multifactorial and incompletely understood. Whether corpus callosum development is related to impaired motor function is unclear. Potential associations between motor-related measures and diffusion tensor imaging (DTI) of the corpus callosum in preterm infants were explored. Methods. Eight very preterm infants (gestational age of 28–32 weeks) underwent the Hammersmith neonatal neurological examination and DTI assessments at gestational age of 42 weeks. The total Hammersmith score and a motor-specific score (sum of Hammersmith motor subcategories) were calculated. Six corpus callosum regions of interest were defined on the mid-sagittal DTI slice—genu, rostral body, anterior midbody, posterior midbody, isthmus, and splenium. The fractional anisotropy (FA) and mean diffusivity (MD) of these regions were computed, and correlations between these and Hammersmith measures were sought. Results. Anterior midbody FA measures correlated positively with total Hammersmith (rho = 0.929, P = 0.001) and motor-specific scores (rho = 0.857, P = 0.007). Total Hammersmith scores also negatively correlated with anterior midbody MD measures (rho = −0.714, P = 0.047). Discussion. These results suggest the integrity of corpus callosum axons, particularly anterior midbody axons, is important in mediating neurological functions. Greater callosal maturation was associated with greater motor function. Corpus callosum DTI may prove to be a valuable screening or prognostic marker. PMID:23509639

  3. Use of Medical Resources by Preterm Infants Born at Less than 33 Weeks' Gestation Following Discharge from the Neonatal Intensive Care Unit in Korea.

    PubMed

    Lee, Jang Hoon; Chang, Yun Sil

    2015-10-01

    This study was aimed to provide data on the use of medical resources by preterm infants following discharge from the neonatal intensive care unit (NICU). The cohort included preterm infants (n=2,351) born at 22-32 weeks' gestation who were discharged from the NICUs of 44 Korean hospitals between April 2009 to March 2010. Mean duration of post-discharge follow-up was 425±237 days. After discharge from the NICU, 94.5% of total infants visited a pediatric outpatient clinic (11.5±9.8 mean visits), 42.9% visited a pediatric clinic for respiratory problems irregularly (4.9±6.6 mean visits), and 31.1% utilized emergency center at least once. Among all visits to the emergency center, 24.7% resulted in readmission and 50.8% of those visits were due to respiratory problems. At least one episode of readmission was required by 33.6% (788/2,346) of total infants, and 18.4% (431/2,346) of total infants were readmitted with respiratory problems at least once. Among all infants readmitted for respiratory problems, 16.2% (70/341) were diagnosed with respiratory syncytial virus infection which accounted for 30.3% of viral etiologies confirmed by laboratory testing. Infants born at <30 weeks' gestation had more frequent total readmission and respiratory readmission than those ≥30 weeks' gestation (2±1.7 vs. 1.7±1.2, P=0.009, 1.8±1.2 vs. 1.5±1.1, 0.027, respectively). Overall, use of medical resources is common, and respiratory problems are the leading cause of use of medical resources. Total readmissions and respiratory readmissions are more frequent in more immature infants. PMID:26566364

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

    PubMed Central

    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 (<37 wk) and low birth weight (<2500 g) infants. Parental 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

  5. Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm

    PubMed Central

    PATRIANAKOS-HOOBLER, ATHENA I; MSALL, MICHAEL E; HUO, DEZHENG; MARKS, JEREMY D; PLESHA-TROYKE, SUSAN; SCHREIBER, MICHAEL D

    2010-01-01

    AIM To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth. METHOD Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric oxide for respiratory distress syndrome. Abnormal outcomes at the age of 2 years were defined as neurosensory disability (cerebral palsy, blindness, or bilateral hearing loss) or delay (no neurosensory disability but Bayley Scales of Infant Development mental or performance developmental index scores <70). School readiness (assessed at a mean age of 5y 6mo, SD 1y) was determined using neurodevelopmental assessments of motor, sensory, receptive vocabulary, perceptual, conceptual, and adaptive skills. RESULTS The mean birthweight of the cohort (57 males, 64 females) was 987g (SD 374), and the mean gestational age was 27.3 weeks (SD 2.6). At the age of 2 years, the neurodevelopmental classification was ‘disabled’ in 11% and ‘delayed’ in 23%. At the age of 5 years 6 months, intensive special education was required for 11% and some special education for 21%. Disability and delay at the age of 2 years were 92% and 50% predictive of lack of school readiness respectively, whereas only 15% of children who were normal at the age of 2 years were not school ready at the later assessment. Children with delay at 2 years were more likely to need special education if they were socially disadvantaged. INTERPRETATION Without preschool developmental supports, preterm survivors living in poverty will require more special education services. PMID:20002128

  6. Characteristic Processes in Close Peer Friendships of Preterm Infants at Age 12

    PubMed Central

    Sullivan, Mary C.; Barcelos Winchester, Suzy; Parker, Jeffrey G.; Marks, Amy K.

    2012-01-01

    Close friendships become important at middle-school age and are unexplored in adolescents born prematurely. The study aimed to characterize friendship behaviors of formerly preterm infants at age 12 and explore similarities and differences between preterm and full-term peers on dyadic friendship types. From the full sample of N = 186, one hundred sixty-six 12-year-old adolescents (40 born full term, 126 born preterm) invited a close friend to a 1.5 hour videotaped laboratory play session. Twenty adolescents were unable to participate due to scheduling conflicts or developmental disability. Characteristic friendship behaviors were identified by Q-sort followed by Q-factoring analysis. Friendship duration, age, and contact differed between the full-term and preterm groups but friendship activities, behaviors, and quality were similar despite school service use. Three Q-factors, leadership, distancing, and mutual playfulness, were most characteristic of all dyads, regardless of prematurity. These prospective, longitudinal findings demonstrate diminished prematurity effects at adolescence in peer friendship behavior and reveal interpersonal dyadic processes that are important to peer group affiliation and other areas of competence. PMID:23308346

  7. Living with the Sins of Their Fathers: An Analysis of Self-Representation of Adolescents Born of War Rape

    ERIC Educational Resources Information Center

    Erjavec, Karmen; Volcic; Zala

    2010-01-01

    Children born of war rape continue to be a taboo theme in many post-war societies, also in Bosnia and Herzegovina (BH). This study is based on in-depth interviews with eleven adolescents born of war rape in BH. The main goal is to present how these adolescents represent themselves and their life-situations. On the basis of the research we identify…

  8. Risk of Cigarette Smoking Initiation During Adolescence Among US-Born and Non–US-Born Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Parrinello, Christina M.; Isasi, Carmen R.; Xue, Xiaonan; Bandiera, Frank C.; Cai, Jianwen; Lee, David J.; Navas-Nacher, Elena L.; Perreira, Krista M.; Salgado, Hugo

    2015-01-01

    Objectives. We assessed risk of cigarette smoking initiation among Hispanics/Latinos during adolescence by migration status and gender. Methods. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) surveyed persons aged 18 to 74 years in 2008 to 2011. Our cohort analysis (n = 2801 US-born, 13 200 non–US-born) reconstructed participants’ adolescence from 10 to 18 years of age. We assessed the association between migration status and length of US residence and risk of cigarette smoking initiation during adolescence, along with effects of gender and Hispanic/Latino background. Results. Among individuals who migrated by 18 years of age, median age and year of arrival were 13 years and 1980, respectively. Among women, but not men, risk of smoking initiation during adolescence was higher among the US-born (hazard ratio [HR] = 2.10; 95% confidence interval [CI] = 1.73, 2.57; P < .001), and those who had resided in the United States for 2 or more years (HR = 1.47; 95% CI = 1.11, 1.96; P = .01) than among persons who lived outside the United States. Conclusions. Research examining why some adolescents begin smoking after moving to the United States could inform targeted interventions. PMID:25322293

  9. Risk and resilience in preterm children at age 6.

    PubMed

    Poehlmann-Tynan, Julie; Gerstein, Emily D; Burnson, Cynthia; Weymouth, Lindsay; Bolt, Daniel M; Maleck, Sarah; Schwichtenberg, A J

    2015-08-01

    Children born preterm are at risk for experiencing significant deleterious developmental outcomes throughout their childhood and adolescence. However, individual variation and resilience are hallmarks of the preterm population. The present study examined pathways to resilience across multiple domains (e.g., social activities, peer relations, attention-deficit/hyperactivity disorder symptomology, externalizing and internalizing behavior, and sleep quality) as children born preterm reached school age. The study also examined early child and family predictors of resilience. Using a prospective longitudinal design, 173 infants born preterm and without significant neurological complications were assessed at five time points: neonatal intensive care unit discharge, 9 months, 16 months, 24 months, and 6 years. Three pathways of adaptation emerged at 6 years: children who were resilient, those who remained at-risk, and children who exhibited significant difficulties. Resilient children were less likely to have experienced negative parenting at 9 and 16 months, more likely to delay gratification at 24 months, and more likely to experience neonatal health complications than nonresilient children. PMID:25196017

  10. Cognitive and Neuropsychological Outcomes at 5 Years of Age in Preterm Children Born in the 2000s

    ERIC Educational Resources Information Center

    Lind, Annika; Korkman, Marit; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Matomaki, Jaakko; Haataja, Leena

    2011-01-01

    Aim: The aim of this study was to assess the cognitive level and neuropsychological performance at 5 years of age in children with a very low birthweight (VLBW; birthweight less than 1501g) born in 2001 to 2003. Method: A regional cohort of 97 children with a VLBW (mean gestational age 28wks [SD 3wks]; mean birthweight 1054g [SD 259g]; 50 male; 47…

  11. Ontogenic Changes of Villus Growth, Lactase Activity, and Intestinal Glucose Transporters in Preterm and Term Born Calves with or without Prolonged Colostrum Feeding

    PubMed Central

    Steinhoff-Wagner, Julia; Schönhusen, Ulrike; Zitnan, Rudolf; Hudakova, Monika; Pfannkuche, Helga; Hammon, Harald M.

    2015-01-01

    Oral glucose supply is important for neonatal calves to stabilize postnatal plasma glucose concentration. The objective of this study was to investigate ontogenic development of small intestinal growth, lactase activity, and glucose transporter in calves (n = 7 per group) that were born either preterm (PT; delivered by section 9 d before term) or at term (T; spontaneous vaginal delivery) or spontaneously born and fed colostrum for 4 days (TC). Tissue samples from duodenum and proximal, mid, and distal jejunum were taken to measure villus size and crypt depth, protein concentration of mucosa and brush border membrane vesicles (BBMV), total DNA and RNA concentration of mucosa, mRNA expression and activity of lactase, and mRNA expression of sodium-dependent glucose co-transporter-1 (SGLT1) and facilitative glucose transporter 2 (GLUT2) in mucosal tissue. Additionally, protein expression of SGLT1 in BBMV and GLUT2 in crude mucosal membranes and immunochemical localization of GLUT2 in the enterocytes were determined. Villus height in distal jejunum was lower in TC than in T. Crypt depth in all segments was largest and the villus height/crypt depth ratio in jejunum was smallest in TC calves. Concentration of RNA was highest in duodenal mucosa of TC calves, but neither lactase mRNA and activity nor SGLT1 and GLUT2 mRNA and protein expression differed among groups. Localization of GLUT2 in the apical membrane was greater, whereas in the basolateral membrane was lower in TC than in T and PT calves. Our study indicates maturation processes after birth for mucosal growth and trafficking of GLUT2 from the basolateral to the apical membrane. Minor differences of mucosal growth, lactase activity, and intestinal glucose transporters were seen between PT and T calves, pointing at the importance of postnatal maturation and feeding for mucosal growth and GLUT2 trafficking. PMID:26011395

  12. Adaptive Mechanisms of Developing Brain: Cerebral Lateralization in the Prematurely-Born

    PubMed Central

    Kwon, Soo Hyun; Scheinost, Dustin; Lacadie, Cheryl; Sze, Gordon; Schneider, Karen C.; Dai, Feng; Constable, R. Todd; Ment, Laura R.

    2014-01-01

    Preterm birth results in alterations in neural connectivity, but the impact of prematurity on the functional organization of the developing brain has yet to be explored. To test the hypothesis that preterm birth alters cortical organization during the late second and third trimesters of gestation, we interrogated cerebral lateralization at rest in 26 very preterm subjects (birth weight 500–1500 g) with no evidence of brain injury and 25 healthy term control subjects at term equivalent age. Employing an unbiased voxel-based measure of functional connectivity, these data demonstrated that cerebral lateralization is impaired in the prematurely-born. At term equivalent age, preterm neonates showed significantly less lateralization in regions subserving both receptive and expressive language, left Brodmann (BA) areas insula-BA22-BA21 and L BA45-BA47 (p<0.05 corrected for multiple comparisons for both). Exploratory region of interest analyses demonstrated significantly less inter-hemispheric connectivity from L BA22 to R BA22 in preterm infants compared to term controls (p<0.005) and from R BA22 to its homolog (p<0.005). L BA22, Wernicke’s area, was more strongly connected to R BA39, foreshadowing neural networks for language in preterm subjects at school age, adolescence and young adulthood. For these very preterm neonates born at less than 30 weeks PMA, the degree of prematurity had no influence on lateralization in these differential regions. PMID:25528658

  13. Family Advocates' Perspectives on the Early Academic Success of Children Born to Low-Income Adolescent Mothers

    ERIC Educational Resources Information Center

    Luster, Tom; Bates, Laura; Vandenbelt, Marcia; Nievar, M. Angela

    2004-01-01

    Qualitative analyses were conducted to examine family factors related to individual differences in the early school success of children born to low-income adolescent mothers from the perspective of paraprofessional family advocates. These families were participants in a 5-year family support program. Achievement test scores and teacher ratings…

  14. Executive Functioning and Learning Skills of Adolescent Children Born at Fewer than 26 Weeks of Gestation

    PubMed Central

    Farooqi, A.; Adamsson, M.; Serenius, F.; Hägglöf, B.

    2016-01-01

    Aims To assess the cognitive and behavioral aspects of executive functioning (EF) and learning skills in extremely preterm (EPT) children compared with term control children aged 10 to 15 years. Methods A total of 132 of 134 (98% of all eligible survivors) EPT children born at the 2 Swedish regional tertiary care centers from 1992 to 1998 (mean age = 12 years, mean birth weight = 718 g, and mean gestational age = 24.4 weeks) and 103 matched term controls were assessed. General intelligence was assessed using the Wechsler Intelligence Scale for Children (WISC-III-R), and cognitive aspects of EF were analyzed using EF-sensitive subscales of the WISC-III-R and Tower test of the Delis-Kaplan Executive Function Scale (D-KEFS). Behaviors related to EF and learning skills were assessed using the Five to Fifteen questionnaire, which is a validated parent and teacher instrument. Academic performance in school was assessed by teachers’ responses on Achenbach’s Teachers Report Form. Analyses performed included multivariate analyses of covariance (ANCOVA and MANCOVA) and logistic regression analyses. Results The EPT children displayed significant deficits in cognitive aspects of EF compared with the controls, exhibiting decreases on the order of 0.9 SD to 1.2 SD for tasks of verbal conceptual reasoning, verbal and non-verbal working memory, processing speed and planning ability (P <0.001 for all). After excluding the children with major neurosensory impairment (NSI) or a Full Scale intelligence quotient (FSIQ) of < 70, significant differences were observed on all tests. Compared with controls, parents and teachers of EPT children reported significantly more EF-related behavioral problems. MANCOVA of teacher-reported learning skills in children with FSIQ >70 and without major NSI revealed no interactions, but significant main effects were observed for the behavioral composite executive function score, group status (EPT vs control) and FSIQ, for which all effect sizes were

  15. Cognitive, emotional and social development in adolescents born to substance using women.

    PubMed

    Irner, Tina Birk; Teasdale, Thomas William; Nielsen, Tine; Vedal, Sissel; Olofsson, May

    2014-08-01

    The aim of this article is to investigate the long-term developmental consequences of being born to a substance-using mother, focusing on cognitive functions, attention, emotional and social development. The longitudinal sample comprised 48 adolescents aged 12-16 at the time of follow-up assessments, which included the Wechsler Intelligence Scale for Children-III, the Test of Everyday Attention for Children, The Tower of London test and the Strengths and Difficulties Questionnaire. The adolescents scored significantly lower than the norms on Wechsler's subtests and Full-Scale IQ, and on The Everyday Attention test. There were few differences on the Strengths and Difficulties Questionnaire. The girls reported significantly more hyperactivity than the British norms, and the teachers reported higher impact scores in boys, compared to the British norms. Thus, the results on cognitive consequences of maternal substance use appear to be very substantial while the emotional and social consequences do not. The results suggest serious negative effects of substance exposure in utero on attention and cognitive functioning in general. PMID:24828950

  16. Machine-learning to characterise neonatal functional connectivity in the preterm brain

    PubMed Central

    Ball, G.; Aljabar, P.; Arichi, T.; Tusor, N.; Cox, D.; Merchant, N.; Nongena, P.; Hajnal, J.V.; Edwards, A.D.; Counsell, S.J.

    2016-01-01

    Brain development is adversely affected by preterm birth. Magnetic resonance image analysis has revealed a complex fusion of structural alterations across all tissue compartments that are apparent by term-equivalent age, persistent into adolescence and adulthood, and associated with wide-ranging neurodevelopment disorders. Although functional MRI has revealed the relatively advanced organisational state of the neonatal brain, the full extent and nature of functional disruptions following preterm birth remain unclear. In this study, we apply machine-learning methods to compare whole-brain functional connectivity in preterm infants at term-equivalent age and healthy term-born neonates in order to test the hypothesis that preterm birth results in specific alterations to functional connectivity by term-equivalent age. Functional connectivity networks were estimated in 105 preterm infants and 26 term controls using group-independent component analysis and a graphical lasso model. A random forest–based feature selection method was used to identify discriminative edges within each network and a nonlinear support vector machine was used to classify subjects based on functional connectivity alone. We achieved 80% cross-validated classification accuracy informed by a small set of discriminative edges. These edges connected a number of functional nodes in subcortical and cortical grey matter, and most were stronger in term neonates compared to those born preterm. Half of the discriminative edges connected one or more nodes within the basal ganglia. These results demonstrate that functional connectivity in the preterm brain is significantly altered by term-equivalent age, confirming previous reports of altered connectivity between subcortical structures and higher-level association cortex following preterm birth. PMID:26341027

  17. Response inhibition difficulties in preterm children aged 9-12 years: Relations with emotion and behavior.

    PubMed

    Réveillon, Morgane; Borradori Tolsa, Cristina; Monnier, Maryline; Hüppi, Petra S; Barisnikov, Koviljka

    2016-01-01

    Previous studies with children have demonstrated inhibition difficulties associated with prematurity, but the question of potentially catching up with a delay in inhibition processes before adolescence still remains. Moreover, preterm adolescents are more at risk than their term-born peers for presenting behavioral problems such as emotional difficulties and attention deficit/hyperactivity disorder. In addition to examining response inhibition, this study addressed, for the first time, the impact of an emotional context on response inhibition abilities and its relation to behavioral problems in late school-aged preterm children. Fifty-eight preterm children aged 9-12 years were compared with 61 controls on two versions of a stop-signal task, the Delay Frustration Task, and the Strengths and Difficulties Questionnaire. Results showed general difficulties in inhibiting a response, rather than a specific impact of emotional context in preterm children. Compared with controls, these children exhibited more and longer button presses in a delay situation, as well as faster go reaction times associated with lower probability of inhibition in the stop-signal tasks. These difficulties reflected impulsivity and were associated with higher hyperactivity/inattention and conduct problems. Additionally, intrauterine growth restriction was found to be an additional perinatal risk factor for hyperactivity/inattention symptoms. These findings suggest that remaining inhibition difficulties in the preterm population at preadolescence could reveal increasing behavioral issues. PMID:25569693

  18. Neuroprotection in Preterm Infants

    PubMed Central

    Berger, R.; Söder, S.

    2015-01-01

    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. PMID:25650134

  19. 15-epi-lipoxin A4 reduces the mortality of prematurely born pups in a mouse model of infection-induced preterm birth.

    PubMed

    Rinaldi, S F; Catalano, R D; Wade, J; Rossi, A G; Norman, J E

    2015-04-01

    Preterm birth remains the leading cause of neonatal mortality and morbidity worldwide. There are currently few effective therapies and therefore an urgent need for novel treatments. Although there is much focus on trying to alter gestation of delivery, the primary aim of preterm birth prevention therapies should be to reduce prematurity related mortality and morbidity. Given the link between intrauterine infection and inflammation and preterm labour (PTL), we hypothesized that administration of lipoxins, key anti-inflammatory and pro-resolution mediators, could be a useful novel treatment for PTL. Using a mouse model of infection-induced PTL, we investigated whether 15-epi-lipoxin A4 could delay lipopolysaccharide (LPS)-induced PTL and reduce pup mortality. On D17 of gestation mice (n = 9-12) were pretreated with vehicle or 15-epi-lipoxin A4 prior to intrauterine administration of LPS or PBS. Although pretreatment with 15-epi-lipoxin A4 did not delay LPS-induced PTL, there was a significant reduction in the mortality amongst prematurely delivered pups (defined as delivery within 36 h of surgery) in mice treated with 15-epi-lipoxin A4 prior to LPS treatment, compared with those receiving LPS alone (P < 0.05). Quantitative real-time (QRT)-PCR analysis of utero-placental tissues harvested 6 h post-treatment demonstrated that 15-epi-lipoxin A4 treatment increased Ptgs2 expression in the uterus, placenta and fetal membranes (P < 0.05) and decreased 15-Hpgd expression (P < 0.05) in the placenta and uterus, suggesting that 15-epi-lipoxin A4 may regulate the local production and activity of prostaglandins. These data suggest that augmenting lipoxin levels could be a useful novel therapeutic option in the treatment of PTL, protecting the fetus from the adverse effects of infection-induced preterm birth. PMID:25567326

  20. Functional neuroimaging study of performances on a Go/No-go task in 6- to 7-year-old preterm children: Impact of intrauterine growth restriction☆☆☆

    PubMed Central

    Réveillon, Morgane; Urben, Sébastien; Barisnikov, Koviljka; Borradori Tolsa, Cristina; Hüppi, Petra S.; Lazeyras, François

    2013-01-01

    Children born preterm, and more specifically those with intrauterine growth restriction (IUGR), are prone to exhibit scholastic difficulties and behavioral problems later in development. Neuropsychological studies showed that their deficits in response inhibition and attention could be at the heart of these difficulties. Functional magnetic resonance imaging (fMRI) studies using a Go/No-go task in preterm adolescents and adults suggest their use of an alternative neuronal pathway to compensate for a possible delayed development. However, little is known about the impact of IUGR at a functional neural network level. This study used fMRI to explore brain regions activated during a Go/No-go task in 20 preterm children aged 6–7 years, 10 of which were born with IUGR. Results showed that preterm children without IUGR preferentially activated fronto-temporal regions including the inferior frontal cortex, region known to be involved in successful response inhibition. In contrast, IUGR preterm children exhibited greater activation in the putamen, in the medial frontal cortex and parietal regions, specifically involved in attention demanding tasks, some being part of the default-mode network. These findings suggest that IUGR preterm children use different brain regions and a more diffuse network to perform the task, which interfere with goal-directed activity and may reflect inefficient attentional control. The differences observed in IUGR preterm children might relate to their higher risk for neurodevelopmental and behavioral disorders. PMID:24273725

  1. Health-related quality of life and emotional and behavioral difficulties after extreme preterm birth: developmental trajectories

    PubMed Central

    Eide, Geir Egil; Natvig, Gerd Karin; Markestad, Trond; Graue, Marit; Halvorsen, Thomas

    2015-01-01

    Background. Knowledge of long-term health related outcomes in contemporary populations born extremely preterm (EP) is scarce. We aimed to explore developmental trajectories of health-related quality of life (HRQoL) and behavior from mid-childhood to early adulthood in extremely preterm and term-born individuals. Methods. Subjects born at gestational age ≤28 weeks or with birth weight ≤1,000 g within a region of Norway in 1991–92 and matched term-born control subjects were assessed at 10 and 18 years. HRQoL was measured with the Child Health Questionnaire (CHQ) and behavior with the Child Behavior Checklist (CBCL), using parent assessment at both ages and self-assessment at 18 years. Results. All eligible EP (n = 35) and control children participated at 10 years, and 31 (89%) and 29 (83%) at 18 years. At 10 years, the EP born boys were given significantly poorer scores by their parents than term-born controls on most CHQ and CBCL scales, but the differences were minor at 18 years; i.e., significant improvements had occurred in several CHQ (self-esteem, general health and parental impact-time) and CBCL (total problem, internalizing and anxious/depressed) scales. For the girls, the differences were smaller at 10 years and remained unchanged by 18 years. Emotional/behavioral difficulties at 10 years similarly predicted poorer improvement on CHQ-scales for both EP and term-born subjects at 18 years. Self-assessment of HRQoL and behavior at 18 years was similar in the EP and term-born groups on most scales. Conclusions. HRQoL and behavior improved towards adulthood for EP born boys, while the girls remained relatively similar, and early emotional and behavioral difficulties predicted poorer development in HRQoL through adolescence. These data indicate that gender and a longitudinal perspective should be considered when addressing health and wellbeing after extremely preterm birth. PMID:25653912

  2. Health-related quality of life and emotional and behavioral difficulties after extreme preterm birth: developmental trajectories.

    PubMed

    Vederhus, Bente Johanne; Eide, Geir Egil; Natvig, Gerd Karin; Markestad, Trond; Graue, Marit; Halvorsen, Thomas

    2015-01-01

    Background. Knowledge of long-term health related outcomes in contemporary populations born extremely preterm (EP) is scarce. We aimed to explore developmental trajectories of health-related quality of life (HRQoL) and behavior from mid-childhood to early adulthood in extremely preterm and term-born individuals. Methods. Subjects born at gestational age ≤28 weeks or with birth weight ≤1,000 g within a region of Norway in 1991-92 and matched term-born control subjects were assessed at 10 and 18 years. HRQoL was measured with the Child Health Questionnaire (CHQ) and behavior with the Child Behavior Checklist (CBCL), using parent assessment at both ages and self-assessment at 18 years. Results. All eligible EP (n = 35) and control children participated at 10 years, and 31 (89%) and 29 (83%) at 18 years. At 10 years, the EP born boys were given significantly poorer scores by their parents than term-born controls on most CHQ and CBCL scales, but the differences were minor at 18 years; i.e., significant improvements had occurred in several CHQ (self-esteem, general health and parental impact-time) and CBCL (total problem, internalizing and anxious/depressed) scales. For the girls, the differences were smaller at 10 years and remained unchanged by 18 years. Emotional/behavioral difficulties at 10 years similarly predicted poorer improvement on CHQ-scales for both EP and term-born subjects at 18 years. Self-assessment of HRQoL and behavior at 18 years was similar in the EP and term-born groups on most scales. Conclusions. HRQoL and behavior improved towards adulthood for EP born boys, while the girls remained relatively similar, and early emotional and behavioral difficulties predicted poorer development in HRQoL through adolescence. These data indicate that gender and a longitudinal perspective should be considered when addressing health and wellbeing after extremely preterm birth. PMID:25653912

  3. The EPICure Study: Association between Hemodynamics and Lung Function at 11 Years after Extremely Preterm Birth

    PubMed Central

    Bolton, Charlotte E.; Stocks, Janet; Hennessy, Enid; Cockcroft, John R.; Fawke, Joseph; Lum, Sooky; McEniery, Carmel M.; Wilkinson, Ian B.; Marlow, Neil

    2012-01-01

    Objective To investigate the relationship between disturbed lung function and large-artery hemodynamics in school-age children born extremely preterm (EP) (at 25 completed weeks of gestation or less). Study design This was a cross-sectional study of participants from the EPICure study, now aged 11 years (n = 66), and 86 age- and sex-matched term-born classmates. Spirometry parameters (including forced expiratory volume in 1 second), blood pressure, and augmentation index (AIx, a composite of arterial stiffness and global wave reflections) were measured. Results Compared with their classmates, the EP children had significantly impaired lung function, particularly those with neonatal bronchopulmonary dysplasia. Peripheral blood pressure did not differ significantly between the 2 groups, but AIx values were on average 5% higher (95% CI, 2%-8%) in the preterm infants, remaining significant after adjustment for potential confounders. Neonatal bronchopulmonary dysplasia status was not related to AIx. Lung function and maternal smoking were independently associated with AIx; AIx increased by 2.7% per z-score reduction in baseline forced expiratory volume in 1 second and by 4.9% in those whose mothers smoked during pregnancy. Conclusion The independent association between impaired lung function and cardiovascular physiology in early adolescence implies higher cardiovascular risk for children born EP, and suggests that prevention of chronic neonatal lung disease may be a priority in reducing later cardiovascular risk in preterm infants. PMID:22575246

  4. Preterm labor

    MedlinePlus

    ... weight gain during pregnancy Obesity Problems with the placenta, uterus, or cervix that can lead to preterm ... uterus is not normal Poor function of the placenta, placental abruption, and placenta previa

  5. Preterm Labor

    MedlinePlus

    ... labor that starts before 37 completed weeks of pregnancy. It can lead to premature birth. Premature babies ... you might be having preterm labor, contact your health care provider. NIH: National Institute of Child Health and Human ...

  6. Early Delayed Language Development in Very Preterm Infants: Evidence from the MacArthur-Bates CDI

    ERIC Educational Resources Information Center

    Foster-Cohen, Susan; Edgin, Jamie O.; Champion, Patricia R.; Woodward, Lianne J.

    2007-01-01

    This study examined the effects of being born very preterm on children's early language development using prospective longitudinal data from a representative regional cohort of 90 children born very preterm (gestational age less than 33 weeks and/or birth weight less than 1,500 grams) and a comparison sample of 102 children born full term…

  7. Brain morphometry and IQ measurements in preterm children.

    PubMed

    Isaacs, E B; Edmonds, C J; Chong, W K; Lucas, A; Morley, R; Gadian, D G

    2004-12-01

    Although IQ is thought to remain relatively stable in the normal population, a decline in IQ has been noted in children born preterm. It is not clear, however, to what extent the inclusion of children with clear neurological damage has influenced these findings. We examined IQ scores obtained in childhood and then again in adolescence from a group of children born at 30 weeks gestation or less who had been classified as neurologically normal at 7.5-8 years. They showed a significant decline in mean IQ scores over time. MRI scans obtained from a subset of children at adolescence were read as normal in approximately 50% of cases and, in the others, there were no consistent relationships between radiological abnormalities and IQ results. Such children can, however, have relatively subtle brain abnormalities that are not seen on conventional MRI, and we hypothesized that these would be related to declines in IQ. Voxel-based morphometry (VBM) analyses of the MRI scans revealed that absolute IQ scores were related to areas in both the parietal and temporal lobes. The analyses also showed that frontal and temporal lobe regions were associated with the decline in VIQ, while occipital and temporal lobe regions (including the hippocampi) were associated with the decline in PIQ. Hippocampal volume measurements were consistent with the VBM findings. We concluded that preterm children are at risk of declining IQ over time even if they have not suffered obvious neurological damage and that the decline is associated with specific neural regions. Whether this is true of children born at >30 weeks gestation and what other factors predispose to this decline have yet to be determined. PMID:15371289

  8. Preterm birth

    PubMed Central

    2011-01-01

    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 2010 (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

  9. Do First Generation Immigrant Adolescents Face Higher Rates of Bullying, Violence and Suicidal Behaviours Than Do Third Generation and Native Born?

    PubMed

    Pottie, Kevin; Dahal, Govinda; Georgiades, Katholiki; Premji, Kamila; Hassan, Ghayda

    2015-10-01

    We conducted a systematic review to examine first generation immigrant adolescents' likelihood of experiencing bullying, violence, and suicidal behaviours compared to their later-generation and native born counterparts, and to identify factors that may underlie these risks. Eighteen studies met full inclusion criteria. First generation immigrant adolescents experience higher rate of bullying and peer aggression compared to third generation and native counterparts. Refugee status and advanced parental age were associated with increased parent to child aggression among South East Asians. Family cohesion was associated with lower rates of violence. Suicidal ideation was lower across most immigrant adolescents' ethnicities, with the exception of Turkish and South Asian Surinamese female adolescents in the Netherlands. Bullying and peer aggression of immigrant children and adolescents and potential mitigating factors such as family cohesion warrant research and program attention by policymakers, teachers and parents. PMID:25248622

  10. [Development of executive functions in preterm children].

    PubMed

    Borradori Tolsa, C; Barisnikov, K; Lejeune, F; Hüppi, P

    2014-09-01

    The rate of children born prematurely has increased considerably in the last few decades, and their developmental outcome remains of great concern. The literature on the impact of prematurity has reported a wide range of cognitive and behavioral problems that may be related to deficits in executive function (EF) skills. EF refers to a series of high-level processes (selective attention, inhibition, set shifting, working memory, planning, goal setting) that develop throughout childhood and adolescence and play an important role in cognitive and social development as well as in school achievement. EF skills have been linked to the prefrontal cortex, as well as to other neural networks and brain regions including the basal ganglia and cerebellum. This paper focuses on studies related to the development of EF and social behavior in children born preterm. The preschool period is a critical time to perform neuropsychological assessment in addition to IQ testing, and to detect the child's specific needs in order to adapt effective intervention to enhance the development of executive processes in these high-risk children. PMID:25089045

  11. Occipital cortical thickness in very low birth weight born adolescents predicts altered neural specialization of visual semantic category related neural networks.

    PubMed

    Klaver, Peter; Latal, Beatrice; Martin, Ernst

    2015-01-01

    Very low birth weight (VLBW) premature born infants have a high risk to develop visual perceptual and learning deficits as well as widespread functional and structural brain abnormalities during infancy and childhood. Whether and how prematurity alters neural specialization within visual neural networks is still unknown. We used functional and structural brain imaging to examine the visual semantic system of VLBW born (<1250 g, gestational age 25-32 weeks) adolescents (13-15 years, n = 11, 3 males) and matched term born control participants (13-15 years, n = 11, 3 males). Neurocognitive assessment revealed no group differences except for lower scores on an adaptive visuomotor integration test. All adolescents were scanned while viewing pictures of animals and tools and scrambled versions of these pictures. Both groups demonstrated animal and tool category related neural networks. Term born adolescents showed tool category related neural activity, i.e. tool pictures elicited more activity than animal pictures, in temporal and parietal brain areas. Animal category related activity was found in the occipital, temporal and frontal cortex. VLBW born adolescents showed reduced tool category related activity in the dorsal visual stream compared with controls, specifically the left anterior intraparietal sulcus, and enhanced animal category related activity in the left middle occipital gyrus and right lingual gyrus. Lower birth weight of VLBW adolescents correlated with larger thickness of the pericalcarine gyrus in the occipital cortex and smaller surface area of the superior temporal gyrus in the lateral temporal cortex. Moreover, larger thickness of the pericalcarine gyrus and smaller surface area of the superior temporal gyrus correlated with reduced tool category related activity in the parietal cortex. Together, our data suggest that very low birth weight predicts alterations of higher order visual semantic networks, particularly in the dorsal stream. The differences

  12. Preterm Births: A Global Health Problem.

    PubMed

    Ryan, Jane Greene; Dogbey, Evelyn

    2015-01-01

    Globally, in 2012, there were 15 million babies born preterm. The majority of preterm births occur in resource-poor countries including India, Nigeria, Pakistan, and the Democratic Republic of Congo where many die due to lack of basic skilled nursing care. In September 2000, the United Nations signed the Millennium Development Declaration establishing eight Millennium Development Goals (MDGs). These MDGs provide specific, measurable targets that are designed to provide equitable health to all, particularly the most vulnerable including preterm babies. On May 2, 2014, the World Health Organization specifically targeted the nursing workforce as a key stakeholder in strategies to reduce global prematurity and end preventable preterm newborn deaths. Specific strategies include primary care, screening for risk factors, kangaroo mother care, and early initiation of breastfeeding with exclusive breastfeeding for the first 6 months of life. By sharing our knowledge and skills, nurses can contribute to global actions being taken to end preventable preterm newborn deaths. PMID:26295506

  13. Preterm Birth and Adult Wealth: Mathematics Skills Count.

    PubMed

    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. PMID:26324513

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

    ERIC Educational Resources Information Center

    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…

  15. Ophthalmological, Cognitive, Electrophysiological and MRI Assessment of Visual Processing in Preterm Children without Major Neuromotor Impairment

    ERIC Educational Resources Information Center

    O'Reilly, Michelle; Vollmer, Brigitte; Vargha-Khadem, Faraneh; Neville, Brian; Connelly, Alan; Wyatt, John; Timms, Chris; De Haan, Michelle

    2010-01-01

    Many studies report chronic deficits in visual processing in children born preterm. We investigated whether functional abnormalities in visual processing exist in children born preterm but without major neuromotor impairment (i.e. cerebral palsy). Twelve such children (less than 33 weeks gestation or birthweight less than 1000 g) without major…

  16. The Effects of Perinatal Morbidity and Environmental Factors on Health Status of Preterm Children at Age 12

    PubMed Central

    Miller, Robin June; Sullivan, Mary C.; Hawes, Katheleen; Marks, Amy Kerivan

    2009-01-01

    Children born prematurely have later morbidity, yet little is known about their health in adolescence. This study examined multiple dimensions of health at age 12 and the predictors of biological, behavioral, social, and physical environmental factors. ANOVA and logistic regression models were tested. Perinatal morbidity predicted health at age 12. Preterm status increases the risk of later alterations in health. Bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, small-for-gestational age, parental perception of child health, and parental psychological distress affect later health. Prematurity and perinatal morbidity continue to impact child health 12 years after birth. PMID:19268232

  17. Recurrent Preterm Birth

    PubMed Central

    Mazaki-Tovi, Shali; Romero, Roberto; Kusanovic, Juan Pedro; Erez, Offer; Pineles, Beth L.; Gotsch, Francesca; Mittal, Pooja; Than, Nandor Gabor

    2012-01-01

    Recurrent preterm birth is frequently defined as two or more deliveries before 37 completed weeks of gestation. The recurrence rate varies as a function of the antecedent for preterm birth: spontaneous versus indicated. Spontaneous preterm birth is the result of either preterm labor with intact membranes or preterm prelabor rupture of the membranes. This article reviews the body of literature describing the risk of recurrence of spontaneous and indicated preterm birth. Also discussed are the factors which modify the risk for recurrent spontaneous preterm birth (a short sonographic cervical length and a positive cervicovaginal fetal fibronectin test). Patients with a history of an indicated preterm birth are at risk not only for recurrence of this subtype, but also for spontaneous preterm birth. Individuals of African-American origin have a higher rate of recurrent preterm birth. The potential roles of genetic and environmental factors in recurrent preterm birth are considered. PMID:17531896

  18. Acute neonatal appendicitis in a preterm.

    PubMed

    Mammou, Sihem; Ayadi, Imen; Ben Hamida, Emira; Marrakchi, Zahra

    2015-01-01

    Acute neonatal appendicitis is very rare in the neonatal period. It is usually associated with comorbidity including prematurity. Symptoms are non-specific. The prognosis is marked by high risk of mortality and morbidity. Here, we report a case of preterm new born who presented with sepsis, apnoea, and digestive signs. The laparotomy revealed perforated appendicitis complicated with peritonitis. PMID:26712299

  19. Acute neonatal appendicitis in a preterm

    PubMed Central

    Mammou, Sihem; Ayadi, Imen; Hamida, Emira Ben; Marrakchi, Zahra

    2015-01-01

    Acute neonatal appendicitis is very rare in the neonatal period. It is usually associated with comorbidity including prematurity. Symptoms are non-specific. The prognosis is marked by high risk of mortality and morbidity. Here, we report a case of preterm new born who presented with sepsis, apnoea, and digestive signs. The laparotomy revealed perforated appendicitis complicated with peritonitis. PMID:26712299

  20. ARC syndrome in preterm baby.

    PubMed

    Elmeery, A; Lanka, K; Cummings, J

    2013-10-01

    A preterm female infant born of 32 weeks gestational age was presenting with musculoskeletal abnormalities, and cholestasis that later on resolved. Later on, she developed renal tubular acidosis (RTA), poor weight gain, unexplained intermittent fever and recurrent spontaneous bleeding episodes. ARC is an acronym that stands for arthrogryposis, renal dysfunction and cholestasis. ARC syndrome is a rare disorder that is difficult to diagnose and is associated with poor outcomes. We present a case of ARC syndrome in an infant with a history of failure to thrive, early cholestasis and RTA. There are many unique features about this case that should add to our understanding of this genetic condition. To our knowledge this is the first identified case of ARC syndrome in a preterm infant. Although the specific mutation found in our patient has not been reported previously, the type and location of this mutation is consistent with our genetic understanding of this disorder. PMID:24071963

  1. Screening for Autism in Extremely Preterm Infants: Problems in Interpretation

    ERIC Educational Resources Information Center

    Moore, Tamanna; Johnson, Samantha; Hennessy, Enid; Marlow, Neil

    2012-01-01

    Aim: The aim of this article was to report the prevalence of, and risk factors for, positive autism screens using the Modified Checklist for Autism in Toddlers (M-CHAT) in children born extremely preterm in England. Method: All children born at not more than 26 weeks' gestational age in England during 2006 were recruited to the EPICure-2 study. At…

  2. Respiratory Outcome after Preterm Birth: A Long and Difficult Journey.

    PubMed

    Priante, Elena; Moschino, Laura; Mardegan, Veronica; Manzoni, Paolo; Salvadori, Sabrina; Baraldi, Eugenio

    2016-09-01

    Despite notable advances in the survival and management of preterm infants in recent decades, chronic lung disease remains a common complication. Approximately one in three infants born preterm (< 32 weeks of gestation) are hospitalized with respiratory problems (mainly due to infections) in their first 2 years of life, and the risk of childhood wheezing is three times higher in this population. By comparison with infants born at term, there seems to be a higher incidence of respiratory morbidity in those born preterm, even in the absence of bronchopulmonary dysplasia (BPD) and in late-preterm babies. Although long-term follow-up data are still not collected systematically, there is evidence of preterm infants' respiratory symptoms, lung function impairments, and radiological abnormalities, tending to persist throughout childhood and into early adulthood. Respiratory conditions associated with preterm birth are often diagnosed and treated as asthma, but the pathophysiological patterns of BPD and asthma are very different. Future research should focus on characterizing preterm infants' pathological pulmonary features by gestational age at birth, and presence or absence of BPD. Improving our current knowledge of the respiratory disorder associated with prematurity might hopefully prompt targeted follow-up protocols, and novel prevention strategies and treatment approaches. PMID:27603531

  3. Epigenetics—a potential mediator between air pollution and preterm birth

    PubMed Central

    Lin, Vania W.; Baccarelli, Andrea A.; Burris, Heather H.

    2016-01-01

    Preterm birth is a major cause of infant morbidity and mortality and a potential risk factor for adult chronic disease. With over 15 million infants born preterm worldwide each year, preterm birth poses a global health concern. There is a possible association between air pollution and preterm birth, though studies have been inconsistent, likely due to variation in study design. How air pollution induces health effects is uncertain; however, studies have repeatedly demonstrated the effects of air pollution on epigenetic modifications. More recent evidence suggests that epigenetics may, in turn, be linked to preterm birth. Discovery of environmentally modifiable epigenetic processes connected to preterm birth may help to identify women at risk of preterm birth, and ultimately lead to development of new preterm birth prevention measures. PMID:26900485

  4. Emerging executive skills in very preterm children at 2 years corrected age: a composite assessment.

    PubMed

    Pozzetti, Tiziana; Ometto, Alessandra; Gangi, Silvana; Picciolini, Odoardo; Presezzi, Gisella; Gardon, Laura; Pisoni, Silvia; Mosca, Fabio; Marzocchi, Gian Marco

    2014-03-01

    Executive Function (EF) deficits have previously been identified in preterm children. However, only recently have emerging executive functions been studied in preschool children who were born preterm without major brain damage. Our study provides a broad assessment of EFs in 72 extremely preterm births (gestational age < 34 weeks and birth weight < 2500 g) and 73 full-term children, born between 2006 and 2008, at 24 months of corrected age. Three factors were extracted from the EF administered measures: working memory, cognitive flexibility, and impulsivity control. Only cognitive flexibility was found to discriminate preterm children from controls. PMID:23360101

  5. Immunizations for Preterm Babies

    MedlinePlus

    ... Prevention Listen Español Text Size Email Print Share Immunizations For Preterm Babies Page Content Some parents of ... full-term and preterm babies. The hepatitis B vaccine deserves special mention. In most circumstances, the AAP ...

  6. Preterm Labor and Birth

    MedlinePlus

    ... Research Information Clinical Trials Resources and Publications Preterm Labor and Birth: Condition Information Skip sharing on social ... links Share this: Page Content What is preterm labor and birth? In general, a normal human pregnancy ...

  7. Preterm Labor and Birth

    MedlinePlus

    ... Research Information Clinical Trials Resources and Publications Preterm Labor and Birth: Overview Skip sharing on social media ... start of the last menstrual period to childbirth. Labor that begins before 37 weeks is called preterm ...

  8. The epidemiology, etiology, and costs of preterm birth.

    PubMed

    Frey, Heather A; Klebanoff, Mark A

    2016-04-01

    After decades of rising preterm birth rates in the USA and other countries, recent prematurity rates seem to be on the decline. Despite this optimistic trend, preterm birth rates remain higher in the USA, where nearly one in every eight infants is born early, compared to other developed countries. The prevention of preterm birth is considered a public health priority because of the potential to reduce infant and childhood morbidity and mortality related to this condition. Unfortunately, progress has been modest. One of the greatest challenges in studying this outcome is that preterm birth is a complex condition resulting from multiple etiologic pathways. Recently, experts have developed innovative frameworks for classifying and studying preterm birth based on phenotype. These proposed classification systems have only recently been adopted, but a different perspective on a longstanding problem has the potential to lead to new discoveries. PMID:26794420

  9. Could Cord Blood Cell Therapy Reduce Preterm Brain Injury?

    PubMed Central

    Li, Jingang; McDonald, Courtney A.; Fahey, Michael C.; Jenkin, Graham; Miller, Suzanne L.

    2014-01-01

    Major advances in neonatal care have led to significant improvements in survival rates for preterm infants, but this occurs at a cost, with a strong causal link between preterm birth and neurological deficits, including cerebral palsy (CP). Indeed, in high-income countries, up to 50% of children with CP were born preterm. The pathways that link preterm birth and brain injury are complex and multifactorial, but it is clear that preterm birth is strongly associated with damage to the white matter of the developing brain. Nearly 90% of preterm infants who later develop spastic CP have evidence of periventricular white matter injury. There are currently no treatments targeted at protecting the immature preterm brain. Umbilical cord blood (UCB) contains a diverse mix of stem and progenitor cells, and is a particularly promising source of cells for clinical applications, due to ethical and practical advantages over other potential therapeutic cell types. Recent studies have documented the potential benefits of UCB cells in reducing brain injury, particularly in rodent models of term neonatal hypoxia–ischemia. These studies indicate that UCB cells act via anti-inflammatory and immuno-modulatory effects, and release neurotrophic growth factors to support the damaged and surrounding brain tissue. The etiology of brain injury in preterm-born infants is less well understood than in term infants, but likely results from episodes of hypoperfusion, hypoxia–ischemia, and/or inflammation over a developmental period of white matter vulnerability. This review will explore current knowledge about the neuroprotective actions of UCB cells and their potential to ameliorate preterm brain injury through neonatal cell administration. We will also discuss the characteristics of UCB-derived from preterm and term infants for use in clinical applications. PMID:25346720

  10. [Preterm delivery: detection of risks and preventive treatment].

