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Preterm
Kinds of Preterm Terms modified by Preterm Selected AbstractsContingency Learning and Reactivity in Preterm and Full-Term Infants at 3 MonthsINFANCY, Issue 6 2008David W. Haley Learning difficulties in preterm infants are thought to reflect impairment in arousal regulation. We examined relationships among gestational age, learning speed, and behavioral and physiological reactivity in 55 preterm and 49 full-term infants during baseline, contingency, and nonreinforcement phases of a conjugate mobile paradigm at 3 months corrected age. For all infants, negative affect, looking duration, and heart rate levels increased during contingency and nonreinforcement phases, whereas respiratory sinus arrhythmia (RSA, an index of parasympathetic activity) decreased and Cortisol did not change. Learners showed greater RSA suppression and less negative affect than nonleamers. This pattern was particularly evident in the preterm group. Overall, preterm infants showed less learning, spent less time looking at the mobile, and had lower Cortisol levels than full-term infants. Preterm infants also showed greater heart rate responses to contingency and dampened heart rate responses to nonreinforcement compared to full-term infants. Findings underscore differences in basal and reactivity measures in preterm compared to full-term infants and suggest that the capacity to regulate parasympathetic activity during a challenge enhances learning in preterm infants. [source] Predicting Individual Differences in Recall by Infants Born Preterm and Full TermINFANCY, Issue 1 2006Carol L. Cheatham A heterogeneous sample of infants with preterm histories and infants born full term participated in a study of declarative memory and rate of encoding, as measured in an imitation task and an examining task, respectively. Here we report the comparisons of the performances of infants born very preterm (27,34 weeks gestation) and moderately preterm (35,37 weeks gestation) to infants born full term (38,41 weeks gestation) and tested at 12 months corrected age (from due date). Lower levels of recall were seen among the infants born very preterm. Rate of encoding, weeks gestation, and score on the Mental Development Index (MDI) of the Bayley Scales of Infant Development were tested as possible sources of individual differences in recall. Rate of encoding and MDI predicted delayed ordered recall. Implications for early detection of cognitive difficulties in children with preterm histories are discussed. [source] Development of Tactile Responses in Human Preterm and Full-Term Infants From 30 to 40 Weeks Postconceptional AgeINFANCY, Issue 1 2002Isabel Fearon Maturation of tactile sensitivity prior to term was examined in 36 preterm and 13 full-term infants using a fixed-trial, habituation procedure. Each infant was presented with a series of 8 habituation (arm stroke), 2 novel (arm lift), and 2 recovery (arm stroke) stimulus trials while heart rate and body movements were recorded. Maturation was observed with a gradual increase in the magnitude of the stimulus-elicited cardiac acceleration and cardiac-movement coupling from 30 to 40 weeks postconceptional age. The majority of infants displayed habituation,an excitatory response (heart rate acceleration and body movement),to the initial presentation of a tactile stimulus, response decline with repeated stimulations, and renewed response to a novel stimulus. A substantial number of infants (40%) failed to respond initially to the tactile stimulus, increased responding over several stimulus presentations, and failed to discriminate the presentation of a novel stimulus. We speculate that these differences in response patterns observed over all ages represent individual difference in the perception of stimulus intensity. [source] Olfactory Familiarization and Discrimination in Preterm and Full-Term NewbornsINFANCY, Issue 1 2002Nathalie Goubet The purpose of this study was to observe olfactory detection and discrimination in preterm and full-term newborns. Infants were familiarized for 10 trials with either vanillin or anethole. On each trial, a cotton swab perfumed with one of the odors was slowly moved in front of the baby's nose for 10 sec. For half of the preterm and full-term infants, a new odor was presented after the last familiarization trial (experimental groups). For the other half, the same odor as during familiarization was presented (control groups). Facial and head movements for both populations and heart rates for preterm infants were recorded before, during, and after odor presentation. Preterm infants reacted to the scents by increasing facial actions and heart rate but not head movements. Full-term infants increased facial and head movements. Neither population showed a clear behavioral habituation pattern, but full-term newborns had a significantly reduced facial reactivity on the last familiarization trial compared to preterm infants. Preterm newborns did, however, show cardiac habituation on the last familiarization trial. Preterm and full-term infants presented with a new odor after familiarization increased responding compared to infants presented with the same odor, indicating their ability to discriminate between 2 odors. Infants' reactivity and discrimination to odors indicate preterm and full-term newborns' ability to be attuned to their olfactory environment. [source] Umbilical serum concentrations of chemokines (RANTES and MGSA/GRO-,) in preterm and term neonatesPEDIATRICS INTERNATIONAL, Issue 6 2006BARBARA KRÓLAK-OLEJNIK Abstract Background: The objective of this study was to explore the relationship between labor (preterm and term) and umbilical blood serum regulated on activation, normal T cell expressed and secreted (RANTES) and melanoma growth stimulatory activity/growth-related oncogene-a (MSGA/GRO-,) concentration, and to determine whether early sepsis and pneumonia are associated with changes in concentrations of the chemokines (RANTES and MSGA/GRO-,) in umbilical blood serum. Methods: Umbilical blood was obtained from 67 neonates in the