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Adverse Neurodevelopmental Outcome (adverse + neurodevelopmental_outcome)

Distribution by Scientific Domains

Medical Sciences	81%
Humanities and Social Sciences	18%

Selected Abstracts

Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages

ACTA PAEDIATRICA, Issue 5 2009
U Kiechl-Kohlendorfer
Abstract Aim: Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in preterm infants with a gestational age <30 weeks (Group I) and 30,32 weeks (Group II). Methods: Between January 2003 and December 2006, we prospectively enrolled 310 live-born infants between 23 and 32 weeks of gestation. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of infant development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis. Results: Two hundred and fifty infants were eligible for follow-up, and 205 (82.0%) completed the follow-up visit. Intracerebral haemorrhage, small for gestational age and late-onset sepsis were associated with an increased risk for delayed development in Group I (p < 0.05, each). Premature rupture of membranes was a risk condition relevant to Group II. Antenatal steroids were associated with a decreased risk of neurodevelopmental delay in both groups. Conclusion: This study identified distinct risk factors for adverse outcome in preterm infants of lower (<30 weeks) and higher (30,32 weeks) gestational age. In the lower gestational age group, neonatal risk predictors are most important. Antenatal steroids appear to decrease the risk for adverse outcome in both age groups. [source]

One-year infant outcome in women with early-onset hypertensive disorders of pregnancy

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2008
A Rep
Objectives, To evaluate the role of plasma volume expansion on 1-year infant outcome after severe hypertensive disorders of pregnancy and to determine prognostic factors for adverse neurodevelopmental infant outcome. Design, Randomised controlled trial, observational prognostic study. Setting, Two university hospitals in Amsterdam, The Netherlands. Population, One hundred and seventy-two infants alive of 216 mothers with severe hypertensive disorders of pregnancy who were randomised for a temporising management strategy with or without plasma volume expansion. Methods, At 1 year of corrected age, a neurological examination according to Bayley (mental development index [MDI] and psychomotor development index [PDI]) and Touwen was performed. Main outcome measures, Adverse neurodevelopmental infant outcome was defined as a MDI/PDI score below 70 and/or an abnormal Touwen. Risk factors for adverse neurodevelopmental outcome were explored by univariate and multivariate analyses. Results, Adverse neurodevelopmental infant outcome was observed in 31 infants (18%). There were no differences between the randomisation groups. In multivariate analysis, an association with abnormal umbilical artery/middle cerebral artery Doppler ratio higher than the median, major neonatal morbidity, higher education of the parents, multiparity and Caucasian ethnicity was observed. Conclusion, Nearly 70% of the infants were alive at 1 year without adverse neurodevelopmental outcome. Maternal plasma volume expansion during pregnancy has no effect on 1-year infant outcome. The prediction of adverse outcome at 1 year by perinatal parameters is limited. [source]

Smoking in pregnancy: a risk factor for adverse neurodevelopmental outcome in preterm infants?

ACTA PAEDIATRICA, Issue 7 2010
U Kiechl-Kohlendorfer
Abstract Aim:, To assess whether smoking in pregnancy influences neurodevelopmental outcome at 2-years of age in preterm infants with a gestational age <32 weeks. Methods:, Between January 2003 and December 2005 we prospectively enrolled 181 infants born alive between 23 and 32 weeks of gestation; 142 infants (78.5%) completed the follow-up visit. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis. Results:, Low maternal age, smoking in pregnancy, low gestational age, low birth weight, small for gestational age, chronic lung disease, intracerebral haemorrhage, periventricular leucomalacia, and retinopathy of prematurity (stages 3 and 4) all were associated with an increased risk for delayed development (p < 0.05, each). Smoking in pregnancy, small for gestational age and chronic lung disease maintained significance in a multivariable analysis. Conclusion:, Smoking in pregnancy emerged as a risk predictor for adverse neurodevelopmental outcome in our study. Strategies to reduce smoking in pregnancy should be further endorsed. [source]

Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages

Total serum bilirubin levels during cyclooxygenase inhibitor treatment for patent ductus arteriosus in preterm infants

ACTA PAEDIATRICA, Issue 1 2009
C Rheinlaender
Abstract Aim: To determine whether ibuprofen use in VLBW infants is associated with increased serum bilirubin levels and impaired neurodevelopmental outcome at 2 years of age compared to indomethacin. Methods: We retrospectively evaluated bilirubin data and outcome parameters of 178 VLBW infants treated with COX inhibitors for a haemodynamically relevant patent ductus arteriosus (PDA) between 1998 and 2003 in a single institution. In our department ibuprofen replaced indomethacin for PDA treatment in 2001, while clinical and echocardiagraphic criteria for the indication of PDA invention have remained unchanged. Results: Ibuprofen and indomethacin therapy groups did not differ in their baseline clinical profile. Peak serum bilirubin concentration was 10.2 mg/dL in the ibuprofen group and 8.6 mg/dL in the indomethacin group (p < 0.01), while phototherapy duration did not differ. At 2 years of age neurodevelopmental outcome was similar in both groups. In a single case analysis, four cases of adverse neurodevelopmental outcome despite inconspicuous clinical course were identified in the ibuprofen group. Conclusion: In VLBW infants with PDA, ibuprofen treatment was associated with higher bilirubin levels than indomethacin. [source]