    PubMed

    Althabe, F; Carroli, G; Lede, R; Belizán, J M; Althabe, O H

    1999-06-01

    Every year around the world some 13 million premature children are born. Most of these children are born in developing countries, and they account for the largest share of perinatal morbidity and mortality. This review study analyzed scientifically validated data on interventions to prevent at least some portion of these preterm deliveries and to lessen their impact on neonatal health. The Cochrane and MEDLINE bibliographic databases were consulted. Fifty review pieces and research articles were studied, relating to the following aspects of preterm delivery: risk factors and early detection of the risk of preterm delivery; preventing the risk of preterm delivery; treating preterm delivery once it has begun; and preventing neonatal respiratory distress syndrome. There were few successful approaches to the prediction, prevention, or early detection of the threat of preterm delivery. The only measures that can be recommended for all pregnant women are screening for and treating asymptomatic bacteriuria as a part of prenatal check-ups. Screening for bacterial vaginosis and treating it reduce the incidence of preterm births in pregnant women with a history of premature delivery. In addition, prophylactic cerclage decreases the incidence of premature births in pregnant women who have had more than three preterm births. To treat a delivery that starts early, with or without premature membrane rupture, the interventions that have proved to be effective are administering betamimetics to the parturient woman in order to delay delivery for 48 hours, and using indomethacin for the same purpose, as the second-choice drug. The prenatal administration of corticosteroids to the pregnant woman can induce lung maturation in the fetus and reduce respiratory distress syndrome and ventricular hemorrhage, thus decreasing neonatal mortality. There is a need to continue and support basic and epidemiological research in order to develop new knowledge on the causes and mechanisms of preterm

  11. Human milk and the nutritional needs of preterm infants.

    PubMed

    Tudehope, David I

    2013-03-01

    Key principles underpinning feeding guidelines for preterm infants include support for developmental care, breastfeeding, milk expression, and creating feeding plans. Early trophic feeding with colostrum and transitional milk improves immune protection and promotes gut maturation. Studies of preterm infants demonstrate that feeding mother's milk (MM) decreases the incidence of infection and necrotizing enterocolitis and improves neurodevelopmental outcome but may decrease ponderal and linear growth. Standard practice in neonatal units is to promote mother's own milk as the feed of choice for all infants. However, it is not feasible or prudent to do so for all preterm infants. Mothers of preterm infants have lower rates of successful breastfeeding compared with those of term infants. MM can contain harmful bacterial or viral pathogens. Although preterm human milk (HM) contains higher concentrations of protein, sodium, zinc, and calcium than mature HM, it falls short of supplying adequate quantities of nutrients required by preterm infants. Therefore, HM supplemented with nutrients is recommended for all infants born before 32 weeks gestation and for certain infants born at 32-36 weeks of gestation. HM is the preferred feed, but preterm formula is an appropriate option when there is an inadequate supply of MM. PMID:23445843

  12. Visuo-manual coordination in preterm infants without neurological impairments.

    PubMed

    Petkovic, Maja; Chokron, Sylvie; Fagard, Jacqueline

    2016-01-01

    The extent of and reasons for visuo-manual coordination deficits in moderate and late preterm born infants without neurological impairments are not well known. This paper presents a longitudinal study on the visuo-manual development of twelve preterm infants, born after 33-36 weeks of gestation without neurological complications, between the ages of 6 and 12 months. Visuo-manual integration and grasping were assessed using the Peabody Developmental Motor Scales, along with bimanual coordination and handedness tests. Visual function was examined once prior to the beginning of the study. Gross motor development was also evaluated every month. Preterm infants were compared to a control group of ten full-term infants according to corrected age. Compared to full-terms, the visual perception of preterm infants was close to normal, with only a measure of visual fixation lower than in full-terms. In contrast, preterm infants had delayed development of visuo-manual integration, grasping, bimanual coordination, and handedness even when compared using corrected age. Tonicity and gestational age at birth were the main variables associated to the delays. These results are discussed in terms of the possible factors underlying such delays. They need to be confirmed on a larger sample of preterm born children, and to be correlated with later development. This would allow developing markers of future neuropsychological impairments during childhood. PMID:26812594

  13. Maternal Drug Use during Pregnancy: Are Preterm and Full-Term Infants Affected Differently?

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger; Coles, Claire D.; Sexson, William R.; Demi, Alice S.

    1998-01-01

    Examined effects of prenatal drug exposure on infants born preterm and full-term to African American mothers. Found more extreme fetal growth deficits in later-born infants, and more extreme irritability increases in earlier-born infants. Gestation length did not moderate cardiorespiratory reactivity effects. Exposure effects occurred for…

  14. Polyamines in human breast milk for preterm and term infants.

    PubMed

    Plaza-Zamora, J; Sabater-Molina, M; Rodríguez-Palmero, M; Rivero, M; Bosch, V; Nadal, J M; Zamora, S; Larqué, E

    2013-08-28

    Maternal milk is the first source of exogenous polyamines for the newborn. Polyamines modulate gut maturation in neonates, but no studies are available on polyamine concentration in human milk of preterm babies, even though they could be important for their immature gut. The present study aimed to determine polyamine concentration in human breast milk of mothers with preterm or term infants during the first month of lactation. Human milk samples were obtained during the first month of lactation from twenty-seven mothers with preterm babies and twelve mothers with babies born at term. The polyamine concentration in human milk was quantified by HPLC. During the first month of lactation, the total polyamine concentration was significantly higher in preterm milk than in term milk samples (7590 (SD 4990) v. 4660 (SD 4830) nmol/l, respectively (P ¼ 0·034)), as well as individual polyamine concentrations. Polyamine concentration in mature milk for preterm babies was significantly higher than that in mature milk for babies at term, and a similar trend was observed in colostrum and transition human milk. The spermidine/spermine ratio was higher in transition milk in preterm v. term samples, while in mature milk, the ratio was significantly lower in preterm than in term babies. In conclusion, the polyamine concentration was significantly higher in human milk for preterm than for term infants. This and the different spermidine/spermine ratios could influence the gut development of premature babies. PMID:23286699

  15. Neonatal White Matter Abnormality Predicts Childhood Motor Impairment in Very Preterm Children

    ERIC Educational Resources Information Center

    Spittle, Alicia J.; Cheong, Jeanie; Doyle, Lex W.; Roberts, Gehan; Lee, Katherine J.; Lim, Jeremy; Hunt, Rod W.; Inder, Terrie E.; Anderson, Peter J.

    2011-01-01

    Aim: Children born very preterm are at risk for impaired motor performance ranging from cerebral palsy (CP) to milder abnormalities, such as developmental coordination disorder. White matter abnormalities (WMA) at term have been associated with CP in very preterm children; however, little is known about the impact of WMA on the range of motor…

  16. Prediction of Participation and Sensory Modulation of Late Preterm Infants at 12 Months: A Prospective Study

    ERIC Educational Resources Information Center

    Bart, O.; Shayevits, S.; Gabis, L. V.; Morag, I.

    2011-01-01

    The aim of the study was to prospectively assess the differences in participation and sensory modulation between late preterm infants (LPI) and term babies, and to predict it by LPI characteristics. The study population includes 124 late preterm infants at gestational age between 34 and 35 6/7 weeks who were born at the same medical center. The…

  17. The corpus callosum and empathy in adults with a history of preterm birth.

    PubMed

    Lawrence, E J; Allen, G M; Walshe, M; Allin, M; Murray, R; Rifkin, L; McGuire, P K; Nosarti, C

    2010-07-01

    Reduced posterior corpus callosum (CC) area has been consistently observed in children and adolescents born very preterm (VPT). CC structural differences are also observed in people diagnosed with empathy disorders. This study examined empathy in relation to CC size in VPT adults and controls. CC area was manually measured for 17 VPT adults and 9 controls. Participants completed the Interpersonal Reactivity Index (Davis, 1980) and the Empathy Quotient (Baron-Cohen & Wheelwright, 2004). VPT adults had reduced posterior CC area in contrast to controls, and a positive linear trend was observed between posterior CC size and gestational age. No between-group empathy differences were observed, although self-reported personal distress in response to social situations was higher in VPT adults, and negatively associated with anterior CC area. We conclude that VPT adults have a smaller posterior CC, which is associated with gestational age, and elevated social distress, which may be mediated by anterior CC size. PMID:20441689

  18. Parent and family outcomes following very preterm or very low birth weight birth: a review.

    PubMed

    Treyvaud, Karli

    2014-04-01

    Parents and the family environment have a pronounced influence on child development. For children at increased risk such as those born very preterm (VPT) or with very low birth weight (VLBW), parent and family functioning can influence the child's level of risk or resilience. This review describes parent and family outcomes after VPT/VLBW birth, specifically parental mental health, parenting stress and the impact of the child on the family. Factors associated with these outcomes are examined, as well as the specific outcomes for fathers. Overall the influence of VPT/VLBW birth on parents and the family appears to be more pronounced in early childhood, with less influence seen by the time of adolescence. Emerging evidence suggests that fathers experience high rates of psychological distress in the first months after VPT birth. Whereas characteristics of the VPT/VLBW child are strongly associated with parent and family outcomes, parent and social factors are also important influences. PMID:24252709

  19. Academic achievement among immigrant and U.S.-born Latino adolescents: Associations with cultural, family, and acculturation factors

    PubMed Central

    Santiago, Catherine DeCarlo; Gudiño, Omar G.; Baweja, Shilpa; Nadeem, Erum

    2015-01-01

    This study examined proximal risk and protective factors that contribute to academic achievement among 130 Latino students. Participating students were 56.2% female and 35.3% foreign-born (mean age = 11.38, SD = .59). Acculturative stress, immigrant status, child gender, parental monitoring, traditional cultural values, mainstream values, and English language proficiency were explored in relation to academic achievement. Higher levels of parental monitoring, English language proficiency, and female gender were associated with higher grades, while mainstream values were associated with lower grades. In addition, a significant interaction between acculturative stress and immigrant status was found, such that higher acculturative stress was related to poorer grades for U.S.-born students in particular. Thus, parental monitoring and female gender are potential protective factors, while identification with mainstream values and low English language proficiency are risk factors for poor grades. U.S.-born students may be particularly vulnerable to the effects of acculturative stress. PMID:25983352

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

    PubMed Central

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

    2013-01-01

    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

  1. Roles of Perinatal Problems on Adolescent Antisocial Behaviors among Children Born after 33 Completed Weeks: A Prospective Investigation

    ERIC Educational Resources Information Center

    Nomura, Yoko; Rajendran, Khushmand; Brooks-Gunn, Jeanne; Newcorn, Jeffrey H.

    2008-01-01

    Background: There is uncertainty about the extent to which mildly sub-optimal perinatal characteristics among individuals born near-term (greater than 33 weeks of gestation) are associated with various subsequent childhood problems, including antisocial behavior. There is even more uncertainty about whether the pathway to antisocial behavior…

  2. Modeling a Cascade of Effects: The Role of Speed and Executive Functioning in Preterm/Full-Term Differences in Academic Achievement

    ERIC Educational Resources Information Center

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

    2011-01-01

    This study identified deficits in executive functioning in pre-adolescent preterms and modeled their role, along with processing speed, in explaining preterm/full-term differences in reading and mathematics. Preterms (less than 1750 g) showed deficits at 11 years on a battery of tasks tapping the three basic executive functions identified by…

  3. Maternal Height and Preterm Birth: A Study on 192,432 Swedish Women

    PubMed Central

    Derraik, José G. B.; Lundgren, Maria; Cutfield, Wayne S.; Ahlsson, Fredrik

    2016-01-01

    Background There is increasing evidence that lower maternal stature is associated with shorter gestational length in the offspring. We examined the association between maternal height and the likelihood of delivering preterm babies in a large and homogeneous cohort of Swedish women. Methods This study covers antenatal data from the Swedish Medical Birth Register on 192,432 women (aged 26.0 years on average) born at term, from singleton pregnancies, and of Nordic ethnicity. Continuous associations between women's heights and the likelihood of preterm birth in the offspring were evaluated. Stratified analyses were also carried out, separating women into different height categories. Results Every cm decrease in maternal stature was associated with 0.2 days shortening of gestational age in the offspring (p<0.0001) and increasing odds of having a child born preterm (OR 1.03), very preterm (OR 1.03), or extremely preterm (OR 1.04). Besides, odds of all categories of preterm birth were highest among the shortest women but lowest among the tallest mothers. Specifically, women of short stature (≤155 cm or ≤-2.0 SDS below the population mean) had greater odds of having preterm (OR 1.65) or very preterm (OR 1.47) infants than women of average stature (-0.5 to 0.5 SDS). When compared to women of tall stature (≥179 cm), mothers of short stature had even greater odds of giving birth to preterm (OR 2.07) or very preterm (OR 2.16) infants. Conclusions Among Swedish women, decreasing height was associated with a progressive increase in the odds of having an infant born preterm. Maternal short stature is a likely contributing factor to idiopathic preterm births worldwide, possibly due to maternal anatomical constraints. PMID:27100080

  4. Neurodevelopmental and Psychological Assessment of Adolescents Born to Drug-Addicted Parents: Effects of SES and Adoption

    ERIC Educational Resources Information Center

    Ornoy, Asher; Daka, Lulu; Goldzweig, Gil; Gil, Yoni; Mjen, Ludmila; Levit, Shabtai; Shufman, Emi; Bar-Hamburger, Rachel; Greenbaum, Charles W.

    2010-01-01

    Objectives: Prenatal exposure to heroin may have long-term consequences for development during early and middle childhood. The present research studied the cognitive, social, and emotional functioning of adolescents exposed to drugs prenatally, and investigated the extent to which the early adoption of children exposed prenatally to drugs would…

  5. Prenatal stress alters amygdala functional connectivity in preterm neonates.

    PubMed

    Scheinost, Dustin; Kwon, Soo Hyun; Lacadie, Cheryl; Sze, Gordon; Sinha, Rajita; Constable, R Todd; Ment, Laura R

    2016-01-01

    Exposure to prenatal and early-life stress results in alterations in neural connectivity and an increased risk for neuropsychiatric disorders. In particular, alterations in amygdala connectivity have emerged as a common effect across several recent studies. However, the impact of prenatal stress exposure on the functional organization of the amygdala has yet to be explored in the prematurely-born, a population at high risk for neuropsychiatric disorders. We test the hypothesis that preterm birth and prenatal exposure to maternal stress alter functional connectivity of the amygdala using two independent cohorts. The first cohort is used to establish the effects of preterm birth and consists of 12 very preterm neonates and 25 term controls, all without prenatal stress exposure. The second is analyzed to establish the effects of prenatal stress exposure and consists of 16 extremely preterm neonates with prenatal stress exposure and 10 extremely preterm neonates with no known prenatal stress exposure. Standard resting-state functional magnetic resonance imaging and seed connectivity methods are used. When compared to term controls, very preterm neonates show significantly reduced connectivity between the amygdala and the thalamus, the hypothalamus, the brainstem, and the insula (p < 0.05). Similarly, when compared to extremely preterm neonates without exposure to prenatal stress, extremely preterm neonates with exposure to prenatal stress show significantly less connectivity between the left amygdala and the thalamus, the hypothalamus, and the peristriate cortex (p < 0.05). Exploratory analysis of the combined cohorts suggests additive effects of prenatal stress on alterations in amygdala connectivity associated with preterm birth. Functional connectivity from the amygdala to other subcortical regions is decreased in preterm neonates compared to term controls. In addition, these data, for the first time, suggest that prenatal stress exposure amplifies these

  6. CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth.

    PubMed

    Shapiro-Mendoza, Carrie K; Barfield, Wanda D; Henderson, Zsakeba; James, Arthur; Howse, Jennifer L; Iskander, John; Thorpe, Phoebe G

    2016-01-01

    Preterm birth (delivery before 37 weeks and 0/7 days of gestation) is a leading cause of infant morbidity and mortality in the United States. In 2013, 11.4% of the nearly 4 million U.S. live births were preterm; however, 36% of the 8,470 infant deaths were attributed to preterm birth (1). Infants born at earlier gestational ages, especially <32 0/7 weeks, have the highest mortality (Figure) and morbidity rates. Morbidity associated with preterm birth includes respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage; longer-term consequences include developmental delay and decreased school performance. Risk factors for preterm delivery include social, behavioral, clinical, and biologic characteristics (Box). Despite advances in medical care, racial and ethnic disparities associated with preterm birth persist. Reducing preterm birth, a national public health priority (2), can be accomplished by implementing and monitoring strategies that target modifiable risk factors and populations at highest risk, and by providing improved quality and access to preconception, prenatal, and interconception care through implementation of strategies with potentially high impact. PMID:27536925

  7. Investigation of maternal environmental exposures in association with self-reported preterm birth

    PubMed Central

    Patel, Chirag J; Yang, Ting; Hu, Zhongkai; Wen, Qiaojun; Sung, Joyce; El-Sayed, Yasser Y; Cohen, Harvey; Gould, Jeffrey; Stevenson, David K; Shaw, Gary M; Ling, Xuefeng Bruce; Butte, Atul J

    2015-01-01

    Identification of maternal environmental factors influencing preterm birth risks is important to understand the reasons for the increase in prematurity since 1990. Here, we utilized a health survey, the US National Health and Nutrition Examination Survey (NHANES) to search for personal environmental factors associated with preterm birth. 201 urine and blood markers of environmental factors, such as allergens, pollutants, and nutrients were assayed in mothers (range of N: 49 to 724) who answered questions about any children born preterm (delivery <37 weeks). We screened each of the 201 factors for association with any child born preterm adjusting by age, race/ethnicity, education, and household income. We attempted to verify the top finding, urinary bisphenol A, in an independent study of pregnant women attending Lucile Packard Children’s Hospital. We conclude that the association between maternal urinary levels of bisphenol A and preterm birth should be evaluated in a larger epidemiological investigation. PMID:24373932

  8. Preterm Infant Hippocampal Volumes Correlate with Later Working Memory Deficits

    ERIC Educational Resources Information Center

    Beauchamp, Miriam H.; Thompson, Deanne K.; Howard, Kelly; Doyle, Lex W.; Egan, Gary F.; Inder, Terrie E.; Anderson, Peter J.

    2008-01-01

    Children born preterm exhibit working memory deficits. These deficits may be associated with structural brain changes observed in the neonatal period. In this study, the relationship between neonatal regional brain volumes and working memory deficits at age 2 years were investigated, with a particular interest in the dorsolateral prefrontal…

  9. Preterm Birth and Leisure Participation: A Synthesis of the Literature

    ERIC Educational Resources Information Center

    Dahan-Oliel, Noemi; Mazer, Barbara; Majnemer, Annette

    2012-01-01

    Leisure participation has been associated with happiness and well-being in children. Individuals born preterm are at greater risk for motor, cognitive and behavioral difficulties which may contribute to difficulties participating in leisure activities. This systematic review examined the current knowledge on participation in leisure activities in…

  10. Executive Function in Very Preterm Children at Early School Age

    ERIC Educational Resources Information Center

    Aarnoudse-Moens, Cornelieke S. H.; Smidts, Diana P.; Oosterlaan, Jaap; Duivenvoorden, Hugo J.; Weisglas-Kuperus, Nynke

    2009-01-01

    We examined whether very preterm ([less than or equal to] 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 children (27 boys and 23 girls) born very…

  11. Cognitive Visual Dysfunctions in Preterm Children with Periventricular Leukomalacia

    ERIC Educational Resources Information Center

    Fazzi, Elisa; Bova, Stefania; Giovenzana, Alessia; Signorini, Sabrina; Uggetti, Carla; Bianchi, Paolo

    2009-01-01

    Aim: Cognitive visual dysfunctions (CVDs) reflect an impairment of the capacity to process visual information. The question of whether CVDs might be classifiable according to the nature and distribution of the underlying brain damage is an intriguing one in child neuropsychology. Method: We studied 22 children born preterm (12 males, 10 females;…

  12. The Emergence of Tool Use in Preterm Infants.

    PubMed

    Petkovic, Maja; Rat-Fischer, Lauriane; Fagard, Jacqueline

    2016-01-01

    Preterm born children without neurological impairments have been shown to present some visual-manual coordination deficits, more or less depending on their tonicity and the degree of prematurity. In this paper, we compare the development of tool use in 15-23-month-old preterm infants born after 33-36 weeks of gestation without neurological complications with that of full-term infants according to corrected age. Understanding the affordance of a tool is an important cognitive milestone in early sensorimotor period. Using a tool to bring within reach an out-of-reach object, for instance, has been shown to develop during the 2nd year in full-term infants. Here we presented preterm infants with an attractive toy out of reach and with a rake-like tool within reach in five conditions of spatial relationships between the toy and the tool. Like full-terms, preterm infants used the tool with success in conditions of spatial contiguity around 15-17 months. In conditions of a spatial gap between tool and toy, i.e., the only conditions which shows without ambiguity that the infant understands the affordance of the tool, preterm infants as a group showed no delay for tool use: the frequency of spontaneous successes started to increase after 18 months, and demonstration became effective after that age. However, further analyses showed that only the preterm infants without hypotonia and born after 36 weeks of pregnancy developed tool use without delay. Hypotonic preterm infants were still largely unsuccessful in the conditions of spatial gap, even at the end of the study. The degree of prematurity also influenced the performance at tool use. These results, following the observation of a delay in the development of bimanual coordination and of handedness in the same infants at 10-12 months in a previous study, show that low risk preterm infants can still be impaired for the development of new manual skills beyond the 1st year. Thus, hypotonic preterm infants and infants born

  13. The Emergence of Tool Use in Preterm Infants

    PubMed Central

    Petkovic, Maja; Rat-Fischer, Lauriane; Fagard, Jacqueline

    2016-01-01

    Preterm born children without neurological impairments have been shown to present some visual-manual coordination deficits, more or less depending on their tonicity and the degree of prematurity. In this paper, we compare the development of tool use in 15–23-month-old preterm infants born after 33–36 weeks of gestation without neurological complications with that of full-term infants according to corrected age. Understanding the affordance of a tool is an important cognitive milestone in early sensorimotor period. Using a tool to bring within reach an out-of-reach object, for instance, has been shown to develop during the 2nd year in full-term infants. Here we presented preterm infants with an attractive toy out of reach and with a rake-like tool within reach in five conditions of spatial relationships between the toy and the tool. Like full-terms, preterm infants used the tool with success in conditions of spatial contiguity around 15–17 months. In conditions of a spatial gap between tool and toy, i.e., the only conditions which shows without ambiguity that the infant understands the affordance of the tool, preterm infants as a group showed no delay for tool use: the frequency of spontaneous successes started to increase after 18 months, and demonstration became effective after that age. However, further analyses showed that only the preterm infants without hypotonia and born after 36 weeks of pregnancy developed tool use without delay. Hypotonic preterm infants were still largely unsuccessful in the conditions of spatial gap, even at the end of the study. The degree of prematurity also influenced the performance at tool use. These results, following the observation of a delay in the development of bimanual coordination and of handedness in the same infants at 10–12 months in a previous study, show that low risk preterm infants can still be impaired for the development of new manual skills beyond the 1st year. Thus, hypotonic preterm infants and infants

  14. Specific language and reading skills in school-aged children and adolescents are associated with prematurity after controlling for IQ.

    PubMed

    Lee, Eliana S; Yeatman, Jason D; Luna, Beatriz; Feldman, Heidi M

    2011-04-01

    Although studies of long-term outcomes of children born preterm consistently show low intelligence quotient (IQ) and visual-motor impairment, studies of their performance in language and reading have found inconsistent results. In this study, we examined which specific language and reading skills were associated with prematurity independent of the effects of gender, socioeconomic status (SES), and IQ. Participants from two study sites (N=100) included 9-16-year old children born before 36 weeks gestation and weighing less than 2500 grams (preterm group, n=65) compared to children born at 37 weeks gestation or more (full-term group, n=35). Children born preterm had significantly lower scores than full-term controls on Performance IQ, Verbal IQ, receptive and expressive language skills, syntactic comprehension, linguistic processing speed, verbal memory, decoding, and reading comprehension but not on receptive vocabulary. Using MANCOVA, we found that SES, IQ, and prematurity all contributed to the variance in scores on a set of six non-overlapping measures of language and reading. Simple regression analyses found that after controlling for SES and Performance IQ, the degree of prematurity as measured by gestational age group was a significant predictor of linguistic processing speed, β=-.27, p<.05, R(2)=.07, verbal memory, β=.31, p<.05, R(2)=.09, and reading comprehension, β=.28, p<.05, R(2)=.08, but not of receptive vocabulary, syntactic comprehension, or decoding. The language and reading domains where prematurity had a direct effect can be classified as fluid as opposed to crystallized functions and should be monitored in school-aged children and adolescents born preterm. PMID:21195100

  15. Energy density at a buffet-style lunch differs for adolescents born at high and low risk of obesity

    PubMed Central

    Kral, Tanja V.E.; Stunkard, Albert J.; Berkowitz, Robert I.; Stettler, Nicolas; Stallings, Virginia A.; Kabay, April; Faith, Myles S.

    2009-01-01

    The energy density (ED; kcal/g) of foods, when manipulated in the laboratory, affects short-term energy intake. The aim of this study was to examine if, when given a choice, dietary ED (foods only) and energy intake (expressed as a percentage of subjects’ estimated daily energy requirement) at a self-selected, single meal differs for teens born with a different familial predisposition to obesity and as a function of their sex. Subjects (13 males, 17 females) were 12 years of age and born at high-risk (HR; n = 15) or low-risk (LR; n = 15) for obesity based on maternal pre-pregnancy body mass index (BMI; kg/m2). The buffet meal, served for lunch and consumed ad libitum, consisted of a variety of foods and beverages with a range in ED. HR subjects consumed a more energy-dense meal (foods only) than LR subjects (1.84 vs. 1.42 kcal/g; P = 0.02) and males consumed a more energy-dense meal than females (1.83 vs. 1.43 kcal/g; P = 0.03). Total energy intake, when expressed as a percentage of subjects’ daily EER, did not differ between HR and LR subjects (42% vs. 33%; P = 0.16). Males, compared to females, consumed ∼ 59% more energy from foods and beverages during the meal (46 vs. 29%; P = 0.008). During a single multi-item lunch meal, teens with a familial predisposition to obesity and males, independent of their obesity risk status, self-selected a more energy-dense meal. Familial risk for obesity, through either genetic or environmental pathways, may facilitate a more energy-dense diet. PMID:19778749

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

    ERIC Educational Resources Information Center

    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…

  17. The Quality of Preterm Infants' Spontaneous Movements: An Early Indicator of Intelligence and Behaviour at School Age

    ERIC Educational Resources Information Center

    Butcher, Phillipa R.; van Braeckel, Koen; Bouma, Anke; Einspieler, Christa; Stremmelaar, Elisabeth F.; Bos, Arend F.

    2009-01-01

    Background: The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that children born very preterm often experience.…

  18. Infant Physiological Regulation and Maternal Risks as Predictors of Dyadic Interaction Trajectories in Families with a Preterm Infant

    ERIC Educational Resources Information Center

    Poehlmann, Julie; Schwichtenberg, A. J. Miller; Bolt, Daniel M.; Hane, Amanda; Burnson, Cynthia; Winters, Jill

    2011-01-01

    This longitudinal study examined predictors of rates of growth in dyadic interaction quality in children born preterm who did not experience significant neurological findings during neonatal intensive care unit (NICU) hospitalization. Multiple methods were used to collect data from 120 preterm infants (48% girls, 52% boys) and their mothers.…

  19. Subjective Visual Vertical and Postural Capability in Children Born Prematurely

    PubMed Central

    Bucci, Maria Pia; Wiener-Vacher, Sylvette; Trousson, Clémence; Baud, Olivier; Biran, Valerie

    2015-01-01

    Purpose We compared postural stability and subjective visual vertical performance in a group of very preterm-born children aged 3-4 years and in a group of age-matched full-term children. Materials and Methods A platform (from TechnoConcept) was used to measure postural control in children. Perception of subjective visual vertical was also recorded with posture while the child had to adjust the vertical in the dark or with visual perturbation. Two other conditions (control conditions) were also recorded while the child was on the platform: for a fixation of the vertical bar, and in eyes closed condition. Results Postural performance was poor in preterm-born children compared to that of age-matched full-term children: the surface area, the length in medio-lateral direction and the mean speed of the center of pressure (CoP) were significantly larger in the preterm-born children group (p < 0.04, p < 0.01, and p < 0.04, respectively). Dual task in both groups of children significantly affected postural control. The subjective visual vertical (SVV) values were more variable and less precise in preterm-born children. Discussion-Conclusions We suggest that poor postural control as well as perception of verticality observed in preterm-born children could be due to immaturity of the cortical processes involved in the motor control and in the treatment of perception and orientation of verticality. PMID:25790327

  20. Prevention of preterm birth.

    PubMed

    Flood, Karen; Malone, Fergal D

    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. PMID:21893439

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

    ERIC Educational Resources Information Center

    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…

  2. Assisted reproductive technology and the risk of preterm birth among primiparas

    PubMed Central

    Dunietz, Galit Levi; Holzman, Claudia; McKane, Patricia; Li, Chenxi; Boulet, Sheree L.; Todem, David; Kissin, Dmitry M.; Copeland, Glenn; Bernson, Dana; Sappenfield, William M.; Diamond, Michael P.

    2015-01-01

    Objective To investigate the risk of preterm birth among liveborn singletons to primiparas who conceived with assisted reproductive technology (ART) using four mutually exclusive categories of infertility (female infertility only, male infertility only, female and male infertility, and unexplained infertility) and to examine preterm birth risk along the gestational age continuum. Design Retrospective cohort study. Setting Not applicable. Patient(s) Singletons born to primiparas who conceived with or without ART. Intervention(s) None. Main Outcome Measure(s) Preterm (<37 weeks’ gestation) and preterm/early term birth <39 weeks’ gestation). Result(s) For the male infertility only, female infertility only, combined male and female infertility, and unexplained infertility groups, ART-conceived singletons were significantly more likely than non-ART singletons to be born preterm: adjusted odds ratio (aOR) 1.24 (95% CI, 1.13, 1.37), aOR 1.60 (95% CI, 1.50, 1.70), aOR 1.49 (95% CI, 1.35, 1.64), and aOR 1.26 (1.12, 1.43) respectively. Among infants whose mothers were diagnosed with infertility, the odds of preterm birth were highest between 28–30 weeks [female infertility only, aOR 1.95 (95% CI, 1.59, 2.39); male and female infertility: 2.21 (95% CI, 1.62, 3.00)] compared with infants in the general population. Within the ART population, singletons of couples with female infertility only were more likely to be born preterm than singletons born to couples with other infertility diagnoses. Conclusion(s) Among singleton births to primiparas, those conceived with ART had an increased risk for preterm birth, even when only the male partner had been diagnosed with infertility. The risk of preterm birth for ART-conceived infants whose mothers were diagnosed with infertility included the earliest deliveries. PMID:25707336

  3. Epigenetic Biomarkers of Preterm Birth and Its Risk Factors

    PubMed Central

    Knight, Anna K.; Smith, Alicia K.

    2016-01-01

    A biomarker is a biological measure predictive of a normal or pathogenic process or response. Biomarkers are often useful for making clinical decisions and determining treatment course. One area where such biomarkers would be particularly useful is in identifying women at risk for preterm delivery and related pregnancy complications. Neonates born preterm have significant morbidity and mortality, both in the perinatal period and throughout the life course, and identifying women at risk of delivering preterm may allow for targeted interventions to prevent or delay preterm birth (PTB). In addition to identifying those at increased risk for preterm birth, biomarkers may be able to distinguish neonates at particular risk for future complications due to modifiable environmental factors, such as maternal smoking or alcohol use during pregnancy. Currently, there are no such biomarkers available, though candidate gene and epigenome-wide association studies have identified DNA methylation differences associated with PTB, its risk factors and its long-term outcomes. Further biomarker development is crucial to reducing the health burden associated with adverse intrauterine conditions and preterm birth, and the results of recent DNA methylation studies may advance that goal. PMID:27089367

  4. Preterm birth and necrotizing enterocolitis alter gut colonization in pigs.

    PubMed

    Cilieborg, Malene S; Boye, Mette; Mølbak, Lars; Thymann, Thomas; Sangild, Per T

    2011-01-01

    Necrotizing enterocolitis (NEC) in preterm neonates is dependent on bacterial colonization, but it remains unclear whether a particular microbiota or specific pathogens are involved. We hypothesized that gut colonization differs between preterm and term neonates and that overgrowth of Clostridium perfringens predisposes to NEC. By using terminal-RFLP and FISH, we characterized the gut microbiota of preterm, caesarean-delivered, formula-fed pigs (n = 44) with or without NEC and of formula- or colostrum-fed term, and vaginally born pigs (n = 13). A different microbiota with high C. perfringens abundance was observed in preterm pigs with NEC compared with healthy individuals. However, immunization against C. perfringens toxins did not prevent NEC, and C. perfringens inoculation (3.6 × 10 cfu/d) failed to induce NEC (n = 16), whereas prophylactic broad-spectrum antibiotics treatment prevented NEC (n = 24). Colonization in both groups of term pigs differed from preterm pigs and was dominated by Lactobacilli spp. In conclusion, gestational age (GA) and NEC influence neonatal gut colonization, whereas diet has minor effects. C. perfringens is more abundant in pigs with NEC but rather as a consequence than a cause of disease. The general bacterial load and underdeveloped gut immune responses in preterm neonates seem more important for NEC development than specific pathogens. PMID:20924317

  5. Epigenetics: linking social and environmental exposures to preterm birth.

    PubMed

    Burris, Heather H; Baccarelli, Andrea A; Wright, Robert O; Wright, Rosalind J

    2016-01-01

    Preterm birth remains a leading cause of infant mortality and morbidity. Despite decades of research, marked racial and socioeconomic disparities in preterm birth persist. In the Unites States, more than 16% of African-American infants are born before 37 wk of gestation compared with less than 11% of white infants. While income and education differences predict a portion of these racial disparities, income and education are proxies of the underlying causes rather than the true cause. How these differences lead to the pathophysiology remains unknown. Beyond tobacco smoke exposure, most preterm birth investigators overlook environment exposures that often correlate with poverty. Environmental exposures to industrial contaminants track along both socioeconomic and racial/ethnic lines due to cultural variation in personal product use, diet, and residential geographical separation. Emerging evidence suggests that environmental exposure to metals and plasticizers contribute to preterm birth and epigenetic modifications. The extent to which disparities in preterm birth result from interactions between the social and physical environments that produce epigenetic modifications remains unclear. In this review, we highlight studies that report associations between environmental exposures and preterm birth as well as perinatal epigenetic sensitivity to environmental contaminants and socioeconomic stressors. PMID:26460521

  6. Epigenetics, linking social and environmental exposures to preterm birth

    PubMed Central

    Burris, Heather H; Baccarelli, Andrea A; Wright, Robert O; Wright, Rosalind J

    2015-01-01

    Preterm birth remains a leading cause of infant mortality and morbidity. Despite decades of research, marked racial and socioeconomic disparities in preterm birth persist. In the US, more than 16% of African American infants are born before 37 weeks of gestation compared to less than 11% of white infants. While income and education differences predict a portion of these racial disparities, income and education are proxies of the underlying causes rather than the true cause. How these differences lead to the pathophysiology remains unknown. Beyond tobacco smoke exposure, most preterm birth investigators overlook environment exposures that often correlate with poverty. Environmental exposures to industrial contaminants track along both socioeconomic and racial/ethnic lines due to cultural variation in personal product use, diet and residential geographical separation. Emerging evidence suggests that environmental exposure to metals and plasticizers contribute to preterm birth and epigenetic modifications. The extent to which disparities in preterm birth result from interactions between the social and physical environments that produce epigenetic modifications remains unclear. In this review, we highlight studies that report associations between environmental exposures and preterm birth as well as perinatal epigenetic sensitivity to environmental contaminants and socioeconomic stressors. PMID:26460521

  7. Epigenetic Biomarkers of Preterm Birth and Its Risk Factors.

    PubMed

    Knight, Anna K; Smith, Alicia K

    2016-01-01

    A biomarker is a biological measure predictive of a normal or pathogenic process or response. Biomarkers are often useful for making clinical decisions and determining treatment course. One area where such biomarkers would be particularly useful is in identifying women at risk for preterm delivery and related pregnancy complications. Neonates born preterm have significant morbidity and mortality, both in the perinatal period and throughout the life course, and identifying women at risk of delivering preterm may allow for targeted interventions to prevent or delay preterm birth (PTB). In addition to identifying those at increased risk for preterm birth, biomarkers may be able to distinguish neonates at particular risk for future complications due to modifiable environmental factors, such as maternal smoking or alcohol use during pregnancy. Currently, there are no such biomarkers available, though candidate gene and epigenome-wide association studies have identified DNA methylation differences associated with PTB, its risk factors and its long-term outcomes. Further biomarker development is crucial to reducing the health burden associated with adverse intrauterine conditions and preterm birth, and the results of recent DNA methylation studies may advance that goal. PMID:27089367

  8. Visual Development and Neuropsychological Profile in Preterm Children from 6 Months to School Age.

    PubMed

    Sayeur, Mélissa Sue; Vannasing, Phetsamone; Tremblay, Emmanuel; Lepore, Franco; McKerral, Michelle; Lassonde, Maryse; Gallagher, Anne

    2015-08-01

    The aim of this semilongitudinal study was to investigate the development of central visual pathways in children born preterm but without major neurologic impairments and to establish their cognitive and behavioral profile at school age. Ten children born preterm were assessed at 6 months and at school age, using visual evoked potentials at both time points and cognitive and behavioral tests at school age. We also tested 10 age-matched children born full-term. At 6 months' corrected age, we found no significant differences between preterm and full-term groups for either amplitude or latency of N1 and P1 components. At school age, the preterm group manifested significantly higher N1 amplitudes and tended to show higher P1 amplitudes than the full-term group. We found no significant differences in cognitive and behavioral measures at school age. These results suggest that preterm birth affects visual pathways development, yet the children born preterm did not manifest cognitive problems. PMID:25414236

  9. Neonatal White Matter Abnormalities an Important Predictor of Neurocognitive Outcome for Very Preterm Children

    PubMed Central

    Woodward, Lianne J.; Clark, Caron A. C.; Bora, Samudragupta; Inder, Terrie E.

    2012-01-01

    Background Cerebral white matter abnormalities on term MRI are a strong predictor of motor disability in children born very preterm. However, their contribution to cognitive impairment is less certain. Objective Examine relationships between the presence and severity of cerebral white matter abnormalities on neonatal MRI and a range of neurocognitive outcomes assessed at ages 4 and 6 years. Design/Methods The study sample consisted of a regionally representative cohort of 104 very preterm (≤32 weeks gestation) infants born from 1998–2000 and a comparison group of 107 full-term infants. At term equivalent, all preterm infants underwent a structural MRI scan that was analyzed qualitatively for the presence and severity of cerebral white matter abnormalities, including cysts, signal abnormalities, loss of white matter volume, ventriculomegaly, and corpus callosal thinning/myelination. At corrected ages 4 and 6 years, all children underwent a comprehensive neurodevelopmental assessment that included measures of general intellectual ability, language development, and executive functioning. Results At 4 and 6 years, very preterm children without cerebral white matter abnormalities showed no apparent neurocognitive impairments relative to their full-term peers on any of the domain specific measures of intelligence, language, and executive functioning. In contrast, children born very preterm with mild and moderate-to-severe white matter abnormalities were characterized by performance impairments across all measures and time points, with more severe cerebral abnormalities being associated with increased risks of cognitive impairment. These associations persisted after adjustment for gender, neonatal medical risk factors, and family social risk. Conclusions Findings highlight the importance of cerebral white matter connectivity for later intact cognitive functioning amongst children born very preterm. Preterm born children without cerebral white matter abnormalities on

  10. An allometric scaling relationship in the brain of preterm infants

    PubMed Central

    Paul, Rachel A; Smyser, Christopher D; Rogers, Cynthia E; English, Ian; Wallendorf, Michael; Alexopoulos, Dimitrios; Meyer, Erin J; Van Essen, David C; Neil, Jeffrey J; Inder, Terrie E

    2014-01-01

    Allometry has been used to demonstrate a power–law scaling relationship in the brain of premature born infants. Forty-nine preterm infants underwent neonatal MRI scans and neurodevelopmental testing at age 2. Measures of cortical surface area and total cerebral volume demonstrated a power–law scaling relationship (α = 1.27). No associations were identified between these measures and investigated clinical variables. Term equivalent cortical surface area and total cerebral volume measures and scaling exponents were not related to outcome. These findings confirm a previously reported allometric scaling relationship in the preterm brain, and suggest that scaling is not a sensitive indicator of aberrant cortical maturation. PMID:25540808

  11. Glucocorticoid-Induced Preterm Birth and Neonatal Hyperglycemia Alter Ovine β-Cell Development.

    PubMed

    Bansal, Amita; Bloomfield, Frank H; Connor, Kristin L; Dragunow, Mike; Thorstensen, Eric B; Oliver, Mark H; Sloboda, Deborah M; Harding, Jane E; Alsweiler, Jane M

    2015-10-01

    Adults born preterm are at increased risk of impaired glucose tolerance and diabetes. Late gestation fetuses exposed to high blood glucose concentration also are at increased risk of impaired glucose tolerance as adults. Preterm babies commonly become hyperglycemic and are thus exposed to high blood glucose concentration at an equivalent stage of pancreatic maturation. It is not known whether preterm birth itself, or complications of prematurity, such as hyperglycemia, alter later pancreatic function. To distinguish these, we made singleton preterm lambs hyperglycemic (HYPER) for 12 days after birth with a dextrose infusion and compared them with vehicle-treated preterm and term controls and with HYPER lambs made normoglycemic with an insulin infusion. Preterm birth reduced β-cell mass, apparent by 4 weeks after term and persisting to adulthood (12 mo), and was associated with reduced insulin secretion at 4 months (juvenile) and reduced insulin mRNA expression in adulthood. Hyperglycemia in preterm lambs further down-regulated key pancreatic gene expression in adulthood. These findings indicate that reduced β-cell mass after preterm birth may be an important factor in increased risk of diabetes after preterm birth and may be exacerbated by postnatal hyperglycemia. PMID:26204462

  12. Factors for Preterm Births in Germany – An Analysis of Representative German Data (KiGGS)

    PubMed Central

    Weichert, A.; Weichert, T. M.; Bergmann, R. L.; Henrich, W.; Kalache, K. D.; Richter, R.; Neymeyer, J.; Bergmann, K. E.

    2015-01-01

    Introduction: Preterm birth is a global scourge, the leading cause of perinatal mortality and morbidity. This study set out to identify the principal risk factors for preterm birth, based on the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A range of possible factors influencing preterm birth were selected for inclusion in the questionnaire, covering factors such as gender, national origin, immigrant background, demography, living standard, family structure, parental education and vocational training. Methods: All data were taken from the aforementioned KiGGS survey conducted between 2003 and 2006. A total of 17 641 children and adolescents (8656 girls and 8985 boys) drawn from 167 German towns and municipalities deemed to be representative of the Federal Republic of Germany were included in the study. Gestational age at birth was available for 14 234 datasets. The questionnaire included questions from the following areas as possible factors influencing preterm birth: gender, national origins, immigrant background, demography, living standard, family structure, parental education and vocational training. Results: The preterm birth rate was 11.6 %, higher than that of other national statistical evaluations. Around 57.4 % of multiple pregnancies and 10 % of singleton pregnancies resulted in preterm delivery. Multiple pregnancy was found to be the most important risk factor (OR 13.116). With regard to national origins and immigration background, mothers from Turkey, the Middle East, and North Africa had a higher incidence of preterm birth. Preterm birth was more prevalent in cities and large towns than in small towns and villages. Conclusion: Risk factors associated with preterm birth were identified. These should help with the early identification of pregnant women at risk. The preterm birth rate in our survey was higher than that found in other national statistical evaluations based on process data. More than half of

  13. Investigating Preterm Care at the Facility Level: Stakeholder Qualitative Study in Central and Southern Malawi.

    PubMed

    Gondwe, Austrida; Munthali, Alister; Ashorn, Per; Ashorn, Ulla

    2016-07-01

    Objectives Malawi is estimated to have one of the highest preterm birth rates in the world. However, care of preterm infants at facility level in Malawi has not been explored. We aimed to explore the views of health stakeholders about the care of preterm infants in health facilities and the existence of any policy protocol documents guiding the delivery of care to these infants. Methods We conducted 16 in-depth interviews with health stakeholders (11 service providers and 5 policy makers) using an interview guide and asked for any existing policy protocol documents guiding care for preterm infants in the health facilities in Malawi. The collected documents were reviewed and all the interviews were digitally recorded, transcribed and translated. All data were analysed using content analysis approach. Results We identified four policy protocol documents and out of these, one had detailed information explaining the care of preterm infants. Policy makers reported that policy protocol documents to guide care for preterm infants were available in the health facilities but majority (63.6 %) of the service providers lacked knowledge about the existence of these documents. Health stakeholders reported several challenges in caring for preterm infants including lack of trained staff in preterm infant care, antibiotics, space, supervision and poor referral system. Conclusions Our study highlights that improving health care service provider knowledge of preterm infant care is an integral part in preterm child birth. Our findings suggests that policy makers and health decision makers should retain those trained in preterm new born care in the health facility's preterm unit. PMID:26976282

  14. A whole brain morphometric analysis of changes associated with pre-term birth

    NASA Astrophysics Data System (ADS)

    Thomaz, C. E.; Boardman, J. P.; Counsell, S.; Hill, D. L. G.; Hajnal, J. V.; Edwards, A. D.; Rutherford, M. A.; Gillies, D. F.; Rueckert, D.

    2006-03-01

    Pre-term birth is strongly associated with subsequent neuropsychiatric impairment. To identify structural differences in preterm infants we have examined a dataset of magnetic resonance (MR) images containing 88 preterm infants and 19 term born controls. We have analyzed these images by combining image registration, deformation based morphometry (DBM), multivariate statistics, and effect size maps (ESM). The methodology described has been performed directly on the MR intensity images rather than on segmented versions of the images. The results indicate that the approach described makes clear the statistical differences between the control and preterm samples, showing a leave-one-out classification accuracy of 94.74% and 95.45% respectively. In addition, finding the most discriminant direction between the groups and using DBM features and ESM we are able to identify not only what are the changes between preterm and term groups but also how relatively relevant they are in terms of volume expansion and contraction.