following groups: (i) preterm neonates with early sepsis; (ii) preterm neonates with pneumonia; (iii) non-infected preterm neonates; and (iv) full-term healthy neonates. RANTES and MGSA/GRO-, concentrations were determined by use of a commercially available immunoassay kit. Results: Non-infected preterm neonates had lower RANTES concentrations than healthy term neonates. Preterm infected neonates (pneumonia or sepsis) did not have higher RANTES concentrations than non-infected preterm neonates. In contrast, non-infected preterm neonates had higher MSGA/GRO-, concentrations than full-term healthy neonates. And preterm neonates with sepsis had higher MGSA/GRO-, concentrations than preterm ones with pneumonia and non-infected preterm ones. Conclusions: Preterm neonates had constitutively lower RANTES concentrations than term ones and it seems that during infection RANTES concentrations did not increase. MGSA/GRO-a concentrations were constitutively higher in preterm than term neonates, and septic events further increased its concentrations in preterm neonates. [source] Preterm and at term children: morphological and functional analysis of optic nerve and visual pathway with OCT, HRT and pVEPACTA OPHTHALMOLOGICA, Issue 2009R ANGELI Purpose To compare optic nerve morphology and visual function in 14 preterm children(mean gestational age:33,38) with normal cerebral ultrasound at birth and 15 at term children (mean gestational age:39,67). Methods Mean preterm age was 7,6 years, mean at term was 9,1 years. Children underwent to complete functional and morphological evaluation of Optic Nerve Head (ONH) with Heidelberg Retinal Tomography and Optical Coherence Tomography. The same children were evaluated at birth and at the time of morphological examinations by mean of transient and steady state pVEP. Results Mean visual acuity was 9,85 in the preterm, 10 in the at term children. HRT in preterm and at term children at term(n=28) preterm(n=25) P value mean sd mean sd Disc Area 2,5 0,7 2,34 0,68 0,38 Cup Area 0,50 0,44 0,58 0,47 0,51 Rim Area 2 0,45 1,76 0,37 0,047 C/D Area Ratio 0,18 0,12 0,22 0,14 0,23 C/D Linear Ratio 0,4 0,15 0,45 0,16 0,30 Mean RNFL Thick 0,2 0,07 0,24 0,2 0,26 Tab.1 A statistically significant reduction was found in preterm children as regard rim area (p=0,047,tab 1) at HRT and superior RNFL thickness (p=0,01), temporal and inferior inner macular thickness (p=0,03) at OCT. Differences in the pVep latencies were found at 3 and 8 months after birth, but not at the time of morphological examination. Steady State pVEP amplitudes differences were not statistically significant. Conclusion Morphologic optic disk and macula differences between term and preterm children seems not functionally affect the visual pathway. [source] Development of swallowing and feeding: Prenatal through first year of lifeDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2008Amy L. Delaney Abstract The development of feeding and swallowing involves a highly complex set of interactions that begin in embryologic and fetal periods and continue through infancy and early childhood. This article will focus on swallowing and feeding development in infants who are developing normally with a review of some aspects of prenatal development that provide a basis for in utero sucking and swallowing. Non-nutritive sucking in healthy preterm infants, nipple feeding in preterm and term infants, and selected processes of continued development of oral skills for feeding throughout the first year of life will be discussed. Advances in research have provided new information in our understanding of the neurophysiology related to swallowing, premature infants' sucking and swallowing patterns, and changes in patterns from preterm to near term to term infants. Oral skill development as texture changes are made throughout the second half of the first year of life is an under studied phenomenon. Knowledge of normal developmental progression is essential for professionals to appreciate differences from normal in infants and children with feeding and swallowing disorders. Additional research of infants and children who demonstrate overall typical development in oral skills for feeding is encouraged and will provide helpful reference points in increasing understanding of children who exhibit differences from typical development. It is hoped that new technology will provide noninvasive means of delineating all phases of sucking and swallowing from prenatal through infancy. Further related topics in other articles of this issue provide a comprehensive review of factors influencing oral intake, growth, nutrition, and neurodevelopmental status of children. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:105,117. [source] Assessment of gestational age and neuromaturationDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 1 2005Marilee C. Allen Abstract Neuromaturation is the functional development of the central nervous system (CNS). It is by its very nature a dynamic process, a continuous interaction between the genome and first the intrauterine environment, then the extrauterine environment. Understanding neuromaturation and being able to measure it is fundamental to infant neurodevelopmental assessment. Fetal and preterm neuromaturation has become easier to observe with the advent of prenatal ultrasonography and neonatal intensive care units. A number of measures of degree of fetal maturation have been developed and used to estimate gestational age (GA) at birth. The most reliable measures of GA are prenatal measures, especially from the first trimester. Postnatal GA measurements tend to be least accurate at the extremes of gestation, that is, in extremely preterm and post-term infants. Observations of measures of neuromaturation in infants born to mothers with pregnancy complications, including intrauterine growth restriction, multiple gestation, and chronic hypertension, have led to the discovery that stressed pregnancies may accelerate fetal pulmonary and CNS maturation. This acceleration of neuromaturation does not occur before 30 weeks' gestation and has a cost with respect to cognitive limitations manifested in childhood. The ability to measure fetal and preterm neuromaturation provides an assessment of neurodevelopmental progress that can be used to reassure parents or identify at risk infants who would benefit from limited comprehensive follow-up and early intervention services. In addition, measures of neuromaturation have the potential to provide insight into mechanisms of CNS injury and recovery, much-needed early feedback in intervention or treatment trials and a measure of early CNS function for research into the relationships between CNS structure and function. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:21,33. [source] Preterm birth or foetal growth impairment and psychiatric hospitalization in adolescence and early adulthood in a Swedish population-based birth cohortACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009W. Monfils Gustafsson Objective:, Preterm birth and restricted foetal growth are related to symptoms of psychiatric disorder. Our aim was therefore to investigate possible relations between being born preterm and/or small for gestational age (SGA) and later psychiatric hospitalization. Method:, A population-based registry study of psychiatric hospitalization of in total 155 994 boys and 148 281 girls born in Sweden in 1973,1975. Results:, The risk of hospitalization for all mental disorders was increased for preterm SGA boys (OR 2.19, 95% CI 1.49,3.21); at-term SGA boys (OR 1.55, 95% CI 1.34,1.79); at-term SGA girls (OR 1.31, 95% CI 1.15,1.50). At-term SGA boys and girls suffered increased risk of anxiety and adjustment disorders (OR 1.70, 95% CI 1.18,2.45 and OR 1.49, 95% CI 1.14,1.94). Preterm SGA boys were at risk of personality disorders (OR 3.30, 95% CI 1.16,9.41) and psychotic disorders (OR 4.36, 95% CI 1.85,10.30). Conclusion:, The results show a relationship between being born SGA and later psychiatric hospitalization, where preterm birth and male gender seem to increase the risk. [source] Do healthy preterm children need neuropsychological follow-up?DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2010Preschool outcomes compared with term peers 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 weeks' gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term-born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short-term memory, visual,motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education. Results, The mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; p<0.001). Factors associated with higher Griffiths score were maternal university education (,=6.2; 95% confidence interval [CI] 0.7,11.7) and having older siblings or a twin (,=4.0; 95% CI 0.5,7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual-processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (p<0.05) and comprehension, short-term memory, and spatial abilities (p<0.01). Interpretation, Neuropsychological follow-up is also recommended for healthy very preterm children to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success. [source] Eating problems at age 6 years in a whole population sample of extremely preterm childrenDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2010MUTHANNA SAMARA 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%]) aged 6 years who were born at 25 weeks' gestation or earlier (mean 24.5wks, SD 0.7wks; mean birthweight 749.1g, SD 116.8g), and parents of 148 classmates born at term (66 males [44.6%], 82 females [55.4%]). All children underwent neurological, cognitive, and anthropometric assessment, and parents and teachers completed a behaviour scale. Results, Eating problems were more common among the EPC than the comparison group (odds ratio [OR] 3.6, 95% confidence interval [CI] 2.1,6.3), including oral motor (OR 5.2, 95% CI 2.8,9.9), hypersensitivity (OR 3.0, 95% CI 1.6,5.6), and behavioural (OR 3.8, 95% CI 1.9,7.6) problems. Group differences were reduced after adjustment for cognitive impairment, neuromotor disability, and other behaviour problems. EPC with eating problems were shorter, lighter, and had lower mid-arm circumference and lower body mass index (BMI) even after adjusting for disabilities, gestational age, birthweight, and feeding problems at 30 months. Interpretation, Eating problems are still frequent in EPC at school age. They are only partly related to other disabilities but make an additional contribution to continued growth failure and may require early recognition and intervention. [source] Cognitive visual dysfunctions in preterm children with periventricular leukomalaciaDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2009ELISA FAZZI MD PHD 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; mean age at examination 8y, range 6,15y; mean gestational age 30wks, range 28,36wks) with periventricular leukomalacia, spastic diplegia, normal intelligence (mean Full-scale IQ 84; mean Verbal IQ 97; mean Performance IQ 74), and normal visual acuity, focusing on higher visual functions. Brain magnetic resonance images (MRI) were analysed to establish the presence of lesions along the primary optic pathway, in the occipitoparietal and occipitotemporal regions. Results, Most children displayed an uneven cognitive profile, with deficits in visual object recognition, visual imagery, visual,spatial skills, and visual memory, and sparing of visual associative abilities, non-verbal intelligence, and face and letter recognition. Conventional brain MRI did not document major alterations of parietal and temporal white matter, or cortical alteration of areas involved in visual associative functions. Interpretation, We suggest a widespread involvement of higher visual processing systems, involving both the ventral and dorsal streams, in preterm children with periventricular leukomalacia. The lack of major alterations on conventional MRI does not exclude the possibility of malfunctioning of higher visual processing systems, expressing itself through discrete CVDs. Possible mechanisms underlying these neuropsychological deficits are discussed. [source] Socio-economic achievements of individuals born very preterm at