Survival and neurodevelopmental morbidity at 1 year of age following extremely preterm delivery over a 20-year period: a single centre cohort study

ACTA PAEDIATRICA, Issue 2 2008
K Riley
Abstract Aim: To assess survival and neurodevelopmental outcome of extremely preterm infants over a 20-year period at a single tertiary neonatal centre. Methods: All infants between 22 and 25+6 weeks of gestation admitted to a single UK neonatal centre between 1981 and 2000 were enrolled prospectively. Infants in the same gestational age range who were born alive at the hospital but not admitted to the neonatal unit were also identified over the period 1991,2000. All surviving infants received neurological and developmental assessment at a corrected age of 1 year. Results: There was a progressive increase in survival at all gestational ages over the 20-year period. Overall survival rose from 32% to 71% as a proportion of all admissions. The proportion of survivors with adverse neurodevelopmental outcome at 1 year of age showed no consistent change over the same period. Conclusion: In this single centre cohort study, marked improvements in survival over a 20-year period were not accompanied by a significant increase in neurodevelopmental morbidity. [source]

Pharmacogenetics of the neurodevelopmental impact of anticancer chemotherapy

DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 3 2008
Philippe Robaey
Abstract Pharmacogenetics holds the promise of minimizing adverse neurodevelopmental outcomes of cancer patients by identifying patients at risk, enabling the individualization of treatment and the planning of close follow-up and early remediation. This review focuses first on methotrexate, a drug often implicated in neurotoxicity, especially when used in combination with brain irradiation. The second focus is on glucocorticoids that have been found to be linked to adverse developmental effects in relation with the psychosocial environment. For both examples, we review how polymorphisms of genes encoding enzymes involved in specific mechanisms of action could moderate adverse neurodevelopmental consequences, eventually through common final pathways such as oxidative stress. We discuss a multiple hit model and possible strategies required to rise to the challenge of this integrative research. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:211,220. [source]

Epigenetic influence of social experiences across the lifespan

DEVELOPMENTAL PSYCHOBIOLOGY, Issue 4 2010
Frances A. Champagne
Abstract The critical role of social interactions in driving phenotypic variation has long been inferred from the association between early social deprivation and adverse neurodevelopmental outcomes. Recent evidence has implicated molecular pathways involved in the regulation of gene expression as one possible route through which these long-term outcomes are achieved. These epigenetic effects, though not exclusive to social experiences, may be a mechanism through which the quality of the social environment becomes embedded at a biological level. Moreover, there is increasing evidence for the transgenerational impact of these early experiences mediated through changes in social and reproductive behavior exhibited in adulthood. In this review, recent studies which highlight the epigenetic effects of parent,offspring, peer and adult social interactions both with and across generations will be discussed and the implications of this research for understanding the developmental origins of individual differences in brain and behavior will be explored. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 299,311, 2010. [source]

Influence of clinical status on the association between plasma total and unbound bilirubin and death or adverse neurodevelopmental outcomes in extremely low birth weight infants

ACTA PAEDIATRICA, Issue 5 2010
W Oh
Abstract Objectives:, To assess the influence of clinical status on the association between total plasma bilirubin and unbound bilirubin on death or adverse neurodevelopmental outcomes at 18,22 months corrected age in extremely low birth weight infants. Method:, Total plasma bilirubin and unbound bilirubin were measured in 1101 extremely low birth weight infants at 5 ± 1 days of age. Clinical criteria were used to classify infants as clinically stable or unstable. Survivors were examined at 18,22 months corrected age by certified examiners. Outcome variables were death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death prior to follow-up. For all outcomes, the interaction between bilirubin variables and clinical status was assessed in logistic regression analyses adjusted for multiple risk factors. Results:, Regardless of clinical status, an increasing level of unbound bilirubin was associated with higher rates of death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss and death before follow-up. Total plasma bilirubin values were directly associated with death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death before follow-up in unstable infants, but not in stable infants. An inverse association between total plasma bilirubin and death or cerebral palsy was found in stable infants. Conclusions:, In extremely low birth weight infants, clinical status at 5 days of age affects the association between total plasma bilirubin and death or adverse neurodevelopmental outcomes at 18,22 months of corrected age. An increasing level of UB is associated a higher risk of death or adverse neurodevelopmental outcomes regardless of clinical status. Increasing levels of total plasma bilirubin are directly associated with increasing risk of death or adverse neurodevelopmental outcomes in unstable, but not in stable infants. [source]