  15. Cerebellar white matter pathways are associated with reading skills in children and adolescents

    PubMed Central

    Travis, Katherine E; Leitner, Yael; Feldman, Heidi M.; Ben-Shachar, Michal

    2015-01-01

    Reading is a critical life skill in the modern world. The neural basis of reading incorporates a distributed network of cortical areas and their white matter connections. The cerebellum has also been implicated in reading and reading disabilities. However, little is known about the contribution of cerebellar white matter pathways to major component skills of reading. We used diffusion magnetic resonance imaging (dMRI) with tractography to identify the cerebellar peduncles in a group of 9–17 year old children and adolescents born full term (n=19) or preterm (n=26). In this cohort, no significant differences were found between fractional anisotropy (FA) measures of the peduncles in the preterm and full term groups. FA of the cerebellar peduncles correlated significantly with measures of decoding and reading comprehension in the combined sample of full term and preterm subjects. Correlations were negative in the superior and inferior cerebellar peduncles and positive in the middle cerebellar peduncle. Additional analyses revealed that full term and preterm groups demonstrated similar patterns of reading associations within the left SCP, MCP and left ICP. Partial correlation analyses showed that distinct sub-skills of reading were associated with FA in segments of different cerebellar peduncles. Overall, the present findings are the first to document associations of microstructure of the cerebellar peduncles and the component skills of reading. PMID:25504986

  16. Socioeconomic inequalities in survival and provision of neonatal care: population based study of very preterm infants

    PubMed Central

    Draper, Elizabeth S; Manktelow, Bradley N; Field, David J

    2009-01-01

    Objectives To assess socioeconomic inequalities in survival and provision of neonatal care among very preterm infants. Design Prospective cohort study in a geographically defined population. Setting Former Trent health region of the United Kingdom (covering about a twelfth of UK births). Participants All infants born between 22+0 and 32+6 weeks’ gestation from 1 January 1998 to 31 December 2007 who were alive at the onset of labour and followed until discharge from neonatal care. Main outcome measures Survival to discharge from neonatal care per 1000 total births and per 1000 very preterm births. Neonatal care provision for very preterm infants surviving to discharge measured with length of stay, provision of ventilation, and respiratory support. Deprivation measured with the UK index of multiple deprivation 2004 score at super output area level. Results 7449 very preterm singleton infants were born in the 10 year period. The incidence of very preterm birth was nearly twice as high in the most deprived areas compared with the least deprived areas. Consequently rates of mortality due to very preterm birth per 1000 total births were almost twice as high in the most deprived areas compared with the least deprived (incidence rate ratio 1.94, 95% confidence interval 1.62 to 2.32). Mortality rates per 1000 very preterm births, however, showed little variation across all deprivation fifths (incidence rate ratio for most deprived fifth versus least deprived 1.02, 0.86 to 1.20). For infants surviving to discharge from neonatal care, measures of length of stay and provision of ventilation and respiratory support were similar across all deprivation fifths. Conclusions The burden of mortality and morbidity is greater among babies born to women from deprived areas because of increased rates of very preterm birth. After very preterm birth, however, survival rates and neonatal care provision is similar for infants from all areas. PMID:19952036

  17. Intravenous iron administration together with parenteral nutrition to very preterm Jehovah's Witness twins

    PubMed Central

    Poorisrisak, Porntiva; Schroeder, Allan Mikael; Greisen, Gorm; Zachariassen, Gitte

    2014-01-01

    Preterm twin sisters (monozygotic) were born at gestational age 27 weeks and 5 days with birth weights of 935 and 735 g. They were admitted to our neonatal intensive care unit for a period of 1 month. Their parents were Jehovah’s Witnesses and refused blood transfusion for their preterm daughters. Subcutaneous erythropoietin and intravenous iron were given as a prophylactic to avoid anaemia. PMID:24891477

  18. Healthy Immigrant Effect: Preterm Births Among Immigrants and Refugees in Syracuse, NY.

    PubMed

    Miller, Lauren S; Robinson, Jonnell Allen; Cibula, Donald A

    2016-02-01

    Objectives The healthy immigrant effect is the phenomenon by which immigrants experience more positive health outcomes than the native-born population in developed countries. The strength of this effect appears to be related to country of origin, health outcome, healthcare and integration policies of receiving countries, as well as immigration class. This secondary analysis of birth records examines whether immigrants and mothers from refugee countries have lower adjusted risk of preterm births than US-born mothers in Syracuse, NY, a preferred refugee resettlement area. Methods This secondary analysis included 6354 electronic birth records for residents in the city of Syracuse, NY who gave birth to singleton infants between 2009 and 2011. Multivariate log-binomial regression was used to calculate the adjusted relative risk for preterm birth among foreign-born mothers and mothers from refugee countries, compared to US-born mothers. Results Infants born to both foreign-born women and to women from refugee countries had decreased risks of being born preterm compared to infants born to US mothers, controlling for race, late/no prenatal care, maternal age less than 18 years and smoking. Conclusion Our findings support a healthy immigrant effect for preterm births both among all foreign-born immigrants and among the subsample of women from refugee countries. Mother's nativity is likely a proxy for unmeasured factors (e.g., prenatal stress, maternal diet, etc.) that may explain the relationship between mother's nativity and preterm births. Additional research is needed to better understand the underlying factors. PMID:26525555

  19. Hyperbilirubinemia in Preterm Neonates.

    PubMed

    Bhutani, Vinod K; Wong, Ronald J; Stevenson, David K

    2016-06-01

    Preterm neonates with increased bilirubin production loads are more likely to sustain adverse outcomes due to either neurotoxicity or overtreatment with phototherapy and/or exchange transfusion. Clinicians should rely on expert consensus opinions to guide timely and effective interventions until there is better evidence to refine bilirubin-induced neurologic dysfunction or benefits of bilirubin. In this article, we review the evolving evidence for bilirubin-induced brain injury in preterm infants and highlight the clinical approaches that minimize the risk of bilirubin neurotoxicity. PMID:27235203

  20. Duration of breastfeeding in preterm infants followed at a secondary referral service

    PubMed Central

    de Freitas, Brunnella Alcantara Chagas; Lima, Luciana Moreira; Carlos, Carla Fernanda Lisboa Valente; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

    2016-01-01

    Abstract Objective: Identify and analyze variables associated with shorter duration of breastfeeding in preterm infants. Methods: Retrospective cohort of premature infants followed up at secondary referral service in the period of 2010-2015. Inclusion: first appointment in the first month of corrected age and have undergone three or more consultations. Exclusion: diseases that impaired oral feeding. Outcome: duration of breastfeeding. A total of 103 preterm infants were evaluated, accounting for 28.8% of the preterm infants born in the municipality in that period, with a power of study of 80%. Descriptive analysis, t-test, chi-square test, Kaplan-Meier curves and Cox regression were used. p-values <0.05 were considered significant. Results: The median duration of breastfeeding among preterm infants was 5.0 months. The risk of breastfeeding discontinuation among preterm infants with gestational age <32 weeks was 2.6-fold higher than for those born at 32 weeks or more and the risk of breastfeeding interruption in preterm infants who were receiving breastfeeding supplementation in the first outpatient visit was 3-fold higher when compared to those who were exclusively breastfed in the first consultation. Conclusions: The median duration of breastfeeding in preterm infants was below the recommended one and discontinuation was associated with gestational <32 weeks and the fact that the infant was no longer receiving exclusive breastfeeding in the first outpatient visit. When these two variables were associated, their negative effect on the median duration of breastfeeding was potentiated. PMID:26614258

  1. Executive functions in extremely low birth weight and late-preterm preschoolers: effects on working memory and response inhibition.

    PubMed

    Baron, Ida Sue; Kerns, Kimberly A; Müller, Ulrich; Ahronovich, Margot D; Litman, Fern R

    2012-01-01

    Executive function (EF) refers to fundamental capacities that underlie more complex cognition and have ecological relevance across the individual's lifespan. However, emerging executive functions have rarely been studied in young preterm children (age 3) whose critical final stages of fetal development are interrupted by their early birth. We administered four novel touch-screen computerized measures of working memory and inhibition to 369 participants born between 2004 and 2006 (52 Extremely Low Birth Weight [ELBW]; 196 late preterm; 121 term-born). ELBW performed worse than term-born on simple and complex working memory and inhibition tasks and had the highest percentage of incomplete performance on a continuous performance test. The latter finding indicates developmental immaturity and the ELBW group's most at-risk preterm status. Additionally, late-preterm participants performed worse compared with term-born on measures of complex working memory but did not differ from those term-born on response inhibition measures. These results are consistent with a recent literature that identifies often subtle but detectable neurocognitive deficits in late-preterm children. Our results support the development and standardization of computerized touch-screen measures to assess EF subcomponent abilities during the formative preschool period. Such measures may be useful to monitor the developmental trajectory of critical executive function abilities in preterm children, and their use is necessary for timely recognition of deficit and application of appropriate interventional strategies. PMID:22122351

  2. Antenatal magnesium sulfate: Neuro-protection for preterm infants.

    PubMed

    Oddie, S; Tuffnell, D J; McGuire, W

    2015-11-01

    The neuro-protective effect of antenatal magnesium sulfate on very preterm infants has been demonstrated in good-quality randomised controlled trials and meta-analyses. Magnesium administered prior to preterm delivery crosses over to the foetal circulation and acts via several pathways to reduce perinatal neuronal damage. Meta-analysis of the trial data indicates that antenatal magnesium sulfate reduces the risk of cerebral palsy by one-third, and results in one fewer case in every 50 women treated. Treatment is associated with discomfort and flushing in some women, but maternal side-effects are mostly transient and manageable. Magnesium sulfate has also been found to be without any serious adverse consequences in newborn infants. Consensus recommendations and guidelines have been developed and implemented internationally, and endorsed by the UK Royal College of Obstetricians and Gynaecologists. However, magnesium sulfate for neuro-protection of very preterm infants has not yet become established widely in UK practice. Paediatricians, neonatologists and advocacy groups for preterm infants and their families could contribute to raising awareness and engage in dissemination activities and implementation initiatives to develop local protocols for adoption of this safe, effective and cost-effective intervention to reduce the burden of cerebral palsy in children born very preterm. PMID:25896966

  3. [Course and neurological/behavioral development of preterm children].

    PubMed

    Marret, S; Chollat, C; de Quelen, R; Pinto Cardoso, G; Abily-Donval, L; Chadie, A; Torre, S; Vanhulle, C; Mellier, D; Charollais, A; Ancel, P-Y

    2015-02-01

    Preterm birth remains a public health priority given that one child out of ten is born before 37 weeks of gestation. Survival without major neonatal morbidity has increased in high-income countries, in particular in France and in cases of extreme preterm birth before 27 weeks of gestation. Rate of severe handicaps, such as cerebral palsy, is probably decreasing, but specific cognitive disabilities in a variety of domains remain frequent, interfering with normal learning abilities at school and explaining the high rate of special education needs. Prevalence of sequelae increases when gestational age at birth decreases. However, because there are more moderate to late preterm children compared to very preterm children, the absolute number of children with specific cognitive or neurological disabilities is equivalent in these two groups. Better characterization of the development in a recent cohort of very preterm children is necessary to improve the early detection of variations in normal neurodevelopment and to propose trials with remediation actions targeting working memory and language for example. These protocols could decrease the rates of learning disabilities at school. PMID:25541510

  4. Body water content of extremely preterm infants at birth

    PubMed Central

    Hartnoll, G.; Betremieux, P.; Modi, N.

    2000-01-01

    BACKGROUND—Preterm birth is often associated with impaired growth. Small for gestational age status confers additional risk.
AIM—To determine the body water content of appropriately grown (AGA) and small for gestational age (SGA) preterm infants in order to provide a baseline for longitudinal studies of growth after preterm birth.
METHODS—All infants born at the Hammersmith and Queen Charlotte's Hospitals between 25 and 30 weeks gestational age were eligible for entry into the study. Informed parental consent was obtained as soon after delivery as possible, after which the extracellular fluid content was determined by bromide dilution and total body water by H218O dilution.
RESULTS—Forty two preterm infants were studied. SGA infants had a significantly higher body water content than AGA infants (906 (833-954) and 844 (637-958) ml/kg respectively; median (range); p = 0.019). There were no differences in extracellular and intracellular fluid volumes, nor in the ratio of extracellular to intracellular fluid. Estimates of relative adiposity suggest a body fat content of about 7% in AGA infants, assuming negligible fat content in SGA infants and lean body tissue hydration to be equivalent in the two groups.
CONCLUSIONS—Novel values for the body water composition of the SGA preterm infant at 25-30 weeks gestation are presented. The data do not support the view that SGA infants have extracellular dehydration, nor is their regulation of body water impaired.

 PMID:10873174

  5. Neighbourhood deprivation and very preterm birth in an English and French cohort

    PubMed Central

    2013-01-01

    Background Social factors affect the risk of very preterm birth and may affect subsequent outcomes in those born preterm. We assessed the influence of neighbourhood socio-economic characteristics on the risk and outcomes of singleton very preterm birth (<32 weeks of gestation) in two European regions with different health systems. Methods Live births (n=1118) from a population-based cohort of very preterm infants in 2003 in Trent (UK) and Ile-de-France (France) regions were geocoded to their neighbourhood census tracts. Odds ratios for very preterm singleton birth by neighbourhood characteristics (unemployment rate, proportion manual workers, proportion with high school education only, non home ownership) were computed using infants enumerated in the census as a control population. The impact of neighbourhood variables was further assessed by pregnancy and delivery characteristics and short term infant outcomes. Results Risk of very preterm singleton birth was higher in more deprived neighbourhoods in both regions (OR between 2.5 and 1.5 in the most versus least deprived quartiles). No consistent associations were found between neighbourhood deprivation and maternal characteristics or health outcomes for very preterm births, although infants in more deprived neighbourhoods were less likely to be breastfed at discharge. Conclusions Neighbourhood deprivation had a strong consistent impact on the risk of singleton very preterm birth in two European regions, but did not appear to be associated with maternal characteristics or infant outcomes. Differences in breastfeeding at discharge suggest that socio-economic factors may affect long term outcomes. PMID:23617598

  6. The effect of kangaroo care on neurodevelopmental outcomes in preterm infants.

    PubMed

    Head, Lauren M

    2014-01-01

    Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. As advances in neonatal care enable more preterm infants to survive, development of strategies to address high rates of neurodevelopmental disabilities and poor academic achievement in preterm infants are crucial. Evidence suggests that infants' brains are plastic in nature and, therefore, can be shaped by the environment. Kangaroo care has become popularized as a means of modifying the stress of the NICU environment. However, few studies have examined whether kangaroo care affects neurodevelopmental outcomes in preterm infants. This review examined available literature that investigated the effect of kangaroo care on cognition in preterm infants. Current evidence suggests that short-term benefits of kangaroo care are associated with improved neurodevelopment. However, few studies have examined the long-term impact of kangaroo care on cognitive outcomes in preterm infants. To address neurological disparities in children born preterm, research using kangaroo care as a strategy to improve neurodevelopment in preterm infants is warranted. PMID:25347107

  7. Assessment and Stability of Early Learning Abilities in Preterm and Full-Term Infants across the First Two Years of Life

    ERIC Educational Resources Information Center

    Lobo, Michele A.; Galloway, James C.

    2013-01-01

    Infants born preterm have increased risk for learning disabilities yet we lack assessments to successfully detect these disabilities in early life. We followed 23 full-term and 29 preterm infants from birth through 24 months to assess for differences in and stability of learning abilities across time. Measures included the Bayley-III cognitive…

  8. Visual Perception and Visual-Motor Integration in Very Preterm and/or Very Low Birth Weight Children: A Meta-Analysis

    ERIC Educational Resources Information Center

    Geldof, C. J. A.; van Wassenaer, A. G.; de Kieviet, J. F.; Kok, J. H.; Oosterlaan, J.

    2012-01-01

    A range of neurobehavioral impairments, including impaired visual perception and visual-motor integration, are found in very preterm born children, but reported findings show great variability. We aimed to aggregate the existing literature using meta-analysis, in order to provide robust estimates of the effect of very preterm birth on visual…

  9. Early repetitive pain in preterm infants in relation to the developing brain

    PubMed Central

    Ranger, Manon; Grunau, Ruth E

    2014-01-01

    SUMMARY Infants born preterm (<37 weeks of gestation) are particularly vulnerable to procedural stress and pain exposure during neonatal intensive care, at a time of rapid and complex brain development. Concerns regarding effects of neonatal pain on brain development have long been expressed. However, empirical evidence of adverse associations is relatively recent. Thus, many questions remain to be answered. This review discusses the short- and long-term effects of pain-related stress and associated treatments on brain maturation and neurodevelopmental outcomes in children born preterm. The current state of the evidence is presented and future research directions are proposed. PMID:24641344

  10. Cellular and biochemical mechanisms, risk factors and management of preterm birth: state of the art.

    PubMed

    Vitale, S G; Marilli, I; Rapisarda, A M; Rossetti, D; Belluomo, G; Iapichino, V; Stancanelli, F; Cianci, A

    2014-12-01

    Preterm birth (PTB) is usually defined as a delivery before 37 completed weeks or 259 days of gestation. World Health Organization estimates a worldwide incidence of PTB of 9.6%. Infants born preterm are at higher risks than infants born at term for mortality, and acute and chronic morbidity. Major causes of PTB are the following: spontaneous preterm labor with intact membranes (50%), labor induction or caesarean delivery for maternal or fetal indications (30%), and preterm premature rupture of membranes or PPROM (20%). The aim of this review is to analyze this medical condition, focusing on cellular and biochemical mechanisms, maternal risk factors and role of inflammation and infections in preterm premature rupture of membranes (PPROM) and PTB. Moreover we will discuss about the proper therapeutic strategies for its management. Although different methods have been introduced to predict the advent of preterm labour in asymptomatic women, possibilities for real primary prevention are rare. An early estimation of potential risk factors is pivotal in the secondary prevention of PTB. Finally most efforts so far have been tertiary interventions. These measures have reduced perinatal morbidity and mortality. Advances in primary and secondary care will be needed to prevent prematurity-related illness in infants and children. PMID:25373016

  11. Gait in Very Preterm School-Aged Children in Dual-Task Paradigms

    PubMed Central

    Hagmann-von Arx, Priska; Manicolo, Olivia; Perkinson-Gloor, Nadine; Weber, Peter; Grob, Alexander; Lemola, Sakari

    2015-01-01

    Objective The control of gait requires executive and attentional functions. As preterm children show executive and attentional deficits compared to full-term children, performing concurrent tasks that impose additional cognitive load may lead to poorer walking performance in preterm compared to full-term children. Knowledge regarding gait in preterm children after early childhood is scarce. We examined straight walking and if it is more affected in very preterm than in full-term children in dual-task paradigms. Study design Twenty preterm children with very low birth-weight (≤ 1500 g), 24 preterm children with birth-weight > 1500 g, and 44 full-term children, born between 2001 and 2006, were investigated. Gait was assessed using an electronic walkway system (GAITRite) while walking without a concurrent task (single-task) and while performing one concurrent (dual-task) or two concurrent (triple-task) tasks. Spatio-temporal gait parameters (gait velocity, cadence, stride length, single support time, double support time), normalized gait parameters (normalized velocity, normalized cadence, normalized stride length) and gait variability parameters (stride velocity variability, stride length variability) were analyzed. Results In dual- and triple-task conditions children showed decreased gait velocity, cadence, stride length, as well as increased single support time, double support time and gait variability compared to single-task walking. Further, results showed systematic decreases in stride velocity variability from preterm children with very low birth weight (≤ 1500 g) to preterm children with birth weight > 1500 g to full-term children. There were no significant interactions between walking conditions and prematurity status. Conclusions Dual and triple tasking affects gait of preterm and full-term children, confirming previous results that walking requires executive and attentional functions. Birth-weight dependent systematic changes in stride velocity

  12. Limited effects of preterm birth and the first enteral nutrition on cerebellum morphology and gene expression in piglets.

    PubMed

    Bergström, Anders; Kaalund, Sanne S; Skovgaard, Kerstin; Andersen, Anders D; Pakkenberg, Bente; Rosenørn, Ann; van Elburg, Ruurd M; Thymann, Thomas; Greisen, Gorm O; Sanglid, Per T

    2016-07-01

    Preterm pigs show many signs of immaturity that are characteristic of preterm infants. In preterm infants, the cerebellum grows particularly rapid and hypoplasia and cellular lesions are associated with motor dysfunction and cognitive deficits. We hypothesized that functional brain delays observed in preterm pigs would be paralleled by both structural and molecular differences in the cerebellum relative to term born piglets. Cerebella were collected from term (n = 56) and preterm (90% gestation, n = 112) pigs at 0, 5, and 26 days after birth for stereological volume estimations, large-scale qPCR gene expression analyses (selected neurodevelopmental genes) and western blot protein expression analysis (Sonic Hedgehog pathway). Memory and learning was tested using a T-maze, documenting that preterm pigs showed delayed learning. Preterm pigs also showed reduced volume of both white and gray matter at all three ages but the proportion of white matter increased postnatally, relative to term pigs. Early initiation of enteral nutrition had limited structural or molecular effects. The Sonic Hedgehog pathway was unaffected by preterm birth. Few differences in expression of the selected genes were found, except consistently higher mRNA levels of Midkine, p75, and Neurotrophic factor 3 in the preterm cerebellum postnatally, probably reflecting an adaptive response to preterm birth. Pig cerebellar development appears more affected by postconceptional age than by environmental factors at birth or postnatally. Compensatory mechanisms following preterm birth may include faster white matter growth and increased expression of selected genes for neurotrophic factors and regulation of angiogenesis. While the pig cerebellum is immature in 90% gestation preterm pigs, it appears relatively mature and resilient toward environmental factors. PMID:27462071

  13. [A comparative study of the perceptual and motor performance at school age of preterm and full term children].

    PubMed

    Magalhães, Lívia de Castro; Catarina, Patrícia Wendling; Barbosa, Vanêssa Maziero; Mancini, Marisa Cota; Paixão, Maria Lúcia

    2003-06-01

    The objective of this study was to compare the perceptualmotor performance in school age children who were born preterm and full term. Two groups of children, ages 5 to 7, participated in this study. Group I had 35 children, from low-income families, born up to the 34 week of gestation and/or weight bellow 1500 g. Group II had 35 full-term children, matched by age, gender and socioeconomic status to the children in Group I. Children were tested on the Bender gestalt, the motor accuracy test and on balance and postural responses measures. The preterm group obtained significantly lower scores in the majority of the tests. These besides reinforcing the importance of the follow-up of preterm children up to school age, also indicate the need to stimulate the fine motor and postural control Devment, even among preterm children who do not show evidence of neurological impairment. PMID:12806505

  14. Preterm Birth: A Primary Etiological Factor for Delayed Oral Growth and Development

    PubMed Central

    Thayath, Muhamad Nishad; Singh, Shikha; Sinha, Anju

    2015-01-01

    ABSTRACT Preterm and low birthweight children comprise approximately 6% of all live births. It is now a well-known fact that premature children experience many oral complications associated with their preterm births. Prematurely born infants have a short prenatal development period and they are prone to many serious medical problems during the neonatal period, which may affect the development of oral tissues. Adverse perinatal factors, premature birth and exceptional early adaptation to extra-uterine life and functional activity may influence dental occlusal development and symmetry in the jaws. Thus, the goal of the present paper is to elucidate further the effect of preterm birth on the development of the dentition. How to cite this article: Zaidi I, Thayath MN, Singh S, Sinha A. Preterm Birth: A Primary Etiological Factor for Delayed Oral Growth and Development. Int J Clin Pediatr Dent 2015;8(3): 215-219. PMID:26628856

  15. Risk of Developmental Delay Increases Exponentially as Gestational Age of Preterm Infants Decreases: A Cohort Study at Age 4 Years

    ERIC Educational Resources Information Center

    Kerstjens, Jorien M.; de Winter, Andrea F.; Bocca-TJeertes, Inger F.; Bos, Arend F.; Reijneveld, Sijmen A.

    2012-01-01

    Aim: The aim of the study was to assess the influence of decreasing gestational age on the risk of developmental delay in various domains at age 4 years among children born at a wide range of gestational ages. Method: In a community-based cohort, the parents of 1439 preterm-born children (24 0/7 to 35 6/7wks) and 544 term-born children (38 0/7 to…

  16. Invulnerable High Risk Preterm Infants.

    ERIC Educational Resources Information Center

    Pederson, David R.; And Others

    In an effort to look at factors moderating the negative effects of preterm low birthweight and perinatal illness, the study followed up (at 7 and 12 months of age) 50 preterm infants whose cumulative morbidity score was greater than 100 and/or who had a life threatening complication. Home visits provided ratings of maternal sensitivity, the…

  17. Neurodevelopmental Outcome in Preterm Infants

    ERIC Educational Resources Information Center

    Bos, Arend F.; Roze, Elise

    2011-01-01

    Aim: To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon. Method: One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6wk; birthweight 480-2275g) were assessed for cognition and motor outcome at 6…

  18. EPIPAGE 2: a preterm birth cohort in France in 2011

    PubMed Central

    2014-01-01

    Background Children born at low gestational ages face a range of risks and number of neonates surviving very preterm birth is increasing. We present the objectives and methods of a French national cohort of very and moderately preterm children, the EPIPAGE 2 study. It aims to examine short- and long-term outcomes of very preterm children and their determinants. Methods/Design Eligible participants for this prospective population-based study include all infants live born or stillborn and all terminations of pregnancy between 22 and 31 completed weeks of gestation in all the maternity units in 25 French regions. In addition, a sample of moderate preterm births, i.e. births and late terminations at 32–34 weeks, was included in the same regions. In all, 7804 babies (stillbirths and live births) and terminations of pregnancy out of 8400 eligible births in France in 2011 that were either very (22–31 weeks) or moderately preterm (32–34 weeks) were included. Data on pregnancy, delivery, and neonatal events were extracted from the obstetric and neonatal records. The follow-up will collect information at corrected ages of one and 2 years and at 5, 8, and 12 years of age. Of the 4467 children discharged alive from the hospital and eligible for follow-up, 155 (4%) families refused further follow-up and 22 died before one-year of age. Finally, 4290 were included in the follow-up. Eight additional projects investigating specific hypotheses among subsamples of the cohort by collecting specific data in addition to the core cohort data are being conducted to investigate 1) diagnosis of histologic chorioamnionitis, 2) early biomarkers of child health, 3) attitudes of care for extremely preterm infants, 4) painful procedures in neonatal intensive care units, 5) neonatal MRI cerebral abnormalities and their relation to executive functions, 6) associations between early gut colonization and early and late onset diseases, 7) impact of neonatal nutrition on child development

  19. Erythropoietin Restores Long-Term Neurocognitive Function Involving Mechanisms of Neuronal Plasticity in a Model of Hyperoxia-Induced Preterm Brain Injury.

    PubMed

    Hoeber, Daniela; Sifringer, Marco; van de Looij, Yohan; Herz, Josephine; Sizonenko, Stéphane V; Kempe, Karina; Serdar, Meray; Palasz, Joanna; Hadamitzky, Martin; Endesfelder, Stefanie; Fandrey, Joachim; Felderhoff-Müser, Ursula; Bendix, Ivo

    2016-01-01

    Cerebral white and grey matter injury is the leading cause of an adverse neurodevelopmental outcome in prematurely born infants. High oxygen concentrations have been shown to contribute to the pathogenesis of neonatal brain damage. Here, we focused on motor-cognitive outcome up to the adolescent and adult age in an experimental model of preterm brain injury. In search of the putative mechanisms of action we evaluated oligodendrocyte degeneration, myelination, and modulation of synaptic plasticity-related molecules. A single dose of erythropoietin (20,000 IU/kg) at the onset of hyperoxia (24 hours, 80% oxygen) in 6-day-old Wistar rats improved long-lasting neurocognitive development up to the adolescent and adult stage. Analysis of white matter structures revealed a reduction of acute oligodendrocyte degeneration. However, erythropoietin did not influence hypomyelination occurring a few days after injury or long-term microstructural white matter abnormalities detected in adult animals. Erythropoietin administration reverted hyperoxia-induced reduction of neuronal plasticity-related mRNA expression up to four months after injury. Thus, our findings highlight the importance of erythropoietin as a neuroregenerative treatment option in neonatal brain injury, leading to improved memory function in adolescent and adult rats which may be linked to increased neuronal network connectivity. PMID:27493706

  20. Erythropoietin Restores Long-Term Neurocognitive Function Involving Mechanisms of Neuronal Plasticity in a Model of Hyperoxia-Induced Preterm Brain Injury

    PubMed Central

    Sifringer, Marco; van de Looij, Yohan; Herz, Josephine; Sizonenko, Stéphane V.; Kempe, Karina; Palasz, Joanna; Hadamitzky, Martin; Fandrey, Joachim

    2016-01-01

    Cerebral white and grey matter injury is the leading cause of an adverse neurodevelopmental outcome in prematurely born infants. High oxygen concentrations have been shown to contribute to the pathogenesis of neonatal brain damage. Here, we focused on motor-cognitive outcome up to the adolescent and adult age in an experimental model of preterm brain injury. In search of the putative mechanisms of action we evaluated oligodendrocyte degeneration, myelination, and modulation of synaptic plasticity-related molecules. A single dose of erythropoietin (20,000 IU/kg) at the onset of hyperoxia (24 hours, 80% oxygen) in 6-day-old Wistar rats improved long-lasting neurocognitive development up to the adolescent and adult stage. Analysis of white matter structures revealed a reduction of acute oligodendrocyte degeneration. However, erythropoietin did not influence hypomyelination occurring a few days after injury or long-term microstructural white matter abnormalities detected in adult animals. Erythropoietin administration reverted hyperoxia-induced reduction of neuronal plasticity-related mRNA expression up to four months after injury. Thus, our findings highlight the importance of erythropoietin as a neuroregenerative treatment option in neonatal brain injury, leading to improved memory function in adolescent and adult rats which may be linked to increased neuronal network connectivity. PMID:27493706

  1. Mathematics Deficiencies in Children with Very Low Birth Weight or Very Preterm Birth

    ERIC Educational Resources Information Center

    Taylor, H. Gerry; Espy, Kimberly Andrews; Anderson, Peter J.

    2009-01-01

    Children with very low birth weight (VLBW, less than 1500 g) or very preterm birth (VPTB, less than 32 weeks gestational age or GA) have more mathematics disabilities or deficiencies (MD) and higher rates of mathematics learning disabilities (MLD) than normal birth weight term-born children (NBW, greater than 2500 g and greater than 36 weeks GA).…

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

    ERIC Educational Resources Information Center

    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…

  3. Comforting touch in the very preterm hospitalized infant: an integrative review.

    PubMed

    Smith, Joan Renaud

    2012-12-01

    Infants born prematurely lose the protection of the uterus at a time of fetal development when the brain is growing and organizing exponentially. Environmental factors such as stress in the neonatal intensive care unit (NICU) may play a role in altered brain maturation and neurobehavioral outcomes. Strategies aimed at reducing stress and promoting infant well-being are essential to improve neurologic and behavioral outcomes. Infant massage is a developmentally supported strategy aimed at promoting relaxation. However, despite the well-documented benefits of infant massage, infants born very preterm (≤30 weeks' gestation) are often excluded from these studies, leaving neonatal clinicians and families without guidance in how to provide a stress-reducing supplemental touch. Much of the touch in the NICU is a procedural touch, and infants born very preterm often miss out on comforting touch stimulation. A systematic review of the literature is presented with an aim to explore the research that examines the various comforting touch therapies used on hospitalized NICU infants born very preterm within the first few days of postnatal life. The purpose of this review was to identify appropriate stress-reducing comforting touch techniques for physiologically fragile very preterm infants in order to inform and provide guidance to neonatal clinicians and families. PMID:23187642

  4. Psychiatric Disorders in Extremely Preterm Children: Longitudinal Finding at Age 11 Years in the EPICure Study

    ERIC Educational Resources Information Center

    Johnson, Samantha; Hollis, Chris; Kochhar, Puja; Hennessy, Enid; Wolke, Dieter; Marlow, Neil

    2010-01-01

    Objective: To investigate the prevalence and risk factors for psychiatric disorders in extremely preterm children. Method: All babies born less than 26 weeks gestation in the United Kingdom and Ireland from March through December 1995 were recruited to the EPICure Study. Of 307 survivors at 11 years of age, 219 (71%) were assessed alongside 153…

  5. Neuro-Cognitive Performance of Very Preterm or Very Low Birth Weight Adults at 26 Years

    ERIC Educational Resources Information Center

    Eryigit Madzwamuse, Suna; Baumann, Nicole; Jaekel, Julia; Bartmann, Peter; Wolke, Dieter

    2015-01-01

    Background: Children born very preterm (VP <32 weeks gestation) and/or with very low birth weight (VBLW <1500 g; subsequently VP/VLBW) have been previously reported to have more cognitive impairment and specific executive functioning problems than term children; however, it remains unclear whether these problems persist into adulthood. This…

  6. Zinc for preterm infants: Who needs it and how much is needed?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The establishment of micronutrient requirements for infants remains a challenge. For healthy full-term infants, breast milk is an appropriate standard for virtually all nutrients. In contrast, guidelines for infants who are not healthy, and infants who are born preterm, are much more tenuous....

  7. Eating Problems at Age 6 Years in a Whole Population Sample of Extremely Preterm Children

    ERIC Educational Resources Information Center

    Samara, Muthanna; Johnson, Samantha; Lamberts, Koen; Marlow, Neil; Wolke, Dieter

    2010-01-01

    Aim: The aim of this study was to investigate the prevalence of eating problems and their association with neurological and behavioural disabilities and growth among children born extremely preterm (EPC) at age 6 years. Method: A standard questionnaire about eating was completed by parents of 223 children (125 males [56.1%], 98 females [43.9%])…

  8. Understanding preterm labor.

    PubMed

    Challis, J R; Lye, S J; Gibb, W; Whittle, W; Patel, F; Alfaidy, N

    2001-09-01

    Increased uterine contractility at term and preterm results from activation and then stimulation of the myometrium. Activation can be provoked by mechanical stretch of the uterus and by an endocrine pathway resulting from increased activity of the fetal hypothalamic-pituitary-adrenal (HPA) axis. In fetal sheep, increased cortisol output during pregnancy regulates prostaglandin H synthase type 2 (PGHS2) expression in the placenta in an estrogen-independent manner, resulting in increased levels of PGE2 in the fetal circulation. Later increases in maternal uterine expresssion of PGHS2 require elevations of estrogen and lead to increased concentrations of PGF2alpha in the maternal circulation. Thus, regulation of PGHS2 at term is differentially controlled in fetal (trophoblast) and maternal (uterine epithelium) tissue. This difference may reflect expression of the glucocorticoid receptor (GR), but not estrogen receptor (ER), in placental trophoblast cells. In women, cortisol also contributes to increased PG production in fetal tissues through upregulation of PGHS2 (amnion and chorion) and downregulation of 15-OH PG dehydrogenase (chorion trophoblasts). The effect of cortisol on chorion expression of PGDH reverses a tonic stimulatory effect of progesterone, potentially through a paracrine or autocrine action. We have interpreted this interaction as a reflection of "progesterone withdrawal" in the primate, in relation to birth. Other agents, such as proinflammatory cytokines, similarly upregulate PGHS2 and decrease expression of PGDH, indicating the presence of several mechanisms by which labor at term or preterm may be initiated. These different mechanisms need to be considered in the development of strategies for the detection and management of the patient in preterm labor. PMID:11594542

  9. Cholestasis in Preterm Infants.

    PubMed

    Satrom, Katie; Gourley, Glenn

    2016-06-01

    Cholestasis in preterm infants has a multifactorial etiology. Risk factors include degree of prematurity, lack of enteral feeding, intestinal injury, prolonged use of parenteral nutrition (PN), and sepsis. Soy-based parenteral lipid emulsions have been implicated in the pathophysiology of PN-associated liver injury. Inflammation plays an important role. Medical therapies are used; however, their effects have not consistently proven effective. Evaluation of cholestasis involves laboratory work; direct bilirubin levels are used for diagnosis and trending. Adverse outcomes include risk for hepatobiliary dysfunction, irreversible liver failure, and death. Early enteral feedings as tolerated is the best way to prevent and manage cholestasis. PMID:27235213

  10. Hemolysis in Preterm Neonates.

    PubMed

    Christensen, Robert D; Yaish, Hassan M

    2016-06-01

    Hemolysis can be an important cause of hyperbilirubinemia in premature and term neonates. It can result from genetic abnormalities intrinsic to or factors exogenous to normal to red blood cells (RBCs). Hemolysis can lead to a relatively rapid increase in total serum/plasma bilirubin, hyperbilirubinemia that is somewhat slow to fall with phototherapy, or hyperbilirubinemia that is likely to rebound after phototherapy. Laboratory methods for diagnosing hemolysis are more difficult to apply, or less conclusive, in preterm infants. Transfusion of donor RBCs can present a bilirubin load that must be metabolized. Genetic causes can be identified by next-generation sequencing panels. PMID:27235204

  11. Neonatal MRI is associated with future cognition and academic achievement in preterm children.

    PubMed

    Ullman, Henrik; Spencer-Smith, Megan; Thompson, Deanne K; Doyle, Lex W; Inder, Terrie E; Anderson, Peter J; Klingberg, Torkel

    2015-11-01

    School-age children born preterm are particularly at risk for low mathematical achievement, associated with reduced working memory and number skills. Early identification of preterm children at risk for future impairments using brain markers might assist in referral for early intervention. This study aimed to examine the use of neonatal magnetic resonance imaging measures derived from automated methods (Jacobian maps from deformation-based morphometry; fractional anisotropy maps from diffusion tensor images) to predict skills important for mathematical achievement (working memory, early mathematical skills) at 5 and 7 years in a cohort of preterm children using both univariable (general linear model) and multivariable models (support vector regression). Participants were preterm children born <30 weeks' gestational age and healthy control children born ≥37 weeks' gestational age at the Royal Women's Hospital in Melbourne, Australia between July 2001 and December 2003 and recruited into a prospective longitudinal cohort study. At term-equivalent age ( ±2 weeks) 224 preterm and 46 control infants were recruited for magnetic resonance imaging. Working memory and early mathematics skills were assessed at 5 years (n = 195 preterm; n = 40 controls) and 7 years (n = 197 preterm; n = 43 controls). In the preterm group, results identified localized regions around the insula and putamen in the neonatal Jacobian map that were positively associated with early mathematics at 5 and 7 years (both P < 0.05), even after covarying for important perinatal clinical factors using general linear model but not support vector regression. The neonatal Jacobian map showed the same trend for association with working memory at 7 years (models ranging from P = 0.07 to P = 0.05). Neonatal fractional anisotropy was positively associated with working memory and early mathematics at 5 years (both P < 0.001) even after covarying for clinical factors using support vector regression but not

  12. Immigrant and Native-Born Adolescents' Civic Knowledge and Attitudes in Sweden and the United States: Emergent Citizenship within Developmental Niches

    ERIC Educational Resources Information Center

    Barber, Carolyn; Torney-Purta, Judith; Wilkenfeld, Britt; Ross, Jessica

    2015-01-01

    Using the Developmental Niche for Emergent Participatory Citizenship (Torney-Purta and Amadeo, 2011) as a framework, we examined differences between immigrant and native-born youth's civic knowledge and support for women's rights in Sweden and the United States, and explored whether experiences with peers and parents, and in formal and informal…

  13. Preterm births: can neonatal pain alter the development of endogenous gating systems?

    PubMed

    Goffaux, Philippe; Lafrenaye, Sylvie; Morin, Mélanie; Patural, Hugues; Demers, Geneviève; Marchand, Serge

    2008-10-01

    Prematurity is known to affect the development of various neurophysiological systems, including the maturation of pain and cardiac circuits. The purpose of this study was to see if numerous painful interventions, experienced soon after birth, affect counterirritation-induced analgesia (triggered using the cold pressor test) later in life. A total of 26 children, between the ages of 7 and 11 participated in the study. Children were divided into three groups, according to their birth status (i.e., term-born, born preterm and exposed to numerous painful interventions, or born preterm and exposed to few painful interventions). Primary outcome measures were heat pain thresholds, heat sensitivity scores, and cardiac reactivity. Results showed that preterm children and term-born children had comparable pain thresholds. Exposure to conditioning cold stimulation significantly increased heart rate and significantly decreased the thermal pain sensitivity of term-born children. These physiological reactions were also observed among preterm children who were only exposed to a few painful interventions at birth. Changes in heart rate and pain sensitivity in response to conditioning cold stimulation were not observed in preterm children that had been exposed to numerous painful procedures during the neonatal period. These results suggest that early pain does not lead to enhanced pain sensitivity when premature babies become children, but that their endogenous pain modulatory mechanisms are not as well developed as those of children not exposed to noxious insult at birth. Greater frequency of painful procedures also dampened the rise in heart rate normally observed when experimental pain is experienced. PMID:18308597

  14. Shwachman-Diamond syndrome (SDS) in a preterm neonate.

    PubMed

    Saito-Benz, Maria; Miller, Helen Elizabeth; Berry, Mary Judith

    2015-12-01

    A preterm neonate at 29-week gestational age was born with intrauterine growth restriction, severe pancytopaenia and gross skeletal dysplasia. Antenatal screening bloods, TORCH/parvovirus tests and karyotype were unremarkable. Postnatally, he had normal microarray comparative genomic hybridization and serum B12/folate levels, and human immunodeficiency virus and cytomegalovirus polymerase chain reaction and antoimmune screening were negative. Targeted gene testing for Shwachman-Diamond syndrome (SDS) revealed the pathognomic mutation (c.183_184delTAinsCT). His postnatal clinical course was complicated by: (i) Ventilator dependency because of a combination of a pathologically compliant chest wall and preterm-associated chronic lung disease. (ii) Progressive bone marrow failure, resulting in transfusion dependence and profound neutropenia associated with recurrent sepsis. (iii) Gastrointestinal failure and TPN dependency. (iv) Poor postnatal growth with weight/length/head circumference all <3rd centile. (v) Prognostication was complicated by the lack of published literature on the presentation of SDS in a preterm infant. However, because of inexorable progression of multiorgan failure, intensive care was withdrawn on day 54 of life. SDS is a rare autosomal recessive disorder characterised by haematological abnormalities, skeletal dysplasia and exocrine pancreatic dysfunction. Neonatal presentation is thought to be extremely rare. However, with the availability of genetic testing, it has now become clear that because of overlap in clinical presentation, term-born infants with skeletal dysplasia and severe respiratory distress may initially be misdiagnosed as asphyxiating thoracic dystrophy. This case report highlights the complexities of preterm birth complicating clinical manifestations of SDS. PMID:26081292

  15. Brain injury and development in preterm infants exposed to fentanyl

    PubMed Central

    McPherson, Christopher; Haslam, Matthew; Pineda, Roberta; Rogers, Cynthia; Neil, Jeffrey J.; Inder, Terrie E.

    2015-01-01

    Background Fentanyl is commonly utilized in preterm infants. Relatively little is known regarding the neurodevelopmental outcomes of preterm infants exposed to fentanyl. Objective To investigate the association between cumulative fentanyl dose and brain injury and diameters in a cohort of preterm infants Methods Data on demographics, perinatal course, and neonatal course, including total fentanyl exposure prior to term equivalent age, were retrospectively evaluated for 103 infants born at ≤ 30 weeks gestational age who underwent magnetic resonance imaging at term equivalent age (mean gestational age 26.9 ± 1.8 weeks). Magnetic resonance images were evaluated for brain injury and regional brain diameters. Developmental testing was conducted at term equivalent and 2 years of age. Results Seventy-eight infants (76%) received fentanyl (median cumulative dose 3 μg/kg, interquartile range 1 – 441 μg/kg). Cumulative fentanyl dose in the first week of life correlated with the incidence of cerebellar hemorrhage after correction for covariates (OR 2.1, 95% confidence interval 1.1 – 4.1). Cumulative fentanyl dose before term equivalent age correlated with reductions in transverse cerebellar diameter after correction for covariates including the presence of cerebellar hemorrhage (r = 0.461, p = 0.002). No correlation was detected between cumulative fentanyl dose and development at 2 years of age. Conclusions Higher cumulative fentanyl dose in preterm infants correlated with a higher incidence of cerebellar injury and lower cerebellar diameter at term equivalent age. Our findings must be taken with caution, but emphasize the need for future prospective trials examining the risks and benefits of commonly utilized analgesic agents in preterm infants. PMID:26369570

  16. The General Movement Assessment Helps Us to Identify Preterm Infants at Risk for Cognitive Dysfunction

    PubMed Central

    Einspieler, Christa; Bos, Arend F.; Libertus, Melissa E.; Marschik, Peter B.

    2016-01-01

    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 (GMs) 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 GMs up to 8 weeks after term had lower intelligence quotients at school age than children with an early normalization of GMs; (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 7–10 years of age. These findings in 428 individuals born preterm suggest that normal GMs along with a normal motor repertoire during the first months after term are markers for normal cognitive development until at least age 10. PMID:27047429

  17. The case of late preterm birth: sliding forwards the critical window for cognitive outcome risk.

    PubMed

    Mento, Giovanni; Nosarti, Chiara

    2015-07-01

    Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood. These methodological concerns become even more relevant when considering the case of late preterm children (born between 34 and 36 gestational weeks). Although these children have been traditionally considered as having similar risks for developmental problems as neonates born at term, a recent line of research has provided growing evidence that even late preterm children display altered structural and functional brain maturation, with potential life-long implications for neurocognitive functioning. A recent study by Heinonen put forward the hypothesis that environmental factors, in this case educational attainment, could moderate the association between late preterm birth (LPT) and neuropsychological impairments commonly associated with aging. In this paper we bring together clinical literature and recent neuroimaging evidence in order to provide two different but complementary approaches for a better understanding of the "nature-nurture" interplay underlying the lifespan neurocognitive development of preterm babies. PMID:26835378

  18. The case of late preterm birth: sliding forwards the critical window for cognitive outcome risk

    PubMed Central

    Nosarti, Chiara

    2015-01-01

    Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood. These methodological concerns become even more relevant when considering the case of late preterm children (born between 34 and 36 gestational weeks). Although these children have been traditionally considered as having similar risks for developmental problems as neonates born at term, a recent line of research has provided growing evidence that even late preterm children display altered structural and functional brain maturation, with potential life-long implications for neurocognitive functioning. A recent study by Heinonen put forward the hypothesis that environmental factors, in this case educational attainment, could moderate the association between late preterm birth (LPT) and neuropsychological impairments commonly associated with aging. In this paper we bring together clinical literature and recent neuroimaging evidence in order to provide two different but complementary approaches for a better understanding of the “nature-nurture” interplay underlying the lifespan neurocognitive development of preterm babies. PMID:26835378

  19. Salivary and hair glucocorticoids and sleep in very preterm children during school age.

    PubMed

    Maurer, Natalie; Perkinson-Gloor, Nadine; Stalder, Tobias; Hagmann-von Arx, Priska; Brand, Serge; Holsboer-Trachsler, Edith; Wellmann, Sven; Grob, Alexander; Weber, Peter; Lemola, Sakari

    2016-10-01

    Very preterm birth involves increased stress for the child, which may lead to programming of the hypothalamic-pituitary-adrenal (HPA) axis activity and poor sleep in later life. Moreover, there is evidence for a relationship between HPA axis activity and sleep. However, research with objective sleep measures in very preterm children during school-age is rare. Eighty-five healthy children born very preterm (<32nd gestational week) and 91 full-term children aged 7-12 years were recruited for the present study. To assess HPA axis activity, salivary cortisol was measured at awakening, 10, 20, and 30min later. In addition, hair cortisol and cortisone concentrations were quantified using liquid chromatography tandem mass spectrometry to assess cumulative endocrine activity over the preceding months. One night of in-home polysomnographic sleep assessment was conducted to assess sleep duration, sleep continuity, and sleep architecture. Children born very preterm showed significantly lower levels of cortisol at awakening and lower overall post-awakening cortisol secretion, lower cortisone in hair, and earlier sleep onset than full-term children. Across the whole sample, overall post-awakening cortisol secretion was positively related to sleep onset time and negatively to sleep duration. The association between prematurity status and post-awakening cortisol secretion was partially mediated by earlier sleep onset time. In conclusion, this study provides evidence for a possible down-regulation of the HPA axis activity and slightly earlier sleep phase in very preterm children during school age. PMID:27434634

  20. Preterm (Premature) Labor and Birth

    MedlinePlus

    ... with serious health problems. Some health problems, like cerebral palsy , can last a lifetime. Other problems, such as ... This medication may help reduce the risk of cerebral palsy that is associated with early preterm birth. What ...

  1. Controversies in preterm brain injury.

    PubMed

    Penn, Anna A; Gressens, Pierre; Fleiss, Bobbi; Back, Stephen A; Gallo, Vittorio

    2016-08-01

    In this review, we highlight critical unresolved questions in the etiology and mechanisms causing preterm brain injury. Involvement of neurons, glia, endogenous factors and exogenous exposures is considered. The structural and functional correlates of interrupted development and injury in the premature brain are under active investigation, with the hope that the cellular and molecular mechanisms underlying developmental abnormalities in the human preterm brain can be understood, prevented or repaired. PMID:26477300

  2. U.S.- and Mexico-Born Hispanic Teen Mothers: A Descriptive Study of Factors That Relate to Postpartum Compliance.

    ERIC Educational Resources Information Center

    Weinman, Maxine L.; Smith, Peggy B.

    1994-01-01

    In a group of 154 U.S.-born and 127 Mexico-born Hispanic teens delivering at a county hospital in Houston, only 50 returned for their scheduled postpartum visit. Returning teens across groups were more likely to have no prenatal care, have a preterm or expired infant, report no educational plan, and have a support system. (KS)

  3. Smoking and Preterm Birth.

    PubMed

    Ion, Rachel; Bernal, Andrés López

    2015-08-01

    Premature birth is a significant global problem and the leading cause of newborn deaths. Tobacco smoking has been associated with premature birth for over 50 years. The mechanisms through which smoking exerts its effects on pregnancy outcomes remain unclear. In this review, we discuss rates of prematurity and smoking in pregnancy, the evidence of a causal relationship between tobacco and preterm birth, and proposed biochemical pathways through which the interaction is mediated. The suggested mechanisms include nicotine-induced vasoconstriction, carbon monoxide-induced fetal hypoxia, cadmium disruption of calcium signaling, altered steroid hormone production, disruption of prostaglandin synthesis, and changed responses to oxytocin. The relative importance of each of these pathways is yet to be ascertained. Further research is necessary to explore the mechanisms through which smoking exerts its effect on gestational length and the process of parturition. Moreover, the risks of nicotine replacement in pregnancy should be investigated further. PMID:25394641

  4. Differential expression of human placental neurotrophic factors in preterm and term deliveries.

    PubMed

    Dhobale, Madhavi V; Pisal, Hemlata R; Mehendale, Savita S; Joshi, Sadhana R

    2013-12-01

    Neurotrophic factors such as brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) are involved in development of the placenta and fetal brain. A series of human and animal studies in our department have shown that micronutrients (folic acid, vitamin B12) and omega 3 fatty acids like DHA are all interlinked in the one carbon cycle. Any alterations in one carbon components will lead to changes in methylation patterns that further affect the gene expression at critical periods of development resulting in complications during pregnancy. This may further contribute to risk for neurodevelopmental disorders in children born preterm. Therefore this study for the first time examines the mRNA levels from preterm and term placentae. A total number of 38 women delivering preterm (<37 weeks gestation) and 37 women delivering at term (=>37 weeks gestation) were recruited. The mRNA levels of BDNF and NGF were analyzed by real time quantitative polymerase chain reaction. Our results indicate that BDNF and NGF mRNA levels were lower in preterm group as compared to term group. There was a positive association of placental BDNF and NGF mRNA levels with cord plasma BDNF and NGF levels. The differential expression of BDNF and NGF gene in preterm placentae may also alter the vascular development in preterm deliveries. Our data suggests that the reduced mRNA levels of BDNF and NGF may possibly be a result of altered epigenetic mechanisms and may have an implication for altered fetal programming in children born preterm. PMID:24076518

  5. Prepregnancy body size, gestational weight gain, and risk of preterm birth in African-American women

    PubMed Central

    Wise, Lauren A.; Palmer, Julie R.; Heffner, Linda J.; Rosenberg, Lynn

    2011-01-01

    Objective We examined the risk of preterm birth in relation to prepregnancy BMI (kg/m2), waist circumference, adult weight gain, and gestational weight gain among African-American women. Methods Using prospective data from the Black Women's Health Study, we assessed the association between maternal anthropometric factors and preterm birth among 7,841 singletons born to women ages 21–44 in 1995–2003. We compared mothers of infants born three or more weeks early (597 spontaneous preterm births (SPTB); 517 medically-indicated preterm births (MPTB)) with mothers of 6,727 term infants. We used generalized estimating equation models to derive odds ratios (OR) and 95% confidence intervals (CI) adjusted for potential confounders. Results Women with prepregnancy BMI <18 were at increased risk of SPTB and MPTB relative to normal weight women (BMI 20–24), and obese women (BMI ≥30) were at increased risk of MPTB. There were modest positive associations between waist circumference, a measure of central adiposity, and both preterm birth subtypes. Adult weight gain was also positively related to both preterm birth subtypes. Associations with SPTB were generally stronger for gestations of <32 weeks. Low gestational weight gain (<0.5 lbs/week) was associated with an increased risk of SPTB among normal weight and obese women. High gestational weight gain (≥1.5 lbs/week) was associated with increased risk of SPTB among overweight (BMI 25–29) and obese women. Conclusion Our data suggest that prepregnancy adiposity (overall and central), prepregnancy weight gain, and gestational weight gain influence risk of preterm birth among African-American women. PMID:20124904

  6. Comparison of black–white disparities in preterm birth between Canada and the United States

    PubMed Central

    McKinnon, Britt; Yang, Seungmi; Kramer, Michael S.; Bushnik, Tracey; Sheppard, Amanda J.; Kaufman, Jay S.