the age of 27 to 29 years: a nationwide cohort studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2009RENÉ MATHIASEN MD 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 (gestational age <33wks, n=1422; 51.8% males, n=736) with individuals born at term (>36wks, n=192 223; 51.1% males, n=98 240), of whom 4.08% (n=58) of the VPT and 0.19% (n=373) of the term individuals had a diagnosis of cerebral palsy (CP). Results, Overall results in the two groups were similar, but significant differences appeared. The VPT group had a lower educational level than the term group: 23.9% versus 16.3% had a basic education (corresponding to attendance at basic school for 9y or less; odds ratio [OR] =1.61, 95% confidence interval [CI] 1.42,1.82). Similarly, 31.9% versus 37.6% had a tertiary education (corresponding to different levels of professional education; OR=0.77, CI 0.69,0.86). Net income was 11% lower in the VPT group and 10.8% versus 5.3% were receiving welfare support (OR=2.14, CI 1.81,2.55). In the VPT group 59% versus 52% did not have children (p<0.001) and there were more individuals living alone without children (28.8% vs 21.8%; OR=1.45, CI 1.29,1.63). Interpretation, VPT birth in the 1970s in Denmark is associated with a highly statistically significant educational and social disadvantage persisting into young adulthood. CP increased the relative risk of social disadvantage in VPT individuals. However, the majority of the survivors are well integrated in society. [source] Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestationDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2007Louise Marston MSc 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 MacArthur-Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7- 23); (2) sex (39 males, 44 females; 95% CI 0.4-11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI -12 to -4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1,9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm. [source] Psychological functioning and health-related quality of life in adulthood after preterm birthDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2007Stuart R Dalziel FRACP PhD The aim of this study was to determine if preterm birth is associated with socioeconomic status (SES), psychological functioning, and health-related quality of life (HRQoL) in adulthood. We used prospective follow-up of 192 adult offspring of mothers who took part in a randomized controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (66 born at term [33 males, 33 females] 126 born preterm [66 males, 60 females]). Cognitive functioning was assessed using the Wechsler Abbreviated Scale of Intelligence. Working memory and attention was assessed using the Benton Visual Retention Test, the Paced Auditory Serial Addition Test, and the Brown Attention Deficit Disorder Scale. Psychiatric morbidity was assessed using the Beck Depression Inventory II, the State-Trait Anxiety Inventory, and the Schizotypy Traits Questionnaire. Handedness was assessed using the Edinburgh Handedness Inventory. HRQoL was assessed using the Short Form-36 Health Survey. Moderately preterm birth (median gestation 34wks, mean birthweight 1946g [SD 463g]) was not related to later marital status, educational attainment, SES, cognitive functioning, working memory, attention, or symptoms of anxiety or schizotypy at 31 years of age. Preterm birth was associated with fewer symptoms of depression and higher levels of satisfaction in three of the eight HRQoL domains measured (bodily pain, general health perception, and social functioning). Adults who were born moderately preterm have SES, psychological functioning, and HRQoL consistent with those who were born at term. This good long-term outcome cannot be extrapolated to those with early childhood disability or very low birthweights. [source] Motor incoordination in children born preterm: coordinated efforts neededDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2007Annette Majnemer No abstract is available for this article. [source] Absence of pestivirus antigen in brains with white matter damageDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2006Olaf Dammann We previously suggested that antenatal pestivirus infection might play a role in the pathogenesis of perinatal brain white matter damage (WMD) in preterm infants. We have now examined 22 brains from stillborns and deceased newborns (both preterm and term) for the presence of bovine virus diarrhoea virus (BVDV) antigen. The brains of five females and five males with WMD (median gestational age 36.5wks), and nine female and three male controls (median gestational age 36.5wks) were used in the study. No BVDV antigen was detected in any of the 22 brains. We conclude that brain infection with BVDV is unlikely to play a role in WMD pathogenesis among preterm or term newborns. Further research is needed to test the hypothesis that intrauterine exposure to pestivirus antigen elicits a fetal inflammatory response which then contributes to WMD. [source] Victimization: a newly recognized outcome of prematurityDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2004Line Nadeau PhD Victimization by peers affects 10 to 20% of school children under the age of 12 years. Physical, verbal, and psychological victimization (being pushed, hit, called names, teased, being the target of rumours, theft, extortion) is associated with short- and long-term adjustment problems, such as peer rejection, social withdrawal, low self-esteem, anxiety, loneliness, and depression, as well as academic problems and school drop-out. Research on populations of school children (primary and secondary) has associated victimization with personal risk factors (the victim's characteristics and behaviour) and interpersonal risk factors (social relationships between peers). Studies on the social adjustment of preterm children at school age show that, even in the absence of a major motor or cognitive disability, this population has several personal risk factors associated with victimization. The objective of this study was to compare the level of victimization experienced by a group of 96 seven-year-old children born extremely preterm (EP, <29 weeks of gestation; 49 females) against that experienced by a group of 63 term children (34 females) matched for age and sex, maternal level of education, and family socioeconomic status. The children born EP had a mean gestational age of 27.3 weeks (SD 1.2) and a mean birthweight of 1001.1g (SD 223) and normal birth weight children had a mean gestational age of 39.5 weeks (SD 1.5) and a mean birthweight of 3468.7g (SD 431). Physical and verbal victimization were assessed in a school setting by peers with individual sociometric interviews (Modified Peer Nomination Inventory). After controlling for physical growth (height and weight) at the age of 7 years, the data indicate two independent effects: males were more victimized than females, and children born preterm experienced more verbal victimization by their peers than their term classmates, even when participants with a visible motor, intellectual, or sensory disability were excluded. Several hypotheses are presented to account for the higher incidence of verbal victimization of preterm children. [source] Factors associated with microcephaly at school age in a very-low-birthweight populationDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2003Claudia A Chiriboga MD MPH The neonatal predictors of microcephaly, defined as a head circumference <5th centile in children born preterm, has not been systematically assessed. Children were drawn from the Developmental Epidemiology Network (DEN) cohort of very low-birth weight children (VLBW: 500,1500g) born from 1991 to 1993 at three sites in the USA. Neurological assessments were carried out among 198 singleton children (mean age 6 years 8 months, SD 0.5 years). Ninety-six children (48.5%) were male. Microcephaly was observed in 30 children (15%) and, using multivariate analysis, it was found to be associated with gestational age <26 weeks and bronchopulmonary dysplasia (BPD). Sonography-defined white-matter damage (WMD, i.e. echolucency or echodensities) was not associated with increased odds of microcephaly, while occurrence of intraventricular hemorrhage (IVH) was in univariate but not multivariate analysis. In analyses that excluded children with IVH/WMD, odds of microcephaly increased in dose-related fashion according to number of days on ventilator: >5 days, OR=4.5; 95%CI=1.4 to 15; >10 days, OR=5.7; 95%CI=1.7 to 19; >15 days OR=8.3; 95% CI=2.3 to 29.2. Among children without BPD, microcephaly was not associated with differences in IQ, while IQ scores among children with BPD or any ventilation were disproportionately lower among those with microcephaly. In multivariate analyses predicting IQ at age 7 years, microcephaly was found to modify the association between neonatal lung disease and IQ. [source] Ophthalmological, cognitive, electrophysiological and MRI assessment of visual processing in preterm children without major neuromotor impairmentDEVELOPMENTAL SCIENCE, Issue 5 2010Michelle O'Reilly 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 (< 33 weeks gestation or birthweight < 1000 g) without major neuromotor impairment and 12 born full-term controls were assessed at 8,12 years of age by means of ophthalmological assessment (visual acuity, colour vision, stereopsis, stereoacuity, visual fields, ocular motility, motor fusion), cognitive tests of visual-motor, visual-perceptual and visual-spatial skills and pattern-reversal visual evoked potentials (PR-VEPs). All participants also underwent magnetic resonance imaging (MRI) of the brain and neuromotor assessments. No significant differences were found between the groups on the ophthalmological, visual cognitive, neurological, neuromotor or MRI measures. The P100 component of the PR-VEP showed a significantly shorter latency in the preterm compared with the full-term participants. Whilst this P100 finding suggests that subtle abnormalities may exist at the neurophysiological level, we conclude that visual dysfunction is not systematically associated with preterm birth in the context of normal neurological status. [source] Type I collagen markers in cord serum of appropriate vs. small for gestational age infants born during the second half of pregnancyEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 5 2001T. Saarela Background The serum concentration of the N-terminal propeptide of type I procollagen (PINP) reflects the synthesis rate of type I collagen, whereas the corresponding C-terminal telopeptide (ICTP) mirrors its degradation. Design PINP and ICTP were measured in a total of 690 cord serum samples from 592 appropriate-for-gestational-age (AGA) infants and 98 smal-for-gestational-age (SGA) infants. These markers were compared between AGA and SGA infants of different gestational ages, ranging from 23 to 41 weeks, and birth weights, from 620 to 4555 g. Results Both PINP and ICTP levels were very high in the preterm AGA infants and declined significantly with advancing gestational age, paralleling the shape of the fetal growth velocity curve. Regardless of the quite large interindividual variations observed in these markers, PINP was significantly lower in both the preterm and term AGA infants than in the SGA infants. This was also the case for ICTP in the preterm infants of gestational age less than 36 weeks. In stepwise multiple regression analyses, gestational age, being either AGA or SGA and head circumference were significant factors to explain the levels of PINP and ICTP. The levels of PINP and ICTP were correlated with each other highly significantly in both the AGA and SGA infants (rs = 0·700 and 0·692, respectively; P < 0·001 in both). Conclusions The levels of type I collagen markers seem to follow closely the shape of the fetal growth velocity curve during different stages of gestation. However, because of the large interindividual variations observed, further studies are needed before the significance of these markers for the assessment of normal and abnormal fetal growth can be established. [source] Serum transferrin receptor, ferritin, and reticulocyte maturity indices during the