    2016-01-01

    Background: A higher risk of preterm birth among black women than among white women is well established in the United States. We compared differences in preterm birth between non-Hispanic black and white women in Canada and the US, hypothesizing that disparities would be less extreme in Canada given the different historical experiences of black populations and Canada’s universal health care system. Methods: Using data on singleton live births in Canada and the US for 2004–2006, we estimated crude and adjusted risk ratios and risk differences in preterm birth (< 37 wk) and very preterm birth (< 32 wk) among non-Hispanic black versus non-Hispanic white women in each country. Adjusted models for the US were standardized to the covariate distribution of the Canadian cohort. Results: In Canada, 8.9% and 5.9% of infants born to black and white mothers, respectively, were preterm; the corresponding figures in the US were 12.7% and 8.0%. Crude risk ratios for preterm birth among black women relative to white women were 1.49 (95% confidence interval [CI] 1.32 to 1.66) in Canada and 1.57 (95% CI 1.56 to 1.58) in the US (p value for heterogeneity [pH] = 0.3). The crude risk differences for preterm birth were 2.94 (95% CI 1.91 to 3.96) in Canada and 4.63 (95% CI 4.56 to 4.70) in the US (pH = 0.003). Adjusted risk ratios for preterm birth (pH = 0.1) were slightly higher in Canada than in the US, whereas adjusted risk differences were similar in both countries. Similar patterns were observed for racial disparities in very preterm birth. Interpretation: Relative disparities in preterm birth and very preterm birth between non-Hispanic black and white women were similar in magnitude in Canada and the US. Absolute disparities were smaller in Canada, which reflects a lower overall risk of preterm birth in Canada than in the US in both black and white populations. PMID:26553860

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

    PubMed

    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. PMID:27320366

  8. [Paradise lost - Reflexion of preterm birth from the perspective after a brain injury. A case study].

    PubMed

    Cignacco, Eva; Zuñiga, Franziska; Kurth, Elisabeth

    2011-04-01

    This case study describes the history of an older person, born in 1942 preterminally, who suffered from a brain injury in 2005. Problems in rehabilitation elicited the search for a new meaning in life. In analysing and interpreting the brain injury, preterm birth played a crucial role. The theme of lifelong compensation of deficits, caused by preterm birth, gained new importance. The consequences of brain injury left unsuccessful his former modes of compensation. He was confronted with finding new strategies in order to counterbalance the growing decompensation. This report is based on and was developed through respect for the principles of user involvement in research. PMID:21480177

  9. Preterm birth alters neonatal, functional rich club organization.

    PubMed

    Scheinost, Dustin; Kwon, Soo Hyun; Shen, Xilin; Lacadie, Cheryl; Schneider, Karen C; Dai, Feng; Ment, Laura R; Constable, R Todd

    2016-07-01

    Alterations in neural networks are associated with the cognitive difficulties of the prematurely born. Using functional magnetic resonance imaging, we analyzed functional connectivity for preterm (PT) and term neonates at term equivalent age. Specifically, we constructed whole-brain networks and examined rich club (RC) organization, a common construct among complex systems where important (or "rich") nodes connect preferentially to other important nodes. Both PT and term neonates showed RC organization with PT neonates exhibiting significantly reduced connections between these RC nodes. Additionally, PT neonates showed evidence of weaker functional segregation. Our results suggest that PT birth is associated with fundamental changes of functional organization in the developing brain. PMID:26341628

  10. Born Too Soon: Accelerating actions for prevention and care of 15 million newborns born too soon

    PubMed Central

    2013-01-01

    Preterm birth complication is the leading cause of neonatal death resulting in over one million deaths each year of the 15 million babies born preterm. To accelerate change, we provide an overview of the comprehensive strategy required, the tools available for context-specific health system implementation now, and the priorities for research and innovation. There is an urgent need for action on a dual track: (1) through strategic research to advance the prevention of preterm birth and (2) improved implementation and innovation for care of the premature neonate. We highlight evidence-based interventions along the continuum of care, noting gaps in coverage, quality, equity and implications for integration and scale up. Improved metrics are critical for both burden and tracking programmatic change. Linked to the United Nation's Every Women Every Child strategy, a target was set for 50% reduction in preterm deaths by 2025. Three analyses informed this target: historical change in high income countries, recent progress in best performing countries, and modelling of mortality reduction with high coverage of existing interventions. If universal coverage of selected interventions were to be achieved, then 84% or more than 921,000 preterm neonatal deaths could be prevented annually, with antenatal corticosteroids and Kangaroo Mother Care having the highest impact. Everyone has a role to play in reaching this target including government leaders, professionals, private sector, and of course families who are affected the most and whose voices have been critical for change in many of the countries with the most progress. Declaration This article is part of a supplement jointly funded by Save the Children's Saving Newborn Lives programme through a grant from The Bill & Melinda Gates Foundation and March of Dimes Foundation and published in collaboration with the Partnership for Maternal, Newborn and Child Health and the World Health Organization (WHO). The original article was

  11. Pre-Term Babies. Caring About Kids.

    ERIC Educational Resources Information Center

    Sargent, Marilyn

    One of a series designed to help parents care for their children and themselves by promoting good mental health, this pamphlet provides information about preterm babies. In nine brief sections, readers find various information, including a description of the preterm infant, a discussion of causes of preterm birth and low-weight babies, and a…

  12. Preterm labor: role of the nurse practitioner.

    PubMed

    Doyle, Jennifer; Silber, Angela

    2015-03-12

    The nurse practitioner may play a pivotal role in diagnosing preterm labor through risk assessment and physical exam. While treatment and management of preterm labor are usually beyond the nurse practitioner's scope of practice, they can play an important role in preventing preterm birth through assessment, action, or advocacy. PMID:25585096

  13. Population-Level Correlates of Preterm Delivery among Black and White Women in the U.S

    PubMed Central

    Carmichael, Suzan L.; Cullen, Mark R.; Mayo, Jonathan A.; Gould, Jeffrey B.; Loftus, Pooja; Stevenson, David K.; Wise, Paul H.; Shaw, Gary M.

    2014-01-01

    Objective This study examined the ability of social, demographic, environmental and health-related factors to explain geographic variability in preterm delivery among black and white women in the US and whether these factors explain black-white disparities in preterm delivery. Methods We examined county-level prevalence of preterm delivery (20–31 or 32–36 weeks gestation) among singletons born 1998–2002. We conducted multivariable linear regression analysis to estimate the association of selected variables with preterm delivery separately for each preterm/race-ethnicity group. Results The prevalence of preterm delivery varied two- to three-fold across U.S. counties, and the distributions were strikingly distinct for blacks and whites. Among births to blacks, regression models explained 46% of the variability in county-level risk of delivery at 20–31 weeks and 55% for delivery at 32–36 weeks (based on R-squared values). Respective percentages for whites were 67% and 71%. Models included socio-environmental/demographic and health-related variables and explained similar amounts of variability overall. Conclusions Much of the geographic variability in preterm delivery in the US can be explained by socioeconomic, demographic and health-related characteristics of the population, but less so for blacks than whites. PMID:24740117

  14. Pre-pregnancy BMI and weight gain: where is the tipping point for preterm birth?

    PubMed Central

    2013-01-01

    Background Obesity in pregnant women is a major problem affecting both the mother and her offspring. Literature on the effect of obesity on preterm birth is inconsistent and few studies have investigated the influence of weight gain during pregnancy. This study examined the effect of maternal pre-pregnancy BMI and weight gain during pregnancy on preterm birth. Methods Data from the Collaborative Perinatal Project (CPP) on 45,824 pregnant women with singleton, live-born infants with no sever congenital anomalies was analyzed. Primary outcome variables included preterm (< 37 weeks of gestation), categorized into spontaneous preterm with and without premature rupture of membrane (PROM) and indicated preterm. Maternal BMI was categorized into underweight (BMI < 18.50), normal weight (BMI =1 8.50 – 24.99), overweight (BMI = 25.00 – 29.99), and obese (BMI ≥ 30.00). Multinomial regression analysis was conducted and OR and 95% CI were calculated. Results The rate of spontaneous preterm birth with PROM among overweight women decreased with increasing weight gain but increased among women who had excessive weight gain. Similarly, a U-shaped rate of spontaneous preterm birth with and without PROM was observed in obese women. Gaining less weight was protective of spontaneous preterm with and without PROM among overweight and obese women compared to normal weight women. Among underweight women, gaining < 7 kg or 9.5-12.7 kg was associated with increased odds of indicated preterm birth. Appreciable differences were also observed in the association between pre-pregnancy BMI, gestational weight gain and the subtypes of preterm births among African Americans and Caucasian Americans. Conclusion Reduced weight gain during pregnancy among overweight and obese women is associated with reduced spontaneous preterm birth with and without PROM. Health care professionals and public health workers should be aware of this risk and adhere to the 2009 IOM guideline that

  15. Cortisol levels in former preterm children at school age are predicted by neonatal procedural pain-related stress

    PubMed Central

    Brummelte, Susanne; Chau, Cecil MY; Cepeda, Ivan L.; Degenhardt, Amanda; Weinberg, Joanne; Synnes, Anne R.; Grunau, Ruth E.

    2014-01-01

    Summary Early life stress can alter hypothalamic pituitary adrenal (HPA) axis function. Differences in cortisol levels have been found in preterm infants exposed to substantial procedural stress during neonatal intensive care, compared to infants born full-term, but only a few studies investigated whether altered programming of the HPA axis persists past toddler age. Further, there is a dearth of knowledge of what may contribute to these changes in cortisol. This prospective cohort study examined the cortisol profiles in response to the stress of cognitive assessment, as well as the diurnal rhythm of cortisol, in children (n=129) born at varying levels of prematurity (24–32 weeks gestation) and at full-term (38–41 weeks gestation), at age 7 years. Further, we investigated the relationships among cortisol levels and neonatal procedural pain-related stress (controlling for multiple medical confounders), concurrent maternal factors (parenting stress, depressive and anxiety symptoms) and children’s behavioral problems. For each aim we investigate acute cortisol response profiles to a cognitive challenge as well as diurnal cortisol patterns at home. We hypothesized that children born very preterm will differ in their pattern of cortisol secretion from children born full-term, possibly depended on concurrent child and maternal factors, and that exposure to neonatal pain-related stress would be associated with altered cortisol secretion in children born very preterm, possibly in a sex-dependent way. Saliva samples were collected from 7-year old children three times during a laboratory visit for assessment of cognitive and executive functions (pretest, mid-test, end - study day acute stress profile) and at four times over two consecutive non-school days at home (i.e. morning, mid-morning, afternoon and bedtime - diurnal rhythm profile). We found that cortisol profiles were similar in preterm and full-term children, albeit preterms had slightly higher cortisol at

  16. Perforated Meckel's diverticulum in a very preterm baby revealed at birth.

    PubMed

    Borgi, Aida; Bouziri, Asma; Boujelbene, Nedia; Sghairoun, Nedia; Belhadj, Serra; Benjeballah, Najla

    2014-04-01

    Perforated Meckel's diverticulum (MD) in a preterm baby is very rare. We report a case of a very preterm baby, born at 29-week gestation, with a birth weight of 1400 g, admitted in the third hour of life to our intensive care unit (ICU) for respiratory distress syndrome with abdominal distention. An abdominal radiograph showed a pneumoperitoneum. Laparotomy revealed Meckel's perforation. The baby was discharged healthy at the age of 16 days. MD should be kept in mind as one cause of an acute abdomen in preterm neonates mimicking necrotizing enterocolitis. To our knowledge, our patient is the third reported case described in the literature and the first one revealed at birth. PMID:24328940

  17. Modifications of recognition memory processes in preterm children: an event-related potential study.

    PubMed

    Kipp, Kerstin H; Mecklinger, Axel; Brunnemann, Nicole; Shamdeen, Mohammed G; Meng-Hentschel, Juliane; Gortner, Ludwig

    2015-01-01

    Prematurity may cause hippocampal compromise. Therefore, hippocampus-dependent memory processes (recollection-based retrieval) may be more impaired than hippocampus-independent processes (familiarity-based retrieval). The memory of 18 children born preterm with reduced hippocampal volumes, without neonatal complications (weeks of gestation < 34, weight < 1,600 g), and 15 controls (8-10 years) was tested using an item recognition task. While groups were equal in memory performance, dissociation was found: The event-related potential (ERP) correlate of familiarity was intact in the preterm group, whereas the correlate of recollection was attenuated. A follow-up experiment ruled out that this was due to general cognitive deficits. Furthermore, gestational age correlated with the ERP index of recollection. Thus, recognition memory in preterm children may be characterized by a compensation of attenuated recollection by familiarity. PMID:25521668

  18. Hot executive function following moderate-to-late preterm birth: altered delay discounting at 4 years of age.

    PubMed

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

    2016-03-01

    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 children have almost exclusively assessed EF in affectively neutral contexts in high-risk preterm children (< 32 weeks gestation). Disrupted function in motivational or emotionally charged contexts (hot EF) following preterm birth remains uninvestigated, despite evidence that preterm children show differential development of neural circuitry subserving hot EF, including reduced orbitofrontal cortex volume. The present study is the first to examine whether low-risk, healthy children born moderate-to-late preterm exhibit impairments in the development of hot EF. Preterm children at age 4.5 years were less likely to choose larger, delayed rewards across all levels of reward magnitude on a delay discounting task using tangible rewards, but performed more similarly to their full-term peers on a delay aversion task involving abstract rewards and on measures of cool EF. The relationship between gestational age at birth and selection of delayed rewards extended across the entire gestational age range of the sample (32-42 weeks), and remained significant after controlling for intelligence and processing speed. Results imply that there is not a finite cut-off point at which children are spared from potential long-term neurodevelopmental effects of PT birth. Further investigation of reward processing and hot EF in individuals with a history of PT birth is warranted given the susceptibility of prefrontal cortex development to early environmental variations. PMID:25873181

  19. Percutaneous absorption in preterm infants.

    PubMed

    West, D P; Halket, J M; Harvey, D R; Hadgraft, J; Solomon, L M; Harper, J I

    1987-11-01

    The skin of preterm infants varies considerably in its level of maturity. To understand skin absorption in premature infants better, we report a technique for the assessment of percutaneous absorption at various gestational and postnatal ages using stable, isotope-labeled (13C6) benzoic acid. Our results indicate that in the preterm infant, this method detects enhanced skin absorption in the first postnatal days, which declines over three weeks to that expected of a full-term infant. This approach also indicates an inverse relationship between gestational age and skin absorption, as well as postnatal age and skin absorption. The reported technique is a safe and noninvasive method using a model skin penetrant for the study of percutaneous absorption in preterm infants from which basic data may be derived to add to our understanding of skin barrier function. PMID:3422856

  20. Very Pre-Term Infants' Behaviour at 1 and 2 Years of Age and Parental Stress Following Basic

    ERIC Educational Resources Information Center

    van der Pal, Sylvia M.; Maguire, Celeste M.; Bruil, Jeanet; le Cessie, Saskia; van Zwieten, Paul; Veen, Sylvia; Wit, Jan M.; Walther, Frans J.

    2008-01-01

    This study explored the effects of basic developmental care on the behaviour of very pre-term infants and parental stress at 1 and 2 years of corrected age. A randomized controlled trial was done to compare basic Developmental Care (standardized nests and incubator covers) and controls (standard care). Parents of infants born less than 32 weeks of…

  1. Young Adult Outcomes of Children Born to Teen Mothers: Effects of Being Born during Their Teen or Later Years

    ERIC Educational Resources Information Center

    Lipman, Ellen L.; Georgiades, Katholiki; Boyle, Michael H.

    2011-01-01

    Objective: Children of teen mothers exhibit adverse outcomes through adolescence. It is unclear whether these adverse outcomes extend to adulthood and apply to all of her children, or only those born when she was a teen. We examine the associations between young adult functioning and being born to a teen mother aged less than or equal to 20 years…

  2. Caffeine therapy in preterm infants

    PubMed Central

    Abdel-Hady, Hesham; Nasef, Nehad; Shabaan, Abd Elazeez; Nour, Islam

    2015-01-01

    Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies exist among various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants. PMID:26566480

  3. Caffeine therapy in preterm infants.

    PubMed

    Abdel-Hady, Hesham; Nasef, Nehad; Shabaan, Abd Elazeez; Nour, Islam

    2015-11-01

    Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies exist among various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants. PMID:26566480

  4. Preterm Birth and Childhood Wheezing Disorders: A Systematic Review and Meta-Analysis

    PubMed Central

    Been, Jasper V.; Lugtenberg, Marlies J.; Smets, Eline; van Schayck, Constant P.; Kramer, Boris W.; Mommers, Monique; Sheikh, Aziz

    2014-01-01

    Background Accumulating evidence implicates early life factors in the aetiology of non-communicable diseases, including asthma/wheezing disorders. We undertook a systematic review investigating risks of asthma/wheezing disorders in children born preterm, including the increasing numbers who, as a result of advances in neonatal care, now survive very preterm birth. Methods and Findings Two reviewers independently searched seven online databases for contemporaneous (1 January 1995–23 September 2013) epidemiological studies investigating the association between preterm birth and asthma/wheezing disorders. Additional studies were identified through reference and citation searches, and contacting international experts. Quality appraisal was undertaken using the Effective Public Health Practice Project instrument. We pooled unadjusted and adjusted effect estimates using random-effects meta-analysis, investigated “dose–response” associations, and undertook subgroup, sensitivity, and meta-regression analyses to assess the robustness of associations. We identified 42 eligible studies from six continents. Twelve were excluded for population overlap, leaving 30 unique studies involving 1,543,639 children. Preterm birth was associated with an increased risk of wheezing disorders in unadjusted (13.7% versus 8.3%; odds ratio [OR] 1.71, 95% CI 1.57–1.87; 26 studies including 1,500,916 children) and adjusted analyses (OR 1.46, 95% CI 1.29–1.65; 17 studies including 874,710 children). The risk was particularly high among children born very preterm (<32 wk gestation; unadjusted: OR 3.00, 95% CI 2.61–3.44; adjusted: OR 2.81, 95% CI 2.55–3.12). Findings were most pronounced for studies with low risk of bias and were consistent across sensitivity analyses. The estimated population-attributable risk of preterm birth for childhood wheezing disorders was ≥3.1%. Key limitations related to the paucity of data from low- and middle-income countries, and risk of residual

  5. Long-Term Impact of Preterm Birth on Exercise Capacity in Healthy Young Men: A National Population-Based Cohort Study

    PubMed Central

    Svedenkrans, Jenny; Henckel, Ewa; Kowalski, Jan

    2013-01-01

    Background Increasing numbers of survivors of preterm birth are growing into adulthood today. Long-term health-effects of prematurity are still poorly understood, but include increased risk for diabetes, obesity and cardiovascular diseases in adult life. To test if reduced physical fitness may be a link in the causal chain of preterm birth and diseases in later life, the association of preterm birth and adult exercise capacity was investigated. The hypothesis was that preterm birth contributes independently of other risk factors to lower physical fitness in adulthood. Methods and Findings Population-based national cohort study of all males conscripting for military service in 1993–2001 and born in Sweden 1973–1983, n = 218,820. Data were retrieved from the Swedish Conscript Register, the Medical Birth Register and the Population and Housing Census 1990. Primary outcome was the results from maximal exercise test (Wmax in Watt) performed at conscription. Association to perinatal and socioeconomic risk factors, other co-variates and confounders were analysed. General linear modelling showed that preterm birth predicted low Wmax in a dose-response related pattern, with 25 Watt reduction in Wmax for the lowest gestational ages, those born ≤27 weeks. Low birth weight for gestational age also independently predicted low Wmax compared to normal and high birth weight (32 Watt reduction for those with a birth weight Standard Deviation Score <2). Low parental education was significantly associated with reduced Wmax (range 17 Watt), as well as both low and high current BMI, with severe obesity resulting in a 16 Watt deficit compared to Wmax top performance. Conclusion Being born preterm as well as being born small for gestational age predicts low exercise capacity in otherwise healthy young men. The effect size of being born preterm equal or exceed that of other known risk factors for unfitness in adults, such as low parental education and overweight. PMID:24324639

  6. Respiratory consequences of late preterm birth.

    PubMed

    Pike, Katharine C; Lucas, Jane S A

    2015-06-01

    In developed countries most preterm births occur between 34 and 37 weeks' gestation. Deliveries during this 'late preterm' period are increasing and, since even mild prematurity is now recognised to be associated with adverse health outcomes, this presents healthcare challenges. Respiratory problems associated with late preterm birth include neonatal respiratory distress, severe RSV infection and childhood wheezing. Late preterm birth prematurely interrupts in utero lung development and is associated with maternal and early life factors which adversely affect the developing respiratory system. This review considers 1) mechanisms underlying the association between late preterm birth and impaired respiratory development, 2) respiratory morbidity associated with late preterm birth, particularly long-term outcomes, and 3) interventions which might protect respiratory development by addressing risk factors affecting the late preterm population, including maternal smoking, early life growth restriction and vulnerability to viral infection. PMID:25554628

  7. Teenage Childbearing among Youth Born to Teenage Mothers

    ERIC Educational Resources Information Center

    Wildsmith, Elizabeth; Manlove, Jennifer; Jekielek, Susan; Moore, Kristin Anderson; Mincieli, Lisa

    2012-01-01

    Using data from the National Longitudinal Survey of Youth, this article examined how early maternal characteristics, an adolescent's family environment, and the adolescent's own attitudes and behaviors were associated with the odds of a nonmarital teenage birth among youth born to teenage mothers. Multivariate analyses indicated that these domains…

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

    PubMed Central

    Souza, Renato T.; Cecatti, Jose G.; Passini, Renato; Tedesco, Ricardo P.; Lajos, Giuliane J.; Nomura, Marcelo L.; Rehder, Patricia M.; Dias, Tabata Z.; Haddad, Samira M.; Pacagnella, Rodolfo C.; Costa, Maria L.

    2016-01-01

    Background 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. Methods and Findings 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

  9. Longitudinal measurement of the developing grey matter in preterm subjects using multi-modal MRI.

    PubMed

    Eaton-Rosen, Zach; Melbourne, Andrew; Orasanu, Eliza; Cardoso, M Jorge; Modat, Marc; Bainbridge, Alan; Kendall, Giles S; Robertson, Nicola J; Marlow, Neil; Ourselin, Sebastien

    2015-05-01

    Preterm birth is a major public health concern, with the severity and occurrence of adverse outcome increasing with earlier delivery. Being born preterm disrupts a time of rapid brain development: in addition to volumetric growth, the cortex folds, myelination is occurring and there are changes on the cellular level. These neurological events have been imaged non-invasively using diffusion-weighted (DW) MRI. In this population, there has been a focus on examining diffusion in the white matter, but the grey matter is also critically important for neurological health. We acquired multi-shell high-resolution diffusion data on 12 infants born at ≤ 28 weeks of gestational age at two time-points: once when stable after birth, and again at term-equivalent age. We used the Neurite Orientation Dispersion and Density Imaging model (NODDI) (Zhang et al., 2012) to analyse the changes in the cerebral cortex and the thalamus, both grey matter regions. We showed region-dependent changes in NODDI parameters over the preterm period, highlighting underlying changes specific to the microstructure. This work is the first time that NODDI parameters have been evaluated in both the cortical and the thalamic grey matter as a function of age in preterm infants, offering a unique insight into neuro-development in this at-risk population. PMID:25681570

  10. Transcriptome Analysis of the Preterm Rabbit Lung after Seven Days of Hyperoxic Exposure

    PubMed Central

    Brady, Paul; Jimenez, Julio; Nagatomo, Taro; Deprest, Jan; Toelen, Jaan

    2015-01-01

    The neonatal management of preterm born infants often results in damage to the developing lung and subsequent morbidity, referred to as bronchopulmonary dysplasia (BPD). Animal models may help in understanding the molecular processes involved in this condition and define therapeutic targets. Our goal was to identify molecular pathways using the earlier described preterm rabbit model of hyperoxia induced lung-injury. Transcriptome analysis by mRNA-sequencing was performed on lungs from preterm rabbit pups born at day 28 of gestation (term: 31 days) and kept in hyperoxia (95% O2) for 7 days. Controls were preterm pups kept in normoxia. Transcriptomic data were analyzed using Array Studio and Ingenuity Pathway Analysis (IPA), in order to identify the central molecules responsible for the observed transcriptional changes. We detected 2217 significantly dysregulated transcripts following hyperoxia, of which 90% could be identified. Major pathophysiological dysregulations were found in inflammation, lung development, vascular development and reactive oxygen species (ROS) metabolism. To conclude, amongst the many dysregulated transcripts, major changes were found in the inflammatory, oxidative stress and lung developmental pathways. This information may be used for the generation of new treatment hypotheses for hyperoxia-induced lung injury and BPD. PMID:26317699

  11. A randomized clinical trial of care for women with preterm labour: home management versus hospital management

    PubMed Central

    Goulet, Céline; Gévry, Hélène; Lemay, Michel; Gauthier, Robert J.; Lepage, Linda; Fraser, William; Polomeno, Viola

    2001-01-01

    Background Preterm labour occurs in about 10% of all pregnancies and is the most important cause of premature birth. Women with preterm labour are admitted to hospital to have the contractions stopped. Thereafter, many women remain in hospital until delivery. We conducted a randomized clinical trial to compare hospital care with home care of women who had been admitted to hospital for preterm labour. Methods After they had received treatment for an acute episode of premature labour, women at 2 regional perinatal centres associated with teaching hospitals were randomly assigned to home care or hospital care. Eligible women (n = 250) were aged 18 years or older, lived within 50 km of the hospital, had a gestational age between 20 and 35 weeks, had no prior preterm delivery and were experiencing their first episode of preterm labour and first admission to hospital for preterm labour. Analysis was by intention to treat. Results There were no significant differences between the 2 groups in mean gestational age at delivery (home: 37.52 weeks, hospital: 37.50 weeks) or in mean birth weight (home: 2974 g, hospital: 3020 g). There were no significant differences between the 2 groups with respect to the proportions of babies born before term or the mean duration of neonatal hospital stay, neonatal intensive care unit stay and intermediate care nursery stay. The mean duration of the first stay in hospital for the women in the home group (3.8 days) was significantly shorter than the mean duration for women in the hospital group (6.1 days). In addition, the mean duration of all maternal stays in hospital was significantly shorter for the women in the home group (3.7 days) than in the hospital group (5.0 days). Interpretation Home care management is an efficient and acceptable alternative to hospital care for women experiencing preterm labour. PMID:11314452

  12. Assessment of the Optic Nerve Head Parameters Using Heidelberg Retinal Tomography III in Preterm Children

    PubMed Central

    Alshaarawi, Salem; Shatriah, Ismail; Zunaina, Embong; Wan Hitam, Wan Hazabbah

    2014-01-01

    Background Variations in optic nerve head morphology and abnormal retinal vascular pattern have been described in preterm children using digital image analysis of fundus photograph, optical coherence tomograph and serial funduscopy. We aimed to compare the optic nerve head parameters in preterm and term Malay children using Heidelberg Retinal Tomograph III. Design A cross sectional study. Methodology/Principal Findings Thirty-two preterm Malay children who were born at up to 32 weeks postconception, and 32 term Malay children aged 8–16 years old were recruited into this cross sectional study, which was conducted in the Hospital Universiti Sains Malaysia, Malaysia from January to December 2011. Their optic nerves were scanned and analyzed using a Heidelberg Retinal Tomography (HRT) III (Heidelberg Engineering, Germany). Preterm children showed an increased rim volume (SD) (0.56 (0.26) vs 0.44 (0.18) mm3, respectively), smaller cup shape (SD) (0.18 (0.07) vs 0.25 (0.06) mm, respectively), increased height variation contour (SD) (0.44 (0.14) vs 0.35 (0.08) mm, respectively), and increased cup depth (SD) (0.24 (0.11) vs 0.17 (0.05) mm3, respectively) when compared to their normal peers (p<0.05). There were no significant differences in the mean disc area, cup area, cup to disc ratio or rim area between the preterm and term children (p>0.05) in our study. Conclusions/Significance Preterm children exhibit different characteristics of optic nerve head parameters with HRT III analysis. Increased cup depth in preterm children suggests a need for close observation and monitoring. It may raise suspicion of pediatric glaucoma when proper documentation of intraocular pressure and clinical funduscopy are unsuccessful in uncooperative children. PMID:24551076

  13. The human uterine smooth muscle S-nitrosoproteome fingerprint in pregnancy, labor, and preterm labor

    PubMed Central

    Ulrich, Craig; Quilici, David R.; Schlauch, Karen A.

    2013-01-01

    Molecular mechanisms involved in uterine quiescence during gestation and those responsible for induction of labor at term are incompletely known. More than 10% of babies born worldwide are premature and 1,000,000 die annually. Preterm labor results in preterm delivery in 50% of cases in the United States explaining 75% of fetal morbidity and mortality. There is no Food and Drug Administration-approved treatment to prevent preterm delivery. Nitric oxide-mediated relaxation of human uterine smooth muscle is independent of global elevation of cGMP following activation of soluble guanylyl cyclase. S-nitrosation is a likely mechanism to explain cGMP-independent relaxation to nitric oxide and may reveal S-nitrosated proteins as new therapeutic targets for the treatment of preterm labor. Employing S-nitrosoglutathione as an nitric oxide donor, we identified 110 proteins that are S-nitrosated in 1 or more states of human pregnancy. Using area under the curve of extracted ion chromatograms as well as normalized spectral counts to quantify relative expression levels for 62 of these proteins, we show that 26 proteins demonstrate statistically significant S-nitrosation differences in myometrium from spontaneously laboring preterm patients compared with nonlaboring patients. We identified proteins that were up-S-nitrosated as well as proteins that were down-S-nitrosated in preterm laboring tissues. Identification and relative quantification of the S-nitrosoproteome provide a fingerprint of proteins that can form the basis of hypothesis-directed efforts to understand the regulation of uterine contraction-relaxation and the development of new treatment for preterm labor. PMID:23948706

  14. Adverse birth outcomes among native-born and foreign-born mothers in Taiwan: A population-based birth cohort study

    PubMed Central

    2012-01-01

    Background The number of children born to foreign-born mothers in Taiwan has significantly increased since the 1990s. These foreign-born mothers are mainly from China and Southeast Asia. Children born to foreign-born mothers, according to media reports, are subject to inferior health. This study sought to determine whether socioeconomic disparities in birth outcomes exist between native and foreign-born mothers in Taiwan. Methods Analysis data were obtained from the Taiwan Birth Cohort Study of 20,090 nationally representative 6-month-old babies, born in 2005. The data on the babies were divided into two groups, those of foreign-born mothers and those of Taiwanese mothers. The health outcome variables that were examined included two adverse birth outcomes: low birth weight and preterm birth. Multiple logistic regression was used to examine the association between income and foreign-born status, as well as birth outcomes among both groups. Results Children of native Taiwanese mothers had a higher prevalence of low birth weight (6.9%) than did children of China-born (4.7%) and Southeast Asia-born mothers (5.2%). The prevalence of preterm birth was also higher among children of native Taiwanese mothers (8.4%) than among children of Southeast Asia-born (7.2%) and China-born mothers (6.3%). Foreign-born status was associated with lower odds of low birth weight among families with a monthly family income < NT$30,000 (adjusted odds ratio (AOR) = 0.24, 95% confidence interval (CI) = 0.14–0.42, p < 0.001), and lower odds of preterm birth among families with a monthly family income < NT$30,000 and NT$30,000–69,999 (AOR = 0.63, CI = 0.40–0.99, p < 0.05, and AOR = 0.68, CI = 0.53–0.88, p < 0.01, respectively). Having a higher monthly family income (NT$70,000+ and NT$30,000–69,999) was associated with lower odds of low birth weight (AOR = 0.59, CI = 0.46–0.77, p < 0.001 and AOR = 0.75, CI = 0.60–0.94, p < 0.05, respectively) among Taiwanese mothers, but not among

  15. Can infant lung function predict respiratory morbidity during the first year of life in preterm infants?

    PubMed

    Proietti, Elena; Riedel, Thomas; Fuchs, Oliver; Pramana, Isabelle; Singer, Florian; Schmidt, Anne; Kuehni, Claudia; Latzin, Philipp; Frey, Urs

    2014-06-01

    Compared with term-born infants, preterm infants have increased respiratory morbidity in the first year of life. We investigated whether lung function tests performed near term predict subsequent respiratory morbidity during the first year of life and compared this to standard clinical parameters in preterms. The prospective birth cohort included randomly selected preterm infants with and without bronchopulmonary dysplasia. Lung function (tidal breathing and multiple-breath washout) was measured at 44 weeks post-menstrual age during natural sleep. We assessed respiratory morbidity (wheeze, hospitalisation, inhalation and home oxygen therapy) after 1 year using a standardised questionnaire. We first assessed the association between lung function and subsequent respiratory morbidity. Secondly, we compared the predictive power of standard clinical predictors with and without lung function data. In 166 preterm infants, tidal volume, time to peak tidal expiratory flow/expiratory time ratio and respiratory rate were significantly associated with subsequent wheeze. In comparison with standard clinical predictors, lung function did not improve the prediction of later respiratory morbidity in an individual child. Although associated with later wheeze, noninvasive infant lung function shows large physiological variability and does not add to clinically relevant risk prediction for subsequent respiratory morbidity in an individual preterm. PMID:24696112

  16. Consistency of maternal cognitions and principles across the first five months following preterm and term deliveries

    PubMed Central

    Winstanley, A.; Sperotto, R.G.; Putnick, D.L.; Cherian, S.; Bornstein, M.H.; Gattis, M.

    2014-01-01

    The aims of this study were to examine and compare the development of parenting cognitions and principles in mothers following preterm and term deliveries. Parenting cognitions about child development, including thinking that is restricted to single causes and single outcomes (categorical thinking) and thinking that takes into account multiple perspectives (perspectivist thinking), have been shown to relate to child outcomes. Parenting principles about using routines (structure) or infant cues (attunement) to guide daily caregiving have been shown to relate to caregiving practices. We investigated the continuity and stability of parenting cognitions and principles in the days following birth to 5 months postpartum for mothers of infants born term and preterm. All parenting cognitions were stable across time. Categorical thinking increased at a group level across time in mothers of preterm, but not term, infants. Perspectivist thinking increased at a group level for first-time mothers (regardless of birth status) and tended to be lower in mothers of preterm infants. Structure at birth did not predict later structure (and so was unstable) in mothers of preterm, but not term, infants and neither group changed in mean level across time. Attunement was consistent across time in both groups of mothers. These results indicate that prematurity has multiple, diverse effects on parenting beliefs, which may in turn influence maternal behavior and child outcomes. PMID:25459794

  17. Optimizing Early Protein Intake for Long-Term Health of Preterm Infants.

    PubMed

    Singhal, Atul

    2016-01-01

    The idea that early protein intake may influence, or program, long-term health in preterm infants is strongly supported by decades of research starting from the early 1980s. At this time, it was recognized that preterm infants required a high protein intake to achieve postnatal growth closer to the intrauterine growth rate of a normal fetus of the same postconceptional age, a goal regarded optimal for short- and long-term health. Subsequently, follow-up of preterm infants randomized to different neonatal diets demonstrated that those receiving higher protein intakes that promoted growth had benefits for brain structure and function up to 16 years later, but also detrimental effects on cardiovascular risk factors such as insulin resistance and adiposity. These effects of early growth on risk of metabolic disease, termed the 'growth acceleration' hypothesis, have been demonstrated in randomized and observational studies in infants born preterm and at term. Nevertheless, on balance, current nutrition policy for preterm infants is based on the consensus that supporting optimal neurodevelopment is the neonatologist's highest priority. Therefore, this policy appropriately favors early administration of a high protein intake to benefit neurodevelopment, irrespective of any increase in cardiovascular risk. The current review will consider the evidence underlying this policy. PMID:27336311

  18. Consistency of maternal cognitions and principles across the first five months following preterm and term deliveries.

    PubMed

    Winstanley, A; Sperotto, R G; Putnick, D L; Cherian, S; Bornstein, M H; Gattis, M

    2014-11-01

    The aims of this study were to examine and compare the development of parenting cognitions and principles in mothers following preterm and term deliveries. Parenting cognitions about child development, including thinking that is restricted to single causes and single outcomes (categorical thinking) and thinking that takes into account multiple perspectives (perspectivist thinking), have been shown to relate to child outcomes. Parenting principles about using routines (structure) or infant cues (attunement) to guide daily caregiving have been shown to relate to caregiving practices. We investigated the continuity and stability of parenting cognitions and principles in the days following birth to 5 months postpartum for mothers of infants born term and preterm. All parenting cognitions were stable across time. Categorical thinking increased at a group level across time in mothers of preterm, but not term, infants. Perspectivist thinking increased at a group level for first-time mothers (regardless of birth status) and tended to be lower in mothers of preterm infants. Structure at birth did not predict later structure (and so was unstable) in mothers of preterm, but not term, infants and neither group changed in mean level across time. Attunement was consistent across time in both groups of mothers. These results indicate that prematurity has multiple, diverse effects on parenting beliefs, which may in turn influence maternal behavior and child outcomes. PMID:25459794

  19. Particulate matter and preterm birth

    EPA Science Inventory

    Particulate matter (PM) has been variably associated with preterm birth (PTB) (gestation <37 weeks), but the role played by specific chemical components of PM has been little studied. We examined the association between ambient PM <2.5 micrometers in aerodynamic diameter (PM2.S) ...

  20. Allostatic Load and Preterm Birth

    PubMed Central

    Olson, David M.; Severson, Emily M.; Verstraeten, Barbara S. E.; Ng, Jane W. Y.; McCreary, J. Keiko; Metz, Gerlinde A. S.

    2015-01-01

    Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that there are no means to predict who is at risk when pregnancy begins or when women will actually deliver. Until these problems are addressed, there will be no interventions to reduce the risk because those who should be treated will not be known. Considerable evidence now exists that chronic life, generational or accumulated stress is a risk factor for preterm delivery in animal models and in women. This wear and tear on the body and mind is called allostatic load. This review explores the evidence that chronic stress contributes to preterm birth and other adverse pregnancy outcomes in animal and human studies. It explores how allostatic load can be used to, firstly, model stress and preterm birth in animal models and, secondly, how it can be used to develop a predictive model to assess relative risk among women in early pregnancy. Once care providers know who is in the highest risk group, interventions can be developed and applied to mitigate their risk. PMID:26694355

  1. Global Incidence of Preterm Birth.

    PubMed

    Tielsch, James M

    2015-01-01

    Estimating the incidence of preterm birth depends on accurate assessment of gestational age and pregnancy outcomes. In many countries, such data are not routinely collected, making global estimates difficult. A recent systematic approach to this problem has estimated a worldwide incidence of 11.1 per 100 live births in 2010. Significant variation in rates by country and region of the world was noted, but this variation is smaller than observed for a number of other important reproductive outcomes. Rates range from approximately 5% in some northern European countries to over 15% in some countries in sub-Saharan Africa and Asia. Time trends suggest that preterm birth incidence is increasing, but much of this change may reflect changes in medically induced early delivery practices as improvements in survival of preterm infants has improved. Whether there have been major changes in spontaneous preterm birth is unknown. New approaches to classifying etiologic heterogeneity have been proposed and offer the promise of developing specific interventions to address the range of underlying causes of this important health problem. PMID:26111559

  2. Allostatic Load and Preterm Birth.

    PubMed

    Olson, David M; Severson, Emily M; Verstraeten, Barbara S E; Ng, Jane W Y; McCreary, J Keiko; Metz, Gerlinde A S

    2015-01-01

    Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that there are no means to predict who is at risk when pregnancy begins or when women will actually deliver. Until these problems are addressed, there will be no interventions to reduce the risk because those who should be treated will not be known. Considerable evidence now exists that chronic life, generational or accumulated stress is a risk factor for preterm delivery in animal models and in women. This wear and tear on the body and mind is called allostatic load. This review explores the evidence that chronic stress contributes to preterm birth and other adverse pregnancy outcomes in animal and human studies. It explores how allostatic load can be used to, firstly, model stress and preterm birth in animal models and, secondly, how it can be used to develop a predictive model to assess relative risk among women in early pregnancy. Once care providers know who is in the highest risk group, interventions can be developed and applied to mitigate their risk. PMID:26694355

  3. Factors Affecting Vocabulary Acquisition at Age 2 in Children Born between 23 and 28 Weeks' Gestation

    ERIC Educational Resources Information Center

    Marston, Louise; Peacock, Janet L.; Calvert, Sandra A.; Greenough, Anne; Marlow, Neil

    2007-01-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the…

  4. Intravenous Lipids for Preterm Infants: A Review

    PubMed Central

    Salama, Ghassan SA; Kaabneh, Mahmmoud AF; Almasaeed, Mai N; Alquran, Mohammad IA

    2015-01-01

    Extremely low birth weight infants (ELBW) are born at a time when the fetus is undergoing rapid intrauterine brain and body growth. Continuation of this growth in the first several weeks postnatally during the time these infants are on ventilator support and receiving critical care is often a challenge. These infants are usually highly stressed and at risk for catabolism. Parenteral nutrition is needed in these infants because most cannot meet the majority of their nutritional needs using the enteral route. Despite adoption of a more aggressive approach with amino acid infusions, there still appears to be a reluctance to use early intravenous lipids. This is based on several dogmas that suggest that lipid infusions may be associated with the development or exacerbation of lung disease, displace bilirubin from albumin, exacerbate sepsis, and cause CNS injury and thrombocytopena. Several recent reviews have focused on intravenous nutrition for premature neonate, but very little exists that provides a comprehensive review of intravenous lipid for very low birth and other critically ill neonates. Here, we would like to provide a brief basic overview, of lipid biochemistry and metabolism of lipids, especially as they pertain to the preterm infant, discuss the origin of some of the current clinical practices, and provide a review of the literature, that can be used as a basis for revising clinical care, and provide some clarity in this controversial area, where clinical care is often based more on tradition and dogma than science. PMID:25698888

  5. Progesterone to prevent spontaneous preterm birth.

    PubMed

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

    2014-02-01

    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 present as a clinically silent 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 the neonatal intensive care unit, respiratory distress syndrome, need for mechanical ventilation, etc.). To prevent one case of spontaneous preterm birth <33 weeks of gestation, 11 patients with a short cervix would need to be treated (based on an individual patient meta-analysis). Vaginal progesterone reduces the rate of spontaneous preterm 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

  6. Progesterone to prevent spontaneous preterm birth

    PubMed Central

    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 <33 weeks of gestation, 12 patients with a short cervix would need to be treated. Vaginal progesterone reduces the rate of spontaneous preterm 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

  7. Exploring the Personal Narratives of Mothers of Former Preterm Infants Now at Preschool Age

    ERIC Educational Resources Information Center

    Adkins, Cherie Sue

    2010-01-01

    Having a preterm-born child is often fraught with ongoing challenges for the child's mother. Yet little is known regarding how that experience, over time, may influence the mother's health and well-being, how it influences her perceptions and practices of parenting, and the meaning(s) she attributes to it. The purpose of this study was…

  8. Evaluation of a practice guideline for the management of respiratory distress syndrome in preterm infants: A quality improvement initiative

    PubMed Central

    Read, Brooke; Lee, David SC; Fraser, Debbie

    2016-01-01

    BACKGROUND: The use of mechanical ventilation to treat respiratory distress syndrome in preterm infants has been associated with the development of bronchopulmonary dysplasia. As part of a quality improvement initiative to reduce the incidence of bronchopulmonary dysplasia in preterm infants, a new practice guideline for the management of respiratory distress syndrome was developed and adopted into practice in a neonatal intensive care unit in February 2012. OBJECTIVE: To evaluate the effects of implementing the new guideline in regard to the use of mechanical ventilation and surfactant, and the incidence of bronchopulmonary dypslasia. METHODS: An historical cohort of very preterm infants (gestational age 260 to 326 weeks) born one year before guideline implementation was compared with a similar cohort of infants born one year following guideline implementation. Data were collected retrospectively from the local neonatal intensive care unit database. RESULTS: A total of 272 preterm infants were included in the study: 129 in the preguideline cohort and 143 in the postguideline cohort. Following the implementation of the guideline, the proportion of infants treated with ongoing mechanical ventilation was reduced from 49% to 26% (P<0.001) and there was a trend toward a reduction in bronchopulmonary dysplasia (27% versus 18%; P=0.07). There was no difference in the proportion of infants treated with surfactant (54% versus 50%). CONCLUSION: The implementation of the practice guideline helped to minimize the use of ongoing mechanical ventilation in preterm infants. PMID:26941562

  9. 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

    ERIC Educational Resources Information Center

    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…

  10. [An unusual case of a 35 days preterm birth of a German Holstein calf].

    PubMed

    Reinartz, Sina; Höltershinken, Martin; Distl, Ottmar

    2016-01-01

    A female calf of the breed German Holstein (GH) was spontaneously born on July 28, 2013 which was 35 days before the expected term of birth. The dam was a heifer when she got pregnant from the first insemination on November 23, 2012. Calving was without complications. The calf was fully viable and without visible anomalies. We assume that the calf was fully mature at the termination of the pregnancy. Growth rate after the second month of life was comparable to calves born in the same herd after normal length of gestation. The sire of this preterm calf was a GH-bull used for artificial insemination. This bull had already sired 151 daughters. For this bull, preterm calvings were not yet reported. The dam was a heifer, and neither external influences on this dam or in the herd could be identified that could have induced this premature calving. In the herd, no further premature calvings were observed or reasons associated with a preterm calving were found. In this exceptional case, however, gestation length was 248 days and the prematurely born calf survived without any signs of debility, organ defects and respiratory distress. PMID:26904901

  11. LOW PRETERM BIRTH RATE WITH DECREASING EARLY NEONATAL MORTALITY IN BOSNIA AND HERZEGOVINA DURING 2007-2014

    PubMed Central

    Hudic, Igor; Stray-Pedersen, Babill; Skokic, Fahrija; Fatusic, Zlatan; Zildzic-Moralic, Aida; Skokic, Maida; Fatusic, Jasenko

    2016-01-01

    The aim: of the study was to determine the situation of preterm births and early neonatal mortality during 2007-2014 in Tuzla Canton, Bosnia and Herzegovina. Methods: The study covers a 8-year period and is based on the protocols at the Tuzla Clinic for Gynecology and Obstetrics that covers all birth in Tuzla Canton area. We analyzed the gestational age of all newborns and recorded the number of neonatal deaths in the first week after birth. Demographics, pregnancy and birth characteristics were collected from the maternal records. Results: The total number of births in the period was 32738. Preterm birth was identified in 2401 (7.3%) cases with 12,5% occurring before 32 gestational weeks and 64% in 35-36 gestational weeks. The mothers of the 24-31 gws preterm group were significantly younger that those in the 32-36 group. In the 32-36 group there were significantly greater proportions of mothers with assisted reproductive technology and pre-eclampsia and 16.7% was medical induced preterm births versus 11.4 % in the 24-31 PTB group, p<0.05. The incidence of PTB did no vary significantly during the period, the lowest rate was found in 2010 (6.4%). A total of 221 children died giving a early mortality rate of 6.8 per 1000 live born over the 8 years. The majority 156 dying infants (70.6%) were preterm, only 5.7% died being born in the 35-36 gestational week (5.9 per 1000). Overall the preterm early mortality (7.3 per 1000) has shown a decreasing tendency during the latter years. Conclusion: During the last 8 years there have been no significant decline in preterm birth in the Tuzla region while a decline in early neonatal death has been registered. PMID:27047264

  12. Development of preterm infants: feeding behaviors and brazelton neonatal behavioral assessment scale at 40 and 44 weeks' postconceptional age.

    PubMed

    Medoff-Cooper, Barbara; Ratcliffe, Sarah J

    2005-01-01

    The purpose of this study was twofold: (1) to explore potential changes in the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) from 40 to 44 weeks postconceptional age (PCA) and (2) to determine the relationship between the BNBAS scores and feeding behaviors in preterm infants at 40 and 44 weeks PCA. The BNBAS and sucking behavior measurements were completed on 104 preterm infants at 40 and 44 weeks PCA. The Orientation (p = .001), Motor (p = .001), Range of State (p = .001), Autonomic Regulation (p = .01), and Reflexes (p = .00) clusters were significantly more mature at 44 weeks PCA than at 40 weeks. Infants that were extremely early born (n = 24) had a significantly larger change in BNBAS scores over time as compared to the more mature preterm infants (n = 77), largely catching up with their more mature preterm counterparts. At 40 and 44 weeks PCA, the BNBAS cluster scores for orientation (p = .02), motor (p = .048), range of state (p = .048), and regulation of state (p < .001) were significantly related to the average maximum pressure, adjusted for gestational age and weeks PCA. Significant neurobehavioral maturation takes place between 40 and 44 weeks PCA in preterm infants, with the greatest changes occurring in the most preterm infants. These findings highlight the relationship between neurobehavioral maturation and feeding behaviors. PMID:16292021

  13. Adjusting to being a father to an infant born prematurely: experiences from Swedish fathers.

    PubMed

    Lindberg, Birgitta; Axelsson, Karin; Ohrling, Kerstin

    2008-03-01

    The aim of this study was to describe the experiences of being a father to a prematurely born infant. Eight fathers of prematurely born children were interviewed using a narrative approach, and a thematic content analysis was used to analyse the interviews. The fathers described that the preterm birth gave them the chance to get to know their infant as they had to spend time at the intensive care unit. They also felt better educated by professionals who helped them take care of their infant. Their feelings and attachment for their infant increased over time and the fathers felt that they had a stronger bond with their child compared with friends who had babies born at term. As time passed, they became more confident as a father. In spite of the strain, the experience made them change as a person and they expressed having different values. The relationship with their partner was strengthened as they handled this situation together as a couple. However, the fathers felt fortunate despite everything and described having managed a prematurely born infant rather well. Although there are similarities between being a father to a child born at term and to one born preterm, it is significant to gain further knowledge about the specific experiences of fathers of prematurely born infants. The results of this study have implications for nurses working with families who have children born prematurely. PMID:18269426

  14. Prevention of preterm birth in modern obstetrics.

    PubMed

    Markham, Kara B; Klebanoff, Mark

    2014-12-01

    Spontaneous preterm labor is a complex process characterized by the interplay of multiple different pathways. Prevention of preterm labor and delivery is also complicated. The most effective interventions for prevention of preterm birth (PTB) are progestin prophylaxis and lifestyle modifications, with cerclage placement also playing a role in selected populations. Interventions such as activity modification, home tocometry, and routine antibiotic use have fallen out of favor because of lack of effectiveness and possibility of harm. The solution to the problem of PTB remains elusive, and researchers and clinicians must collaborate to find a cure for preterm labor. PMID:25459773

  15. Strategies to Prevent Preterm Birth

    PubMed Central

    Newnham, John P.; Dickinson, Jan E.; Hart, Roger J.; Pennell, Craig E.; Arrese, Catherine A.; Keelan, Jeffrey A.

    2014-01-01

    After several decades of research, we now have evidence that at least six interventions are suitable for immediate use in contemporary clinical practice within high-resource settings and can be expected to safely reduce the rate of preterm birth. These interventions involve strategies to prevent non-medically indicated late preterm birth; use of maternal progesterone supplementation; surgical closure of the cervix with cerclage; prevention of exposure of pregnant women to cigarette smoke; judicious use of fertility treatments; and dedicated preterm birth prevention clinics. Quantification of the extent of success is difficult to predict and will be dependent on other clinical, cultural, societal, and economic factors operating in each environment. Further success can be anticipated in the coming years as other research discoveries are translated into clinical practice, including new approaches to treating intra-uterine infection, improvements in maternal nutrition, and lifestyle modifications to ameliorate maternal stress. The widespread use of human papillomavirus vaccination in girls and young women will decrease the need for surgical interventions on the cervix and can be expected to further reduce the risk of early birth. Together, this array of clinical interventions, each based on a substantial body of evidence, is likely to reduce rates of preterm birth and prevent death and disability in large numbers of children. The process begins with an acceptance that early birth is not an inevitable and natural feature of human reproduction. Preventative strategies are now available and need to be applied. The best outcomes may come from developing integrated strategies designed specifically for each health-care environment. PMID:25477878

  16. Evaluation of recent New Vaccine Surveillance Network data regarding respiratory syncytial virus hospitalization rates in US preterm infants

    PubMed Central

    DeVincenzo, John P.; Ambrose, Christopher S.; Makari, Doris; Weiner, Leonard B.

    2016-01-01

    abstract In July 2014, the Committee on Infectious Diseases (COID) updated their guidance on the use of palivizumab, recommending against use in preterm infants 29 to 35 weeks' gestational age (wGA). A primary data source cited to support this significant change was the low respiratory syncytial virus (RSV) hospitalization rate observed in the subpopulation of preterm (<37 wGA) infants evaluated from 2000 to 2005 through the New Vaccine Surveillance Network (NVSN). Here we critically appraise the preterm infant data from the NVSN in the context of data regarding the use of palivizumab in this same time period. Data from the NVSN, an analysis of Florida Medicaid data, and a national survey of US in-hospital palivizumab administration demonstrated that during 2001 to 2007, palivizumab was administered to 59% to 83% of preterm infants born at <32 wGA and 21% to 27% of all preterm infants (<37 wGA). When the NVSN data regarding incidence of RSV hospitalization in preterm infant subgroups were evaluated as a function of chronologic age, preterm infants <32 wGA showed a paradoxical increase in RSV hospitalization with older age, with the highest risk of RSV hospitalization occurring at 18 to 23 months of age. This pattern is most consistent with a reduction in RSV hospitalizations in <32 wGA infants in the first 12 to 18 months of life due to high palivizumab use at these young ages. The NVSN data were not designed to and cannot accurately describe RSV disease burden in preterm infants given the small size of the analyzed subpopulation and the high use of palivizumab during the study period. PMID:26889568

  17. Stress response and cardiac activity of term and preterm calves in the perinatal period.

    PubMed

    Nagel, Christina; Aurich, Jörg; Trenk, Lisa; Ille, Natascha; Drillich, Marc; Pohl, Werner; Aurich, Christine

    2016-10-01

    This study tested the hypothesis of gestational age affecting fetal cardiac activity and the stress response at birth. Heart rate (HR), heart rate variability variables, SD of the beat-to-beat interval and root mean square of successive beat-to-beat differences, and postnatal salivary cortisol concentration were studied in calves born at term (Term, n = 7, gestation length 286.3 ± 2.1 days) or after induction of parturition (Preterm, n = 7, gestation length 279.6 ± 0.2 days). Observation periods covered the last month of gestation (phase A), the last hours before birth including the first stage of labor (phase B), and the neonatal period (phase C). Fetal HR decreased in phase A (P < 0.001) and did not differ between groups. During phase B, HR increased (P < 0.05) and was higher in Preterm than in Term calves in phases B (P < 0.05) and C (P < 0.01). In Term calves, heart rate variability increased from Day 6 until birth (P < 0.05). At birth, SD of the beat-to-beat interval was higher in Term than in Preterm calves (P < 0.01). On Day 1 after birth (phase C), HR accelerations were more frequent in Term than Preterm calves (P < 0.01), whereas decelerations were more frequent in Preterm calves (P < 0.05). Cortisol concentration increased postnatally (P < 0.001) and was correlated with gestation length (r ≥ 0.68, P < 0.01). Because of a certain degree of immaturity, the ability to cope with the stress of birth may be impaired in calves born 1 week before term. PMID:27312949

  18. [The prognosis for children born after assisted reproduction].

    PubMed

    Henningsen, Anna-Karina Aaris; Loft, Anne; Malchau, Sara Sofia; Pinborg, Anja

    2012-10-01

    Children who are born after assisted reproduction (ART) have a slightly increased risk of being born preterm, of having low birthweight and a higher perinatal mortality than spontaneously conceived children. The higher rate of multiple births among women having had ART can to some extent explain this. However, adverse outcomes persist even in ART singletons. The characteristics of the infertile parents have negative effects on the outcome, but also the hormone stimulation and the in vitro techniques are thought to play a role. A milder hormone stimulation and elective single embryo transfer, which reduces the number of multiples after ART, have improved the overall health of children born as a result of ART. PMID:23050688

  19. Breastfeeding and dietary variety among preterm children aged 1-3 years.

    PubMed

    Husk, Jesse S; Keim, Sarah A

    2016-04-01

    Among infants born at term, breastfeeding is associated with increased dietary variety in childhood. Preterm birth can limit early feeding options while simultaneously increasing risk for negative health outcomes that could benefit from dietary-based preventative measures. We assessed whether breastfeeding is associated with increased dietary variety at 1-3 years amongst children born preterm. We analyzed baseline data from two clinical trials investigating cognitive development after fatty-acid supplementation for 10-39 month-old children born before 35 weeks gestation (n = 189). At baseline, mothers reported breastfeeding history and completed a 161-item food-frequency questionnaire for their child. Dietary variety was assessed via 3 measures: (1) proportion items consumed at least once per month, (2) servings of a given item consumed relative to total monthly food servings, (3) daily probability of consuming a given item. Overall, 88% of children were ever breastfed (median duration = 89 days, range = 0-539), and 48% of children were ever exclusively breastfed (median duration = 59 days, range = 3-240). Exclusive breastfeeding duration was associated with dietary variety increases of 0.9% (95% CI = 0.1-1.7) for vegetables, 1.6% (95% CI = 0.2-3.0) for meat/fish, and 1.3% (95% CI = 0.2-2.4) for grain/starch, for each additional month of exclusive breastfeeding after adjustment for key confounders. Correspondingly, the variety of sweets consumed decreased by 1.2% (CI: -2.1, -0.3) per month of any breastfeeding after adjustment. These results are consistent with those in children born at term, and if causal, could provide additional support for exclusive breastfeeding to improve diet and health in children born preterm. PMID:26792771

  20. Lung consequences in adults born prematurely.

    PubMed

    Bolton, Charlotte E; Bush, Andrew; Hurst, John R; Kotecha, Sailesh; McGarvey, Lorcan

    2015-12-01

    Although survival has improved significantly in recent years, prematurity remains a major cause of infant and childhood mortality and morbidity. Preterm births (<37 weeks of gestation) account for 8% of live births representing >50,000 live births each year in the UK. Preterm birth, irrespective of whether babies require neonatal intensive care, is associated with increased respiratory symptoms, partially reversible airflow obstruction and abnormal thoracic imaging in childhood and in young adulthood compared with those born at term. Having failed to reach their optimal peak lung function in early adulthood, there are as yet unsubstantiated concerns of accelerated lung function decline especially if exposed to noxious substances leading to chronic respiratory illness; even if the rate of decline in lung function is normal, the threshold for respiratory symptoms will be crossed early. Few adult respiratory physicians enquire about the neonatal period in their clinical practice. The management of these subjects in adulthood is largely evidence free. They are often labelled as asthmatic although the underlying mechanisms are likely to be very different. Smoking cessation, maintaining physical fitness, annual influenza immunisation and a general healthy lifestyle should be endorsed irrespective of any symptoms. There are a number of clinical and research priorities to maximise the quality of life and lung health in the longer term not least understanding the underlying mechanisms and optimising treatment, rather than extrapolating from other airway diseases. PMID:26607737

  1. Lung consequences in adults born prematurely.

    PubMed

    Bolton, Charlotte E; Bush, Andrew; Hurst, John R; Kotecha, Sailesh; McGarvey, Lorcan

    2015-06-01

    Although survival has improved significantly in recent years, prematurity remains a major cause of infant and childhood mortality and morbidity. Preterm births (<37 weeks of gestation) account for 8% of live births representing >50 000 live births each year in the UK. Preterm birth, irrespective of whether babies require neonatal intensive care, is associated with increased respiratory symptoms, partially reversible airflow obstruction and abnormal thoracic imaging in childhood and in young adulthood compared with those born at term. Having failed to reach their optimal peak lung function in early adulthood, there are as yet unsubstantiated concerns of accelerated lung function decline especially if exposed to noxious substances leading to chronic respiratory illness; even if the rate of decline in lung function is normal, the threshold for respiratory symptoms will be crossed early. Few adult respiratory physicians enquire about the neonatal period in their clinical practice. The management of these subjects in adulthood is largely evidence free. They are often labelled as asthmatic although the underlying mechanisms are likely to be very different. Smoking cessation, maintaining physical fitness, annual influenza immunisation and a general healthy lifestyle should be endorsed irrespective of any symptoms. There are a number of clinical and research priorities to maximise the quality of life and lung health in the longer term not least understanding the underlying mechanisms and optimising treatment, rather than extrapolating from other airway diseases. PMID:25825005

  2. Environmental phthalate exposure and preterm birth

    PubMed Central

    Ferguson, Kelly K.; McElrath, Thomas F.; Meeker, John D.

    2014-01-01

    IMPORTANCE Preterm birth is a leading cause of neonatal mortality with a variety of contributing causes and risk factors. Environmental exposures represent a group of understudied but potentially important factors. Phthalate diesters are used extensively in a variety of consumer products worldwide. Consequently, exposure in pregnant women is highly prevalent OBJECTIVE To assess the relationship between phthalate exposure during pregnancy and preterm birth. DESIGN Nested case-control study. SETTING Brigham and Women’s Hospital, Boston, MA, USA. PARTICIPANTS Women were recruited for a prospective observational cohort study from 2006–2008. Each provided demographic data, biological samples, and information about birth outcomes. Within this group we selected 130 cases of preterm birth and 352 randomly assigned controls, and analyzed urine samples from up to three time points during pregnancy for levels of phthalate metabolites. MAIN OUTCOME MEASURES We examined associations between average levels of phthalate exposure during pregnancy and preterm birth, defined as <37 weeks completed gestation, as well as spontaneous preterm birth, defined as preterm preceded by spontaneous preterm labor or preterm premature rupture of the membranes (N=57). RESULTS Geometric means of the di-2-ethylhexyl phthalate (DEHP) metabolites mono-(2-ethyl)-hexyl phthalate (MEHP) and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), as well as mono-n-butyl phthalate (MBP) were significantly higher in cases compared to controls. In adjusted models, MEHP, MECPP, and ∑DEHP metabolites were associated with significantly increased odds of preterm birth. When spontaneous preterm births were examined alone, MEHP, mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), MECPP, ∑DEHP, MBP, and mono-(3-carboxypropyl) phthalate (MCPP) metabolite levels were all associated with significantly elevated odds of prematurity. CONCLUSIONS AND RELEVANCE Women exposed to phthalates during pregnancy have significantly

  3. Executive Function and IQ Predict Mathematical and Attention Problems in Very Preterm Children

    PubMed Central

    Aarnoudse-Moens, Cornelieke Sandrine Hanan; Weisglas-Kuperus, Nynke; Duivenvoorden, Hugo Joseph; van Goudoever, Johannes Bernard; Oosterlaan, Jaap

    2013-01-01

    Objective of this study was to examine the impact of executive function (EF) on mathematical and attention problems in very preterm (gestational age ≤ 30 weeks) children. Participants were 200 very preterm (mean age 8.2 ± 2.5 years) and 230 term children (mean age 8.3 ± 2.3 years) without severe disabilities, born between 1996 and 2004. EFs assessed included verbal fluency, verbal working memory, visuospatial span, planning, and impulse control. Mathematics was assessed with the Dutch Pupil Monitoring System and parents and teachers rated attention problems using standardized behavior questionnaires. The impact of EF was calculated over and above processing speed indices and IQ. Interactions with group (very preterm versus term birth status) were examined. Analyses were conducted separately for two subsamples: children in preschool and children in primary school. Very preterm children performed poorer on tests for mathematics and had more parent and teacher rated attention problems than term controls (ßs>.11, Ps<.01). IQ contributed unique variance to mathematics in preschool and in primary school (ßs>.16, Ps<.007). A significant interaction of group with IQ (ß = −. 24, P = .02) showed that IQ contributed unique variance to attention problems as rated by teachers, but that effects were stronger for very preterm than for term infants. Over and above IQ, EF contributed unique variance to mathematics in primary school (ß = .13, P<.001), to parent rated inattention in preschool and in primary school (ßs>−.16, Ps<.04), and to teacher rated inattention in primary school (ß = −.19; ß = .19, Ps<.009). In conclusion, impaired EF is, over and above impaired IQ, an important predictor for poor mathematics and attention problems following very preterm birth. PMID:23390558

  4. Effects of White Matter Injury on Resting State fMRI Measures in Prematurely Born Infants

    PubMed Central

    Smyser, Christopher D.; Snyder, Abraham Z.; Shimony, Joshua S.; Blazey, Tyler M.; Inder, Terrie E.; Neil, Jeffrey J.

    2013-01-01

    The cerebral white matter is vulnerable to injury in very preterm infants (born prior to 30 weeks gestation), resulting in a spectrum of lesions. These range from severe forms, including cystic periventricular leukomalacia and periventricular hemorrhagic infarction, to minor focal punctate lesions. Moderate to severe white matter injury in preterm infants has been shown to predict later neurodevelopmental disability, although outcomes can vary widely in infants with qualitatively comparable lesions. Resting state functional connectivity magnetic resonance imaging has been increasingly utilized in neurodevelopmental investigations and may provide complementary information regarding the impact of white matter injury on the developing brain. We performed resting state functional connectivity magnetic resonance imaging at term equivalent postmenstrual age in fourteen preterm infants with moderate to severe white matter injury secondary to periventricular hemorrhagic infarction. In these subjects, resting state networks were identifiable throughout the brain. Patterns of aberrant functional connectivity were observed and depended upon injury severity. Comparisons were performed against data obtained from prematurely-born infants with mild white matter injury and healthy, term-born infants and demonstrated group differences. These results reveal structural-functional correlates of preterm white matter injury and carry implications for future investigations of neurodevelopmental disability. PMID:23874510

  5. Reduction of head flattening in preterm infants.

    PubMed Central

    Cartlidge, P H; Rutter, N

    1988-01-01

    During the first few weeks of life many preterm infants develop flattened heads. We have shown that this deformity can be reduced by nursing preterm infants on soft, air filled mattresses of the type used for detecting apnoea. Images Fig 2 PMID:3415321

  6. Immune cells in term and preterm labor.

    PubMed

    Gomez-Lopez, Nardhy; StLouis, Derek; Lehr, Marcus A; Sanchez-Rodriguez, Elly N; Arenas-Hernandez, Marcia

    2014-11-01

    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

  7. Phonotactic Acquisition in Healthy Preterm Infants

    ERIC Educational Resources Information Center

    Gonzalez-Gomez, Nayeli; Nazzi, Thierry

    2012-01-01

    Previous work has shown that preterm infants are at higher risk for cognitive/language delays than full-term infants. Recent studies, focusing on prosody (i.e. rhythm, intonation), have suggested that prosodic perception development in preterms is indexed by maturational rather than postnatal/listening age. However, because prosody is heard…

  8. Longitudinal Analysis of Neural Network Development in Preterm Infants

    PubMed Central

    Inder, Terrie E.; Shimony, Joshua S.; Hill, Jason E.; Degnan, Andrew J.; Snyder, Abraham Z.; Neil, Jeffrey J.

    2010-01-01

    Application of resting state functional connectivity magnetic resonance imaging (fcMRI) to the study of prematurely born infants enables assessment of the earliest forms of cerebral connectivity and characterization of its early development in the human brain. We obtained 90 longitudinal fcMRI data sets from a cohort of preterm infants aged from 26 weeks postmenstrual age (PMA) through term equivalent age at PMA-specific time points. Utilizing seed-based correlation analysis, we identified resting state networks involving varied cortical regions, the thalamus, and cerebellum. Identified networks demonstrated a regionally variable age-specific pattern of development, with more mature forms consisting of localized interhemispheric connections between homotopic counterparts. Anatomical distance was found to play a critical role in the rate of connection development. Prominent differences were noted between networks identified in term control versus premature infants at term equivalent, including in the thalamocortical connections critical for neurodevelopment. Putative precursors of the default mode network were detected in term control infants but were not identified in preterm infants, including those at term equivalent. Identified patterns of network maturation reflect the intricate relationship of structural and functional processes present throughout this important developmental period and are consistent with prior investigations of neurodevelopment in this population. PMID:20237243

  9. Preterm Birth: An Overview of Risk Factors and Obstetrical Management

    ERIC Educational Resources Information Center

    Stewart, Amanda; Graham, Ernest

    2010-01-01

    Preterm birth is the leading cause of neonatal mortality and a major public health concern. Risk factors for preterm birth include a history of preterm birth, short cervix, infection, short interpregnancy interval, smoking, and African-American race. The use of progesterone therapy to treat mothers at risk for preterm delivery is becoming more…

  10. Maternal Commenting: Profiles during Preterm and Full-Term Play.

    ERIC Educational Resources Information Center

    Miguel, Shirley A.

    1995-01-01

    This observational study examined 60 mothers' comments during play with their 4- to 8-month-old infants who had been either full-term, preterm well, or preterm sick. Mothers of sick preterm babies engaged in the most overall talking, mothers of full-term babies made the most negative remarks, and mothers of healthy preterm babies made the fewest…

  11. Does time since immigration modify neighborhood deprivation gradients in preterm birth? A multilevel analysis.

    PubMed

    Urquia, Marcelo Luis; Frank, John William; Moineddin, Rahim; Glazier, Richard Henry

    2011-10-01

    Immigrants' health is jointly influenced by their pre- and post-migration exposures, but how these two influences operate with increasing duration of residence has not been well-researched. We aimed to examine how the influence of maternal country of birth and neighborhood deprivation effects, if any, change over time since migration and how neighborhood effects among immigrants compare with those observed in the Canadian-born population. Birth data from Ontario hospital records (2002-2007) were linked with an official Canadian immigration database (1985-2000). The outcome measure was preterm birth. Neighborhoods were ranked according to a neighborhood deprivation index developed for Canadian urban areas and collapsed into tertiles of approximately equal size. Time since immigration was measured from the date of arrival to Canada to the date of delivery, ranging from 1 to 22 years. We used cross-classified random effect models to simultaneously account for the membership of births (N = 83,233) to urban neighborhoods (N = 1,801) and maternal countries of birth (N = 168). There were no differences in preterm birth between neighborhood deprivation tertiles among immigrants with less than 15 years of residence. Among immigrants with 15 years of stay or more, the adjusted absolute risk difference (ARD%, 95% confidence interval) between high-deprived (tertile 3) and low-deprived (tertile 1) neighborhoods was 1.86 (0.68, 2.98), while the ARD% observed among the Canadian-born (N = 314,237) was 1.34 (1.11, 1.57). Time since migration modifies the neighborhood deprivation gradient in preterm birth among immigrants living in Ontario cities. Immigrants reached the level of inequalities in preterm birth observed at the neighborhood level among the Canadian-born after 14 years of stay, but neighborhoods did not influence preterm birth among more recent immigrants, for whom the maternal country of birth was more predictive of preterm birth. PMID:21503816

  12. Cervical leukocytes and spontaneous preterm birth

    PubMed Central

    Hunter, Patricia J.; Sheikh, Sairah; David, Anna L.; Peebles, Donald M.; Klein, Nigel

    2016-01-01

    The objective was to characterise cervical leukocyte populations and inflammatory mediators associated with term and recurrent spontaneous preterm birth (SPTB) in pregnant women with a history of SPTB. A prospective observational study was undertaken on 120 women with a history of SPTB. A cytobrush was used to sample cells from the cervix at 12–25 weeks’ gestation. Cells were enumerated and characterised by flow cytometry. Cytokines and chemokines were also measured. Participants were then grouped according to delivery at term (>36 + 6 weeks), late SPTB (34–36 + 6 weeks) or early SPTB (<34 weeks). Differences in leukocyte sub-populations, cytokine and chemokine levels were compared with outcome. Cervical leukocytes comprised up to 60% of the host-derived cells. Most of these (90–100%) were polymorphonuclear cells (PMN). Most of the remaining cells were mucosal macrophages expressing CD68 and CD103 in addition to markers shared with blood-borne monocytes. Failure to detect cervical macrophages in at least 250,000 cervical epithelial cells was a feature of women who experienced early SPTB (6 out of 6 cases, 95% CI 61–100%) compared with 34% (30 out of 88 cases, 95% CI 25–43%, P < 0.001) of women delivering after 34 weeks. CCL2 (MCP-1) was also low in SPTB before 34 weeks and levels above 75 ng/g and/or the presence of macrophages increased the specificity for birth after 34 weeks from 66% to 82% (55 out of 67 cases, 95% CI 73–91%). Absence of cervical macrophages and low CCL2 may be features of pregnancies at risk of early SPTB. PMID:26637953

  13. The influence of preterm birth on structural alterations of the vision-deprived brain.

    PubMed

    Wan, Catherine Y; Wood, Amanda G; Chen, Jian; Wilson, Sarah J; Reutens, David C

    2013-04-01

    Differences in brain structures between blind and sighted individuals have not been widely investigated. Furthermore, existing studies have included individuals who were blinded by retinopathy of prematurity, a condition that is associated with premature birth. Recent pediatric research has reported structural differences in individuals who were born prematurely, suggesting that some of the structural abnormalities previously observed in blind individuals may be related to prematurity rather than being specific to blindness. In the present study, we used voxel-based morphometry to investigate gray and white matter differences between 24 blind and 16 sighted individuals. Of the blind individuals, six were born prematurely and 18 at term. Compared to those born at term, blind individuals born preterm showed differences in gray, but not white, matter volumes in various brain regions. When the preterm individuals were excluded from analysis, there were significant differences between blind and sighted individuals. Full-term blind individuals showed regional gray matter decreases in the cuneus, lingual gyrus, middle occipital gyrus, precuneus, inferior and superior parietal lobules, and the thalamus, and gray matter increases in the globus pallidus. They also showed regional white matter decreases in the cuneus, lingual gyrus, and the posterior cingulate. These differences were observed in blind individuals irrespective of blindness onset age, providing evidence for structural alterations in the mature brain. Our findings highlight the importance of considering the potential impact of premature birth on neurodevelopmental outcomes in studies of blind individuals. PMID:22591801

  14. Cardiorespiratory events in preterm infants: etiology and monitoring technologies.

    PubMed

    Di Fiore, J M; Poets, C F; Gauda, E; Martin, R J; MacFarlane, P

    2016-03-01

    Every year, an estimated 15 million infants are born prematurely (<37 weeks gestation) with premature birth rates ranging from 5 to 18% across 184 countries. Although there are a multitude of reasons for this high rate of preterm birth, once birth occurs, a major challenge of infant care includes the stabilization of respiration and oxygenation. Clinical care of this vulnerable infant population continues to improve, yet there are major areas that have yet to be resolved including the identification of optimal respiratory support modalities and oxygen saturation targets, and reduction of associated short- and long-term morbidities. As intermittent hypoxemia is a consequence of immature respiratory control and resultant apnea superimposed upon an immature lung, improvements in clinical care must include a thorough knowledge of premature lung development and pathophysiology that is unique to premature birth. In Part 1 of a two-part review, we summarize early lung development and diagnostic methods for cardiorespiratory monitoring. PMID:26583939

  15. Systemic inflammation and cerebral palsy risk in extremely preterm infants

    PubMed Central

    Kuban, KCK; O’Shea, TM; Allred, EN; Paneth, N; Hirtz, D; Fichorova, RN; Leviton, A

    2013-01-01

    We hypothesized that among extremely preterm infants, elevated concentrations of inflammation-related proteins in neonatal blood are associated with cerebral palsy (CP) at 24 months. Methods In 939 infants born before 28 weeks gestation, we measured blood concentrations of 25 proteins on postnatal days 1, 7, and 14 and evaluated associations between elevated protein concentrations and CP diagnosis. Results Protein elevations within three days of birth were not associated with CP. Elevations of TNF-α, TNF-R1, IL-8, ICAM-1, on at least two days were associated with diparesis. Recurrent-persistent elevations of IL-6, E-SEL, or IGFBP-1 were associated with hemiparesis. Diparesis and hemiparesis were more likely among infants who had at least four of nine proteins elevations that previously have been associated with cognitive impairment and microcephaly. Interpretation Repeated elevations of inflammation-related proteins during the first two postnatal weeks are associated with increased risk of CP. PMID:24646503

  16. Hair-thread tourniquet syndrome in a preterm baby

    PubMed Central

    Baştuğ, Osman; Korkmaz, Levent; Korkut, Sabriye; Halis, Hülya; Kurtoğlu, Selim

    2015-01-01

    Hair-thread tourniquet syndrome is a rare disorder characterized by the encircling of an appendage by a hair or thread. It usually occurs in children under the age of one year. The tourniquet syndrome may occur in different parts of the body, particularly in toes, fingers, penis, clitoris, labia, neck and uvula. It is an emergency condition that induces progressive edema, ischaemia and tissue necrosis and can lead to autoamputation of digits or other strangulated structures. Emergency treatment is careful removal of the constricting fiber. We report a preterm newborn with hair-thread tourniquet syndrome affecting multiple toes born at the 28th gestational week with the aim of preventing potential complications by increasesing awareness of the condition. PMID:26884695

  17. Health-related quality of life of preterm children and their caregivers.

    PubMed

    Donohue, Pamela K

    2002-01-01

    As advances in medical science have extended the limit of viability downward to 23 or 24 weeks gestation, interest has turned from long-term health outcomes to quality of life for survivors. During the last decade, the first studies of the health-related quality of life (HRQOL) of children and young adults who were born extremely preterm were published. Taken from the fields of anthropology, economics, sociology, and psychology, the foundation of HRQOL is formed by theories of functionalism, positive well-being, and utility. HRQOL can be defined as the physical, psychological, and social domains of health, which can be influenced by an individual's experiences and perception. HRQOL instruments are generally composed of multiple domains and measure physical functioning, mental health, and social role functioning in some form. Utilities, or preferences for health outcomes under conditions of uncertainty, are also used. Studies of HRQOL to-date indicate that preterm children have, on average, poorer health than their normal birthweight peers, but the majority do not perceive their quality of life as significantly different than others of their own age. Measures of HRQOL should not replace the traditional measures of morbidity, but should become part of the standard battery of tools used to assess a preterm child's health and well-being. Ultimately, studies of the HRQOL of preterm children should identify aspects of life, physical, psychological, or social, that could be improved with intervention. PMID:12454905

  18. Evidence for increased risks of preterm delivery in a population residing near a freeway in Taiwan.

    PubMed

    Yang, Chun-Yuh; Chang, Chih-Ching; Chuang, Hung-Yi; Ho, Chi-Kung; Wu, Trong-Neng; Tsai, Shang-Shyue

    2003-10-01

    Traffic emissions are a major source of air pollution in urban areas. The results of recent studies have suggested that air pollution may be related to adverse pregnancy outcomes such as low birth weight and preterm delivery. The authors investigated the association between traffic-related air pollution and preterm deliveries. The study group included all first-parity singleton live births that occurred during 1992-1997 to women who lived in a zone along the Zhong-Shan Freeway in Taiwan (N = 6,251). The zone was defined as areas 1,500-m wide on either side of the freeway; it was located in the San-Ming, Nan-Tzu, Chienchen, and Linya wards-all of which are residential areas in East Kaohsiung. The prevalence of deliveries of preterm birth infants was significantly higher among mothers who lived within 500 m of the freeway than among mothers who resided 500-1,500 m from the freeway. In their analysis, the authors controlled for several confounders (e.g., maternal age, season, marital status, maternal education, infant gender). The adjusted odds ratio was 1.30 (95% confidence interval = 1.03, 1.65) for delivery of preterm infants born to mothers who lived within 500 m of the freeway. Such data provide additional support for the hypothesis that air pollution can affect the outcome of pregnancy. PMID:15562637

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

    PubMed Central

    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

  20. Cerebral palsy in children: Movements and postures during early infancy, dependent on preterm vs. full term birth

    PubMed Central

    Yang, Hong; Einspieler, Christa; Shi, Wei; Marschik, Peter B.; Wang, Yi; Cao, Yun; Li, Hui; Liao, Yuan-Gui; Shao, Xiao-Mei

    2012-01-01

    Background A deviant motor behaviour at age 3 to 5 months is predictive of cerebral palsy (CP). Particular features of the early motor repertoire even proved predictive of the degree of functional limitations as classified on the Gross Motor Function Classification System (GMFCS) in children with CP, born preterm. Aims We aimed to determine whether an association between the early motor repertoire and the GMFCS also holds true for children born at term. Study design Longitudinal study. Subjects 79 infants (60 boys and 19 girls; 47 infants born at term; video recorded for the assessment of movements and posture at age 9 to 20 weeks postterm age) who developed CP. Outcome measures The GMFCS was applied at age 2 to 5 years. Results Motor optimality at age 3 to 5 months showed a significant correlation with functional mobility and activity limitation as classified on the GMFCS at age 2 to 5 years in both children born at term (Spearman rho = − 0.66, p < 0.001) and born preterm (rho = − 0.37, p < 0.05). Infants born preterm were more likely to show normal movement patterns than infants born at term. A normal posture and an abnormal, jerky (yet not monotonous) movement character resulted in better levels of function and mobility. With the exception of one, none of the infants showed fidgety movements. A cramped-synchronised movement character, repetitive opening and closing of the mouth, and abnormal finger postures characterised children who would show a poor self-mobility later. Conclusions Assessing the quality of motor performance at 9 to 20 weeks postterm age (irrespective of the gestational age) improves our ability to predict later functional limitations in children with CP. PMID:22795821

  1. Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

    ERIC Educational Resources Information Center

    Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

    2004-01-01

    Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

  2. Quality of life assessment in preterm children: physicians’ knowledge, attitude, belief, practice - a KABP study

    PubMed Central

    2013-01-01

    Background The sequelae of extremely preterm birth have an impact on the quality of life (QoL) of these children. Standardized assessment of their QoL is rarely done in France. The aim of this study is to examine among all the types of physicians involved in the management of children born extremely preterm, their knowledge, use in routine practice and expectations concerning QoL assessment of these children using standardized questionnaires. Methods Prospective survey among heads of obstetric, neonatal medicine and paediatric neurology departments, by means of questionnaires. Two qualitative methods were used: focus groups and Delphi method. Results Seventy-eight physicians participated (obstetricians 24%, neonatologists 58%, paediatric neurologists 18%). The physicians considered QoL a relevant concept which they assessed subjectively. They expressed a need for information on methods of assessment. An ideal QoL questionnaire was described. Expectations regarding availability of QoL data were expressed from a medical, family and societal perspective. The impact of QoL measurement on the ethical aspect of decision-making was approached, in particular the potential impact of this tool on the decision made. Expectations were found to differ between specialties. Conclusion This original study reports the perspective of experts on taking into consideration the QoL of children born extremely preterm. This is a subjective notion that is difficult to implement and which may influence therapeutic choices. PMID:23601174

  3. Inflammatory Response in Preterm and Very Preterm Newborns with Sepsis

    PubMed Central

    Segura-Cervantes, Enrique; Mancilla-Ramírez, Javier; González-Canudas, Jorge; Alba, Erika; Santillán-Ballesteros, René; Morales-Barquet, Deneb; Sandoval-Plata, Gabriela

    2016-01-01

    The response of the adaptive immune system is usually less intense in premature neonates than term neonates. The primary objective of this study was to determine whether immunological parameters vary between preterm (PT) neonates (≥32 weeks of gestational age) and very preterm (VPT) neonates (<32 weeks of gestational age). A cross-sectional study was designed to prospectively follow PT and VPT neonates at risk of developing sepsis. Plasma concentrations of IFN-γ, TNF-α, IL-6, IL-4, and IL-10 were detected using flow cytometry. C-reactive protein (C-RP) and the complex SC5b-9 were detected in the plasma using commercial kits. A total of 83 patients were included. The laboratory results and clinical histories showed that 26 patients had sepsis; 14 were VPT, and 12 were PT. The levels of C-RP, SC5b-9 (innate immune response mediators), and IL-10 or IL-4 (anti-inflammatory cytokines) were elevated during sepsis in both groups. IFN-γ, TNF-α, and IL-6 (proinflammatory cytokines) were differentially elevated only in PT neonates. The VPT neonates with sepsis presented increases in C-RP, SC5b-9, and anti-inflammatory cytokines but not in proinflammatory cytokines, whereas PT neonates showed increases in all studied mediators of inflammation. PMID:27293317

  4. Inflammatory Response in Preterm and Very Preterm Newborns with Sepsis.

    PubMed

    Segura-Cervantes, Enrique; Mancilla-Ramírez, Javier; González-Canudas, Jorge; Alba, Erika; Santillán-Ballesteros, René; Morales-Barquet, Deneb; Sandoval-Plata, Gabriela; Galindo-Sevilla, Norma

    2016-01-01

    The response of the adaptive immune system is usually less intense in premature neonates than term neonates. The primary objective of this study was to determine whether immunological parameters vary between preterm (PT) neonates (≥32 weeks of gestational age) and very preterm (VPT) neonates (<32 weeks of gestational age). A cross-sectional study was designed to prospectively follow PT and VPT neonates at risk of developing sepsis. Plasma concentrations of IFN-γ, TNF-α, IL-6, IL-4, and IL-10 were detected using flow cytometry. C-reactive protein (C-RP) and the complex SC5b-9 were detected in the plasma using commercial kits. A total of 83 patients were included. The laboratory results and clinical histories showed that 26 patients had sepsis; 14 were VPT, and 12 were PT. The levels of C-RP, SC5b-9 (innate immune response mediators), and IL-10 or IL-4 (anti-inflammatory cytokines) were elevated during sepsis in both groups. IFN-γ, TNF-α, and IL-6 (proinflammatory cytokines) were differentially elevated only in PT neonates. The VPT neonates with sepsis presented increases in C-RP, SC5b-9, and anti-inflammatory cytokines but not in proinflammatory cytokines, whereas PT neonates showed increases in all studied mediators of inflammation. PMID:27293317

  5. Preventing preterm births: trends and potential reductions with current interventionsin 39 very high human development index countries

    PubMed Central

    Chang, Hannah H.; Larson, Jim; Blencowe, Hannah; Spong, Catherine Y.; Howson, Christopher P.; Cairns-Smith, Sarah; Lackritz, Eve M.; Lee, Shoo K.; Mason, Elizabeth; Serazin, Andrew C.; Walani, Salimah; Simpson, Joe Leigh; Lawn, Joy E.

    2013-01-01

    Summary Background Each year,1.1 million babies die from prematurity, andmany survivors are disabled. Worldwide, 15 million babies are preterm(<37 weeks’ gestation),withtwo decades of increasing ratesinalmost all countries with reliable data. Improved care of babies has reduced mortality in high-income countries, although effective interventions have yet to be scaled-up in most low-income countries. A 50% reduction goal for preterm-specific mortality by 2025 has been set in the “Born Too Soon” report. However, for preterm birth prevention,understanding of drivers and potential impact of preventive interventions is limited. We examine trends and estimate the potential reduction in preterm birthsforvery high human development index (VHHDI) countries if current evidence-based interventions were widely implemented. This analysis is to inform a “Born Too Soon” rate reduction target. Methods Countries were assessed for inclusion based on availability and quality ofpreterm prevalence data (2000-2010), and trend analyses with projections undertaken. We analysed drivers of rate increases in the USA, 1998-2004. For 39 VHHDI countrieswith >10,000 births, country-by-country analyses were performed based on target population, incremental coverage increase,and intervention efficacy. Cost savings were estimated based on reported costs for preterm care in the USAadjusted usingWorld Bank purchasing power parity. Findings From 2010, even if all VHHDI countries achieved annual preterm birth rate reductions of the best performers, (Sweden and Netherlands), 2000-2010 or 2005-2010(Lithuania, Estonia)), rates would experience a relative reduction of<5% by 2015 on average across the 39 countries.Our analysis of preterm birth rise 1998-2004 in USA suggests half the change is unexplained, but important drivers includeinductions/cesareandelivery and ART.For all 39 VHHDI countries, five interventionsmodeling at high coveragepredicted 5%preterm birth rate relative reduction from 9

  6. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010

    PubMed Central

    Blencowe, Hannah; Lawn, Joy E.; Vazquez, Thomas; Fielder, Alistair; Gilbert, Clare

    2013-01-01

    Background: Retinopathy of prematurity (ROP) is a leading cause of potentially avoidable childhood blindness worldwide. We estimated ROP burden at the global and regional levels to inform screening and treatment programs, research, and data priorities. Methods: Systematic reviews and meta-analyses were undertaken to estimate the risk of ROP and subsequent visual impairment for surviving preterm babies by level of neonatal care, access to ROP screening, and treatment. A compartmental model was used to estimate ROP cases and numbers of visually impaired survivors. Results: In 2010, an estimated 184,700 (uncertainty range: 169,600–214,500) preterm babies developed any stage of ROP, 20,000 (15,500–27,200) of whom became blind or severely visually impaired from ROP, and a further 12,300 (8,300–18,400) developed mild/moderate visual impairment. Sixty-five percent of those visually impaired from ROP were born in middle-income regions; 6.2% (4.3–8.9%) of all ROP visually impaired infants were born at >32-wk gestation. Visual impairment from other conditions associated with preterm birth will affect larger numbers of survivors. Conclusion: Improved care, including oxygen delivery and monitoring, for preterm babies in all facility settings would reduce the number of babies affected with ROP. Improved data tracking and coverage of locally adapted screening/treatment programs are urgently required. PMID:24366462

  7. Temporal-spatial gait parameters and neurodevelopment in very-low-birth-weight preterm toddlers at 18-22 months.

    PubMed

    Cahill-Rowley, Katelyn; Rose, Jessica

    2016-03-01

    Children born preterm with very-low birth-weight (VLBW) have increased risk of motor impairment. Early identification of impairment guides treatment to improve long-term function. Temporal-spatial gait parameters are an easily-recorded assessment of gross motor function. The objective of this study was to characterize preterm toddlers' gait and its relationship with neurodevelopment. Velocity, cycle time, step width, step length and time asymmetry, %stance, %single-limb support, and %double-limb support were calculated for 81 VLBW preterm and 43 typically-developing (TD) toddlers. Neurodevelopment was assessed with Bayley Scales of Infant Development-3rd Edition (BSID-III) motor composite and gross motor scores. Mean step width (p=.009) was wider in preterm compared to TD toddlers. Preterm toddlers with <85 BSID-III motor composite scores, indicating mild-to-moderate delay, had significantly increased step width, step length asymmetry, and step time compared to TD toddlers. Step time was also significantly longer for lower-scoring compared to higher-scoring (≥85 BSID-III motor composite scores) preterm toddlers, suggesting that step time may be particularly sensitive to gradations of motor performance. Velocity, cycle time, step length asymmetry, %stance, step length, and step time significantly correlated with BSID-III gross motor scores, suggesting that these parameters may be revealing of gross motor function. The differences in gait between lower-scoring preterm toddlers and TD toddlers, together with the correlations between gait and BSID-III motor scores, suggest that temporal-spatial gait parameters may be useful in building a clinically-relevant, easily-conducted assessment of toddler gross motor development. PMID:26979887

  8. The role of microbial communities in parturition: is there evidence of association with preterm birth and perinatal morbidity and mortality?

    PubMed

    Ganu, Radhika S; Ma, Jun; Aagaard, Kjersti M

    2013-09-01

    In 2005, the World Health Organization estimated that 9.6% or 12.9 million births worldwide were born preterm at <37 weeks of gestation and were accompanied by a mortality rate as high as 42% (http://www.who.int/bulletin/volumes/88/1/08-062554). Significant data suggesting that intrauterine infection is an important modifier for the risk of preterm birth have emerged over the past four decades. However, causative microbial culprits have yet to be identified, and interventional trials with antimicrobials have uniformly failed to demonstrate a significant benefit. To the contrary, treatment for clinically asymptomatic, commonly associated polymicrobial communities (i.e., bacterial vaginosis) has resulted in an increase in the rate of preterm birth. This article discusses the importance of vaginal microbiome and the variance in its composition during normal pregnancy. We will expand this discussion to include possible mechanisms that might trigger preterm birth in at-risk subjects. Finally, we will review why preterm birth may be an ideal forum with which to apply our rapidly expanding metagenomic sequencing and analytic pipelines to discern the role of host and microbe in the relative continuum of health and disease. PMID:23161352

  9. Reinforcement of the Brain's Rich-Club Architecture Following Early Neurodevelopmental Disruption Caused by Very Preterm Birth.

    PubMed

    Karolis, Vyacheslav R; Froudist-Walsh, Sean; Brittain, Philip J; Kroll, Jasmin; Ball, Gareth; Edwards, A David; Dell'Acqua, Flavio; Williams, Steven C; Murray, Robin M; Nosarti, Chiara

    2016-03-01

    The second half of pregnancy is a crucial period for the development of structural brain connectivity, and an abrupt interruption of the typical processes of development during this phase caused by the very preterm birth (<33 weeks of gestation) is likely to result in long-lasting consequences. We used structural and diffusion imaging data to reconstruct the brain structural connectome in very preterm-born adults. We assessed its rich-club organization and modularity as 2 characteristics reflecting the capacity to support global and local information exchange, respectively. Our results suggest that the establishment of global connectivity patterns is prioritized over peripheral connectivity following early neurodevelopmental disruption. The very preterm brain exhibited a stronger rich-club architecture than the control brain, despite possessing a relative paucity of white matter resources. Using a simulated lesion approach, we also investigated whether putative structural reorganization takes place in the very preterm brain in order to compensate for its anatomical constraints. We found that connections between the basal ganglia and (pre-) motor regions, as well as connections between subcortical regions, assumed an altered role in the structural connectivity of the very preterm brain, and that such alterations had functional implications for information flow, rule learning, and verbal IQ. PMID:26742566

  10. Reinforcement of the Brain's Rich-Club Architecture Following Early Neurodevelopmental Disruption Caused by Very Preterm Birth

    PubMed Central

    Karolis, Vyacheslav R.; Froudist-Walsh, Sean; Brittain, Philip J.; Kroll, Jasmin; Ball, Gareth; Edwards, A. David; Dell'Acqua, Flavio; Williams, Steven C.; Murray, Robin M.; Nosarti, Chiara

    2016-01-01

    The second half of pregnancy is a crucial period for the development of structural brain connectivity, and an abrupt interruption of the typical processes of development during this phase caused by the very preterm birth (<33 weeks of gestation) is likely to result in long-lasting consequences. We used structural and diffusion imaging data to reconstruct the brain structural connectome in very preterm-born adults. We assessed its rich-club organization and modularity as 2 characteristics reflecting the capacity to support global and local information exchange, respectively. Our results suggest that the establishment of global connectivity patterns is prioritized over peripheral connectivity following early neurodevelopmental disruption. The very preterm brain exhibited a stronger rich-club architecture than the control brain, despite possessing a relative paucity of white matter resources. Using a simulated lesion approach, we also investigated whether putative structural reorganization takes place in the very preterm brain in order to compensate for its anatomical constraints. We found that connections between the basal ganglia and (pre-) motor regions, as well as connections between subcortical regions, assumed an altered role in the structural connectivity of the very preterm brain, and that such alterations had functional implications for information flow, rule learning, and verbal IQ. PMID:26742566

  11. Food-borne Zoonoses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: The awareness of food borne illness has shifted over the years as international agribusiness and transportation have steadily increased. At least 30 food borne agents have been identified, with one-third emerging in the last 3 decades. Despite an increased emphasis on control measures, t...

  12. Tick-borne protozoa

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tick-borne protozoa impose a significant health burden on humans and animals throughout the world. The virulence of tick-borne protozoa, and the geographic distribution of their tick vectors and vertebrate hosts remain in flux as they adapt to changing environmental and climatic conditions. Babesios...