first year of life in ,large' preterm infantsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2007Vassiliki Schiza Abstract Background:, Preterm infants are at risk of developing iron deficiency; among the iron status and hemopoiesis indices the serum transferrin receptor (sTfr) has been shown to be a useful indicator in assessing iron status, while immature reticulocyte production is regarded as an estimator of erythropoiesis. Objective:, To investigate age-related changes in iron status infants born ,moderately' preterm, with a gestational age (GA) of 32,36 wk, and identify associations between sTfr and other hematological and biochemical iron indices. Design:, Hospital-based prospective, longitudinal study in preterm infants. Methods:, Iron and erythropoiesis parameters were evaluated in 181 formula-fed preterm infants at 2 and 6 wk and 3, 6, 9, and 12 months chronological age. Hemoglobulin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), reticulocytes, serum iron (sFe), serum ferritin (sFer), sTfr, and reticulocyte subpopulations were measured. Results:, A total of 756 measurements were performed. After an initial decline, Hb rose from month 3 to 12 of life. SFe and sFer and immature reticulocyte count decreased from the second week to the third month and remained stable thereafter. STfr was lower up to 6 wk and stable from month 3 to 12. Iron deficiency anemia (IDA) was found in 5.5% of infants. In 76 measurements sFer was <12 ,g/L, implying storage iron deficiency (SID). A negative correlation was observed between sTfr and other indices of iron status such as Hb, Hct, MCV, sFe, and sFer. Infants with sFer <12 ,g/L had lower sTfr than those with sFer >12 ,g/L. Reticulocyte production was positively associated with STfr, but this association was dependent on the chronological age of the infant. Conclusion:, Iron depletion is common in formula-fed preterm (32,36 wk GA) infants between month 3 and 12 of life. STfr appears to be an indicator of iron status in preterm infants during the first year of life. [source] Regulation of Human Myometrial Contractility During Pregnancy and Labour: Are Calcium Homeostatic Pathways Important?EXPERIMENTAL PHYSIOLOGY, Issue 2 2001Rachel M. Tribe If we are to develop new strategies for the treatment and management of preterm and dysfunctional term labour, it is imperative that we improve current understanding of the control of human uterine activity. Despite many studies of animal pregnancy, there is a paucity of knowledge relating to the complex control of human myometrium during pregnancy. It is hypothesized that human myometrium is relatively quiescent during the majority of pregnancy and that as term approaches there is cascade of molecular events that prepare the uterus for labour. This review will consider the cellular mechanisms involved in the regulation of human myometrial activity and the modulation of these by hormonal and mechanical signals. In particular, the contribution of calcium homeostatic pathways to the control of human myometrial contractility during gestation will be discussed. [source] Contingency Learning and Reactivity in Preterm and Full-Term Infants at 3 MonthsINFANCY, Issue 6 2008David W. Haley Learning difficulties in preterm infants are thought to reflect impairment in arousal regulation. We examined relationships among gestational age, learning speed, and behavioral and physiological reactivity in 55 preterm and 49 full-term infants during baseline, contingency, and nonreinforcement phases of a conjugate mobile paradigm at 3 months corrected age. For all infants, negative affect, looking duration, and heart rate levels increased during contingency and nonreinforcement phases, whereas respiratory sinus arrhythmia (RSA, an index of parasympathetic activity) decreased and Cortisol did not change. Learners showed greater RSA suppression and less negative affect than nonleamers. This pattern was particularly evident in the preterm group. Overall, preterm infants showed less learning, spent less time looking at the mobile, and had lower Cortisol levels than full-term infants. Preterm infants also showed greater heart rate responses to contingency and dampened heart rate responses to nonreinforcement compared to full-term infants. Findings underscore differences in basal and reactivity measures in preterm compared to full-term infants and suggest that the capacity to regulate parasympathetic activity during a challenge enhances learning in preterm infants. [source] Predicting Individual Differences in Recall by Infants Born Preterm and Full TermINFANCY, Issue 1 2006Carol L. Cheatham A heterogeneous sample of infants with preterm histories and infants born full term participated in a study of declarative memory and rate of encoding, as measured in an imitation task and an examining task, respectively. Here we report the comparisons of the performances of infants born very preterm (27,34 weeks gestation) and moderately preterm (35,37 weeks gestation) to infants born full term (38,41 weeks gestation) and tested at 12 months corrected age (from due date). Lower levels of recall were seen among the infants born very preterm. Rate of encoding, weeks gestation, and score on the Mental Development Index (MDI) of the Bayley Scales of Infant Development were tested as possible sources of individual differences in recall. Rate of encoding and MDI predicted delayed ordered recall. Implications for early detection of cognitive difficulties in children with preterm histories are discussed. [source] Development of Tactile Responses in Human Preterm and Full-Term Infants From 30 to 40 Weeks Postconceptional AgeINFANCY, Issue 1 2002Isabel Fearon Maturation of tactile sensitivity prior to term was examined in 36 preterm and 13 full-term infants using a fixed-trial, habituation procedure. Each infant was presented with a series of 8 habituation (arm stroke), 2 novel (arm lift), and 2 recovery (arm stroke) stimulus trials while heart rate and body movements were recorded. Maturation was observed with a gradual increase in the magnitude of the stimulus-elicited cardiac acceleration and