  13. Neonatal Brain Injury and Neuroanatomy of Memory Processing following Very Preterm Birth in Adulthood: An fMRI Study

    PubMed Central

    Kalpakidou, Anastasia K.; Allin, Matthew P.; Walshe, Muriel; Giampietro, Vincent; Nam, Kie-woo; McGuire, Philip; Rifkin, Larry; Murray, Robin M.; Nosarti, Chiara

    2012-01-01

    Altered functional neuroanatomy of high-order cognitive processing has been described in very preterm individuals (born before 33 weeks of gestation; VPT) compared to controls in childhood and adolescence. However, VPT birth may be accompanied by different types of adverse neonatal events and associated brain injury, the severity of which may have differential effects on brain development and subsequent neurodevelopmental outcome. We conducted a functional magnetic resonance imaging (fMRI) study to investigate how differing degrees of neonatal brain injury, detected by neonatal ultrasounds, affect the functional neuroanatomy of memory processing in VPT young adults. We used a verbal paired associates learning task, consisting of four encoding, four cued-recall and four baseline condition blocks. To further investigate whether differences in neural activation between the groups were modulated by structural brain changes, structural MRI data were also collected. We studied 12 VPT young adults with a history of periventricular haemorrhage with associated ventricular dilatation, 17 VPT individuals with a history of uncomplicated periventricular haemorrhage, 12 individuals with normal ultrasonographic findings, and 17 controls. Results of a linear trend analysis demonstrated that during completion of the paired associates learning task right frontal and right parietal brain activation decreased as the severity of neonatal brain injury increased. There were no statistically significant between-group differences in on-line task performance and participants' intelligence quotient (IQ) at assessment. This pattern of differential activation across the groups was observed particularly in the right middle frontal gyrus during encoding and in the right posterior cingulate gyrus during recall. Structural MRI data analysis revealed that grey matter volume in the right superior temporal gyrus, right cerebellum, left middle temporal gyrus, right globus pallidus and right medial

  14. SOCIODEMOGRAPHIC DOAMINS OF DEPRIVATION AND PRETERM BIRTH

    EPA Science Inventory

    Background. Neighborhood-level deprivation has long been associated with adverse outcomes, including preterm birth (PTB), as observed in the authors' previous work using a composite deprivation index. Area disadvantage is multifaceted comprising income, employment, education and...

  15. Antimicrobials for Preterm Birth Prevention: An Overview

    PubMed Central

    Subramaniam, Akila; Abramovici, Adi; Andrews, William W.; Tita, Alan T.

    2012-01-01

    Objective. Preterm birth (PTB) remains a major cause of neonatal morbidity and mortality. The association between PTB and infection is clear. The purpose of this report is to present a focused review of information on the use of antibiotics to prevent PTB. Methods. We performed a search of the PubMed database restricted to clinical trials or meta-analyses published in English from 1990 through May 2011 using keywords “antibiotics or antimicrobials” and “preterm.” Results. The search yielded 67 abstracts for review. We selected 31 clinical trials (n = 26) or meta-analysis (n = 5) for further full-text review. Discussion of each eligible clinical trial, its specific inclusion criteria, antibiotic regimen used, and study results are presented. Overall, trials evaluating antibiotic treatment to prevent preterm birth have yielded mixed results regarding any benefit. Conclusion. Routine antibiotic prophylaxis is not recommended for prevention of preterm birth. PMID:22505797

  16. INCOME INCONGRUITY, RACE AND PRETERM BIRTH

    EPA Science Inventory

    Previous research with vital records finds income incongruity associated with adverse birth outcomes. We examined the effects of negative income incongruity (reporting lower household income than the census tract median household income) on preterm birth (PTB <37 weeks completed ...

  17. Local and global aspects of biological motion perception in children born at very low birth weight

    PubMed Central

    Williamson, K. E.; Jakobson, L. S.; Saunders, D. R.; Troje, N. F.

    2015-01-01

    Biological motion perception can be assessed using a variety of tasks. In the present study, 8- to 11-year-old children born prematurely at very low birth weight (<1500 g) and matched, full-term controls completed tasks that required the extraction of local motion cues, the ability to perceptually group these cues to extract information about body structure, and the ability to carry out higher order processes required for action recognition and person identification. Preterm children exhibited difficulties in all 4 aspects of biological motion perception. However, intercorrelations between test scores were weak in both full-term and preterm children—a finding that supports the view that these processes are relatively independent. Preterm children also displayed more autistic-like traits than full-term peers. In preterm (but not full-term) children, these traits were negatively correlated with performance in the task requiring structure-from-motion processing, r(30) = −.36, p < .05), but positively correlated with the ability to extract identity, r(30) = .45, p < .05). These findings extend previous reports of vulnerability in systems involved in processing dynamic cues in preterm children and suggest that a core deficit in social perception/cognition may contribute to the development of the social and behavioral difficulties even in members of this population who are functioning within the normal range intellectually. The results could inform the development of screening, diagnostic, and intervention tools. PMID:25103588

  18. Maternal Education Level Predicts Cognitive, Language, and Motor Outcome in Preterm Infants in the Second Year of Life

    PubMed Central

    Patra, Kousiki; Greene, Michelle M.; Patel, Aloka L.; Meier, Paula

    2016-01-01

    Objective To evaluate the relative impact of maternal education level (MEL) on cognitive, language, and motor outcomes at 20 months’ corrected age (CA) in preterm infants. Study Design A total of 177 preterm infants born between 2008 and 2010 were tested at 20 months’ CA using the Bayley Scales of Infant and Toddler Development-III. Multiple regression analyses were done to determine the relative impact of MEL on cognitive, language, and motor scores. Results Infants born to mothers with high school MEL were 3.74 times more likely to have a subnormal motor index, while those born to mothers with some college and graduate school MEL had reduced odds (0.36 and 0.12, respectively) of having subnormal language index at 20 months. In linear regression, MEL was the strongest predictor of cognitive, language, and motor scores, and graduate school MEL was associated with increases in cognitive, motor, and language scores of 8.49, 8.23, and 15.74 points, respectively. Conclusions MEL is the most significant predictor of cognitive, language, and motor outcome at 20 months’ CA in preterm infants. Further research is needed to evaluate if targeted interventions that focus on early childhood learning and parenting practices can ameliorate the impact of low MEL. PMID:26890439

  19. Maternal Education Level Predicts Cognitive, Language, and Motor Outcome in Preterm Infants in the Second Year of Life.

    PubMed

    Patra, Kousiki; Greene, Michelle M; Patel, Aloka L; Meier, Paula

    2016-07-01

    Objective To evaluate the relative impact of maternal education level (MEL) on cognitive, language, and motor outcomes at 20 months' corrected age (CA) in preterm infants. Study Design A total of 177 preterm infants born between 2008 and 2010 were tested at 20 months' CA using the Bayley Scales of Infant and Toddler Development-III. Multiple regression analyses were done to determine the relative impact of MEL on cognitive, language, and motor scores. Results Infants born to mothers with high school MEL were 3.74 times more likely to have a subnormal motor index, while those born to mothers with some college and graduate school MEL had reduced odds (0.36 and 0.12, respectively) of having subnormal language index at 20 months. In linear regression, MEL was the strongest predictor of cognitive, language, and motor scores, and graduate school MEL was associated with increases in cognitive, motor, and language scores of 8.49, 8.23, and 15.74 points, respectively. Conclusions MEL is the most significant predictor of cognitive, language, and motor outcome at 20 months' CA in preterm infants. Further research is needed to evaluate if targeted interventions that focus on early childhood learning and parenting practices can ameliorate the impact of low MEL. PMID:26890439

  20. Preterm infants' manipulative exploration of objects.

    PubMed

    Ruff, H A; McCarton, C; Kurtzberg, D; Vaughan, H G

    1984-08-01

    Because manipulative exploration of objects may be important to the infant's perception and conceptualization of objects, this study compared full-term infants with preterm infants who are considered to be at risk for cognitive deficits. 30 preterms at 9 months, with age corrected for prematurity, and 20 9-month-old full-terms were videotaped while they explored novel objects; the videotapes were scored for behaviors such as looking, handling, mouthing, turning the object around, fingering, transferring from hand to hand, and banging. There were no differences between the preterms and the full-terms. A "low-risk" subgroup and a "high-risk" subgroup of preterms were then compared with each other as well as to the full-terms. The low-risk subgroup was essentially the same as the full-terms. The high-risk preterms, however, fingered, rotated, and transferred the objects less than either the full-terms or the low-risk preterms. There was a relationship between manipulative exploration at 9 months and later cognitive functioning, suggesting that lower levels of manipulation may be one way in which cognitive deficits originate or are maintained. PMID:6488951

  1. The Well-Being of Children Born to Teen Mothers

    ERIC Educational Resources Information Center

    Levine, Judith A.; Emery, Clifton R.; Pollack, Harold

    2007-01-01

    Children born to early child bearers are more likely than other children to display problem behaviors or poor academic performance, but it is unclear whether early childbearing plays a causal role in these outcomes. Using multiple techniques to control for background factors, we analyze 2,908 young children and 1,736 adolescents and young adults…

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

    PubMed Central

    Odd, David; Evans, David; Emond, Alan

    2016-01-01

    Objective To investigate if the detrimental impact of year of entering education in preterm infants persists into adolescence. Background 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. Design A cohort study, drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC). The exposure measurement was gestational age (defined as preterm (<37 weeks gestation) or term (37–42 weeks)). The primary outcome was a low score at the Key Stage 4 (KS4) educational assessment or receiving special educational needs support (both at age 16). We derived conditional regression models matching preterm to term infants on their date of birth (DOB), their expected date of delivery (EDD), or their expected date of delivery and year of school entry. Results 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)). Conclusions 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

  3. Altered Methylation of IGF2 Locus 20 Years after Preterm Birth at Very Low Birth Weight

    PubMed Central

    Wehkalampi, Karoliina; Muurinen, Mari; Wirta, Sara Bruce; Hannula-Jouppi, Katariina; Hovi, Petteri; Järvenpää, Anna-Liisa; Eriksson, Johan G.; Andersson, Sture; Kere, Juha; Kajantie, Eero

    2013-01-01

    Introduction People born preterm at very low birth weight (VLBW, ≤1500g) have higher rates of risk factors for adult-onset diseases, including cardiovascular diseases and type 2 diabetes. These risks may be mediated through epigenetic modification of genes that are critical to normal growth and development. Methods We measured the methylation level of an imprinted insulin-like-growth-factor 2 (IGF2) locus (IGF2/H19) in young adults born preterm at VLBW and in their peers born at term. We studied 158 VLBW and 161 control subjects aged 18 to 27 years from the Helsinki Study of Very Low Birth Weight Adults. Methylation fraction at two IGF2 differentially methylated regions (DMRs) – IGF2 antisense transcript (IGF2AS, also known as IGF2 DMR0) and last exon of IGF2 (IGF2_05, also known as IGF2 DMR2) – were measured with Sequenom Epityper. We used linear regression and adjustment for covariates to compare methylation fractions at these DMRs between VLBW and control subjects. Results At one IGF2AS CpG site, methylation was significantly lower in VLBW than in control subjects, mean difference −0.017 (95% CI; −0.028, −0.005), P = 0.004. Methylation at IGF2_05 was not different between the groups. Conclusions Methylation of IGF2AS is altered 20 years after preterm birth at VLBW. Altered methylation may be a mechanism of later increased disease risk but more data are needed to indicate causality. PMID:23840686

  4. Differences in Risk Factors for Recurrent Versus Incident Preterm Delivery

    PubMed Central

    Grantz, Katherine L.; Hinkle, Stefanie N.; Mendola, Pauline; Sjaarda, Lindsey A.; Leishear, Kira; Albert, Paul S.

    2015-01-01

    Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002–2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with multiplicative interactions between each preterm risk factor and prior preterm delivery status to explore whether risk factors varied between incident and recurrent preterm delivery at <37 weeks. Fewer second pregnancy factors were associated with recurrent preterm delivery, including alcohol, thyroid disease, and depression. Smoking was associated with increased risk for incident (relative risk (RR) = 1.95, 95% confidence interval (CI): 1.53, 2.49) but not recurrent (RR = 1.09, 95% CI: 0.71, 1.19) preterm delivery, whereas alcohol was associated with an increased risk for recurrent (RR = 2.38, 95% CI: 1.53, 3.71) but not incident (RR = 0.98, 95% CI: 0.67, 1.43; Pinteraction = 0.02 and <0.01) preterm delivery, respectively. Prior term delivery did not necessarily confer protection from known second pregnancy preterm delivery risk factors. In the setting of a prior preterm delivery, many risk factors did not persist. Prior preterm delivery history is important when assessing subsequent preterm delivery risk factors. PMID:26033931

  5. Differences in risk factors for recurrent versus incident preterm delivery.

    PubMed

    Grantz, Katherine L; Hinkle, Stefanie N; Mendola, Pauline; Sjaarda, Lindsey A; Leishear, Kira; Albert, Paul S

    2015-07-15

    Risk factors for preterm delivery have been described, but whether risk factors differ in the context of prior preterm delivery history is less understood. We assessed whether known risk factors were different in women with versus without prior preterm delivery using medical records of the first and second singleton deliveries in 25,820 Utah women (2002-2010). Longitudinal transition models with modified Poisson regression calculated adjusted relative risks and 95% confidence intervals, with multiplicative interactions between each preterm risk factor and prior preterm delivery status to explore whether risk factors varied between incident and recurrent preterm delivery at <37 weeks. Fewer second pregnancy factors were associated with recurrent preterm delivery, including alcohol, thyroid disease, and depression. Smoking was associated with increased risk for incident (relative risk (RR) = 1.95, 95% confidence interval (CI): 1.53, 2.49) but not recurrent (RR = 1.09, 95% CI: 0.71, 1.19) preterm delivery, whereas alcohol was associated with an increased risk for recurrent (RR = 2.38, 95% CI: 1.53, 3.71) but not incident (RR = 0.98, 95% CI: 0.67, 1.43; Pinteraction = 0.02 and <0.01) preterm delivery, respectively. Prior term delivery did not necessarily confer protection from known second pregnancy preterm delivery risk factors. In the setting of a prior preterm delivery, many risk factors did not persist. Prior preterm delivery history is important when assessing subsequent preterm delivery risk factors. PMID:26033931

  6. Language Development of Preterm Children.

    ERIC Educational Resources Information Center

    Holdgrafer, Gary

    An assessment battery, measuring multiple aspects of language, was administered to 29 children between 4 and 5 years of age who had been born prematurely. The children, who weighed less than 2,500 grams at birth after less than 37 weeks of gestation, were recruited from a cohort of children originally admitted to the neonatal intensive care unit…

  7. Post-neonatal Mortality, Morbidity, and Developmental Outcome after Ultrasound-Dated Preterm Birth in Rural Malawi: A Community-Based Cohort Study

    PubMed Central

    Gladstone, Melissa; White, Sarah; Neilson, James P.; van den Broek, Nynke

    2011-01-01

    Background Preterm birth is considered to be associated with an estimated 27% of neonatal deaths, the majority in resource-poor countries where rates of prematurity are high. There is no information on medium term outcomes after accurately determined preterm birth in such settings. Methods and Findings This community-based stratified cohort study conducted between May–December 2006 in Southern Malawi followed up 840 post-neonatal infants born to mothers who had received antenatal antibiotic prophylaxis/placebo in an attempt to reduce rates of preterm birth (APPLe trial ISRCTN84023116). Gestational age at delivery was based on ultrasound measurement of fetal bi-parietal diameter in early-mid pregnancy. 247 infants born before 37 wk gestation and 593 term infants were assessed at 12, 18, or 24 months. We assessed survival (death), morbidity (reported by carer, admissions, out-patient attendance), growth (weight and height), and development (Ten Question Questionnaire [TQQ] and Malawi Developmental Assessment Tool [MDAT]). Preterm infants were at significantly greater risk of death (hazard ratio 1.79, 95% CI 1.09–2.95). Surviving preterm infants were more likely to be underweight (weight-for-age z score; p<0.001) or wasted (weight-for-length z score; p<0.01) with no effect of gestational age at delivery. Preterm infants more often screened positively for disability on the Ten Question Questionnaire (p = 0.002). They also had higher rates of developmental delay on the MDAT at 18 months (p = 0.009), with gestational age at delivery (p = 0.01) increasing this likelihood. Morbidity—visits to a health centre (93%) and admissions to hospital (22%)—was similar for both groups. Conclusions During the first 2 years of life, infants who are born preterm in resource poor countries, continue to be at a disadvantage in terms of mortality, growth, and development. In addition to interventions in the immediate neonatal period, a refocus on early childhood is

  8. Resting-State Network Complexity and Magnitude Are Reduced in Prematurely Born Infants.

    PubMed

    Smyser, Christopher D; Snyder, Abraham Z; Shimony, Joshua S; Mitra, Anish; Inder, Terrie E; Neil, Jeffrey J

    2016-01-01

    Premature birth is associated with high rates of motor and cognitive disability. Investigations have described resting-state functional magnetic resonance imaging (rs-fMRI) correlates of prematurity in older children, but comparable data in the neonatal period remain scarce. We studied 25 term-born control infants within the first week of life and 25 very preterm infants (born at gestational ages ranging from 23 to 29 weeks) without evident structural injury at term equivalent postmenstrual age. Conventional resting-state network (RSN) mapping revealed only modest differences between the term and prematurely born infants, in accordance with previous work. However, clear group differences were observed in quantitative analyses based on correlation and covariance matrices representing the functional MRI time series extracted from 31 regions of interest in 7 RSNs. In addition, the maximum likelihood dimensionality estimates of the group-averaged covariance matrices in the term and preterm infants were 5 and 3, respectively, indicating that prematurity leads to a reduction in the complexity of rs-fMRI covariance structure. These findings highlight the importance of quantitative analyses of rs-fMRI data and suggest a more sensitive method for delineating the effects of preterm birth in infants without evident structural injury. PMID:25331596

  9. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    PubMed Central

    Roggeri, Daniela Paola; Roggeri, Alessandro; Rossi, Elisa; Cataudella, Salvatore; Martini, Nello

    2016-01-01

    Purpose Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3) with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures). Results Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases) and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively). The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in infants hospitalized for bronchiolitis during the entire follow-up period. Conclusion Preterm infants hospitalized for bronchiolitis in the first year of life were associated with increased resource consumption and costs throughout the entire period

  10. Paracetamol serum concentrations in preterm infants treated with paracetamol intravenously: a case series

    PubMed Central

    2012-01-01

    Introduction Until now, studies on paracetamol given intravenously have mainly been performed with the pro-drug propacetamol or with paracetamol in preterm babies above 32 weeks of gestation. Studies in these babies indicate that intravenous paracetamol is tolerated well, however studies on the efficacy of intravenous paracetamol are lacking. There are no pharmacokinetic data on the administration of multiple doses of paracetamol in preterm babies with a gestational age below 32 weeks. Case presentation We present a case series of nine Caucasian preterm babies, six boys and three girls, with a mean gestational age of 28.6 weeks (range 25.9 to 31.6 weeks). Case one, a girl with a gestational age of 25 weeks and six days, presented with necrotizing enterocolitis. In the second case, a female baby with a gestational age of 26 weeks and two days presented with hematoma. In case three, a female baby with a gestation of 26 weeks and one day developed intraventricular hemorrhage. In case four, a male baby with a gestational age of 31 weeks and four days presented with pain after vacuum delivery. Case five, a female baby born after a gestation of 29 weeks and six days presented with hematoma. In case six, a male baby with a gestation of 30 weeks and six days presented with hematoma. In case seven, a male baby, born with a gestational age of 30 weeks and six days, presented with caput succedaneum and hematoma. In case eight, a male baby, born after a gestation of 28 weeks and four days, developed abdominal distention. Case nine, a female baby, born with a gestational age of 27 weeks and three days presented with hematoma. These babies were treated with intravenous paracetamol 15 mg/kg every six hours. Serum concentrations and aspartate transaminase were determined after prolonged administration. Pain scores were assessed using the Premature Infant Pain Profile. Conclusion Paracetamol serum concentrations ranged from 8 to 64 mg/L after eight to 12 doses of intravenous

  11. The relationship between planned and reported home infant sleep locations among mothers of late preterm and term infants.

    PubMed

    Tully, Kristin P; Holditch-Davis, Diane; Brandon, Debra

    2015-07-01

    To compare maternal report of planned and practiced home sleep locations of infants born late preterm (34 0/7 to 36 6/7 gestational weeks) with those infants born term (≥37 0/7 gestational weeks) over the first postpartum month. Open-ended semi-structured maternal interviews were conducted in a US hospital following birth and by phone at 1 month postpartum during 2010-2012. Participants were 56 mother-infant dyads: 26 late preterm and 30 term. Most women planned to room share at home with their infants and reported doing so for some or all of the first postpartum month. More women reported bed sharing during the first postpartum month than had planned to do so in both the late preterm and term groups. The primary reason for unplanned bed sharing was to soothe nighttime infant fussiness. Those participants who avoided bed sharing at home commonly discussed their fear for infant safety. A few parents reported their infants were sleeping propped on pillows and co-sleeping on a recliner. Some women in both the late preterm and term groups reported lack of opportunity to obtain a bassinet prior to childbirth. The discrepancy between plans for infant sleep location at home and maternally reported practices were similar in late preterm and term groups. Close maternal proximity to their infants at night was derived from the need to assess infant well-being, caring for infants, and women's preferences. Bed sharing concerns related to infant safety and the establishment of an undesirable habit, and alternative arrangements included shared recliner sleep. PMID:25626714

  12. The immune consequences of preterm birth

    PubMed Central

    Melville, Jacqueline M.; Moss, Timothy J. M.

    2013-01-01

    Preterm birth occurs in 11% of live births globally and accounts for 35% of all newborn deaths. Preterm newborns have immature immune systems, with reduced innate and adaptive immunity; their immune systems may be further compromised by various factors associated with preterm birth. The immune systems of preterm infants have a smaller pool of monocytes and neutrophils, impaired ability of these cells to kill pathogens, and lower production of cytokines which limits T cell activation and reduces the ability to fight bacteria and detect viruses in cells, compared to term infants. Intrauterine inflammation is a major contributor to preterm birth, and causes premature immune activation and cytokine production. This can induce immune tolerance leading to reduced newborn immune function. Intrauterine inflammation is associated with an increased risk of early-onset sepsis and likely has long-term adverse immune consequences. Requisite medical interventions further impact on immune development and function. Antenatal corticosteroid treatment to prevent newborn respiratory disease is routine but may be immunosuppressive, and has been associated with febrile responses, reductions in lymphocyte proliferation and cytokine production, and increased risk of infection. Invasive medical procedures result in an increased risk of late-onset sepsis. Respiratory support can cause chronic inflammatory lung disease associated with increased risk of long-term morbidity. Colonization of the infant by microorganisms at birth is a significant contributor to the establishment of the microbiome. Caesarean section affects infant colonization, potentially contributing to lifelong immune function and well-being. Several factors associated with preterm birth alter immune function. A better understanding of perinatal modification of the preterm immune system will allow for the refinement of care to minimize lifelong adverse immune consequences. PMID:23734091

  13. A Star Is Born?

    ERIC Educational Resources Information Center

    Williamson, Gail

    1992-01-01

    The mother of an adolescent with Down's syndrome recounts his experiences in acting including commercials and working with Media Access, an organization that assists and encourages the accurate portrayal and employment of people with disabilities in the media industry. (DB)

  14. Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight

    PubMed Central

    Pyhälä, Riikka; Hovi, Petteri; Räikkönen, Katri; Van Lieshout, Ryan J.; Boyle, Michael H.; Saigal, Saroj; Morrison, Katherine M.; Kajantie, Eero; Schmidt, Louis A.

    2015-01-01

    Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood. PMID:27335948

  15. Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight.

    PubMed

    Mathewson, Karen J; Pyhälä, Riikka; Hovi, Petteri; Räikkönen, Katri; Van Lieshout, Ryan J; Boyle, Michael H; Saigal, Saroj; Morrison, Katherine M; Kajantie, Eero; Schmidt, Louis A

    2015-01-01

    Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood. PMID:27335948

  16. Development of cortical microstructure in the preterm human brain.

    PubMed

    Ball, Gareth; Srinivasan, Latha; Aljabar, Paul; Counsell, Serena J; Durighel, Giuliana; Hajnal, Joseph V; Rutherford, Mary A; Edwards, A David

    2013-06-01

    Cortical maturation was studied in 65 infants between 27 and 46 wk postconception using structural and diffusion magnetic resonance imaging. Alterations in neural structure and complexity were inferred from changes in mean diffusivity and fractional anisotropy, analyzed by sampling regions of interest and also by a unique whole-cortex mapping approach. Mean diffusivity was higher in gyri than sulci and in frontal compared with occipital lobes, decreasing consistently throughout the study period. Fractional anisotropy declined until 38 wk, with initial values and rates of change higher in gyri, frontal and temporal poles, and parietal cortex; and lower in sulcal, perirolandic, and medial occipital cortex. Neuroanatomical studies and experimental diffusion-anatomic correlations strongly suggested the interpretation that cellular and synaptic complexity and density increased steadily throughout the period, whereas elongation and branching of dendrites orthogonal to cortical columns was later and faster in higher-order association cortex, proceeding rapidly before becoming undetectable after 38 wk. The rate of microstructural maturation correlated locally with cortical growth, and predicted higher neurodevelopmental test scores at 2 y of age. Cortical microstructural development was reduced in a dose-dependent fashion by longer premature exposure to the extrauterine environment, and preterm infants at term-corrected age possessed less mature cortex than term-born infants. The results are compatible with predictions of the tension theory of cortical growth and show that rapidly developing cortical microstructure is vulnerable to the effects of premature birth, suggesting a mechanism for the adverse effects of preterm delivery on cognitive function. PMID:23696665

  17. Respiratory Syncytial Virus Hospitalizations in Healthy Preterm Infants

    PubMed Central

    Margulis, Andrea V.; Samuel, Miny; Lohr, Kathleen N.

    2016-01-01

    Background: Studies have explored the risk for and impact of respiratory syncytial virus (RSV) infection requiring hospitalization among healthy preterm infants born at 29–35 weeks of gestational age not given RSV immunoprophylaxis. We performed a systematic review and qualitative synthesis of these studies. Methods: Two experienced reviewers used prespecified inclusion/exclusion criteria to screen titles/abstracts and full-text studies using MEDLINE, Embase, BIOSIS and Cochrane Library (January 1, 1985, to November 6, 2014). We abstracted data on risk factors for RSV hospitalization, incidence and short- and long-term outcomes of RSV hospitalization. Using standard procedures, we assessed study risk of bias and graded strength of evidence (SOE). Results: We identified 4754 records and reviewed 27. Important risk factors for RSV hospitalization included young age during the RSV season, having school-age siblings and day-care attendance, with odds ratios >2.5 in at least one study (high SOE). Incidence rates for RSV hospitalizations ranged from 2.3% to 10% (low SOE). Length of hospital stays ranged from 3.8 to 6.1 days (low SOE). Recurrent wheezing rates ranged from 20.7% to 42.8% 1 to 2 years after RSV hospitalization (low SOE). Conclusions: Young chronological age and some environmental risk factors are important clinical indicators of an increased risk of RSV hospitalization in healthy preterm infants 32 to 35 weeks of gestational age. SOE was low for estimates of incidence of RSV hospitalizations, in-hospital resource use and recurrent wheezing in this population. Studies were inconsistent in study characteristics, including weeks of gestational age, age during RSV season and control for confounding factors. PMID:27093166

  18. Neonatal mortality due to preterm birth at 28-36 weeks' gestation in China, 2003-2008.

    PubMed

    Liang, Juan; Mao, Meng; Dai, Li; Li, Xiaohong; Miao, Lei; Li, Qi; He, Chunhua; Li, Mingrong; Wang, He; Zhu, Jun; Wang, Yanping

    2011-11-01

    Almost all (99%) neonatal deaths occur in developing countries, where the progress in reducing neonatal mortality rates (NMR) has been small; the Millennium Development Goal for child survival cannot be met if this situation continues. China is among the 10 countries that have the largest numbers of neonatal deaths. In order to provide effective interventions to reduce the national NMR for government policy makers, we analyse the trends, causes and characteristics of the neonatal deaths of preterm babies in different regions of China during the period 2003-2008. The data for this retrospective study were retrieved from the population-based Maternal and Child Health Surveillance System of China. The Cochran-Armitage trend test was used to analyse the trend of NMRs due to immaturity. The national NMR due to immaturity has decreased by 38.7% in 6 years. However, the proportion of preterm births among the causes of neonatal death has increased significantly from 33.6% in 2003 to 40.9% in 2008. The relative risk of neonatal death among preterm babies has shown significant regional disparity. In 2008, the adjusted relative risk was 1.30 [95% confidence interval (CI) 0.95, 1.78] in the inland regions and 2.37 [95% CI 1.56, 3.60] in the remote regions, both compared with the coastal regions. The proportion of neonatal deaths with a gestational age <32 weeks or a birthweight <1500 g was highest among the coastal regions. Most neonatal deaths of preterm babies in remote areas were born at home and were not treated before death. Our study suggests that preterm birth is the leading cause of neonatal death in China and neonatal mortality due to immaturity displayed regional differences. The Chinese government should implement major effective strategies for reducing the mortality of preterm infants to further decrease the total NMR. Priority interventions should be region-specific, depending on the availability of economic and health care resources. PMID:21980948

  19. Preterm birth among American Indian/Alaskan natives in Washington and Montana: comparison with non-Hispanic Whites.

    PubMed

    Hwang, Melody; Shrestha, Archana; Yazzie, Sheldwin; Jackson, Michael L

    2013-12-01

    Preterm birth is the single most important cause of perinatal mortality in North America. Given that American Indians/Alaskan Natives (AI/ANs) in the United States continue to have adverse birth outcomes, the purpose of this study is to compare the risk of preterm birth among AI/AN mothers to Non-Hispanic White mothers living in Washington and Montana from 2003 to 2009. A population-based retrospective cohort study was conducted examining the association between AI/AN mothers (self-reported) and the risk of preterm birth (gestational age <37 weeks) using birth certificate data from Washington and Montana. All AI/AN singleton lives births (n = 26,648) from residents of Washington and Montana from 2003 to 2009 were identified and included in our study. An identical number of Non-Hispanic White singleton infants (n = 26,648) born to residents of Washington and Montana were randomly selected as a comparison group and logistic regression was used to analyze the data. AI/AN mothers living in Washington and Montana between 2003 and 2009 were 1.34 times (95 % CI 1.25-1.44) as likely to have a preterm birth compared to Non-Hispanic Whites after adjusting for maternal and paternal characteristics as well as pregnancy risk factors. AI/AN mothers residing in Washington and Montana from 2003 to 2009 were at a significantly increased risk of having a preterm birth compared to Non-Hispanic Whites. Identifying etiologic differences in preterm birth experienced by AI/ANs is essential in targeting future interventions. PMID:23288503

  20. Food-Borne Trematodiases

    PubMed Central

    Keiser, Jennifer; Utzinger, Jürg

    2009-01-01

    Summary: An estimated 750 million people are at risk of infections with food-borne trematodes, which comprise liver flukes (Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, and Opisthorchis viverrini), lung flukes (Paragonimus spp.), and intestinal flukes (e.g., Echinostoma spp., Fasciolopsis buski, and the heterophyids). Food-borne trematodiases pose a significant public health and economic problem, yet these diseases are often neglected. In this review, we summarize the taxonomy, morphology, and life cycle of food-borne trematodes. Estimates of the at-risk population and number of infections, geographic distribution, history, and ecological features of the major food-borne trematodes are reviewed. We summarize clinical manifestations, patterns of infection, and current means of diagnosis, treatment, and other control options. The changing epidemiological pattern and the rapid growth of aquaculture and food distribution networks are highlighted, as these developments might be associated with an elevated risk of transmission of food-borne trematodiases. Current research needs are emphasized. PMID:19597009

  1. Short-term respiratory outcomes in late preterm infants

    PubMed Central

    2014-01-01

    Objective To evaluate short-term respiratory outcomes in late preterm infants (LPI) compared with those of term infants (TI). Methods A retrospective study conducted in a single third level Italian centre (2005–2009) to analyse the incidence and risk factors of composite respiratory morbidity (CRM), the need for adjunctive therapies (surfactant therapy, inhaled nitric oxide, pleural drainage), the highest level of respiratory support (mechanical ventilation – MV, nasal continuous positive airway pressure – N-CPAP, nasal oxygen) and the duration of pressure support (hours in N-CPAP and/or MV). Results During the study period 14,515 infants were delivered. There were 856 (5.9%) LPI and 12,948 (89.2%) TI. CRM affected 105 LPI (12.4%), and 121 TI (0.9%), with an overall rate of 1.6%. Eighty-four LPI (9.8%) and 73 TI (0.56%) received respiratory support, of which 13 LPI (1.5%) and 16 TI (0.12%) were ventilated. The adjusted OR for developing CRM significantly increased from 3.3 (95% CI 2.0-5.5) at 37 weeks to 40.8 (95% CI 19.7-84.9%) at 34 weeks. The adjusted OR for the need of MV significantly increased from 3.4 (95% CI 1.2-10) at 37 weeks to 34.4 (95% CI 6.7-180.6%) at 34 weeks. Median duration of pressure support was significantly higher at 37 weeks (66.6 h vs 40.5 h). Twin pregnancies were related to a higher risk of CRM (OR 4.3, 95% CI 2.6-7.3), but not independent of gestational age (GA). Cesarean section (CS) was associated with higher risk of CRM independently of GA, but the OR was lower in CS with labour (2.2, 95% CI 1.4-3.4 vs 3.0, 95% CI 2.1-4.2). Conclusions In this single third level care study late preterm births, pulmonary diseases and supportive respiratory interventions were lower than previously documented. LPI are at a higher risk of developing pulmonary disease than TI. Infants born from elective cesarean sections, late preterm twins in particular and 37 weekers too might benefit from preventive intervention. PMID:24893787

  2. Altered Amygdala Development and Fear Processing in Prematurely Born Infants

    PubMed Central

    Cismaru, Anca Liliana; Gui, Laura; Vasung, Lana; Lejeune, Fleur; Barisnikov, Koviljka; Truttmann, Anita; Borradori Tolsa, Cristina; Hüppi, Petra S.

    2016-01-01

    Context: Prematurely born children have a high risk of developmental and behavioral disabilities. Cerebral abnormalities at term age have been clearly linked with later behavior alterations, but existing studies did not focus on the amygdala. Moreover, studies of early amygdala development after premature birth in humans are scarce. Objective: To compare amygdala volumes in very preterm infants at term equivalent age (TEA) and term born infants, and to relate premature infants’ amygdala volumes with their performance on the Laboratory Temperament Assessment Battery (Lab-TAB) fear episode at 12 months. Participants: Eighty one infants born between 2008 and 2014 at the University Hospitals of Geneva and Lausanne, taking part in longitudinal and functional imaging studies, who had undergone a magnetic resonance imaging (MRI) scan at TEA enabling manual amygdala delineation. Outcomes: Amygdala volumes assessed by manual segmentation of MRI scans; volumes of cortical and subcortical gray matter, white matter and cerebrospinal fluid (CSF) automatically segmented in 66 infants; scores for the Lab-TAB fear episode for 42 premature infants at 12 months. Results: Amygdala volumes were smaller in preterm infants at TEA than term infants (mean difference 138.03 mm3, p < 0.001), and overall right amygdala volumes were larger than left amygdala volumes (mean difference 36.88 mm3, p < 0.001). White matter volumes were significantly smaller (p < 0.001) and CSF volumes significantly larger (p < 0.001) in preterm than in term born infants, while cortical and subcortical gray matter volumes were not significantly different between groups. Amygdala volumes showed significant correlation with the intensity of the escape response to a fearsome toy (rs = 0.38, p = 0.013), and were larger in infants showing an escape response compared to the infants showing no escape response (mean difference 120.97 mm3, p = 0.005). Amygdala volumes were not significantly correlated with the intensity

  3. Optimising preterm nutrition: present and future.

    PubMed

    Brennan, Ann-Marie; Murphy, Brendan P; Kiely, Mairead E

    2016-05-01

    The goal of preterm nutrition in achieving growth and body composition approximating that of the fetus of the same postmenstrual age is difficult to achieve. Current nutrition recommendations depend largely on expert opinion, due to lack of evidence, and are primarily birth weight based, with no consideration given to gestational age and/or need for catch-up growth. Assessment of growth is based predominately on anthropometry, which gives insufficient attention to the quality of growth. The present paper provides a review of the current literature on the nutritional management and assessment of growth in preterm infants. It explores several approaches that may be required to optimise nutrient intakes in preterm infants, such as personalising nutritional support, collection of nutrient intake data in real-time, and measurement of body composition. In clinical practice, the response to inappropriate nutrient intakes is delayed as the effects of under- or overnutrition are not immediate, and there is limited nutritional feedback at the cot-side. The accurate and non-invasive measurement of infant body composition, assessed by means of air displacement plethysmography, has been shown to be useful in assessing quality of growth. The development and implementation of personalised, responsive nutritional management of preterm infants, utilising real-time nutrient intake data collection, with ongoing nutritional assessments that include measurement of body composition is required to help meet the individual needs of preterm infants. PMID:27032990

  4. Pharmacokinetics of melatonin in preterm infants

    PubMed Central

    Merchant, Nazakat M; Azzopardi, Denis V; Hawwa, Ahmed F; McElnay, James C; Middleton, Benita; Arendt, J; Arichi, Tomoki; Gressens, Pierre; Edwards, A David

    2013-01-01

    Aims Preterm infants are deprived of the normal intra-uterine exposure to maternal melatonin and may benefit from replacement therapy. We conducted a pharmacokinetic study to guide potential therapeutic trials. Methods Melatonin was administered to 18 preterm infants in doses ranging from 0.04–0.6 μg kg−1 over 0.5–6 h. Pharmacokinetic profiles were analyzed individually and by population methods. Results Baseline melatonin was largely undetectable. Infants receiving melatonin at 0.1 μg kg−1 h−1 for 2 h showed a median half-life of 15.82 h and median maximum plasma concentration of 203.3 pg ml−1. On population pharmacokinetics, clearance was 0.045 l h−1, volume of distribution 1.098 l and elimination half-life 16.91 h with gender (P = 0.047) and race (P < 0.0001) as significant covariates. Conclusions A 2 h infusion of 0.1 μg kg−1 h−1 increased blood melatonin from undetectable to approximately peak adult concentrations. Slow clearance makes replacement of a typical maternal circadian rhythm problematic. The pharmacokinetic profile of melatonin in preterm infants differs from that of adults so dosage of melatonin for preterm infants cannot be extrapolated from adult studies. Data from this study can be used to guide therapeutic clinical trials of melatonin in preterm infants. PMID:23432339

  5. Complementary assessments of executive function in preterm and full-term preschoolers.

    PubMed

    Loe, Irene M; Chatav, Maya; Alduncin, Nidia

    2015-01-01

    Executive functions (EFs) are interrelated cognitive processes that have been studied in relation to behavior, attention, academic achievement, and developmental disorders. Studies of EF skills assessed through parent report and performance-based measures show correlations between them ranging from none to modest. Few studies have examined the relationship between EF skills measured through parent report and performance-based measures in relation to adaptive function. The present study included preschool children born preterm as a population at high risk for EF impairments. Preschool children (N = 149) completed a battery of EF tasks that assess working memory, response inhibition, idea generation, and attention shifting or cognitive flexibility. Parents reported on children's EF and adaptive skills. Preterm children showed more parent-rated and performance-based EF impairments than did full-term children. The combined use of either parent report or performance-based measures resulted in the identification of a large number of children at risk for EF impairment, especially in the preterm group. Both parent report and performance-based EF measures were associated with children's adaptive function. EF skills are measurable in young child'ren, and we suggest that EF skills may serve as targets for intervention to improve functional outcomes. We recommend the use of both parent report and performance-based measures to characterize children's EF profiles and to customize treatment. PMID:24754400

  6. Rethinking preventive post-discharge intervention programmes for very preterm infants and their parents.

    PubMed

    van Wassenaer-Leemhuis, Aleid G; Jeukens-Visser, Martine; van Hus, Janeline W P; Meijssen, Dominique; Wolf, Marie-Jeanne; Kok, Joke H; Nollet, Frans; Koldewijn, Karen

    2016-03-01

    Post-discharge preventive intervention programmes with involvement of the parent may support the resilience and developmental outcomes of infants born very preterm. Randomized controlled trials of home-based family-centred intervention programmes in very preterm infants that aimed to improve cognitive outcome, at least at age two, were selected and updated on the basis of a recent systematic review to compare their content and effect over time to form the basis of a narrative review. Six programmes were included in this narrative review. Four of the six programmes led to improved child cognitive and/or motor development. Two programmes, which focused primarily on responsive parenting and development, demonstrated improved cognitive outcome up till 5 years after completion of the programme. The programmes that also focused on maternal anxiety remediation led to improved maternal mental well-being, along with improved child behaviour, in one study - even at 3 years after completion of the programme. The magnitude of the effects was modest. Family-centred preventive intervention programmes that aim at improvement of child development should be continued after discharge home to improve the preterm child's resilience. Programmes may be most effective when they support the evolvement of a responsive parent-infant relationship over time, as well as the parent's well-being. PMID:27027610

  7. Brain functional network connectivity development in very preterm infants: The first six months.

    PubMed

    He, Lili; Parikh, Nehal A

    2016-07-01

    Nearly 10% of premature infants are born very preterm at 32weeks gestational age or less in the United States. Up to 35% of these very preterm survivors are at risk for cognitive and behavioral deficits. Yet accurate diagnosis of such deficits cannot be made until early childhood. Resting-state fMRI provides noninvasive assessment of the brain's functional networks and is a promising tool for early prognostication. In our present study, we enrolled a cohort of very preterm infants soon after birth and performed resting state fMRI at 32, 39 and additionally at 52weeks postmenstrual age. Using group probabilistic independent component analysis, we identified the following resting-state networks: visual, auditory, motor, somatosensory, cerebellum, brainstem, subcortical gray matter, default mode, executive control, and frontoparietal network. We observed increasing functional connectivity strength from 32 to 52weeks postmenstrual age for the auditory, somatosensory, visual, subcortical gray matter, executive control, and frontoparietal networks. Future studies with neurodevelopmental follow-up are needed to potentially identify prognostic biomarkers of long-term cognitive and behavioral deficits. PMID:27351350

  8. Influence of light exposure at nighttime on sleep development and body growth of preterm infants

    PubMed Central

    Kaneshi, Yosuke; Ohta, Hidenobu; Morioka, Keita; Hayasaka, Itaru; Uzuki, Yutaka; Akimoto, Takuma; Moriichi, Akinori; Nakagawa, Machiko; Oishi, Yoshihisa; Wakamatsu, Hisanori; Honma, Naoki; Suma, Hiroki; Sakashita, Ryuichi; Tsujimura, Sei-ichi; Higuchi, Shigekazu; Shimokawara, Miyuki; Cho, Kazutoshi; Minakami, Hisanori

    2016-01-01

    Previous studies have demonstrated that a light-dark cycle has promoted better sleep development and weight gain in preterm infants than constant light or constant darkness. However, it was unknown whether brief light exposure at night for medical treatment and nursing care would compromise the benefits brought about by such a light-dark cycle. To examine such possibility, we developed a special red LED light with a wavelength of >675 nm which preterm infants cannot perceive. Preterm infants born at <36 weeks’ gestational age were randomly assigned for periodic exposure to either white or red LED light at night in a light-dark cycle after transfer from the Neonatal Intensive Care Unit to the Growing Care Unit, used for supporting infants as they mature. Activity, nighttime crying and body weight were continuously monitored from enrolment until discharge. No significant difference in rest-activity patterns, nighttime crying, or weight gain was observed between control and experimental groups. The data indicate that nursing care conducted at 3 to 4-hour intervals exposing infants to light for <15 minutes does not prevent the infants from developing circadian rest-activity patterns, or proper body growth as long as the infants are exposed to regular light-dark cycles. PMID:26877166

  9. Regional White Matter Development in Very Preterm Infants: Perinatal Predictors and Early Developmental Outcomes

    PubMed Central

    Rogers, Cynthia E.; Smyser, Tara; Smyser, Christopher D.; Shimony, Joshua; Inder, Terrie E.; Neil, Jeffrey J.

    2015-01-01

    Background Preterm infants are at risk for white matter injury and adverse neurodevelopmental outcomes. Methods Serial diffusion tensor MRI data were obtained from very preterm infants (N=78) born <30 weeks gestation imaged up to four times from 26-42 weeks postmenstrual age. Slopes were calculated for fractional anisotropy (FA) and mean diffusivity (MD) within regions of interest for infants with ≥2 scans (N=50). Sixty-five children underwent neurodevelopmental testing at age two years. Results 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 PDA had lower FA slope in the ALIC. MD slope was lower with prolonged ventilation or lack of antenatal steroids. At age 2 years, lower motor scores were associated with lower FA in the left but higher FA in the right inferior temporal lobe at term-equivalent. Better social-emotional competence was related to lower FA in the left cingulum bundle. Conclusion This study demonstrates regional variability in the susceptibility/sensitivity of white matter maturation to perinatal factors and relationships between altered diffusion measures and developmental outcomes in preterm neonates. PMID:26372513

  10. Preterm white matter brain injury is prevented by early administration of umbilical cord blood cells.

    PubMed

    Li, Jingang; Yawno, Tamara; Sutherland, Amy; Loose, Jan; Nitsos, Ilias; Bischof, Robert; Castillo-Melendez, Margie; McDonald, Courtney A; Wong, Flora Y; Jenkin, Graham; Miller, Suzanne L

    2016-09-01

    Infants born very preterm are at high risk for neurological deficits including cerebral palsy. In this study we assessed the neuroprotective effects of umbilical cord blood cells (UCBCs) and optimal administration timing in a fetal sheep model of preterm brain injury. 50 million allogeneic UCBCs were intravenously administered to fetal sheep (0.7 gestation) at 12h or 5d after acute hypoxia-ischemia (HI) induced by umbilical cord occlusion. The fetal brains were collected at 10d after HI. HI (n=7) was associated with reduced number of oligodendrocytes (Olig2+) and myelin density (CNPase+), and increased density of activated microglia (Iba-1+) in cerebral white matter compared to control fetuses (P<0.05). UCBCs administered at 12h, but not 5d after HI, significantly protected white matter structures and suppressed cerebral inflammation. Activated microglial density showed a correlation with decreasing oligodendrocyte number (P<0.001). HI caused cell death (TUNEL+) in the internal capsule and cell proliferation (Ki-67+) in the subventricular zone compared to control (P<0.05), while UCBCs at 12h or 5d ameliorated these effects. Additionally, UCBCs at 12h induced a significant systemic increase in interleukin-10 at 10d, and reduced oxidative stress (malondialdehyde) following HI (P<0.05). UCBC administration at 12h after HI reduces preterm white matter injury, via anti-inflammatory and antioxidant actions. PMID:27317990

  11. Impact of Hospital-Based Environmental Exposures on Neurodevelopmental Outcomes of Preterm Infants

    PubMed Central

    Santos, Janelle; Pearce, Sarah E.; Stroustrup, Annemarie

    2015-01-01

    Purpose of review Over 300,000 infants are hospitalized in a neonatal intensive care unit (NICU) in the United States annually during a developmental period critical to later neurobehavioral function. Environmental exposures during the fetal period and infancy have been shown to impact long-term neurobehavioral outcomes. This review summarizes evidence linking NICU-based environmental exposures to neurodevelopmental outcomes of children born preterm, Recent findings Preterm infants experience multiple exposures important to neurodevelopment during the NICU hospitalization. The physical layout of the NICU, management of light and sound, social interactions with parents and NICU staff, and chemical exposures via medical equipment are important to long-term neurobehavioral outcomes in this highly vulnerable population. Summary Existing research documents NICU-based exposure to 1) neurotoxic chemicals, 2) aberrant light, 3) excess sound, and 4) restricted social interaction. In total, this creates an environment of co-existing excesses (chemicals, light, sound) and deprivation (touch, speech). The full impact of these co-exposures on the long-term neurodevelopment of preterm infants has not been adequately elucidated. Research into the importance of the NICU from an environmental health perspective is in its infancy, but could provide understanding about critical modifiable factors impacting the neurobehavioral health of hundreds of thousands of children each year. PMID:25635585

  12. Influence of light exposure at nighttime on sleep development and body growth of preterm infants.

    PubMed

    Kaneshi, Yosuke; Ohta, Hidenobu; Morioka, Keita; Hayasaka, Itaru; Uzuki, Yutaka; Akimoto, Takuma; Moriichi, Akinori; Nakagawa, Machiko; Oishi, Yoshihisa; Wakamatsu, Hisanori; Honma, Naoki; Suma, Hiroki; Sakashita, Ryuichi; Tsujimura, Sei-Ichi; Higuchi, Shigekazu; Shimokawara, Miyuki; Cho, Kazutoshi; Minakami, Hisanori

    2016-01-01

    Previous studies have demonstrated that a light-dark cycle has promoted better sleep development and weight gain in preterm infants than constant light or constant darkness. However, it was unknown whether brief light exposure at night for medical treatment and nursing care would compromise the benefits brought about by such a light-dark cycle. To examine such possibility, we developed a special red LED light with a wavelength of >675 nm which preterm infants cannot perceive. Preterm infants born at <36 weeks' gestational age were randomly assigned for periodic exposure to either white or red LED light at night in a light-dark cycle after transfer from the Neonatal Intensive Care Unit to the Growing Care Unit, used for supporting infants as they mature. Activity, nighttime crying and body weight were continuously monitored from enrolment until discharge. No significant difference in rest-activity patterns, nighttime crying, or weight gain was observed between control and experimental groups. The data indicate that nursing care conducted at 3 to 4-hour intervals exposing infants to light for <15 minutes does not prevent the infants from developing circadian rest-activity patterns, or proper body growth as long as the infants are exposed to regular light-dark cycles. PMID:26877166

  13. Race, genes and preterm delivery.

    PubMed Central

    Fiscella, Kevin

    2005-01-01

    High rates of preterm delivery (PTD) among African Americans are the leading cause of excess infant mortality among African Americans. Failure to fully explain racial disparity in PTD has led to speculation that genetic factors might contribute to this disparity. Current evidence suggests that genetic factors contribute to PTD, but this does not imply that genetic factors contribute to racial disparity in PTD. Environmental factors clearly contribute to PTD. Many of these factors acting over a women's life prior to pregnancy disproportionately affect African Americans and contribute significantly to racial disparity in PTD. Thus, inferring genetic contribution to racial disparity in PTD by attempting to control for environmental factors measured at a single point in time is flawed. There is emerging evidence of gene-environment interactions for PTD, some of which disproportionately affect African Americans. There is also evidence of racial differences in the prevalence of polymorphisms potentially related to PTD. However, to date there is no direct evidence that these differences contribute significantly to racial disparity in PTD. Given the complexity of polygenic conditions such as PTD, the possibility of any single gene contributing substantially to racial disparity in PTD seems remote. PMID:16334498

  14. Balloon borne Infrared Surveys

    NASA Astrophysics Data System (ADS)

    Lubin, Philip M.

    2015-08-01

    We report on modeling of a balloon borne mission to survey the 1-5 micron region with sensitivity close to the zodiacal light limits in portions of this band. Such a survey is compelling for numerous science programs and is complimentary to the upcoming Euclid, WFIRST and other orbital missions. Balloons borne missions offer much lower cost access and rapid technological implementation but with much less exposure time and increased backgrounds. For some science missions the complimentary nature of these is extremely useful. .

  15. The Role of Parental Attitudes and the Quality of the Home Learning Environment in the Mental Development of Prematurely Born Children.

    ERIC Educational Resources Information Center

    Kalmar, Magda; Boronkai, Judit

    Data are presented from a long-term follow-up study investigating the interplay of various factors contributing to the developmental outcome of prematurely born children. Fifty-eight low-risk pre-term Hungarian children are compared to 100 full-term children, from birth to age 6, on socioeconomic status, family climate, and intellectual…

  16. Sleep Apnea in Early Childhood Associated with Preterm Birth but Not Small for Gestational Age: A Population-Based Record Linkage Study

    PubMed Central

    Raynes-Greenow, Camille H.; Hadfield, Ruth M.; Cistulli, Peter A.; Bowen, Jenny; Allen, Hugh; Roberts, Christine L.

    2012-01-01

    Study Objectives: Investigate the relationship between gestational age and weight for gestational age and sleep apnea diagnosis in a cohort of children aged up to 6 years old. Design: A cohort study, using record linked population health data. Setting: New South Wales, Australia. Participants: 398,961 children, born between 2000 and 2004, aged 2.5 to 6 years. Measurements: The primary outcome was sleep apnea diagnosis in childhood, first diagnosed between 1 and 6 years of age. Children with sleep apnea were identified from hospital records with the ICD-10 code G47.3: sleep apnea, central or obstructive. Results: A total of 4,145 (1.0%) children with a first diagnosis of sleep apnea were identified. Mean age at first diagnosis was 44.2 months (SD 13.9). Adenoidectomy, tonsillectomy, or both were common among the children diagnosed with sleep apnea (85.6%). Children born preterm compared to term were significantly more likely to be diagnosed with sleep apnea (< 32 weeks versus term hazard ratio 2.74 [95% CI: 2.16, 3.49]) this remained even after adjustment for known confounding variables. Children born small for gestational age were not at increased risk of sleep apnea compared to children born appropriate for gestational age, hazard ratio 0.95 (95% CI 0.86-1.06). Conclusions: This is the largest study investigating preterm birth and sleep apnea diagnosis and suggests that diagnosis of sleep disordered breathing is more prevalent in children born preterm, but not those who are small for gestational age. Citation: Raynes-Greenow CH; Hadfield RM; Cistulli PA; Bowen J; Allen H; Roberts CL. Sleep apnea in early childhood associated with preterm birth but not small for gestational age: a population-based record linkage study. SLEEP 2012;35(11):1475-1480. PMID:23115396

  17. Future directions in preterm birth research.

    PubMed

    Jain, Joses; Gyamfi-Bannerman, Cynthia

    2016-04-01

    The problem of preterm birth continues to pose one of the most significant research challenges that we face due to its immense scope and complexity. With evidence that 95% of cases of spontaneous preterm birth are intractable to current interventions, our best hope in resolving this problem may lie in new, innovative ideas. Novel approaches to researching preterm birth are currently underway, building upon our prior discoveries and probing into the unknown on multiple fronts. Here we discuss some of the major focuses of future investigation that provide a promising outlook for discovery, including advanced techniques to evaluate the cervix, new strategies to identify the role of the microbiome, and advances in molecular and epigenetic-based research. PMID:26640166

  18. Postnatal Changes in Humerus Cortical Bone Thickness Reflect the Development of Metabolic Bone Disease in Preterm Infants

    PubMed Central

    Tokuriki, Shuko; Igarashi, Aiko; Okuno, Takashi; Ohta, Genrei; Kosaka, Takuya; Ohshima, Yusei

    2016-01-01

    Objective. To use cortical bone thickness (CBT) of the humerus to identify risk factors for the development of metabolic bone disease in preterm infants. Methods. Twenty-seven infants born at <32 weeks of gestational age, with a birth weight of <1,500 g, were enrolled. Humeral CBT was measured from chest radiographs at birth and at 27-28, 31-32, and 36–44 weeks of postmenstrual age (PMA). The risk factors for the development of osteomalacia were statistically analyzed. Results. The humeral CBT at 36–44 weeks of PMA was positively correlated with gestational age and birth weight and negatively correlated with the duration of mechanical ventilation. CBT increased with PMA, except in six very early preterm infants in whom it decreased. Based on logistic regression analysis, gestational age and duration of mechanical ventilation were identified as risk factors for cortical bone thinning. Conclusions. Humeral CBT may serve as a radiologic marker of metabolic bone disease at 36–44 weeks of PMA in preterm infants. Cortical bones of extremely preterm infants are fragile, even when age is corrected for term, and require extreme care to lower the risk of fractures. PMID:27194819

  19. The Effects of Alternative Positioning on Preterm Infants in the Neonatal Intensive Care Unit: A Randomized Clinical Trial

    PubMed Central

    Madlinger-Lewis, Laura; Reynolds, Lauren; Zarem, Cori; Crapnell, Tara; Inder, Terrie; Pineda, Roberta

    2014-01-01

    There is a paucity of studies that have investigated the developmental benefits of positioning in the neonatal intensive care unit. The purpose of this study was to investigate the effects of a new, alternative positioning device compared to traditional positioning methods used with preterm infants. In this randomized, blinded clinical trial, one hundred preterm infants (born ≤32 weeks gestation) from a level III neonatal intensive care unit in the United States were enrolled at birth. Participants were randomized to be positioned in the alternative positioning device or to traditional positioning methods for their length of stay in the neonatal intensive care unit. Infants were assessed using the NICU Network Neurobehavioral Scale at term equivalent age. Clinical and feeding outcomes were also captured. Linear and logistic regression were used to investigate differences in neurobehavioral outcome, feeding performance, and medical outcomes. Infants in the alternative positioning arm of the study demonstrated less asymmetry of reflex and motor responses on the NICU Network Neurobehavioral Scale (p=0.04; Adjusted Mean Difference=0.90, 95% CI 0.05–1.75) than those positioned using traditional positioning methods. No other significant differences were observed. Reductions in asymmetry among preterm infants is an important benefit of alternative positioning, as symmetrical movement and responses are crucial for early development. However, it will be important to follow this sample of preterm infants to determine the effects of early positioning on neurodevelopmental outcome in childhood. PMID:24374602

  20. Total and Differential Phylloquinone (Vitamin K₁) Intakes of Preterm Infants from All Sources during the Neonatal Period.

    PubMed

    Clarke, Paul; Mitchell, Simon J; Shearer, Martin J

    2015-01-01

    All newborns require phylloquinone after birth to prevent vitamin K deficiency bleeding. Babies born prematurely may be at particular risk of deficiency without adequate supplementation during infancy. The main sources of phylloquinone in preterm babies during the neonatal period are the prophylactic dose of phylloquinone given at birth, and that derived from parenteral and/or enteral feeding. This observational study formed part of a prospective, multicentre, randomised, controlled trial that examined the vitamin K status of preterm infants after random allocation to one of three phylloquinone prophylactic regimens at birth (0.5 or 0.2 mg intramuscularly or 0.2 mg intravenously). In this nutritional sub-study we quantified the proportional and total phylloquinone intakes of preterm infants within the neonatal period from all sources. Almost all infants had average daily phylloquinone intakes that were in excess of the currently recommended amounts. In infants who did not receive parenteral nutrition, the bolus dose of phylloquinone given at birth was the major source of phylloquinone intake, whereas in infants who received parenteral nutrition, the intake from the parenteral preparation exceeded that from the bolus dose by a ratio of approximately 3:1. Our study supports the concern of others that preterm infants who receive current parenteral nutrition formulations may be receiving excessive vitamin K. PMID:26426042

  1. Total and Differential Phylloquinone (Vitamin K1) Intakes of Preterm Infants from All Sources during the Neonatal Period

    PubMed Central

    Clarke, Paul; Mitchell, Simon J.; Shearer, Martin J.

    2015-01-01

    All newborns require phylloquinone after birth to prevent vitamin K deficiency bleeding. Babies born prematurely may be at particular risk of deficiency without adequate supplementation during infancy. The main sources of phylloquinone in preterm babies during the neonatal period are the prophylactic dose of phylloquinone given at birth, and that derived from parenteral and/or enteral feeding. This observational study formed part of a prospective, multicentre, randomised, controlled trial that examined the vitamin K status of preterm infants after random allocation to one of three phylloquinone prophylactic regimens at birth (0.5 or 0.2 mg intramuscularly or 0.2 mg intravenously). In this nutritional sub-study we quantified the proportional and total phylloquinone intakes of preterm infants within the neonatal period from all sources. Almost all infants had average daily phylloquinone intakes that were in excess of the currently recommended amounts. In infants who did not receive parenteral nutrition, the bolus dose of phylloquinone given at birth was the major source of phylloquinone intake, whereas in infants who received parenteral nutrition, the intake from the parenteral preparation exceeded that from the bolus dose by a ratio of approximately 3:1. Our study supports the concern of others that preterm infants who receive current parenteral nutrition formulations may be receiving excessive vitamin K. PMID:26426042

  2. The Special Needs of Preterm Children - An Oral Health Perspective.

    PubMed

    Tsang, Annetta Kit Lam

    2016-07-01

    Preterm births are defined as those before 37 weeks of gestation. With advances in fertility medicine and neonatal medicine, the numbers of preterm children in the community have significantly increased. Developmental delays and complications among preterm children are well recognized. Much less consideration is given to the dental complications of preterm children. Manifestations include palatal deformations, enamel defects, tooth size variations and tooth shape deformities, malocclusions, and increased risks of early childhood caries and tooth wear. This article explores orodental risks and orodental needs of preterm children and suggests preventive and management strategies for optimizing the oral health of special needs children. PMID:27264860

  3. Mechanisms of term and preterm birth.

    PubMed

    Gibb, W; Challis, J R G

    2002-11-01

    Labour at term and preterm results from activation and then stimulation of the myometrium. Activation can occur through mechanical stretch of the uterus, and by endocrine pathways resulting from increased activity of the fetal hypothalamic-pituitary-adrenal axis. In women and in experimental animals, cortisol likely contributes to increased prostaglandin production in fetal tissues through up-regulation of the type 2 prostaglandin H2, synthase-2 (PGHS-2) and down-regulation of 15-OH prostaglandin dehydrogenase. Cortisol increases expression of prostaglandin dehydrogenase in the chorion by reversing the stimulatory effect of progesterone, and may represent "progesterone withdrawal" in the primate. By competing with progesterone inhibition, cortisol also increases expression of placental corticotropin-releasing hormone. Other agents, such as pro-inflammatory cytokines, similarly up-regulate PGHS-2 and decrease expression of prostaglandin dehydrogenase. Oxytocin, produced locally within the intrauterine tissues, is also thought to be involved in parturition, and there is a marked increase in oxytocin receptor expression at term. There are thus several mechanisms by which labour at term or preterm may be initiated. These different mechanisms need to be considered in the development of strategies for the detection and management of women in preterm labour. Ongoing studies are investigating the use of oxytocin receptor antagonists, PGHS-2 inhibitors, and nitric oxide to prevent or regulate preterm labour. The presence of fibronectin in vaginal secretions, and elevated maternal serum levels of corticotropin-releasing hormone, estrogens, and cytokines have been examined as possible markers of preterm labour. However, at the present time, we do not have the ability to accurately predict or diagnose preterm labour, nor do we have specific or efficient methods to inhibit labour once it has started. PMID:12417902

  4. Tick-borne disease.

    PubMed

    Bratton, Robert L; Corey, Ralph

    2005-06-15

    Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially affecting the palms and soles of the feet is associated with Rocky Mountain spotted fever, whereas erythema migrans (annular macule with central clearing) is associated with Lyme disease. Various other rashes or skin lesions accompanied by fever and influenza-like illness also may signal the presence of a tick-borne disease. Early, accurate diagnosis allows treatment that may help prevent significant morbidity and possible mortality. Because 24 to 48 hours of attachment to the host are required for infection to occur, early removal can help prevent disease. Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. In patients with clinical findings suggestive of tick-borne disease, treatment should not be delayed for laboratory confirmation. If no symptoms follow exposure to tick bites, empiric treatment is not indicated. The same tick may harbor different infectious pathogens and transmit several with one bite. Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases. PMID:15999870

  5. Tick-borne viruses*

    PubMed Central

    Work, Telford H.

    1963-01-01

    More than 150 arthropod-borne viruses are now recognized, and over 50 of these are known to produce human infections and disease. Among these viruses are those of the tick-borne Russian spring-summer complex, which is etiologically involved in a wide variety of human diseases of varying severity. The eight antigenically different members of this complex so far known are Russian spring-summer encephalitis, louping-ill, Central European encephalitis, Omsk haemorrhagic fever, Kyasanur Forest disease, Langat, Negishi and Powassan viruses. In his review of the problems posed by these viruses and of research on them, the author points out that, while this complex is distributed around the globe in the temperate zone of the northern hemisphere, the only serious tick-borne virus disease known in the tropics is Kyasanur Forest disease. It is probable, however, that there are other, unrecognized tick-borne viruses in the tropical areas of Asia, Africa and America of importance to human health, and that these will be brought to light as virological studies of diseases of now obscure etiology are pursued. PMID:14043753

  6. Vector-borne diseases.

    PubMed

    Gubler, D J

    2009-08-01

    Vector-borne diseases have been the scourge of man and animals since the beginning of time. Historically, these are the diseases that caused the great plagues such as the 'Black Death' in Europe in the 14th Century and the epidemics of yellow fever that plagued the development of the New World. Others, such as Nagana, contributed to the lack of development in Africa for many years. At the turn of the 20th Century, vector-borne diseases were among the most serious public and animal health problems in the world. For the most part, these diseases were controlled by the middle of the 20th Century through the application of knowledge about their natural history along with the judicious use of DDT (dichlorodiphenyltrichloroethane) and other residual insecticides to interrupt the transmission cycle between arthropod and vertebrate host. However, this success initiated a period of complacency in the 1960s and 1970s, which resulted in the redirection of resources away from prevention and control of vector-borne diseases. The 1970s was also a time in which there were major changes to public health policy. Global trends, combined with changes in animal husbandry, urbanisation, modern transportation and globalisation, have resulted in a global re-emergence of epidemic vector-borne diseases affecting both humans and animals over the past 30 years. PMID:20128467

  7. Food-Borne Noroviruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Noroviruses have emerged as the number one cause of food-borne illness in the United States. In this book chapter, the current molecular classification criteria are described as well as the current information regarding the molecular biology of the virus and its putative gene functions. Identifica...

  8. Neurobehaviour between birth and 40 weeks’ gestation in infants born <30 weeks’ gestation and parental psychological wellbeing: predictors of brain development and child outcomes

    PubMed Central

    2014-01-01

    Background Infants born <30 weeks’ gestation are at increased risk of long term neurodevelopmental problems compared with term born peers. The predictive value of neurobehavioural examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Yet there is little knowledge surrounding earlier neurobehavioural development in preterm infants prior to term equivalent age, and how it relates to perinatal factors, cerebral structure, and later developmental outcomes. In addition, maternal psychological wellbeing has been associated with child development. Given the high rate of psychological distress reported by parents of preterm children, it is vital we understand maternal and paternal wellbeing in the early weeks and months after preterm birth and how this influences the parent–child relationship and children’s outcomes. Therefore this study aims to examine how 1) early neurobehaviour and 2) parental mental health relate to developmental outcomes for infants born preterm compared with infants born at term. Methods/Design This prospective cohort study will describe the neurobehaviour of 150 infants born at <30 weeks’ gestational age from birth to term equivalent age, and explore how early neurobehavioural deficits relate to brain growth or injury determined by magnetic resonance imaging, perinatal factors, parental mental health and later developmental outcomes measured using standardised assessment tools at term, one and two years’ corrected age. A control group of 150 healthy term-born infants will also be recruited for comparison of outcomes. To examine the effects of parental mental health on developmental outcomes, both parents of preterm and term-born infants will complete standardised questionnaires related to symptoms of anxiety, depression and post-traumatic stress at regular intervals from the first week of their child’s birth until their child’s second birthday. The parent–child relationship will be

  9. [Tocolysis in preterm labour--current recommendations].

    PubMed

    Wielgoś, Mirosław; Bomba-Opoń, Dorota A

    2014-05-01

    Common use of tocolytic drugs in preterm labor has not been shown to reduce the rate of neonatal mortality and morbidity Currently tocolytics should be administered in the course of a 48-h administration of antepartum glucocorticoids and/or transfer of the gravida to a center with neonatal intensive care unit. Only oxytocin receptor antagonist--atosiban and short-acting beta-agonists--fenoterol are licensed to reduce preterm uterine activity Owing to its safety and efficacy atosiban should be the first-choice tocolytic, especially in women with other diseases or multiple gestations. PMID:25011212

  10. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    PubMed Central

    2016-01-01

    Purpose: The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD) due to adrenal insufficiency (AI) in preterm infants. Methods: Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2), early AI (n=5), sepsis (n=1), and patent ductus arteriosus (n=13). Results: Fourteen of 257 infants (5.4%) were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days). The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE) in all 14 patients and germinal matrix hemorrhage (GMH) with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%), grade 1 PVE with newly appearing GMH in three (21%), and increased PVE in three (21%) infants. Five infants (36%) showed new development (n=4) or increased size (n=1) of GMH. Two of three infants (14%) with increased PVE developed cystic periventricular leukomalacia (PVL) and rapid progression to macrocystic encephalomalacia. Conclusion: LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia. PMID:27156563

  11. A preterm pig model of lung immaturity and spontaneous infant respiratory distress syndrome.

    PubMed

    Caminita, Frank; van der Merwe, Marie; Hance, Brittany; Krishnan, Ramesh; Miller, Sarah; Buddington, Karyl; Buddington, Randal K

    2015-01-15

    Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia remain the leading causes of preterm infant morbidity, mortality, and lifelong disability. Research to improve outcomes requires translational large animal models for RDS. Preterm pigs delivered by caesarian section at gestation days (GD) 98, 100, 102, and 104 were provided 24 h of neonatal intensive care, monitoring (pulse oximetry, blood gases, serum biomarkers, radiography), and nutritional support, with or without intubation and mechanical ventilation (MV; pressure control ventilation with volume guarantee). Spontaneous development of RDS and mortality without MV are inversely related with GD at delivery and correspond with inadequacy of tidal volume and gas exchange. GD 98 and 100 pigs have consolidated lungs, immature alveolar architecture, and minimal surfactant protein-B expression, and MV is essential at GD 98. Although GD 102 pigs had some alveoli lined by pneumocytes and surfactant was released in response to MV, blood gases and radiography revealed limited recruitment 1-2 h after delivery, and mortality at 24 h was 66% (35/53) with supplemental oxygen provided by a mask and 69% (9/13) with bubble continuous positive airway pressure (8-9 cmH2O). The lungs at GD 104 had higher densities of thin-walled alveoli that secreted surfactant, and MV was not essential. Between GD 98 and 102, preterm pigs have ventilation inadequacies and risks of RDS that mimic those of preterm infants born during the saccular phase of lung development, are compatible with standards of neonatal intensive care, and are alternative to fetal nonhuman primates and lambs. PMID:25398985

  12. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data

    PubMed Central

    2010-01-01

    Introduction This is the first of seven articles from a preterm birth and stillbirth report. Presented here is an overview of the burden, an assessment of the quality of current estimates, review of trends, and recommendations to improve data. Preterm birth Few countries have reliable national preterm birth prevalence data. Globally, an estimated 13 million babies are born before 37 completed weeks of gestation annually. Rates are generally highest in low- and middle-income countries, and increasing in some middle- and high-income countries, particularly the Americas. Preterm birth is the leading direct cause of neonatal death (27%); more than one million preterm newborns die annually. Preterm birth is also the dominant risk factor for neonatal mortality, particularly for deaths due to infections. Long-term impairment is an increasing issue. Stillbirth Stillbirths are currently not included in Millennium Development Goal tracking and remain invisible in global policies. For international comparisons, stillbirths include late fetal deaths weighing more than 1000g or occurring after 28 weeks gestation. Only about 2% of all stillbirths are counted through vital registration and global estimates are based on household surveys or modelling. Two global estimation exercises reached a similar estimate of around three million annually; 99% occur in low- and middle-income countries. One million stillbirths occur during birth. Global stillbirth cause-of-death estimates are impeded by multiple, complex classification systems. Recommendations to improve data (1) increase the capture and quality of pregnancy outcome data through household surveys, the main data source for countries with 75% of the global burden; (2) increase compliance with standard definitions of gestational age and stillbirth in routine data collection systems; (3) strengthen existing data collection mechanisms—especially vital registration and facility data—by instituting a standard death certificate for

  13. The Association of Urbanicity with Cognitive Development at Five Years of Age in Preterm Children

    PubMed Central

    Gouin, Marion; Flamant, Cyril; Gascoin, Géraldine; Rouger, Valérie; Florin, Agnès; Guimard, Philippe; Rozé, Jean-Christophe; Hanf, Matthieu

    2015-01-01

    Objective To determine the association of urbanicity, defined as living in an urban area, with cognitive development at five years of age in preterm children who were free of any disabilities or neurodevelopmental delays. Design Prospective population-based cohort. Setting French regional Loire Infant Follow-up Team (LIFT) network. Participants Included in the study were 1738 surviving infants born between March 2003 and December 2008 before 35 weeks of gestational age. At two years of age, the children were free of any disabilities and neurodevelopmental delays and were living in the Pays de la Loire region from their birth to five years of age. Main Outcome Measures The cognitive development at five years of age was evaluated with the Global School Adaptation score (GSA). The urbanicity of the residence for each child was classified into three groups: urban, quasi-rural, and rural area. Results Quantile regression approaches were used to identify a significant association between urbanicity and the GSA score at five years of age (adjusting for child and family characteristics). We found that the negative impact of urbanicity on the GSA score was more important for the lower quantile of the GSA scores. Conclusions Urbanicity was significantly associated with cognitive neurodevelopment at five years of age in preterm children born before 35 weeks of gestation. Complementary results additionally suggest that this relation could be mediated at the residence level by a high socioeconomic deprivation level. If these results are confirmed, more personalized follow-ups could be developed for preterm children. Further studies are needed to finely identify the contextual characteristics of urbanicity that underlie this association. PMID:26161862

  14. Maternal sounds elicit lower heart rate in preterm newborns in the first month of life

    PubMed Central

    Rand, Katherine; Lahav, Amir

    2015-01-01

    Background The preferential response to mother’s voice in the fetus and term newborn is well documented. However, the response of preterm neonates is not well understood and more difficult to interpret due to the intensive clinical care and range of medical complications. Aim This study examined the physiological response to maternal sounds and its sustainability in the first month of life in infants born very pretermaturely. Methods Heart rate changes were monitored in 20 hospitalized preterm infants born between 25 and 32 weeks of gestation during 30-minute exposure vs. non-exposure periods of recorded maternal sounds played inside the Neonatal incubator. A total of 13,680 min of HR data was sampled throughout the first month of life during gavage feeds Heart rate with and without exposure to maternal sounds. Results During exposure periods, infants had significantly lower heart rate compared to matched periods of care Auditory without exposure on the same day (p < .0001). This effect was observed in all infants, across the first month of life, irrespective of day of life, gestational age at birth, birth weight, age at testing, Apgar score, caffeine therapy, and requirement for respiratory support. No adverse effects were observed. Conclusion Preterm newborns responded to maternal sounds with decreased heart rate throughout the first month of life. It is possible that maternal sounds improve autonomic stability and provide a more relaxing environment for this population of newborns. Further studies are needed to determine the therapeutic implications of maternal sound exposure for optimizing care practices and developmental outcomes. PMID:25194837

  15. Reproductive health differences among Latin American- and US-born young women.

    PubMed

    Minnis, A M; Padian, N S

    2001-12-01

    Investigations of reproductive health within Latinos living in the United States suggest that sexual behaviors and contraception use practices vary by ethnicity and between foreign- and US-born adolescents. This article compares high-risk sexual behaviors and reproductive health among foreign-born Latinas, US-born Latinas, and US-born non-Latinas aged 15-24 years. We recruited 361 females from reproductive health clinics in the San Francisco Bay Area of California between 1995 and 1998; these women completed an interview that assessed sexual risk behaviors and history of pregnancy, abortion, and sexually transmitted infections. Current chlamydial and gonococcal infections were detected through biological testing. Among participants aged 15-18 years, US-born Latinas were more likely to have been pregnant (odds ratio [OR] comparing US-born Latinas and US-born non-Latinas = 3.9, 95% confidence interval [CI] 1.3, 11.4), whereas among respondents aged 19-24 years, foreign-born Latinas were more likely to have been pregnant than US-born Latinas (OR = 11.3, 95% CI 1.0, 130.8) and US-born non-Latinas (OR = 64.2, 95% CI 9.9, 416.3). US-born Latinas were most likely to have had an abortion (OR comparing US-born Latinas and US-born non-Latinas = 2.0, 95% CI 0.9, 4.7). They were also most likely to have chlamydial infection at study enrollment (8.2% prevalence compared to 2.2% and 1.0%for foreign-born Latinas and US-born non-Latinas, respectively; P =.009). Reproductive health differences between foreign and US-born females and within the US-born population warrant further examination and highlight the need for targeted prevention. PMID:11796809

  16. Preterm preeclampsia in relation to country of birth

    PubMed Central

    Ray, J G; Wanigaratne, S; Park, A L; Bartsch, E; Dzakpasu, S; Urquia, M L

    2016-01-01

    Objective: To examine the association between maternal country of birth and the risk of preeclampsia+preterm birth (PTB). Study Design: We completed a population-based study in the entire province of Ontario, where there is universal access to obstetrical care. We included 881 700 singleton livebirths among Canadian-born mothers and 305 547 births among immigrant mothers. Adjusted risk ratios (aRRs) were adjusted for maternal age, parity and income quintile. Results: Compared with a rate of preeclampsia+PTB of 4.0 per 1000 among Canadian-born mothers, the aRR of preeclampsia+PTB at 24 to 36 weeks was significantly higher for immigrant women from Nigeria (1.79, 95% confidence interval (CI) 1.12 to 2.84), the Philippines (1.54, 95% CI 1.30 to 1.86), Colombia (1.68, 95% CI 1.04 to 2.73), Jamaica (2.06, 95% CI 1.66 to 2.57) and Ghana (2.12, 95% CI 1.40 to 3.21). The aRRs generally followed a similar pattern for secondary outcomes. Specifically, women from Ghana were at highest risk of preeclampsia+very PTB (4.55, 95% CI 2.57 to 8.06), and women from Jamaica at the highest risk of preeclampsia+indicated PTB (1.89, 95% CI 1.43 to 2.50). Conclusion: The risk of preeclampsia+PTB is highest among women from a select number of countries. This information can enhance initiatives aimed at reducing the risk of PTB related to preeclampsia. PMID:27149056

  17. Association of preterm birth with brain malformations

    PubMed Central

    Brown, William R.

    2009-01-01

    This study investigates the rate of preterm birth in babies with congenital brain defects. Autopsy case reports of congenital brain anomalies were obtained from the literature. The control cases were from a large registry, a published report from the Metropolitan Atlanta Congenital Defects Program. From 428 publications, 1168 cases were abstracted that had autopsy studies of congenital brain defects and information on the gestational age at birth. The control data from Atlanta included 7738 infants with significant birth defects of any kind and 264,392 infants without birth defects. In the autopsy cases with brain defects, the mean gestational age was 36.6 weeks, whereas the Atlanta data showed a mean gestational age of 39.3 weeks for infants with no defects and a significantly shorter gestation of 38.1 weeks (p < 0.0001) for infants with defects. In the Atlanta data, the rate of preterm birth was 9.3 % for those with no defects compared to 21.5 % (p < 0.0001) for those with defects. In the autopsy cases with brain defects, the rate of preterm birth was even greater (33.1%, p < 0.0001). In conclusion, these data show an association of brain defects with preterm births. PMID:19218881

  18. Nutrition of Preterm Infants After Hospital Discharge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Growth failure in preterm infants remains extremely common despite advances in neonatal care. Many, or even a majority, leave the hospital with weights below the 10th centile for age. Because of this, the possibility of nutritional interventions to improve postdischarge growth has been considered. A...

  19. Karaya gum electrocardiographic electrodes for preterm infants.

    PubMed Central

    Cartlidge, P H; Rutter, N

    1987-01-01

    Changes in transepidermal water loss were used to measure skin damage caused by removal of electrocardiograph electrodes in 20 preterm infants. Electrodes secured by conventional adhesive damaged the skin, leading to a potentially dangerous increase in skin permeability. In contrast, those secured by karaya gum caused no skin damage. PMID:3435167

  20. Preterm infant massage therapy research: a review.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2010-04-01

    In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies. PMID:20137814

  1. [Consequences preterm birth for the family].

    PubMed

    Garel, Micheline

    2014-01-01

    Current intensive care techniques enable more and more very preterm babies to survive. It is important to be aware of the nature and extent of the specific difficulties which the parents and any siblings may encounter following this birth, both in the long and medium-term. This understanding will also enable measures for improving the support of families to be offered. PMID:24779173

  2. Recurrent wheezing in very preterm infants.

    PubMed Central

    Elder, D. E.; Hagan, R.; Evans, S. F.; Benninger, H. R.; French, N. P.

    1996-01-01

    AIMS: To document the prevalence of, and identify risk factors for, recurrent wheezing treated with bronchodilators in the first year of life. METHODS: Parental history and neonatal data were collected prospectively in a regional cohort of very preterm infants (< 33 weeks). Data on maternal smoking, siblings at home, breast feeding, respiratory symptoms, and hospital re-admissions were documented at 12 months. RESULTS: Outcome data were available for 525/560 (95%) of survivors. The incidence of recurrent wheeze was 76/525 (14.5%) in very preterm infants and 20/657 (3%) in a cohort of term newborns. Significant risk factors for recurrent wheeze in very preterm infants were parental history of asthma, maternal smoking, siblings at home, neonatal oxygen supplementation at 28 days, 36, and 40 weeks of gestation. CONCLUSIONS: Wheezing respiratory illnesses are common in very preterm infants. The factors involved are similar to those in more mature infants, with the addition of immaturity and neonatal lung injury. PMID:8777678

  3. Advancing Evidence in Preterm Neonatal Medicine

    ERIC Educational Resources Information Center

    Donahue, Pamela K.; Robinson, Karen A.

    2010-01-01

    Few interventions and treatments for premature infants have undergone the rigors of a randomized controlled trial (RCT), the cornerstone of evidence-based healthcare. Multiple barriers in establishing a quality evidence base for the care of preterm infants are examined including the systematic exclusion of children from drug trials, vulnerability…

  4. Primary Cutaneous Aspergillosis in a Preterm Infant.

    PubMed

    Frick, Marie Antoinette; Boix, Hector; Camba Longueira, Fátima; Martin-Gomez, M Teresa; Rodrigo-Pendás, José Ángel; Soler-Palacin, Pere

    2016-06-01

    Primary cutaneous aspergillosis is rare in premature infants. It requires combined medical and surgical strategies. Liposomal amphotericin B is recommended as first-line therapy, but salvage regimens with others antifungal agents, such as voriconazole, have been reported. Voriconazole's pharmacodynamics is unknown in this population. We report a case of severe toxicity to voriconazole in a preterm patient with primary cutaneous aspergillosis. PMID:26974892

  5. The Effect of Russian Versus Hebrew Instructions on the Reaction to Social Pressure of Russian-Born Israeli Children

    ERIC Educational Resources Information Center

    Kav-Venaki, Sophie; And Others

    1976-01-01

    An experiment on the role of the language of instruction in mediating responses to social pressure was conducted with a sample of 41 Russian-born adolescents who had recently immigrated to Israel. (Editor)

  6. Injury to the Preterm Brain and Cerebral Palsy: Clinical Aspects, Molecular Mechanisms, Unanswered Questions, and Future Research Directions

    PubMed Central

    Babcock, Michael A.; Kostova, Felina V.; Ferriero, Donna M.; Johnston, Michael V.; Brunstrom, Jan E.; Hagberg, Henrik; Maria, Bernard L.

    2013-01-01

    Cerebral palsy will affect nearly 10% of the 60,000 very-low-birth-weight infants born in the United States in the next year, and an even greater percentage will display some form of permanent neurological impairment resulting from injury to the preterm brain. The 2008 Neurobiology of Disease in Children Symposium, held in conjunction with the 37th annual meeting of the Child Neurology Society, aimed to define current knowledge and to develop specific aims for future clinical, translational, and fundamental science. A complex interplay of both destructive and developmental forces is responsible for injury to the preterm brain. Advances in imaging and histology have implicated a variety of cell types, though pre-oligodendrocyte injury remains the focus. Research into different mechanisms of injury is facilitating new neuroprotective and rehabilitative interventions. A cooperative effort is necessary to translate basic research findings into clinically effective therapies and better care for these children. PMID:19745084

  7. Early electrophysiological markers of atypical language processing in prematurely born infants.

    PubMed

    Paquette, Natacha; Vannasing, Phetsamone; Tremblay, Julie; Lefebvre, Francine; Roy, Marie-Sylvie; McKerral, Michelle; Lepore, Franco; Lassonde, Maryse; Gallagher, Anne

    2015-12-01

    Because nervous system development may be affected by prematurity, many prematurely born children present language or cognitive disorders at school age. The goal of this study is to investigate whether these impairments can be identified early in life using electrophysiological auditory event-related potentials (AERPs) and mismatch negativity (MMN). Brain responses to speech and non-speech stimuli were assessed in prematurely born children to identify early electrophysiological markers of language and cognitive impairments. Participants were 74 children (41 full-term, 33 preterm) aged 3, 12, and 36 months. Pre-attentional auditory responses (MMN and AERPs) were assessed using an oddball paradigm, with speech and non-speech stimuli presented in counterbalanced order between participants. Language and cognitive development were assessed using the Bayley Scale of Infant Development, Third Edition (BSID-III). Results show that preterms as young as 3 months old had delayed MMN response to speech stimuli compared to full-terms. A significant negative correlation was also found between MMN latency to speech sounds and the BSID-III expressive language subscale. However, no significant differences between full-terms and preterms were found for the MMN to non-speech stimuli, suggesting preserved pre-attentional auditory discrimination abilities in these children. Identification of early electrophysiological markers for delayed language development could facilitate timely interventions. PMID:26476371

  8. Autism spectrum disorder in children born preterm—role of exposure to perinatal inflammation

    PubMed Central

    Meldrum, Suzanne J.; Strunk, T.; Currie, A.; Prescott, S. L.; Simmer, K.; Whitehouse, A. J. O.

    2013-01-01

    Autism Spectrum Disorder (ASD) is the collective term for neurodevelopmental disorders characterized by qualitative impairments in social interaction, communication, and a restricted range of activities and interests. Many countries, including Australia, have reported a dramatic increase in the number of diagnoses over the past three decades, with current prevalence of ASD at 1 in every 110 individuals (~1%). The potential role for an immune-mediated mechanism in ASD has been implicated by several studies, and some evidence suggests a potential link between prenatal infection-driven inflammation and subsequent development of ASD. Furthermore, a modest number of contemporary studies have reported a markedly increased prevalence of ASD in children born preterm, who are at highest risk of exposure to perinatal inflammation. However, the mechanisms that underpin the susceptibility to infection-driven inflammation during pregnancy and risk of preterm birth, and how these intersect with the subsequent development of ASD in the offspring, is not understood. This review aims to summarize and discuss the potential mechanisms and evidence for the role of prenatal infection on the central nervous system, and how it may increase the susceptibility for ASD pathogenesis in children born preterm. PMID:23885233

  9. Abnormal ventricular development in preterm neonates with visually normal MRIs

    NASA Astrophysics Data System (ADS)

    Shi, Jie; Wang, Yalin; Lao, Yi; Ceschin, Rafael; Mi, Liang; Nelson, Marvin D.; Panigrahy, Ashok; Leporé, Natasha

    2015-12-01

    Children born preterm are at risk for a wide range of neurocognitive and neurobehavioral disorders. Some of these may stem from early brain abnormalities at the neonatal age. Hence, a precise characterization of neonatal neuroanatomy may help inform treatment strategies. In particular, the ventricles are often enlarged in neurocognitive disorders, due to atrophy of surrounding tissues. Here we present a new pipeline for the detection of morphological and relative pose differences in the ventricles of premature neonates compared to controls. To this end, we use a new hyperbolic Ricci flow based mapping of the ventricular surfaces of each subjects to the Poincaré disk. Resulting surfaces are then registered to a template, and a between group comparison is performed using multivariate tensor-based morphometry. We also statistically compare the relative pose of the ventricles within the brain between the two groups, by performing a Procrustes alignment between each subject's ventricles and an average shape. For both types of analyses, differences were found in the left ventricles between the two groups.

  10. Systemic inflammation associated with mechanical ventilation among extremely preterm infants

    PubMed Central

    Bose, Carl L.; Laughon, Matthew M.; Allred, Elizabeth N.; O’Shea, T. Michael; Van Marter, Linda J.; Ehrenkranz, Richard A.; Fichorova, Raina N.; Leviton, Alan

    2012-01-01

    Little evidence is available to document that mechanical ventilation is an antecedent of systemic inflammation in preterm humans. We obtained blood on postnatal day 14 from 726 infants born before the 28th week of gestation and measured the concentrations of 25 inflammation-related proteins. We created multivariable models to assess the relationship between duration of ventilation and protein concentrations in the top quartile. Compared to newborns ventilated for fewer than 7 days (N=247), those ventilated for 14 days (N=330) were more likely to have elevated blood concentrations of pro-inflammatory cytokines (IL-1β, TNF-α), chemokines (IL-8, MCP-1), an adhesion molecule (ICAM-1), and a matrix metalloprotease (MMP-9), and less likely to have elevated blood concentrations of two chemokines (RANTES, MIP-1β), a matrix metalloproteinase (MMP-1), and a growth factor (VEGF). Newborns ventilated for 7-13 days (N=149) had systemic inflammation that approximated the pattern of newborns ventilated for 14 days. These relationships were not confounded by chorioamnionitis or antenatal corticosteroid exposure, and were not altered appreciably among infants with and without bacteremia. These findings suggest that two weeks of ventilation are more likely than shorter durations of ventilation to be accompanied by high blood concentrations of pro-inflammatory proteins indicative of systemic inflammation, and by low concentrations of proteins that might protect from inflammation-mediated organ injury. PMID:23148992

  11. Is preterm birth a human-specific syndrome?

    PubMed Central

    Phillips, Julie Baker; Abbot, Patrick; Rokas, Antonis

    2015-01-01

    Human preterm birth (PTB), a multifactorial syndrome affecting offspring born before 37 completed weeks of gestation, is the leading cause of newborn death worldwide. Remarkably, the degree to which early parturition contributes to mortality in other placental mammals remains unclear. To gain insights on whether PTB is a human-specific syndrome, we examined within- and between-species variation in gestation length across placental mammals and the impact of early parturition on offspring fitness. Within species, gestation length is normally distributed, and all species appear to occasionally give birth before the ‘optimal’ time. Furthermore, human gestation length, like that of many mammalian species, scales proportionally to body mass, suggesting that this trait, like many others, is constrained by body size. Premature humans suffer from numerous cognitive impairments, but little is known of cognitive impairments in other placental mammals. Human gestation differs in the timing of the ‘brain growth spurt’, where unlike many mammals, including closely related primates, the trajectory of human brain growth directly overlaps with the parturition time window. Thus, although all mammals experience early parturition, the fitness costs imposed by the cognitive impairments may be unique to our species. Describing PTB broadly in mammals opens avenues for comparative studies on the physiological and genetic regulators of birth timing as well as the development of new mammalian models of the disease. PMID:26077822

  12. Retinopathy of prematurity in infants born before 25 weeks gestation in a Korean single neonatal intensive care unit: incidence, natural history and risk factors.

    PubMed

    Kong, Mingui; Shin, Dong Hoon; Kim, Sang Jin; Ham, Don Il; Kang, Se Woong; Chang, Yun Sil; Park, Won Soon

    2012-12-01

    As younger preterm infants are able to survive, more extremely preterm infants are at risk of developing retinopathy of prematurity (ROP). To investigate the incidence, progression and risk factors of ROP in extremely preterm infants in Korea, the medical records of infants born before 25 weeks gestation were retrospectively reviewed. The criteria for laser treatment agreed with type 1 ROP as defined by the Early Treatment for Retinopathy of Prematurity study. Of the 121 infants included in the analysis, 119 (98.4%) infants developed any stage ROP, including 78 infants (64.5%) with type 1 ROP. The mean postmenstrual age (PMA) at the onset of any ROP and type 1 ROP were 33.5 and 36.1 weeks, respectively. All but one infant developed type 1 ROP after 31 weeks PMA. Univariate analysis showed that duration of total parenteral nutrition and onset of any ROP (PMA) were associated with the development of type 1 ROP. In conclusion, this study shows high incidence of ROP in extremely preterm infants and suggests that, although current screening protocols are feasible for most preterm infants born before 25 weeks gestation, earlier screening before 31 weeks PMA may be necessary in infants with an unstable clinical course. PMID:23255858

  13. Risk assessment and management to prevent preterm birth.

    PubMed

    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. PMID:26906339

  14. Practice Bulletin No. 159: Management of Preterm Labor.

    PubMed

    2016-01-01

    Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization . In the United States, approximately 12% of all live births occur before term, and preterm labor preceded approximately 50% of these preterm births . Although the causes of preterm labor are not well understood, the burden of preterm births is clear-preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths as well as 25-50% of cases of long-term neurologic impairment in children . A 2006 report from the Institute of Medicine estimated the annual cost of preterm birth in the United States to be $26.2 billion or more than $51,000 per premature infant . However, identifying women who will give birth preterm is an inexact process. The purpose of this document is to present the various methods proposed to manage preterm labor and to review the evidence for the roles of these methods in clinical practice. Identification and management of risk factors for preterm labor are not addressed in this document. PMID:26695585

  15. Practice Bulletin No. 159 Summary: Management of Preterm Labor.

    PubMed

    2016-01-01

    Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization (1-4). In the United States, approximately 12% of all live births occur before term, and preterm labor preceded approximately 50% of these preterm births (5, 6). Although the causes of preterm labor are not well understood, the burden of preterm births is clear-preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths as well as 25-50% of cases of long-term neurologic impairment in children (7-9). A 2006 report from the Institute of Medicine estimated the annual cost of preterm birth in the United States to be $26.2 billion or more than $51,000 per premature infant (10). However, identifying women who will give birth preterm is an inexact process. The purpose of this document is to present the various methods proposed to manage preterm labor and to review the evidence for the roles of these methods in clinical practice. Identification and management of risk factors for preterm labor are not addressed in this document. PMID:26695580

  16. Center Variation in the Delivery of Indicated Late Preterm Births.

    PubMed

    Aliaga, Sofia; Zhang, Jun; Long, D Leann; Herring, Amy H; Laughon, Matthew; Boggess, Kim; Reddy, Uma M; Grantz, Katherine Laughon

    2016-08-01

    Objective Evidence for optimal timing of delivery for some pregnancy complications at late preterm gestation is limited. The purpose of this study was to identify center variation of indicated late preterm births. Study design We performed an analysis of singleton late preterm and term births from a large U.S. retrospective obstetrical cohort. Births associated with spontaneous preterm labor, major congenital anomalies, chorioamnionitis, and emergency cesarean were excluded. We used modified Poisson fixed effects logistic regression with interaction terms to assess center variation of indicated late preterm births associated with four medical/obstetric comorbidities after adjusting for socio-demographics, comorbidities, and hospital/provider characteristics. Results We identified 150,055 births from 16 hospitals; 9,218 were indicated late preterm births. We found wide variation of indicated late preterm births across hospitals. The extent of center variation was greater for births associated with preterm premature rupture of membranes (risk ratio [RR] across sites: 0.45-3.05), hypertensive disorders of pregnancy (RR across sites: 0.36-1.27), and placenta previa/abruption (RR across sites: 0.48-1.82). We found less center variation for births associated with diabetes (RR across sites: 0.65-1.39). Conclusion Practice variation in the management of indicated late preterm deliveries might be a source of preventable late preterm birth. PMID:27120474

  17. Prostaglandins are essential for cervical ripening in LPS-mediated preterm birth but not term or antiprogestin-driven preterm ripening.

    PubMed

    Timmons, Brenda C; Reese, Jeff; Socrate, Simona; Ehinger, Noah; Paria, Bibhash C; Milne, Ginger L; Akins, Meredith L; Auchus, Richard J; McIntire, Don; House, Michael; Mahendroo, Mala

    2014-01-01

    Globally, an estimated 13 million preterm babies are born each year. These babies are at increased risk of infant mortality and life-long health complications. Interventions to prevent preterm birth (PTB) require an understanding of processes driving parturition. Prostaglandins (PGs) have diverse functions in parturition, including regulation of uterine contractility and tissue remodeling. Our studies on cervical remodeling in mice suggest that although local synthesis of PGs are not increased in term ripening, transcripts encoding PG-endoperoxide synthase 2 (Ptgs2) are induced in lipopolysaccharide (LPS)-mediated premature ripening. This study provides evidence for two distinct pathways of cervical ripening: one dependent on PGs derived from paracrine or endocrine sources and the other independent of PG actions. Cervical PG levels are increased in LPS-treated mice, a model of infection-mediated PTB, consistent with increases in PG synthesizing enzymes and reduction in PG-metabolizing enzymes. Administration of SC-236, a PTGS2 inhibitor, along with LPS attenuated cervical softening, consistent with the essential role of PGs in LPS-induced ripening. In contrast, during term and preterm ripening mediated by the antiprogestin, mifepristone, cervical PG levels, and expression of PG synthetic and catabolic enzymes did not change in a manner that supports a role for PGs. These findings in mice, supported by correlative studies in women, suggest PGs do not regulate all aspects of the parturition process. Additionally, it suggests a need to refocus current strategies toward developing therapies for the prevention of PTB that target early, pathway-specific processes rather than focusing on common late end point mediators of PTB. PMID:24189143

  18. [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].

    PubMed

    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. PMID:25839361

  19. Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in The Netherlands.