cardiac-movement coupling from 30 to 40 weeks postconceptional age. The majority of infants displayed habituation,an excitatory response (heart rate acceleration and body movement),to the initial presentation of a tactile stimulus, response decline with repeated stimulations, and renewed response to a novel stimulus. A substantial number of infants (40%) failed to respond initially to the tactile stimulus, increased responding over several stimulus presentations, and failed to discriminate the presentation of a novel stimulus. We speculate that these differences in response patterns observed over all ages represent individual difference in the perception of stimulus intensity. [source] Olfactory Familiarization and Discrimination in Preterm and Full-Term NewbornsINFANCY, Issue 1 2002Nathalie Goubet The purpose of this study was to observe olfactory detection and discrimination in preterm and full-term newborns. Infants were familiarized for 10 trials with either vanillin or anethole. On each trial, a cotton swab perfumed with one of the odors was slowly moved in front of the baby's nose for 10 sec. For half of the preterm and full-term infants, a new odor was presented after the last familiarization trial (experimental groups). For the other half, the same odor as during familiarization was presented (control groups). Facial and head movements for both populations and heart rates for preterm infants were recorded before, during, and after odor presentation. Preterm infants reacted to the scents by increasing facial actions and heart rate but not head movements. Full-term infants increased facial and head movements. Neither population showed a clear behavioral habituation pattern, but full-term newborns had a significantly reduced facial reactivity on the last familiarization trial compared to preterm infants. Preterm newborns did, however, show cardiac habituation on the last familiarization trial. Preterm and full-term infants presented with a new odor after familiarization increased responding compared to infants presented with the same odor, indicating their ability to discriminate between 2 odors. Infants' reactivity and discrimination to odors indicate preterm and full-term newborns' ability to be attuned to their olfactory environment. [source] The influence of prematurity, maternal anxiety, and infants' neurobiological risk on mother,infant interactionsINFANT MENTAL HEALTH JOURNAL, Issue 5 2005Gesine Schmücker In this study, we investigated how the birth of a very low birth weight preterm (VLBW) infant influences the mother,infant interaction at 3 months. We also focused on the impact of the infant's neurobiological risk and maternal anxiety, and their interaction. The comparison of the VLBW preterm sample (n = 79) with an external full-term sample (n = 35) showed mother,infant interactions of the families with the preterm infant to be more vocally responsive during the interaction, but less facially responsive during the interaction. Additionally, higher levels of maternal anxiety were associated with preterm infants being less facially responsive in interaction with their mother. While neurobiological risk of the infant played a part in this association, with higher risk infants also being less facially responsive, the relationship with maternal anxiety and the mother,child interaction was stronger. How these findings may influence therapeutic interventions is discussed. [source] Nursing and midwifery management of hypoglycaemia in healthy term neonatesINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 7 2005Vivien Hewitt BSc(Hons) GradDipLib Executive summary Objectives The primary objective of this review was to determine the best available evidence for maintenance of euglycaemia, in healthy term neonates, and the management of asymptomatic hypoglycaemia in otherwise healthy term neonates. Inclusion criteria Types of studies The review included any relevant published or unpublished studies undertaken between 1995 and 2004. Studies that focus on the diagnostic accuracy of point-of-care devices for blood glucose screening and/or monitoring in the neonate were initially included as a subgroup of this review. However, the technical nature and complexity of the statistical information published in diagnostic studies retrieved during the literature search stage, as well as the considerable volume of published research in this area, suggested that it would be more feasible to analyse diagnostic studies in a separate systematic review. Types of participants The review focused on studies that included healthy term (37- to 42-week gestation) appropriate size for gestational age neonates in the first 72 h after birth. Exclusions ,,preterm or small for gestational age newborns; ,,term neonates with a diagnosed medical or surgical condition, congenital or otherwise; ,,babies of diabetic mothers; ,,neonates with symptomatic hypoglycaemia; ,,large for gestational age neonates (as significant proportion are of diabetic mothers). Types of intervention All interventions that fell within the scope of practice of a midwife/nurse were included: ,,type (breast or breast milk substitutes), amount and/or timing of feeds, for example, initiation of feeding, and frequency; ,,regulation of body temperature; ,,monitoring (including screening) of neonates, including blood or plasma glucose levels and signs and symptoms of hypoglycaemia. Interventions that required initiation by a medical practitioner were excluded from the review. Types of outcome measures Outcomes that were of interest included: ,,occurrence of hypoglycaemia; ,,re-establishment and maintenance of blood or plasma glucose levels at or above set threshold (as defined by the particular study); ,,successful breast-feeding; ,,developmental outcomes. Types of research designs The review initially focused on randomised controlled trials reported from 1995 to 2004. Insufficient randomised controlled trials were identified and the review was expanded to include additional cohort and cross-sectional studies for possible inclusion in a narrative summary. Search strategy The major electronic databases, including MEDLINE/PubMed, CINAHL, EMBASE, LILACS, Cochrane Library, etc., were searched using accepted search techniques to identify relevant published and unpublished studies undertaken between 1995 and 2004. Efforts were made to locate any relevant unpublished materials, such as conference papers, research reports and dissertations. Printed journals were hand-searched and reference lists checked for potentially useful research. The year 1995 was selected as the starting point in order to identify any research that had not been included in the World Health Organisation review, which covered literature published up to 1996. The search was not limited to English language studies. Assessment of quality Three primary reviewers conducted the review assisted by a review panel. The review panel was comprised of nine nurses with expertise in neonatal care drawn from senior staff in several metropolitan neonatal units and education programs. Authorship of journal articles was not concealed from the reviewers. Methodological quality of each study that met the inclusion criteria was assessed by two reviewers, using a quality assessment checklist developed for the review. Disagreements between reviewers were resolved through discussion or with the assistance of a third reviewer. Data extraction and analysis Two reviewers used a data extraction form to independently extract data relating to the study design, setting and participants; study focus and intervention(s); and measurements and outcomes. As only one relevant randomised controlled trial was found, a meta-analysis could not be conducted nor tables constructed to illustrate comparisons between studies. Instead, the findings were summarised by a narrative identifying any relevant findings that emerged from the data. Results Seven studies met the inclusion criteria for the objective of this systematic review. The review provided information on the effectiveness of three categories of intervention , type of feeds, timing of feeds and thermoregulation on two of the outcome measures identified in the review protocol , prevention of hypoglycaemia, and re-establishment and maintenance of blood or plasma glucose levels above the set threshold (as determined by the particular study). There was no evidence available on which to base conclusions for effectiveness of monitoring or developmental outcomes, and insufficient evidence for breast-feeding success. Given that only a narrative review was possible, the findings of this review should be interpreted with caution. The findings suggest that the incidence of hypoglycaemia in healthy, breast-fed term infants of appropriate size for gestational age is uncommon and routine screening of these infants is not indicated. The method and timing of early feeding has little or no influence on the neonatal blood glucose measurement at 1 h in normal term babies. In healthy, breast-fed term infants the initiation and timing of feeds in the first 6 h of life has no significant influence on plasma glucose levels. The colostrum of primiparous mothers provides sufficient nutrition for the infant in the first 24 h after birth, and supplemental feeds or extra water is unnecessary. Skin-to-skin contact appears to provide an optimal environment for fetal to neonatal adaptation after birth and can help to maintain body temperature and adequate blood glucose levels in healthy term newborn infants, as well as providing an ideal opportunity to establish early bonding behaviours. Implications for practice The seven studies analysed in this review confirm the World Health Organisation's first three recommendations for prevention and management of asymptomatic hypoglycaemia, namely: 1Early and exclusive breast-feeding is safe to meet the nutritional needs of healthy term newborns worldwide. 2Healthy term newborns that are breast-fed on demand need not have their blood glucose routinely checked and need no supplementary foods or fluids. 3Healthy term newborns do not develop ,symptomatic' hypoglycaemia as a result of simple underfeeding. If an infant develops signs suggesting hypoglycaemia, look for an underlying condition. Detection and treatment of the cause are as important as correction of the blood glucose level. If there are any concerns that the newborn infant might be hypoglycaemic it should be given another feed. Given the importance of thermoregulation, skin-to-skin contact should be promoted and ,kangaroo care' encouraged in the first 24 h after birth. While it is important to main the infant's body temperature care should be taken to ensure that the child does not become overheated. [source] Parental perspectives on preterm children's oral health behaviour and experience of dental care during preschool and early school yearsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2009SUSANNE BROGÅRDH-ROTH Background., Children born preterm (PT) have medical conditions and impairments that may affect their oral health. Hypothesis., Our hypothesis for the study was that PT children display more dental behaviour management problems (BMPs) and less favourable oral health behaviour than controls (C). Methods., Parents of 153 PT children and 153 C children were interviewed regarding the children's oral health behaviour and experience of dental care on two occasions, 2 years apart. The interviews concerned the preschool period and the early school years, respectively. Results., BMPs were more common in PT children of preschool age, but not during the early school years. Regarding oral health behaviour, there were no differences between the groups, except that PT children had more problems with toothbrushing than C children in the preschool period, in spite of the fact that the PT group reported more medical health problems and more anxious behaviour and indications of cognitive problems than the C group. Conclusions., Children born PT exhibit several risk factors for both BMP and impaired oral health. It is essential that this group of patients is identified early and receives special attention from the dental services. [source] | ||||||||||||||||||||||||||||||||||||||||