    PubMed

    Verkerk, P H; Zaadstra, B M; Reerink, J D; Herngreen, W P; Verloove-Vanhorick, S P

    1994-02-01

    Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and easy access to medical care for all its inhabitants. Other risk factors that were taken into account were smoking, drinking, occupation, age and height. Information was collected by interview in the first 3 weeks of life of the mothers of 2027 (response 97%) live-born singletons born in the period from April 1988 to October 1989 in the study area. After adjustment for possible confounding factors very low social class, compared with high social class, was significantly associated with reduced birthweight (-4.0%; 95% CI, -7.4% to -0.7%), but not with preterm delivery (OR, 2.09; 95% CI, 0.67-6.48). The adjusted birthweight of Turkish infants (2.7%; 95% CI, -1.1% to 6.5%) and the adjusted birthweight of infants from Suriname or the Antilles (-1.6%; 95% CI, -5.5% to 2.1%) were not significantly different compared with infants of Dutch mothers. After adjustment, the frequency of preterm birth was lower in Turkish infants, but not significantly (OR, 0.22; 95% CI, 0.04-1.10), whereas the frequency of preterm birth in infants from Suriname or the Antilles was significantly higher (OR, 2.51; 95% CI, 1.04-6.08) compared with Dutch infants. Of the other factors the main risk factors were smoking (negatively related with birth-weight) and maternal age(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8194649

  20. Parental Ethnic Socialization and Adolescent Coping with Problems Related to Ethnicity.

    ERIC Educational Resources Information Center

    Phinney, Jean S.; Chavira, Victor

    1995-01-01

    Investigated ethnic socialization by parents of minority group adolescents and adolescents' ethnic identity and strategies for coping with stereotypes and discrimination. Interviewed 60 American-born adolescents drawn from 3 ethnic groups (Japanese, Mexican, African) and 1 parent of each adolescent. Discovered significant differences in parental…

  1. Bile salt-stimulated lipase of human milk: characterization of the enzyme from preterm and term milk

    SciTech Connect

    Freed, L.M.; Hamosh, P.; Hamosh, M.

    1986-03-01

    The bile salt-stimulated lipase (BSSL) of human milk is an important digestive enzyme in the newborn whose pancreatic function is immature. Milk from mothers delivering premature infants (preterm milk) has similar levels of BSSL activity to that of mothers of term infants (term milk). This study has determined whether the BSSL in preterm milk has the same characteristics as that in term milk. Milk samples were collected during the first 12 wk of lactation from seven mothers of infants born at 26-30 wk (very preterm, VPT), 31-37 wk (preterm, PT) and 37-42 wk (term, T) gestation. BSSL activity was measured using /sup 3/H-triolein emulsion as substrate. Time course, bile salt and enzyme concentration, pH and pH stability were studied, as well as inhibition of BSSL by eserine. The characteristics of BSSL from preterm and term milk were identical as were comparisons between colostrum and mature milk BSSL. BSSL from all milk sources had a neutral-to-alkaline pH optimum (pH 7.3-8.9), was stable at low pH for 60 min, and was 95-100% inhibited by eserine (greater than or equal to 0.6 mM). BSSL activity, regardless of enzyme source, was bile-salt dependent and was stimulated only by primary bile salts (taurocholate, glycocholate). The data indicate that the BSSL in milks of mothers delivering as early as 26 wk gestation is identical to that in term milk.

  2. Parenteral and enteral feeding in preterm piglets differently affects extracellular matrix proteins, enterocyte proliferation and apoptosis in the small intestine.

    PubMed

    Oste, Marijke; De Vos, Maartje; Van Haver, Els; Van Brantegem, Leen; Thymann, Thomas; Sangild, Per; Weyns, Andre; Van Ginneken, Chris

    2010-10-01

    The preterm intestine is immature and responds differently to total parenteral nutrition (TPN) and enteral nutrition, compared with the term intestine. We hypothesised that in preterms, diet composition and feeding route affect mucosal morphology, enterocyte mitosis and apoptosis, and the distribution of laminin-1, fibronectin and collagen IV (extracellular matrix proteins (ECMP)). Preterm piglets (93.5 % of gestation) were delivered via caesarean section and birth weight-matched allocated to one of the four experimental groups: the piglets were either euthanised immediately after delivery, after 3 d of TPN or after 2 d enteral feeding with colostrum or milk formula, following 3 d of TPN. We combined immunohistochemistry, image analysis and stereological measurements to describe the intestinal mucosal layer. No significant changes occurred after 3 d of TPN. Feeding colostrum or milk replacer for 2 d after TPN was associated with an increased crypt depth. Only enteral feeding with colostrum resulted in an increased villus height and mitotic index. Neither TPN nor enteral feeding changed the distribution pattern of ECMP or the occurrence of bifid crypts. The immature distribution pattern of ECMP in TPN-fed piglets, coupled with unchanged enterocyte mitosis and apoptosis indices, illustrates that feeding preterm pigs 3 d TPN does not lead to mucosal atrophy. Despite the invariable distribution of ECMP, colostrum was associated with crypt hyperplasia resulting in an increased villus height. These data illustrate that some mechanisms regulating cell turnover are immature in preterms and may in part explain the abnormal gut responses to TPN and enteral feeding in prematurely born pigs. PMID:20887647

  3. Progestogens to Prevent Preterm Birth: A Review of the Research about Progestogens for Women at Risk

    MedlinePlus

    ... Summary – Sept. 21, 2012 Progestogens To Prevent Preterm Birth: A Review of the Research About Progestogens for ... cfm . Understanding Your Condition What is spontaneous preterm birth? A preterm birth is when birth happens before ...

  4. Parent behaviors moderate the relationship between neonatal pain and internalizing behaviors at 18 months corrected age in children born very prematurely.

    PubMed

    Vinall, Jillian; Miller, Steven P; Synnes, Anne R; Grunau, Ruth E

    2013-09-01

    Children born very preterm (≤ 32 weeks gestation) exhibit greater internalizing (anxious/depressed) behaviors compared to term-born peers as early as 2 years corrected age (CA); however, the role of early stress in the etiology of internalizing problems in preterm children remains unknown. Therefore, we examined the relationship between neonatal pain and internalizing behavior at 18 months CA in children born very preterm and examined whether parent behavior and stress moderated this relationship. Participants were 145 children (96 very preterm, 49 full term) assessed at 18 months CA. Neonatal data were obtained from medical and nursing chart review. Neonatal pain was defined as the number of skin-breaking procedures. Cognitive ability was measured with the Bayley Scales of Infant Development II. Parents completed the Parenting Stress Index III, Child Behavior Checklist 1.5-5, and participated in a videotaped play session with their child, which was coded using the Emotional Availability Scale IV. Very preterm children displayed greater Internalizing behaviors compared to full-term control children (P=.02). Parent Sensitivity and Nonhostility moderated the relationship between neonatal pain and Internalizing behavior (all P<.05); higher parent education (P<.03), lower Parenting Stress (P=.001), and fewer children in the home (P<.01) were associated with lower Internalizing behavior in very preterm children, after adjusting for neonatal medical confounders, gender, and child cognitive ability (all P>.05). Parent Emotional Availability and stress were not associated with Internalizing behaviors in full-term control children. Positive parent interaction and lower stress appears to ameliorate negative effects of neonatal pain on stress-sensitive behaviors in this vulnerable population. PMID:23748079

  5. Between-Hospital Variation in Treatment and Outcomes in Extremely Preterm Infants

    PubMed Central

    Rysavy, Matthew A.; Li, Lei; Bell, Edward F.; Das, Abhik; Hintz, Susan R.; Stoll, Barbara J.; Vohr, Betty R.; Carlo, Waldemar A.; Shankaran, Seetha; Walsh, Michele C.; Tyson, Jon E.; Cotten, C. Michael; Smith, P. Brian; Murray, Jeffrey C.; Colaizy, Tarah T.; Brumbaugh, Jane E.; Higgins, Rosemary D.

    2015-01-01

    BACKGROUND Between-hospital variation in outcomes among extremely preterm infants is largely unexplained and may reflect differences in hospital practices regarding the initiation of active lifesaving treatment as compared with comfort care after birth. METHODS We studied infants born between April 2006 and March 2011 at 24 hospitals included in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Data were collected for 4987 infants born before 27 weeks of gestation without congenital anomalies. Active treatment was defined as any potentially lifesaving intervention administered after birth. Survival and neurodevelopmental impairment at 18 to 22 months of corrected age were assessed in 4704 children (94.3%). RESULTS Overall rates of active treatment ranged from 22.1% (interquartile range [IQR], 7.7 to 100) among infants born at 22 weeks of gestation to 99.8% (IQR, 100 to 100) among those born at 26 weeks of gestation. Overall rates of survival and survival without severe impairment ranged from 5.1% (IQR, 0 to 10.6) and 3.4% (IQR, 0 to 6.9), respectively, among children born at 22 weeks of gestation to 81.4% (IQR, 78.2 to 84.0) and 75.6% (IQR, 69.5 to 80.0), respectively, among those born at 26 weeks of gestation. Hospital rates of active treatment accounted for 78% and 75% of the between-hospital variation in survival and survival without severe impairment, respectively, among children born at 22 or 23 weeks of gestation, and accounted for 22% and 16%, respectively, among those born at 24 weeks of gestation, but the rates did not account for any of the variation in outcomes among those born at 25 or 26 weeks of gestation. CONCLUSIONS Differences in hospital practices regarding the initiation of active treatment in infants born at 22, 23, or 24 weeks of gestation explain some of the between-hospital variation in survival and survival without impairment among such patients. (Funded by the National Institutes

  6. Recent advances in the prevention and management of preterm birth

    PubMed Central

    Tan, Min Yi

    2015-01-01

    The management of preterm birth has seen major transformations in the last few decades with increasing interest worldwide, due to the impact of preterm birth on neonatal morbidity and mortality. The prevention strategies currently available for asymptomatic women at risk of preterm birth include progesterone, cervical cerclage and cervical pessary. Each approach has varying effects depending on the patient's prior history of preterm birth, cervical length and the presence of multiple gestations. There is a shift in the focus of antenatal treatment, with the use of prenatal magnesium sulphate and corticosteroids, to reduce neonatal intensive care admissions and longer-term disabilities associated with preterm birth, consequently relieving emotional and economical burden. This article provides an update on the recent advances in prevention and management approaches available for women at risk of preterm birth. PMID:26097713

  7. Passive Smoking and Preterm Birth in Urban China

    PubMed Central

    Qiu, Jie; He, Xiaochun; Cui, Hongmei; Zhang, Chong; Zhang, Honghong; Dang, Yun; Han, Xudong; Chen, Ya; Tang, Zhongfeng; Zhang, Hanru; Bai, Haiya; Xu, Ruifeng; Zhu, Daling; Lin, Xiaojuan; Lv, Ling; Xu, Xiaoying; Lin, Ru; Yao, Tingting; Su, Jie; Liu, Xiaohui; Wang, Wendi; Wang, Yueyuan; Ma, Bin; Liu, Sufen; Huang, Huang; Lerro, Catherine; Zhao, Nan; Liang, Jiaxin; Ma, Shuangge; Ehrenkranz, Richard A.; Liu, Qing; Zhang, Yawei

    2014-01-01

    Studies investigating the relationship between maternal passive smoking and the risk of preterm birth have reached inconsistent conclusions. A birth cohort study that included 10,095 nonsmoking women who delivered a singleton live birth was carried out in Lanzhou, China, between 2010 and 2012. Exposure to passive smoking during pregnancy was associated with an increased risk of very preterm birth (<32 completed weeks of gestation; odds ratio = 1.98, 95% confidence interval: 1.41, 2.76) but not moderate preterm birth (32–36 completed weeks of gestation; odds ratio = 0.98, 95% confidence interval: 0.81, 1.19). Risk of very preterm birth increased with the duration of exposure (P for trend = 0.0014). There was no variability in exposures by trimester. The associations were consistent for both medically indicated and spontaneous preterm births. Overall, our findings support a positive association between passive smoking and the risk of very preterm birth. PMID:24838804

  8. Cognitive correlates in toddlers born very low birth weight and full-term.

    PubMed

    Lowe, Jean; Erickson, Sarah J; MacLean, Peggy

    2010-12-01

    Understanding what contributes to children's cognitive development can improve our ability to identify those children at risk for later developmental disorders. We hypothesized that cognition would be more strongly associated with child and mother interaction variables such as communication, sensitivity and affect during play in contrast to medical variables in preterm children, and that these same variables would also be correlates of cognition in children born full-term. Cognition was measured by the Bayley Scales of Infant Development-II Mental Developmental Index and mother-toddler play interactions were coded with the Caregiver-Child Affect, Responsiveness and Engagement Scales (C-CARES) for child and mother affect, communication, and sensitivity in 40 very low birth weight (VLBW) and 54 full-term toddlers at 18-22 months of age, adjusted for gestational age. Two different multivariate models were identified that best predicted cognition in the two sets of toddlers. For the toddlers born VLBW, days on ventilation, maternal education and the three C-CARES Child Play scales (sensitivity, affect and communication) were the best predictors of cognition. In contrast, the multivariate model that best correlated with cognition for the children born full-term included the Maternal Communication scale of the C-CARES. The different multivariate models identified for toddlers born preterm compared to those born full-term emphasizes the importance of using identification and cognitive intervention techniques that are uniquely tailored for children born very low birth weight. Findings highlight the importance of investigating beyond more traditional measures of cognition by incorporating play-based socio-emotional measures. PMID:20708803

  9. Balloon-Borne Polarimetry

    NASA Astrophysics Data System (ADS)

    Rust, D. M.; Murphy, G.; Strohbehn, K.; Keller, C. U.

    1996-03-01

    For about two weeks in 1995, the balloon-borne Flare Genesis Experiment will continuously observe the Sun well above the turbulent, image-blurring layers of the Earth's atmosphere. The polarization-free 80 cm telescope will supply images to a liquid-crystal based vector magnetograph, which will measure magnetic features at a resolution of 0.2 arcsec. An electrically tunable lithium-niobate Fabry-Perot provides a spectral resolution of about 0.015 nm. In a follow-up series of Antarctic balloon flights, the Flare Genesis Experiment (FGE) will provide unprecedented details about sunspots, flares, magnetic elements, filaments, and the quiet solar atmosphere.

  10. Adolescent development

    MedlinePlus

    Development - adolescent; Growth and development - adolescent ... During adolescence, children develop the ability to: Understand abstract ideas. These include grasping higher math concepts, and developing moral ...

  11. Adolescent development

    MedlinePlus

    Development - adolescent; Growth and development - adolescent ... rights and privileges. Establish and maintain satisfying relationships. Adolescents will learn to share intimacy without feeling worried ...

  12. Bacterial Hyaluronidase Promotes Ascending GBS Infection and Preterm Birth

    PubMed Central

    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

  13. Bilirubin-Induced Neurotoxicity in the Preterm Neonate.

    PubMed

    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. PMID:27235209

  14. Predicting Preterm Labour: Current Status and Future Prospects

    PubMed Central

    Georgiou, Harry M.; Di Quinzio, Megan K. W.; Permezel, Michael; Brennecke, Shaun P.

    2015-01-01

    Preterm labour and birth are a major cause of perinatal morbidity and mortality. Despite modern advances in obstetric and neonatal management, the rate of preterm birth in the developed world is increasing. Yet even though numerous risk factors associated with preterm birth have been identified, the ability to accurately predict when labour will occur remains elusive, whether it is at a term or preterm gestation. In the latter case, this is likely due to the multifactorial aetiology of preterm labour wherein women may display different clinical presentations that lead to preterm birth. The discovery of novel biomarkers that could reliably identify women who will subsequently deliver preterm may allow for timely medical intervention and targeted therapeutic treatments aimed at improving maternal and fetal outcomes. Various body fluids including amniotic fluid, urine, saliva, blood (serum/plasma), and cervicovaginal fluid all provide a rich protein source of putative biochemical markers that may be causative or reflective of the various pathophysiological disorders of pregnancy, including preterm labour. This short review will highlight recent advances in the field of biomarker discovery and the utility of single and multiple biomarkers for the prediction of preterm birth in the absence of intra-amniotic infection. PMID:26160993

  15. Tick-borne encephalitis.

    PubMed

    Gritsun, T S; Lashkevich, V A; Gould, E A

    2003-01-01

    Tick-borne encephalitis (TBE) is one of the most dangerous human infections occurring in Europe and many parts of Asia. The etiological agent Tick-borne encephalitis virus (TBEV), is a member of the virus genus Flavivirus, of the family Flaviviridae. TBEV is believed to cause at least 11,000 human cases of encephalitis in Russia and about 3000 cases in the rest of Europe annually. Related viruses within the same group, Louping ill virus (LIV), Langat virus (LGTV) and Powassan virus (POWV), also cause human encephalitis but rarely on an epidemic scale. Three other viruses within the same group, Omsk hemorrhagic fever virus (OHFV), Kyasanur Forest disease virus (KFDV) and Alkhurma virus (ALKV), are closely related to the TBEV complex viruses and tend to cause fatal hemorrhagic fevers rather than encephalitis. This review describes the clinical manifestations associated with TBEV infections, the main molecular-biological properties of these viruses, and the different factors that define the incidence and severity of disease. The role of ticks and their local hosts in the emergence of new virus variants with different pathogenic characteristics is also discussed. This review also contains a brief history of vaccination against TBE including trials with live attenuated vaccine and modern tendencies in developing of vaccine virus strains. PMID:12615309

  16. Born Rule(s)

    NASA Astrophysics Data System (ADS)

    Sinha, Urbasi

    2011-09-01

    This paper is based on work published in [1]. It describes a triple slit experiment using single photons that has been used to provide a bound on one of the most fundamental axioms of quantum mechanics i.e. Born's rule for probabilities [2]. In spite of being one of the most successful theories which describes various natural phenomena, quantum mechanics has enough intricacies and "weirdness" associated with it which makes many physicists believe that it may not be the final theory and hints towards the possibility of more generalized versions. Quantum interference as shown by a double slit diffraction experiment only occurs from pairs of paths. Even in multi-slit versions, interference can only occur between pairs of possibilities and increasing the number of slits does not increase the complexity of the theory that still remains second-order. However, more generalized versions of quantum mechanics may allow for multi-path i.e. higher than second order interference. This experiment also provides a bound on the magnitude of such higher order interference. We have been able to bound the magnitude of three-path interference to less than 10-2 of the expected two-path interference, thus ruling out third and higher order interference and providing a bound on the accuracy of Born's rule.

  17. Microglia toxicity in preterm brain injury

    PubMed Central

    Baburamani, Ana A.; Supramaniam, Veena G.; Hagberg, Henrik; Mallard, Carina

    2014-01-01

    Microglia are the resident phagocytic cells of the central nervous system. During brain development they are also imperative for apoptosis of excessive neurons, synaptic pruning, phagocytosis of debris and maintaining brain homeostasis. Brain damage results in a fast and dynamic microglia reaction, which can influence the extent and distribution of subsequent neuronal dysfunction. As a consequence, microglia responses can promote tissue protection and repair following brain injury, or become detrimental for the tissue integrity and functionality. In this review, we will describe microglia responses in the human developing brain in association with injury, with particular focus on the preterm infant. We also explore microglia responses and mechanisms of microglia toxicity in animal models of preterm white matter injury and in vitro primary microglia cell culture experiments. PMID:24768662

  18. Maternal microbiome - A pathway to preterm birth.

    PubMed

    Vinturache, Angela E; Gyamfi-Bannerman, Cynthia; Hwang, Joseph; Mysorekar, Indira U; Jacobsson, Bo

    2016-04-01

    Despite great medical advances in preventing maternal and infant mortality in the past century, one issue remains unresolved: why do so many women give birth prematurely? A major new field of human microbiome studies has begun to shed light on the impact of microbes (of both the commensal and pathogen varieties) on pregnancy outcomes. Recent advances in next-generation sequencing and metagenomic analysis have revealed that maternal microbiomes at a variety of niches including the oral, vaginal, gut, cervical, and even the placenta itself govern pregnancy outcomes. In this review, we describe how alterations in the microbial biomasses impact preterm birth and we discuss the major research questions concerning the cause and/or interdependent relationships between microbiome, infection, and preterm delivery. PMID:26936188

  19. Parents as practitioners in preterm care.

    PubMed

    Jiang, Siyuan; Warre, Ruth; Qiu, Xiangming; O'Brien, Karel; Lee, Shoo K

    2014-11-01

    The very preterm birth of an infant is physiologically traumatic for the infant and physiologically and psychologically traumatic for the parents. The manner of care delivery in the first few days and weeks of the infant's life plays a large role in determining the impact of that trauma. For optimal outcomes parents need to be integrated into the care process as the primary practitioners of their infant's care in the neonatal intensive care unit. Supporting and enabling parents to be central to the care process establishes a consistent care environment where parents are in control and able to support their infant's physiological and psychological needs, thereby improving infant outcomes and reducing parent stress and anxiety. This article reviews the role of parents in the optimal development of preterm neonates, and discusses the elements crucial to promoting parent involvement in the neonatal intensive care unit and supporting parents following discharge. PMID:25246323

  20. [Association between Mycoplasma genitalium and preterm labor].

    PubMed

    Kovachev, E; Popova, A; Protopopov, F; Minkov, R; Tsvetkova, S

    2002-01-01

    M. genitalium was identified by using polymerase chain reaction (PCR). The samples were obtained from the posterior vaginal fornix between 21-25 gestation weeks and investigated for PH, Gram Stain for bacterial vaginosis; Chlamidia trachomartis; Neisseria gonorrhoeae; Trichomonas vaginalis. Of 102 pregnant women, only five had a PCR-positive for M. genitalium. The occurrence of M. genitalium in posterior vaginal fornix at midtrimester is infrequent in pregnant women and unlikely to be a contributing factor for spontaneous preterm birth. PMID:12577501

  1. Preterm EEG: a multimodal neurophysiological protocol.

    PubMed

    Stjerna, Susanna; Voipio, Juha; Metsäranta, Marjo; Kaila, Kai; Vanhatalo, Sampsa

    2012-01-01

    Since its introduction in early 1950s, electroencephalography (EEG) has been widely used in the neonatal intensive care units (NICU) for assessment and monitoring of brain function in preterm and term babies. Most common indications are the diagnosis of epileptic seizures, assessment of brain maturity, and recovery from hypoxic-ischemic events. EEG recording techniques and the understanding of neonatal EEG signals have dramatically improved, but these advances have been slow to penetrate through the clinical traditions. The aim of this presentation is to bring theory and practice of advanced EEG recording available for neonatal units. In the theoretical part, we will present animations to illustrate how a preterm brain gives rise to spontaneous and evoked EEG activities, both of which are unique to this developmental phase, as well as crucial for a proper brain maturation. Recent animal work has shown that the structural brain development is clearly reflected in early EEG activity. Most important structures in this regard are the growing long range connections and the transient cortical structure, subplate. Sensory stimuli in a preterm baby will generate responses that are seen at a single trial level, and they have underpinnings in the subplate-cortex interaction. This brings neonatal EEG readily into a multimodal study, where EEG is not only recording cortical function, but it also tests subplate function via different sensory modalities. Finally, introduction of clinically suitable dense array EEG caps, as well as amplifiers capable of recording low frequencies, have disclosed multitude of brain activities that have as yet been overlooked. In the practical part of this video, we show how a multimodal, dense array EEG study is performed in neonatal intensive care unit from a preterm baby in the incubator. The video demonstrates preparation of the baby and incubator, application of the EEG cap, and performance of the sensory stimulations. PMID:22371054

  2. Indicated preterm birth for fetal anomalies.

    PubMed

    Craigo, Sabrina D

    2011-10-01

    Between 2% and 3% of pregnancies are complicated by fetal anomalies. For most anomalies, there is no advantage to late preterm or early-term delivery. The risks of maternal or fetal complication are specific for each anomaly. Very few anomalies pose potential maternal risk. Some anomalies carry ongoing risks to the fetus, such as an increased risk of fetal death, hemorrhage, or organ damage. In a limited number of select cases, the advantages of late preterm or early-term birth may include avoiding an ongoing risk of fetal death related to the anomaly, allowing delivery in a controlled setting with availability of subspecialists and allowing direct care for the neonate with organ injury. The optimal gestational age for delivery cannot be determined for all pregnancies complicated by fetal anomalies. For most pregnancies complicated by anomalies, there is no change to obstetrical management regarding timing of delivery. For those that may benefit from late preterm or early-term delivery, variability exists such that each management plan should be individualized. PMID:21962626

  3. Unexpected behavioural consequences of preterm newborns' clothing.

    PubMed

    Durier, Virginie; Henry, Séverine; Martin, Emmanuelle; Dollion, Nicolas; Hausberger, Martine; Sizun, Jacques

    2015-01-01

    Restrictions of preterm newborns' movements could have consequences ranging from stress enhancement to impairment of their motor development. Therefore, ability to freely express motor activities appears crucial for their behavioural and physiological development. Our aim was to evaluate behavioural issues of two types of clothing used in NICU. We observed 18 healthy 34-37 post-conception week-old preterm newborns, during resting periods, when they were undisturbed by any interventions. Newborns wore either light clothing (bodysuit and a light wrapping) or heavy clothing (pyjamas, cardigan and sleep-sack). The percentages of time each subject spent in different postures were compared between clothing situations. Arm and hand postures differed in relation to clothing: babies bent their arms more and held their hands nearer their heads when in bodysuits than when in sleepwear. Consequently, babies in bodysuits spent more time touching their body or their environment whereas the others generally were touching nothing. Self-touch is an important way to comfort one's self. Heavy clothing may impair self-soothing behaviours of preterm newborn babies that already lack other forms of contact. Results suggest that more attention should be paid to apparently routine and marginal decisions such as choice of clothes. PMID:25776252

  4. Unexpected behavioural consequences of preterm newborns' clothing

    PubMed Central

    Durier, Virginie; Henry, Séverine; Martin, Emmanuelle; Dollion, Nicolas; Hausberger, Martine; Sizun, Jacques

    2015-01-01

    Restrictions of preterm newborns' movements could have consequences ranging from stress enhancement to impairment of their motor development. Therefore, ability to freely express motor activities appears crucial for their behavioural and physiological development. Our aim was to evaluate behavioural issues of two types of clothing used in NICU. We observed 18 healthy 34–37 post-conception week-old preterm newborns, during resting periods, when they were undisturbed by any interventions. Newborns wore either light clothing (bodysuit and a light wrapping) or heavy clothing (pyjamas, cardigan and sleep-sack). The percentages of time each subject spent in different postures were compared between clothing situations. Arm and hand postures differed in relation to clothing: babies bent their arms more and held their hands nearer their heads when in bodysuits than when in sleepwear. Consequently, babies in bodysuits spent more time touching their body or their environment whereas the others generally were touching nothing. Self-touch is an important way to comfort one's self. Heavy clothing may impair self-soothing behaviours of preterm newborn babies that already lack other forms of contact. Results suggest that more attention should be paid to apparently routine and marginal decisions such as choice of clothes. PMID:25776252

  5. Executive Function Skills are Associated with Reading and Parent-Rated Child Function in Children Born Prematurely

    PubMed Central

    Loe, Irene M.; Lee, Eliana S.; Luna, Beatriz; Feldman, Heidi M.

    2011-01-01

    Background Preterm children are at risk for executive function (EF) problems, which have been linked to behavior and learning problems in full term children. In this study, we examine the relationship between EF and functional outcomes in preterm children. Aims To evaluate (1) EF skills of 9- to 16-year-old children born across the spectrum of gestational age (GA), (2) relationship of degree of prematurity to EF skills, and (3) contributions of EF skills to two functional outcomes--reading scores and parent-rated child function. Method Preterm children <36 weeks gestation (n=72) were compared to full term children (n=42) of similar age, gender and SES, on measures of EF, reading, and parent-ratings of child function. Multiple regression models evaluated contributions to EF skills and functional outcomes. Results Compared to full term controls, preterm children had poorer EF performance on a complex planning and organization task and did not increase planning time as task difficulty increased. Their spatial memory capacity was not different. GA contributed to EF skills, but was mediated by IQ. EF contributed to the variance in reading skills but did not add to the variance in reading when IQ was considered. EF skills significantly contributed to the variance in parent-rated child function, but IQ did not. Conclusion EF skills contribute to measures of functional outcome in this high-risk population. The use of EF skills as an early marker for learning and functional problems and as a target for intervention in children born preterm warrants future study. PMID:21849240

  6. Altered Structural and Functional Connectivity in Late Preterm Preadolescence: An Anatomic Seed-Based Study of Resting State Networks Related to the Posteromedial and Lateral Parietal Cortex

    PubMed Central

    Degnan, Andrew J.; Wisnowski, Jessica L.; Choi, SoYoung; Ceschin, Rafael; Bhushan, Chitresh; Leahy, Richard M.; Corby, Patricia; Schmithorst, Vincent J.; Panigrahy, Ashok

    2015-01-01

    Objective Late preterm birth confers increased risk of developmental delay, academic difficulties and social deficits. The late third trimester may represent a critical period of development of neural networks including the default mode network (DMN), which is essential to normal cognition. Our objective is to identify functional and structural connectivity differences in the posteromedial cortex related to late preterm birth. Methods Thirty-eight preadolescents (ages 9–13; 19 born in the late preterm period (≥32 weeks gestational age) and 19 at term) without access to advanced neonatal care were recruited from a low socioeconomic status community in Brazil. Participants underwent neurocognitive testing, 3-dimensional T1-weighted imaging, diffusion-weighted imaging and resting state functional MRI (RS-fMRI). Seed-based probabilistic diffusion tractography and RS-fMRI analyses were performed using unilateral seeds within the posterior DMN (posterior cingulate cortex, precuneus) and lateral parietal DMN (superior marginal and angular gyri). Results Late preterm children demonstrated increased functional connectivity within the posterior default mode networks and increased anti-correlation with the central-executive network when seeded from the posteromedial cortex (PMC). Key differences were demonstrated between PMC components with increased anti-correlation with the salience network seen only with posterior cingulate cortex seeding but not with precuneus seeding. Probabilistic tractography showed increased streamlines within the right inferior longitudinal fasciculus and inferior fronto-occipital fasciculus within late preterm children while decreased intrahemispheric streamlines were also observed. No significant differences in neurocognitive testing were demonstrated between groups. Conclusion Late preterm preadolescence is associated with altered functional connectivity from the PMC and lateral parietal cortex to known distributed functional cortical networks

  7. Brain network characterization of high-risk preterm-born school-age children

    PubMed Central

    Fischi-Gomez, Elda; Muñoz-Moreno, Emma; Vasung, Lana; Griffa, Alessandra; Borradori-Tolsa, Cristina; Monnier, Maryline; Lazeyras, François; Thiran, Jean-Philippe; Hüppi, Petra S.

    2016-01-01

    Higher risk for long-term cognitive and behavioral impairments is one of the hallmarks of extreme prematurity (EP) and pregnancy-associated fetal adverse conditions such as intrauterine growth restriction (IUGR). While neurodevelopmental delay and abnormal brain function occur in the absence of overt brain lesions, these conditions have been recently associated with changes in microstructural brain development. Recent imaging studies indicate changes in brain connectivity, in particular involving the white matter fibers belonging to the cortico-basal ganglia-thalamic loop. Furthermore, EP and IUGR have been related to altered brain network architecture in childhood, with reduced network global capacity, global efficiency and average nodal strength. In this study, we used a connectome analysis to characterize the structural brain networks of these children, with a special focus on their topological organization. On one hand, we confirm the reduced averaged network node degree and strength due to EP and IUGR. On the other, the decomposition of the brain networks in an optimal set of clusters remained substantially different among groups, talking in favor of a different network community structure. However, and despite the different community structure, the brain networks of these high-risk school-age children maintained the typical small-world, rich-club and modularity characteristics in all cases. Thus, our results suggest that brain reorganizes after EP and IUGR, prioritizing a tight modular structure, to maintain the small-world, rich-club and modularity characteristics. By themselves, both extreme prematurity and IUGR bear a similar risk for neurocognitive and behavioral impairment, and the here defined modular network alterations confirm similar structural changes both by IUGR and EP at school age compared to control. Interestingly, the combination of both conditions (IUGR + EP) does not result in a worse outcome. In such cases, the alteration in network topology appears mainly driven by the effect of extreme prematurity, suggesting that these brain network alterations present at school age have their origin in a common critical period, both for intrauterine and extrauterine adverse conditions. PMID:26955515

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

    PubMed Central

    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 <30 weeks’ gestational age or <1,250 g were recruited from all admissions to the 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

  9. Plastic Bags for Prevention of Hypothermia in Preterm and Low Birth Weight Infants

    PubMed Central

    Leadford, Alicia E.; Warren, Jamie B.; Manasyan, Albert; Chomba, Elwyn; Salas, Ariel A.; Schelonka, Robert

    2013-01-01

    BACKGROUND AND OBJECTIVES: Hypothermia contributes to neonatal mortality and morbidity, especially in preterm and low birth weight infants in developing countries. Plastic bags covering the trunk and extremities of very low birth weight infants reduces hypothermia. This technique has not been studied in larger infants or in many resource-limited settings. The objective was to determine if placing preterm and low birth weight infants inside a plastic bag at birth maintains normothermia. METHODS: Infants at 26 to 36 weeks’ gestational age and/or with a birth weight of 1000 to 2500 g born at the University Teaching Hospital in Lusaka, Zambia, were randomized by using a 1:1 allocation and parallel design to standard thermoregulation (blanket or radiant warmer) care or to standard thermoregulation care plus placement inside a plastic bag at birth. The primary outcome measure was axillary temperature in the World Health Organization–defined normal range (36.5–37.5°C) at 1 hour after birth. RESULTS: A total of 104 infants were randomized. At 1 hour after birth, infants randomized to plastic bag (n = 49) were more likely to have a temperature in the normal range as compared with infants in the standard thermoregulation care group (n = 55; 59.2% vs 32.7%; relative risk 1.81; 95% confidence interval 1.16–2.81; P = .007). The temperature at 1 hour after birth in the infants randomized to plastic bag was 36.5 ± 0.5°C compared with 36.1 ± 0.6°C in standard care infants (P < .001). Hyperthermia (>38.0°C) did not occur in any infant. CONCLUSIONS: Placement of preterm/low birth weight infants inside a plastic bag at birth compared with standard thermoregulation care reduced hypothermia without resulting in hyperthermia, and is a low-cost, low-technology tool for resource-limited settings. PMID:23733796

  10. Vitamin D nutritional status in preterm infants and response to supplementation.

    PubMed

    McCarthy, Roberta A; McKenna, Malachi J; Oyefeso, Oyinkansola; Uduma, Ogenna; Murray, Barbara F; Brady, Jennifer J; Kilbane, Mark T; Murphy, John F; Twomey, Anne; O' Donnell, Colm P; Murphy, Nuala P; Molloy, Eleanor J

    2013-07-14

    Little is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol/l (20 ng/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11-28) d, found that 78 % had serum 25OHD levels below 50 nmol/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r 2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78-127) d, 87 % achieved levels ≥ 50 nmol/l and 8 % had levels >125 nmol/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection. PMID:23182428

  11. Early outcome of pre-term neonates delivered at Soba University Hospital

    PubMed Central

    Salih, Sarah A/Salam; A/Gadir, Yahia S

    2013-01-01

    In Sudan, several studies have been conducted on low birth weight, a few concentrated on pre-term births per se. The objectives of this study were to describe maternal and obstetric factors predisposing to pre-term delivery, to determine the incidence of early neonatal complications, to identify causes of early neonatal deaths and to determine survival rates relative to gestational age and birth weight. A descriptive hospital-based study was conducted at Soba University Hospital, over a seven months-period, from December 2003 to June 2004. One hundred consecutively born premature infants were followed up from the moment of delivery till the end of the first week of life. Chi squared tests and p-values, using confidence intervals of 95%, were used for analysis. Eighty four mothers gave birth to 100 premature babies who were admitted to the Neonatal Unit of Soba University Hospital. Pregnancy induced hypertension (38.1%), multiple pregnancy ( 29%) and maternal infection ( 42.9%) were the main obstetric factors predisposing to premature birth. Morbidity among the pre-term birth population showed that respiratory distress syndrome was the main disease accounting for 36% and 46.2% of the deaths, respectively. Neonatal jaundice, apnoea, and neonatal infection occurred in 46%, 16% and 14% of the premature infants, respectively. However, respiratory distress syndrome and apnoea have been strongly associated with early neonatal mortality (P<0.05). A survival rate for the whole premature infant study was 74% and survival rates increased with increasing gestational age and increasing birth weight.

  12. Monitoring Lung Aeration during Respiratory Support in Preterm Infants at Birth

    PubMed Central

    Kang, Liane J.; Cheung, Po-Yin; Pichler, Gerhard; O’Reilly, Megan; Aziz, Khalid; Schmölzer, Georg M.

    2014-01-01

    Background If infants fail to initiate spontaneous breathing, resuscitation guidelines recommend respiratory support with positive pressure ventilation (PPV). The purpose of PPV is to establish functional residual capacity and deliver an adequate tidal volume (VT) to achieve gas exchange. Objective The aim of our pilot study was to measure changes in exhaled carbon dioxide (ECO2), VT, and rate of carbon dioxide elimination (VCO2) to assess lung aeration in preterm infants requiring respiratory support immediately after birth. Method A prospective observational study was performed between March and July 2013. Infants born at <37 weeks gestational age who received continuous positive airway pressure (CPAP) or PPV immediately after birth had VT delivery and ECO2 continuously recorded using a sensor attached to the facemask. Results Fifty-one preterm infants (mean (SD) gestational age 29 (3) weeks and birth weight 1425 (592 g)) receiving respiratory support in the delivery room were included. Infants in the CPAP group (n = 31) had higher ECO2 values during the first 10 min after birth compared to infants receiving PPV (n = 20) (ranging between 18–30 vs. 13–18 mmHg, p<0.05, respectively). At 10 min no significant difference in ECO2 values was observed. VT was lower in the CPAP group compared to the PPV group over the first 10 min ranging between 5.2–6.6 vs. and 7.2–11.3 mL/kg (p<0.05), respectively. Conclusions Immediately after birth, spontaneously breathing preterm infants supported via CPAP achieved better lung aeration compared to infants requiring PPV. PPV guided by VT and ECO2 potentially optimize lung aeration without excessive VT administered. PMID:25029553

  13. Preterm infant linear growth and adiposity gain: tradeoffs for later weight status, and IQ

    PubMed Central

    Belfort, Mandy B.; Gillman, Matthew W.; Buka, Stephen L.; Casey, Patrick H.; McCormick, Marie C.

    2013-01-01

    Objective Among preterm infants, to examine tradeoffs between cognitive outcome and overweight/obesity at school age and in young adulthood in relation to infancy weight gain and linear growth. Study design We studied 945 participants in the Infant Health and Development Program, an 8-center study of preterm (≤37 weeks), low birth weight (≤2500 grams) infants from birth to 18 years. Adjusting for maternal and child factors in logistic regression, we estimated the odds of overweight/obesity (BMI ≥85th percentile at age 8 or ≥25 kg/m2 at age 18) and in separate models, low IQ (<85) per z-score change in infant length and BMI from term to 4 months, 4-12 months, and 12-18 months. Results More rapid linear growth from term to 4 months was associated with lower odds of IQ<85 at age 8 (OR 0.82, 95% CI 0.70, 0.96), but a higher odds of overweight/obesity (OR 1.27, 95% CI 1.05, 1.53). More rapid BMI gain in all 3 infant time intervals was also associated with a higher odds of overweight/obesity, and from 4-12 months with a lower odds of IQ <85 at age 8. Results at age 18 were similar. Conclusions In preterm, low birth weight infants born in the 1980’s, faster linear growth soon after term was associated with better cognition but also with a higher risk of overweight/obesity at 8 and 18 years of age. BMI gain over the entire 18 months after term was associated with later risk of overweight/obesity, with less evidence for a benefit to IQ. PMID:23910982

  14. Recombinant Bile Salt-Stimulated Lipase in Preterm Infant Feeding: A Randomized Phase 3 Study

    PubMed Central

    Casper, Charlotte; Hascoet, Jean-Michel; Ertl, Tibor; Gadzinowski, Janusz S.; Carnielli, Virgilio; Rigo, Jacques; Lapillonne, Alexandre; Couce, María L.; Vågerö, Mårten; Palmgren, Ingrid; Timdahl, Kristina; Hernell, Olle

    2016-01-01

    Introduction Feeding strategies are critical for healthy growth in preterm infants. Bile salt-stimulated lipase (BSSL), present in human milk, is important for fat digestion and absorption but is inactivated during pasteurization and absent in formula. This study evaluated if recombinant human BSSL (rhBSSL) improves growth in preterm infants when added to formula or pasteurized breast milk. Patients and Methods LAIF (Lipase Added to Infant Feeding) was a randomized, double-blind, placebo-controlled phase 3 study in infants born before 32 weeks of gestation. The primary efficacy variable was growth velocity (g/kg/day) during 4 weeks intervention. Follow-up visits were at 3 and 12 months. The study was performed at 54 centers in 10 European countries. Results In total 415 patients were randomized (rhBSSL n = 207, placebo n = 208), 410 patients were analyzed (rhBSSL n = 206, placebo n = 204) and 365 patients were followed until 12 months. Overall, there was no significantly improved growth velocity during rhBSSL treatment compared to placebo (16.77 vs. 16.56 g/kg/day, estimated difference 0.21 g/kg/day, 95% CI [-0.40; 0.83]), nor were secondary endpoints met. However, in a predefined subgroup, small for gestational age infants, there was a significant effect on growth in favor of rhBSSL during treatment. The incidence of adverse events was higher in the rhBSSL group during treatment. Conclusions Although this study did not meet its primary endpoint, except in a subgroup of infants small for gestational age, and there was an imbalance in short-term safety, these data provide insights in nutrition, growth and development in preterm infants. Trial Registration ClinicalTrials.gov NCT01413581 PMID:27244221

  15. Promoting Moral Maturity among Adolescents: An Ethnographic Study of the Israeli Kibbutz.

    ERIC Educational Resources Information Center

    Snarey, John

    1987-01-01

    A longitudinal ethnographic study of adolescent moral development in an Israeli kibbutz examined the process by which urban-born adolescents, "adopted" by the kibbutz, and their kibbutz-born peers are socialized into a cohesive group. Kibbutz educators support the development of democratic self-governing peer groups that foster community…

  16. Protective and Risk Influences of Drug Use among a Multiethnic Sample of Adolescent Boys

    ERIC Educational Resources Information Center

    Galaif, E. R.; Newcomb, M. D.; Vega, W. A.; Krell, R. D.

    2007-01-01

    A measurement model was analyzed to demonstrate a differential distribution and cumulative exposure to psychosocial risk and protective influences of adolescent drug use among ethnically-diverse adolescent samples. The sample included U.S.-born (US) Latino (N = 837), foreign-born (FB) Latino (N = 447), White (N = 632), and African American (N =…

  17. Neuropsychological Outcomes in Extremely Preterm Preschoolers Exposed to Tiered Low Oxygen Targets: An Observational Study.

    PubMed

    Baron, Ida Sue; Weiss, Brandi A; Baker, Robin; Ahronovich, Margot D; Litman, Fern R; Baveja, Rajiv

    2016-03-01

    An observational study of neuropsychological outcomes at preschool age of tiered lowered oxygen (O2) saturation targets in extremely preterm neonates. We studied 111 three-year-olds born <28 weeks' gestational age. Fifty-nine participants born in 2009-2010 during a time-limited quality improvement initiative each received three-tiered stratification of oxygen rates (83-93% until age 32 weeks, 85-95% until age 35 weeks, and 95% after age 35 weeks), the TieredO2 group. Comparisons were made with 52 participants born in 2007-2008 when pre-initiative saturation targets were non-tiered at 89-100%, the Non-tieredO2 group. Neuropsychological domains included general intellectual, executive, attention, language, visuoperceptual, visual-motor, and fine and gross motor functioning. Descriptive and inferential analyses were conducted. Group comparisons were not statistically significant. Descriptively, the TieredO2 group had better general intellectual, executive function, visual-motor, and motor performance and the Non-tieredO2 group had better language performance. Cohen's d and confidence intervals around d were in similar direction and magnitude across measures. A large effect size was found for recall of digits-forward in participants born at 23 and 24 weeks' gestation, d=0.99 and 1.46, respectively. Better TieredO2 outcomes in all domains except language suggests that the tiered oxygen saturation target method is not harmful and merits further investigation through further studies. Benefit in auditory attention appeared greatest in those born at 23 and 24 weeks. Participants in the tiered oxygen saturation group also had fewer ventilation days and a lower incidence of bronchopulmonary dysplasia, perhaps explanatory for these neuropsychological outcomes at age 3. (JINS, 2015, 21, 322-331). PMID:26646724

  18. The adaptation of Chinese adolescents in two societies: a comparison of Chinese adolescents in Hong Kong and Australia.

    PubMed

    Leung, Cynthia; Karnilowicz, Wally

    2009-06-01

    This study aimed to compare the adaptation of two groups of migrant Chinese adolescents with their nonmigrant peers. The migrant adolescents included 55 Chinese migrant adolescents who migrated to Australia (Chinese-Australian) and 111 China-born adolescents who migrated to Hong Kong (Chinese-Hong Kong). The nonmigrant adolescents included 157 Anglo-Australian adolescents residing in Australia and 456 Hong Kong-born Chinese adolescents residing in Hong Kong. There were three research questions in this study. First, would there be any differences in the adaptation of Chinese migrant adolescents in different societies of settlement? Second, would migrant adolescents experience more adaptation problems than nonmigrant adolescents? Third, would there be any differences in the adaptation of adolescents in the two societies, Australia and Hong Kong? It was hypothesized that: (1) mainland Chinese migrant adolescents in Hong Kong would experience more adaptation problems than Chinese migrant adolescents in Australia; (2) migrant adolescents would report better adaptation than nonmigrant adolescents; (3) adolescents in Hong Kong would report poorer adaptation than adolescents in Australia. The participants were requested to complete a questionnaire on various adaptation outcome measures including life satisfaction, self-esteem, psychological symptoms, academic satisfaction, and behaviour problems. The results indicated that Chinese-Australian adolescents reported better psychological adaptation but Chinese-Hong Kong adolescents reported better sociocultural adaptation. Adolescents resident in Australia reported higher psychological adaptation but lower sociocultural adaptation than those in Hong Kong. Migrant adolescents reported better psychological and sociocultural adaptation than their nonmigrant counterparts. The results were discussed in relation to the social and educational systems of the two societies. PMID:22029492

  19. System-level biomechanical approach for the evaluation of term and preterm pregnancy maintenance.

    PubMed

    Mahmoud, Hussam; Wagoner Johnson, Amy; Chien, Edward K; Poellmann, Michael J; McFarlin, Barbara

    2013-02-01

    Preterm birth is the primary contributor to perinatal morbidity and mortality, with those born prior to 32 weeks disproportionately contributing compared to those born at 32-37 weeks. Outcomes for babies born prematurely can be devastating. Parturition is recognized as a mechanical process that involves the two processes that are required to initiate labor: rhythmic myometrial contractions and cervical remodeling with subsequent dilation. Studies of parturition tend to separate these two processes rather than evaluate them as a unified system. The mechanical property characterization of the cervix has been primarily performed on isolated cervical tissue, with an implied understanding of the contribution from the uterine corpus. Few studies have evaluated the function of the uterine corpus in the absence of myometrial contractions or in relationship to retaining the fetus. Therefore, the cervical-uterine interaction has largely been neglected in the literature. We suggest that a system-level biomechanical approach is needed to understand pregnancy maintenance. To that end, this paper has two main goals. One goal is to highlight the gaps in current knowledge that need to be addressed in order to develop any comprehensive and clinically relevant models of the system. The second goal is to illustrate the utility of finite element models in understanding pregnancy maintenance of the cervical-uterine system. The paper targets an audience that includes the reproductive biologist/clinician and the engineer/physical scientist interested in biomechanics and the system level behavior of tissues. PMID:23445054

  20. Brain Growth Gains and Losses in Extremely Preterm Infants at Term.

    PubMed

    Padilla, Nelly; Alexandrou, Georgios; Blennow, Mats; Lagercrantz, Hugo; Ådén, Ulrika

    2015-07-01

    Premature exposure to the extrauterine environment negatively affects the brains' developmental trajectory. Our aim was to determine whether extremely preterm (EPT) infants, with no evidence of focal brain lesions, show morphological brain differences when compared with term-born infants. Additionally, we investigated associations between perinatal factors and neuroanatomical alterations. Conventional magnetic resonance imaging was acquired at term-equivalent age (TEA) from 47 EPT infants born before 27 weeks of gestation, and 15 healthy, term-born controls. Automatic segmentation and voxel-based morphometry-Diffeomorphic Anatomical Registration through Exponentiated Lie algebra (DARTEL) were used. Compared with controls, EPT infants displayed global reductions in cortical and subcortical gray matter, brainstem, and an increased cerebrospinal fluid volume. Regionally, they showed decreased volumes of all brain tissues, in particular cortical gray matter. Increased volumes of cortical gray and white matter were observed in regions involved in visual processing. Increasing prematurity, intraventricular hemorrhage grade I-II, and patent ductus arteriosus ligation were associated with decreased volumes and had a particular effect on the cerebellum. Concluding, EPT infants without focal brain lesions had an altered brain growth at TEA that particularly affected the gray matter, and varied when it came to the presence of perinatal risk factors. Brain growth gains in EPT infants may be related to a longer extrauterine experience. PMID:24488941